Systematic comparison of risky choices in humans and monkeys

The past decades have seen tremendous progress in fundamental studies on economic choice in humans. However, elucidation of the underlying neuronal processes requires invasive neurophysiological studies that are met with difficulties in humans. Monkeys as evolutionary closest relatives offer a solution. The animals display sophisticated and well-controllable behavior that allows to implement key constructs of proven economic choice theories. However, the similarity of economic choice between the two species has never been systematically investigated. We investigated compliance with the independence axiom (IA) of expected utility theory as one of the most demanding choice tests and compared IA violations between humans and monkeys. Using generalized linear modeling and cumulative prospect theory (CPT), we found that humans and monkeys made comparable risky choices, although their subjective values (utilities) differed. These results suggest similar fundamental choice mechanism across these primate species and encourage to study their underlying neurophysiological mechanisms.

Reward Maximization Assessed Using a Sequential Patch Depletion Task in a Large Sample of Heterogeneous Stock Rats

Choice behavior requires animals to evaluate both short- and long-term advantages and disadvantages of all potential alternatives. Impulsive choice is traditionally measured in laboratory tasks by utilizing delay discounting (DD), a paradigm that offers a choice between a smaller immediate reward, or a larger more delayed reward. This study tested a large sample of Heterogeneous Stock (HS) male (n = 896) and female (n = 898) rats, part of a larger genetic study, to investigate whether measures of reward maximization overlapped with traditional models of delay discounting via the patch depletion model using a Sequential Patch Depletion procedure. In this task, rats were offered a concurrent choice between two water "patches" and could elect to "stay" in the current patch or "leave" for an alternative patch. Staying in the current patch resulted in decreasing subsequent reward magnitudes, whereas the choice to leave a patch was followed by a delay and a resetting to the maximum reward magnitude. Based on the delay in a given session, different visit durations were necessary to obtain the maximum number of rewards. Visit duration may be analogous to an indifference point in traditional DD tasks. While differences in traditional DD measures (e.g., delay gradient) have been detected between males and females, these effects were small and inconsistent. However, when examining measures of reward maximization, females made fewer patch changes at all delays and spent more time in the patch before leaving for the alternative patch compared to males. This pattern of choice resulted in males having a higher rate of reinforcement than females. Consistent with this, there was some evidence that females deviated from the optimal more, leading to less reward. Measures of reward maximization were only weakly associated with traditional DD measures and may represent distinctive underlying processes. Taken together, females performance differed from males with regard to reward maximization that were not observed utilizing traditional measures of DD, suggesting that the patch depletion model was more sensitive to modest sex differences when compared to traditional DD measures in a large sample of HS rats.

Large-scale brain correlates of sweet versus cocaine reward in rats

Cocaine induces many supranormal changes in neuronal activity in the brain, notably in learning- and reward-related regions, in comparison with nondrug rewards-a difference that is thought to contribute to its relatively high addictive potential. However, when facing a choice between cocaine and a nondrug reward (e.g., water sweetened with saccharin), most rats do not choose cocaine, as one would expect from the extent and magnitude of its global activation of the brain, but instead choose the nondrug option. We recently showed that cocaine, though larger in magnitude, is also an inherently more delayed reward than sweet water, thereby explaining why it has less value during choice and why rats opt for the more immediate nondrug option. Here, we used a large-scale Fos brain mapping approach to measure brain responses to each option in saccharin-preferring rats, with the hope to identify brain regions whose activity may explain the preference for the nondrug option. In total, Fos expression was measured in 142 brain levels corresponding to 52 brain subregions and composing 5 brain macrosystems. Overall, our findings confirm in rats with a preference for saccharin that cocaine induces more global brain activation than the preferred nondrug option does. Only very few brain regions were uniquely activated by saccharin. They included regions involved in taste processing (i.e., anterior gustatory cortex) and also regions involved in processing reward delay and intertemporal choice (i.e., some components of the septohippocampal system and its connections with the lateral habenula).

Prioritizing choice and assent in the assessment and treatment of food selectivity

Food selectivity affects up to 72% and 45% of individuals with and without disabilities, respectively, and there is a need for interventions that rely on positive, unrestrictive strategies. We evaluated an assessment and treatment package for food selectivity for young children with developmental disabilities that prioritized caregiver collaboration, client autonomy, and did not rely on restrictive procedures (e.g. escape extinction). The process involved: (a) collaborating with caregivers on the selection of foods and design of the children's functional analyses; (b) indirectly and directly measuring food preferences prior to treatment; (c) evaluating the sensitivity of mealtime problem behavior to environmental variables through an interview-informed synthesized contingency analysis (IISCA); and (c) incorporating the assessment results into a progressive treatment process consisting of choice-making opportunities and differential reinforcement of successive approximations to consumption. Children also had the ability to opt in and out of treatment sessions. The treatment was effective in increasing consumption of nonpreferred foods and successfully extended to caregivers. Practical implications and directions for future research are discussed.

Choice Set Size Shapes Self-Expression

Across six studies (total N = 3,549), we find that participants who were randomly assigned to choose from larger assortments thought their choices were more self-expressive, an effect that emerged regardless of whether larger sets actually enabled participants to better satisfy their preferences. Studies examining the moderating role of choice domain and cultural context show that the effect of choice set size on perceived self-expression may be particular to contexts in which choices have some initial potential to express choosers' identities. We then test novel predictions from this theoretical perspective, finding that self-expression mediates the effect of choice set size on choice satisfaction, the likelihood of publicly sharing choices, and the perceived importance of choices. Together, these studies show that choice set size shapes perceived self-expression and illustrate how this meaning-based theoretical lens provides both novel explanations for existing effects and novel predictions for future research.

An evaluation of methods for studying the effects of conditioned reinforcement on human choice

Shahan et al. (2006) found that the relative rate of pigeons' pecking on two observing responses (i.e., responses that only produced an S+ or stimulus correlated with primary reinforcement) was well described by the relative rate of S+ delivery. Researchers have not evaluated the effects of S+ delivery rate in a concurrent observing response procedure with human subjects, so the necessary procedural modifications for studying the effects of conditioned reinforcement on human choice remain unclear. The purpose of the current study was to conduct an additive component analysis of modifications to the procedures of Shahan et al. (2006). We evaluated the additive effects of introducing response cost, a changeover response, and ordinal discriminative stimuli on correspondence with the results of Shahan et al. and the quality of fits of the generalized matching equation. When our procedures were most similar to those of Shahan et al., we observed low rates of observing and indifference between the two observing responses. For the group of subjects with whom all three additive components were included, we obtained the highest level of sensitivity to relative rate of S+ delivery, but the slope and R² of our fits of the generalized matching equation were still much lower than those obtained by Shahan et al. Potential reasons for these discrepancies, methods of resolving them, and implications for future research are discussed.

A practitioner's guide to emphasizing choice-making opportunities in behavioral services provided to individuals with intellectual and developmental disabilities

Promoting choice is a defining value guiding Positive Behavior Support (PBS) models for serving individuals with intellectual and/or developmental disabilities (IDD). The ability to make independent choices is of paramount importance to self-advocacy and self-determination. Promoting choice is also an essential commitment of trauma-informed care (TIC) in the provision of services to vulnerable individuals, as trauma often involves experiences in which an individual has no control over aversive events that occur, and choice-making opportunities can empower traumatized individuals to regain control over the environments they routinely encounter. However, incorporating meaningful choice making into behavioral programming is often more difficult than it seems. We synthesize the relevant, contemporary literature to provide professionals with actionable suggestions for incorporating choice making into everyday behavioral services. After summarizing the importance of promoting choice into behavioral services based on the values that define both PBS and TIC frameworks, we (a) offer a behavior-analytic interpretation of the skill of making choices, (b) synthesize key literature on how to teach choice making skills, (c) provide recommendations for the situations within one's care in which choice-making opportunities may be most beneficial, and (d) discuss some of the barriers and potential solutions to incorporating choice-making opportunities for individuals with IDD.

