Sample records for perceived side effects

  1. Period Prevalence and Perceived Side Effects of Hormonal Contraceptive Use and the Menstrual Cycle in Elite Athletes.

    PubMed

    Martin, Daniel; Sale, Craig; Cooper, Simon B; Elliott-Sale, Kirsty J

    2017-12-28

    To identify the period prevalence of hormonal contraceptive (HC) use and characterise the perceived side effects associated with the menstrual cycle and HC use. 430 elite female athletes completed a questionnaire to assess; the period prevalence of HC use, the reasons for initiation and discontinuation of HCs and the side effects experienced by HC and non-HC users. Descriptive statistics, between-group comparisons and associations between categorical variables were calculated. 49.5% of athletes were currently using HCs and 69.8% had used HCs at some point. Combined oral contraceptives were most commonly used (68.1%), with 30.0% using progestin-only contraceptives (implant = 13.1%; injection = 3.7%; intrauterine system = 2.8%). Perceived negative side effects were more common with progestin-only HC use (39.1%) compared to combined HC use (17.8%; P = 0.001) and were most prevalent in implant users (53.6%; P = 0.004). HC users reported perceived positive side effects relating to the ability to predict and/or manipulate the timing, frequency and amount of menstrual bleeding. Non-HC users had a menstrual cycle length of 29 ± 5 d and 77.4% reported negative side effects during their menstrual cycle, primarily during days 1-2 of menstruation (81.6%). Approximately half of elite athletes used HCs and progestin-only contraceptive users reported greater incidences of negative side effects, especially with the implant. Due to the high inter-individual variability in reported side effects, athletes and practitioners should maintain an open dialogue to pursue the best interests of the athlete.

  2. Psychological factors associated with uptake of the childhood influenza vaccine and perception of post-vaccination side-effects: A cross-sectional survey in England.

    PubMed

    Smith, Louise E; Webster, Rebecca K; Weinman, John; Amlôt, Richard; Yiend, Jenny; Rubin, G James

    2017-04-04

    To identify predictors of: uptake of the childhood influenza vaccine in the 2015-2016 influenza season, parental perceptions of side-effects from the influenza vaccine and intention to vaccinate one's child for influenza in the 2016-2017 influenza season. Cross-sectional online survey. Data were collected in England shortly after the end of the 2015-2016 immunization campaign. 1001 parents or guardians of children aged between two and seven. Self-reported uptake of the childhood influenza vaccine in the 2015-2016 influenza season, perception of side-effects from the influenza vaccine and intention to vaccinate one's child in the 2016-2017 influenza season. Self-reported uptake of the childhood influenza vaccine was 52.8%. Factors strongly positively associated with uptake included the child having previously been vaccinated against influenza, perceiving the vaccine to be effective and perceiving the child to be susceptible to flu. Factors strongly negatively associated with uptake included perceiving the vaccine to be unsafe, to cause short-term side-effects or long-term health problems and believing that yearly vaccination may overload the immune system. Predictors of intended vaccine uptake in 2016-2017 were similar. Participants who perceived side-effects after the 2015-2016 vaccination reported being less likely to vaccinate their child next year. Side-effects were more likely to be reported in first-born children, by participants who knew another child who had side-effects, those who thought that the vaccine would interact with medication that the child was currently taking, and those who believed the vaccine causes short-term side-effects. Perceptions about the childhood influenza vaccine show strong associations with uptake, intended uptake and perception of side-effects. Attempts to improve uptake rates from their current low levels must address these perceptions. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  3. Acceptability and perceived side effects of insecticide indoor residual spraying under different resistance management strategies.

    PubMed

    Rodríguez, Américo David; Penilla, Rosa Patricia; Rodríguez, Mario Henry; Hemingway, Janet; Trejo, Antonio; Hernández-Avila, Juan Eugenio

    2006-01-01

    To assess household acceptability and perceived side effects of residual indoor pyrethroid (PYR), carbamate and organophosphate insecticides sprayed by annual rotation (ROT), spatial mosaic (MOS), and a single insecticide (DDT or PYR) in communities of the coastal plain of Chiapas, Mexico. A questionnaire to assess the acceptability and perceived side effects of indoor insecticides was administered to one member of 30% of the families in eight villages of Chiapas. The association of different insecticide treatments with their responses was evaluated (Chi-square). The intensity of side effects indicated under different treatments was compared in an ordered logistic model, using a severity index as the response variable. Insecticide spraying as a probable cause of symptoms was identified by 2.1% of interviewees. A significantly high percentage of persons with blurred vision, dizziness, sneezing, coughing, numbness, watery eyes, and itching lived in villages under MOS and ROT and a high severity index was significantly associated with ROT treatment. Reduction of mosquito bites and cockroaches were the perceived main benefits, and most villagers that perceived no benefits lived in DDT treated villages. Most of the interviewees welcomed spraying (83.7%), but the smell and having to remove furniture from houses were the main arguments against it. Acceptability correlated with insecticide spray coverage, although the most frequent suggestion for improvement was to increase the understanding of the objectives of spraying in the communities. The frequency of side effects was low, but higher in localities where a combination of insecticides was applied. This is a limitation for the use of this type of resistance management strategy in public health.

  4. Parental Expectation of Side Effects Following Vaccination Is Self-fulfilling: A Prospective Cohort Study.

    PubMed

    Smith, Louise E; Weinman, John; Amlôt, Richard; Yiend, Jenny; Rubin, G James

    2018-06-02

    One of the major factors contributing to parental refusal of vaccinations is the perception that vaccines cause side effects. Although symptoms are commonly reported following vaccinations, their causes are not always straightforward. Although some may be directly attributable to the vaccine itself, others may reflect pre-existing or coincidental symptoms that are misattributed to the vaccine. To investigate psychological factors associated with parental report of side effects following vaccination with the child influenza vaccine, and parental intention to re-vaccinate one's child the following year. A prospective cohort study was run in primary care practices in London in the 2016-2017 influenza season (ClinicalTrials.gov number NCT02909855). Two hundred seventy parents from 14 practices completed a questionnaire before their child's vaccination. Follow-up questionnaires were completed 3 days after vaccination and one month after vaccination. Parental report of side effects and vaccination intention for the subsequent year were measured. Parental report of side effects was strongly associated with pre-vaccination expectation of side effects. Suggestions received from the media, National Health Service (NHS) vaccination leaflet, and health care workers, as well as uncertainty-related beliefs, perceived sensitivity of the child to medicines, pessimism, and anxiety were also associated with reporting side effects. Side effect report was associated with lower vaccination intention for the following influenza season. Side effect perception following vaccination is influenced by psychological factors, in particular expectations. Perceiving side effects reduces future vaccination intention. Future public health communications should aim to decrease unrealistic expectations of side effects to increase vaccine uptake.

  5. The side-effects to CPAP treatment inventory: the development and initial validation of a new tool for the measurement of side-effects to CPAP treatment.

    PubMed

    Broström, Anders; Arestedt, Kristofer Franzén; Nilsen, Per; Strömberg, Anna; Ulander, Martin; Svanborg, Eva

    2010-12-01

    Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but side-effects are common. No validated self-rating scale measuring side-effects to CPAP treatment exists today. The aim was to develop the side-effects to CPAP treatment inventory (SECI), and investigate the validity and reliability of the instrument among patients with OSAS. SECI was developed on the basis of: (1) in-depth interviews with 23 patients; (2) examination of the scientific literature and (3) consensus agreement of a multi-professional expert panel. This yielded 15 different types of side-effects related to CPAP treatment. Each side-effect has three sub-questions (scales): perceived frequency (a) and magnitude (b) of the side-effect, as well as its perceived impact on CPAP use (c). A cross-sectional descriptive design was used. A total of 329 patients with OSAS with an average use of CPAP treatment for 39 months (2 weeks to 182 months) were recruited. Data were collected with SECI, and obtained from medical records (clinical variables and data related to CPAP treatment). Construct validity was confirmed with factor analysis (principal component analysis with orthogonal rotation). A logical two-factor solution, the device subscale and symptom subscale, emerged across all three scales. The symptom subscale describing physical and psychological side-effects and the device subscale described mask and device-related side-effects. Internal consistency reliability of the three scales was good (Cronbach's α = 0.74-0.86) and acceptable for the subscales (Cronbach's α = 0.62-0.86). The satisfactory measurement properties of this new instrument are promising and indicate that SECI can be used to measure side-effects to CPAP treatment. © 2010 European Sleep Research Society.

  6. Association of Type D personality to perceived side effects and adherence in CPAP-treated patients with OSAS.

    PubMed

    Broström, Anders; Strömberg, Anna; Mårtensson, Jan; Ulander, Martin; Harder, Lena; Svanborg, Eva

    2007-12-01

    Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but side effects are common and long-term adherence low. The Type D (distressed) personality is defined as a combination of negative affectivity and social inhibition. The association of Type D personality with adherence has not been studied in CPAP-treated patients with OSAS. This study aimed to describe the prevalence of Type D personality in OSAS patients with CPAP treatment longer than 6 months and the association with self-reported side effects and adherence. A cross-sectional descriptive design was used. A total of 247 OSAS patients with a mean use of CPAP treatment for 55 months (6-182 months) were included. Data collection was achieved by two questionnaires; the Type D scale 14 (DS14) (Type D personality), SECI (side effects of CPAP), as well as from medical records (clinical variables and objective adherence to CPAP treatment). Type D personality occurred in 30% of the patients with OSAS and significantly (P < 0.05-0.001) increased the perceived frequency and severity of a broad range of side effects. The objective adherence was significantly lower (P < 0.001) for OSAS patients with Type D compared to OSAS patients without Type D, both with regard to a mean use of 4 h per night and 85% of the self-rated sleep time per night. The additional effect of a Type D personality on perceived side effects and adherence to CPAP treatment found in this study could be used by healthcare personnel when evaluating patients waiting for treatment.

  7. Impact of an early education multimedia intervention in managing nutrition-related chemotherapy side effects: a pilot study.

    PubMed

    Thompson, Julie; Silliman, Kathryn; Clifford, Dawn E

    2013-12-01

    The purpose of the educational intervention was to measure changes in knowledge, perceived benefit of nutrition, and perceived self efficacy in handling side effects of chemotherapy before and after viewing a 15 minute DVD among patients with cancer. A convenience sample of 14 (4 male, 10 female, 61 ± 9 years) patients with cancer, early to chemotherapy, participated in the study. Participants completed a survey with demographic, knowledge items, and perceived health belief and self efficacy statements; viewed the DVD; and were then sent home with a one page handout. Two weeks after the nutrition education intervention, a second survey was completed including an item about tips used. Change was measured using paired t-test and wilcoxon signed rank tests. The mean score on the four knowledge items significantly increased (p < 0.05). No significant differences were noted in statements intended to evaluate changes in perceived health beliefs. However, perceived knowledge and skills related to managing side effects increased (p < 0.05). All participants responded that the DVD was informative and most (n = 11, 79%) responded that it was useful. The majority reported (n = 10, 71%) a tip they used from the DVD. This short multimedia nutrition education intervention was found primarily to increase knowledge and could form a useful component of counseling services for patients undergoing chemotherapy.

