Flawed Self-Assessment

Hand hygiene in emergencies: Multiprofessional perceptions from a mixed methods based online survey in Germany

Introduction

Despite high vulnerability to infection, hand disinfection compliance in emergencies is low. This is regularly justified as the disinfection procedure delays life support, and instead, wearing disposable gloves is preferred. Simulation studies showed higher achievable compliance than detected in real-life situations. This study aimed to explore healthcare providers' attitudes toward hand disinfection and using gloves in emergencies.

Methods

We conducted an anonymous online survey in Germany on the attitude and subjective behavior in the five moments of hand hygiene in a closed environment and an open convenience sampling survey. Statistics included paired student's t-tests corrected for multiple testing. For qualitative analysis, we employed a single-coder approach.

Results

In 400 participants, we detected low priority of WHO-1 (before touching a patient) and WHO-2 (before clean/aseptic procedure) hand hygiene moments, despite knowing the risks of omission of hand disinfection. For all moments, self-assessment exceeded the assessment of colleagues (p < 0.001). For WHO-3, we detected a lower disinfection priority for wearing gloves compared to contaminated bare hands. Qualitative analyses revealed five themes: basic conditions, didactic implementations, cognitive load, and uncertainty about feasibility and efficacy.

Discussion

Considering bias, the study's subjective nature, the unknown role of emergency-related infections contributing to hospital-acquired infections, and different experiences of healthcare providers, we conclude that hand disinfection before emergencies is de-prioritized and justified by the emergency situation regardless of the objective feasibility.

Conclusion

This study reveals subjective and objective barriers to implementation of WHO-1 and WHO-2 moments of hand disinfection to be further evaluated and addressed in educational programs.

Shadows of wisdom: Classifying meta-cognitive and morally grounded narrative content via large language models

We investigated large language models' (LLMs) efficacy in classifying complex psychological constructs like intellectual humility, perspective-taking, open-mindedness, and search for a compromise in narratives of 347 Canadian and American adults reflecting on a workplace conflict. Using state-of-the-art models like GPT-4 across few-shot and zero-shot paradigms and RoB-ELoC (RoBERTa -fine-tuned-on-Emotion-with-Logistic-Regression-Classifier), we compared their performance with expert human coders. Results showed robust classification by LLMs, with over 80% agreement and F1 scores above 0.85, and high human-model reliability (Cohen's κ Md across top models = .80). RoB-ELoC and few-shot GPT-4 were standout classifiers, although somewhat less effective in categorizing intellectual humility. We offer example workflows for easy integration into research. Our proof-of-concept findings indicate the viability of both open-source and commercial LLMs in automating the coding of complex constructs, potentially transforming social science research.

Wheeled repair alliance: Rolling out wheelchair repair and maintenance in community bicycle shops

The increasing population of wheelchair users in the United States highlights the importance of access to reliable and affordable wheelchair maintenance and repair. Having a well-maintained mobility device is essential to living a safe, healthy, and social life as a wheelchair user. Unfortunately, access to these services is limited. This study aims to address this need by developing and evaluating a workshop program designed to teach basic wheelchair maintenance skills to bike shop employees, allied health professionals, and wheelchair users themselves. The workshops covered key wheelchair maintenance tasks. Pre and post workshop surveys assessed participants' confidence in basic maintenance and repair skills and overall satisfaction with the workshop. Workshop participants reported increased confidence in all maintenance skills following the workshops and bike shop employees expressed increased confidence in their ability to work with and provide resources for wheelchair users. This study highlights that community-based workshops may help to enhance confidence in wheelchair maintenance skills, potentially aiding in bridging the gap in affordable and accessible repair services. The Wheeled Repair Alliance has the potential to empower wheelchair users and improve their quality of life. Further research should consider increasing the precision of measurements and assessing long-term outcomes related to wheelchair maintenance and repair.

Large environmental changes reduce valence-dependent belief updating

When updating beliefs, humans tend to integrate more desirable information than undesirable information. In stable environments (low uncertainty and high predictability), this asymmetry favors motivation towards action and perceived self-efficacy. However, in changing environments (high uncertainty and low predictability), this process can lead to risk underestimation and increase unwanted costs. Here, we examine how people (n = 388) integrate threatening information during an abrupt environmental change (mandatory quarantine during the COVID-19 pandemic). Given that anxiety levels are associated with the magnitude of the updating belief asymmetry; we explore its relationship during this particular context. We report a significant reduction in asymmetrical belief updating during a large environmental change as individuals integrated desirable and undesirable information to the same extent. Moreover, this result was supported by computational modeling of the belief update task. However, we found that the reduction in asymmetrical belief updating was not homogeneous among people with different levels of Trait-anxiety. Individuals with higher levels of Trait-anxiety maintained a valence-dependent updating, as it occurs in stable environments. On the other hand, updating behavior was not associated with acute anxiety (State-Anxiety), health concerns (Health-Anxiety), or having positive expectations (Trait-Optimism). These results suggest that highly uncertain environments can generate adaptive changes in information integration. At the same time, it reveals the vulnerabilities of individuals with higher levels of anxiety to adapt the way they learn.

Food fraud detection and reporting by food control officers in Finland

We studied food fraud detection and the reporting of suspected cases using a questionnaire survey and interviews with Finnish food control officers (FCOs). In total, 95 FCOs responded to the questionnaire, and 17 were interviewed. We found that even though many respondents had either suspected (69.2%) or detected (43.4%) food fraud or other food-related crime during the past five years, 46.8% thought they had no realistic chance of detecting food fraud during inspections. Challenges raised by the FCOs we interviewed included inadequate resources (8/17) and difficulties in inspecting documents or establishing their authenticity (14/17). Moreover, many interviewees highlighted difficulties in assessing whether to inform the police about a suspected case (7/17), and 62% (18/29) of respondents who had detected fraud had not reported it to the police. Training in food fraud detection, increased resources and guidelines on reporting suspected food fraud would improve food fraud detection and harmonize reporting.

Learning motivation and self-assessment in health economics: a survey on overconfidence in healthcare providers

INTRODUCTION

Lifelong learning is the foundation for professionals to maintain competence and proficiency in several aspects of economy and medicine. Until now, there is no evidence of overconfidence (the belief to be better than others or tested) and clinical tribalism (the belief that one's own group outperforms others) in the specialty of health economics. We investigated the hypothesis of overconfidence effects and their relation to learning motivation and motivational patterns in healthcare providers regarding healthcare economics.

