This research aims to study the food practices and perceptions related to excessive consumption of salt/sodium when cooking and eating outside the home in a study population representing the wide intergenerational and sociocultural diversity of Costa Rica. Key communities from around the country, cultural experts, and key informants were selected. Four qualitative research techniques were applied. Data was systematized based on the Social Ecological Model. Women are generally in charge of cooking and family food purchases. Salt is perceived as a basic ingredient, used in small amounts that can be reduced—but not eliminated—when cooking. Changes in food preparations and emotions associated with the consumption of homemade food with salt were identified. The population likes to eat out, where the establishments selected depend mainly on age group and income. Beyond cultural and geographical differences, age aspects are suggested as being the main differentiators, in terms of use of salt, seasonings, and condiments in the preparation of food at home, the recipes prepared, and the selection of establishments in which to eat out. The deeply rooted values and meanings associated with salt in food indicate that the implementation of salt reduction strategies in Costa Rica is challenging. Food consumption is a social activity . Far froThe association between excessive salt and sodium consumption with high blood pressure, the leading cause of death worldwide  and the In Latin America, the prevalence of hypertension in adults (>35 years old) varies between 26% and 42% . In 2014Clinical trials and population studies have shown that reducing salt intake is associated with a reduction in the rate of hypertension and that this strategy is profitable. However, only a few countries have implemented successful interventions .p < 0.001) [p < 0.001) [Sodium consumption and time trends have been estimated in the Costa Rican population (based on food and beverage acquisitions). Sodium available for consumption in national households largely exceeded the intake levels recommended by the World Health Organization (<2 g sodium/person/day) and increased between 2005 and 2013 from 3.9 to 4.6 g/per adult person/day (< 0.001) . The est® sauce ; pastries and sandwiches; fast food such as “caldosas” ; hamburgers; hot dogs; French fries; Ketchup or pink sauce (mix of Ketchup and mayonnaise) contributed to most of their sodium intake. These examples indicate that studies on food preparation and the use of salt should be contextualized, as they are modulated by historical, geographical, generational, social, and cultural elements [The source of dietary salt varies according to the population group, the food system, the cooking and preparation methods of food in the household and out, and water sources for human consumption ,15. In delements .A qualitative exploratory study to identify the knowledge, perceptions, and behaviors (KABs) related to the consumption of salt and sodium in food and its relationship to health was conducted during 2011 in urban and rural areas of Costa Rica, as well as two other Latin American countries. Most interviewees felt that food could not be consumed without salt. They did not know that processed food contains salt and sodium. Although they did not measure the amount of added salt in foods and understood that excessive consumption poses a health risk, the participants believed that they consumed little salt and did not perceive that their health was at risk. It was also found that there is a public awareness about salt, but not of “sodium”, and it was supposed that more sodium is consumed than what is reported, with no prospects of reducing its consumption . AnotherThis study is part of the National Plan to Reduce the Consumption of Salt/Sodium in Costa Rica 2011–2021  were traIn this research, we aimed to study food practices and perceptions related to excessive consumption of salt and sodium, at home and outside the home, in communities from all regions of Costa Rica, including various cultural practices of the population’s diet. Findings derived from participant responses served as input to identify the sociodemographic profile of the target segment and design formative research questions, in order to build a social marketing and communication plan for reducing the excessive consumption of salt and sodium.The present observational study is anthropological–ethnological. Ethnography was used as a research method, as ethnology is a branch of anthropology. This method allowed us to observe the behaviors of the participants. It also allowed for recording their cultural practices, decisions, and actions related to food consumption and the intake of salt/sodium in their diets. Explicit efforts were made to understand food consumption practices from the individual participant’s perspective. Ethnographic investigations have great potential for the interpretive and reconstructive analysis of reality .In order to meet the goal of constructing a reliable and comprehensive picture, four research techniques were used: (1) a semistructured interview , (2) an (1) Semistructured interview: the interviewee had the opportunity to express their points of view in an open remark interview situation. (2) Investigative workshop: offered the ability to explore the research topic from comprehensive and participatory perspectives through discussion, reflection, and group feedback. The purpose of these workshops was to complement and deepen the information obtained from the interviews with cultural experts and key informants from the communities. The workshops were conducted by an anthropologist, further facilitating the study investigation. Each workshop consisted of an introductory section, such as the explanation of dynamics and individual presentation, or the recapitulation of the previous workshop; a development section and a closing activity. (3) Demonstrations: were carried out by the participants who agreed to prepare dishes that they usually eat at home as a family. This allowed the researchers to verify what was reported during the interviews and workshops, and to identify other details surrounding culinary practices and family eating habits. (4) Participant observation: allowed the researchers to methodically systematize the information they observed, overheard, and otherwise gathered regarding daily practices and processes of salt/sodium consumption. Research team observations were made and recorded according to guides developed specifically for each technique, as well as the characteristics of the participants.First, interviews were carried out and systematized with cultural experts. Workshops and interviews with key informants were then developed, and observations were made during both. Last, demonstrations were conducted, with those participants who agreed to perform them. The four techniques allowed a progression from the description of the data, to reflection and action, on through the prioritization of facts and needs, culminating in the formation of decisions supported by the majority of the participants.The techniques are complementary to one another, enabling the collection of abundant, richly significant data, that when triangulated, validates the research results as pointed out by Maxwell (2002) .(a)Location according to geographical region: the selection of locations for data collection was based on the regionalization proposed by the Ministry of National Planning and Economic Policy (MIDEPLAN), considering the dimensions of the economy, social participation, health, and education. The country consists of seven provinces divided into six regions: Central, Brunca, Chorotega, Huetar—Atlantic, Huetar—North, and Central Pacific. Most of the population (62%) resides in the Central Region, which was thus subdivided into four subregions: Central North (Heredia), Central East (Alajuela), Central West (San José), and Central South (Cartago) .(b)Statistics on cardiovascular mortality were provided by the Directorate of Health Surveillance of the Ministry of Health of Costa Rica . Key comThe study was carried out in 23 communities in Costa Rica, selected based on two criteria:Key informants were recruited by our cultural experts primarily via, by the following criteria: ages between 20 and 65 years; sex ; minimum residency time in the community of 10 years; cultural roots (knowledge of the region’s food supply), and responsibility for home meal preparation, purchasing of food ingredients or doing both. In addition, snowball sampling increased the number of participants.The cultural experts (managers) were social scientists with knowledge of the region and its culture. They were hired by the Ministry of Culture and Youth to work with the local counterparts of these communities, promoting processes associated with sociocultural management . Their work is aimed at co-ordination, production, participatory training, and research, in order to instill self-management capacities that allow each community to direct its own cultural development, well-being, and holistic health.Due to the small population of our communities, the sample size for this qualitative study was determined by relying on past investigative projects in which optimal results were achieved by interviewing two individuals, and having group discussions of 6–8 participants (19). This saturation-based criterion was applied to each of the communities involved