  8. Explaining Effects and Side Effects of School Inspections: A Path Analysis

    ERIC Educational Resources Information Center

    Penninckx, Maarten; Vanhoof, Jan; De Maeyer, Sven; Van Petegem, Peter

    2016-01-01

    There are large differences between schools with regard to how they are affected by a school inspection. This study provides quantitative evidence about the extent to which perceived effects and side effects of an inspection are related to the inspection's judgement on the school, to features of the inspection, and to school features. This study…

  9. Development of a New Self-Reporting Instrument Measuring Benefits and Side Effects of Corticosteroids in Duchenne Muscular Dystrophy: Report from a Pilot Study.

    PubMed

    Hendriksen, Ruben G F; Lionarons, Judith M; Hendriksen, Jos G M; Vles, Johan S H; McAdam, Laura C; Biggar, W Douglas

    There is no cure for Duchenne Muscular Dystrophy (DMD); treatment is symptomatic and corticosteroids slow the progression. Side effects of corticosteroids - especially the physical effects - have been described, however patients' and caregivers perception on chronic corticosteroid treatment and their side effects is less well known, in particular with regards to cognition, behaviour, and emotional functioning. The primary aim of this pilot study was to (i) construct a self-report questionnaire to assess the perceived benefits and side effects of corticosteroids for patients with DMD and their parents. Furthermore we aimed to (ii) investigate the psychometric qualities of this questionnaire, (iii) whether there was a difference between parents' and patient's perceptions, and finally (iv) to what extent reported side effects may alter over time. A 23-item questionnaire (SIDECORT: side effect of corticosteroids) was constructed to assess the perception of these benefits and side effects in a systematic manner. In total, 86 patients (aged 5 - 28 years) and 125 of their parents completed the questionnaire. Internal consistency was good. Using factor analyses on the side effect items as reported by parents, two underlying factors were found, with the first factor describing cognitive, behavioural and emotional functioning, and the second factor describing physical functioning. The potential benefits of corticosteroids were highly rated among both parents and patients, although parents rated the importance of the benefits higher than their sons (p = 0.002). Similarly, parents rated the severity of the side effects generally higher than their sons (p = 0.011), especially with regards to the physical side effects (p = 0.014). Based on the parent's perception, the neurodevelopmental side effects generally appeared to decline the longer corticosteroids were used. To our knowledge, this is the first explicit study on perceived cognitive-, behavioural-, and emotional side effects and the allocation of benefits to corticosteroids in DMD. On the basis of our research we suggest a short form questionnaire, which proves to be reliable and valid for research- and clinical practice. This questionnaire could provide useful insights for the care of boys and men with DMD.

  10. An analysis of the diffusion of new antidepressants: variety, quality, and marketing efforts.

    PubMed

    Berndt, Ernst R; Bhattacharjya, Ashoke; Mishol, David N; Arcelus, Almudena; Lasky, Thomas

    2002-03-01

    We are not aware of any published research that quantifies and compares the importance of effectiveness and side effects for pharmaceutical sales, and that simultaneously incorporates the impacts of marketing efforts on the diffusion of new pharmaceutical agents in the U.S. The overall level and market share success of the various selective serotonin reuptake inhibitors ( SSRIs ) relative to a representative older generation tricyclic (such as amitriptyline) provides a useful focus for studying such issues. To model jointly the marketing and sales relationships of the SSRIs in the U.S., to quantify the extent to which marketing efforts are responsive to the availability of new scientific information accompanying changes in quality and increases in product variety, and in turn to assess how the new FDA indication approvals and the enhanced marketing initiatives involving product quality and variety affect sales of the SSRI and other novel antidepressants. Quarterly US sales, price, quantity and marketing data 1988Q1-1997Q4 are taken from IMS Health for the eight new antidepressants introduced into the US during this time period. Measures of physician-perceived quality attributes of the antidepressants are drawn from Market Measures, Inc., a medical survey research firm. These data are used to construct measures of product quality (effectiveness and side effect profile), and attribute variety across all antidepressants. Multivariate regression methods are used in estimating parameters of a marketing efforts model, a sales demand model encompassing the aggregate of the newer antidepressants, and a product share model. Simulation methods are employed to quantify elasticities. Since 1988, and relative to amitriptyline, there has been only a rather modest increase in the perceived average effectiveness of the SSRIs and related products, but the side effect profiles have improved substantially. Variety measures for effectiveness show greater increases over time than do those for side effects. Marketing efforts respond to science-based events, such as new FDA indication approvals, and to effectiveness and side-effect quality improvements. Total antidepressant sales are positively and significantly related to price reductions, increased marketing efforts, and the level and variety of side effect profiles involving antidepressants. The level and variety of effectiveness does not significantly affect total antidepressant sales. Order of entry effects are important in affecting product market shares, while marketing efforts and relative quality attributes (particularly a more favorable side effect profile) have positive and significant impacts on relative market shares. Since patient response to SSRIs and related products is idiosyncratic, greater product variety facilitates better matching of antidepressant with patient. Much of the growth of the SSRIs and related antidepressants since 1988 can be attributed to increased product attribute variety, to improved changes in side effect quality relative to that of the tricyclics, and to the marketing of those improvements. Marketing efforts play an important role in diffusing product information. Marketing efforts increase considerably following FDA approval for indications other than depression, and also increase with the average effectiveness and the average side effect rating of the products. Whether the relatively minor role that perceived effectiveness has in affecting sales relative to perceived side effect profile is unique to antidepressants, or generalizes to other therapeutic classes, merits further examination.

  11. What matters when judging intentionality-moral content or normative status? Testing the rational scientist model of the side-effect.

    PubMed

    Papadopoulos, C; Hayes, B K

    2018-06-01

    Previous work has demonstrated a "side-effect effect," such that intentionality is more likely to be attributed to agents who bring about negatively valenced as opposed to positively valenced side effects. The rational-scientist model explains this by suggesting that norm-violating side effects are more informative for inferring intentionality than norm-conforming side effects. In the present study we reexamined this account, addressing limitations of previous empirical tests (e.g., Uttich & Lombrozo, Cognition 116: 87-100, 2010). Side-effect valence and norm status were manipulated factorially, enabling an examination of the impact of norm status on intentionality judgments in both positively and negatively valenced side effects. Additionally, the impact of side-effect norm status on the perceived valences of side effects and agents was examined. Effects of norm status were found for both positive and negative side effects. Violation of an ostensibly neutral norm led to negative perceptions of the side effect. However, a norm status effect on intentionality judgments persisted when these effects were controlled. These results support the view that the side-effect effect is the result of the rational use of social-cognitive evidence.

  12. Optimal vaccination choice, vaccination games, and rational exemption: an appraisal.

    PubMed

    Manfredi, Piero; Posta, Pompeo Della; d'Onofrio, Alberto; Salinelli, Ernesto; Centrone, Francesca; Meo, Claudia; Poletti, Piero

    2009-12-10

    A threat for vaccination policies might be the onset of "rational" exemption, i.e. the family's decision not to vaccinate children after a seemingly rational comparison between the perceived risk of infection and the perceived risk of vaccine side effects. We study the implications of rational exemption by models of vaccination choice. By a simple model of individual choice we first prove the "elimination impossible" result in presence of informed families, i.e. aware of herd immunity, and suggest that limited information might explain patterns of universal vaccination. Next, we investigate vaccination choice in a game-theoretic framework for communities stratified into two groups, "pro" and "anti" vaccinators, having widely different perceived costs of infection and of vaccine side effects. We show that under informed families neither a Nash nor a Stackelberg behaviour (characterized, respectively, by players acting simultaneously and by an asymmetric situation with a "leader" and a "follower) allow elimination, unless "pro-vaccinators" assign no costs to vaccine side effects. Elimination turns out to be possible when cooperation is encouraged by a social planner, provided, however, he incorporates in the "social loss function" the preferences of anti-vaccinators only. This allows an interpretation of the current Italian vaccination policy.

  13. No blank slates: Pre-existing schemas about pharmaceuticals predict memory for side effects.

    PubMed

    Heller, Monika K; Chapman, Sarah C E; Horne, Rob

    2017-04-01

    Attribution of symptoms as medication side effects is informed by pre-existing beliefs about medicines and perceptions of personal sensitivity to their effects (pharmaceutical schemas). We tested whether (1) pharmaceutical schemas were associated with memory (recall/recognition) for side effect information (2) memory explained the attribution of a common unrelated symptom as a side effect. In this analogue study participants saw the patient leaflet of a fictitious asthma drug listing eight side effects. We measured recall and recognition memory for side effects and used a vignette to test whether participants attributed an unlisted common symptom (headache) as a side effect. Participants who perceived pharmaceuticals as more harmful in general recalled fewer side effects correctly (r Correct Recall  = -.273), were less able to differentiate between listed and unlisted side effects (r Recognition Sensitivity  = -.256) and were more likely to attribute the unlisted headache symptom as a side effect (r side effect attribution  = .381, ps < .01). The effect of harm beliefs on side effect attribution was partially mediated by correct recall of side effects. Pharmaceutical schemas are associated with memory for side effect information. Memory may explain part of the association between pharmaceutical schemas and the attribution of unrelated symptoms as side effects.

  14. Medical use of cannabis in the Netherlands.

    PubMed

    Gorter, Robert W; Butorac, Mario; Cobian, Eloy Pulido; van der Sluis, Willem

    2005-03-08

    The authors investigated the indications for cannabis prescription in the Netherlands and assessed its efficacy and side effects. A majority (64.1%) of patients reported a good or excellent effect on their symptoms. Of these patients, approximately 44% used cannabis for >/=5 months. Indications were neurologic disorders, pain, musculoskeletal disorders, and cancer anorexia/cachexia. Inhaled cannabis was perceived as more effective than oral administration. Reported side effects were generally mild.

  15. Do patients with chronic unilateral orofacial pain due to a temporomandibular disorder show increased attending to somatosensory input at the painful side of the jaw?

    PubMed

    Van Damme, Stefaan; Vanden Bulcke, Charlotte; Van Den Berghe, Linda; Poppe, Louise; Crombez, Geert

    2018-01-01

    Patients with chronic orofacial pain due to temporomandibular disorders (TMD) display alterations in somatosensory processing at the jaw, such as amplified perception of tactile stimuli, but the underlying mechanisms remain unclear. This study investigated one possible explanation, namely hypervigilance, and tested if TMD patients with unilateral pain showed increased attending to somatosensory input at the painful side of the jaw. TMD patients with chronic unilateral orofacial pain ( n  = 20) and matched healthy volunteers ( n  = 20) performed a temporal order judgment (TOJ) task indicated which one of two tactile stimuli, presented on each side of the jaw, they had perceived first. TOJ methodology allows examining spatial bias in somatosensory processing speed. Furthermore, after each block of trials, the participants rated the perceived intensity of tactile stimuli separately for both sides of the jaw. Finally, questionnaires assessing pain catastrophizing, fear-avoidance beliefs, and pain vigilance, were completed. TMD patients tended to perceive tactile stimuli at the painful jaw side as occurring earlier in time than stimuli at the non-painful side but this effect did not reach conventional levels of significance ( p  = .07). In the control group, tactile stimuli were perceived as occurring simultaneously. Secondary analyses indicated that the magnitude of spatial bias in the TMD group is positively associated with the extent of fear-avoidance beliefs. Overall, intensity ratings of tactile stimuli were significantly higher in the TMD group than in the control group, but there was no significant difference between the painful and non-painful jaw side in the TMD patients. The hypothesis that TMD patients with chronic unilateral orofacial pain preferentially attend to somatosensory information at the painful side of the jaw was not statistically supported, although lack of power could not be ruled out as a reason for this. The findings are discussed within recent theories of pain-related attention.