Assent in applied behaviour analysis and positive behaviour support: ethical considerations and practical recommendations

The term positive behaviour support (PBS) is used to describe the integration of the contemporary ideology of disability service provision with the clinical framework of applied behaviour analysis (ABA). Assent, the participation consent of those not legally able to consent, has gained recent popularity in the fields of ABA and PBS. The goal of assent-based ABA and PBS is a person-centered approach to assessment, intervention, and all other decision-making. In this model, the learner's assent withdrawal for participation is honored, whether it be a vocal 'no' or a non-vocal expression of verbal behaviour. There is currently a limited subset of studies that mention or utilize assent with learners in ABA or PBS. The lack of published research can make assent-based practices seem to be a choice of the practitioner. The authors of this manuscript seek to further define assent, illuminate the necessity of assent-based practices, and offer assent-based procedures in ABA- and PBS-based intervention.

Choice between food and cocaine reinforcers under fixed and variable schedules in female and male rhesus monkeys

Illicit drugs like cocaine may be uncertain in terms of the time and effort required to obtain them. Behavior maintained by variable schedules resembles excessive drug-taking compared with fixed schedules. However, no prior research has examined fixed versus variable schedules in drug versus nondrug choice. The present study evaluated cocaine versus food choice under fixed- (FR) and variable-ratio (VR) schedules. The simpler food versus food and cocaine versus cocaine arrangements also were included. Adult female (n = 6) and male (n = 7) rhesus monkeys chose between cocaine (0.01-0.18 mg/kg/injection) and food (4 pellets/delivery), food and food (4 pellets/delivery), or cocaine and cocaine (0.018-0.03 mg/kg/injection) under FR and VR 100 and 200 schedules. In cocaine versus food choice, cocaine's potency to maintain choice was greatest when available under a VR 100 or 200 schedule and food under an FR schedule and was lowest when cocaine was available under an FR 200 schedule and food was available under a VR 200 schedule. In food versus food choice, males chose food associated with a VR schedule more than food associated with an FR schedule. In cocaine versus cocaine choice, females and males chose cocaine associated with a VR schedule more than cocaine associated with an FR schedule, particularly under VR 200. These findings suggest that uncertainty in terms of time and effort required to obtain cocaine, or perhaps the occasional low-cost access that results from VR schedules, results in greater allocation of behavior toward drug reinforcers at the expense of more certain, nondrug alternatives. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Worth the work? Monkeys discount rewards by a subjective adapting effort cost

All life must solve how to allocate limited energy resources to maximise benefits from scarce opportunities. Economic theory posits decision makers optimise choice by maximising the subjective benefit (utility) of reward minus the subjective cost (disutility) of the required effort. While successful in many settings, this model does not fully account for how experience can alter reward-effort trade-offs. Here we test how well the subtractive model of effort disutility explains the behavior of two non-human primates ( Macaca mulatta ) in a binary choice task in which reward quantity and physical effort to obtain were varied.Applying random utility modelling to independently estimate reward utility and effort disutility, we show the subtractive effort model better explains out-of-sample choice behavior when compared to parabolic and exponential effort discounting. Furthermore, we demonstrate that effort disutility is dependent on previous experience of effort: in analogy to work from behavioral labour economics, we develop a model of reference-dependent effort disutility to explain the increased willingness to expend effort following previous experience of effortful options in a session. The result of this analysis suggests that monkeys discount reward by an effort cost that is measured relative to an expected effort learned from previous trials. When this subjective cost of effort, a function of context and experience, is accounted for, trial-by-trial choice behavior can be explained by the subtractive cost model of effort.Therefore, in searching for net utility signals that may underpin effort-based decision-making in the brain, careful measurement of subjective effort costs is an essential first step.

Significance

All decision-makers need to consider how much effort they need to expend when evaluating potential options. Economic theories suggest that the optimal way to choose is by cost-benefit analysis of reward against effort. To be able to do this efficiently over many decision contexts, this needs to be done flexibly, with appropriate adaptation to context and experience. Therefore, in aiming to understand how this might be achieved in the brain, it is important to first carefully measure the subjective cost of effort. Here we show monkeys make reward-effort cost-benefit decisions, subtracting the subjective cost of effort from the subjective value of rewards. Moreover, the subjective cost of effort is dependent on the monkeys’ experience of effort in previous trials.

Authoritative parenting style positively correlates with increased adherence to COVID-19 health and safety guidelines by college students

During the COVID-19 pandemic, there has been inconsistency in choice behavior across people with regards to compliance with health and safety guidelines suggested by the CDC. The current study aimed to identify a possible correlation between parenting style experienced during childhood and opinions/actions regarding CDC COVID-19 health guidance. College students were given a self-report survey aimed to measure childhood experience, parent-child relationship, and COVID-19 pandemic behavior. Participants that identified with Authoritarian parenting scored higher on the COVID Behavior measure, indicating a higher degree of compliance compared to participants that identified with Authoritative parenting. Additionally, gender and race category differences on the COVID Behavior measure were observed. Specifically, African American/Black participants scored higher than White or Other race identifying participants on the COVID Behavior measure. Lastly, females identifying as African American/Black or Other race scored higher than males identifying as African American/Black or Other race on the COVID Behavior measure. These findings begin to illuminate some of the variables that might play a role in choice behavior with regard to compliance to health guidelines. Further investigation into these variables could inform us about what plays a role in choice behavior and how better to integrate this knowledge when messaging the public about health guidelines.

Preserving choice in breast cancer treatment: A different perspective on contralateral prophylactic mastectomy

Contralateral prophylactic mastectomy is the removal of both breasts when only one is affected by cancer. Rates of this controversial cancer treatment have been increasing since the late 1990s, even among women who do not have the kind of family history or known genetic mutation that would put them at high-risk for another breast cancer. Citing contralateral prophylactic mastectomy's lack of oncologic benefit and increased risk of surgical complications, the American Society of Breast Surgeons discourages contralateral prophylactic mastectomy for average-risk women with unilateral cancer, as does most of the medical literature on this topic. Within this literature, desire for contralateral prophylactic mastectomy is often painted as the product of an emotional overreaction to a cancer diagnosis and misunderstanding of breast cancer risk. Drawing on the personal experience of a breast cancer survivor, as well as relevant medical literature on breast cancer screening and surgery, this article offers a different perspective on the ongoing popularity of contralateral prophylactic mastectomy, one that focuses on practical experiences and logical deliberations about those experiences. Specifically, it calls attention to two features of the contralateral prophylactic mastectomy decision-making situation that have been inadequately covered in the medical literature: (1) the way that breast cancer screening after a breast cancer diagnosis can become a kind of radiological overtreatment, even for "average-risk" women; and (2) how desire for bodily symmetry after breast cancer, which can best be achieved through bilateral reconstruction or no reconstruction, drives interest in contralateral prophylactic mastectomy. The goal of this article is not to suggest that all women who want contralateral prophylactic mastectomy should have the surgery. In some cases, it is not advisable. But many "average-risk" women with unilateral cancer have good reasons for wanting contralateral prophylactic mastectomy, and we believe their right to choose it should be protected.