METHODS

We conducted a national convenience online survey of 116 healthcare workers recruited from social and personal networks to detect overconfidence effects and clinical tribalism and to assess learning motivation. Instruments included self-assessments for five learning dimensions (factual knowledge, skills, attitude, problem-solving and behaviour) and a four-item situational motivation scale. The analysis comprised paired t-tests, correlation analyses and two-step cluster analyses.

RESULTS

We detected overplacement, overestimation and signs of clinical tribalism. Responders in the physician subgroup rated themselves superior to colleagues and that their professional group was superior to other professions. Participants being educators in other competencies showed high overconfidence in health economics. We detected two groups of learners: overconfident but motivated persons and overconfident and unmotivated learners. Learning motivation did not correlate with overconfidence effects.

DISCUSSION

We could show the presence of overconfidence in health economics, which is consistent with studies in healthcare and the economy. The subjective perception of some medical educators, being role models to students and having a superior 'attitude' (eg, morality) concerning the economy may foster prejudice against economists as students might believe them. It also may aggravate moral distress and disrupts interactions between healthcare providers managers and leaders. Considering the study's limitations, lifelong interprofessional and reflective training and train-the-trainer programmes may be mandatory to address the effects.

Examining the Outcomes of Project ECHO® as an Interprofessional Community of Practice for Pediatric Feeding Clinicians

Project ECHO® is a virtual, interprofessional, cased-based peer-learning model. To date, no studies have explored ECHO as a model for pediatric feeding education. This study examined the outcomes of establishing a pediatric feeding ECHO network. Using a prospective, mixed-methods design, two cohorts of allied health professionals were recruited. Each cohort participated in eight, 90-min videoconference sessions incorporating a didactic presentation and clinical case presentation. The case was presented by a participant, with questions and recommendations provided by the ECHO network. Participants completed: (1) a learning needs analysis before the ECHO series, (2) a self-reported confidence questionnaire pre, post, and 3-month post, (3) a satisfaction questionnaire after each session, and (4) an overall satisfaction questionnaire post-ECHO series. Time spent by hospital allied health clinicians providing impromptu phone/email feeding support to external clinicians was recorded for 8 weeks prior to and 8 weeks during the ECHO series. Forty-seven participants were included in the study, attending an average of 5.8 sessions. Significant improvements in self-reported confidence were observed across the three time points (p < 0.01) with less experienced participants demonstrating greater improvements. Participants reported high satisfaction with ECHO, with 93% (40/43) wanting continued access to ECHO in future. The multidisciplinary format, interactivity, structure, and case-based nature of ECHO were considered beneficial. A 75% reduction in requests for support from clinicians in the same catchment area was noted during the ECHO series. Results demonstrated that Project ECHO is a viable model for pediatric feeding education for clinicians working in the field. Further research is needed to investigate the long-term effects and impacts on clinical care.

Critical review of self-diagnosis of mental health conditions using artificial intelligence

The advent of artificial intelligence (AI) has revolutionised various aspects of our lives, including mental health nursing. AI-driven tools and applications have provided a convenient and accessible means for individuals to assess their mental well-being within the confines of their homes. Nonetheless, the widespread trend of self-diagnosing mental health conditions through AI poses considerable risks. This review article examines the perils associated with relying on AI for self-diagnosis in mental health, highlighting the constraints and possible adverse outcomes that can arise from such practices. It delves into the ethical, psychological, and social implications, underscoring the vital role of mental health professionals, including psychologists, psychiatrists, and nursing specialists, in providing professional assistance and guidance. This article aims to highlight the importance of seeking professional assistance and guidance in addressing mental health concerns, especially in the era of AI-driven self-diagnosis.

The Development and Feasibility of a Novel Group Intervention to Support Helping Professionals in Metabolizing Suffering and Engaging Strengths: The CHRYSALIS Program

This feasibility study reports on the development and initial evaluation of a novel online intervention for helping professionals (HPs; i.e. mental health professionals, chaplains, clergy) designed to (a) address occupational hazards, such as burnout and vicarious traumatization, and (b) promote well-being and flourishing at work. In contrast with competency and self-care focused models, the CHRYSALIS (Catalyzing Helping Professionals' Resilience, VitalitY, Spirituality, Authentic Living, and Inner Strength) intervention centers the self of the provider, explores cultural and spiritual contexts, and attends to systemic challenges. As part of a larger randomized controlled trial evaluating two program formats, the group format entails eight online sessions exploring strengths that can promote well-being, including processing, relational, vitalizing, orienting, and agentic capacities. To pilot test this framework and establish proof of concept, this study analyzed data from 41 HPs who had been randomly assigned to the group condition and completed surveys at four time points. Quantitative results indicated significant reductions in vicarious traumatization and burnout as well as increased well-being and meaning in work. Qualitative results suggest the intervention fostered relational support, cultivated new perspectives, and increased engagement with strengths, positively impacting participants' work and navigation of caregiving systems. Feedback about cohesion and group dynamic challenges in an online format informed further program development. This study provides initial support for the feasibility and efficacy of the group format of the CHRYSALIS intervention as a creative means to address HPs' risk for occupational hazards and promote holistic formation in a relational context.

Subjectively salient faces differ from emotional faces: ERP evidence

The self-face is processed differently than emotional faces. A question arises whether other highly familiar and subjectively significant non-self faces (e.g. partner's face) are also differentiated from emotional faces. The aim of this event-related potential (ERP) study was to investigate the neural correlates of personally-relevant faces (the self and a close-other's) as well as emotionally positive (happy) and neutral faces. Participants were tasked with the simple detection of faces. Amplitudes of N170 were more negative in the right than in the left hemisphere and were not modulated by type of face. A similar pattern of N2 and P3 results for the self-face and close-other's face was observed: they were associated with decreased N2 and increased P3 relative to happy and neutral faces. However, the self-face was preferentially processed also when compared to a close-other's face as revealed by lower N2 and higher P3 amplitudes. Nonparametric cluster-based permutation tests showed an analogous pattern of results: significant clusters for the self-face compared with all other faces (close-other's, happy, neutral) and for close-other's face compared to happy and neutral faces. In summary, the self-face prioritization was observed, as indicated by significant differences between one's own face and all other faces. Crucially, both types of personally-relevant faces differed from happy faces. These findings point to the pivotal role of subjective evaluation of the saliency factor.

A newly detected bias in self-evaluation

The widely observed positive bias on self-evaluation is mainly explained by the self-enhancement motivation which minimizes negative feedbacks and emphasizes positive ones. Recent agent based simulations suggest that a positive bias also emerges if the sensitivity to feedbacks decreases when the self-evaluation increases. This paper proposes a simple mathematical model in which these different biases are integrated. Moreover, it describes an experiment (N = 1509) confirming that the sensitivity to feedbacks tends to decrease when self-evaluation increases and that a directly related positive bias is detected.