  16. Visual illusions and plate design: the effects of plate rim widths and rim coloring on perceived food portion size.

    PubMed

    McClain, A D; van den Bos, W; Matheson, D; Desai, M; McClure, S M; Robinson, T N

    2014-05-01

    The Delboeuf Illusion affects perceptions of the relative sizes of concentric shapes. This study was designed to extend research on the application of the Delboeuf illusion to food on a plate by testing whether a plate's rim width and coloring influence perceptual bias to affect perceived food portion size. Within-subjects experimental design. Experiment 1 tested the effect of rim width on perceived food portion size. Experiment 2 tested the effect of rim coloring on perceived food portion size. In both experiments, participants observed a series of photographic images of paired, side-by-side plates varying in designs and amounts of food. From each pair, participants were asked to select the plate that contained more food. Multilevel logistic regression examined the effects of rim width and coloring on perceived food portion size. Experiment 1: participants overestimated the diameter of food portions by 5% and the visual area of food portions by 10% on plates with wider rims compared with plates with very thin rims (P<0.0001). The effect of rim width was greater with larger food portion sizes. Experiment 2: participants overestimated the diameter of food portions by 1.5% and the visual area of food portions by 3% on plates with rim coloring compared with plates with no coloring (P=0.01). The effect of rim coloring was greater with smaller food portion sizes. The Delboeuf illusion applies to food on a plate. Participants overestimated food portion size on plates with wider and colored rims. These findings may help design plates to influence perceptions of food portion sizes.

  17. The effect of an apparent change to a branded or generic medication on drug effectiveness and side effects.

    PubMed

    Faasse, Kate; Cundy, Tim; Gamble, Greg; Petrie, Keith J

    2013-01-01

    Generic medications are associated with reduced perceived effectiveness, increased perceived adverse effects, and increased rates of nonadherence compared with brand-name medications. This study examined the effect of an apparent medication formulation change on subjective and objective measures of medication effectiveness and medication side effects. Sixty-two university students participated in a study purportedly testing the effectiveness of fast-acting β-blocker medications in reducing preexamination anxiety. All tablets were placebos. In session 1, all participants received a yellow tablet ("Betaprol"). In session 2, participants were randomly allocated to receive Betaprol (no change condition) or a white tablet labeled either as "Novaprol" (branded change condition) or "Generic" (generic change condition). Blood pressure and state anxiety were measured before and after tablet ingestion. Side effects attributed to medication were assessed. The no change group showed significantly greater decreases in systolic blood pressure (mean [M] [standard deviation] = -7.72 mm Hg, standard error [SE] = 1.45) than the branded change (M = -2.75 mm Hg, SE = 1.44, p = .02) and generic change (M = -3.26 mm Hg, SE = 1.45, p = .03) groups. The no-change group showed significantly greater decreases in state anxiety (M = -1.53, SE = 0.33) than the branded change (M = -0.50, SE = 0.33, p = .03) and generic change (M = -0.52, SE = 0.33, p = .04) groups. Significantly more side effects were attributed to the medication in the generic change (M = 1.83, SE = 0.23) (but not the branded change) condition when compared with the no change condition (M = 0.87, SE = 0.31, p = .03). Medication formulation change, particularly to generic medication, seems to be associated with reduced subjective and objective measures of medication effectiveness and increased side effects.

  18. Side Effect Perceptions and Their Impact on Treatment Decisions in Women.

    PubMed

    Waters, Erika A; Pachur, Thorsten; Colditz, Graham A

    2017-04-01

    Side effects prompt some patients to forego otherwise-beneficial therapies. This study explored which characteristics make side effects particularly aversive. We used a psychometric approach, originating from research on risk perception, to identify the factors (or components) underlying side effect perceptions. Women ( N = 149) aged 40 to 74 years were recruited from a patient registry to complete an online experiment. Participants were presented with hypothetical scenarios in which an effective and necessary medication conferred a small risk of a single side effect (e.g., nausea, dizziness). They rated a broad range of side effects on several characteristics (e.g., embarrassing, treatable). In addition, we collected 4 measures of aversiveness for each side effect: choosing to take the medication, willingness to pay to avoid the side effect (WTP), negative affective attitude associated with the side effect, and how each side effect ranks among others in terms of undesirability. A principal components analysis (PCA) was used to identify the components underlying side effect perceptions. Then, for each aversiveness measure separately, regression analyses were used to determine which components predicted differences in aversiveness among the side effects. The PCA revealed 4 components underlying side effect perceptions: affective challenge (e.g., frightening), social challenge (e.g., disfiguring), physical challenge (e.g., painful), and familiarity (e.g., common). Side effects perceived as affectively and physically challenging elicited the highest levels of aversiveness across all 4 measures. Understanding what side effect characteristics are most aversive may inform interventions to improve medical decisions and facilitate the translation of novel biomedical therapies into clinical practice.

  19. Side Effect Perceptions and their Impact on Treatment Decisions in Women

    PubMed Central

    Waters, Erika A.; Pachur, Thorsten; Colditz, Graham A.

    2016-01-01

    Background Side effects prompt some patients to forego otherwise-beneficial therapies. This study explored which characteristics make side effects particularly aversive. Methods We used a psychometric approach, originating from research on risk perception, to identify the factors (or components) underlying side effect perceptions. Women (N=149) aged 40–74 were recruited from a patient registry to complete an online experiment. Participants were presented with hypothetical scenarios in which an effective and necessary medication conferred a small risk of a single side effect (e.g., nausea, dizziness). They rated a broad range of side effects on several characteristics (e.g., embarrassing, treatable). In addition, we collected four measures of aversiveness for each side effect: choosing to take the medication, willingness to pay to avoid the side effect (WTP), negative affective attitude associated with the side effect, and how each side effect ranks among others in terms of undesirability. A principle-components analysis (PCA) was used to identify the components underlying side effect perceptions. Then, for each aversiveness measure separately, regression analyses were used to determine which components predicted differences in aversiveness among the side effects. Results The PCA revealed four components underlying side effect perceptions: affective challenge (e.g., frightening), social challenge (e.g., disfiguring), physical challenge (e.g., painful), and familiarity (e.g., common). Side effects perceived as affectively and physically challenging elicited the highest levels of aversiveness across all four measures. Conclusions Understanding what side effect characteristics are most aversive may inform interventions to improve medical decisions and facilitate the translation of novel biomedical therapies into clinical practice. PMID:27216581

  20. Visual illusions and plate design: The effects of plate rim widths and rim coloring on perceived food portion size

    PubMed Central

    McClain, Arianna; van den Bos, Wouter; Matheson, Donna; Desai, Manisha; McClure, Samuel M.; Robinson, Thomas N.

    2013-01-01

    OBJECTIVE The Delboeuf Illusion affects perceptions of the relative sizes of concentric shapes. This study was designed to extend research on the application of the Delboeuf illusion to food on a plate by testing whether a plate’s rim width and coloring influence perceptual bias to affect perceived food portion size. DESIGN AND METHODS Within-subjects experimental design. Experiment 1 tested the effect of rim width on perceived food portion size. Experiment 2 tested the effect of rim coloring on perceived food portion size. In both experiments, participants observed a series of photographic images of paired, side-by-side plates varying in designs and amounts of food. From each pair, participants were asked to select the plate that contained more food. Multi-level logistic regression examined the effects of rim width and coloring on perceived food portion size. RESULTS Experiment 1: Participants overestimated the diameter of food portions by 5% and the visual area of food portions by 10% on plates with wider rims compared to plates with very thin rims (P<0.0001). The effect of rim width was greater with larger food portion sizes. Experiment 2: Participants overestimated the diameter of food portions by 1.5% and the visual area of food portions by 3% on plates with rim coloring compared to plates with no coloring (P=0.01). The effect of rim coloring was greater with smaller food portion sizes. CONCLUSION The Delboeuf illusion applies to food on a plate. Participants overestimated food portion size on plates with wider and colored rims. These findings may help design plates to influence perceptions of food portion sizes. PMID:24005858

  1. Using a graphical risk tool to examine willingness to take migraine prophylactic medications.

    PubMed

    Turner, Dana P; Golding, Adrienne N; Houle, Timothy T

    2016-10-01

    Many migraine sufferers use daily prophylactic therapy to reduce the frequency of their headache attacks. The Food and Drug Administration has approved several different medications for migraine prophylaxis, but it is not clear whether sufferers perceive these treatments to provide clinically significant benefits given their side effect profiles. Three hundred headache sufferers were recruited from the community and local headache clinics using print and television advertising. Participants reported experiencing problematic headache attacks with a median (IQR) frequency of 7.0 (4-13) headache days per month. These sufferers participated in a cross-sectional, single-site, study that used a specially designed computer assessment task. Participants were instructed on the probability of experiencing the 3 most commonly experienced side effects for several blinded medication profiles: divalproex sodium, venlafaxine, gabapentin, propranolol, and topiramate. After learning the likelihood of experiencing side effect profiles of each medication, participants were asked whether they would be willing to take the medication for a given headache reduction level, which ranged from 0 to 7 days per month. The side effect profile for divalproex sodium was associated with the smallest willingness to take, with gabapentin, propranolol, and topiramate perceived to be much more agreeable. However, <60% of participants reported willingness to take any of these medications even if they provided a 50% reduction in headache frequency. Several general predictors of willingness to take were observed including high headache-related disability, depressive symptoms, and pain medication concerns including fear of tolerance. These findings suggest that if properly informed of the side effect profiles of these medications, many patients might opt for other treatments.

  2. Motives of Dutch men who have sex with men for daily and intermittent HIV pre-exposure prophylaxis usage and preferences for implementation: A qualitative study.

    PubMed

    Bil, Janneke P; van der Veldt, Wendy M; Prins, Maria; Stolte, Ineke G; Davidovich, Udi

    2016-09-01

    Although PrEP is not yet registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. To inform future pre-exposure prophylaxis (PrEP) implementation, this study aimed to gain insight into motives and preferences for daily or intermittent PrEP use among Dutch HIV-negative men having sex with men (MSM).Between February and December 2013, semistructured interviews were conducted until data saturation was reached (N = 20). Interviews were analyzed using the Grounded Theory approach.Motives for (not) using daily PrEP were based on beliefs about PrEP efficacy and side effects, preferences for other prevention strategies, self-perceived HIV risk, self-perceived efficacy of PrEP adherence, beliefs about possible benefits (e.g., anxiety reduction, sex life improvement), and barriers of PrEP use (e.g., costs, monitoring procedures). The perceived benefits of intermittent versus daily PrEP use were the lower costs and side effects and the lower threshold to decision to start using intermittent PrEP. Barriers of intermittent PrEP versus daily PrEP use were the perceived need to plan their sex life and adhere to multiple prevention strategies. Although some perceived PrEP as a condom substitute, others were likely to combine PrEP and condoms for sexually transmitted infections (STI) prevention and increased HIV protection. Participants preferred PrEP service locations to have specialized knowledge of HIV, antiretroviral therapy, sexual behavior, STIs, patients' medical background, be easily approachable, be able to perform PrEP follow-up monitoring, and provide support.To maximize the public health impact of PrEP, ensuring high uptake among MSM at highest risk is important. Therefore, targeted information about PrEP efficacy and side effects need to be developed, barriers for accessing PrEP services should be minimized, and perceived self-efficacy to use PrEP should be addressed and improved. To prevent increases in STIs, condom use should be monitored and PrEP should be integrated into routine STI screening and counseling.

