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PubMedDate not supplied

Avoidance behaviors in patients with implantable cardioverter defibrillators.

BACKGROUND: Although the implantable cardioverter defibrillator (ICD) has become standard therapy for some malignant cardiac arrhythmias, the shocks delivered by the device are often experienced as aversive. Anecdotal accounts of patients avoiding specific objects or places raise the possibility that conditioned avoidance responses can be established in response to ICD shocks. OBJECTIVE: The objective of the study was to better understand the nature of avoidance behavior among ICD recipients and to examine the relevance of classical conditioning and cognitive models to ICD-related avoidance behavior. METHODS: A total of 143 recipients of ICDs completed an anonymous survey reporting on aspects of their experience with the ICD and whether they had begun avoiding specific places, objects, or activities since receiving an ICD. RESULTS: Fifty-five percent of respondents reported at least 1 category of avoidance since receiving an ICD. The frequency of reported avoidances was highest in activities (39%), followed by objects (27%) and places (17%), which were least avoided. There was no relationship between the reported experience of shocks and avoidance behavior, and little evidence for conditioned avoidance. CONCLUSION: Avoidance that is not medically recommended is common among patients with ICDs. This may have adverse effects on quality of life and perhaps the physical health of some patients. Cognitive models, rather than classical conditioning, seem to explain the majority of avoidance behavior reported in this sample. A brief educational intervention or regular participation in ICD support groups could help to dispel misinformation among patients and discourage inappropriate avoidance.

Adult↗
PubMed2005

Steroid phobia and adherence--problems, solutions, impact on benefit/risk profile.

Adherence is important with all medications. It can be more difficult with inhaled steroids in light of concern about adverse effects. Although the degree of fear regarding inhaled steroids is difficult to quantify, it appears to be an important factor in adherence. These fears exist for several reasons, including misinformation obtained from such sources as the Internet. To improve adherence and decrease morbidity and mortality, it is vital that health care providers are aware of potential barriers to adherence. Measures such as simplifying and properly explaining medication regimens are helpful. Just as important is the establishment of a strong patient-provider relationship. This makes it easier to convince patients of the need for recommended medications. If the provider is able to effectively communicate and convince the patient of the benefit/risk ratio of steroids, improved patient outcomes can be achieved.

Administration, Inhalation↗
PubMed2004

Mechanistic actions of the risks and adverse events associated with vaccine administration.

Vaccine-preventable disease levels in the United States are at or near record lows. Most parents today have never seen a case of diphtheria, measles, or other once commonly encountered infectious diseases now preventable by vaccine administration. As a result, some parents wonder why their children must receive shots for diseases that do not seem to exist. Myths and misinformation about vaccine safety abound and can confuse parents who are trying to make sound decisions about their children's health care. However, we cannot take continued high immunization coverage levels for granted. A successful vaccination program, like a successful society, depends on the cooperation of every individual to ensure the good of all. This review outlines for clinical allergists-immunologists the molecular basis for the risks and adverse events associated with vaccine administration so that they can be better informed as experts on vaccine-associated adverse reactions.

Hepatitis B Vaccines↗
PubMed2004

A media literacy nutrition education curriculum for head start parents about the effects of television advertising on their children's food requests.

OBJECTIVE: To evaluate whether a media literacy nutrition education curriculum about the effects of television advertising on children's food choices influenced the behavior, attitudes, and knowledge of Head Start parents. SUBJECTS: Participants were a convenience sample of 35 parents from Head Start programs. DESIGN: This study used a pretest-posttest, comparison condition-intervention condition design. INTERVENTION: The 35 parents participated in both a four-week food safety curriculum (to serve as an educational placebo, comparison condition) that was followed immediately by a four-week media literacy nutrition education curriculum (intervention condition). MAIN OUTCOME MEASURES: Evaluation measures included parents' understanding of the persuasive techniques of commercials; ability to distinguish between truths and claims in advertising; and outcome expectations, values, self-efficacy, and behaviors in relation to talking about television advertisements with children while co-viewing or in response to purchase requests in the grocery store. STATISTICAL ANALYSES: Paired t tests, analysis of covariance, and chi(2) analyses were used. RESULTS: The media literacy nutrition education intervention curriculum had significant effects in terms of Head Start parents' understanding television advertising (P<.001), attitudes about television advertisements (P<.001), outcome expectations (P<.05), values (P<.01), self-efficacy (P<.001), and TV mediation behaviors (P<.001), and understanding of, and ability to read, food labels (P<.001). CONCLUSIONS/APPLICATIONS: Results suggest that a media literacy nutrition education curriculum can be easily conducted by dietitians. Dietitians can modify the curriculum to teach parents how to critically analyze many other forms of media (supermarket magazines, brochures, newspapers, Web sites) that sell nutrition misinformation to the public.