Subjective Confidence as a Monitor of the Replicability of the Response

Confidence is commonly assumed to monitor the accuracy of responses. However, intriguing results, examined in the light of philosophical discussions of epistemic justification, suggest that confidence actually monitors the reliability of choices rather than (directly) their accuracy. The focus on reliability is consistent with the view that the construction of truth has much in common with the construction of reality: extracting reliable properties that afford prediction. People are assumed to make a binary choice by sampling cues from a "collective wisdomware," and their confidence is based on the consistency of these cues, in line with the self-consistency model. Here, however, I propose that internal consistency is taken to index the reliability of choices themselves-the likelihood that they will be repeated. The results of 10 studies using binary decisions from different domains indicated that confidence in a choice predicts its replicability both within individuals and across individuals. This was so for domains for which choices have a truth value and for those for which they do not. For the former domains, differences in replicability mediated the prediction of accuracy whether confidence was diagnostic or counterdiagnostic of accuracy. Metatheoretical, methodological, and practical implications are discussed.

The future of metacognition research: Balancing construct breadth with measurement rigor

Foundational work in the psychology of metacognition identified a distinction between metacognitive knowledge (stable beliefs about one's capacities) and metacognitive experiences (local evaluations of performance). More recently, the field has focused on developing tasks and metrics that seek to identify metacognitive capacities from momentary estimates of confidence in performance, and providing precise computational accounts of metacognitive failure. However, this notable progress in formalising models of metacognitive judgments may come at a cost of ignoring broader elements of the psychology of metacognition - such as how stable meta-knowledge is formed, how social cognition and metacognition interact, and how we evaluate affective states that do not have an obvious ground truth. We propose that construct breadth in metacognition research can be restored while maintaining rigour in measurement, and highlight promising avenues for expanding the scope of metacognition research. Such a research programme is well placed to recapture qualitative features of metacognitive knowledge and experience while maintaining the psychophysical rigor that characterises modern research on confidence and performance monitoring.

Computerized Suicide Prevention Clinical Training Simulations: A Pilot Study

Purpose

Mental health providers are well-positioned to engage in suicide prevention efforts, yet implementation depends on skill acquisition and providers often report feeling underprepared. This pilot study explored the acceptability, feasibility, and preliminary effectiveness of three suicide prevention-focused simulations with virtual clients.

Method

Students (n=22) were recruited from a MSW program, completed pre- and post-test surveys, and engaged with three simulated trainings: 1) suicide risk assessment, 2) safety planning, and 3) motivating a client to treatment.

Results

Simulations were reported to be acceptable and feasible, with strong student desire and need for greater suicide prevention training. We observed significant improvements over time in clinical skills via simulated training scores and perceptions of clinical preparedness.

Discussion

Preliminary findings indicate simulated training with virtual clients is promising and suggest the three suicide prevention simulations may be useful, scalable, and effective in social work training programs and beyond.

Unskilled, underperforming, or unaware? Testing three accounts of individual differences in metacognitive monitoring

Many studies show that competence (e.g., skill, expertise, natural ability) influences individuals' capabilities of monitoring their item-level performance. However, debate persists about how best to explain these individual differences in metacognition. The competence-based account ascribes differences in monitoring to individuals' objective ability level, arguing that the same skills necessary to perform a task are required to effectively monitor performance. The performance-based account attributes differences in monitoring to changes in overall task performance - no individual differences in competence required. Finally, the metacognitive awareness account proposes that alignment between an individuals' self-assessed and objective ability leads to differences in monitoring. In this study, 603 participants completed a self-assessment of face recognition ability, a lineup identification task, and an objective assessment of face recognition ability. We manipulated the number of encoding repetitions and delay between encoding and test to produce varying levels of task performance across objective face recognition ability. Following each lineup decision, participants provided both a numeric confidence rating and a written expression of verbal confidence. We transformed verbal confidence into a quantitative value using machine learning techniques. When matched on overall identification accuracy, objectively stronger face recognizers used numeric and verbal confidence that a) better discriminates between correct and filler lineup identifications than weaker recognizers, and b) shows better calibration to accuracy. Participants with greater self-assessed ability used higher levels of confidence, irrespective of trial accuracy. These results support the competence-based account.

Knowing more than we know: metacognition, semantic fluency, and originality in younger and older adults

We examined age-related similarities and differences in people's metacognitive awareness of retrieval from semantic long-term memory as well as the originality of their responses. Participants completed several semantic fluency tasks, and before recalling items, made metacognitive predictions of their performance. Additionally, after retrieval, participants made metacognitive evaluations of the originality of their responses. Results revealed that both younger (Mage = 24.49) and older adults (Mage = 68.31) were underconfident in their performance, despite some metacognitive awareness of their ability to retrieve information from semantic memory. Younger and older adults became more metacognitively aware of their abilities with task experience, but there were no significant differences in participants' metacognitive predictions and postdictions, although older adults believed that they were less original than younger adults. These findings revealed a "skilled and unaware" effect whereby participants were underconfident on the first trial and became less underconfident on later trials. These patterns may fit with a broader literature that has found a lack of adult age differences in metacognition for verbal skills but shows that older adults may believe that their access to original verbal knowledge may decline in older age.

Knowledge, Attitudes, and Behaviours Concerning the Mediterranean Diet Among Older Adults in Australia

Despite the growing body of evidence demonstrating the positive health effects of the Mediterranean diet, it is not routinely recommended in practice and adherence is low in the general population in Australia. The knowledge-attitude-behaviour model explains how health behaviours are supported through a process of acquiring knowledge, developing attitudes, and forming behaviours. Evidence has suggested that having a high level of nutrition-related knowledge is associated with more positive attitudes, which is directly linked to positive dietary behaviours. However, reports of knowledge and attitudes towards the Mediterranean diet, and how these directly relate to behaviours in older adults, are lacking. This study explored Mediterranean diet-related knowledge, attitudes, and behaviours among community-dwelling older adults in Australia. Participants were adults aged 55 years and older who completed an online survey that contained three parts: (a) knowledge - Mediterranean Diet Nutrition Knowledge Questionnaire (Med-NKQ); (b) nutrition-related attitudes and behaviours, and barriers and enablers to dietary change; (c) demographics. The sample included 61 adults who ranged in age from 55 to 89 years. The overall knowledge score was 30.5 out of a possible 40 points, with 60.7% classified as having a high level of knowledge. Knowledge was lowest for nutrient content and label reading. Attitudes and behaviours were generally positive and were not associated with level of knowledge. The most common barriers to dietary change were perceived cost and lack of knowledge, and motivational factors. There are a number of key gaps in knowledge that should be addressed through targeted educational programs. Strategies and tools to overcome perceived barriers and improve self-efficacy are needed to facilitate positive dietary behaviours.