in our study.The 91 participating adults comprised 11 cultural managers and 80 key informants (26 participated in interviews and 54 in 12 workshops).In the present study, special attention was paid to the ingredients added during food preparation to increase taste and aroma. Salt, seasonings, and condiments were classified according to the Costa Rican context and the research objective. Common or discretionary salt was tested independently of other flavorings, such as seasonings and condiments. Seasonings were conceptualized as herbs and natural seasonings without added salt, such as onion, garlic, bell pepper, and cilantro, among others. Condiments were defined as those processed products with added salt, such as dehydrated bouillon powder, bouillon cubes, sauces, and dressings, among others.The list of the questions (by study category) used in the participant interviews and their corresponding community workshops can be found in The field research was conducted between February and July of 2016. It was carried out by an anthropologist with the assistance of social, nutritional, and food science professionals. The statements were recorded with a voice recorder and photographic images were taken in order to have evidence of the cultural material  related The themes and concepts of the data were derived from the predefined categories in the previous exploratory study (19) and considered those emerging from the present study. For the systematization of qualitative data, we considered the theoretical–conceptual components, based on the Social Ecological Model ,30. All The analyzed information was classified into two types—household cooking and eating out—given that the food sources of sodium, and strategies to control excessive consumption differ for each of these scenarios. In addition, for food prepared at home, details on practices and perceptions to enhance flavor with (a) common salt and other salts and (b) seasonings and condiments were given, as they are the primary sources of sodium in Costa Rica . Speech The Scientific Ethical Committee of the Costa Rican Institute of Research and Teaching on Nutrition and Health (INCIENSA) approved this observational study; the code is IC-2015-01. All participants voluntarily agreed to sign an informed consent form, including authorization to record conversation and capture photographs. At the time of the study, the Costa Rican National Health Research Council (CONIS) certified the researchers as observational and interventional researchers.The cultural managers were 55% men and 45% women with university degrees and professional training in the areas of social sciences, communication, or dramatic arts. They were over 30 years old and had worked for the office for more than 4 years (some exceeding 15 years). Through their work, cultural managers understand the sociocultural characteristics of the population, as they carry out activities focused on cultural management, artistic cultural expression, entrepreneurship, and the revitalization of (tangible and intangible) cultural heritage.Of the community members, most (>61%) were middle-age adults (35–65 years) and women (88%) with different occupations. Most women were engaged exclusively with domestic work (>42%), followed by merchants and professionals (17% each) and students (13%). The remaining were operators and technicians.The participants interviewed were additionally categorized. They had very different educative levels . Most reported belonging to lower and middle socioeconomic strata , which was confirmed through the index created. Most (71%) reported their ethnic group as mixed ancestry (“mestizos”), the remaining being white (17%), indigenous (8%), or Afro-Caribbean (4%). Most reported not having high blood pressure (72%) and none as having noncommunicable diseases (NCD).®) was mentioned for breakfast. In the Chorotega Region, dinner was served with “gallo pinto” and corn tortillas with smoked cheese or “Bagaces”-type artisanal products with high sodium content.According to the statements of the participants and the observations made by the research team, the basic meal for lunch (noon) in the study communities was “casado”, which consists of rice and beans (black or red) with some protein of animal origin , ripe banana, a salad consisting of cabbage and tomato, “picadillo” (chopped vegetables), and corn tortillas; the latter common mainly in the Chorotega Region. In all regions, the consumption of “gallo pinto” . Flavoring was carried out by adding common table salt, “olores” , and herbs , which had been partially displaced by bouillon cubes, dehydrated bouillon powder known as “consomé”, dry herb mixes with added salt, and commercial sauces to achieve the desired flavor, mainly in the younger generations. In all regions, table salt was added to food with the fingers, or sometimes a spoon. Participants indicated that people of indigenous origins (or their descendants) salted food for its preservation, a practice that is being lost.® sauce had become popular in recent years. The intake of fast food, which is rich in salt, has spread throughout the country, due to the demands of young people and tourism. International cuisine has been mainly introduced through tourism in coastal areas. Youth from the Central Region reported new trends in cooking  or lifestyle .The consumption of tropical fruits with salt, especially among the youngest participants, was present in all of the communities of the country, while LizanoAccording to the population consulted, the acquisition of family food or grocery shopping was carried out conjointly by both parents (37%); just a father or mother (13% each); or sons and daughters, but in low proportion (12%); while the remaining 38% were a combination of father with daughter, mother with daughter, and all members of the family. The decision-making process was usually carried out jointly, with its variants according to the composition of the family nucleus.Based on these observations, three types of buyer profiles were identified within the residents of the different participating regions: young people who had begun living independently, families that have minors among their members, and families where there are no minors.As most participants were women of economically active age who work part-time or full time, mothers alone (54%) or with their daughters (13%) prepared and served meals during the night and morning before going to work. Just 12% of men reported cooking food at home .“Do you cook every day at home? Who cooks?Yes, we cook every day. Women are the ones who cook, and, on special occasions, men feel probably ashamed, sorry, men get involved. Hahaha”Participating mothers agreed that they have changed their taste for adding salt or condiments when preparing food. Furthermore, they declared that in the past, seasonings were used to cook, while commercial products are now added. The use of seasonings in combination with condiments is frequent during the preparation of food.® sauce, mustard, we can add… what else can we add, it can be complete with Lizano® sauce.”“Look, here it is, this is the rice with chicken that we are going to prepare, we are going to add all kinds of condiments, vegetables..., we are going to add bell pepper, celery, cilantro and condiments, and a little salt. And then, here are the mayonnaises; the dressings that also have a little salt for taste and a few condiments, also to add a little flavor, we can add mustard. And here are the condiments that we are adding. It can be a few bouillon cubes, that’s what the lady says, we can add a little bit of LizanoParticipants pointed out that, while preparing food, they try the food and add more salt or condiments until they feel that it has a good flavor:® sauce, all that—haha—I try it for salt with the tip of the spoon. If it’s salty I do not add any more, but I do if it needs a little. As I was saying, I only calculate it myself, a half teaspoon, a pinch, a teaspoon.”“Because I add condiment, bouillon… LizanoMost participants believed they cook with only a little salt; one participant, for instance, indicated:“You taste it, you never know (…), add a little first and, then taste it. If you feel like you almost don’t taste salt, you add a little more, and so on, you continue tasting it.”® sauce, ketchup, mayonnaise, and/or dressings.Most informants agreed that salt in excess is “bad” and exemplified it with phrases such as: “If you eat a lot of salt you become a donkey,” “It is salty,” and “Some salt fell on it.” Most of the interviewees showed no reluctance to reduce salt/sodium consumption during food preparation. However, there were reservations about family members who would complain when a meal was prepared with less salt and end up adding more salt to the dish served, as well as LizanoAnanas comosus) and orange (Citrus sinensis), in natural state or juice, with salt. In addition, they reported eating mango with salt and lemon and, as observed in the parks of the communities, they sometimes add Lizano® sauce. Additionally, they mentioned that sweet-tasting food and products do not contain salt/sodium.Data collected through interviews and observations confirmed that locals usually consumed instant soft drinks, breakfast cereals, cream sandwich cookies, sweet bread, canned sweet corn, canned fruit cocktails, and added ketchup in meals. In addition, depending on the taste, the population tended to balance sweet and sour flavors by adding salt to enhance the flavor. They consumed pineapple  with a side salad , mashed beans, and chips; these are served with soda crackers on “special” occasions.Psidium friedrichsthalianum), guava (Psidium guajava), mango (Mangifera indica), and pineapple; to fruit drinks (orange juice); to alcoholic beverages, such as tequila  and “michelada” beer . Young adults pointed out that they would not stop consuming salt and will continue with the practices of directly adding salt or Lizano® sauce to fruits.Most community participants stated that salt is a basic ingredient used to give flavor to foods. It is also used to give flavor to fruits such as orange, cas  located in the kitchen and add it to the food served (only on their plate). They reported that the use of saltshakers on the table is rare.Those responsible for preparing food in families reported not usually using standardized measures to add salt to the dishes but, instead, would use a spoon (for ease) or a pinch  to get food to the desired level of saltiness.