Adult↗
PubMed2004

"It's magic!" The effects of presentation modality on children's event memory, suggestibility, and confidence judgments.

The current study investigated the influence of presentation modality (live, video, and slide show) on children's memory, suggestibility, recognition, and metamemorial monitoring processes. A total of 270 children in three age groups (5- and 6-year-olds, 7- and 8-year-olds, and 9- and 10-year-olds) watched a magic show and were questioned about it 1 week later. The live show yielded more correct answers to nonleading questions, higher resistance to misleading questions, and better recognition memory than did the video condition, which in turn resulted in better performance than did the slide show. Although presentation modality raised the general level of memory performance, the effects were equally strong in all age groups and did not affect memory phenomena such as the size of the misinformation effect and confidence judgments.

Child↗
PubMed2005

Children's suggestibility for an instance of a repeated event versus a unique event: the effect of degree of association between variable details.

Are children who experience an event repeatedly more suggestible about an instance of the event than children who experience it once? Researchers have answered this question both in the affirmative and in the negative. In this study, we hypothesized that the degree of association between details that changed across instantiations of the event would help to explain the discrepancy. Preschoolers (4- and 5-year-olds) and first graders (6- and 7-year-olds) participated in either a single play session or four repeated play sessions, each of which contained 16 critical details. Across play sessions in the repeat-event condition, half of the critical details were associated and half were not associated. During a biasing interview 2 weeks later, children were misinformed about half of the critical details. The next day, children answered free and cued recall questions about the target play session. Among older children, repeat-event participants were more suggestible than single-event participants, especially for high-association details. Among younger children, repeat-event participants were more suggestible than single-event participants for low-association details. Consistent with some current theories of children's memory, older children were more suggestible than younger children.

Age Factors↗
PubMed2006

Health literacy in the field of infectious diseases: the paradigm of brucellosis.

OBJECTIVES: Treatment outcome for infectious diseases, including brucellosis, may be influenced by patient awareness of the disease itself, as well as by compounding socioeconomic factors. We attempted to evaluate parameters of patient awareness and disease perception in brucellosis and the ways they influence outcome. METHODS: We used a specifically developed questionnaire assessing various parameters of patient literacy on brucellosis in 70 patients with a new diagnosis of brucellosis. Patients were assessed by interviewing at the time of diagnosis and during follow-up. Awareness and perception of the disease, willingness for epidemiologic surveillance, mode of referral, treatment preferences, and adherence were evaluated. RESULTS: Although basic disease awareness is high, willingness to collaborate in epidemiologic surveillance is limited. Patient education may improve adherence to treatment and willingness to undergo surveillance, but may also result in many false referrals for relapse. Level of academic education does not influence the results. Convenience is the major factor when determining treatment preferences. CONCLUSION: Improving health literacy may result in improved treatment outcome and improved control of disease incidence. There is a need for constant evaluation of the quality and quantity of information distributed in order to reduce transmission of misinformation and occurrences of public anxiety.

Brucellosis↗
PubMed2005

The definition of abstinence.

A teen's definition of sexual activity most often does not include oral or anal sex. Abstinence only programs vary widely as to how they define sexual behavior and may be contributing to misinformation about STD transmission. Unknown is the extent to which declining teen pregnancy rates are due to non-coital activities replacing vaginal intercourse.

Adolescent↗
PubMed2026

Uncertainty and information management for Lynch syndrome in a genomic screening cohort: Connections to clinical engagement.

