Mechanisms Underlying Economic Revealed Preference Of Multi-Component Bundles In Primate Orbitofrontal Cortex

ABSTRACTClassic neuro-economic studies suggest that people and animals alike assign values to individual attributes arriving at a total summed valuation and therefore overall appraisal of the offer (Kahnt et al., 2011; Lak et al., 2014). However, further work is needed to determine whether such individual attribute appraisals can predict choice between multi-component bundles. In this paper we show the importance and applications of economic theory to decision neurophysiology concerning multi-component attribute options or bundles. We applied random utility modelling (McFadden, 1973) to choices amongst 10 different two-component bundles in non-human primates (Macacca mulatta). We found that behavioural random utility (RUM) complies well with revealed preference theory and recapitulates the fundamental properties of empirically obtained indifference curves (IC) revealing the synergetic interactions between components. We extended RUM to neurophysiological data and focused our investigation to orbitofrontal cortex A13. Neuronal RUM complied with behavioural RUM at single neuron and population level (N:54). Neural coding of utility was present at target onset, choice, and reward. However, a distinct and separate group of neurons (N:26) showed partial compliance with utility in either the chosen or the unchosen bundle options and correlated with both value and probability of choice. We show that relative chosen-utility coding constitutes a separate type of computation and suggest a role for this type of neuron in value-to-choice processing in OFC.

Baby-Friendly Hospital Initiative for Neonatal Wards: impact on breastfeeding practices among preterm infants

ABSTRACT Objective: to assess breastfeeding support practices for preterm infants at two Baby-Friendly hospitals in southeastern Brazil, comparing the effect of implementing the guidelines for Baby-Friendly Hospital Initiative for Neonatal wards. Methods: a quasi-experimental study, pre- and post-intervention with control. Implementation of this initiative in the intervention hospital using Knowledge Translation. Data collection on compliance with the adapted Ten Steps, Three Guiding Principles and the Code before and after the intervention was carried out via interviews with mothers of preterm babies and professionals, unit observation and documentary analysis in the intervention and control hospitals. Intra-intergroup comparison was performed. Results: increases in global compliance with the Three Principles, Ten Steps, the Code, partial compliance with each Principle and in most Steps was greater in the intervention hospital. Conclusion: this initiative improved practices related to breastfeeding in the intervention hospital, demonstrating the potential to improve care and breastfeeding in neonatal wards.

Screening the adequacy of hydroxychloroquine prescription and monitoring of ocular toxicity in patients with rheumatic disease

Background: Hydroxychloroquine (HCQ) an anti-inflammatory drug used in treatment of rheumatic diseases causes retinal toxicity in a minority of patients which are both time and dose dependent. The aim of this study was to assess the compliance with guidelines of American Association of Ophthalmology for screening and dosage of this drug. Patients and methods: In this cross-sectional analysis, the medical records of patients who were on HCQ, attending Rheumatology Outpatient Department of Fatima Memorial Hospital Shadman, Lahore from 25-05-2019 to 30-05-2019 were reviewed. The dosage and, duration of HCQ were collected, files were reviewed for physician recommendation of screening tests for retinal toxicity. HCQ dose of 5mg/kg/day was labeled as adequate dose; dose below 4.5mg/kg/day under dosed, while dose of 6mg/kg/day and above was considered overdose. Results: Data was collected from 81 patients during the study period, 74 (91.4%) of them being female, with mean age 35.15 ± 12.6 years. Based on total body weight, 23 patients (28.4%) were receiving the correct dosage of the drug around 5mg/kg/day whereas 39 (48.1%) patients were under-dosed below 4.5mg/kg/day, and 19 patients (23.5%) were over dosed, out of which 5 (6.17%) were receiving doses above 6.5mg/kg. Baseline eye screening examination by ophthalmologist was performed within 1 year of commencing treatment in 54 (66%) patients. Of the 27 patients receiving HCQ more than 5 years, 6 patients underwent Spectral coherence Ocular CT scan (SD-OCT) evaluation at 5 years. There was minimal compliance (less than 70% of Patients) to optimum drug dosage, partial compliance (70-89% patients) to preventing over-dosage of the drug, and full compliance (more than 90% patients) was achieved in baseline screening exam recommendation. Follow-up screening documentation and 5-years screening examination had minimal compliance. Conclusion: A significant proportion of patients are underdosed, especially the obese population where the recommended dosage is not prescribed.