® salt brand in their homes. To improve the taste of foods, they also use other types of salt, such as sea salt, flavored or seasoned salts . Some bought sea salt, as they believed it to be thicker and healthier, as it does not contain bleaching additives, while others tried low-sodium salt on the recommendation of health personnel, but did not like the taste and, so, stopped using it:Most of the mothers interviewed mentioned that they had become used to the SalSol“It was Naty who, when we were preparing hash for an event, told me to please get her the sea salt, and since then, I only buy that. Then I bought sea salt and this one. It is more expensive, but for me, it salts more with less quantity.”“Well, I try to buy this sea salt from a friend who goes to Lepanto, Puntarenas to bring salt, she brings this one and another one a little thicker, but it’s not as thin as common salt, it is not a specific brand. And if I don’t have this one, I buy SalSol.”“I always look for... this one... I don’t know! I think this is the best one, coarser, well, let’s say it like that, it has like bigger grains. I believe the more refined the salt, the more harmful, you know, how they process it and all that. So, I think this is the best one... I always go to the supermarket and look for the one with bigger grains.”“I generally use the coarse salt for meats, either broiled or baked. It is usually very used for that.”There is a community recognized in the country for the commercialization of pork rinds (fried pork meat), to which they add a different type of salt—curing salts (composed of sodium nitrites and nitrates)—which provide intense color and flavor to meats, such as pork meat:“Then, it depends on how it is done. My husband learned how to cook pork rinds from my sister’s husband, who in turned learned the recipe from Puriscal residents, and his pork rinds are delicious without being too salty. Another fact is that people from Puriscal and Mora use pink salt, they use it on the pork rinds to give them that color and taste that you cannot find elsewhere. My husband has even had one glass of that salt, bought from the butcheries in Puriscal. It is like salt contraband because it is what they use and it is one of Puriscal pork rind’s secrets. You can go eat pork rinds anywhere else and they will never taste like pork rinds from there.”When key informants from the community were queried about salt fortification, it was evident they did not have any knowledge about it. Few of them knew that salt serves as a source of fluoride and iodine, although they recognized the contributions that iodine and fluoride make to the body separately.® sauce, mayonnaise, and tomato sauce). In a few cases, they just used a small amount of seasonings.It was observed that, while preparing food, women mixed seasonings  with condiments, instant soup, dehydrated creams, and commercial sauces , and dressings . A smaller group declared using bouillon cubes and flavored salts to give more flavor or to improve the taste of food during its preparation and to quickly achieve the flavor preferred by most of their family members, who judged whether the food needs more salt or flavor; or, on the other hand, consider that it was prepared with “love”.Most participating mothers indicated the use of condiments, such as bouillon powders , dry-herb mixtures with added salt, commercial sauces  referenced new dish preparation practices, mainly due to the offer of products sold to create specific flavors. They added shrimp bouillon to rice to prepare rice with shrimp flavor. They used dehydrated soups with mushrooms, noodles, meat, or vegetables to prepare sauces for meats or pasta, and also used breading batter to prepare fish, seafood, and chicken.Participating younger and older women, as well as men, indicated that the incorporation of new practices into food preparation related to the diversity of products in the market and the desire to give food the taste of international dishes. There were mentions of using soy sauce and oyster sauce to give food an Asian flavor.“Condiments, all of them, or seasonings better said and a little oyster sauce. And I do not add salt because it (oyster sauce) is salted already.”“(…) mostly when they eat fried chicken, they put it on the fries and the one I use is oyster sauce.”Soy sauce, called Chinese sauce in Costa Rica is used in the preparation of fried rice :“I cook lots of fried rice. I boil it first, because rice needs to be boiled in order to be fried. Boiled rice without salt in it. I do not use salt when I am frying it; I put Chinese sauce in it. Chinese sauce is salty; therefore, no salt is required. Well, before I would put a little “ajinomoto”  in it. I no longer buy it for anything, but the Chinese sauce will salt it.”Another sauce that mainly young men mentioned as a red meat and chicken wing seasoning was BBQ sauce, either for grilling or frying. Its use was attributed to various goals:“(…) it gives food a very original taste, delicious.”“Those BBQ ribs; take the ribs and the wings and wash them well and put them to… (pauses) pour oil in a pan and put them in the oven. When they are almost done, before taking them out, pour the BBQ sauce. Then the BBQ sauce will give them flavor and you do not need to put anything else on them.”Moreover, it was common to use a commercial vegetable sauce to prepare many dishes. One of the informants expressed:® sauce is used in all dishes here, it is almost indispensable, and I know it must have lots of sodium because it is pure condiment, right? It is used in “pinto”, in eggs…well not in white rice and beans, but certainly when recipes are prepared: “picadillo” (hash) or like the soup I am currently preparing, I will put a little Lizano® sauce in it shortly. But yes, generally almost everything has Lizano® sauce in it; well…it is English sauce…”“For everything! LizanoThere was a diversity of commercial bouillon powder brands in the national market. However, people expressed a preference for one specific brand, which is well-positioned in the market:® because that is what my mom used to buy. I have never tried a different one, I always buy that one, let’s say bouillon powders…”“Well, I do not know, I always buy MaggiAs part of food preparation practices, some participants combined bouillon powders and domestic salt; others added bouillon powder instead of natural seasonings:“Many people do not know that if they work with spices, food is really good without putting bouillon powders on them; that is what salt is for. Nevertheless, people do not realize it. People think that if they do not use bouillon powder, their food will not taste good.”® products had prevailed from generation to generation, for its use in chicken and beef rib broths, as well as instant soups and dehydrated creams. The majority said they consumed these products due to tradition and the taste they give food. The observed practice was to add natural seasonings by adding a small packet of bouillon powder and Lizano® sauce. Participants highlighted that foods with high salt/sodium content, despite being “harmful”, were utilized due to their “ease of use”, low cost, and social consumption tendencies, as these are often advertised in television programs.The participants of the workshop expressed that the consumption of Maggi“It would be hypocritical to say that I do not buy, when I like to make rice with chicken and put some in it, I buy canned sweet corn. Because it comes ready, so it is better. To avoid chopping, maybe and reduce effort, to avoid being in a rush.”It was discovered that in certain communities, foods with high sodium/salt content were consumed and a taste for other types of food had been acquired. The further a community is located from the country’s central region, the more some products vary, both in price and availability. In some communities of the Brunca region (the southern region of the country), the consumption of canned goods, prepared sauces, and export fruits is more common than in the central region of Costa Rica, as its closeness to the border with Panama facilitates the commerce of these products at a cheaper price than in national stores.Through observation of the warehouses or distribution centers in the different regions—specifically in the population’s main places of purchase, such as markets, supermarkets, grocery stores, and soda shops—an ample offering of foods with high sodium/salt content at low cost was found.The participants explained how this resulted in a rapid increase in the popularity of certain food items, such as was the case with “caldosas” (corn snacks with fish cocktail stock), which originated in Palmares (a county in the Alajuela province) and, in less than 2 years, were being sold in restaurants, soda shops, and grocery stores in the Central and Northern Huetar regions. Some inhabitants discussed how vegetarian and vegan alimentary trends had spread as ideals, implying changes in the acquisition of products and how food is prepared in these communities.