  3. Motives of Dutch men who have sex with men for daily and intermittent HIV pre-exposure prophylaxis usage and preferences for implementation

    PubMed Central

    Bil, Janneke P.; van der Veldt, Wendy M.; Prins, Maria; Stolte, Ineke G.; Davidovich, Udi

    2016-01-01

    Abstract Although PrEP is not yet registered in Europe, including the Netherlands, its approval and implementation are expected in the near future. To inform future pre-exposure prophylaxis (PrEP) implementation, this study aimed to gain insight into motives and preferences for daily or intermittent PrEP use among Dutch HIV-negative men having sex with men (MSM). Between February and December 2013, semistructured interviews were conducted until data saturation was reached (N = 20). Interviews were analyzed using the Grounded Theory approach. Motives for (not) using daily PrEP were based on beliefs about PrEP efficacy and side effects, preferences for other prevention strategies, self-perceived HIV risk, self-perceived efficacy of PrEP adherence, beliefs about possible benefits (e.g., anxiety reduction, sex life improvement), and barriers of PrEP use (e.g., costs, monitoring procedures). The perceived benefits of intermittent versus daily PrEP use were the lower costs and side effects and the lower threshold to decision to start using intermittent PrEP. Barriers of intermittent PrEP versus daily PrEP use were the perceived need to plan their sex life and adhere to multiple prevention strategies. Although some perceived PrEP as a condom substitute, others were likely to combine PrEP and condoms for sexually transmitted infections (STI) prevention and increased HIV protection. Participants preferred PrEP service locations to have specialized knowledge of HIV, antiretroviral therapy, sexual behavior, STIs, patients’ medical background, be easily approachable, be able to perform PrEP follow-up monitoring, and provide support. To maximize the public health impact of PrEP, ensuring high uptake among MSM at highest risk is important. Therefore, targeted information about PrEP efficacy and side effects need to be developed, barriers for accessing PrEP services should be minimized, and perceived self-efficacy to use PrEP should be addressed and improved. To prevent increases in STIs, condom use should be monitored and PrEP should be integrated into routine STI screening and counseling. PMID:27684827

  4. Side effect burden of antipsychotic drugs in real life - Impact of gender and polypharmacy.

    PubMed

    Iversen, Trude Seselie Jahr; Steen, Nils Eiel; Dieset, Ingrid; Hope, Sigrun; Mørch, Ragni; Gardsjord, Erlend Strand; Jørgensen, Kjetil Nordbø; Melle, Ingrid; Andreassen, Ole A; Molden, Espen; Jönsson, Erik G

    2018-03-02

    Antipsychotic-associated side effects are well known and represent a significant treatment challenge. Still, few large studies have investigated the overall side effect burden of antipsychotics in real-life settings. To describe the occurrence of side effects and perceived burden of antipsychotics in a large naturalistic sample, taking polypharmacy and patient characteristics into account. Patients (n=1087) with psychotic disorders were assessed for side effects using the Udvalg for Kliniske Undersøgelser (UKU) side effect rating scale in addition to assessment of clinical and pharmacological data. Statistical analyses were performed controlling for possible confounding factors. Use of antipsychotics showed significant associations to neurologic and sexual symptoms, sedation and weight gain, and >75% of antipsychotics-users reported side effects. More side effects were observed in patients using several antipsychotics (p=0.002), with increasing total dose (p=0.021) and with antipsychotics in combinations with other psychotropic drugs. Patients and investigators evaluated the side effect burden differently, particularly related to severity, gender and antipsychotics dose. Twice as many females described side effect burden as severe (p=0.004). Patients with psychotic disorders have a high occurrence of symptoms associated with use of antipsychotics, and polypharmacy and female gender are seemingly risk factors for reporting a severe side effect burden. Due to the cross-sectional design evaluation of causality is tentative, and these findings should be further investigated in prospective studies. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Assessment of the efficacy and tolerance of a new combination of retinoids and depigmenting agents in the treatment of melasma.

    PubMed

    Truchuelo, Maria Teresa; Jiménez, Natalia; Jaén, Pedro

    2014-12-01

    Melasma is a dermatosis with significant repercussions on patients' quality of life, and there is currently no standard treatment. Hydroquinone is deemed the treatment of choice, but its safety has been questioned in certain cases. To determine the efficacy and safety of a new combination of retinoids in the improvement of melasma. Prospective, double-blind, vehicle-controlled, and randomized study in 30 patients with melasma. The product was applied on one side of the face and the vehicle on the other, twice daily during 3 months. Standardized photographs were taken using RBX technology on the three visits (basal, at one and a half months and at 3 months). The main variable to determine the efficacy was the improvement of the hemifacial Melasma Area Severity Index (MASI). Other variables were determined such as improvement perceived by the investigator, improvement perceived by the patient, impact on quality of life or side effects. The MASI improvement at 3 months of treatment was significant on the treated side vs. the vehicle side, reaching an improvement of 70%, which is comparable to the percentage of improvement described with hydroquinone. No notable side effects were detected, in spite of a significant percentage of patients included in the study citing a history that could be compatible with sensitive skin. This new combination of retinoids and depigmenting agents proved to be effective and safe in the treatment of melasma. © 2014 Wiley Periodicals, Inc.

  6. Beliefs regarding medication and side effects influence treatment adherence in adolescents with attention deficit hyperactivity disorder.

    PubMed

    Emilsson, Maria; Gustafsson, Per A; Öhnström, Gisela; Marteinsdottir, Ina

    2017-05-01

    Adherence to attention deficit hyperactivity disorder (ADHD) treatment is important because, when untreated, it may have serious consequences with lifelong effects. In the case of adolescents on long-term medicine prescription, more knowledge is needed regarding adherence and factors influencing adherence, which was the purpose of this study. Adolescents (n = 101) on ADHD medication ≥6 months were administrated questionnaires at a monitoring appointment: Medication Adherence Report Scale (MARS), beliefs about medicines (BMQ) and the Brief Illness Perception Questionnaire (B-IPQ). Adherence was high, the mean value was 88% of the maximum MARS score, and correlated positively with the "BMQ-necessity-concerns differential" but negatively with "BMQ-concerns" and "BMQ-side effects". Adolescents with more belief in the necessity of the medication, less concerns and less experience of side effects tended to be more adherent to medication prescription ("intentional non-adherence"), while "unintentional non-adherence" (forgetfulness) was associated with how much they perceived that their ADHD affected their lives. In a multiple regression model, the variance of MARS total (R 2  = 0.21) and "intentional non-adherence" (R 2  = 0.24) was explained by the "BMQ-necessity-concern differential" and "BMQ-experienced side effects". The variance of "unintentional non-adherence" (R 2  = 0.12) was explained by the "BMQ-necessity-concern differential" and "B-IPQ-consequences of ADHD". In conclusion, adolescents on long-term medication reported good adherence, mainly influenced by more beliefs in the necessity versus concerns of the medications, less experienced side effects and more perceived consequences of ADHD. BMQ could be useful to identify risks of low adherence, which should be counteracted by partially gender-specific interventions.

  7. Information giving and involvement in treatment decisions: is more really better? Psychological effects and relation with adherence.

    PubMed

    Wroe, Abigail L; Salkovskis, Paul M; Rees, Margaret; Jack, Tim

    2013-01-01

    The aim of this study is to improve our understanding of the ways in which a medical consultation style relates to satisfaction and adherence. Participants completed questionnaires about preferred and perceived consultation styles; psychological variables such as satisfaction, anxiety and depression; and questions about taking medication. Questionnaires were completed prior to the consultation, immediately after, three months later and one year later. Doctors also completed a scale on completion of the consultation. The decisions in question related to women seeking advice about Hormone Replacement Therapy (HRT) and decisions about pain management. Patients expressed preferences for information about the treatment options and for active involvement in the decision process. The extent to which patients perceived themselves as having received information about the treatment options was a particularly consistent predictor of satisfaction. The extent to which patients perceived themselves as having been prepared for the side effects of HRT was a consistent predictor of anxiety. Perceptions of the amount of information received about medical options, including information preparing individuals for potential side effects of medication, appears to be more important to satisfaction and anxiety, than actual involvement in the decision.

  8. How does the side-effect information in patient information leaflets influence peoples' side-effect expectations? A cross-sectional national survey of 18- to 65-year-olds in England.

    PubMed

    Webster, Rebecca K; Weinman, John; Rubin, G James

    2017-12-01

    To establish how the terms recommended by the European Commission to describe side-effect risk in patient information leaflets (PILs) influences expectations of side-effects and to identify factors associated with these side-effect expectations. A cross-sectional online survey was carried out by a market research company. Data were collected in England between 18th March and 1st April 2016. A total of 1003 adults aged between 18 and 65. Self-reported expectation that the described side-effects would affect participants if they took the medicine, measured on a likelihood scale from 1 (very unlikely) to 5 (very likely). Participants formed high expectations of side-effects for "very common" and "common" side-effects, with 51.9% and 45.0% of participants rating these as "very likely" or "likely" to happen to them, respectively. This fell to 8.1% for "uncommon," 5.8% for "rare" and 4.1% for "very rare." For each descriptor, higher expectations of side-effects were more associated with women or being from an ethnic minority, or having less education, a household illness, high perceived sensitivity to medicines or negative beliefs about medicines. The current use of verbal descriptors to communicate side-effect risk in PILs leads to high side-effect expectations. These expectations could contribute to nocebo-induced medication side-effects experienced by patients. Additional work is required to identify ways to improve the way risk information is conveyed in PILs. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  9. Perceived risk of tamoxifen side effects: a study of the use of absolute frequencies or frequency bands, with or without verbal descriptors.

    PubMed

    Knapp, Peter; Gardner, Peter H; Raynor, David K; Woolf, Elizabeth; McMillan, Brian

    2010-05-01

    To investigate the effectiveness of presenting medicine side effect risk information in different forms, including that proposed by UK guidelines [[1] Medicines and Healthcare products Regulatory Agency. Always read the leaflet-Getting the best information with every medicine. (Report of the Committee on Safety of Medicines Working Group on Patient Information). London: The Stationery Office, 2005.]. 134 Cancer Research UK (CRUK) website users were recruited via a 'pop-up'. Using a 2x2 factorial design, participants were randomly allocated to one of four conditions and asked to: imagine they had to take tamoxifen, estimate the risks of 4 side effects, and indicate a presentation mode preference. Those presented with absolute frequencies demonstrated greater accuracy in estimating 2 of 4 side effects, and of any side effect occurring, than those presented with frequency bands. Those presented with combined descriptors were more accurate at estimating the risk of pulmonary embolism than those presented with numeric descriptors only. Absolute frequencies outperform frequency bands when presenting side effect risk information. However, presenting such exact frequencies for every side effect may be much less digestible than all side effects listed under 5 frequency bands. Combined numerical and verbal descriptors may be better than numeric only descriptors when describing infrequent side effects. Information about side effects should be presented in ways that patients prefer, and which result in most accurate risk estimates. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  10. Decreasing the Burden of Side Effects Through Positive Message Framing: an Experimental Proof-of-Concept Study.

