Do deepfake videos undermine our epistemic trust? A thematic analysis of tweets that discuss deepfakes in the Russian invasion of Ukraine.

Deepfakes are a form of multi-modal media generated using deep-learning technology. Many academics have expressed fears that deepfakes present a severe threat to the veracity of news and political communication, and an epistemic crisis for video evidence. These commentaries have often been hypothetical, with few real-world cases of deepfake's political and epistemological harm. The Russo-Ukrainian war presents the first real-life example of deepfakes being used in warfare, with a number of incidents involving deepfakes of Russian and Ukrainian government officials being used for misinformation and entertainment. This study uses a thematic analysis on tweets relating to deepfakes and the Russo-Ukrainian war to explore how people react to deepfake content online, and to uncover evidence of previously theorised harms of deepfakes on trust. We extracted 4869 relevant tweets using the Twitter API over the first seven months of 2022. We found that much of the misinformation in our dataset came from labelling real media as deepfakes. Novel findings about deepfake scepticism emerged, including a connection between deepfakes and conspiratorial beliefs that world leaders were dead and/or replaced by deepfakes. This research has numerous implications for future research, societal media platforms, news media and governments. The lack of deepfake literacy in our dataset led to significant misunderstandings of what constitutes a deepfake, showing the need to encourage literacy in these new forms of media. However, our evidence demonstrates that efforts to raise awareness around deepfakes may undermine trust in legitimate videos. Consequentially, news media and governmental agencies need to weigh the benefits of educational deepfakes and pre-bunking against the risks of undermining truth. Similarly, news companies and media should be careful in how they label suspected deepfakes in case they cause suspicion for real media.

Face/Off: Changing the face of movies with deepfakes.

There are growing concerns about the potential for deepfake technology to spread misinformation and distort memories, though many also highlight creative applications such as recasting movies using other actors, or younger versions of the same actor. In the current mixed-methods study, we presented participants (N = 436) with deepfake videos of fictitious movie remakes (such as Will Smith staring as Neo in The Matrix). We observed an average false memory rate of 49%, with many participants remembering the fake remake as better than the original film. However, deepfakes were no more effective than simple text descriptions at distorting memory. Though our findings suggest that deepfake technology is not uniquely placed to distort movie memories, our qualitative data suggested most participants were uncomfortable with deepfake recasting. Common concerns were disrespecting artistic integrity, disrupting the shared social experience of films, and a discomfort at the control and options this technology would afford.

The efficacy of interventions in reducing belief in conspiracy theories: A systematic review.

Conspiracy beliefs have become a topic of increasing interest among behavioural researchers. While holding conspiracy beliefs has been associated with several detrimental social, personal, and health consequences, little research has been dedicated to systematically reviewing the methods that could reduce conspiracy beliefs. We conducted a systematic review to identify and assess interventions that have sought to counter conspiracy beliefs. Out of 25 studies (total N = 7179), we found that while the majority of interventions were ineffective in terms of changing conspiracy beliefs, several interventions were particularly effective. Interventions that fostered an analytical mindset or taught critical thinking skills were found to be the most effective in terms of changing conspiracy beliefs. Our findings are important as we develop future research to combat conspiracy beliefs.

Establishing Requirements for Technology to Support Clinical Trial Retention: Systematic Scoping Review and Analysis Using Self-determination Theory.

BACKGROUND: Retaining participants in clinical trials is an established challenge. Currently, the industry is moving to a technology-mediated, decentralized model for running trials. The shift presents an opportunity for technology design to aid the participant experience and promote retention; however, there are many open questions regarding how this can be best supported. We advocate the adoption of a stronger theoretical position to improve the quality of design decisions for clinical trial technology to promote participant engagement. OBJECTIVE: This study aimed to identify and analyze the types of retention strategies used in published clinical trials that successfully retain participants. METHODS: A systematic scoping review was carried out on 6 electronic databases for articles published from 1990 to September 2020, namely CINAHL, The Cochrane Library, EBSCO, Embase, PsycINFO, and PubMed, using the concepts "retention," "strategy," "clinal trial," and "clinical research." This was followed by an analysis of the included articles through the lens of self-determination theory, an evidence-based theory of human motivation. RESULTS: A total of 26 articles were included in this review. The motivational strategies identified in the clinical trials in our sample were categorized into 8 themes: autonomy; competence; relatedness; controlled motivation; branding, communication material, and marketing literature; contact, tracking, and scheduling methods and data collection; convenience to contribute to data collection; and organizational competence. The trials used a wide range of motivational strategies. Notably, the trials often relied on controlled motivation interventions and underused strategies to support intrinsic motivation. Moreover, traditional clinical trials relied heavily on human interaction and "relatedness" to support motivation and retention, which may cause problems in the move to technology-led decentralized trials. We found inconsistency in the data-reporting methods and that motivational theory-based approaches were not evident in strategy design. CONCLUSIONS: This study offers direction and a framework to guide digital technology design decisions for future decentralized clinical trials to enhance participant retention during clinical trials. This research defines previous clinical trial retention strategies in terms of participant motivation, identifies motivational strategies, and offers a rationale for selecting strategies that will improve retention. It emphasizes the benefits of using theoretical frameworks to analyze strategic approaches and aid decision-making to improve the quality of technology design decisions.