“tastes like hospital food” ; “it is our means of life, we cannot live without salt because it is the flavor in food” (Woman Liberia); “it lacks love” referring to food preparation (Woman Limon); “without salt, food has no taste”  and “food tastes better with salt” . A link between flavor and the feeling of love for homemade food and the satisfaction produced when food is consumed was identified among the participating population of this study. The main sources of emotions associated with the consumption of foods with salt are shown in Female participants said they could reduce the quantity of salt added during meal preparation but could not eliminate it completely unless it was a medical recommendation—and in any case it would be difficult to abide by. Some expressions or meanings used to reference food with less than desired salt were: Piper auritum), and “bijagua” (cigar plant) leaves (in the Northern region), to provide flavor and seasoning to food, thus reducing the use of salt.Most interviewed mothers recommended the use of traditional seasonings, such as natural seasonings, Panamanian pepper and ginger in lemon juice, “anisillo” .Some women mentioned the influence of what is cooked when certain chronic diseases like diabetes and high blood pressure are diagnosed, as it becomes necessary to make adjustments in meal preparation. The members of the family tended to rate this adjustment as being flavorless. In addition, the participants believed healthy food to have a high economic cost.Teenagers and young adults who were interviewed reported a shift toward contemporary alimentary practices; they prepared nontraditional recipes, while others were vegan, vegetarian, or alternative in type. According to the participating population, the latter are oriented—from their point of view—to healthier lifestyles, as they associate healthy nutrition with fat-restricted diets and emphasize the importance of performing physical activity.“His wife prepares him a healthy snack because she loves him and does not want to be widowed early, and it turns out that at the office the guy takes out the healthy food she prepared, opens his desk drawer and pulls out the salt shaker…”Consumers wishing to raise awareness in their households about the products they buy were among the group of young adults; they promoted reading the ingredients list of processed products. However, none indicated being interested in observing the amount of salt/sodium in food.“As a consumer, what do you need in order to buy products that are low on salt? I think what I am missing is to read a little more because normally almost all products have details of the composition. Well, the fact that everything is labeled makes shopping easier, to know the quantities and as I was saying, it is good to go to lectures where you are told about the good stuff and the right amounts. At least about sugars, she told us mostly about sugar not so much about salt. She told us that one spoon a day is what the body needs to fall into excess.”Most participants, regardless of their age, expressed having a good income and confessed eating out more than twice a week, which was mainly driven by social engagements with friends, family, or work colleagues. On the other hand, participants who expressed having a more limited budget listed special occasion celebrations or time constraints as motives to eat out, with the immediate solution being “eating at a fast-food restaurant” or “ordering take-outs” with high sodium content, such as fried chicken, hamburgers, Chinese food, French fries with ketchup, “tacos”, and pizza, among others.®”. When adults are celebrated, they choose places where the food is more elaborate. Adults expressed preference for seafood restaurants and restaurants with à la carte menus. For most of the celebrations, participants reported using sauces and dressings to season meals, and consumed soda and alcoholic beverages in greater quantities than usual. Young participants said they “look for a healthy meal” so they usually visited establishments with sushi, vegetarian, or vegan food, which are mainly located in the central region of the country. They noted that in remote regions there are few establishments of this type; there are only shops with natural smoothies and mango strips  and if is outside and it is dinner, it is a triple sin. I categorized it in two scenarios. One goes out to eat or one is invited to dinner at someone else’s house. Then, if one goes out to eat, maybe the healthiest choice is ordering sushi…a miso soup, a salad or a roll. Otherwise, it is probably going to be pizza, but it depends of the quantity. Depends on the quantity and personal finance. Nowadays life is hard, even if I have strong cravings, I cannot treat myself, at least not me…because you know, you need money…dammit…things are tough.”Two main types of dining out establishments were identified: fast food sales and restaurants.In a similar fashion, most inhabitants stated noticing an increase in the number of food establishments, especially fried chicken and “caldosas,” as they are very cheap and liked by youths in the participating communities.“Fried chicken, the shops are everywhere, on every corner. In Heredia, chicken is sold all over the place. Chicken is sold everywhere. Chicken is always sold with lots of condiments. Lots of condiments. Since it is sold very cheap, it is sold a lot.”In the present study, we reiterate that in Costa Rica—as in other countries of Latin America—women are generally still in charge of cooking and “setting the table” ,33. NeveFood preparation at home has been linked to better diet quality, as the intake of sodium can be reduced ,35. NoneIn Peru, most mothers use condiments when preparing food ; this prthe food is just right”, “this is how I wanted it”, “and “this is how my mom (grandma) made it”.The explanations provided by participants regarding home food preparation highlighted the primordial role of natural seasonings and the practice of combining them with condiments to achieve the desired flavor in a dish, similar to findings in Peru . It was In regard to new ingredients incorporated into preparations, a lack of knowledge was observed regarding the amount of salt or sodium that these contain and the need for participants to have educational competence to read and interpret nutritional labels—a tool widely used to select healthier food . These nSome people who suffered from hypertension or had relatives with this illness mentioned the importance of having a low-salt diet in order to keep blood pressure in check. In general, they recognized that excessive salt/sodium intake is detrimental to human health; however, they made inadequate use of this knowledge and were unable to explain why, reflecting inadequate biomedical knowledge. These findings are similar to those found in Peru  and are One fact to consider is that people prioritize taste over possible detrimental effects that food high in salt/sodium has on their health, as found in the present and other studies ,40. MostThe present study confirmed a link between flavor and the feeling of love in food prepared at home and the satisfaction generated when consumed; this coincides with the findings of an exploratory study conducted in Argentina, Ecuador, and Costa Rica , as wellDuring the interviews, most of the participants (72%) stated that they did not have hypertension, while 28% reported having diagnosed hypertension—a value slightly lower than the national prevalence . It is pWhen participants of the community spoke about changes to their diet and cooking practices, this was often due to changes associated with age, lifestyle, or generation. There was concern among the participants about the change in flavor caused by a reduction of the salt/sodium content, which requires time for the consumer’s palate to adjust. These synergistic efforts between the communities and the Costa Rican food industry could enhance the success of future social marketing interventions .Most of the interviewed participants acknowledged the frequent use of condiments to enhance the flavor of their meals; thus, learning about the use of condiments in the culinary culture should be considered a strategic measure for reducing salt/sodium consumption . In the As salt is not the only source of sodium, social marketing strategies could also highlight the importance of learning to moderate the use of sodium products, such as curing salts and monosodium glutamate. Salt measurement would allow people to be aware of when they are using too much salt and to consider reducing it.