COVID-19 vaccination telephone outreach: an analysis of the medical student experience

INTRODUCTION

The COVID-19 pandemic diminished opportunities for medical students to gain clinical confidence and the ability to contribute to patient care. Our study sought out to understand the value of telephone outreach to schedule COVID-19 vaccines on medical student education.

MATERIALS AND METHODS

Forty students engaged in telephone outreach targeting patients aged 65+ without active patient portals to schedule COVID-19 vaccines. Data consisted of a single administration retrospective pre/post survey inquiring about what students learned, expectations, other health-care processes that would benefit from outreach, and interest in a population health elective. Likert items were analyzed and open response analysis involved inductive coding and generation of thematic summaries by condensing codes into broader themes. Demographic data of patients called and subsequently received the vaccine were also collected.

RESULTS

There were 33 survery respondents. There was a statistically significant increase in net comfortability for pre-clerkship students for documenting in Epic, providing telehealth care, counseling on common health-care myths, having challenging conversations, cold-calling patients, and developing an initial trusting relationship with patients. The majority called and who received the vaccine were non-Hispanic Black, within the high SVI category, and had Medicare and/or Medicaid. Qualitative data showed that students emphasized communication, the role of trusted messengers, the need to be open minded, and meeting patients where they are.

DISCUSSION

Engaging students in telephone outreach early in the COVID-19 pandemic provided students the opportunity to develop their skills as physicians-in-training, contribute to combating the ongoing pandemic, and add value to the primary care team. This experience allowed students to practice patience, empathy, and vulnerability to understand why patients had not received the COVID-19 vaccine; this was an invaluable experience that helped students develop the skills to become empathetic and caring physicians, and supports the continued role of telehealth in future medical school curriculum.

Gaming passion contributes to the definition and identification of problematic gaming

Even if for most people playing video games is a healthy leisure activity, a minority of vulnerable users present an excessive use associated to negative consequences (e.g., psychosocial maladjustment, sleep interference) and functional impairment. The current study first aims to identify psychological factors that contribute to discriminate highly involved (but healthy) gamers from problematic gamers. For that purpose, we used a cluster analysis approach to identify different groups of gamers based on their profiles of passion towards gaming (using the Dualistic Model of Passion). Another objective of the present study is to explore, using supervised machine-learning, how gaming disorder symptoms, assessed within the substance use disorder framework (e.g., tolerance, withdrawal), might be linked to harmonious and/or an obsessive passion for gaming. Three distinct clusters of gamers were identified based on their passion profiles, including risky gamers, engaged gamers, and casual gamers. Supervised machine-learning algorithms identified that specific gaming disorder symptoms (salience, mood modification, tolerance, low level of conflict) were predominantly related to harmonious passion, whereas others (withdrawal, high level of conflict, relapse) were more directly related to obsessive passion. Our results support the relevance of person-centered approaches to the treatment of problematic gaming.

The Relations between Father-Perceived Family Strength and Maternal Gatekeeping in Chinese Families-Focusing on the Dual Mediation Effect of Father Involvement and Mutual Communication

According to Murray Bowen's family systems theory, the family is an emotional unit where members influence each other. Family strength, in that members care for, respect, and communicate with each other sincerely and freely and overcome difficulties together through joint efforts, is what every family yearns for and pursues. Maternal gatekeeping behavior not only affects the relationship between each family member but also has an impact on family strength. Father-perceived family strength and maternal gatekeeping were investigated in this study, along with the mediation effect of father involvement and mutual communication. In total, 320 fathers of children aged 3-5 were randomly recruited to complete self-report questionnaires. The correlation results indicated that maternal gate-opening behavior, father involvement, mutual communication, and family strength are positively correlated with each other, whereas maternal gate closing is negatively associated with father involvement, mutual communication, and family strength. Path analysis verified the partial (dual) mediation effect of father involvement and mutual communication between maternal gate opening and family strength, as well as a complete (dual) mediation effect upon maternal gate closing. The current study provides new insights into understanding the underlying mechanisms of father-perceived family strength influenced by maternal gatekeeping behavior. Meanwhile, the mediation effect of father involvement and mutual communication also highlights the importance of parenting preparation for fathers, such as psychological self-adjustment, especially under interception or restriction.

Toward a General Framework of Biased Reasoning: Coherence-Based Reasoning

A considerable amount of experimental research has been devoted to uncovering biased forms of reasoning. Notwithstanding the richness and overall empirical soundness of the bias research, the field can be described as disjointed, incomplete, and undertheorized. In this article, we seek to address this disconnect by offering "coherence-based reasoning" as a parsimonious theoretical framework that explains a sizable number of important deviations from normative forms of reasoning. Represented in connectionist networks and processed through constraint-satisfaction processing, coherence-based reasoning serves as a ubiquitous, essential, and overwhelmingly adaptive apparatus in people's mental toolbox. This adaptive process, however, can readily be overrun by bias when the network is dominated by nodes or links that are incorrect, overweighted, or otherwise nonnormative. We apply this framework to explain a variety of well-established biased forms of reasoning, including confirmation bias, the halo effect, stereotype spillovers, hindsight bias, motivated reasoning, emotion-driven reasoning, ideological reasoning, and more.

When Feedback is Not Perceived as Feedback: Challenges for Regulatory Body-Mandated Peer Review

PURPOSE

Safe and competent patient care depends on physicians recognizing and correcting performance deficiencies. Generating effective insight depends on feedback from credible sources. Unfortunately, physicians often have limited access to meaningful guidance. To facilitate quality improvement, many regulatory authorities have designed peer-facilitated practice enhancement programs. Their mandate to ensure practice quality, however, can create tension between formative intentions and risk (perceived or otherwise) of summative repercussions. This study explored how physicians engage with feedback when required to undergo review.

METHOD

Between October 2018 and May 2020, 30 physicians representing various specialties and career stages were interviewed about their experiences with peer review in the context of regulatory body-mandated programs. Twenty had been reviewees and reviewers and, hence, spoke from both vantage points. Interview transcripts were analyzed using a 3-stage coding process informed by constructivist grounded theory.

