Addressing climate change with behavioral science: A global intervention tournament in 63 countries.

Effectively reducing climate change requires marked, global behavior change. However, it is unclear which strategies are most likely to motivate people to change their climate beliefs and behaviors. Here, we tested 11 expert-crowdsourced interventions on four climate mitigation outcomes: beliefs, policy support, information sharing intention, and an effortful tree-planting behavioral task. Across 59,440 participants from 63 countries, the interventions' effectiveness was small, largely limited to nonclimate skeptics, and differed across outcomes: Beliefs were strengthened mostly by decreasing psychological distance (by 2.3%), policy support by writing a letter to a future-generation member (2.6%), information sharing by negative emotion induction (12.1%), and no intervention increased the more effortful behavior-several interventions even reduced tree planting. Last, the effects of each intervention differed depending on people's initial climate beliefs. These findings suggest that the impact of behavioral climate interventions varies across audiences and target behaviors.

Engaging nurse practitioners and physician assistants to improve patient care and drive productivity in a radiology consult practice at a comprehensive cancer center.

BACKGROUND: The demand for health care in the United States is increasing because of an aging population and an increase in the number of individuals insured. This has led to requests to revamp the primary care infrastructure fundamentally. LOCAL PROBLEM: The optimal use of nurse practitioners (NPs) and physician assistants (PAs) is still a subject of debate, but recently, it was reported that for many medical conditions, NP and PA-managed care outcomes are consistent with physician-managed care outcomes. METHODS: Radiologists' productivity was measured according to relative value units (RVUs)/shift and professional billing changes. Patient care metrics measured were prescribed protocol to patient appointment lead time and number of same-day prescribed imaging protocol changes. INTERVENTIONS: The focus was on radiologists' productivity and patient care for three months before and three months after integrating NP and PA into our abdominal radiology consult service. RESULTS: We observed significant increases in the mean RVUs/shift (15.2 ± 0.9 vs. 6.2 ± 1.8; p = .02), studies read per shift (10.1 ± 0.5 vs. 4.4 ± 1.5; p = .003), revenue per shift hour ($756.20 ± 55.40 vs. $335.40 ± 32.60; p = .007), and protocol prescription to patient appointment lead time (39.3 ± 6.7 days vs. 16.3 ± 2.9 days; p = .005) and saw significant decreases in the mean prescribed CT (19.3 ± 0.6 vs. 3.3 ± 0.6; p = .001) and MRI (11.7 ± 0.6 vs. 8.30 ± 0.12; p = .011) same day protocol changes in NP and PA integrated workflow. CONCLUSIONS: These findings suggest that NP and PA can be effectively integrated into the abdominal radiology consult service, increasing radiologists' productivity and enhancing clinical care.

Both prey and predator features predict the individual predation risk and survival of schooling prey.

Predation is one of the main evolutionary drivers of social grouping. While it is well appreciated that predation risk is likely not shared equally among individuals within groups, its detailed quantification has remained difficult due to the speed of attacks and the highly dynamic nature of collective prey response. Here, using high-resolution tracking of solitary predators (Northern pike) hunting schooling fish (golden shiners), we not only provide insights into predator decision-making, but show which key spatial and kinematic features of predator and prey predict the risk of individuals to be targeted and to survive attacks. We found that pike tended to stealthily approach the largest groups, and were often already inside the school when launching their attack, making prey in this frontal 'strike zone' the most vulnerable to be targeted. From the prey's perspective, those fish in central locations, but relatively far from, and less aligned with, neighbours, were most likely to be targeted. While the majority of attacks were successful (70%), targeted individuals that did manage to avoid being captured exhibited a higher maximum acceleration response just before the attack and were further away from the pike's head. Our results highlight the crucial interplay between predators' attack strategy and response of prey underlying the predation risk within mobile animal groups.

Combining interventions to reduce the spread of viral misinformation.

Misinformation online poses a range of threats, from subverting democratic processes to undermining public health measures. Proposed solutions range from encouraging more selective sharing by individuals to removing false content and accounts that create or promote it. Here we provide a framework to evaluate interventions aimed at reducing viral misinformation online both in isolation and when used in combination. We begin by deriving a generative model of viral misinformation spread, inspired by research on infectious disease. By applying this model to a large corpus (10.5 million tweets) of misinformation events that occurred during the 2020 US election, we reveal that commonly proposed interventions are unlikely to be effective in isolation. However, our framework demonstrates that a combined approach can achieve a substantial reduction in the prevalence of misinformation. Our results highlight a practical path forward as misinformation online continues to threaten vaccination efforts, equity and democratic processes around the globe.