® sauce, mayonnaise, and tomato sauce), seasonings, and flavored salts to meals. Finally, education about the health risk of the use of curing salts, which have been associated with certain types of cancer, should be facilitated [Therefore, those responsible for public health policies must change their approach and methodology. This could consist of carrying out several strategies simultaneously, such as social marketing, emphasizing the physical visualization of the recommended 5–6 g of table salt per day and the dangers of food types with hidden excess salt/sodium, as well as providing education on how to interpret the sodium/salt content from the labels of processed products. Furthermore, it is important to discourage the excessive addition of salt/sodium, condiments, breading, dressings, bouillon , bouillon cubes, instant soups, dehydrated creams, commercial sauces . These flavored salts may have influenced the evolution of Costa Rica’s culinary culture, which has become globalized , as evidAnother important issue to take into consideration is the ignorance of the population about salt content in food that does not have a salty flavor. In developed countries, researchers have found that many people did not recognize hidden salt in processed food . By contSocial marketing and communication in Costa Rica should be directed toward promoting the reduction of salt/sodium consumption in Costa Rican households, taking into account the following items: negative attitudes towards diet changes, the value of taste/flavor in food, the notion of preparing food with “love”, the practicality of achieving desired flavors, the low availability of certain ingredients in some areas of Costa Rica, and economic limitations.Therefore, the strategy should be focused on the positive aspects of reducing salt/sodium consumption, such as health improvement with an emphasis on preventing high blood pressure. Even though the participants made this association, they did it in a weak fashion at best; not strongly enough to drive the desired behavioral change. Some participants even perceived hypertension as a disease that is common among people and not very serious when compared with diabetes or cancer. They believed that high blood pressure can be controlled by just taking a pill, while diabetes is painful and complicated, as one needs to take insulin shots and may eventually suffer from limb amputation.The strengths of the current research include its national scope and accountability for cultural diversity concerning food preparation practices and perceptions about the use of salt, seasonings, and condiments. The socioeconomic status of the participating population predominates in Costa Rica; therefore, the results on food preparation and acquisition reflected what happens in a majority of Costa Rican families during the period of study.A significant limitation of the present study is that most of the participants were women, given their availability at home during the daytime when the research team made their visits; therefore, it is necessary to explore the perspectives of men in more depth. Some studies have shown that men use health services less than women and have less knowledge of their health status ,56; howeThe addition of excess salt, as well as other industrialized ingredients with high sodium content, was found to be characteristic of the preparation of food, both at home and outside the home, in Costa Rica.Beyond the cultural and geographical differences in Costa Rica, age factors were suggested as being the main differentiators, in the use of salt, seasonings, and condiments for home food preparation, the type of recipes prepared, and in the selection of the type of establishment to eat out at (the latter was affected by economic aspects as well).Most participants did not have a clear understanding of their daily salt/sodium intake, as they could not calculate the salt added during food preparation or hidden in a variety of foods, including sweet flavored and processed products.Finally, the present study revealed that salt is an essential component of foods with strong cultural roots. Its flavoring function in food preparations is associated with emotions and caring of the family. The deeply rooted values and meanings associated with its use in food indicate that the implementation of salt reduction strategies in Costa Rican communities is challenging, requiring scientific precision in designing community interventions.


Dear editor,well. However, a closer look at the current literature in the field of radiopharmaceutical development reveals a plethora of flaws and inconsistencies in the design and execution of preclinical animal experiments, challenging what we aim for most, i.e., validity of our data as an indispensable basis for clinical translation.Animal experiments are vitally important for evaluation of newly developed nuclear tracers for imaging and therapy of cancers and cannot (yet) be adequately replaced. We have the ethical responsibility to keep the number of animals and level of discomfort to a minimum, but at the same time, we aim at generating preclinical data with maximum validity and statistical significance. The best way to balance these aspects is to design and perform these experiments The validity of preclinical animal data is primarily defined by (A) the choice of an animal model with maximum achievable similarity in biology and symptoms with the human disease and (B) the choice of realistic, clinically translatable experimental conditions  . Both asIn this research area, it is particularly important to differentiate between the “natural” bias that is inherently connected with using mouse tumor models, and the bias that is introduced by choosing an inappropriate model for the evaluation of a novel radiopharmaceutical.As to the first aspect, it is evident that a model, per definition, cannot be a perfect replication of the clinical condition . We willtracer evaluation rather than target evaluation as in, e.g., classical oncological fundamental research studies trying to elucidate the role of a given molecular component in tumor biology or as a target for novel therapeutics. This entails a slightly different angle of view concerning the selection of an “appropriate” tumor model, and in this letter, we try to draw attention to some, in our opinion, crucial factors that challenge the validity of animal experiments in current nuclear oncology practice.However, preclinical radiopharmaceutical research is usually centered on 18F-labeled MCR1-targeted imaging agents Lu-DOTA-TATE or [177Lu]Lu-PSMA-617 are in the range of 7.4 GBq/patient, corresponding to ~ 0.1 MBq/g body weight. Mice are injected with 30 MBq, leading to a more than tenfold higher ratio of activity/gram body weight, i.e., > 1 MBq/g. Given this substantial “overdosing” of mice compared with the human situation, it is not surprising that almost any radioligand therapy treatment has some effect on survival in mice, an outcome that is expected—and strongly biased. This, in our view, generally challenges the usefulness of radioligand therapy studies in mice, especially in the light of the excellent and constantly improving dosimetry extrapolations from mice to humans. Representative mouse biodistribution studies  allow us to generate initial dosimetry data with good congruence with the human situation, and subsequent individual patient dosimetry, applying the therapeutic tracer at a low dose (< 185 MBq), provides much more valuable information on whole body dosimetry and the expected therapeutic efficiency of a given tracer than mouse therapy studies will ever do. We thus suggest to critically question our established workflows and to adjust them accordingly, driven as much by ethical considerations as by the desire to produce valid and valuable data.Another example, where metrics are in blatant disfavor of data validity, is the concept of radioligand therapy in mouse models. In therapy studies, the relevant parameter of observation is, by definition, the therapeutic efficiency of a given radiotracer. This, in turn, is determined by the dose deposited in the tumor—which, when considering the currently used protocols, is subject to substantial bias, just looking at simple mathematics: A tumor with 6 mm diameter (~ 1 g) represents a small tumor in a human and constitutes in average 1/75000 of the total body weight (TBW). In a mouse, the same tumor—and tumors frequently reach that size in therapy studies—corresponds to 1/25 of TBW. In humans, standard administered doses of, e.g., [In summary, we are well aware that all those involved in preclinical tracer development are doing their best for generating valid data with translational relevance. However, we do see room for improvement, not only on the experimental level but also on the level of peer review and Editorial Offices as well as Nuclear Medicine Societies. The community would certainly profit from a sharpened awareness concerning the “sense and nonsense” in our current practice of conducting animal experiments, including more critical review of obvious inconsistencies in the experimental setup and stricter quality control before publication. Moreover, a certain degree of harmonization concerning “approved” tumor models with realistic target expression or translatable tracer doses/molar activities, at least for one given molecular target, would greatly support a better comparability between data from different groups. And ultimately, it would allow us to reduce the number of bias “traps” on our way towards translating our developments into the clinic for the benefit of our patients.