    PubMed

    Wilhelm, Marcel; Rief, Winfried; Doering, Bettina K

    2018-05-21

    Informing patients about treatment side effects increases the occurrence and intensity of side effects. Since the obligatory informed consent procedure in drug treatments requires transparency and nocebo research suggests that the informed consent of a drug leads to an increased occurrence of the mentioned side effects, the aim of this proof of concept study was to determine the effect of two different framings of informed consent on the occurrence, intensity, and perceived threat of side effects. Healthy male participants (n = 80) were randomized to one of two framing groups. The positive framing group was informed that the common side effect dizziness was a sign that the drug had started to work, while the neutral framing group was told that dizziness is an unpleasant but well-known side effect. Side effects were measured after the administration of metoprolol, an antihypertensive agent. Post hoc moderator analyses investigated the effect of pre-existing negative beliefs about the general harm of medication on the framing manipulation. Metoprolol-specific drug-attributed side effects were rated significantly less threatening in the positive framing group. The between-group effect size (Cohen's d) was small (d = 0.38, p = 0.049). Exploratory post hoc moderator analyses suggest that participants who believed that medication is a source of harmful effects benefited from positive framing, compared to neutral framing of drug-attributed side effects. Positive framing was partially effective in decreasing specific side effect measures, particularly among participants with a tendency to believe that medicine is harmful. Informed consent procedures should therefore be personalized, focusing on patients with negative treatment beliefs.

  11. Combined use of alcohol and energy drinks: Dose relationship with self-reported physiological stimulation and sedation side effects.

    PubMed

    Droste, Nicolas; Peacock, Amy; Bruno, Raimondo; Pennay, Amy; Zinkiewicz, Lucy; Lubman, Dan I; Miller, Peter

    2017-08-01

    Negative physiological stimulation and sedation side effects are experienced by a significant proportion of consumers who consume alcohol mixed with energy drinks (AmED). Few studies have compared the frequency of side effects between sessions of AmED and sessions of alcohol only within-subject, and none have explored a dose relationship. Explore the occurrence of self-reported physiological stimulant and sedative side effects between sessions of AmED and alcohol only, and at varying ED dosage levels within AmED sessions. A convenience sample of 2953 residents of New South Wales, Australia completed an online survey. N=731 AmED users reported daily caffeine intake, typical alcohol and AmED consumption, and past 12-month experience of physiological stimulation and sedation side effects during AmED and alcohol only sessions. Within-subject analyses compared occurrence of side effects between session types. Hierarchical binary logistic regression analyses explored the association of ED dose during AmED sessions with the experience of physiological side effects. There were greater odds of most stimulant side effects, and lower odds of sedation side effects, during AmED sessions compared to alcohol only sessions. Compared to one ED, consumption of three or more EDs was significantly associated with the majority of both stimulant and alcohol intoxication side effects after controlling for demographics and consumption covariates. AmED is associated with perceived changes in physiological stimulant and sedation side effects of alcohol. Experience of side effects is positively associated with ED dosage. Future research should account for varying ED dosage, and reflect real world consumption levels. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Surviving Performance Improvement "Solutions": Aligning Performance Improvement Interventions

    ERIC Educational Resources Information Center

    Bernardez, Mariano L.

    2009-01-01

    How can organizations avoid the negative, sometimes chaotic, effects of multiple, poorly coordinated performance improvement interventions? How can we avoid punishing our external clients or staff with the side effects of solutions that might benefit our bottom line or internal efficiency at the expense of the value received or perceived by…

  13. Breaking the barrier: the Health Belief Model and patient perceptions regarding contraception.

    PubMed

    Brown, Wendy; Ottney, Anne; Nguyen, Sammie

    2011-05-01

    The study was conducted to determine the discrepancy between unintended pregnancies and use of contraception is attributed to imperfect use, misconceptions and an inability to adjust therapy to lifestyle. A survey administered at a Federal clinic incorporated the Health Belief Model to determine patient's emphasis in pregnancy prevention. Analysis focused on comparing participant demographics to reasons for contraceptive selection. Ease of use ranked the most important for contraception as patient's education levels increased (p=.001). As household income increased, emphasis on potential side effects became less (p=.02). Patients with private insurance ranked ease of use most frequently (p=.01). Males emphasized effectiveness and menstrual suppression more than females (p=.04 and .008). A positive correlation between perceived benefit regarding ease of use as educational level increased and perceived barriers due to side effects as income level decreased immerged. Special counseling by practitioners to improve patient's self-efficacy, ultimately enhancing contraceptive adherence, are warranted. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Coverage and parental perceptions of influenza vaccination among parents of children aged 6 to 23 months in Hong Kong

    PubMed Central

    2013-01-01

    Background The impact of influenza on young children can be severe and even fatal. Influenza vaccination (IV) has been shown to be effective in reducing complications of influenza among children. This study investigated the prevalence and factors of IV among children aged 6-23 months in Hong Kong. Methods A sample of 401 Chinese parents of children aged 6-23 months were interviewed at local Maternal and Child Health Centers. Socio-demographic information, variables related to Health Belief Model, including perceptions about the child’s chance of contracting influenza, perceived harm of influenza on children, perceived benefits and side-effects of IV, having received recommendations from health professionals to uptake IV, and IV behaviors of the children were measured. Multivariate analysis was used to examine factors associated with IV behaviors of children. Results Only 9% of the children had ever been vaccinated. Among those parents who had heard of IV (92.0%), substantial proportions perceived that IV could reduce the risk of influenza-induced complications (70.5%), hospitalization (70.5%) and death (65.9%). Relatively few of the participants believed that IV had no side effects (17.1%) and even less had been recommended by health care professionals to uptake IV (10.6%). Results from multivariate analysis showed that physician recommendations were associated with a higher likelihood for IV among younger children, whilst parental perceptions of the side effects of IV was associated with a lower likelihood for IV. Conclusion The prevalence of IV among children aged 6-23 months in Hong Kong was very low. Promotion of IV with the component of physician recommendations and parents’ knowledge about IV safety for this group is warranted. PMID:24171947

  15. Diuretics in primary hypertension - Reloaded.

    PubMed

    Mishra, Sundeep

    Diuretics have long been cherished as drugs of choice for uncomplicated primary hypertension. Robust mortality and morbidity data is available for diuretics to back this strategy. Off-late the interest for diuretics has waned off perhaps due to availability of more effective drugs but more likely due to perceived lack of tolerance and side-effect profile of high-dose of diuretics required for mortality benefit. Low-dose diuretics particularly thiazide diuretics are safer but lack the mortality benefit shown by high-dose. However, indapamide and low dose chlorthalidone have fewer side-effects but continue to provide mortality benefit. Copyright © 2016. Published by Elsevier B.V.

  16. Traditional and non-traditional treatments for autism spectrum disorder with seizures: an on-line survey

    PubMed Central

    2011-01-01

    Background Despite the high prevalence of seizure, epilepsy and abnormal electroencephalograms in individuals with autism spectrum disorder (ASD), there is little information regarding the relative effectiveness of treatments for seizures in the ASD population. In order to determine the effectiveness of traditional and non-traditional treatments for improving seizures and influencing other clinical factor relevant to ASD, we developed a comprehensive on-line seizure survey. Methods Announcements (by email and websites) by ASD support groups asked parents of children with ASD to complete the on-line surveys. Survey responders choose one of two surveys to complete: a survey about treatments for individuals with ASD and clinical or subclinical seizures or abnormal electroencephalograms, or a control survey for individuals with ASD without clinical or subclinical seizures or abnormal electroencephalograms. Survey responders rated the perceived effect of traditional antiepileptic drug (AED), non-AED seizure treatments and non-traditional ASD treatments on seizures and other clinical factors (sleep, communication, behavior, attention and mood), and listed up to three treatment side effects. Results Responses were obtained concerning 733 children with seizures and 290 controls. In general, AEDs were perceived to improve seizures but worsened other clinical factors for children with clinical seizure. Valproic acid, lamotrigine, levetiracetam and ethosuximide were perceived to improve seizures the most and worsen other clinical factors the least out of all AEDs in children with clinical seizures. Traditional non-AED seizure and non-traditional treatments, as a group, were perceived to improve other clinical factors and seizures but the perceived improvement in seizures was significantly less than that reported for AEDs. Certain traditional non-AED treatments, particularly the ketogenic diet, were perceived to improve both seizures and other clinical factors. For ASD individuals with reported subclinical seizures, other clinical factors were reported to be worsened by AEDs and improved by non-AED traditional seizure and non-traditional treatments. The rate of side effects was reportedly higher for AEDs compared to traditional non-AED treatments. Conclusion Although this survey-based method only provides information regarding parental perceptions of effectiveness, this information may be helpful for selecting seizure treatments in individuals with ASD. PMID:21592359

  17. Traditional and non-traditional treatments for autism spectrum disorder with seizures: an on-line survey.

    PubMed

    Frye, Richard E; Sreenivasula, Swapna; Adams, James B

    2011-05-18

    Despite the high prevalence of seizure, epilepsy and abnormal electroencephalograms in individuals with autism spectrum disorder (ASD), there is little information regarding the relative effectiveness of treatments for seizures in the ASD population. In order to determine the effectiveness of traditional and non-traditional treatments for improving seizures and influencing other clinical factor relevant to ASD, we developed a comprehensive on-line seizure survey. Announcements (by email and websites) by ASD support groups asked parents of children with ASD to complete the on-line surveys. Survey responders choose one of two surveys to complete: a survey about treatments for individuals with ASD and clinical or subclinical seizures or abnormal electroencephalograms, or a control survey for individuals with ASD without clinical or subclinical seizures or abnormal electroencephalograms. Survey responders rated the perceived effect of traditional antiepileptic drug (AED), non-AED seizure treatments and non-traditional ASD treatments on seizures and other clinical factors (sleep, communication, behavior, attention and mood), and listed up to three treatment side effects. Responses were obtained concerning 733 children with seizures and 290 controls. In general, AEDs were perceived to improve seizures but worsened other clinical factors for children with clinical seizure. Valproic acid, lamotrigine, levetiracetam and ethosuximide were perceived to improve seizures the most and worsen other clinical factors the least out of all AEDs in children with clinical seizures. Traditional non-AED seizure and non-traditional treatments, as a group, were perceived to improve other clinical factors and seizures but the perceived improvement in seizures was significantly less than that reported for AEDs. Certain traditional non-AED treatments, particularly the ketogenic diet, were perceived to improve both seizures and other clinical factors.For ASD individuals with reported subclinical seizures, other clinical factors were reported to be worsened by AEDs and improved by non-AED traditional seizure and non-traditional treatments. The rate of side effects was reportedly higher for AEDs compared to traditional non-AED treatments. Although this survey-based method only provides information regarding parental perceptions of effectiveness, this information may be helpful for selecting seizure treatments in individuals with ASD.

