The lockdown effect: A counterfactual for Sweden.
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ABSTRACT:
SUBMITTER: Born B
PROVIDER: S-EPMC8031244 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The UK and Sweden have among the worst per-capita COVID-19 mortality in Europe. Sweden stands out for its greater reliance on voluntary, rather than mandatory, control measures. We explore how the timing and effectiveness of control measures in the UK, Sweden and Denmark shaped COVID-19 mortality in each country, using a counterfactual assessment: what would the impact have been, had each country adopted the others' policies? Using a Bayesian semi-mechanistic model without prior assumptions on the mechanism or effectiveness of interventions, we estimate the time-varying reproduction number for the UK, Sweden and Denmark from daily mortality data. We use two approaches to evaluate counterfactuals which transpose the transmission profile from one country onto another, in each country's first wave from 13th March (when stringent interventions began) until 1st July 2020. UK mortality would have approximately doubled had Swedish policy been adopted, while Swedish mortality would have more than halved had Sweden adopted UK or Danish strategies. Danish policies were most effective, although differences between the UK and Denmark were significant for one counterfactual approach only. Our analysis shows that small changes in the timing or effectiveness of interventions have disproportionately large effects on total mortality within a rapidly growing epidemic.
| S-EPMC8358009 | biostudies-literature
Project description:BACKGROUND: The counterfactual approach provides a clear and coherent framework to think about a variety of important concepts related to causation. Meanwhile, directed acyclic graphs have been used as causal diagrams in epidemiologic research to visually summarize hypothetical relations among variables of interest, providing a clear understanding of underlying causal structures of bias and effect modification. In this study, the authors aim to further clarify the concepts of bias (confounding bias and selection bias) and effect modification in the counterfactual framework. METHODS: The authors show how theoretical data frequencies can be described by using unobservable response types both in observational studies and in randomized controlled trials. By using the descriptions of data frequencies, the authors show epidemiologic measures in terms of response types, demonstrating significant distinctions between association measures and effect measures. These descriptions also demonstrate sufficient conditions to estimate effect measures in observational studies. To illustrate the ideas, the authors show how directed acyclic graphs can be extended by integrating response types and observed variables. RESULTS: This study shows a hitherto unrecognized sufficient condition to estimate effect measures in observational studies by adjusting for confounding bias. The present findings would provide a further understanding of the assumption of conditional exchangeability, clarifying the link between the assumptions for making causal inferences in observational studies and the counterfactual approach. The extension of directed acyclic graphs using response types maintains the integrity of the original directed acyclic graphs, which allows one to understand the underlying causal structure discussed in this study. CONCLUSIONS: The present findings highlight that analytic adjustment for confounders in observational studies has consequences quite different from those of physical control in randomized controlled trials. In particular, the present findings would be of great use when demonstrating the inherent distinctions between observational studies and randomized controlled trials.
| S-EPMC3765813 | biostudies-other
Project description:Previous research has linked perceived social isolation (loneliness) to reduced antiviral immunity, but the immunologic effects of the objective social isolation imposed by pandemic “shelter in place” (SIP) policies is unknown. We assessed the immunologic impact of SIP by relocating 21 adult male rhesus macaques from 2000 sq-m field cage communities of 70-132 other macaques to 2 wks of individual housing in indoor shelters. SIP was associated with down-regulation of Type I interferon (IFN) antiviral gene expression. This effect emerged within the first 48 hrs of SIP, persisted for at least 2 wks, and abated within 4 wks of return to social housing. A subsequent round of SIP in the presence of a novel juvenile macaque abrogated this effect. These results identify a significant adverse effect of SIP social isolation on antiviral immune regulation in circulating immune cells and they suggest a potential behavioral strategy for ameliorating such effects by promoting pro-social engagement during SIP.
