Permanent injectables for soft tissue augmentation: avoiding misinformation and a reprise of the breast implant debacle.
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To determine whether the total and differential leukocyte count is of value as a case-finding test, we applied the evaluation criteria developed by the US Preventive Services Task Force. The criteria comprise review of the current burden of suffering of the disease to be prevented, the attributes of the intervention to be used, and the quality of the evidence available. A literature search revealed no evidence in the form of data from patients, so a chart review of all complete blood cell counts ordered during a 1-year period by one group of pediatricians was undertaken. At least one value outside of published normal ranges was found on 74.7% of the tests performed on clinically well children. No unsuspected illness was discovered as a result of an abnormal total and differential leukocyte count.
This study explored whether a source-monitoring training (SMT) procedure, in which children distinguished between events they recently witnessed versus events they only heard described, would help 3- to 8-year-olds to report only experienced events during a target interview. Children (N = 132) who witnessed science demonstrations and subsequently heard their parents describe nonexperienced events received SMT before or after a forensic-style interview. SMT reduced the number of false reports that 7- and 8-year-old children reported in response to direct questions but had no impact on the performance of younger children. Combined with earlier results, these data suggest a transition between 3 and 8 years of age in the strategic use of source-monitoring information to support verbal reports, such that only 7- and 8-year-olds generalize training to a difficult memory task that does not include mention of specific alternative sources.
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A middle-aged woman in a Newfoundland outport fishing village visits the doctor at a local medical clinic and complains of a case of bad nerves. Because he neither adequately understands the subtleties of the village concept of nerves nor the local etiquette of disease disclosure, the physician misinterprets the women's complaint and treats her for an ailment she does not have. The incident discourages the woman and other villagers from seeking medical care in the future. Any outport doctor should be familiar with the character of nerves as effectors of temperament, as conversation capital, and as female status enhancers and also with the role that 'women the worrier' plays in the local fishery. Features of village life which the physician, in this case study, fails to understand include: the complex patterns of social interaction behind the woman's decision to seek medical aid, the outporter's reluctance to ask for help or become obligated to others, and the local fear of persons in positions of authority. Most importantly the doctor is ignorant of the local view of the physician as a kind of moral adjudicator with the power to undermine the patient's reputation as a good woman in the community.
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According to the cognitive-behavioral model, hypochondriacal individuals hold dysfunctional assumptions about illness, which may be triggered by critical incidents. In this study 1,158 participants completed measures of hypochondriacal concerns and self-esteem, and estimated the likelihood of various symptoms indicating catastrophic and minor illnesses. Participants who were more hypochondriacal believed that catastrophic outcomes were more likely than did the less hypochondriacal participants, but they did not differ in their estimates for minor illnesses. Estimates of the likelihood of catastrophic illness and self-esteem independently contributed to the prediction of hypochondriacal concerns. In this study 2,177 participants completed a measure of hypochondriacal concerns, performed a scrambled-sentences task that included either illness terms or neutral terms, and completed a state anxiety inventory. The illness terms did not trigger higher levels of anxiety in the more hypochondriacal participants; instead, these terms appeared to make the less hypochondriacal participants as anxious as their hypochondriacal counterparts.
PURPOSE: We assessed the quality of information available to patients on prostate cancer on the Internet. MATERIALS AND METHODS: The search engine Webcrawler was used with the search term "prostate cancer" to generate a list of 75 websites which were reviewed for currency, disclosure, attribution, interactivity and content. A rating tool was designed including 50 elements considered essential for a comprehensive review of prostate cancer, and each website was judged for degree of coverage and accuracy (each rated on a scale of 1 to 3) of information for each element. RESULTS: Of the 75 sites 39 contained information about prostate cancer. Only 9 sites indicated a date of last update within 6 months. References were rarely given (in 5) and a disclaimer was provided on less than half of the sites (18). The sites covered a mean of 24 elements (range 6 to 43) with a mean coverage rating of 1.0 to 2.6 (1.8 overall). Of 943 elements covered on 39 sites, 94% were completely correct, 5% were mostly correct and 1% was mostly incorrect. CONCLUSIONS: The information on the Internet is of sufficient quality to aid in patient decision making. However, there are numerous shortcomings especially related to currency, disclosure and attribution. Degree of coverage is highly variable and there is a deficiency in balance of evidence found on many sites. The urologist needs to be aware of such shortcomings when counseling patients on prostate cancer.
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To assess mothers' knowledge of good infant nutritional practices, a survey was conducted by the Institute of Pediatric Nutrition. The survey addressed issues related to breast-feeding, the use of iron-fortified formula, frequent spitting up, the introduction of cow's milk into the infant diet, and the nutritional value of fruit juice. Mothers who responded to the survey had difficulty identifying the most appropriate choices. This article presents the survey results and discusses the implications for health care providers who care for children and their families.
The hijacking and purposeful crashing of airplanes into the World Trade Center and the Pentagon on September 11, 2001, prompts questions about why the passengers and crew of those airplanes did not act to prevent these attacks, as did at least some passengers on a hijacked flight that crashed in Pennsylvania. We argue, first, that humans have an evolved cognitive bias that leads to the expectation that antagonists hope to survive conflict and, second, that highly credible information to the contrary is needed to overcome this bias. Absent such information, the passengers on at least two airplanes incorrectly interpreted the game being played as a hawk-dove version of a conflict-of-interest game, when it was actually a "suicidal terrorism" variant of that family. Given that other terrorists may have been in the air and ready to act, the airlines' policy of not informing passengers about such events could have risked disabling them from reacting forcefully when force alone was advisable.
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