  18. Effects of Message Framing on Influenza Vaccination: Understanding the Role of Risk Disclosure, Perceived Vaccine Efficacy, and Felt Ambivalence.

    PubMed

    Kim, Sungsu; Pjesivac, Ivanka; Jin, Yan

    2017-10-20

    The current study examined the effects of framing in promotional health messages on intention to vaccinate against seasonal influenza virus. The findings of an experimental study (N = 86) indicated that exposure to both benefits and side effects of vaccination (gain-framed with risk disclosure message) led to lower intention to receive the flu vaccine. This relationship was mediated by both perceived vaccine efficacy and felt ambivalence in a serial order, revealing the underlying psychological mechanisms important for understanding health-related behaviors. Theoretical implications of constructing sub-framed messages are discussed and the concept of second-order framing is introduced.

  19. Side effects, adherence self-efficacy, and adherence to antiretroviral treatment: a mediation analysis in a Chinese sample.

    PubMed

    Zhang, Liying; Li, Xiaoming; Lin, Zhenping; Jacques-Tiura, Angela J; Xu, Jinping; Zhou, Yuejiao; Qiao, Shan; Shen, Zhiyong; Stanton, Bonita

    2016-07-01

    Antiretroviral therapy (ART) is a lifelong treatment. To date, ART adherence is suboptimal for most patients in resource-poor settings. Previous research indicates that medication side effects are perceived to be a significant barrier of high ART adherence. Data regarding the role of adherence self-efficacy in mediating the relationship between side effects from ART and adherence to ART are limited; thus, this study examines this potential mediational role of self-efficacy. A cross-sectional survey of 2987 people living with HIV aged ≥18 years was conducted in 2012-2013 in Guangxi Autonomous Region (Guangxi) which has one of the fastest-growing HIV rates in China. Of the total sample, 2146 (72.1%) participants had initiated ART. Participants reported the number of days of completing the daily dose of ART in the past month; adherence was defined as completing the daily dose at least 28 days in the last month (≥90%). Side effects were significantly negatively related to adherence to ART. Mediation analyses indicated that adherence self-efficacy significantly mediated the side effects-adherence relationship. Future interventions to increase adherence self-efficacy and effective coping with side effects among HIV patients are needed in order to improve their ART adherence.

  20. Misperceptions About β-Blockers and Diuretics

    PubMed Central

    Ubel, Peter A; Jepson, Christopher; Asch, David A

    2003-01-01

    BACKGROUND Based on a series of clinical trials showing no difference in the effectiveness or tolerability of most major classes of antihypertensive medications, the Joint National Commission on High Blood Pressure Treatment recommends that physicians prescribe β-blockers or diuretics as initial hypertensive therapy unless there are compelling indications for another type of medication. Nevertheless, many physicians continue to favor more expensive medications like angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers as first line agents. The persistent use of these agents raises questions as to whether physicians perceive ACE inhibitors and calcium channel blockers to be better than β-blockers and diuretics. METHODS We surveyed 1,200 primary care physicians in 1997, and another 500 primary care physicians in 2000, and asked them to estimate the relative effectiveness and side effects of 4 classes of medication in treating a hypothetical patient with uncomplicated hypertension: ACE inhibitors, β-blockers, calcium channel blockers, and diuretics. In addition, we asked them to indicate whether they ever provided free samples of hypertension medications to their patients. RESULTS Perceptions of the relative effectiveness and side effects of the 4 classes of hypertension medications did not significantly change over the 3 years, nor did prescription recommendations. Physicians perceive that diuretics are less effective at lowering blood pressure than the other 3 classes (P < .001). They also perceive that β-blockers are less tolerated than the other 3 classes (P < .001). In a multivariate model, perceptions of effectiveness and tolerability displayed significant associations with prescription preference independent of background variables. The only other variable to contribute significantly to the model was provision of free medication samples to patients. CONCLUSIONS Despite numerous clinical trials showing no difference in the effectiveness or side-effect profiles of these 4 classes of drugs, most physicians believed that diuretics were less effective and β-blockers were less tolerated than other medications. Moreover, their prescription practices were associated with their provision of free samples provided by pharmaceutical representatives, even after adjusting for other demographic characteristics. Efforts to increase physicians' prescribing of β-blockers and diuretics may need to be directed at overcoming misunderstandings about the effectiveness and tolerability of these medicines. PMID:14687255

  1. Misperceptions about beta-blockers and diuretics: a national survey of primary care physicians.

    PubMed

    Ubel, Peter A; Jepson, Christopher; Asch, David A

    2003-12-01

    Based on a series of clinical trials showing no difference in the effectiveness or tolerability of most major classes of antihypertensive medications, the Joint National Commission on High Blood Pressure Treatment recommends that physicians prescribe beta-blockers or diuretics as initial hypertensive therapy unless there are compelling indications for another type of medication. Nevertheless, many physicians continue to favor more expensive medications like angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers as first line agents. The persistent use of these agents raises questions as to whether physicians perceive ACE inhibitors and calcium channel blockers to be better than beta-blockers and diuretics. We surveyed 1,200 primary care physicians in 1997, and another 500 primary care physicians in 2000, and asked them to estimate the relative effectiveness and side effects of 4 classes of medication in treating a hypothetical patient with uncomplicated hypertension: ACE inhibitors, beta-blockers, calcium channel blockers, and diuretics. In addition, we asked them to indicate whether they ever provided free samples of hypertension medications to their patients. Perceptions of the relative effectiveness and side effects of the 4 classes of hypertension medications did not significantly change over the 3 years, nor did prescription recommendations. Physicians perceive that diuretics are less effective at lowering blood pressure than the other 3 classes (P <.001). They also perceive that beta-blockers are less tolerated than the other 3 classes (P <.001). In a multivariate model, perceptions of effectiveness and tolerability displayed significant associations with prescription preference independent of background variables. The only other variable to contribute significantly to the model was provision of free medication samples to patients. Despite numerous clinical trials showing no difference in the effectiveness or side-effect profiles of these 4 classes of drugs, most physicians believed that diuretics were less effective and beta-blockers were less tolerated than other medications. Moreover, their prescription practices were associated with their provision of free samples provided by pharmaceutical representatives, even after adjusting for other demographic characteristics. Efforts to increase physicians' prescribing of beta-blockers and diuretics may need to be directed at overcoming misunderstandings about the effectiveness and tolerability of these medicines.

  2. Context as a drug: some consequences of placebo research for primary care.

    PubMed

    Lucassen, P; Olesen, F

    2016-12-01

    On the basis of emerging research evidence, this review aims to discuss the importance of the context surrounding the doctor-patient encounter for the success of treatment. Discussion paper based on placebo-nocebo and pain studies conducted in the western world. Literature-based theory about impact of communication elements on seriousness of symptoms in clinical practice. The therapeutic outcome seems to be impacted by rituals around a clinical encounter and by the doctor patient communication and relation. A warm, friendly and empathic attitude is crucial in the first contact with the practice and during the consultation as it influences the patient's perceived outcome. It is important to raise positive expectations when discussing the prognosis, conducting treatment and prescribing medications as the effect may be reduced if the physician expresses doubt about the effectiveness of the medication. Additionally, overly focus on side effects in the doctor-patient conversation about proposed treatments seems to influence the magnitude of perceived side effects in the patient. Thus, shared decision-making might be a desirable tool for ensuring better expectations in the patient and successful symptom relief. The context of the doctor-patient interplay matters. Placebo-nocebo research provides strong evidence for this link. The therapeutic context induces biomedical processes in the patient's brain that may enhance or reduce the effects of chosen interventions. The context thus works as a drug, with real effects and side effects. KEY POINTS Increased awareness of the context drug may help GPs alleviate symptoms and better motivate patients for treatment. Treatment is affected by multiple types of context, as also confirmed by placebo-nocebo research. The therapeutic context influences the biomedical processes, which may enhance or reduce intervention effects on symptoms. The impact of context should be considered in daily general practice as it may serve as a drug, with real effects and side effects.

  3. Conflict between aftereffects of retinal sweep and looming motion.

    PubMed

    Bridgeman, B; Nardello, C

    1994-01-01

    Observers looked monocularly into a tunnel, with gratings on the left and right sides drifting toward the head. An exposure period was followed by a test with fixed gratings. With fixation points, left and right retinal fields could be stimulated selectively. When exposure and test were on the same retinal fields, but fixation was on opposite sides of the tunnel during exposure and test periods, aftereffects of retinal sweep and of perceived looming were in opposite directions. The two effects tended to cancel, yielding no perceived aftereffect. When they did occur, aftereffects in the retinal and the looming directions were equally likely. Cancellation was significantly more likely in the experimental conditions than in the control, when fixation always remained on the same side. When areas of retinal stimulation in the exposure and test periods did not overlap, cancellation was less frequent and aftereffects of looming were more frequent. Results were not significantly different for left and right visual fields, indicating that cortical vs. subcortical OKN pathways do not influence the illusion. Vection resulted for 16 of 20 observers under one or another of our conditions.

  4. Characteristics of e-cigarette users and their perceptions of the benefits, harms and risks of e-cigarette use: survey results from a convenience sample in Ottawa, Canada.

    PubMed

    Volesky, K D; Maki, A; Scherf, C; Watson, L M; Cassol, E; Villeneuve, P J

    2016-07-01

    Although e-cigarette use ("vaping") is increasing in Canada, few attempts have been made to describe e-cigarette users ("vapers"). In this context, we conducted a study in Ottawa, Canada, to describe e-cigarette users' perceptions of the benefits, harms and risks of e-cigarettes. We also collected information on why, how and where they use e-cigarettes as well as information on side effects. A 24-item online survey was administered to individuals who purchased e-cigarettes or e-cigarette-related supplies at one of Ottawa's 17 e-cigarette shops. Descriptive analyses characterized respondents, and logistic regression models were fitted to evaluate the relationship between respondents' characteristics and their perception of e-cigarette harms. The mean age of the 242 respondents was 38.1 years (range: 16-70 years); 66% were male. Nearly all had smoked 100 or more cigarettes in their lifetime (97.9%). More than 80% indicated that quitting smoking was a very important reason for starting to use e-cigarettes and 60% indicated that they intend to stop using e-cigarettes at some point. About 40% reported experiencing some side effects within 2 hours of using e-cigarettes. Those who did not report experiencing any of the listed side effects had approximately 3.2 times higher odds of perceiving e-cigarettes as harmless than those who reported having side effects (odds ratio = 3.17; 95% confidence interval: 1.75-5.73). Our findings suggest that most e-cigarette users are using them to reduce or stop smoking cigarettes and perceive them as harmless. Due to our use of convenience sampling, the reader should be cautious in generalizing our findings to all Canadian e-cigarette users.