In relation to COVID-19, little research has focused on the study of variables that affect well-being during this pandemic. The purpose of this research is twofold: (1) to find out if people experiencing a quarantine are able to appreciate any positive aspects of it, and to analyze how these responses are categorized and (2) to check if there are differences in levels of well-being according to these categories. There were 243 representative participants of the Spanish population according to sex, age, and educational level. The methodology was mixed, qualitative for the first objective and quantitative for the second. The first used the Thematic Network, while the second used logistic regression. From the qualitative analysis, three major categories were extracted: intrinsic orientation, extrinsic orientation, and empty orientation. The quantitative results showed a clear advantage in well-being for the intrinsically oriented group. The group of intrinsic orientation presented a better coping ability while the group of extrinsic orientation was as little adaptive as the group of empty orientation. Recommendations are extracted from the results. Coronavirus disease 2019 (COVID-19), caused by SARS-COV-2, is the physical health problem having the greatest global impact in recent decades  showed tDifferent studies  show howAlthough the proliferation of research on the psychological effects of COVID-19 on the population increases every day, little research has focused on studying the variables affecting well-being during this pandemic. In general, studies on well-being can be classified into two different but interrelated perspectives: hedonic well-being and eudaimonic well-being. The first, or subjective well-being, refers to the balance between positive and negative affect (affective component) as well as to the overall assessment of one’s own life (cognitive component). The second, or psychological well-being, identifies happiness with personal realization and puts its focus on the human potentialities that allow us to function positively and “flourish” as people ,13. In the relationship between COVID-19 and well-being, the small amount of research found has focused on studying the association between fear of getting the illness and well-being, measured in different ways. For example, Lu et al.  found thTo understand if people who are experiencing a situation of confinement are capable of appreciating positive aspects in it and, in this sense, to identify which categories emerge from their responses.To analyze whether there are differences in subjective and psychological well-being in the categories identified through objective 1.Our research is related to this studies that attempt to analyze well-being during the quarantine due to COVID-19. In our case, the question was whether people could find something positive in being confined in their homes, due to mandatory quarantine. As far as we know, to date, this question has not been investigated. Mandatory confinement can be a sign of the severity of the infection and is associated with greater discomfort than voluntary confinement . In addiThe method used was mixed: qualitative to respond to the first objective (Part 1) and quantitative to respond to the second objective (Part 2). To respond to the first objective, we used a qualitative method because : (1) It To respond the second objective, we used a quantitative transversal method with the purpose to understand which of the categories identified before were better predicting well-being under lockdown due to COVID-19Using a non-probability sampling procedure called snowball or chain sampling , the parAn ethical committee from a Spanish public university (Ref. 2019/20-030) approved the research. An online questionnaire, which contained both the qualitative and quantitative components for data collection, was designed through the Google Surveys application. The link to the questionnaire was launched via social media, and subjects interested in participating accessed the questionnaire after reading and accepting the informed consent form. Responses were obtained in the last week of March.Qualitative component“Considering your particular case, what is the best thing about this situation?” (the situation refers to confinement because of COVID-19).To explore the insights for the qualitative objective, the following open question was asked:Quantitative componentThere were three measures used for the quantitative component of the questionnaire:A question used by the Centre for Sociological Research  was adapWe used the updated Spanish adaptation  of the oThis scale is a measure of psychological well-being with five Likert-type response points. It consists of 33 items that group together 11 psychological resources, which in turn form a second-order factor, which is what provides the scale’s name . It has To analyze answers to the question, “Considering your particular case, what is the best thing about this situation?” (confinement because of COVID-19), the Thematic Network proposed by Attride-Stirling  was usedIt should be noted that in order to avoid subjectivities of the authors and to triangulate the result, all steps were discussed in analytical meetings by the four researchers until reaching inter-judge agreements. Descriptive statistics were calculated for each of the well-being dimensions, utilized according to the type of orientation found in the qualitative analysis . A logistic regression analysis was later done comparing people with intrinsic orientation with those who have extrinsic orientation and with those having empty orientation, and the group having extrinsic orientation versus empty orientation in psychological and subjective dimensions of well-being.From analysis of the responses given by the 244 participants, seven categories surfaced that we have arranged here from highest to lowest of occurrence and which structured 100% of the responses. It should be said that only 5.7% of total responses had double references. For example: “Spend more time with family and telecommuting.” In these cases, only the first reference was classified in order to not have repeated dimensions. The first category was called “creating closer ties with the family”. This dimension brought together 24.69% of the answers given. By analyzing this information, it is inferred that the situation of confinement in homes has made it possible for family members and people who cohabitate to spend more time together, creating closer ties, strengthening their union and the enjoyment of living together, something they could not do in a normal situation. Some examples that illustrate this category would be: “Enjoying the family more” (Subject 100). “I’m spending more time with my parents and playing a lot with them” (Subject 132). “Family togetherness” (Subject 161). “Being with your loved ones” (Subject 167). “Having more time to be with my son” (Subject 192). The second category was called “personal development” and brings together a set of responses regarding with personal growth. There were 22.2% in this group. Thus, included in this category were responses mentioning reflection and introspection, returning to essential values, and learning. Some examples of reflection and introspection of are: “You value things that didn’t matter before” (Subject 9). “Inner reflection” (Subject 42). “Time to think and reconsider what is urgent and what is really important” (Subject 92). “Self-analysis” (Subject 158). In regard to values: “Resilience” (Subject 29). “Civic response” (Subject 41). “Togetherness” (Subject 59). “Seeing there is increasing awareness, more solidarity” (Subject 141). With respect to learning: “Time to learn new things” (Subject 13). “Learning to do things better” (Subject 220).The third category was called “time” (17.3% of the responses). This dimension gathered answers related to the possibility of taking advantage of the time the confinement gave them to devote themselves to doing things they had pending, to devote more time to themselves, and to enjoy time for itself. Some examples of this category included: “Having time to do things I don’t usually do” (Subject 221). “Having more time for myself without outside pressures” (Subject 179). “Having free time” (Subject 76).The fourth category was called “nothing”. 13.9% of the subjects found nothing positive in the confinement. Some examples are “Nothing” (Subject 2). “I don’t see anything positive” (Subject 113).The fifth category was called “health”, and it groups together a whole series of responses that refer to taking care of your health by isolating, which makes it possible for subjects to sleep more, not have the usual stress, and to feel protected from infection. Some 10.28% of the answers belonged to this category. Some examples here are: “Relax” (Subject 114). “Don’t have to wake up early” (Subject 125). “Having a lower risk of infection” (Subject 222).The sixth category, called “telecommuting and study”, was very small (7.4%) and grouped together references to the perceived advantage in the change of daily obligations, whether work or study, due to not having to be physically present. Some examples were: “Telecommuting” (Subject 16). “Not having to be physically present at work” (subject 28). “Cyber-classes” (Subject 134). “More time to focus on studying” (Subject 128).The seventh category, the last, was called “miscellaneous”. A few responses (4.5%) were grouped here that did not fall into any of the six categories mentioned above. They mentioned issues such as the following: “Saving” (Subject 4). “My location” (Subject 63). “Going out to walk the dogs” (Subject 228). Analysis of these categories reveals three global themes: Intrinsic orientation, extrinsic orientation, and empty orientation. In intrinsic orientation we group those categories that, due to their content, refer to positive aspects that are valued for themselves. Categories forming part of this large group would be strengthening family ties, personal development, and time. In extrinsic orientation we include those categories that, from their analysis, refer to practical issues directly associated with the state of confinement itself, such as