2021-07-28 | GSE174065 | GEO
Project description:Background and objectiveCounterfactual thinking (CFT) refers to the generation of mental simulations of alternatives to past events, actions and outcomes. CFT is a pervasive cognitive feature in every-day life and is closely related to decision-making, planning and problem-solving - all of which are cognitive processes linked to unimpaired frontal lobe functioning. Huntington's Disease (HD) is a neurodegenerative disorder characterised by motor, behavioral and cognitive dysfunctions. Because an impairment in frontal and executive functions has been described in HD, we hypothesised that HD patients may have a CFT impairment.MethodsTests of spontaneous counterfactual thoughts and counterfactual-derived inferences were administered to 24 symptomatic HD patients and 24 age- and sex-matched healthy subjects.ResultsOur results show a significant impairment in the spontaneous generation of CFT and low performance on the Counterfactual Inference Test (CIT) in HD patients. Low performance on the spontaneous CFT test significantly correlates with impaired attention abilities, verbal fluency and frontal lobe efficiency, as measured by Trail Making Test - Part A, Phonemic Verbal Fluency Test and FAB.ConclusionsSpontaneous CFT and the use of this type of reasoning are impaired in HD patients. This deficit may be related to frontal lobe dysfunction, which is a hallmark of HD. Because CFT has a pervasive role in patients' daily lives regarding their planning, decision making and problem solving skills, cognitive rehabilitation may improve HD patients' ability to analyse current behaviors and future actions.
| S-EPMC4466481 | biostudies-literature
Project description:BackgroundCounterfactual thinking is a specific type of conditional reasoning that enables the generation of mental simulations of alternatives to past factual events. Although it has been broadly studied in the general population, research on schizophrenia is still scarce. The aim of the current study was to further examine counterfactual reasoning in this illness.MethodsForty schizophrenia patients and 40 controls completed a series of tests that assessed the influence of the "causal order effect" on counterfactual thinking, and the ability to generate counterfactual thoughts and counterfactually derive inferences from a hypothetical situation. Socio-demographic and clinical characteristics, as well as neurocognitive variables, were also examined.ResultsCompared to controls, the schizophrenia patients generated fewer counterfactual thoughts when faced with a simulated scenario. The pattern of response when assessing the causality effect of the order was also different between the groups, with the patients being more frequently unable to attribute any ordering of events than the control subjects. Additionally, the schizophrenia patients showed more difficulties when deriving normative counterfactual inferences from hypothetical social situations. None of the counterfactual reasoning measures was associated to any of the cognitive functions or clinical and socio-demographic variables assessed.ConclusionsA global impairment in counterfactual thinking characterizes schizophrenia patients. Because of the potential impact of such deficits on psychosocial functioning, targeting counterfactual reasoning for improvement might be considered in future treatment approaches.
| S-EPMC4734710 | biostudies-literature
Project description:Causal judgments are widely known to be sensitive to violations of both prescriptive norms (e.g., immoral events) and statistical norms (e.g., improbable events). There is ongoing discussion as to whether both effects are best explained in a unified way through changes in the relevance of counterfactual possibilities, or whether these two effects arise from unrelated cognitive mechanisms. Recent work has shown that moral norm violations affect causal judgments of agents, but not inanimate artifacts used by those agents. These results have been interpreted as showing that prescriptive norm violations only affect causal reasoning about intentional agents, but not the use of inanimate artifacts, thereby providing evidence that the effect of prescriptive norm violations arises from mechanisms specific to reasoning about intentional agents, and thus casting doubt on a unified counterfactual analysis of causal reasoning. Four experiments explore this recent finding and provide clear support for a unified counterfactual analysis. Experiment 1 demonstrates that these newly observed patterns in causal judgments are closely mirrored by judgments of counterfactual relevance. Experiment 2 shows that the relationship between causal and counterfactual judgments is moderated by causal structure, as uniquely predicted by counterfactual accounts. Experiment 3 directly manipulates the relevance of counterfactual alternatives and finds that causal judgments of intentional agents and inanimate artifacts are similarly affected. Finally, Experiment 4 shows that prescriptive norm violations (in which artifacts malfunction) affect causal judgments of inanimate artifacts in much the same way that prescriptive norm violations (in which agents act immorally) affect causal judgments of intentional agents.