  5. Evidence for Adverse Phonatory Change Following an Inhaled Combination Treatment

    ERIC Educational Resources Information Center

    Erickson, Elizabeth; Sivasankar, Mahalakshmi

    2010-01-01

    Purpose: Voice problems are reported as a frequent side effect of inhaled combination (IC) treatments. The purpose of this experimental study was to investigate whether IC treatments are detrimental to phonation. We hypothesized that IC treatment would significantly increase phonation threshold pressure (PTP) and perceived phonatory effort (PPE),…

  6. Contraceptive methods and use by women aged 35 and over: A qualitative study of perspectives.

    PubMed

    Godfrey, Emily M; Chin, Nancy P; Fielding, Stephen L; Fiscella, Kevin; Dozier, Ann

    2011-02-16

    More than 30% of the pregnancies in women aged 35 and over are unintended. This paper compares perceptions about contraceptive methods and use among women with and without an unintended pregnancy after turning age 35. Semi-structured, in-depth interviews were conducted with 17 women. They were all 35 to 49 years old, regularly menstruating, sexually active, not sterilized, not desiring a pregnancy in the near future, and at least 3 months postpartum. We purposely sampled for women who had had at least one unintended pregnancy after age 35 (n = 9) and women who did not (n = 8). We assessed partnership, views of pregnancy and motherhood, desired lifestyle, perceived advantages and disadvantages of using and obtaining currently available well-known reversible contraceptives in the U.S. ''We also assessed contraceptive methods used at any time during their reproductive years, including current method use and, if appropriate, circumstances surrounding an unintended pregnancy after age 35.'' Each interview was taped and transcribed verbatim. Data were analyzed using Grounded Theory. Analysis focused on partnership, views of pregnancy, motherhood, desired lifestyle and perceived advantages and disadvantages of various reversible contraceptive methods. The women without an unintended pregnancy after age 35 were more likely to (1) use contraceptive methods that helped treat a medical condition, (2) consider pregnancy as dangerous, or (3) express concerns about the responsibilities of motherhood. The women who experienced an unintended pregnancy after age 35 were more likely to (1) report unstable partnerships, (2) perceive themselves at lower risk of pregnancy, or (3) report past experiences with unwanted contraceptive side effects. There was a greater likelihood a woman would choose a contraceptive method if it was perceived as easy to use, accessible, affordable and had minimal side effects. Women's perspective on contraceptive use after age 35 varies. Public health messages and health providers' care can help women in this age group by reviewing their fertility risks, as well as all contraceptive methods and their associated side effects. The impact of such interventions on unintended pregnancy rates in this age group should be tested in other areas of evidence-based medicine.

  7. Type and frequency of side effects during PC6 acupuncture: observations from therapists and patients participating in clinical efficacy trials of acupuncture.

    PubMed

    Enblom, Anna; Johnsson, Anna

    2017-12-01

    Many therapists practise PC6 acupuncture for emesis (nausea and vomiting) during pregnancy, different cancer therapies, palliative care, after surgery, or to induce relaxing effects in general. Knowledge of side effects is central to shared decision-making. To describe the type and frequency of side effects and the level of needle-induced pain during PC6 acupuncture. We included 1298 PC6 acupuncture treatments, delivered to 221 participants (77% women, mean age 52.5, range 18-91 years). The subjects had received genuine PC6 acupuncture, in one of two previous randomised controlled trials, aimed at inducing antiemetic (n=100, with 100 providing data on side effects and 94 on needle-induced pain, respectively) or relaxing (n=121, with 120 providing data) effects. Side effects during and after the acupuncture treatments were registered in structured treatment protocols and study diaries. No serious complications occurred. Side effects during the acupuncture sessions included minor bleeding in 5.0%, tiredness in 4.9%, numbness in 4.5% and dizziness in 1.4% of the 1298 treatments. After treatment, the mean proportions of participants reporting side effects each week were: tiredness 25.8%; feeling cold 17.8%; dizziness 9.7%; sweating 9.3%; haematoma 8.8%; and soreness at the needling sites 4.3%. Participants perceived the needling to be not painful (47.4% of participants), or mildly (39.1%), moderately (11.6%) or very painful (1.4%). Few side effects occurred and those that did were mild. Nearly 90% found PC6 acupuncture to be not painful or only mildly painful. Healthcare professionals may consider the observed levels of side effects when informing patients about side effects of PC6 acupuncture. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Duration of use of oral cannabis extract in a cohort of pediatric epilepsy patients.

    PubMed

    Treat, Lauren; Chapman, Kevin E; Colborn, Kathryn L; Knupp, Kelly G

    2017-01-01

    Oral cannabis extracts (OCEs) are being used in the treatment of epilepsy with increasing rates in the United States following product legalization; however, no studies demonstrate clear efficacy. We evaluated the duration of use of OCEs as a measure of perceived benefit in a cohort of patients with pediatric epilepsy. Retrospective chart review was performed of children and adolescents who were given OCEs for treatment of epilepsy. Of the 119 patients included in the analysis, 71% terminated use of their OCE product during the study period. The average length of use of OCE was 11.7 months (range 0.3-57 months). Perceived seizure benefit was the only factor associated with longer duration of treatment with OCE (p < 0.01). Relocation to Colorado was associated with perceived benefit of OCEs for seizures (65% vs. 38%, p = 0.01), but was not independently associated with longer OCE use. Factors associated with shorter use included adverse effects (p = 0.03) and a diagnosis of Dravet syndrome (p = 0.02). Twenty-four percent of patients were considered OCE responders, which was defined by a parent's report of a > 50% reduction in seizures while on this therapy. Adverse events (AEs) were reported in 19% of patients, with the most common side effects being somnolence and worsening of seizures. Parental report of OCE use in refractory pediatric epilepsy suggests that some families perceive benefit from this therapy; however, discontinuation of these products is common. Duration appears to be affected by logical factors, such as perceived benefit and side effect profile. Surprisingly, families of patients with Dravet syndrome terminated use of OCEs more quickly than patients with other epilepsy syndromes. Results from this study highlight the need for rigorous clinical studies to characterize the efficacy and safety of OCEs, which can inform discussions with patients and families. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  9. Evaluation of patients’ experiences with antidepressants reported by means of a medicine reporting system

    PubMed Central

    van Geffen, E. C. G.; van der Wal, S. W.; van Hulten, R.; de Groot, M. C. H.; Egberts, A. C. G.

    2007-01-01

    Objective To assess experiences related to antidepressant use reported to an internet-based medicine reporting system and to compare the nature of the side effects reported by patients with those reported by health care professionals (HCPs). Methods All reports submitted from May 2004 to May 2005 to an internet-based medicine reporting system in The Netherlands related to the use of antidepressants were analysed. Spontaneous reports of adverse drug reactions on antidepressants from HCPs received by The Netherlands Pharmacovigilance Centre Lareb from May 2004 to May 2005 were included for comparison. Results Of the 2232 individuals who submitted a report to the internet-based medicine reporting system, 258 submitted a report on antidepressants. Of these, 92 individuals (36%) reported on effectiveness, 40 (16%) of whom reported on ineffectiveness, and 217 (84%) submitted a report on side effects, with 202 (78%) reporting a total of 630 side effects that were experienced as negative. Fourteen individuals (5%) reported a practical issue and four (2%) reported a reimbursement issue. Of all 630 side effects reported, 48% resulted in the patient discontinuing the antidepressant therapy; of these 29% did not inform their HCP. Of all the side effects reported, 52% were perceived as “very negative”. In comparison to the side effects reported by HCPs, patients more often reported apathy, excessive sweating, ineffectiveness, somnolence, insomnia, sexual problems and weight increase. Conclusion Patients report the ineffectiveness and side effects of antidepressant therapy as negative and leading to discontinuation of the therapy. Patients and HCPs differ in the nature of the reported side effects. Patient experiences should be included in the evaluation of antidepressant treatment in clinical practice. PMID:17874086

  10. Inhibition of return shortens perceived duration of a brief visual event.

    PubMed

    Osugi, Takayuki; Takeda, Yuji; Murakami, Ikuya

    2016-11-01

    We investigated the influence of attentional inhibition on the perceived duration of a brief visual event. Although attentional capture by an exogenous cue is known to prolong the perceived duration of an attended visual event, it remains unclear whether time perception is also affected by subsequent attentional inhibition at the location previously cued by an exogenous cue, an attentional phenomenon known as inhibition of return. In this study, we combined spatial cuing and duration judgment. After one second from the appearance of an uninformative peripheral cue either to the left or to the right, a target appeared at a cued side in one-third of the trials, which indeed yielded inhibition of return, and at the opposite side in another one-third of the trials. In the remaining trials, a cue appeared at a central box and one second later, a target appeared at either the left or right side. The target at the previously cued location was perceived to last shorter than the target presented at the opposite location, and shorter than the target presented after the central cue presentation. Therefore, attentional inhibition produced by a classical paradigm of inhibition of return decreased the perceived duration of a brief visual event. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. A Weighty Matter: Heaviness Influences the Evaluation of Disease Severity, Drug Effectiveness, and Side Effects

    PubMed Central

    Kaspar, Kai

    2013-01-01

    Peoples' perception of diseases and pharmaceutical drugs is a critical issue in health research. Beliefs about disease severity influence the compliance with recommendations for convalescence and the motivation to perform proper health-behavior. The estimated effectiveness of drugs and severity of side effects influence medication adherence and contribute to placebo effects. The present paper closes the gap between these effects and the concept of embodied cognition from a metaphor-enriched perspective. In five studies, we demonstrate that the bodily sensation of weight influences our evaluations of diseases and drugs. The experience of heaviness enhanced the estimated seriousness of diseases and the estimated effectiveness of drugs. The perceived seriousness of drug side effects was also affected by weight but only when drug effectiveness was not attended to. Moreover, the incidental sensation of weight shows a novel effect when evaluating weight-related drugs. The results are in line with the idea of embodied metaphors and reveal important boundary conditions which contribute to a better understanding of the underlying mechanisms. PMID:24244302

  12. Caregiver Survey of Pharmacotherapy to Treat Attention Deficit/Hyperactivity Disorder in Individuals with Williams Syndrome

    ERIC Educational Resources Information Center

    Martens, Marilee A.; Seyfer, Daisha L.; Andridge, Rebecca R.; Foster, Jessica E. A.; McClure, Kelsey E.; Coury, Daniel L.

    2013-01-01

    Williams syndrome (WS) is a genetic condition characterized by a unique neurocognitive and behavioral profile, including increased incidence of attention deficit/hyperactivity disorder (ADHD). The purpose of the present study was to examine the perceived helpfulness and side effects of medications used to treat ADHD (methylphenidate class,…

  13. To switch from Botox to Dysport in children with CP, a real world, dose conversion, cost-effectiveness study.

    PubMed

    Tedroff, Kristina; Befrits, Gustaf; Tedroff, Carl Johan; Gantelius, Stefan

    2018-05-01

    Children with cerebral palsy (CP) are routinely treated with botulinum toxin A (BoNT-A). Two non dose-equivalent and differently priced products, Botox and Dysport are used. Depending on the conversion one of the products is considerably cheaper. However, the dose conversion factors studied to date have varied widely and relevant studies have not included children. Our objective here was to compare the efficacy and health economics of the switch from Botox to Dysport in children with CP when conversion was set to 1:2. Specifically were these treatments perceived as equivalent in terms of efficacy, duration and side-effects and were the drug cost lowered by using Dysport. This prospective, real-world, cost-effectiveness population-based observational study included all children with CP, (n = 159) mean age 9.4 years (SD, 4.3), in the larger Stockholm area who received BoNT-A between September 1, 2014, and December 31, 2015. Parents reported the efficacy, duration and side-effects of previous treatment while physicians reported doses and goals set by children and parents for the present treatment. Drug acquisition costs were provided by county administrators. In connection with 341 visits caregivers reported comparable effects of similar duration with these products, with few, similar and transient side-effects. The drug-cost per treatment was 4029 SEK for Botox and 2380 SEK in the case of Dysport. When Botox was replaced by a two-fold higher Unit dose of Dysport (conversion 1:2) parents perceived the treatment of their children with CP to be equally effective while the cost was 41% lower according to procured prices. Copyright © 2018 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  14. Factors affecting members' evaluation of agri-business ventures' effectiveness.