Reducing drug-use harms among higher education students: MyUSE contextual-behaviour change digital intervention development using the Behaviour Change Wheel.

BACKGROUND: Digital harm-reduction interventions typically focus on people with severe drug-use problems, yet these interventions have moderate effectiveness on drug-users with lower levels of risk of harm. The difference in effectiveness may be explained by differences in behavioural patterns between the two groupings. Harnessing behavioural theories to understand what is at the core of drug-use behaviours and mapping the content of new interventions, may improve upon the effectiveness of interventions for lower-risk drug-users. To the best of our knowledge, this is the first study to systematically apply the Behaviour Change Wheel (BCW) approach to understand the components, influencing capabilities, opportunities, and motivations (COM-B) of higher education students to change their drug-use behaviors. It is also the first study which identifies specific patterns of behaviours that are more responsive to harm reduction practices through the use of the Theoretical Domain Framework (TDF). METHODS: We employed an explanatory sequential mix-method design. We first conducted an on-line survey and a Delphi exercise to understand the factors influencing COM-B components of higher education students to change their drug-use. Subsequently, we mapped all evidence onto the COM-B components and the TDF domains to identify clusters of behaviours to target for change, using a pattern-based discourse analysis. Finally, a series of multidisciplinary group meetings identified the intervention functions-the means by which the intervention change targeted behaviours and the Behavioural Change Techniques (BCTs) involved using the behaviour change technique taxonomy (v.1). RESULTS: Twenty-nine BCTs relevant to harm-reduction practices were identified and mapped across five intervention functions (education, modelling, persuasion, incentivization, and training) and five policy categories (communication/marketing, guidelines, regulation, service provision, and environmental/social planning). These BCTs were distributed across eight identified saturated clusters of behaviours MyUSE intervention attempts to change. CONCLUSIONS: The BCTs, identified, will inform the development of a digitally delivered behaviour change intervention that focuses on increasing mindful decision-making with respect to drug-use and promotes alternatives to drug-use activities. The findings can also inform implementation scientists in applying context-specific harm-reduction practices in higher education. We present examples of how the eight identified clusters of target behaviours are mapped across the COM-B components and the TDF, along with suggestions of implementation practices for harm reduction at student population level.

Brief Report: Analysis of Dental Treatment Provided Under General Anaesthesia for Children and Young Adults with Autistic Spectrum Disorder and Identification of Challenges for Dental Services.

Dental treatment provided under general anaesthesia (DGA) is an expectation for many children and young adults (CYA) diagnosed with Autistic Spectrum Disorder (ASD). Planning and delivery of DGA requires consideration of morbidity and mortality risks and implications for families and healthcare services. One hundred patient records of CYA with special healthcare needs were analysed to examine characteristics and experience of DGA revealing that 79% of CYA had a diagnosis of ASD. Forty-seven percent of CYA diagnosed with ASD had at least one previous hospital admission for DGA. For 24% of this repeat DGA group, the previous DGA was within a two-year period. Results highlight a high rate of DGA and need to investigate more effective primary dental care strategies.

A Digital Substance-Use Harm Reduction Intervention for Students in Higher Education (MyUSE): Protocol for Project Development.