Financial Coping Strategies of Households during COVID-19 Induced Lockdown

This paper focuses on the effect of the COVID-19 pandemic-induced lockdown on the financial resources of households, their survival strategies, and planned coping strategies. It employed the survey method of research in which 288 questionnaires were administered online and delivered by hand to respondents across the six geographical zones of Nigeria. The study used frequency and percentages to analyze the perceptions of households regarding their survival strategies, government supports, and the effectiveness of compliance to government orders. The questionnaire was designed to elicit relevant information regarding how households coped with the COVID-19 induced lockdown in Nigeria. It was found that most households had no contingency savings to address such emergencies; therefore, the lockdown put a lot of strain on the personal income and savings of households. It was also found that the household rating of government supports was very poor which led to partial compliance with the stay-at-home order. Finally, it was found that the most preferred coping strategy was to take salary advance, followed by going back to work and borrowing. The study recommends contingency savings habits to households and controlling the inflation rate to the government as important steps for returning towards normality. The government of Nigeria needs to prioritize the health sector in budget allocation for proper healthcare delivery. The study also recommends contingency savings habits to households and social inclusion to the government along with giving out bailouts to households, firms, and industries to boost the economy. Received Date: May 06, 2020 Last Received: October 10, 2020 Acceptance: October 29, 2020

Disability and Partial Compliance Theory

Recent theorizing about justice for circumstances of injustice has largely bypassed disability. This chapter explores partial compliance theory through achieving disability civil rights. After sketching the non-ideal and partial compliance theory landscape since Rawls’s development of an ideal liberal theory of justice, the chapter disavows the misleading assumption that disability is non-ideal. Rather, injustice is located in social responses to differences in bodies and minds, as with the social model of disability. Using examples from the Americans with Disabilities Act, employment, and education, the chapter demonstrates how partial compliance theory can negotiate difficult questions about obligations when others behave unjustly and improvements seem infeasible. The chapter then explores disability civil rights without idealizations about justice. It concludes with thoughts about eugenics, why disability has largely been left aside in partial compliance theory, and how understanding disability civil rights can contribute importantly to our understanding of justice in non-ideal circumstances.

Partial compliance with long-acting paliperidone palmitate and impact on hospitalization: a 6-year mirror-image study

Background: Previous studies showed a linear correlation between partial compliance with an oral antipsychotic medication and hospitalisation risk among patients with schizophrenia. Long-acting injections (LAIs) may significantly improve adherence and reduce relapse in patients with psychosis. The aim of this study was to evaluate the relationship between the level of compliance with 1-monthly paliperidone palmitate (PP1M) and hospitalisation rates. Methods: This was a naturalistic, mirror-image study examining retention, compliance and hospitalisation rates 3 years pre- and 3 years post-PP1M initiation. Compliance was divided in three groups: full (no missed dose/year), good (6–11injections/year), poor (<6 injections/year). Results: A total of 173 patients suffering from a severe mental illness (70% with a diagnosis of schizophrenia and 30% with other diagnoses) were included; 77% of patients continued PP1M for 1 year, 66% for 2 years and 55% for 3 years. Of the 95 patients who remained on PP1 throughout the 3 years of follow up, 81% showed full, 13% good, and only 6% poor compliance. In the patients who were fully compliant, the mean number of hospital admissions decreased from 1.34 to 0.43, and the mean number of bed days from 82 to 19 days per patient 3 years before and 3 years after PP1M initiation ( p < 0.001). It is noteworthy that the reductions in hospital stay were statistically significant for the group of patients with full compliance but not for the other two groups. In fact, patients with poor compliance demonstrated higher hospitalisation rates both before and after PPM1 initiation. These findings were similar in the subgroup of patients with schizophrenia who continued treatment for 3 years ( n = 68). Conclusion: There was a direct association between partial compliance and re-hospitalisation; fully compliant patients maintained the best outcomes in terms of reduced bed use following PPM1 initiation.