preserving health, telecommuting, or miscellaneous issues such as savings or walking the dog. Finally, empty orientation would constitute the smallest segment, made up of the category called nothing, in which responses from subjects who did not perceive any positive aspect in the confinement were grouped together. It has also been shown that when intrinsic orientation model is compared with an extrinsic orientation, and intrinsic or extrinsic orientation is compared with empty orientation, they differ in their levels of subjective and psychological well-being. The results of this analysis can be found in p = 0.062), this result should be considered tendentially. The type of orientation is not associated with either positive or negative affect. Although it is shown that the intrinsic orientation group scores higher in positive affect, close to significance when compared with the empty orientation group  follow an extrinsic oriented strategy. This means they are able to appreciate something positive with confinement. However, it is closely linked to the advantages of confinement itself, such as (1) taking care of health through isolation, which allows you to be more protected from being infected and to rest more; (2) telecommuting and tele-studying, as in many cases being physically present was prohibited; and (3) diverse issues such as the savings associated with lower consumption due to confinement. Only 13.9% belonged to the empty orientation group. This group included people who were unable to find something positive in being confined. When we compare the three groups with respect to the subjective and psychological levels of well-being experienced, it is interesting to see that the group with higher levels of well-being is the one with intrinsic orientation. This group experiences higher levels of psychological well-being, both when compared with the extrinsic orientation group and with the empty orientation group. This is a very consistent result, as these people have been able to identify positive aspects in confinement that are related to factors clearly linked to psychological well-being such as: positive relationships with others ,30, persFurthermore, when comparing the intrinsic orientation group with the empty orientation group, we found that the first one to show higher levels of psychological well-being and subjective well-being. It should be noted, however, that subjective well-being shows higher levels of positive affect (at the limit of significance) and in perception of overall happiness, but not of negative affect. In fact, there are no differences in negative affect in any of the groups. Thus, although people can find advantages in lockdown that allow them to develop more adaptive coping, they experience greater well-being, as is the case with the intrinsic orientation group. This does not mean they are disconnected from reality and do not suffer because of it. In other words, they have been able to develop an adaptive coping strategy. Which cannot revolve around the problem, as its modification is beyond the person’s control and does not imply a positive reinterpretation of it . HoweverFinally, the differences in well-being found at the quantitative level in the three groups triangulate the qualitative analysis, thus enhancing the validity of the findings . If the Cultivate conscious appreciation of the social and individual values that arise in such dramatic situations, such as solidarity, connection, civility, or resilience.Devote time to personal reflection and introspection as an opportunity to improve as individuals.Learn to appreciate the truly important things in life, which in the daily hustle and bustle go unnoticed.Take advantage of the moment to learn about new things that really motivate us but due to lack of time we had never pursued before.Take advantage of and appreciate the time available to do things we have been meaning to do related to learning, reading, taking care of the home or self-care and, in general, resolving pending issues.In the case of structured family that lives together during the quarantine, taking advantage and enjoying the time they have together that daily life during normal situations takes from them, and doing activities in common that distract them, letting you have fun and strengthen ties.Given our results show that intrinsically oriented people are better at coping with the quarantine, we are of the opinion that guiding others the strategies they have followed may help them in similar situations in the future. In this regard, the recommendations inferred from the results would be: It would be interesting to test the strategies identified by practicing them in a possible future situation of confinement with people from the empty and extrinsic groups, and to observe whether their levels of well-being increase. Of course, adapting each strategy to the characteristics of each person, making pre- and post-test measures, and comparing with a control group belonging to the same groups and having the same sociodemographic characteristics, and comparing with the intrinsic group. These results would allow us to clarify whether such strategies are truly effective in situations of quarantine.This is a cross-sectional study with a statistically sufficient sample size, but not representative of the Spanish population. However, the population distribution is respected in terms of sex, age, and educational level (in two levels). It would have been interesting to have longitudinal data that allowed us to understand how the variables studied evolve as the confinement lengthens.According to the results, we can conclude that those with intrinsic orientation are shown to be the most adaptive in the face of experiencing well-being during the quarantine. Nevertheless, the people with extrinsic orientation is just as non-adaptive concerning well-being as those with empty orientation. At the same time, the fact that some groups show lower levels of subjective or psychological well-being does not imply that they are unable to experience positive affect. Finally, it is important to remark that being able to appreciate positive aspects in the confinement does not imply being oblivious to the dramatic situation experienced and not suffering from it.


Friendship is commonly assumed to reduce strategic uncertainty and enhance tacit coordination. However, this assumption has never been tested across two opposite poles of coordination involving either strategic complementarity or substitutability. We had participants interact with friends or strangers in two classic coordination games: the stag-hunt game, which exhibits strategic complementarity and may foster “cooperation”, and the entry game, which exhibits strategic substitutability and may foster “competition”. Both games capture a frequent trade-off between a potentially high paying but uncertain option and a low paying but safe alternative. We find that, relative to strangers, friends are more likely to choose options involving uncertainty in stag-hunt games, but the opposite is true in entry games. Furthermore, in stag-hunt games, friends “tremble” less between options, coordinate better and earn more, but these advantages are largely decreased or lost in entry games. We further investigate how these effects are modulated by risk attitudes, friendship qualities, and interpersonal similarities. Coordination problems arise widely in social and economic contexts: from teams in the workplace . Based on this, we conjectured that friends, relative to strangers, might be at an advantage when they are to coordinate on options that mutually benefit one another , but that this advantage might be reduced—or even reversed—when they are to break the “degree of reciprocity” and coordinate on opposite choices . For example, suppose that, out of love for a friend , a player wants to pick the option that most benefits their friend and, by expecting that their love will be reciprocated, believes their friend will do the same . Under strategic complements, this is clearly optimal given that players have incentives to match their actions, and both preferences and beliefs point in the same direction. On the other hand, under strategic substitutes, preferences and beliefs can run against one another: out of love for their friend, a player may want to leave the most profitable option to their friend, but if she/he believes their friend will do the same, then no one will take advantage of the most profitable option, which is clearly suboptimal. This dilemma is strongly reminiscent of the following considerations by Karl Popper: “That love as such may be unable to settle a conflict can be shown by considering a harmless test case, which may pass as representative of more serious ones. Tom likes the theatre and Dick likes dancing. Tom lovingly insists on going to a dance, while Dick wants for Tom’s sake to go to the theatre. This conflict cannot be settled by love; rather, the greater the love, the stronger will be the conflict.” , henceforth referred to as the “UP” action (short for ‘Uncertain Payoff’), and a lower paying but safe alternative , henceforth referred to as “SP” (short for ‘Sure Payoff’) action. In both games, the UP action thus requires coordinating with others, while the SP does not. The only difference between games is the consequence of choosing the UP action. In the stag-hunt game, players can jointly obtain the highest payoff  only if they both choose UP; in other words, the highest payoff requires a player to opt for UP and their opponent to match such a choice. By contrast, in the entry game, a player receives the highest payoff of $15 if they choose UP, while their opponent does not, namely the opponent needs to mismatch. To isolate the effect of social closeness from learning, here, we focus on one-shot games.To investigate the impact of social closeness in coordination games with strategic complements and substitutes, we have participants interact with either a friend or a stranger in two classic two-player games with real monetary payoffs: in “stag-hunt” games, due to the existence of strategic complements, players have the incentive to In such a framework, we define “strategic