BACKGROUND: Digital interventions have been identified as a possible tool for reducing the harm caused by illicit drug use among students attending higher education (ie, college students). However, the success of interventions in this area has been hampered by a lack of user involvement and behavior change theory in their design. The My Understanding of Substance use Experiences (MyUSE) project combines a rigorous user-centered design (UCD) methodology and a robust behavioral change framework to develop a digitally delivered harm reduction intervention for illicit drug use among students in higher education. OBJECTIVE: This project aims to design and develop a digital intervention that targets drug use-related harm among students in higher education. METHODS: The MyUSE project will take place over 3 phases. The first phase was exploratory in nature, involving 3 systematic reviews, a large survey, and student workshops to gather a comprehensive evidence base to guide the project. The second phase is the development stage of the project, involving the use of the Behavior Change Wheel theoretical framework to determine the behavior change techniques of the intervention and the use of the UCD methodology to guide the development of the digital intervention. The third phase is the evaluation stage, whereby the intervention will undergo a 5-stage evaluation process to comprehensively evaluate its impacts. RESULTS: The exploratory phase 1 of the MyUSE project was completed in December 2018. Phase 2 is currently underway, and phase 3 is due to begin in September 2020. CONCLUSIONS: Higher education institutions (HEIs) are ideally placed to intervene and support students in the area of illicit drug use but are constrained by limited resources. Current digital interventions in this area are sparse and have several weaknesses. The MyUSE project combines a UCD approach with a robust behavior change framework to develop a digitally delivered intervention that is economically viable, effective in changing behavior, usable and acceptable to students, and able to sustain long-term implementation in HEIs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/17829.

Theory in practice: identifying theory-based techniques in health coaches' tailored feedback during a weight loss intervention.

Objective: A taxonomy of ninety-three functionally different behaviour change techniques (BCTs) has been identified. However, it is not fully clear how these and other theory-based techniques are applied in the day-to-day practice of people delivering health behaviour change interventions. This study examines feedback provided by expert health coaches in a behavioural weight-loss intervention, to describe; a) what theory-based techniques are used in sessions, b) which techniques are used most frequently, c) what occurs in sessions, beyond existing theory-based techniques. Main Outcome Measures: Theory-based techniques (BCTs/tailoring strategies); relational/content-based techniques. Design: 10 tailored feedback videos from two health coaches were coded using a hybrid thematic analysis approach. Theory-based techniques were coded deductively; content not matching definitions of theory-based techniques but that addressed a determinant of behaviour change were coded inductively and relational codes were connected into themes. Results: Seventeen BCTs were coded M = 20.88 times (range:1-109). Eight tailoring techniques were coded M = 25.25 times (range:1-91). Relational themes included; 'Autonomous interpersonal coaching style,' 'Supportive accountability,' and 'Coach as expert'. Additional behavioural techniques were also identified. Conclusion: This work highlights what and how theory-based techniques are implemented in a weight-loss intervention, drawing attention to the role of tailoring techniques and health coaches in supporting behaviour change.

Smartphone Monitoring of Participants' Engagement With Home Practice During Mindfulness-Based Stress Reduction: Observational Study.

BACKGROUND: Standardized mindfulness training courses involve significant at-home assignments of meditation practice. Participants' self-reported completion of these assignments has been correlated with treatment outcomes, but self-reported data are often incomplete and potentially biased. In addition, mindfulness teachers typically suggest that participants set aside a regular practice time, preferably in the morning, but the extent to which participants do this has not been empirically examined. OBJECTIVE: This study aimed to analyze patterns of participant engagement with home practice in a mindfulness-based stress reduction course. METHODS: We used a novel smartphone app to provide 25 participants with access to their daily practice assignments during the 8-week course. We analyzed data collected through our smartphone app to determine usage and listening patterns and performed analyses of the regularity and frequency of participant behavior. RESULTS: We found that participants listened to a median of 3 of the 6 practice sessions per week, and they did not typically set aside a regular daily practice time. Across weekdays, participants practiced most frequently in the morning, but there was considerable variation in participants' practice start times. On weekends, the peak practice time was in the evening. CONCLUSIONS: We suggest that it is feasible to integrate a smartphone-monitoring approach into existing mindfulness interventions. High-frequency smartphone monitoring can provide insights into how and when participants complete their homework, information that is important in supporting treatment engagement.

Wide-field amacrine cell inputs to ON parasol ganglion cells in macaque retina.

Parasol cells are one of the major types of primate retinal ganglion cells. The goal of this study was to describe the synaptic inputs that shape the light responses of the ON type of parasol cells, which are excited by increments in light intensity. A connectome from central macaque retina was generated by serial blockface scanning electron microscopy. Six neighboring ON parasol cells were reconstructed, and their synaptic inputs were analyzed. On average, they received 21% of their input from bipolar cells, excitatory local circuit neurons receiving input from cones. The majority of their input was from amacrine cells, local circuit neurons of the inner retina that are typically inhibitory. Their contributions to the neural circuit providing input to parasol cells are not well-understood, and the focus of this study was on the presynaptic wide-field amacrine cells, which provided 17% of the input to ON parasol cells. These are GABAergic amacrine cells with long, relatively straight dendrites, and sometimes also axons, that run in a single, narrow stratum of the inner plexiform layer. The presynaptic wide-field amacrine cells were reconstructed, and two types were identified based on their characteristic morphology. One presynaptic amacrine cell was identified as semilunar type 2, a polyaxonal cell that is electrically coupled to ON parasol cells. A second amacrine was identified as wiry type 2, a type known to be sensitive to motion. These inputs likely make ON parasol cells more sensitive to stimuli that are rapidly changing outside their classical receptive fields.

