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Exposure and Reactions to Cancer Treatment Misinformation and Advice: Survey Study
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Background
Cancer treatment misinformation, or false claims about alternative cures, often spreads faster and farther than true information on social media. Cancer treatment misinformation can harm the psychosocial and physical health of individuals with cancer and their cancer care networks by causing distress and encouraging people to abandon support, potentially leading to deviations from evidence-based care. There is a pressing need to understand how cancer treatment misinformation is shared and uncover ways to reduce misinformation.
Objective
We aimed to better understand exposure and reactions to cancer treatment misinformation, including the willingness of study participants to prosocially intervene and their intentions to share Instagram posts with cancer treatment misinformation.
Methods
We conducted a survey on cancer treatment misinformation among US adults in December 2021. Participants reported their exposure and reactions to cancer treatment misinformation generally (saw or heard, source, type of advice, and curiosity) and specifically on social media (platform, believability). Participants were then randomly assigned to view 1 of 3 cancer treatment misinformation posts or an information post and asked to report their willingness to prosocially intervene and their intentions to share.
Results
Among US adult participants (N=603; mean age 46, SD 18.83 years), including those with cancer and cancer caregivers, almost 1 in 4 (142/603, 23.5%) received advice about alternative ways to treat or cure cancer. Advice was primarily shared through family (39.4%) and friends (37.3%) for digestive (30.3%) and natural (14.1%) alternative cancer treatments, which generated curiosity among most recipients (106/142, 74.6%). More than half of participants (337/603, 55.9%) saw any cancer treatment misinformation on social media, with significantly higher exposure for those with cancer (53/109, 70.6%) than for those without cancer (89/494, 52.6%; P<.001). Participants saw cancer misinformation on Facebook (39.8%), YouTube (27%), Instagram (22.1%), and TikTok (14.1%), among other platforms. Participants (429/603, 71.1%) thought cancer treatment misinformation was true, at least sometimes, on social media. More than half (357/603, 59.2%) were likely to share any cancer misinformation posts shown. Many participants (412/603, 68.3%) were willing to prosocially intervene for any cancer misinformation posts, including flagging the cancer treatment misinformation posts as false (49.7%-51.4%) or reporting them to the platform (48.1%-51.4%). Among the participants, individuals with cancer and those who identified as Black or Hispanic reported greater willingness to intervene to reduce cancer misinformation but also higher intentions to share misinformation.
Conclusions
Cancer treatment misinformation reaches US adults through social media, including on widely used platforms for support. Many believe that social media posts about alternative cancer treatment are true at least some of the time. The willingness of US adults, including those with cancer and members of susceptible populations, to prosocially intervene could initiate the necessary community action to reduce cancer treatment misinformation if coupled with strategies to help individuals discern false claims.
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China\u27s Healthcare Systems - A Status Update from the 2009 Major Health Care Reform
No full textChina\u27s healthcare has undergone several transformations. For the past 15 years, China has tried to expand insurance and improve access to appropriate pharmaceuticals. These efforts; however, have been undermined by inadequate funding and decentralization of responsibility to the provinces, leading to uneven implementation of reform throughout the country. In this article, we present a brief history of the Chinese health system and then present findings from a systematic literature review focused on the implementation of the 2009 reform. Within this review, we explore the impact of reform on access and use of health care services, changes to the health care workforce, the quality of health care, the expansion of insurance coverage, drug regulations, health care financing, efforts to improve the efficiency of the system, and public opinions on the reform effort. We conclude that, while reforms have noticeably improved China\u27s health system, several problems persist. In 2009, after years of debate, China adopted a major reform of its health system. The goals of reform included expanding health insurance, reducing health care disparities, increasing the use of primary care, improving the use of pharmaceuticals, and strengthening the public health workforce (Wang et al. 2011). The government\u27s aim was to reduce inequities in the use of health care and strengthen access to essential services by 2020. In this paper we assess the implementation of health reform in China based on findings from a systematic review of the English language literature. We find that China has succeeded in expanding insurance and reducing regional variation in the use of health care. Efforts to strengthen the primary care system, increase the size of the workforce, and regulate pharmaceuticals, however, have been less successful. To achieve the health reform goals articulated more than a decade ago, China must make additional investments in primary care and its public health infrastructure. In the next section of the paper, we provide a brief overview of the Chinese health system and its evolution since 1949. Next, we describe how we conducted our literature review and summarize its findings. We conclude with some reflections on the status of health reform in China</p