Overconsumption as a function of how individuals make choices: A paper in honor of Howard Rachlin's contributions to psychology

Howard Rachlin's widely influential behavioral economic approach to self-control and related issues provides the model for this submission. The topic is overconsumption. Current human consumption levels are unsustainable. Explanations typically focus on societal factors, such as the seductive power of advertising and/or misguided tax policies. However, the effectiveness of these factors depends on the degree to which individuals are susceptible to the message: "consume more." Humans are not blank slates. This paper argues that how individuals frame their choices establishes the susceptibility to overconsume. According to economic theory, consumers frame their options as bundles, composed of different combinations of the available items and activities. This leads to maximizing. In experiments, participants tend to frame their options as "either-or" choices. This leads to the matching law. Mathematical models of concurrent schedule choice procedures show that (1) the matching law implies overconsumption of the most preferred option and (2) that individuals will persist in preferring their favorite option even when doing so reduces overall reward rates. Given that the matching law better describes how individuals choose than does maximizing, the mathematical models of widely used choice procedures help explain why efforts to increase consumption have been more influential than efforts to control consumption.

"Parenting my parents": Perspectives of adult children on assuming and remaining in the caregiver's role

Background

Family caregivers are essential when responding to the long-term care needs of aging societies. The complex and multifaceted caregiver's role encompasses a unique set of challenges and strains, however, it can be a rewarding experience with many benefits and positive outcomes. Moreover, there is a link between the caregiver's wellbeing, quality of care, and the quality of life of the care recipient. Thus, the current study aimed to explore why adult children are assuming and remaining in the caregiver's role despite its challenges.

Methods

Research data was collected through the use of qualitative semi-structured interviews from September 2021 to July 2022. In total 16 Lithuanian and Italian caregivers were recruited through convenience/snowball sampling. The study utilized the constructivist grounded theory for data analysis and self-determination theory for data interpretation.

Results

Adult children's caregiving experiences revealed three themes related to the motivation to assume and continue with family care: (1) believing in the inherent value of family care; (2) making sense of the changing nature of caregiving; and (3) "making the best of it". Key motivational drivers of these decisions were associated with the satisfaction of the three basic psychological needs - autonomy, competence, and relatedness. Results show that finding meaning and making sense of the caregiving role when responding to a parent's increased care needs may result in positive caregiving experiences and outcomes even at rather low levels of the care recipient's autonomy.

Conclusion

Caregivers were able to experience family care as a meaningful and rewarding experience while acknowledging its challenges and limitations. Implications for family caregiving decisions and experiences, social policy, and future research are discussed in more depth in the paper.

Choice Boosts Curiosity

In our connected era, we spend significant time and effort satisfying our curiosity. Often, we choose which information we seek, but sometimes the selection is made for us. We hypothesized that humans exhibit enhanced curiosity in the context of choice. We designed a task in which healthy participants saw two lotteries on each trial. On some trials, participants chose which lottery to play. On other trials, the lottery was selected for them. Participants then indicated their curiosity about the outcome of the to-be-played lottery via self-report ratings (Experiment 1, N = 34) or willingness-to-wait decisions (Experiment 2, N = 34). We found that participants exhibited higher curiosity ratings and greater willingness to wait for the outcome of lotteries they had chosen than for lotteries that had been selected for them (controlling for initial preference). This demonstrates that choice boosts curiosity, which may have implications for boosting learning, memory, and motivation.

Conceptions of Legacy Among People Making Treatment Choices for Serious Illness: Protocol for a Scoping Review

BACKGROUND

Legacy-what one leaves behind and how one hopes to be remembered after death-is an unexplored and important dimension of decision-making for people facing serious illnesses. A preliminary literature review suggests that patients facing serious illness consider legacy when making medical decisions, for example, forgoing expensive treatment with limited or unknown clinical benefit to preserve one's inheritance for their children. To date, very little is known about the conceptual foundations of legacy. No conceptual frameworks exist that provide a comprehensive understanding of how legacy considerations relate to patient choices about their medical care.

OBJECTIVE

The objective of this scoping review is to understand the extent and type of research addressing the concept of legacy by people facing serious illness to inform a conceptual framework of legacy and patient treatment choices.

METHODS

This protocol follows the guidelines put forth by Levac et al, which expands the framework introduced by Arksey and O'Malley, as well as the Joanna Briggs Institute Reviewer's manual. This scoping review will explore several electronic databases including PubMed, Medline, CINAHL, Cochrane Library, PsycINFO, and others and will include legacy-specific gray literature, including dissertation research available via ProQuest. An initial search will be conducted in English-language literature from 1990 to the present with selected keywords to identify relevant articles and refine the search strategy. After the search strategy has been finalized, 2 independent reviewers will undertake a 2-part study selection process. In the first step, reviewers will screen article titles and abstracts to identify the eligibility of each article based on predetermined exclusion or inclusion criteria. A third senior reviewer will arbitrate discrepancies regarding inclusions or exclusions. During the second step, the full texts will be screened by 2 reviewers, and only relevant articles will be kept. Relevant study data will be extracted, collated, and charted to summarize the key findings related to the construct of legacy.

RESULTS

This study will identify how people facing serious illness define legacy, and how their thinking about legacy impacts the choices they make about their medical treatments. We will note gaps in the literature base. The findings of this study will inform a conceptual model that outlines how ideas about legacy impact the patient's treatment choices. The results of this study will be submitted to an indexed journal.

CONCLUSIONS

Very little is known about the role of legacy in the treatment decisions of patients across the continuum of serious illness. In particular, no comprehensive conceptual model exists that would provide an understanding of how legacy is considered by people making decisions about their care during serious illness. This study will be among the first to construct a conceptual model detailing how considerations of legacy impact medical decision-making for people facing or living with serious illnesses.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/40791.

The impact of alcohol priming on craving and motivation to drink: a meta-analysis

BACKGROUND AND AIMS

An initial dose of alcohol can motivate-or prime-further drinking and may precipitate (re)lapse and bingeing. Lab-based studies have investigated the alcohol priming effect; however, heterogeneity in designs has resulted in some inconsistent findings. The aims of this meta-analysis were to (i) determine the pooled effect size for motivation to drink following priming, measured by alcohol consumption and craving, and (ii) examine whether design characteristics influenced any priming effect.

METHODS

Literature searches of PsycINFO, PubMed and Scopus in October 2020 (updated October 2021) identified lab-based alcohol priming studies that assessed effect of priming on motivation to drink. A tailored risk-of-bias tool assessed quality of lab-based studies. Random effects meta-analyses were computed on outcome data from 38 studies comparing the effect of a priming dose of alcohol against control on subsequent alcohol consumption/self-reported craving. Study characteristics that might have affected outcomes were design type (within/between-participant), dose of prime, time of motivation assessment, type of control drink (placebo alcohol/soft drink).

RESULTS

Relative to control, alcohol had a small-to-moderate priming effect on subsequent alcohol consumption (standardised mean difference [SMD] = 0.336 [95% CI, 0.171, 0.500]) and craving (SMD = 0.431 [95% CI, 0.306, 0.555]). Aspects of study design differentially affected consumption and craving. The size of the priming dose had no effect on consumption, but larger doses were sometimes associated with greater craving (with craving generally following the blood alcohol curve). Alcohol priming effects for consumption, but not craving, were smaller when compared with placebo, relative to soft drink, control.