OBJECTIVE: Lynch syndrome (LS) is a common hereditary cancer predisposition syndrome. This study explores how individuals learning about LS-related cancer risk through a population genomic screening program appraise, reappraise, and manage uncertainty and engage in medical management. METHODS: We recruited participants with an LS result from a population genomic screening study, purposively sampling based on the characteristics of sex, age, LS gene, and family history of cancer. Semi-structured interviews and chart reviews focused on participants' experiences of learning about the LS result and making management decisions. Thematic analysis and heatmapping were used to explore participant characteristics related to uncertainty management and clinical engagement. RESULTS: Seventeen participants completed interviews, describing uncertainty discrepancies or ambivalent appraisals. Most participants who appraised their LS risk as a threat had high clinical engagement. All participants who had lower clinical engagement received misinformation, had little support from clinicians, or had misunderstandings about LS. CONCLUSION: Accurate information from trusted sources is critical to support uncertainty management and subsequent engagement in clinical risk management choices. PRACTICE IMPLICATIONS: Ensuring primary care providers have the information and tools to provide patients with accurate information may support recommended clinical engagement, thereby improving health outcomes for this population.

Clinical Engagement↗
PubMed2007

Thermoregulatory changes around the time of sleep onset.

A causal relationship between declining nocturnal core temperature, increasing peripheral temperature, and sleep onset has been reported. The exact trigger for these thermoregulatory changes around sleep onset, however, is unknown. Our aim was to examine one possible trigger: prior knowledge of bedtime. Fourteen young, healthy male subjects (mean age+/-sem: 21.9+/-0.6 years), participated in a randomized, single-blind crossover study, where knowledge of bedtime was manipulated. Following a baseline night, subjects completed three experimental nights: (A) aware of bedtime; (B) no knowledge of bedtime; (C) misinformed about bedtime. In all conditions lights were turned off at each subject's habitual bedtime (determined from sleep diaries), to individually standardize the time of lights off. Polysomnography, rectal and peripheral (foot) temperatures were recorded continuously on each night. There was no significant difference in the time of sleep onset among conditions (mean+/-s.d.: 11:55 h+/-0.73 min), and in all conditions sleep onset occurred at the same rectal temperature. A significant difference in the temperature gradient between rectal and peripheral temperatures among the conditions was evident from 90 min to 40 min prior to sleep onset (P=0.05), with subjects achieving a more rapid rate of temperature change in the B and C condition relative to condition A. The present findings suggest that knowledge of bedtime may modulate changes in temperature around the time of sleep onset. It appears that there is an optimal core body temperature at which to initiate sleep, and changes in the rate of peripheral heat loss may assist in achieving this optimal temperature, and hence facilitate sleep onset.

Adult↗
PubMed2006

Cosmeceuticals.

The aging population and a desire to maintain a youthful appearance have propelled the recent surge in the U.S. cosmeceuticals market. The rapidly growing number of products claiming to diminish fine lines and wrinkles, decrease redness, smooth texture, and fade discoloration has lead to much confusion and misinformation among dermatologists and consumers alike. Cosmeceuticals can be a useful adjunct to prescription medications and office procedures. Therefore, it behooves us as dermatologists to understand the science behind these products to better educate ourselves and our patients. We present an update of the following categories of cosmeceuticals: antioxidants, growth factors, peptides, anti-inflammatories/botanicals, polysaccharides, and pigment-lightening agents.

Cosmetic Techniques↗
PubMed2004

Death and organ procurement: public beliefs and attitudes.

While brain death and the dead donor rule (patients must not be killed by organ retrieval) have been clinically and legally accepted in the US as a prerequisite to organ removal, there is little data about public attitudes and beliefs concerning these matters. To examine the public attitudes and beliefs about the determination of death and its relationship to organ transplantation, 1351 Ohio residents >or=18 years were randomly selected and surveyed using random digit dialing (RDD) sample frames. The RDD telephone survey was conducted using computer-assisted telephone interviews. The survey instrument was developed from information provided by 12 focus groups and a pilot study of the questionnaire. Three scenarios based on hypothetical patients were presented: brain dead, in a coma, or in a persistent vegetative state (PVS). Respondents' provided personal assessments of whether the patient in each scenario was dead and their willingness to donate that patient's organs in these circumstances. Over 98% of respondents had heard of the term brain death, but only one-third (33.7%) believed that someone who was brain dead was legally dead. The majority of respondents (86.2%) identified the brain dead patient in the first scenario as dead, 57.2% identified the patient in a coma as dead (Scenario 2), and 34.1% identified the patient in a PVS as dead (Scenario 3). Nearly, a third (33.5%) were willing to donate the organs of patients they classified as alive for at least one scenario, in seeming violation of the dead donor rule. Most respondents were not willing to violate the dead donor rule, although a substantial minority was. However, the majority of respondents were unaware, misinformed or held beliefs that were not congruent with current definitions of brain death. This study highlights the need for more public dialogue and education about brain death and organ donation.