Social-Media Based Social Skill and Safety Skill Intervention for Autistic Adults
No full textSocial media, as a favored platform for autistic adults, provides numerous opportunities to socialize and develop close relationships. However, autistic adults may have social skill difficulties that carry over to this platform. Further, social media-related risks pose additional concerns. This study taught four autistic adults social media-related social skills and safety skills. A multiple probe across four participants experimental design was used to evaluate the efficacy of the social media-based social skill and safety skill intervention on social media-related social skills (i.e., correct "Like," correct commenting, correct sharing, and correct creating) and safety skills (i.e., the use of five-step social media-related risk responding strategy) among autistic adults. In addition, the study measured whether implementing the proposed intervention decreased the loneliness level of autistic adults. The participants showed improvement in both social media-related social skills and safety skills. The intervention did not change the participants\u27 self-reported loneliness level.Keywords: autistic adults, social media, social skills training, safety skills trainin
Perceptions of Safety in Online Communities
No full textSafety is an important issue in online communities, particularly for marginalized communities. Prior research has studied safety in terms of data security and privacy, but there is less research about the perception of safety of users in an online community, as in their emotional sense of safety. In particular, there is little to no knowledge about the factors in the design of an online community that influence its users\u27 subjective perception of safety. This paper uses two theories about safety, safe space theory and psychological safety theory, as motivation to study two design features of an online community that may influence users\u27 perceptions of safety: exclusivity and anonymity. Preliminary analysis suggests that both of these factors contribute to users\u27 perceptions of safety in an online community, but additional analysis must be done to account for covariances. Additional analysis also will be done to determine the impact of users\u27 psychological safety on their willingness to participate in an online community. These findings have meaningful implications for the design of safe spaces online, and it also contributes to a theoretical understanding of perceived safety in online communities
Elucidation of local processes in Spontaneous and Turbulent Induced Emulsification
No full textWe performed a comprehensive study on understanding the mechanism of emulsification and developing effective methods to counteract it. In the first phase of this study, we discovered two distinct processes for the continuous extraction of organic-free water from detergent-stabilized oil-in-water emulsions. These findings provide promising solutions for mitigating the negative effects of emulsification.. The first process is based upon a modification of the so-called "electro-coagulation", which uses electro-chemically produced metal hydroxides that remove oil droplets via hetero-coagulation. In this method, metal particles are deposited over a graphite anode whereas an aluminum tube is used as a cathode in an electrolysis cell through which the emulsion flow. With an electrical potential applied between the graphite and aluminum, the metal particles are corroded to produce metal hydroxides that sweep the oil droplets from the emulsion. The study carried out with various metals show that the oil extraction efficiency increases with the basicity of the metal hydroxide. A second process, based on acid base interaction as well, uses surface functionalized nickel particles (~45 µm) that introduces amines onto the nickel surface. Here an additional advantage is that the metal particles bound to the oil droplets can be removed from aqueous phase with a magnetic field. While each of the above processes is effective in demulsifying water, their combination vastly improves the oil extraction efficiency. With the integrated process, the total organic content of the treated water could be as low as about 0.1 ppm with the surface tension of water (72 mN/m) being that of organic free water. As the second phase of this research, we introduce the studies we conducted in the emulsification of an oil in salinized water was under turbulent and agitation-free conditions in the presence of a mixture of an ionic and a non-ionic surfactant. The properties of the air-water and the oil-water interfaces were investigated using the methods of du-Nouy ring, drop resonance vibrometry and Langmuir film balance that allowed pinpointing the relevance of certain interfacial properties in emulsification. Estimation of the droplet size and its distribution from the nanometer to micrometer range was carried out with optical microscopy, acoustic attenuation