PAs and NPs improve patient care and productivity in a radiology consult practice.

OBJECTIVE: To evaluate the effects on efficiency and patient care of the addition of physician assistants (PAs) and NPs to the abdominal radiology consult service. METHODS: We obtained radiologist productivity and patient care metrics for 3 months before and 3 months after the integration of PAs and NPs into our consult service. RESULTS: Integrating PAs and NPs into the workflow led to a significant increase in mean RVUs/shift (15.2 ± 0.9 versus 6.2 ± 1.8; P = .02), number of studies read per shift (10.1 ± 0.5 versus 4.4 ± 1.5; P = .003), revenue per shift hour ($756.20 ± $55.40 versus $335.40 ± $132.60; P = .007), protocol prescription to patient appointment lead time (39.3 ± 6.7 versus 16.3 ± 2.9 days; P = .005), and significant decreases in mean CT (19.3% ± 0.6 versus 3.3% ± 0.6; P = .001) and MRI (11.7% ± 0.6 versus 8.3% ± 0.12; P = .011) same-day protocol changes as patient appointments. CONCLUSIONS: PAs and NPs can be effectively integrated into abdominal radiology consult service, increasing the productivity of radiologists, and enhancing clinical care.

Stewardship of global collective behavior.

Collective behavior provides a framework for understanding how the actions and properties of groups emerge from the way individuals generate and share information. In humans, information flows were initially shaped by natural selection yet are increasingly structured by emerging communication technologies. Our larger, more complex social networks now transfer high-fidelity information over vast distances at low cost. The digital age and the rise of social media have accelerated changes to our social systems, with poorly understood functional consequences. This gap in our knowledge represents a principal challenge to scientific progress, democracy, and actions to address global crises. We argue that the study of collective behavior must rise to a "crisis discipline" just as medicine, conservation, and climate science have, with a focus on providing actionable insight to policymakers and regulators for the stewardship of social systems.

Predictors of Alcohol Use after Bariatric Surgery.

Patients undergoing bariatric surgery are at risk for devloping an alcohol use disorder (AUD). The purpose of this study was to investigate pre-surgical psychosocial risk factors for post-surgical alcohol consumption and hazardous drinking. Participants (N = 567) who underwent bariatric surgery between 2014 and 2017 reported their post-surgical alcohol use. Information was collected from the pre-surgical evaluation including history of alcohol use, psychiatric symptoms, and maladaptive eating behaviors (i.e., binge eating, purging, and emotional eating). Younger age and pre-surgical alcohol use predicted post-surgical alcohol use and hazardous drinking. In addition, higher levels of depressive symptoms and maladaptive eating patterns predicted post-surgical binge drinking. Clinicians conducting pre-surgical psychosocial evaluations should be aware of the multiple risk factors related to post-surgical problematic alcohol use. Future research should evaluate whether preventive interventions for high-risk patients decrease risk for post-surgical alcohol misuse.

The wisdom of stalemates: consensus and clustering as filtering mechanisms for improving collective accuracy.

Groups of organisms, from bacteria to fish schools to human societies, depend on their ability to make accurate decisions in an uncertain world. Most models of collective decision-making assume that groups reach a consensus during a decision-making bout, often through simple majority rule. In many natural and sociological systems, however, groups may fail to reach consensus, resulting in stalemates. Here, we build on opinion dynamics and collective wisdom models to examine how stalemates may affect the wisdom of crowds. For simple environments, where individuals have access to independent sources of information, we find that stalemates improve collective accuracy by selectively filtering out incorrect decisions (an effect we call stalemate filtering). In complex environments, where individuals have access to both shared and independent information, this effect is even more pronounced, restoring the wisdom of crowds in regions of parameter space where large groups perform poorly when making decisions using majority rule. We identify network properties that tune the system between consensus and accuracy, providing mechanisms by which animals, or evolution, could dynamically adjust the collective decision-making process in response to the reward structure of the possible outcomes. Overall, these results highlight the adaptive potential of stalemate filtering for improving the decision-making abilities of group-living animals.