Adolescent↗
PubMed2006

Contraceptive practices in Armenia: Panel evaluation of an Information-Education-Communication Campaign.

Induced abortion remains the major form of birth control among Armenian women, contributing to their excess mortality and preventable morbidity. Reliance on abortion is attributed to limited access to information concerning modern methods of contraception and to widely held misinformation among women regarding family planning and reproductive health. Based on the Steps to Behavior Change model, the Green Path Campaign for Family Health, an information-education-communication (IEC) campaign, was launched in June 2000. This multimedia campaign promoted greater awareness, knowledge, acceptance, and adoption of modern contraception through increased utilization of counseling and related services provided at underutilized family planning centers. A representative panel of 1088 married women aged 18-35 were surveyed on reproductive health/family planning knowledge, attitudes, and practices immediately prior to and immediately following the 6-month national campaign. Exposure to the campaign was associated with significant increases in factors associated with contraceptive behavior change: knowledge, favorable attitudes toward modern methods, favorable attitudes toward family planning services, and information seeking and utilization of family planning services. Women who were more educated, more affluent, and slightly older were more likely to use family planning services as well as modern contraceptive methods. New visits to family planning centers increased by 84%. Despite the usual 25% turnover among those using modern methods at the start of the study, use of modern contraceptive methods increased by 4.6%, significantly exceeding the projected 3% increase. The results document changes in underlying behavioral predictors consistent with the Steps to Behavior Change model and highlight the relatively untapped potential of media-based health promotion efforts in post-Soviet Republics.

Adult↗
PubMed2006

Misconceptions concerning influenza: an overview and clear answers.

An interactive session exposed the common misconceptions about vaccination. The session chair persons, Dr. A. Monto of the University of Michigan and Dr. A.D.M.E. Osterhaus of the Erasmus Medical Centre in The Netherlands, showed video clips of healthcare workers making controversial statements about vaccination. After reacting to the video clips, Monto and Osterhaus entered into a lively debate with members of the audience. Misconceptions and misinformation concerning influenza are widespread, even amongst the medical community. Many people believe that influenza is a relatively benign disease, and that contracting it is an unavoidable fact of life. These people do not realise that getting vaccinated can provide them with a substantial degree of protection. Many also fear "side effects" even though the influenza vaccine rarely induces severe influenza-like illness (ILI) much less any other side effects. Some people feel that it is simply not worth getting vaccinated since they only catch the flu once every 10 years. The probability of being infected by the virus can be quite high for some groups, however,and the consequences of infection - debilitating illness, loss of mobility, secondary infections - can be particularly severe for high-risk groups. Vaccination is still limited to only 17% of the population in the EU countries but ESWI hopes to change that. A direct result of the conference was the decision to promote vaccination of one-third of the population - or about 150 million people - in the 25 EU countries by 2010.

Health Knowledge, Attitudes, Practice↗
PubMed2005

Stigma and safe havens: a medical sociological perspective on African-American female epilepsy patients.

PURPOSE: Very little is known about the attitudes and behaviors of minorities with epilepsy. This pilot study explored access to health care, help-seeking behaviors, and adherence to treatment among African-American females with epilepsy. METHODS: Ethnographic interviews were conducted with 10 African-American female adults. RESULTS: Findings indicate four major obstacles to care: limited financial resources, lack of knowledge about epilepsy among African-Americans, poor patient-provider communication, and lack of social support. Social support impacted individuals seeking surgery, and also affected purchasing medication, adherence to medical treatment, and needed transportation. Lack of knowledge and misinformation about epilepsy in the African-American community and poor communication with physicians contribute to the social stigma felt by these patients. CONCLUSIONS: The behavioral epidemiology of epilepsy among African-Americans is lacking. This disease exacerbates health disparities for this population. These findings point to a need for a safe haven for these individuals.

Adult↗
PubMed2005

Qué es la Epilepsia? Attitudes and knowledge of epilepsy by Spanish-speaking adults in the United States.