| S-EPMC6871661 | biostudies-literature
Project description:In observational studies, treatment may be adapted to covariates at several times without a fixed protocol, in continuous time. Treatment influences covariates, which influence treatment, which influences covariates, and so on. Then even time-dependent Cox-models cannot be used to estimate the net treatment effect. Structural nested models have been applied in this setting. Structural nested models are based on counterfactuals: the outcome a person would have had had treatment been withheld after a certain time. Previous work on continuous-time structural nested models assumes that counterfactuals depend deterministically on observed data, while conjecturing that this assumption can be relaxed. This article proves that one can mimic counterfactuals by constructing random variables, solutions to a differential equation, that have the same distribution as the counterfactuals, even given past observed data. These "mimicking" variables can be used to estimate the parameters of structural nested models without assuming the treatment effect to be deterministic.
| S-EPMC5531214 | biostudies-literature
Project description:Young children often struggle to answer the question "what would have happened?" particularly in cases where the adult-like "correct" answer has the same outcome as the event that actually occurred. Previous work has assumed that children fail because they cannot engage in accurate counterfactual simulations. Children have trouble considering what to change and what to keep fixed when comparing counterfactual alternatives to reality. However, most developmental studies on counterfactual reasoning have relied on binary yes/no responses to counterfactual questions about complex narratives and so have only been able to document when these failures occur but not why and how. Here, we investigate counterfactual reasoning in a domain in which specific counterfactual possibilities are very concrete: simple collision interactions. In Experiment 1, we show that 5- to 10-year-old children (recruited from schools and museums in Connecticut) succeed in making predictions but struggle to answer binary counterfactual questions. In Experiment 2, we use a multiple-choice method to allow children to select a specific counterfactual possibility. We find evidence that 4- to 6-year-old children (recruited online from across the United States) do conduct counterfactual simulations, but the counterfactual possibilities younger children consider differ from adult-like reasoning in systematic ways. Experiment 3 provides further evidence that young children engage in simulation rather than using a simpler visual matching strategy. Together, these experiments show that the developmental changes in counterfactual reasoning are not simply a matter of whether children engage in counterfactual simulation but also how they do so. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
| S-EPMC8262369 | biostudies-literature
Project description:The present study was designed to highlight the physical and psychological health hazards that a young Egyptian soccer team faced during the first COVID-19 wave lockdown. The study included 37 young Egyptian male soccer players. History taking and anthropometric measurements were taken. Two questionnaires were filled covering the athletes'` sleep habits and quality of life (QoL). Finally, the mothers were asked to fill in a questionnaire concerned with depression, anxiety, and stress. More than 50% of the enrolled athletes gained weight during the lockdown especially those without compliance to home exercises. The mothers' anxiety score correlated positively with the increased body mass index (BMI) of the athletes. The athletes mean QoL Score worsened significantly and significant negative correlation was found between the increased BMI and the change of QoL. The increased BMI was significantly reported among the athletes who didn't do home exercises and had a negative correlation with their QoL change throughout the lockdown. The mothers' anxiety had a possible reflection on their youngsters' weight gain. These findings highlight the need for weight control when outdoors physical activity is restricted during pandemics with better compliance to home exercising schedules and less screen time.
| S-EPMC8114258 | biostudies-literature
Project description:Simulation-based approaches to disease progression allow us to make counterfactual predictions about the effects of an untried series of treatment choices. However, building accurate simulators of disease progression is challenging, limiting the utility of these approaches for real world treatment planning. In this work, we present a novel simulation-based reinforcement learning approach that mixes between models and kernel-based approaches to make its forward predictions. On two real world tasks, managing sepsis and treating HIV, we demonstrate that our approach both learns state-of-the-art treatment policies and can make accurate forward predictions about the effects of treatments on unseen patients.
| S-EPMC6231902 | biostudies-literature