Vortex phase matching as a strategy for schooling in robots and in fish.

It has long been proposed that flying and swimming animals could exploit neighbour-induced flows. Despite this it is still not clear whether, and if so how, schooling fish coordinate their movement to benefit from the vortices shed by others. To address this we developed bio-mimetic fish-like robots which allow us to measure directly the energy consumption associated with swimming together in pairs (the most common natural configuration in schooling fish). We find that followers, in any relative position to a near-neighbour, could obtain hydrodynamic benefits if they exhibit a tailbeat phase difference that varies linearly with front-back distance, a strategy we term 'vortex phase matching'. Experiments with pairs of freely-swimming fish reveal that followers exhibit this strategy, and that doing so requires neither a functioning visual nor lateral line system. Our results are consistent with the hypothesis that fish typically, but not exclusively, use vortex phase matching to save energy.

Individual and collective encoding of risk in animal groups.

The need to make fast decisions under risky and uncertain conditions is a widespread problem in the natural world. While there has been extensive work on how individual organisms dynamically modify their behavior to respond appropriately to changing environmental conditions (and how this is encoded in the brain), we know remarkably little about the corresponding aspects of collective information processing in animal groups. For example, many groups appear to show increased "sensitivity" in the presence of perceived threat, as evidenced by the increased frequency and magnitude of repeated cascading waves of behavioral change often observed in fish schools and bird flocks under such circumstances. How such context-dependent changes in collective sensitivity are mediated, however, is unknown. Here we address this question using schooling fish as a model system, focusing on 2 nonexclusive hypotheses: 1) that changes in collective responsiveness result from changes in how individuals respond to social cues (i.e., changes to the properties of the "nodes" in the social network), and 2) that they result from changes made to the structural connectivity of the network itself (i.e., the computation is encoded in the "edges" of the network). We find that despite the fact that perceived risk increases the probability for individuals to initiate an alarm, the context-dependent change in collective sensitivity predominantly results not from changes in how individuals respond to social cues, but instead from how individuals modify the spatial structure, and correspondingly the topology of the network of interactions, within the group. Risk is thus encoded as a collective property, emphasizing that in group-living species individual fitness can depend strongly on coupling between scales of behavioral organization.

Motivating residents to change communication: the role of a brief motivational interviewing didactic.

INTRODUCTION: Motivational interviewing (MI) is a patient-centered approach that encourages patients to change behaviors. MI training programs have increased residents' knowledge and use of MI skills; however, many residency programs may not have the time to dedicate to lengthy MI programs. The purpose of this study was to evaluate the benefits of a brief MI didactic for residents in an academic internal medicine patient-centered medical home. METHODS: Thirty-two residents completed a 1-h MI training between October 2016 and June 2017 and completed measures on their knowledge of, confidence using, and utilization of MI skills prior to the training, immediately after the training, and at a 1-month follow-up. RESULTS: The residents' knowledge of and confidence using MI skills increased from pre-test to post-test and also increased from pre-test to the 1-month follow-up. CONCLUSION: The utilization of MI skills increased from pre-test to the 1-month follow-up. A 1-h didactic offers benefits to residents.

A Brief Mindfulness Intervention for Medically Hospitalized Patients with Acute Pain: A Pilot Randomized Clinical Trial.

OBJECTIVE: Mindfulness interventions may be beneficial for patients with chronic pain; however, the effects for acute pain are not understood. The purpose of this study was to pilot test a brief mindfulness intervention for acute pain and stress for patients in an inpatient medical setting. DESIGN: Pilot randomized clinical trial. SETTING: An inpatient Acute Care Surgery service at an urban hospital. SUBJECTS: Sixty patients with acute pain were randomly selected and agreed to participate. METHODS: Interested patients consented to the study and were randomized to the 10-minute intervention (i.e., mindfulness strategy) or comparison group (i.e., education on the Gate Control Theory of Pain). Participants completed pre- and post-assessment measures on pain severity and stress. RESULTS: Preliminary results showed that within the intervention and comparison groups, participants experienced decreases in pain from pre- to post-intervention (P = 0.002 and 0.005, respectively). Within the intervention group, there was a significant decrease in stress from pre- to post-intervention (P = 0.001). There were no significant changes for stress within the comparison group (P = 0.32). There were no significant differences between the intervention and comparison groups for pain (P = 0.44) or stress (P = 0.07) at post-intervention, although Cohen's d effect sizes were small to medium for pain and stress, respectively. CONCLUSIONS: A brief mindfulness intervention for medically hospitalized patients with acute pain may decrease pain and stress. Future research should examine this intervention with a fully powered, larger sample to examine efficacy.