CONCLUSIONS

Lab-based alcohol priming studies are a valid paradigm from which to investigate the impact of acute intoxication on alcohol motivation. Designs are needed that assess the impact of acute consumption on motivation to drink in more varied and realistic ways.

'I'd have to fight for my life there': a multicentre qualitative interview study of how socioeconomic background influences medical school choice

Students from lower socio-economic backgrounds who were educated in state funded schools are underrepresented in medicine in the UK. Widening access to medical students from these backgrounds has become a key political and research priority. It is known that medical schools vary in the number of applicants attracted and accepted from non-traditional backgrounds but the reasons for this are poorly understood. This study aims to explore what applicants value when choosing medical schools to apply to and how this relates to their socioeconomic background. We conducted a multicentre qualitative interview study, purposively sampling applicants and recent entrants based on socioeconomic background, stage of application and medical school of application. We recruited participants from eight UK medical schools. Participants attended semi-structured interviews. We performed a framework analysis, identifying codes inductively from the data. Sixty-six individuals participated: 35 applicants and 31 first year medical students. Seven main themes were identified; course style, proximity to home, prestige, medical school culture, geographical area, university resources, and fitting in. These were prioritised differently depending on participants' background. Participants from lower socioeconomic backgrounds described proximity to home as a higher priority. This was typically as they intended to be living at home for at least part of the course. Those from higher socioeconomic backgrounds were more concerned with the perceived prestige of medical schools. Since medicine is a highly selective course, only offered at a minority of UK higher education institutions, these differences in priorities may help explain observed differential patterns of medical school applications and success rates by applicant social background.

Bundling and segregation affect pheromone deposition, but not choice, in an ant

Behavioural economists have identified many psychological manipulations which affect perceived value. A prominent example of this is bundling, in which several small gains (or costs) are experienced as more valuable (or costly) than if the same total amount is presented together. While extensively demonstrated in humans, to our knowledge this effect has never been investigated in an animal, let alone an invertebrate. We trained individual Lasius niger workers to two of three conditions in which either costs (travel distance), gains (sucrose reward), or both were either bundled or segregated: (1) both costs and gains bundled, (2) both segregated, and (3) only gains segregated. We recorded pheromone deposition on the ants' return trips to the nest as measure of perceived value. After training, we offer the ants a binary choice between odours associated with the treatments. While bundling treatment did not affect binary choice, it strongly influenced pheromone deposition. Ants deposited c. 80% more pheromone when rewards were segregated but costs bundled as compared with both costs and rewards being bundled. This pattern is further complicated by the pairwise experience each animal made, and which of the treatments it experiences first during training. This demonstrates that even insects are influenced by bundling effects. We propose that the deviation between binary choice and pheromone deposition in this case may be due to a possible linearity in distance perception in ants, while almost all other sensory perception in animals is logarithmic.

Holidays Abroad and the Eating Behavior of the Inhabitants of Poland

A hotel is interested that the guest buys from it not only accommodation, but also catering services, preferably an all-inclusive option. However, many tourists choose only accommodation or accommodation with breakfast, and dinners and other things are purchased outside the place of accommodation. Therefore, it is important to know the eating behavior of tourists, and what hotels must do to make guests want to use food services at the place of accommodation. The purpose of this article is to show the reasons for not buying full meals at hotels during vacations by the inhabitants of Poland. The study used the diagnostic survey method with the help of the direct survey technique. A proprietary survey questionnaire was developed. The direct survey was conducted among 3071 tourists across the country. The study was conducted in 2019-2020. For data analysis, a discriminant function was chosen to examine the differences between groups based on a set of selected independent variables. When buying tourist holidays in travel agencies, 32.40% of Poles bought the all-inclusive option, 33.15% bought breakfast and dinner, 12.47% bought breakfast only, while 21.98%, bought accommodation without any food. For tourists who did not buy any meals at the hotel, the most important factors for eating out were mainly unwillingness to adapt to the hours of serving meals at the place of accommodation, and the desire to control the quality of raw materials needed for preparation of individual dishes. Among hotel guests who only had breakfast at the hotel, the main reasons for eating lunch and dinner outside of the hotel were the desire to try local dishes in regional restaurants, to get to know different restaurants, and to eat meals made entirely of ecological materials. A big barrier to buying meals in a hotel was the lack of offering dietetic dishes or their too high price. Older people dined out because of the lack of dietary dishes or their too high price and because they look for restaurants that serve meals prepared from ecological ingredients. Younger people, on the other hand, did not dine at the hotel because they did not want the hours of serving meals at the hotel to limit their sightseeing in the city and surroundings.

Local Places Ruling Life: Compromises and Restricted Career Choices in Rural Sweden

In this article, we explore the theme of choice in relation to education and work by discussing the notion of “compromise” within career guidance. In particular, we analyse compromises related to career choice in regard to groups and individuals who are restricted — or belong — to a particular geographical place and how this spatial limitation is managed and discussed by career guidance counsellors who work with unemployed individuals. The article is based on the following questions: How are compromises and restricted choices considered in relation to place and belonging? How do career guidance counsellors and other professionals discuss compromises of choice? The qualitative interviews have been conducted with career counsellors working with unemployed individuals in rural Sweden. Four themes emerge: location as a given/non-issue, location as opposed to interest, location as personal life and location as an obstacle. We argue that belonging can be seen as more available to certain groups. For example, career counsellors view the claims of belonging by young people as less valid than for individuals who can present caring and family obligations as reasons for not being mobile.

Cocaine falls into oblivion during volitional initiation of choice trials

When facing a choice, most animals quit drugs in favour of a variety of nondrug alternatives. We recently found, rather unexpectedly, that choice of the nondrug alternative is in fact inflexible and habitual. One possible contributing factor to habitual choice is the intermittency and uncontrollability of choice trials in previous studies. Here, we asked whether and to what extent volitional control over the occurrence of choice trials could change animals' preference by preventing habitual choice. To do so, rats were trained to nosepoke in a hole to trigger the presentation of two operant levers: one associated with cocaine, the other with saccharin. Rats were then free to choose among the two levers to obtain the corresponding reward, after which both levers retracted until rats self-initiated the next choice trial. Overall, we found that volitional control over choice trials did not change preference. Most rats preferred saccharin over cocaine and selected this option almost exclusively. Intriguingly, after repeated choice and consumption of saccharin, rats transiently lost interest in this option (i.e., due to sensory-specific satiety), but they did not switch to cocaine, preferring instead to pause during long periods of time before reinitiating a choice trial for saccharin. This finding suggests that during volitional initiation of a choice trial, rats fail to consider cocaine as an option. We discuss a possible associative mechanism to explain this perplexing behaviour.

Factors Influencing Undergraduate Students' Preference of Health Sciences Specialties

BACKGROUND

It is necessary to determine what motivates students to pursue a particular specialty of their choosing to maintain a balance of medical practitioners from various disciplines.

OBJECTIVE

The study aims to assess factors influencing undergraduate students of Applied Medical Sciences in choosing a specialty or discipline.

METHODS

This cross-sectional study was conducted among first-year students of the faculty of applied medical sciences at Taibah University. One hundred and twenty-five participants were enrolled in the study. The students were asked to respond and complete the designed 9-item questionnaire. The Statistical Package for the Social Sciences (BM SPSS Statistics for Windows, Version 23.0, Armonk, NY: IBM Corp.) was used to analyze the data. A comparison between departments of the faculty was carried out.