spectroscopy and continuous hydrodynamic flow fractionation. These measurements provided the platform for the comparison of the emulsion droplet size with those predicted from the fluctuation of the dynamic stress in the turbulent water via a capillary-hydrodynamic model. While such a comparison was reasonably meaningful for micron size emulsion droplets, production of nanometer size droplets was beyond such a rudimentary expectation. We thus carried out systematic investigations into other factors that contribute to emulsification under both agitated and agitation free conditions. An important finding of these studies is that the infusion of air bubbles that profoundly enhance the hydrodynamic fluctuation produce mainly submicroscopic emulsion droplets, while a fluctuation inhibiting water-soluble polymer has the opposite effect. Furthermore, while a hydrophilic polymer dissolved in water enhances the ripening of the droplets with time, hydrophobic polymer in oil thwarts aging, plausibly by osmotic backpressure and interfacial stiffening, which, upon compression, acts against surface tension, thereby decreasing the chemical potential of the trapped oil molecules inside the droplet. These effects are similarly observed in spontaneous emulsifications, that is when a layer of oil containing the additives is deposited upon the surface of the aqueous phase in the absence of any external work input. Micro and/or Nano emulsions are formed when an organic liquid gently comes in contact with water in the presence of a surfactant, even with a positive interfacial tension. Many years of research made it clear that the driving force for spontaneous emulsification arises from the differences of the bulk chemical potentials of various components, which triggers various non-equilibrium coupled transport processes, such as diffusion and hydrodynamic fluctuation. While extraordinary theoretical developments have taken place that attempt to describe the emulsification processes within the formalisms of global equilibrium and non-equilibrium thermodynamics, the local processes underlying the spontaneous emulsification, however, still remain elusive. In this research, we attempt to shed light on some of the local processes that involve the transfer of surfactant as well as molecular water from one phase to another (i.e. water to oil), subsequent formation of inverted emulsion and its evolution to oil-in- water emulsion as they cross the phase boundary. These processes lead to either strong or weak fluctuation of component concentration just below the interface that announces fast (athermal) diffusion of the emulsion droplets farther into the bulk of water. These studies have been able to identify the relevant interfacial and hydrodynamic parameters, careful controls of which should be valuable in thwarting emulsification in various practical settings
Consensus-and Deep Reinforcement Learning (DRL)-based Real-time Optimal Control of DC Microgrids
No full textIn recent years, Direct Current (DC) microgrids have garnered significant attention due to their inherent simplicity and energy efficiency when connecting DC sources and loads. However, traditional hierarchical control schemes, which implement optimization and control at separate time scales, suffer from loose integration, resulting in reduced energy efficiency and difficulties in achieving real-time optimization. Moreover, even minor disturbances can lead to deviations in bus voltages and output currents from optimal operating points, necessitating advanced and adaptive real-time control for DC microgrids.This dissertation presents a series of comprehensive, real-time control schemes aimed at achieving optimal objectives while ensuring that bus voltages and Distributed Generation (DG) output power/currents remain within safe operating ranges, thereby enhancing the stability and dynamic performance of DC microgrids. The stability and convergence of the closed-loop system under the proposed analytic model-based control policies are rigorously analyzed using Lyapunov methods.Given the optimal control problem\u27s formulation as a constrained nonconvex problem with nonlinearity, a Multi-Agent Deep Reinforcement Learning (MADRL) approach, employing the Twin Delayed Deep Deterministic Policy Gradient (TD3) algorithm, is utilized to address the challenge. MADRL is a data-driven policy that directly interacts with the environment, thereby improving learning efficiency. Both centralized and distributed training frameworks are designed for distributed execution.Furthermore, in order to address the dearth of high-fidelity, real-time platforms for evaluating Deep Reinforcement Learning (DRL) control algorithms in complex power systems, a MADRL online testing platform has been developed for distributed real-time dynamic control of power systems. This platform integrates the Opal-RT real-time simulator for simulating dynamic power system environments and multiple AI workstations for implementing MADRL control algorithms. The EtherCAT communication protocol enables real-time interaction between AI workstations and the Opal-RT real-time simulator, facilitating online and real-time training of distributed MADRL algorithms for power system dynamic control.Employing a detailed switch-level DC microgrid model, simulation results highlight the effectiveness and advantages of the proposed optimal control algorithms and the developed MADRL online testing platform