RESULTS

Perceptions about the learning value of mandated peer review were mixed. Most saw value but felt anxiety about being selected due to being wary of regulatory bodies. Recognizing barriers such perceptions could create, reviewers described techniques for optimizing the value of interactions with reviewees. Their strategies aligned well with the R2C2 feedback and coaching model with which they had been trained but did not always overcome reviewees' concerns. Reasons included that most feedback was "validating," aimed at "tweaks" rather than substantial change.

CONCLUSIONS

This study establishes an intriguing and challenging paradox: feedback appears often to not be recognized as feedback when it poses no threat, yet feedback that carries such threat is known to be suboptimal for inducing performance improvement. In efforts to reconcile that tension, the authors suggest that peer review for individuals with a high likelihood of strong performance may be more effective if expectations are managed through feedforward rather than feedback.

Raring to go? A cross-sectional survey of student paramedics on how well they perceive their UK pre-registration course to be preparing them to manage suspected seizures

BACKGROUND

Paramedics convey a high proportion of seizure patients with no clinical need to emergency departments (EDs). In a landmark study, only 27% of UK paramedics reported being "Very…"/ "Extremely confident" making seizure conveyance decisions. Improved pre-registration education on seizures for paramedics is proposed. Clarity is needed on its potential given recent changes to how UK paramedics train (namely, degree, rather than brief vocational course). This study sought to describe UK student paramedics' perceived readiness to manage seizures and educational needs; compare this to what they report for other presentations; and, explore subgroup differences.

METHODS

Six hundred thirty-eight students, in year 2 or beyond of their pre-registration programme completed a cross-sectional survey. They rated perceived confidence, knowledge, ability to care for, and educational needs for seizures, breathing problems and, headache. Primary measure was conveyance decision confidence.

RESULTS

For seizures, 45.3% (95% CI 41.4-49.2) said they were "Very…"/"Extremely confident" to make conveyance decisions. This was similar to breathing problems, but higher than for headache (25.9%, 95% CI 22.6-29.5). Two hundred and thirty-nine participants (37.9%, 95% CI 34.1-41.8) said more seizure education was required - lower than for headache, but higher than for breathing problems. Subgroup differences included students on university-based programmes reporting more confidence for conveyance decisions than those completing degree level apprenticeships.

CONCLUSIONS

Student paramedics report relatively high perceived readiness for managing seizures. Magnitude of benefit from enhancements to pre-registration education may be more limited than anticipated. Additional factors need attention if a sizeable reduction to unnecessary conveyances for seizures is to happen.

Understanding and managing the Self-Wise during a healthcare crisis

The COVID-19 pandemic has brought an interesting yet worrisome phenomenon to the fore. A segment of the population, which we call the Self-Wise, seems to exhibit an inflated sense of self-expertise relative to domain experts, which - combined with a lack of trust in the latter - leads them to ignore or reject expert advice. We argue and demonstrate that this phenomenon is distinct from other "illusory superiority" phenomena, most notably Dunning-Kruger and Lake Wobegon. Three studies with US participants provide compelling evidence for the existence of the Self-Wise phenomenon. In the context of COVID-19, its behavioral consequences are non-compliance with expert-based COVID-19 guidelines and measures (e.g., wearing a mask and getting vaccinated). The studies also provide insight into additional characteristics of the Self-Wise, which can be used for identification and targeting purposes. We tested the effectiveness of two tailored interventions that aimed at reducing this segment's "illusory superiority" and (re-)establishing their trust in medical experts. The interventions proved effective in terms of reducing the "illusory superiority" of the Self-Wise, and generally enhanced the participants' intention to comply with COVID-19 guidelines. However, to substantially change the non-conforming COVID-19 behavior of the Self-Wise likely requires stronger and sustained mitigation strategies or interventions.

Development and initial validation of the Animal Welfare Cultural Competence Inventory (AWCCI) to assess cultural competence in animal welfare

Cultural competence is recognized as critical to reducing disparities within human healthcare settings, but it is rarely incorporated into evaluations of companion animal services. We developed and validated an animal welfare-focused cultural competence instrument with client and provider versions. We then used the instrument to assess the relationship between animal welfare providers' cultural competence and services provided to clients in historically underserved communities. 24 providers across 17 sites participated in the provider survey. 422 clients across those sites also participated and had their service utilization data analyzed. We found a significant correlation between the number of client-provider interactions and their level of agreement within the instrument's "competence/confidence" subscale. We also found that these interactions had a significant correlation with veterinarian care and spay/neuter services. This study provides initial evidence that increasing the use of culturally competent engagement strategies has the potential to increase service utilization for pets in historically underserved communities.

When thinking you are better leads to feeling worse: Self-other asymmetries in pro-social behavior and increased anxiety during Covid-19

Self-serving biases (e.g., beliefs that one tends to perform better than peers) are generally associated with positive psychological outcomes like increased self-esteem and resilience. However, this tendency may be problematic in the context of collective action problems, wherein individuals are reliant on others' pro-social behaviors to achieve larger goals. We examined this question in the context of the Covid-19 pandemic, and recruited participants for an online study (n = 1023) from a university community in Spring 2020. We found evidence for self-peer asymmetries in Covid-related knowledge and restriction behavior, such that participants reported that they knew more about Covid-related symptoms, were doing more to stop the spread of the disease, and were more pro-socially motivated in doing so than peers. Actual peer reports indicated that these were overestimations. This self-enhancement comes with a cost: the perceived self-peer restriction behavior asymmetry had an indirect effect on the positive relationships both from Covid-specific worry and from perceived stress to general anxiety symptom intensity during the early lockdown period. People tended to have more severe symptoms of anxiety when they were more worried about Covid-19 and when they reported greater perceived stress, especially when they underestimated others' contributions to public health action relative to their own. This suggests that lack of trust in others' pro-sociality may be personally maladaptive for mental health.

International health initiative: Development and pilot testing of a molecular diagnostics training program in Romania

OBJECTIVES

The implementation of nucleic acid testing in laboratory medicine has revolutionized clinical diagnosis. Unfortunately, incorporation of these technologies in less developed countries remains a challenge. Despite Romania's recent economic growth, the country is in dire need of medical and laboratory staff trained in modern technologies. The aim of the study was to develop a curriculum that could easily be delivered to laboratory professionals in Romania and to pilot test the effectiveness of the training in increasing their understanding of molecular tests.

METHODS

The program was developed in accordance with the US Centers for Disease Control and Prevention's (CDC's) quality training standards. It was offered to 50 laboratory professionals and consisted of online, asynchronous lectures and optional synchronous review sessions. Training effectiveness was evaluated using CDC guidelines based on pre- and postassessment questions answered anonymously.