RESULTS

125 participants were satisfied with their current faculty or discipline. They stated that medicine was the first choice (43.2%), followed by clinical nutrition (11.2%), dentistry (8%), diagnostic radiology (7.2%), and clinical laboratory (5.6%). The most important factors that affect students' choice of discipline were helping patients and the community (32.8%), personal desire (30.4%), personal desire and helping patients (22.4%), and job opportunity and prestige (9.5%), with gender variations. Family enforcement and finances were less frequent factors affecting students' specialty preferences.

CONCLUSION

The human medicine specialization was the first choice for most female and male undergraduate students who entered the faculty of applied medical sciences. Furthermore, the most influencing factor affecting students' choices was helping patients and the community.

Opportunity Neglect: An Aversion to Low-Probability Gains

Seven preregistered studies (N = 2,890, adult participants) conducted in the field, in the lab, and online documented opportunity neglect: a tendency to reject opportunities with low probability of success even when they come with little or no objective cost (e.g., time, money, reputation). Participants rejected a low-probability opportunity in an everyday context (Study 1). Participants also rejected incentive-compatible gambles with positive expected value-for both goods (Study 2) and money (Studies 3-7)-even with no possibility of monetary loss and nontrivial rewards (e.g., a 1% chance at $99). Participants rejected low-probability opportunities more frequently than high-probability opportunities with equal expected value (Study 3). Although taking some real-life opportunities comes with costs, we show that people are even willing to incur costs to opt out of low-probability opportunities (Study 4). Opportunity neglect can be mitigated by highlighting that rejecting an opportunity is equivalent to choosing a zero probability of success (Studies 6-7).

The salience of choice reduces social responsibility: evidence from lab experiments and compliance with COVID-19 stay-at-home orders

The tension between self-interest and the collective good is fundamental to human societies. We propose that the idea of choice is a key lever that nudges people to act in a self-interested manner because it leads people to value independence. Making one inconsequential choice at the beginning of an incentive-compatible lab experiment made people 41% more likely to choose a monetary allocation that maximized their own payoff while minimizing the total payoff of their group (Studies 1A and 1B). The next two studies featured seven-participant experimental markets in which sellers decided whether to produce conventional goods (which imposed costs on others) or socially responsible goods (which did not impose any costs), and buyers decided which goods to purchase. In markets in which members made a single inconsequential choice, the market share of the socially responsible good was reduced by a factor of 34% (Studies 2A and 2B). In the context of the COVID-19 pandemic, framing socially responsible actions as choices increased people's willingness to hoard and violate social distancing rules (Study 3). Highlighting the idea of choice reduced people's desire to engage in corporate social responsibility, and this effect was mediated by an increased emphasis on independence (Study 4). Finally, using cell phone location data, an archival study found that in states in which people were more likely to search for choice-related words on the internet in 2019, residents were more likely to leave their homes following a stay-at-home order, after controlling for state-level income, education, diversity, population density, and political orientation (Study 5).

Perspectives and practices associated with consumer-directed care in Australia: Synergies and tensions in supporting planning and delivery of home care for older people with dementia

This study used a qualitative, cross-sectional design to address a gap in understanding the perspectives and practices of care planners and case managers in supporting consumer- directed care (CDC) for community dwelling people living with dementia. Semi-structured telephone interviews were conducted with a convenience sample of n = 16 planners and managers from seven providers of the Australian home care packages (HCP) program in NSW (Australia). All interviewees described the aspirations of supporting choice within CDC as synergistic with their values and with person-centred care. Some described new flexibilities within the more open-ended planning conversations enabled by CDC. However, most acknowledged their capacity to enable choice for clients with dementia was limited by the capped care budgets, as well as the skills and time needed to support choice and decision- making. Organisational practice changes associated with the shift to a market-based system were also perceived as limiting the capacity to support choices. Reducing centralised systems, increasing individual budgets and improving staff capacity to support decision-making by people with dementia may help to improve this situation. However, results suggest a deeper need to re-evaluate whether the CDC model is the most appropriate for supporting the rising numbers of people with dementia to age well in place.

Conditioned stimulus effects on paired or alternative reinforcement depend on presentation duration: Implications for conceptualizations of craving

Conditioned stimuli (CS) associated with alcohol ingestion are thought to play a role in relapse by producing a craving that in turn increases motivation to drink which increases ethanol-seeking and disrupts other ongoing behavior. Alternatively, such CS may provide information indicating a likely increase in the density of the paired unconditioned stimulus and simultaneously elicit behavior that may be incompatible with other ongoing behavior, i.e., approach toward the CS. To explore these possibilities, rats were trained to respond for ethanol or food in two different components of the same session after which a light above the ethanol-lever was lighted twice during each component and each light presentation was followed by ethanol delivery. The duration of this CS was 10 s initially and then increased to 30 s, then to 100 s, and finally returned to 30 s. The change in responding for ethanol or food was compared to a matched period immediately preceding CS presentation. The CS presentation increased responding to ethanol, and this effect increases with longer CS presentations. In contrast, the CS presentation decreased responding to food, and this effect decreases with longer CS presentations. These results appear to support the informational account of CS action rather than simply a change in the motivation to seek and consume ethanol. This suggests that craving as it is commonly understood likely represents multiple behavioral processes, not simply increased desire for alcohol and that reports of craving likely reflect labeling based upon past experiences rather than a cause of future drug-taking.

Contraception among HIV-positive women in Latvia- knowledge, experience and factors influencing the choice

OBJECTIVES

Latvia has one of the highest numbers of new HIV cases in the EU. The latest SRH national survey confirmed low effective contraceptive prevalence in the general population, no data were available about women living with HIV (WLHIV). The study aimed to assess knowledge on the use of different contraceptives, to identify factors in choosing contraception, to assess the availability of family planning health care services, and to investigate contraception habits.

METHODS

A cross-sectional study was conducted among WLHIV aged 18-49 recruited with assistance of non-governmental organisations addressing HIV issues. Interviews in Latvian and Russian languages were based on pre-tested questionnaire. Data were processed and analysed using IBM SPSS 22.0.

RESULTS

102 WLHIV were interviewed and 99 of them met the inclusion criteria. Most women were aware of at least one effective contraceptive method yet around half of them had misconceptions about hormonal methods. Most of the women were able to evaluate the effectiveness of contraceptives. Sexually active women usually used male condoms (76.3%) although around 40% did not use them permanently especially if their partner was HIV-positive. Contraception usage after HIV infection decreased. Women mainly trusted medical professionals on information provided about contraceptives. Over 50% of women experienced situations they could not afford a visit to a gynaecologist or contraceptives.

CONCLUSIONS

The survey showed a wide prevalence of misconceptions and prejudice about hormonal contraceptives. There is a need for health education including sexuality education and financial support to make effective contraception available and affordable for WLHIV.