BACKGROUND: Spanish-speaking adults are the largest minority population group in the United States and are disproportionately afflicted by epilepsy. METHODS: A unique 78-item survey instrument conducted entirely in Spanish and devoted to the topic of epilepsy was administered to 760 Spanish-speaking adults in seven large U.S. Hispanic metropolitan areas representing a cross section of the U.S. Hispanic community. The answers were compared with those of 272 non-Hispanic controls administered the same survey in English in June 2004. RESULTS: The Hispanic sample correlated well with U.S. Census data. Spanish-speaking adults are mostly unaware about epilepsy, with 21% reporting no familiarity with the condition (P=0.0001). The vast majority of Hispanics use the term convulsiones or ataque to describe a seizure. Thirteen percent of Hispanics with less than high school education believe that epilepsy is contagious (P=0.0001); 8% see "sins" as a cause of seizures (P=0.0001); and 10% agree that "exorcism" would be a good remedy (P=0.002). CONCLUSIONS: There is considerable misinformation about epilepsy in the U.S. Hispanic community. Neurologists must be made aware of U.S. Hispanic attitudes and beliefs regarding epilepsy to provide culturally competent care.

Adolescent↗
PubMed2004

Turning free speech into corporate speech: Philip Morris' efforts to influence U.S. and European journalists regarding the U.S. EPA report on secondhand smoke.

BACKGROUND: Previously secret internal tobacco company documents show that the tobacco industry launched an extensive multifaceted effort to influence the scientific debate about the harmful effects of secondhand smoke. Integral to the industry's campaign was an effort to derail the Environmental Protection Agency's (EPA) risk assessment on environmental tobacco smoke (ETS) by recruiting a network of journalists to generate news articles supporting the industry's position and pushing its public relations messages regarding the ETS issue. METHODS: Searches of previously secret internal tobacco industry records were conducted online and at the Minnesota Tobacco Document Depository. In addition, searches on the World Wide Web were conducted for each National Journalism Center alumnus. Lexis-Nexis was used to locate news stories written by the journalists cited in this paper. RESULTS: Philip Morris turned to its public relations firm Burson Marsteller to "build considerable reasonable doubt em leader particularly among consumers" about the "scientific weaknesses" of the EPA report. A Washington, DC, media and political consultant Richard Hines was a key player in carrying out Burson Marsteller's media recommendations of "EPA bashing" for Philip Morris. In March 1993, Philip Morris' vice president of corporate affairs policy and administration reported to Steve Parrish, vice president and general counsel of Philip Morris, that their consultant was "responsible for a number of articles that have appeared in em leader major news publications regarding EPA and ETS." In addition to placing favorable stories in the press through its consultant, Philip Morris sought to expand its journalist network by financially supporting a U.S. school of journalism; the National Journalism Center (NJC). Philip Morris gleaned "about 15 years worth of journalists at print and visual media throughout the country em leader to get across [its] side of the story" resulting in "numerous pieces consistent with our point of view." The company planned to "design innovative strategies to communicate [its] position on ETS through education programs targeting policy makers and the media" via the NJC. Finally, journalists associated with think tanks that were financially supported by Philip Morris wrote numerous articles critical of the EPA. CONCLUSIONS: This is the first report, from the tobacco industry's own documents, to show the extent to which the tobacco industry has gone to influence the print media on the issue of the health effects of secondhand smoke. Unfortunately, what we report here is that even journalists can fall victim to well-orchestrated and presented public relations efforts regardless of their scientific validity. It is not clear how various professional media organizations oversee the ethical conduct of their members. Certainly, on the topic of the health effects of secondhand smoke, more scrutiny is warranted from these organizations for articles written by their members lest the public be misinformed and thus ill served.

Conflict of Interest↗
PubMed1999

How to make nutrition education more meaningful through facilitated group discussions.

Facilitated group discussions provide an alternative method to lecture and one-on-one approaches for conducting educational interventions at clinic sites. They are an interactive form of education wherein learners generate the specific topics to be addressed and share their knowledge and experience with other group members through discussion. In brief, the educator becomes a facilitator who, rather than lecturing, encourages clients to discuss freely among themselves their own approach to the nutrition problems posed during the session. As a facilitator, the nutritionist strives to create a comfortable atmosphere for discussion, encourages participation, and interjects only to correct misinformation and manage group dynamics. Facilitated group discussions allow nutrition practitioners to deliver meaningful nutrition education in a manner that helps empower their clients to improve their dietary habits; at the same time such discussions meet the increased public administrative demands for efficiency. Possible benefits to clients include more confidence, better communication skills, improved thinking skills, and increased motivation and commitment to improving nutrition behavior. We recommend that nutrition educators try facilitated group discussions in their clinics.

Group Processes↗