RESULTS

Forty-two people participated in the program, and 32 (81%) completed the training successfully. Based on 16 participants' self-assessment, the course was successful in improving learners' overall knowledge of molecular diagnostics-specifically, their understanding of molecular techniques and how to interpret results. Those participants were highly satisfied with the overall training.

CONCLUSIONS

The piloted platform presented here is promising and can be a foundation for future larger-scale studies in countries with developing health systems.

There is no belief update bias for neutral events: failure to replicate Burton et al. (2022)

In a recent paper, Burton et al. claim that individuals update beliefs to a greater extent when learning an event is less likely compared to more likely than expected. Here, we investigate Burton's et al.'s, findings. First, we show how Burton et al.'s data do not in fact support a belief update bias for neutral events. Next, in an attempt to replicate their findings, we collect a new data set employing the original belief update task design, but with neutral events. A belief update bias for neutral events is not observed. Finally, we highlight the statistical errors and confounds in Burton et al.'s design and analysis. This includes mis-specifying a reinforcement learning approach to model the data and failing to follow standard computational model fitting sanity checks such as parameter recovery, model comparison and out of sample prediction. Together, the results find little evidence for biased updating for neutral events.

How nervous am I? How computer vision succeeds and humans fail in interpreting state anxiety from dynamic facial behaviour

For human interaction, it is important to understand what emotional state others are in. Especially the observation of faces aids us in putting behaviours into context and gives insight into emotions and mental states of others. Detecting whether someone is nervous, a form of state anxiety, is such an example as it reveals a person's familiarity and contentment with the circumstances. With recent developments in computer vision we developed behavioural nervousness models to show which time-varying facial cues reveal whether someone is nervous in an interview setting. The facial changes, reflecting a state of anxiety, led to more visual exposure and less chemosensory (taste and olfaction) exposure. However, experienced observers had difficulty picking up these changes and failed to detect nervousness levels accurately therewith. This study highlights humans' limited capacity in determining complex emotional states but at the same time provides an automated model that can assist us in achieving fair assessments of so far unexplored emotional states.

The neuroscience of social comparison and competition

The study of competition from a social comparison perspective offers valuable insights into the neuroscience of social judgment and decision making under uncertainty. When engaging in social comparison, individuals seek and assess information about similarities or differences between others and themselves, in large part to improve their self-evaluation. By providing information about one's relative position, abilities, outcomes, and more, social comparisons can inform competitive judgments and decisions. People reasonably turn to social comparisons to reduce uncertainty before, during, and after competition. However, the extent to which they do so and the behavioral consequences of social comparisons often fail to match the potential benefits of improved self-evaluation. An examination of the developing neuroscience of social comparison and competition in light of the behavioral evidence reveals numerous questions that merit further investigation.

Overconfidence effects and learning motivation refreshing BLS: An observational questionnaire study

Aim of the study

Regular refresher skill courses are necessary to maintain competence in basic life support. The utilization of these training programs strongly depends on the motivation to learn. Learning motivation may be affected by overconfidence and clinical tribalism, as they both imply a higher competence compared to others, and therefore, a lower demand for training. This study aimed to assess how overconfidence in basic life support competencies affects learning motivation.

Methods

We conducted a cross-sectional, observational, multicenter, anonymous online questionnaire survey using validated psychometric tests for healthcare professionals in Germany. Further, we tested participants' knowledge and attitude regarding international basic life support guidelines. The study was conducted between March and April 2022, and healthcare providers from 22 German emergency medical services and hospitals at all levels were assessed.

Results

Of 2,000 healthcare professionals assessed, 407 completed the assessment (response rate, 20.4%). We confirmed the presence of overconfidence and clinical tribalism (identity differentiation between social groups) among the 407 physicians, nurses, and emergency medical service providers who completed the survey. Three different learning-motivation groups emerged from cluster analysis: "experts" (confident and motivated), "recruitables" (overconfident and motivated), and "unawares" (overconfident and unmotivated). The three groups were present in all professional groups, independent of the frequency of exposure to cardiac arrest and educational level.

Conclusions

These findings showed the presence of overconfidence effects and different learning motivation types in individuals learning basic life support, even in instructors.

Overconfidence at the time of COVID-19:Does it lead to laxer attitudes?

BACKGROUND

Health education campaigns often aim to create awareness by increasing objective knowledge about pathogens, such as COVID-19. However, the present paper proposes that confidence in one's knowledge more than knowledge is a significant factor that leads to a laxer attitude toward COVID-19 and hence lower support for protective measures and reduced intention to comply with preemptive behaviors.

METHODS

We tested two hypotheses in three studies conducted between 2020 and 2022. In Study 1, we assessed participants' level of knowledge and confidence, as well as attitudes toward COVID-19. In Study 2, we tested the relation between fear of COVID-19 and protective behaviors. In Study 3, we used an experimental approach to show the causal effect of overconfidence on fear of COVID-19. In addition to manipulating overconfidence and measuring fear of COVID-19, we also measured prophylactic behaviors.

RESULTS

In Study 1, more overconfident participants had a laxer attitude toward COVID-19. While knowledge had an increasing effect on worry, confidence in said knowledge significantly decreased worry about COVID-19. In Study 2, participants who were more worried about COVID-19 were more likely to engage in protective behaviors (e.g., wearing masks). In Study 3, we show that when overconfidence was experimentally diminished, fear of COVID-19 increased. The results support our claim that the effect of overconfidence on attitudes toward COVID-19 is causal in nature. Moreover, the results show that people with higher fear of COVID-19 are more likely to wear masks, use hand sanitizers, avoid crowded places or social gatherings, and get vaccinated.

CONCLUSIONS

Managing adherence to public health measures is critical when it comes to highly infectious diseases. Our findings suggest that efficient information campaigns to increase adherence to public health measures should focus on calibrating people's confidence in their knowledge about COVID-19 to prevent the spread of the virus.

Comprehensive evaluation of a cutaneous T-cell lymphoma education webinar

BACKGROUND

Effective and timely referral, treatment and care of people with cutaneous T-cell lymphoma (CTCL) depend on clinical staff possessing highly specialised knowledge and skills. Because of the fragmented nature of the CTCL workforce, specialist education was delivered via a webinar.

AIM

The study aimed to comprehensively evaluate the webinar and test the validity of using an evaluation model for a one-off education event.

METHODS

The webinar was evaluated using Moore et al's conceptual model for evaluation of education. Data were collected using polling questions and post-webinar questionnaires and analysed using descriptive summaries and content analysis.

FINDINGS

Respondents agreed or strongly agreed that the webinar was an effective way to learn, enjoyable, relevant to their role and interesting. Learners also reported improvements in awareness, knowledge and understanding of CTCL, its referral and treatment.