The Influence of Proportion Dominance and Global Need Perception on Donations

Many donation-raising platforms request that first-time donors choose the charitable causes they most care about so that future campaign recommendations can best match donors’ charitable preferences. While matching charitable campaigns to donors’ reported preferences has its benefits, little is known about other effects that choosing charitable causes may evoke. We focus on how choosing charitable causes influences charitable behavior. We find two effects of the number of charitable causes donors choose on their subsequent charitable behavior. In studies 1 and 2, we show that a reference number of the maximum charitable causes donors can choose has a negative effect on charitable behavior. A small (versus large) reference number yields a greater likelihood to donate and a higher donation amount. This effect is aligned with the proportion dominance rationalization. In studies 3 and 4, we show that the number of charitable causes donors voluntarily choose as important to them is positively associated with subsequent charitable behavior. This association is mediated by global need perception. As the number of causes donors choose increases, donors experience an escalation in their perception of global neediness, which in turn motivates their willingness to donate and the donation amount. In Study 5, we show how the two effects together shape charitable behavior. These effects are observed while controlling the donors’ inherent prosocial attitudes toward help giving. With more than 1.5 million registered non-profit organizations operating in the United States (National Center for Charitable Statistics, 2019), it has become almost impossible for donors to easily choose which charitable campaigns to support. Online charitable fundraising platforms (e.g., One Today by Google, Round Up, and Charity Miles), websites (e.g., AmazonSmile) and crowdfunding platforms (e.g., Fundly, JustGiving, and GoFundMe) try to ease donors’ search and decision processes by offering them personalized charitable options. First-time donors are asked to indicate the charitable causes they care most about, and then asked to donate to charitable campaigns that best match their preferences. Interestingly, little is known about how this initial stage of choosing charitable causes influences subsequent donation behavior. In this research, we ask how choosing the charitable causes one cares most about influences subsequent response to a charitable appeal. Obviously, the mere selection of preferred causes enables charities to offer personalized campaigns and create a better fit between non-profits and donors, which has a generally positive effect on charitable giving. However, in this research we focus on an overlooked aspect of these practices. We examine how the number of charitable causes donors indicate as important to them influences their donation giving. We test two opposite effects: the proportion dominance effect, an effect driven by prior research, and the global need perception effect, a new effect identified in this article. Both effects are driven by the number of causes donors choose.

Increasing selection of and engagement in physical activity in children with autism spectrum disorder

Children with autism spectrum disorder (ASD) engage in reduced levels of physical activity relative to neurotypical children. Researchers conducted 2 studies to 1) evaluate the influence of the number of physical activity options and effort on choice and 2) develop a token-based intervention to increase physical activity engagement and evaluate whether the opportunity to access the intervention supported responding similar to physical or sedentary activity alone. Four children with ASD participated. Additional physical activity options alone did not increase physical activity selection, but increased effort reduced selection of sedentary activity. Tokens increased physical activity for 2 participants. A combination of physical and sedentary activities maintained as much as or more responding than either activity in isolation for all participants. Limitations and potential areas of future research on choice and physical activity are discussed.

Acute nicotine reinforcement requires ability to discriminate the stimulus effects of nicotine

This review of research on behavioral discrimination of nicotine and how it informs public health policy for reducing risk of tobacco dependence is adapted from Kenneth A. Perkins's American Psychological Association Division 28 (Psychopharmacology and Substance Abuse) 2020 Med Associates Brady/Schuster Award Lecture. The author's initial programmatic clinical research on nicotine is introduced, especially efforts to develop and validate a novel method of acute nicotine dosing. After the public health rationale for characterizing the discriminative stimulus effects of nicotine in humans are described, details from two separate programs of research on nicotine discrimination in humans are presented. The first, conducted with nicotine dosing by nasal spray, documented that humans could discriminate nicotine administered rapidly, examined nicotine's neuropharmacological specificity, identified discrimination threshold dose in smokers and nonsmokers, and explored other conditions that might alter ability to discriminate its effects. The second, more recent program focused on threshold doses for discrimination of nicotine by cigarette smoking, a program that was very difficult to do until the past decade, and how nicotine's self-reported "reward" and preference via choice behavior relate to its discriminability. Differences due to menthol and degree of tobacco dependence were also examined. For each of these two programs, the main findings of selected studies are noted, followed by very recent work on nicotine discrimination and choice that informs Food and Drug Administration's efforts to formulate public policy to improve health and reduce the nearly half million American deaths per year due to persistent tobacco use. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Rate matching, probability matching, and optimization in concurrent ratio schedules

Much research has documented rate matching in concurrent variable-interval schedules, but comparatively little research has examined performance in concurrent variable-ratio schedules, except in discrete-trials procedures that sometimes produce probability matching. One should expect that the two types of schedule would result in different performances, because ratio schedules cannot improve with time the way interval schedules do; ratio schedules lack the temporal dynamics of interval schedules. The present experiment exposed rats to concurrent variable-ratio schedules. Seven unsignaled components were presented in random order within each daily session, with probability ratios ranging from 1:8 to 8:1. Three conditions were studied that varied the overall probability of food while leaving probability ratios the same. Choice appeared to conform to probability matching, because sensitivities in the rate-matching relation were close to 0.5, whereas sensitivities to probability ratio were close to 1.0. The sensitivities alone, however, could not confirm probability matching, because undermatching to rate occurs often. Analyses at smaller time scales supported the interpretation of probability matching. In particular, control by food deliveries was highly local in concurrent variable-ratio schedules, in contrast with concurrent variable-interval schedules, in which control is extended. Activity continued to switch between alternatives throughout components, contradicting optimal sampling theory.

Effects of repeated exposure to escalating versus constant punishment intensity on response allocation

The present experiment investigated the effects of 1) repeated exposures to escalating punishment intensities and 2) repeated exposure to punishment after periods of vacation on response allocation between punished and unpunished responding in three groups of rats. The first group (intensity + vacation) experienced repeated exposures to escalating punishment intensities after a period of vacation (i.e., return to baseline) from punishment. The second group (intensity-only) experienced repeated exposures to escalating punishment intensities without vacation from punishment. The third group (vacation-only) experienced repeated exposures to a constant punishment intensity after a period of vacation from punishment. Results showed that superimposition of punishment on one of two concurrently available responses decreased allocation toward the punished response and increased allocation toward the unpunished response. Furthermore, greater changes in allocation were observed with the introduction of a moderate constant intensity than with the introduction of a low intensity that increased across sessions. Reexposure to punishment had different effects between the groups. Although there was evidence that high shock intensities can enhance the efficacy of lower intensities to shift allocation away from the punished response and toward the unpunished response, there was little evidence of changes in response allocation with reintroduction of punishment after a period of vacation.

Decision neuroscience and neuroeconomics: Recent progress and ongoing challenges

In the past decade, decision neuroscience and neuroeconomics have developed many new insights in the study of decision making. This review provides an overarching update on how the field has advanced in this time period. Although our initial review a decade ago outlined several theoretical, conceptual, methodological, empirical, and practical challenges, there has only been limited progress in resolving these challenges. We summarize significant trends in decision neuroscience through the lens of the challenges outlined for the field and review examples where the field has had significant, direct, and applicable impacts across economics and psychology. First, we review progress on topics including reward learning, explore-exploit decisions, risk and ambiguity, intertemporal choice, and valuation. Next, we assess the impacts of emotion, social rewards, and social context on decision making. Then, we follow up with how individual differences impact choices and new exciting developments in the prediction and neuroforecasting of future decisions. Finally, we consider how trends in decision-neuroscience research reflect progress toward resolving past challenges, discuss new and exciting applications of recent research, and identify new challenges for the field. This article is categorized under: Psychology > Reasoning and Decision Making Psychology > Emotion and Motivation.