Designing technology tools to support engagement in mindfulness-based interventions: an analysis of teacher and student experiences.

Standard mindfulness-based interventions have significant at-home assignments of formal mindfulness practice as a key component. Engagement with formal home practice has been correlated with treatment outcomes, but participants often complete less than the assigned amounts. Here, we explore the requirements for technology tools that can support and encourage home practice, in a way that is appropriate and consistent with the core principles of mindfulness-based interventions. Interviews were held with a group of five highly experienced mindfulness teachers and a group of five participants who had previously completed an eight-week course. Data was subjected to thematic analysis. A key finding was that providing teachers with information on how students practice could support communication around difficulties with home practice. We also identified questions around the appropriateness of adapting the course in response to participant difficulties and participant preferences. Both teachers and students made numerous suggestions for ways to augment their training using technology, such as via practice reminders and provision of teacher-specific content. Finally, a major design issue for technology developers is how to support participants in reflecting on their experiences of mindfulness practice, and subsequent learning, but not to critically evaluate their practice.

A systematic review of the effectiveness of digital interventions for illicit substance misuse harm reduction in third-level students.

BACKGROUND: Illicit substance misuse is a growing public health problem, with misuse peaking among 18-25 year-olds, and attendance at third-level education identified as a risk factor. Illicit substance misuse has the potential to harm mental and physical health, social relationships, and impact on academic achievements and future career prospects. Digital interventions have been identified as a vehicle for reaching large student populations and circumventing the limited capacity of student health services for delivering face-to-face interventions. Digital interventions have been developed in the area of alcohol and tobacco harm reduction, reporting some effectiveness, but the evidence for the effectiveness of digital interventions targeting illicit substance misuse is lacking. This review aims to systematically identify and critically appraise studies examining the effectiveness of digital interventions for illicit substance misuse harm reduction in third-level students. METHODS: We systematically searched ten databases in April 2018 using keywords and database specific terms under the pillars of "mHealth," "substance misuse," and "student." To be eligible for inclusion, papers had to present a measure of illicit substance misuse harm reduction. Included articles were critically appraised and included in the qualitative synthesis regardless of quality. RESULTS: A total of eight studies were included in the qualitative synthesis. Studies reported harm reduction in terms of substance misuse or initiation, as consequences or problems associated with substance misuse, or as correction of perceived social norms. Overall, five out of the eight studies reported at least one positive outcome for harm reduction. The critical appraisal indicated that the study quality was generally weak, predominantly due to a lack of blinding of study participants, and the use of self-reported substance misuse measures. However, results suggest that digital interventions may produce a modest reduction in harm from illicit substance misuse. CONCLUSIONS: The results of this review are positive, and support the need for further high-quality research in this area, particularly given the success of digital interventions for alcohol and tobacco harm reduction. However, very few studies focused solely on illicit substances, and those that did targeted only marijuana. This suggests the need for further research on the effectiveness of this type of intervention for other illicit substances. TRIAL REGISTRATION: This review is registered on PROSPERO, ID number: CRD42018097203 .

A systematic review of tailored eHealth interventions for weight loss.

OBJECTIVE: The aim of this study is to review the evidence for tailored eHealth weight-loss interventions, describing in detail: 1. how tailoring was implemented in these studies and 2. whether these tailored approaches were effective in producing weight loss compared with generic or inactive controls. METHODS: A systematic review was carried out. Five databases were searched up until 15 March, 2018, including: EBSCO, Science Direct, Pubmed, EMBASE and Web of Science, using combinations of the concepts 'tailoring', 'eHealth' and 'overweight'. RESULTS: Eight articles relating to six interventions were accepted. Tailoring was carried out in a number of ways, based on, for example, anthropometric data, health-related behaviours (e.g. dietary intake, physical activity), goals (e.g. weight goal), theoretical determinants (e.g. confidence/willingness to change behaviours), psychosocial factors (e.g. social support) and participant location. Systems acquired data using strategies that ranged from online questionnaire administration, to the dynamic gathering of data from web-based diaries, websites, mobile applications and SMS messaging. Tailored interventions were more effective in supporting weight loss than generic or waitlist controls in four of the six articles. Effect sizes were very small to moderate, with evidence for fluctuations in effect sizes and differences of effect between tailoring and non-tailoring interventions, and between tailoring types, over time. CONCLUSIONS: We contribute an enhanced understanding of the variety of methods used for the tailoring of eHealth interventions for weight loss and propose a model for categorising tailoring approaches.