CONCLUSION

Evaluating one-off education events using a conceptual model of evaluation for continuous medical education is recommended, with some adaptations to overcome limitations.

Numeracy, gist, literal thinking and the value of nothing in decision making

The onus on the average person is greater than ever before to make sense of large amounts of readily accessible quantitative information, but the ability and confidence to do so are frequently lacking. Many people lack practical mathematical skills that are essential for evaluating risks, probabilities and numerical outcomes such as survival rates for medical treatments, income from retirement savings plans or monetary damages in civil trials. In this Review, we integrate research on objective and subjective numeracy, focusing on cognitive and metacognitive factors that distort human perceptions and foment systematic biases in judgement and decision making. Paradoxically, an important implication of this research is that a literal focus on objective numbers and mechanical number crunching is misguided. Numbers can be a matter of life and death but a person who uses rote strategies (verbatim representations) cannot take advantage of the information contained in the numbers because 'rote' strategies are, by definition, processing without meaning. Verbatim representations (verbatim is only surface form, not meaning) treat numbers as data as opposed to information. We highlight a contrasting approach of gist extraction: organizing numbers meaningfully, interpreting them qualitatively and making meaningful inferences about them. Efforts to improve numerical cognition and its practical applications can benefit from emphasizing the qualitative meaning of numbers in context - the gist - building on the strengths of humans as intuitive mathematicians. Thus, we conclude by reviewing evidence that gist training facilitates transfer to new contexts and, because it is more durable, longer-lasting improvements in decision making.

I Will Get Myself Vaccinated for Others: The Interplay of Message Frame, Reference Point, and Perceived Risk on Intention for COVID-19 Vaccine

The purpose of this study is to seek an effective strategy to promote COVID-19 vaccination among young adults. Given that COVID-19 is less deadly for young adults, this study explores whether highlighting potential benefits or disadvantages that others may experience as a result of one's vaccination increases young adults' intention to get vaccinated, particularly for those who have low perceived risk of COVID-19. To test this idea, we conducted an experiment and analyzed the effect of interaction between message frame (gain vs. loss) and reference point (self vs. others) on intention for vaccination by one's perceived risk (low vs. high). The results show that for those with low perceived risk of COVID-19, messages about potential negative consequences to others (e.g., family, friends, community members) from one's failure to get vaccinated led to message elaboration and favorable attitude toward vaccination, which in turn promoted one's intention to get vaccinated. We discuss practical implications of the findings for message strategies that target populations experiencing COVID-19 disparities.

Insights into the accuracy of social scientists' forecasts of societal change

How well can social scientists predict societal change, and what processes underlie their predictions? To answer these questions, we ran two forecasting tournaments testing the accuracy of predictions of societal change in domains commonly studied in the social sciences: ideological preferences, political polarization, life satisfaction, sentiment on social media, and gender-career and racial bias. After we provided them with historical trend data on the relevant domain, social scientists submitted pre-registered monthly forecasts for a year (Tournament 1; N = 86 teams and 359 forecasts), with an opportunity to update forecasts on the basis of new data six months later (Tournament 2; N = 120 teams and 546 forecasts). Benchmarking forecasting accuracy revealed that social scientists' forecasts were on average no more accurate than those of simple statistical models (historical means, random walks or linear regressions) or the aggregate forecasts of a sample from the general public (N = 802). However, scientists were more accurate if they had scientific expertise in a prediction domain, were interdisciplinary, used simpler models and based predictions on prior data.

Battling Unawareness of One's Test Performance: Do Practice, Self-Efficacy, and Emotional Intelligence Matter?

The "Dunning-Kruger effect" refers to the tendency of poor performers to overestimate test outcomes. Although a widespread phenomenon, questions exist regarding its source and sensitivity to countermeasures. The present field study aimed to (a) examine whether practice with tests used in previous classes can enhance students' ability to estimate test outcomes, (b) determine the main source of the effect (i.e., is it unawareness of one's readiness or wishful thinking?), and (c) assess the extent to which particular individual differences can be used as predictors of test performance. In this study, participants practiced with old tests and then completed the final exam. Before and after the exam, they predicted their grades and indicated their subjective confidence in the predictions made. Furthermore, participants' emotional intelligence and self-efficacy about their academic abilities were surveyed. Results suggested that poor performers were not unaware of their test preparation, but rather engaged in wishful thinking. In fact, although they overestimated their test grades, their estimates not only improved after completing the final test but also were regarded with little confidence. Overall, estimation bias was a good predictor of students' final test performance, whereas subjective confidence and emotional intelligence only weakly predicted such performance. Thus, if proactive interventions are to be developed for at-risk students, performance-estimation tasks may offer valuable information regarding such students' future performance in a course much more than emotional intelligence and self-efficacy measures.

Evaluating the validity of game-based assessments measuring cognitive function among children and adolescents: A systematic review and meta-analysis

Games offer advantages over traditional methods of assessing cognitive function among children and adolescents. However, the validity of game-based assessments has not been systematically evaluated. We conducted a systematic review and meta-analysis to assess the validity of game-based assessments measuring cognitive function among children and adolescents. We systematically searched several databases using pre-defined inclusion criteria. For papers that met the criteria, we extracted and analyzed the cognitive functions measured by each study, the correlation coefficients between game-based and traditional assessments, and factors that could influence the validity of game-based assessments. Our review identified 19 articles featuring 20 studies, 18 games, and 378 unique correlations between game-based and traditional assessments of cognitive function. Game-based assessments yielded significant correlations (n=282, 75%) with traditional assessments, over half of which were in the low to medium range in strength (r=0.3-0.69, n=227, 80%). Factors related to the child, such as age, gender, and prior gaming experience, may influence the validity of game-based assessments by modifying performance on game-based assessments. In addition, we found that game-based assessments that measured cognitive functions across more than one neurocognitive domain and used a prediction model for scoring were more likely to yield significant correlations. In contrast, including a narrative storyline in a game-based assessment was less likely to yield significant correlations. Most studies were of good quality, although the lack of sample size justification was a limiting factor. Further research is needed to elucidate the influence of identified factors on the validity of game-based assessment to justify the wide adoption of game-based assessments of cognitive function among children and adolescents.

Understanding Training Needs in Pediatric Feeding for Allied Health Professionals: An Australian Perspective

PURPOSE

Clinician experience and confidence can negatively impact pediatric feeding service availability, but limited research has investigated what training allied health professionals (AHPs) need to increase these factors. This study developed and distributed a survey investigating Australian AHPs' self-reported confidence and anxiousness, training needs, factors impacting training access, and training preferences.