Reward Salience and Choice in a Controlling Context: A Lab Experiment

One of the challenges in the motivation literature is examining the simultaneous effect of different motivational mechanisms on overall motivation and performance. The motivational congruence theory addresses this by stipulating that different motivational mechanisms can reinforce each other if they have similar effects on the perceived locus of causality. Reward salience and choice are two motivational mechanisms which their joint effects have been long debated. Built upon the motivational congruence effect, a recent empirical study affirms that a salient reward in a condition characterized by lack of choice and a non-salient reward in a condition characterized by provision of choice both increase overall motivation and performance. In this study, we examine the effect of reward salience and choice on overall motivation and performance in a controlling context, an effect which has not been studied before. A 2 (choice: present, absent) × 3 (reward: salient, non-salient, none) factorial design was conducted to examine research hypotheses. The results show that under controlling conditions, salient reward improves overall motivation and performance compared to non-salient and no-reward conditions.

Relapse after incentivized choice treatment in humans: A laboratory model for studying behavior change

Behavior change interventions that incentivize desired behavior are highly effective for improving personal health, but difficult to maintain long term. Relapse is common and examining the mechanisms that contribute to relapse in experimental settings can identify processes relevant to substance abuse treatment. We developed a laboratory task that parallels a recent operant model of relapse after incentivized choice reported in the rodent laboratory. In two experiments, undergraduate participants first learned to make an operant response (keyboard button; R1) to earn a reinforcer consisting of an image of a preferred snack food (O1). In a second phase (Phase 2), R1 was still reinforced, but a new response (R2) was introduced and reinforced with a different reinforcer (a coin; O2). In a test phase, contingent incentives for R2 were removed (extinction) and relapse of R1 was assessed. Experiment 1 found that the O2 contingency suppressed R1 during Phase 2, and R1 relapsed rapidly in the test. Neither effect was consistently related to O2 value. Experiment 2 examined whether noncontingent presentations of O1 or O2 during the test could weaken relapse. Here, we found that noncontingent reinforcers did little to reduce or slow the increase in R1 responding. The present experiments highlight a laboratory approach to studying variables that may influence relapse after incentivized treatment. We identify and discuss areas for development to address differences between the present results and prior observations from animal and clinical studies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Assessing the efficacy of and preference for positive and corrective feedback

Feedback is an effective strategy for improving performance and consists of multiple characteristics. One characteristic that can influence feedback efficacy is its nature (whether feedback is positive or corrective) and little is known about the conditions under which individuals may prefer corrective over positive feedback. Thus, the purpose of this study was to assess the efficacy of and preference for positive and corrective feedback during the acquisition of novel tasks. In the first phase, participants received either positive, corrective, or no feedback across three novel tasks. Participants only mastered the task in which they received corrective feedback. In the second phase, participants chose to receive either positive or corrective feedback after completing trials of the previous phase's control task. All participants chose to receive corrective feedback more frequently than positive feedback. We discuss the implications of the results for feedback delivery in the workplace and provide suggestions for future research.

Love, sex, and commitment: relationship choices and trajectories among unmarried youth in India

There is limited research in India to understand young people's decision-making processes about intimate relationships before marriage. This paper, adopting a life course perspective, explains relationship choices and diachronic trajectories of relationships from adolescence to young adulthood. Retrospective data were collected from 1240 never married 20-29-year-old men and women living in Pune using a relationships history calendar. All the relationships from 10 years of age onwards were plotted on the calendar, and information on predictor variables was collected through structured questionnaires. Data were analysed using descriptive statistics. Sequence analysis approach was used to identify different typologies. Overall, 76% of the participants reported having at least one relationship. More women compared to men (84% vs 70%) ever had a relationship. The median age of starting the first relationship was 17 years for women and 18 for men. Different relationship types were reported, such as "serious", casual, "friends with benefit", and "exploring". The level of emotional involvement, commitment, and physical intimacy significantly differed in different relationship types with significant gender differences. Four typologies of relationships were observed, labelled as (1) Commitment-No sex (N = 187); (2) Commitment-Sex-Some exploration (N = 189); (3) No commitment-Exploration (N = 281), and (4) No relationship (N = 583). Compared to men, women were more likely to follow the trajectory of "Commitment-No sex" (RR 2.13, CI 1.5-3.03). Family environment was significantly related to young people's relationship choices. The findings strongly suggest the need to adopt a developmental perspective towards intimate relationships to understand and address the vulnerabilities of young people across the life course.

Reward Value Revealed by Auction in Rhesus Monkeys

Economic choice is thought to involve the elicitation of the subjective values of the choice options. Thus far, value estimation in animals has relied on stochastic choices between multiple options presented in repeated trials and expressed from averages of dozens of trials. However, subjective reward valuations are made moment-to-moment and do not always require alternative options; their consequences are usually felt immediately. Here, we describe a Becker-DeGroot-Marschak (BDM) auction-like mechanism that provides more direct and simple valuations with immediate consequences. The BDM encourages agents to truthfully reveal their true subjective value in individual choices ("incentive compatibility"). Male monkeys reliably placed well-ranked BDM bids for up to five juice volumes while paying from a water budget. The bids closely approximated the average subjective values estimated with conventional binary choices (BCs), thus demonstrating procedural invariance and aligning with the wealth of knowledge acquired with these less direct estimation methods. The feasibility of BDM bidding in monkeys paves the way for an analysis of subjective neuronal value signals in single trials rather than from averages; the feasibility also bridges the gap to the increasingly used BDM method in human neuroeconomics.SIGNIFICANCE STATEMENT The subjective economic value of rewards cannot be measured directly but must be inferred from observable behavior. Until now, the estimation method in animals was rather complex and required comparison between several choice options during repeated choices; thus, such methods did not respect the imminence of the outcome from individual choices. However, human economic research has developed a simple auction-like procedure that can reveal in a direct and immediate manner the true subjective value in individual choices [Becker-DeGroot-Marschak (BDM) mechanism]. The current study implemented this mechanism in rhesus monkeys and demonstrates its usefulness for eliciting meaningful value estimates of liquid rewards. The mechanism allows future neurophysiological assessment of subjective reward value signals in single trials of controlled animal tasks.

The ethical challenges of artificial intelligence-driven digital pathology

Digital pathology - the digitalisation of clinical histopathology services through the scanning and storage of pathology slides - has opened up new possibilities for health care in recent years, particularly in the opportunities it brings for artificial intelligence (AI)-driven research. Recognising, however, that there is little scholarly debate on the ethics of digital pathology when used for AI research, this paper summarises what it sees as four key ethical issues to consider when deploying AI infrastructures in pathology, namely, privacy, choice, equity, and trust. The themes are inspired from the authors' experience grappling with the challenge of deploying an ethical digital pathology infrastructure to support AI research as part of the National Pathology Imaging Cooperative (NPIC), a collaborative of universities, hospital trusts, and industry partners largely located across the North of England. Though focusing on the UK case, internationally, few pathology departments have gone fully digital, and so the themes developed here offer a heuristic for ethical reflection for other departments currently making a similar transition or planning to do so in the future. We conclude by promoting the need for robust public governance mechanisms in AI-driven digital pathology.

From Choice to Performance in Secondary Schools: Evidence from a Disadvantaged Setting in Italy

This study employs detailed micro-data to uncover the factors influencing secondary school choice and performance and, ultimately, dropout risks within a multidimensional framework. The findings reveal that young people’s choice of a comprehensive secondary school, characterised by a higher dropout rate, is highly influenced by future expectations and family background. Further, teachers’ role, learning methods and technology positively drive performance. Perceived cognitive skills only affect students’ performance given their choice. Besides, an ANOVA analysis assesses that the interaction between cognitive and non-cognitive skills impacts performance. Peer study is pivotal for success in individuals with perceived cognitive difficulties.