uncertainty” as uncertainty related to the players’ behaviour in a situation with interdependent decisions  and the values of the sure payoff X are randomized without replacement. Therefore, each block entails 40 decisions: 20 decisions  having as counterpart a friend and 20 decisions  having as counterpart a randomly selected stranger (with replacement).For each game play, participants view the dollar value of the sure payoff  on one side of their computer screen (labelled “A”), and the fixed $15 on the other (labelled “B”) (the sides are randomized). Thus, the two coordination games visually differ only by what is written next to the uncertain $15 option. Stag-hunt games have the following text: “$15.00 only if your counterpart chooses B, 0.00 if your counterpart chooses A”; entry games simply invert the positions of A and B in the text: that is, “$15.00 only if your counterpart chooses A, 0.00 if your counterpart chooses B”. Participants are informed about whom they are matched with for their current decision. Specifically, they either read “You are matched with a stranger” or “You are matched with [friend’s name]”, followed by this text: “You are both reading these same instructions. You both have to choose between the following two options: A or B. Which one do you prefer?” A screenshot for the stag-hunt game is reproduced in Appendix each game play in the stranger treatment, they will be matched with a randomly selected participant from the experimental session: this could be a different person each time or the same person, but participants are told that the stranger cannot be their friend. Participants are also informed that, at the end of the experimental session, one of their decisions will be randomly drawn, and that they will be paid according to the outcome of that decision. For example, if a decision from the stranger treatment is drawn, then participants are randomly paired with a non-friend counterpart and paid according to their actual choices.Participants are informed that for After playing the coordination games, in the second part of the experiment, subjects take part in a lottery task to elicit individual risk attitudes, which have been shown to correlate with strategic uncertainty  of the University of Southern California. Students from a wide range of academic disciplines were recruited by both ORSEE Greiner  and flye8Participants were required to bring a non-romantic friend to the experimental session. Upon arrival, they were randomly assigned to individually shielded computer cubicles. Instructions were read aloud and followed on individual handouts. Then, participants answered several control questions to ensure their understanding of the instructions and they could progress to the next stage only after providing the correct answers.While participants were completing the post-experimental questionnaires, we downloaded their responses from the Qualtrics website and ran an in-house script to randomly match the participants; select at random the decision relevant for payment and determine participants’ experimental earnings according to their actual decisions. All procedures were approved by the local ethical committee.Our main interest lies in understanding the effects of friendship on strategic uncertainty across coordination games of strategic complements and strategic substitutes. Thus, we first construct the variable “UP action” by coding choices as 1, if the UP action is chosen, and 0 otherwise; then, we operationalise strategic uncertainty as the probability of choosing UP actions . We hypothesise that friendship may decrease strategic uncertainty in stag-hunt games , but not necessarily in entry games, where friendship may even increase strategic uncertainty .A natural question is whether these effects of friendship on strategic uncertainty are entirely driven by prosocial preferences. As argued in the introduction, prosocial preferences for one’s friend  may induce friends to choose the UP action more frequently than strangers in the stag-hunt game and the SP actions in the entry game. We thus code both these actions  into the “prosocial action” dummy variable. We hypothesise that if friendship only operates through a prosocial preference channel , it will equally increase the probability of prosocial actions in both games. Any differential impact of friendship on prosocial actions across games suggests that beliefs may at least partially mediate the effect of friendship on strategic uncertainty.“Trembling” refers to subjects switching back and forth from the UP to the SP actions (or vice versa) across game plays. Trembling is likely to evidence inconsistent decisions in stag-hunt games, while it is additionally compatible with increased reasoning in entry games  their choices with their friend 18 out of 20 times, then i’s percentage is 90% and the coordination rate is thus 0.90. On the other hand, for the Stranger treatment, we compute for each participant in the stag-hunt game (resp. entry game) the percentages of times they could match (resp. mismatch) their choices with any other stranger playing the same game variant. We do so to reduce the noise inherent in the player random matching of the Stranger treatment. Then, we average across the percentages from each variant to calculate the coordination rate. For instance, if participant “j” in the Stranger treatment chooses the UP action in a stag-hunt game variant with a $5 sure payoff, and 78% of the other stranger players choose the UP action on that same variant, then j’s percentage of matching (resp. mismatching) actions for the $5 sure payoff variant is 78%. In the Entry game, everything else being equal, if j chooses the SP action instead of the UP action, their coordination rate is (1–0.78) = 0.22. We then average over the percentages so obtained across all the 20 game variants in the Stranger treatment to compute the coordination rate.As performance-related measures, we focus on coordination and payoff rates. To compute coordination rates we proceed as follows. For the Friend treatment, we calculate for each participant in the stag-hunt game (resp. entry game) the percentage of times they matched (resp. mismatched) their choices with their friend across the twenty game variants. For instance, if participant “Notably, it can be easily shown that coordination rates and payoff rates may markedly differ . We thus proceed to also computing payoff rates as follows: if a participant chooses the UP action, the payoff is simply the maximum payoff  multiplied by the coordination rate; while if a participant chooses the SP action, their payoff is unconditionally the sure payoff value . In this fashion, we computed payoff rates for each treatment and proceeded to investigate how they were affected by friendship. We hypothesise that friendship could increase coordination and payoff rates in the stag-hunt game, but less so in the entry game.Strategic uncertainty, prosocial behavior, as well as trembling are analysed using generalized mixed effect logistic regressions, clustering data at the participant level. As predictors, we use sure payoff, game and friendship, as well each possible two-way interactions between these factors Tables , 6, 7. IStag-hunt Game*Friend Counterpart equal to 1.732) while decreasing it in the entry game . These effects appear very stark in Fig. A mixed effect logistic regression , while it has no association with the corresponding measure in entry games . The same finding is also robust when controlling for other friendship characteristics such as friends’ perceived interpersonal similarities and the frequency of their past interactions , but not in stag-hunt games , while the correlations between the frequency of past interactions and UP choices are not significant in either game . In synthesis, friendship quality appears to play a role in fostering “assurance” in stag-hunt games; perceived interpersonal similarities could deter friends from entering in entry games, while frequency of past interactions has a small negative impact in stag-hunt games that does not appear robust in light of correlational analysis.In Table prosocial actions as 1 if UP choice in the stag-hunt or SP choice in the entry game and 0 otherwise) shows a highly significant interaction between friendship and the game environment . Conversely, relative to strangers, friends are more likely to choose the SP actions in games with strategic substitutes . In other words, friendship is associated with decreased strategic uncertainty in stag-hunts, but increased strategic uncertainty in entry games. These friendship effects are more pronounced at high sure payoff in stag-hunt games, and at low sure payoff in the entry game. In addition, we find that, in stag-hunts, friends tremble less than strangers ; they are also more likely to successfully coordinate their choices and to earn more than strangers. However, each of these advantages is strongly attenuated or lost entirely in entry games.Previous research suggests that social closeness generally has a beneficial impact on economic interactions Sect. . Our expWe speculate that two broad mechanisms may mediate these effects: prosocial preferences and social inferences. In fact, friends are known to care about each other’s payoffs more than strangers, namely prosocial preferences are generally higher among friends than strangers , but with increased strategic uncertainty in games with strategic substitutes . With regard to other performance proxies, such as trembling, coordination, and earnings, friendship has a substantially beneficial impact on games with strategic complements, but these advantages are either attenuated or entirely lost in games with substitutes. Our evidence adds to the fast-growing literature on the importance of the social context in explaining economic behaviour  may interact with well-known gradients in the “strategic space” (here dichotomized as complementarity vs. substitutability) on a larger scale.From an applied viewpoint, our findings have also potentially relevant implications for understanding team production in organizations. In fact, within organizations, as well as in many daily interactions, decision-makers