Neural Mechanisms Mediating Motion Sensitivity in Parasol Ganglion Cells of the Primate Retina.

Considerable theoretical and experimental effort has been dedicated to understanding how neural circuits detect visual motion. In primates, much is known about the cortical circuits that contribute to motion processing, but the role of the retina in this fundamental neural computation is poorly understood. Here, we used a combination of extracellular and whole-cell recording to test for motion sensitivity in the two main classes of output neurons in the primate retina-midget (parvocellular-projecting) and parasol (magnocellular-projecting) ganglion cells. We report that parasol, but not midget, ganglion cells are motion sensitive. This motion sensitivity is present in synaptic excitation and disinhibition from presynaptic bipolar cells and amacrine cells, respectively. Moreover, electrical coupling between neighboring bipolar cells and the nonlinear nature of synaptic release contribute to the observed motion sensitivity. Our findings indicate that motion computations arise far earlier in the primate visual stream than previously thought.

Understanding Care Navigation by Older Adults With Multimorbidity: Mixed-Methods Study Using Social Network and Framework Analyses.

BACKGROUND: Health and social care systems were designed to be used primarily by people with single and acute diseases. However, a growing number of older adults are diagnosed with multiple long-term conditions (LTCs). The process of navigating the intricacies of health and social care systems to receive appropriate care presents significant challenges for older people living with multiple LTCs, which in turn can negatively influence their well-being and quality of life. OBJECTIVE: The long-term goal of this work is to design technology to assist people with LTCs in navigating health and social care systems. To do so, we must first understand how older people living with LTCs currently engage with and navigate their care networks. No published research describes and analyses the structure of formal and informal care networks of older adults with multiple LTCs, the frequency of interactions with each type of care service, and the problems that typically arise in these interactions. METHODS: We conducted a mixed-methods study and recruited 62 participants aged ≥55 years who were living in England, had ≥2 LTCs, and had completed a social network analysis questionnaire. Semistructured interviews were conducted with roughly a 10% subsample of the questionnaire sample: 4 women and 3 men. On average, interviewees aged 70 years and had 4 LTCs. RESULTS: Personal care networks were complex and adapted to each individual. The task of building and subsequently navigating one's personal care network rested mainly on patients' shoulders. It was frequently the patients' task to bridge and connect the different parts of the system. The major factor leading to a satisfying navigation experience was found to be patients' assertive, determined, and proactive approaches. Furthermore, smooth communication and interaction between different parts of the care system led to more satisfying navigation experiences. CONCLUSIONS: Technology to support care navigation for older adults with multiple LTCs needs to support patients in managing complex health and social care systems by effectively integrating the management of multiple conditions and facilitating communication among multiple stakeholders, while also offering flexibility to adapt to individual situations. Quality of care seems to be dependent on the determination and ability of patients. Those with less determination and fewer organization skills experience worse care. Thus, technology must aim to fulfill these coordination functions to ensure care is equitable across those who need it.

Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study.

BACKGROUND: Insomnia is a common psychological complaint. Cognitive behavioural therapy for insomnia (CBT-I), although effective, is little used because of lack of trained providers. Computerised CBT-I (CCBT-I) may be a solution to this shortfall in access. AIM: To explore patient and health professional perspectives and the role of social networking, to develop a novel CCBT-I programme to increase access to this form of intervention. DESIGN AND SETTING: Qualitative methods underpinned by the theory of planned behaviour in primary care in Lincolnshire and Nottinghamshire. METHOD: Semi-structured interviews and focus groups with a purposive sample of health professionals and adults with insomnia. RESULTS: A total of 23 health professionals and 28 patients were interviewed. Features designed to engender trust and improve functionality were perceived to improve uptake and adherence to CCBT-I. Trust lay in programme accreditation; for professionals, trust derived from evidence of effectiveness; for patients, trust depended on the doctor-patient relationship, professional support, the quality of online peer support, and perceptions of risk. Patients wanted mobile applications; access in short periods; self-assessment; interactive, personalised information on sleep; and moderated contact with other users. Patients and practitioners differed over whether useful information could be distinguished from less useful or potentially incorrect information. CONCLUSION: Improving uptake and adherence to online programmes for insomnia requires design features focusing on trust and functionality. Enabling greater patient control and interaction with other users and professionals may stimulate positive experiences of online therapy. CCBT-I would enable greater access to treatment but is limited by lack of online access or poor computer literacy.