Parent Provision of Choice Is a Key Component of Autonomy Support in Predicting Child Executive Function Skills

Although previous work has linked parent autonomy support to the development of children's executive function (EF) skills, the role of specific autonomy-supportive behaviors has not been thoroughly investigated. We compiled data from four preschool-age samples in the Midwestern United States (N = 366; M age = 44.26 months; 72% non-Hispanic White, 19% Black/African American, 5% Multiracial) to examine three relevant autonomy-supportive behaviors (supporting competence, positive verbalizations, and offering choice) and their associations with child EF. We coded parent autonomy-supportive behaviors from a 10-min interaction between parent and child dyads working on challenging jigsaw puzzles together. Children completed a battery of EF. Overall, child EF was most consistently correlated with the offering choice subscale. Additionally, only the offering choice subscale predicted child EF while controlling for the other autonomy support subscales and child age. These results suggest that parent provision of choice is an especially relevant aspect of autonomy-supportive parenting and may be important to the development of EF in early childhood. Future research should directly measure children's experience with choice and how it relates to emerging EF.

Contextual extinction of drug-associated discriminative stimuli fails to attenuate drug-vs-food choice in rhesus monkeys

Relapse within the context of a substance use disorder can be triggered by cues that function as discriminative stimuli to signal contingencies of drug availability and promote drug-taking behavior. Extinction procedures can weaken this association between drug-associated cues and drug-taking behavior and may reduce the probability of relapse. This study evaluated a regimen of extinction training on cocaine and heroin self-administration in rhesus monkeys under a drug-vs-food choice procedure. Behavior was initially maintained under a concurrent schedule of food (1-g food pellets; fixed-ratio 100 schedule) and cocaine injections (0-0.1 mg/kg/injection; fixed-ratio 10) (n = 4 males) or heroin injections (0-0.01 mg/kg/injection; fixed-ratio 10) (n = 3 females and 1 male) during daily 2-hr choice sessions. Subsequently, choice sessions were supplemented by daily 20-hr saline self-administration sessions for 14 consecutive days. During saline self-administration sessions, only drug-associated discriminative stimuli were presented and responding produced saline injections. Drug continued to be available during choice sessions. Prior to extinction training, both cocaine and heroin maintained dose-dependent increases in drug-vs-food choice. Exposure to 14 saline self-administration sessions failed to significantly decrease drug choice and increase food choice. These preclinical results do not support the effectiveness of extinguishing drug-associated discriminative stimuli as a nonpharmacological treatment strategy for reducing drug choice.

Measuring Four Personal Opportunities for Adults With Intellectual and Developmental Disabilities

This study tests an empirically derived model for measuring personal opportunities for people with intellectual and developmental disabilities (IDD) using National Core Indicators In-Person Survey (NCI-IPS) state and national datasets. The four personal opportunities measured, (a) privacy rights, (b) everyday choice, (c) community participation, and (d) expanded friendships, were informed by existing conceptualizations of service as well as NCI-IPS measures. Analyses confirmed the fit of a four-factor model and demonstrated that factors were significantly and positively correlated. To demonstrate the relationships between personal opportunities and personal and environmental characteristics, we estimated a structural equation model that regressed personal opportunities on age, gender, place of residence, and level of intellectual disability. Implications for using personal opportunities for evaluating service quality of IDD systems are discussed.

Trust, affect, and choice in parents' vaccination decision-making and health-care provider selection in Switzerland

This article examines the relationships between biomedicine, complementary and alternative medicine (CAM) and parents' vaccination decision-making in Switzerland. Our empirical evidence sheds light on an understudied phenomenon-parents switching from one doctor to another provider (often one offering CAM services) around issues that arise during vaccination consultations. This is important to understand since CAM is used by 25%-50% of the Swiss population and is integrated into the Swiss health-care system when offered by biomedically trained medical doctors with additional CAM training. Qualitative data gathered from in-depth semi-structured interviews with parents (N = 30) and ethnographic observations of vaccination consultations (N = 16 biomedical consultations, N = 18 CAM consultations) demonstrate how there was not always a clear-cut, direct relationship between (non)vaccination and parents' use of CAM and/or biomedicine. Borrowing from Hirschman (Exit, voice, and loyalty: Responses to decline in firms, organizations, and states, Harvard Univ. Press, 1970), we frame our analysis by using the concepts of exit, voice and loyalty to describe parents' provider selection and vaccination decision-making process, although only four families in the sample described switching solely because of vaccination-related issues. Findings add to vaccine decision-making literature by describing and analysing the underdiscussed provider-switching phenomenon and by demonstrating the importance of parents' experiences of trust, affect and choice in vaccination consultations as they pursue the best health outcomes for their children.

The importance of dignity and choice for people assessed as having intellectual disabilities

Individuals assessed as having an intellectual disability often spend a significant amount of time in day treatment/day habilitation programs after they graduate from school. The quality of these programs varies widely and is not federally legislated. The purpose of the current study is both to explore factors that lead to higher satisfaction for participants in these programs and to better understand what participants want in a program. Using a grounded theory approach, researchers interviewed 25 participants, staff, and family members in focus group settings to collect qualitative data. Interviews focused on what worked and what could be improved at a program located in Western New York. Using the constant comparative method, themes emerged from the data that pointed to the importance of dignity and choice in a day program to facilitate empowerment, higher levels of satisfaction and self-confidence.

On the generality of preference for contingent reinforcement

Reinforcers can be delivered dependent on or independent of responding. Both human and nonhuman animals have shown a preference for contexts involving contingent reinforcement, but the generality of this phenomenon to humans and its implications have not yet been described. We present an integrative summary of studies evaluating preference for contingent versus noncontingent reinforcement, including (a) study participants, reinforcer types, response topographies, and contexts; (b) outcomes; (c) potential variables influencing preference outcomes; and (d) suggestions regarding research to expand behavior analysts' ability to design preferred contexts.

Between a Rock and a Hard Place: Considering "Freebirth" During Covid-19

Background: The global coronavirus (Covid-19) pandemic concerns all people, but has a specific effect on those who are expecting a baby during this time. The advice in the UK changed rapidly, with 14 different sets of national guidance issued within 1 month. Individual NHS Trusts released various guidance relating to the withdrawal of homebirth services, the closure of birth centers, restrictions on the number of birth partners (if any) allowed during labor, and whether any visitors were allowed to attend after birth. With the landscape of maternity care changing so rapidly, research was carried out to provide real-time data to capture the lived experiences of expectant families.

Methods: A mixed methods online survey was carried out over 2 weeks between 10th and 24th April 2020. The survey was open to those in the third trimester of pregnancy, those who had given birth since the beginning of the “lockdown” period in the UK, and the partners of pregnant women and people who were in these circumstances. The survey asked questions about how respondents' holistic antenatal experiences had been affected, whether their plans for birth had changed, and the effect of these changes on respondents' emotional wellbeing. Of the 1,700 responses received, 72 mentioned that they had seriously considered “freebirthing” (giving birth without a healthcare professional present).

Findings: An analysis of the respondents' reasons for considering freebirth was conducted, finding that reasons for considering freebirth were complex and multifaceted. Lesbian, bisexual, pansexual, and queer women were more likely to have considered freebirth than heterosexual people (p < 0.001).

Conclusions: Considering giving birth without a healthcare professional present is unusual in the Global North and represents an emerging field of study. The literature examining the reasons that people consider freebirth shows a variety of underlying motivations. A global pandemic represents a new factor in such considerations. The findings from this research can help inform maternity service planning in future crises.