METHOD

This study was conducted over two phases. Phase 1 involved development and refinement of the survey, and Phase 2 involved distribution to Australian AHPs. Questions pertained to general demographics, feeding experience, feeding confidence and skills perception, and training needs. The questions were composed of multiple-choice, Likert scale, and short-response options.

RESULTS

Overall, 198 complete responses were received. Participants reported significantly lower confidence and higher anxiousness working with infants compared to older children (p < .01). Increased frequency of service provision predicted higher self-reported confidence and lower anxiousness (p < .01). Practical training opportunities including case discussion, videos, and clinical feedback were preferred. Access facilitators were online, on-demand training; however, respondents reported preferring hands-on training opportunities. Common barriers included cost, time, competing professional development priorities, and distance/travel.

CONCLUSIONS

Findings have highlighted that recency and frequency of practice impact self-reported confidence and anxiousness, and that AHPs self-report lowest confidence and highest anxiety working with infants compared to older age groups. Overall, the findings highlight the need for flexible, practical, and remotely accessible training opportunities, as well as the need for access to regular clinical supervision and a pediatric feeding caseload.

Development and initial validation of a measure of cross-lingual practice among mental health practitioners

OBJECTIVE

Despite the importance of spoken language in psychotherapy processes with clients whose native language is distinct from the language of therapy, there is a dearth of research on mental health practitioners (MHPs) language competence. This research aimed to develop the Perceptions of Cross-lingual Practice (PCLP) scale designed to aid MHPs' cross-lingual practice.

METHOD

Study 1 developed items and collected data from Australian MHPs (n = 155) to test the scale's factor structure through exploratory factor analysis. Study 2 (n = 257) confirmed the emergent factor structure of the scale through confirmatory factor analysis and further assessed its reliability and convergent validity.

RESULTS

The final 23-item measure had good reliability and validity. Three factors emerged; MHPs' perceptions of self-competence, MHPs' perceptions of difficulties faced by clients, and MHPs' perceptions of barriers for themselves imposed by language. The perceptions of self-competence subscale was weakly related to the other subscales highlighting a disconnect between MHPs' self-perceptions and perceptions of contextual factors.

CONCLUSION

The PCLP is a reliable and valid measure of MHPs' perceptions of cross-lingual practice composed of three subscales each with good psychometric properties that can be used for various purposes in the evaluation and development of MHPs in post-graduate and professional settings.

Different personality factors drive work and non-work creativity

This study examined whether creativity at work and outside of work had the same (or different) Big Five personality antecedents. Results revealed that although self-reported personal creativity outside of the workplace was related to the Openness to Experience trait only, supervisor-rated work creativity was associated with Openness, Extraversion, and Conscientiousness, and that after controlling for the effects of Extraversion and Conscientiousness, Openness did not contribute incremental validity in predicting work creativity, whereas when the impact of Openness was controlled for, Extraversion and Conscientiousness incrementally contributed to the prediction. Therefore, the study supported that while creativity was consistently driven by Openness across settings, the predictive effects of other traits (i.e., Extraversion and Conscientiousness) on creativity varied in work and non-work environments. Study limitations and implications for research and practices are discussed.

The Operations Triad Model and Youth Mental Health Assessments: Catalyzing a Paradigm Shift in Measurement Validation

Researchers strategically assess youth mental health by soliciting reports from multiple informants. Typically, these informants (e.g., parents, teachers, youth themselves) vary in the social contexts where they observe youth. Decades of research reveal that the most common data conditions produced with this approach consist of discrepancies across informants' reports (i.e., informant discrepancies). Researchers should arguably treat these informant discrepancies as domain-relevant information: data relevant to understanding youth mental health domains (e.g., anxiety, depression, aggression). Yet, historically, in youth mental health research as in many other research areas, one set of paradigms has guided interpretations of informant discrepancies: Converging Operations and the Multi-Trait Multi-Method Matrix (MTMM). These paradigms (a) emphasize shared or common variance observed in multivariate data, and (b) inspire research practices that treat unique variance (i.e., informant discrepancies) as measurement confounds, namely random error and/or rater biases. Several yearsw ago, the Operations Triad Model emerged to address a conceptual problem that Converging Operations does not address: Some informant discrepancies might reflect measurement confounds, whereas others reflect domain-relevant information. However, addressing this problem requires more than a conceptual paradigm shift beyond Converging Operations. This problem necessitates a paradigm shift in measurement validation. We advance a paradigm (Classifying Observations Necessitates Theory, Epistemology, and Testing [CONTEXT]) that addresses problems with using the MTMM in youth mental health research. CONTEXT optimizes measurement validity by guiding researchers to leverage (a) informants that produce domain-relevant informant discrepancies, (b) analytic procedures that retain domain-relevant informant discrepancies, and (c) study designs that facilitate detecting domain-relevant informant discrepancies.

Quantifying changes in societal optimism from online sentiment

Individuals can hold contrasting views about distinct times: for example, dread over tomorrow's appointment and excitement about next summer's vacation. Yet, psychological measures of optimism often assess only one time point or ask participants to generalize about their future. Here, we address these limitations by developing the optimism curve, a measure of societal optimism that compares positivity toward different future times that was inspired by the Treasury bond yield curve. By performing sentiment analysis on over 3.5 million tweets that reference 23 future time points (2 days to 30 years), we measured how positivity differs across short-, medium-, and longer-term future references. We found a consistent negative association between positivity and the distance into the future referenced: From August 2017 to February 2020, the long-term future was discussed less positively than the short-term future. During the COVID-19 pandemic, this relationship inverted, indicating declining near-future- but stable distant-future-optimism. Our results demonstrate that individuals hold differentiated attitudes toward the near and distant future that shift in aggregate over time in response to external events. The optimism curve uniquely captures these shifting attitudes and may serve as a useful tool that can expand existing psychometric measures of optimism.

Saving Regret and Procrastination

In countries, where a substantial proportion of retirement income rests on savings, there is much concern that a sizeable fraction of the population reaches retirement with insufficient financial resources. We define saving regret as the wish in hindsight to have saved more earlier in life. We measured saving regret and possible determinants in a survey of U.S. households in which respondents were aged 60-79. We find high levels of saving regret, affirmed by some 58%. Saving regret exhibits significant and plausible correlations with personal characteristics and wealth: Married, older, healthier and wealthier respondents are less likely to report saving regret, suggesting the measure's validity. We find only weak evidence for correlations between saving regret and measures of procrastination: persons with traits associated with procrastination express saving regret about as often as those without those traits.