Patient Recall of Education about the Risks of Alcohol Use Following Bariatric Surgery.

Patients who undergo bariatric surgery are at increased risk of developing alcohol problems. The purpose of this study was to evaluate whether patients who underwent bariatric surgery recalled receiving education about alcohol prior to having surgery and to investigate their alcohol use patterns. Patients (N = 567) who underwent bariatric surgery completed a survey regarding their knowledge of risks related to post-surgical alcohol use. Although most patients recalled receiving education about abstinence from alcohol after surgery, at least one-third of patients do not appear to understand the risks involved with alcohol consumption, suggesting that patients did not retain the information. Despite recalling receiving education, many patients still consumed alcohol after surgery. It appears that additional interventions are needed to decrease alcohol use after bariatric surgery.

Treating pain in primary care: Optimizing an integrated psychological intervention based on perspectives of psychologists, primary care providers, and patients.

INTRODUCTION: Although behavioral health treatment can improve distress and pain functioning for patients with chronic pain, few who are referred by their primary care physician will see a behavioral health specialist. Given the benefits of integrating behavioral health into primary care, this may be an avenue for delivering a psychological intervention for chronic pain. The purpose of this study was to optimize a psychological intervention for patients with chronic pain to be delivered in primary care, utilizing the perspectives of providers and patients. METHOD: Psychologists (n = 9), primary care providers (n = 9), and patients with chronic pain (n = 9) participated in separate focus groups. Participants reviewed the proposed 4-session intervention, provided feedback prompted by a set of open-ended questions, and completed a survey. RESULTS: Statements from focus groups were transcribed and coded into 2 thematic categories: (a) content of the intervention and (b) logistics and design. Participants believed that offering a brief, behavioral intervention for chronic pain in a primary care clinic was feasible and useful. All providers (100%) agreed or strongly agreed that they would refer a patient to this intervention, and 100% of patients agreed or strongly agreed that they would participate. DISCUSSION: Feedback solicited from the focus groups led to alterations to the treatment manual, such as adding a fifth session, using different psychological strategies, and logistical changes in delivery (i.e., meeting biweekly and intervisit contacts). The modified version of this intervention will be evaluated with a pilot randomized controlled clinical trial. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Counteracting estimation bias and social influence to improve the wisdom of crowds.

Aggregating multiple non-expert opinions into a collective estimate can improve accuracy across many contexts. However, two sources of error can diminish collective wisdom: individual estimation biases and information sharing between individuals. Here, we measure individual biases and social influence rules in multiple experiments involving hundreds of individuals performing a classic numerosity estimation task. We first investigate how existing aggregation methods, such as calculating the arithmetic mean or the median, are influenced by these sources of error. We show that the mean tends to overestimate, and the median underestimate, the true value for a wide range of numerosities. Quantifying estimation bias, and mapping individual bias to collective bias, allows us to develop and validate three new aggregation measures that effectively counter sources of collective estimation error. In addition, we present results from a further experiment that quantifies the social influence rules that individuals employ when incorporating personal estimates with social information. We show that the corrected mean is remarkably robust to social influence, retaining high accuracy in the presence or absence of social influence, across numerosities and across different methods for averaging social information. Using knowledge of estimation biases and social influence rules may therefore be an inexpensive and general strategy to improve the wisdom of crowds.

Collision Detection for Underwater ROV Manipulator Systems.

Work-class ROVs equipped with robotic manipulators are extensively used for subsea intervention operations. Manipulators are teleoperated by human pilots relying on visual feedback from the worksite. Operating in a remote environment, with limited pilot perception and poor visibility, manipulator collisions which may cause significant damage are likely to happen. This paper presents a real-time collision detection algorithm for marine robotic manipulation. The proposed collision detection mechanism is developed, integrated into a commercial ROV manipulator control system, and successfully evaluated in simulations and experimental setup using a real industry standard underwater manipulator. The presented collision sensing solution has a potential to be a useful pilot assisting tool that can reduce the task load, operational time, and costs of subsea inspection, repair, and maintenance operations.