    PubMed

    Hashemi, Seyyed Mahmoud; Hedjazi, Yousef

    2011-02-01

    This paper presents work to identify factors affecting effectiveness of agri-business ventures (A-BVs) on the side of providers as perceived by their members. A survey was conducted among 95 members of A-BVs in Zanjan province, Iran. To collect data, a questionnaire was designed. Two distinct groups of A-BVs with low (group 1) and high (group 2) perceived (evaluated) levels of effectiveness were revealed. The study showed that there were significant differences between the two groups on important characteristics of A-BVs and their members. The study also found that there were statistically significant relationships between A-BVs' governance structure and capacity, management and organization characteristics and the perceived effectiveness, whereas there were no statistically significant relationships between A-BVs' advisory methods characteristic applied by members and the perceived effectiveness. Logistic regression results also showed that level of application of rules encouraging members' active participation in important decision makings, clear terms of reference to guide contracting procedures, roles, and responsibilities of parties involved, type of people served and geographical area of program coverage, and members' ability to use Information and Communication Technologies (ICTs) were predictors of the perceived (evaluated) effectiveness of A-BVs. The study showed that evaluation of members of effectiveness of A-BVs would not be the same. It is suggested that Iranian public agricultural extension organization, as responsible organization for monitoring and evaluating services conducted by A-BVs, considered these differences between members with different levels of some important variables. 2010 Elsevier Ltd. All rights reserved.

  15. Involving Patients in Weighting Benefits and Harms of Treatment in Parkinson's Disease

    PubMed Central

    Weernink, Marieke G. M.; van Til, Janine A.; van Vugt, Jeroen P. P.; Movig, Kris L. L.; Groothuis-Oudshoorn, Catharina G. M.; IJzerman, Maarten J.

    2016-01-01

    Introduction Little is known about how patients weigh benefits and harms of available treatments for Parkinson’s Disease (oral medication, deep brain stimulation, infusion therapy). In this study we have (1) elicited patient preferences for benefits, side effects and process characteristics of treatments and (2) measured patients’ preferred and perceived involvement in decision-making about treatment. Methods Preferences were elicited using a best-worst scaling case 2 experiment. Attributes were selected based on 18 patient-interviews: treatment modality, tremor, slowness of movement, posture and balance problems, drowsiness, dizziness, and dyskinesia. Subsequently, a questionnaire was distributed in which patients were asked to indicate the most and least desirable attribute in nine possible treatment scenarios. Conditional logistic analysis and latent class analysis were used to estimate preference weights and identify subgroups. Patients also indicated their preferred and perceived degree of involvement in treatment decision-making (ranging from active to collaborative to passive). Results Two preference patterns were found in the patient sample (N = 192). One class of patients focused largely on optimising the process of care, while the other class focused more on controlling motor-symptoms. Patients who had experienced advanced treatments, had a shorter disease duration, or were still employed were more likely to belong to the latter class. For both classes, the benefits of treatment were more influential than the described side effects. Furthermore, many patients (45%) preferred to take the lead in treatment decisions, however 10.8% perceived a more passive or collaborative role instead. Discussion Patients weighted the benefits and side effects of treatment differently, indicating there is no “one-size-fits-all” approach to choosing treatments. Moreover, many patients preferred an active role in decision-making about treatment. Both results stress the need for physicians to know what is important to patients and to share treatment decisions to ensure that patients receive the treatment that aligns with their preferences. PMID:27575744

  16. A comparative evaluation of in-vehicle side view displays layouts in critical lane changing situation.

    PubMed

    Beck, Donghyun; Lee, Minho; Park, Woojin

    2017-12-01

    This study conducted a driving simulator experiment to comparatively evaluate three in-vehicle side view displays layouts for camera monitor systems (CMS) and the traditional side view mirror arrangement. The three layouts placed two electronic side view displays near the traditional mirrors positions, on the dashboard at each side of the steering wheel and on the centre fascia with the two displays joined side-by-side, respectively. Twenty-two participants performed a time- and safety-critical driving task that required rapidly gaining situation awareness through the side view displays/mirrors and making a lane change to avoid collision. The dependent variables were eye-off-the-road time, response time, and, ratings of perceived workload, preference and perceived safety. Overall, the layout placing the side view displays on the dashboard at each side of the steering wheel was found to be the best. The results indicated that reducing eye gaze travel distance and maintaining compatibility were both important for the design of CMS displays layout. Practitioner Summary: A driving simulator study was conducted to comparatively evaluate three in-vehicle side view displays layouts for camera monitor systems (CMS) and the traditional side view mirror arrangement in critical lane changing situation. Reducing eye movement and maintaining compatibility were found to be both important for the ergonomics design of CMS displays layout.

  17. Influenza vaccination in healthcare workers; comparison of side effects and preferred route of administration of intradermal versus intramuscular administration.

    PubMed

    Meijer, W J; Wensing, A M J; Bos, A A; Kuiphuis, J C F; Hagelen, E M M; Wilschut, J C; de Vries, M J T; Riezebos-Brilman, A

    2017-03-13

    To explore the nature and severity of side effects and future preference of intradermal versus intramuscular influenza vaccination in healthcare workers. Prospective cohort study. Two University Medical Centers in The Netherlands. Healthcare workers receiving an influenza vaccination. Healthcare workers that were vaccinated during the influenza vaccination season of 2012-2013 were approached for participation in a questionnaire study. The questionnaire was divided into two parts. The first part had to be answered directly after vaccination and the second part two weeks after vaccination. The motivation for vaccine uptake, whether or not the HCWs had direct contact with patients and the prevalence and severity of local and systemic side effects of influenza vaccination were explored. In addition, it was assessed how participants experienced the vaccination and which type of administration they preferred for future vaccination. Side effects of vaccination were more prevalent in the intradermal group versus the intramuscular group (56% versus 26%, p<0.001). Local side effects were perceived as more severe in healthcare workers receiving the intradermal vaccine. Directly after vaccination, healthcare workers preferred the intradermal vaccination. Two weeks after vaccination both types of vaccine were equally appreciated. This study shows that there are significant differences in the nature and severity of side effects upon intramuscular and intradermal influenza vaccination. This difference did not result in a preference among the vaccinated subjects for one type of vaccine. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Advances in Pharmacotherapeutics of Space Motion Sickness

    NASA Technical Reports Server (NTRS)

    Putcha, Lakshmi

    2006-01-01

    Space Motion Sickness (SMS) is common occurrence in the U.S. manned space flight program and nearly 2/3 of Shuttle crewmembers experience SMS. Several drugs have been prescribed for therapeutic management of SMS. Typically, orally-administered SMS medications (scopolamine, promethazine) have poor bioavailability and often have detrimental neurocognitive side effects at recommended doses. Intramuscularly administered promethazine (PMZ) is perceived to have optimal efficacy with minimal side effects in space. However, intramuscular injections are painful and the sedating neurocognitive side effects of promethazine, significant in controlled ground testing, may be masked in orbit because injections are usually given prior to crew sleep. Currently, EVAs cannot be performed by symptomatic crew or prior to flight day three due to the lack of a consistently efficacious drug, concern about neurocognitive side effects, and because an in-suit vomiting episode is potentially fatal. NASA has long sought a fast acting, consistently effective anti-motion sickness medication which has only minor neurocognitive side effects. Development of intranasal formulations of scopolamine and promethazine, the two commonly used SMS drugs at NASA for both space and reduced gravity environment medical operations, appears to be a logical alternative to current treatment modalities for SMS. The advantages are expected to be fast absorption, reliable and high bioavailability, and probably reduced neurocognitive side effects owing to dose reduction. Results from clinical trials with intranasal scopolamine gel formulation and pre-clinical testing of a prototype microcapsule intranasal gel dosage form of PMZ (INPMZ) will be discussed. These formulations are expected to offer a dependable and effective noninvasive treatment option for SMS.

  19. Optimism as a Mediator of the Relation between Perceived Parental Authoritativeness and Adjustment among Adolescents: Finding the Sunny Side of the Street

    ERIC Educational Resources Information Center

    Jackson, Lynne M.; Pratt, Michael W.; Hunsberger, Bruce; Pancer, S. Mark

    2005-01-01

    Authoritative parenting has been associated with positive outcomes for children and adolescents, but less is known about the mechanisms responsible for such effects. Two longitudinal studies examined the hypothesis that the relation between authoritative parenting and adolescents' adjustment is mediated by adolescents' level of dispositional…

  20. Medication adherence and subjective weight perception in patients with first-episode psychotic disorder.

    PubMed

    Wong, Mimi M C; Chen, E Y H; Lui, Simon S Y; Tso, Steve

    2011-10-01

    Medication adherence is critical to the management of psychotic disorder. Different factors associated with medication adherence have been investigated in previous studies. However, the association with subjective weight perception, which is related to the weight gain side effect of antipsychotics, has not been thoroughly investigated. Subjective weight perception may not equal objective weight status. This study tests the hypothesis that medication adherence is related to subjective weight perception in a group of patients with first-episode psychotic disorder who have taken antipsychotics for one year. This study recruited 160 participants with one-year histories of first-episode psychotic disorder and measured their actual and perceived weights, amount of weight gain in the past year, body size satisfaction and medication adherence levels. The associations between medication adherence and both the actual and perceived weight status were analyzed controlling for other confounding factors including insight, drug attitude, illness severity and other medication side effects. Stepwise multiple regression analysis found that the participants' perceived weight status, negative attitude toward their drugs and insight were the major factors associated with poor medication adherence. Of the participants who perceived themselves as being overweight, 86% believed that antipsychotics were responsible. Among those who had such beliefs, 72% had reduced their antipsychotic dosages on their own. About half of the participants had gained more than 7% of their baseline weight and 43.1% of the participants were found to be overweight after one year of treatment with antipsychotics. The results of this study indicate that medication adherence is associated with perceived weight status. Healthcare professionals should be aware of this relationship and address this issue early in the management of patients. Apart from weight management programs, education on a correct weight perception should be carried out with the promotion of proper drug attitudes and better insight for the improvement of medication adherence in the early course of psychotic disorder.

  1. Perceptions of diabetes, barriers to disease management, and service needs: a focus group study of working adults with diabetes in Hawaii.

    PubMed

    Fukunaga, Landry L; Uehara, Denise L; Tom, Tammy

    2011-03-01

    Research about the support needs for and barriers to successful disease management of working adults with diabetes is limited. Our objective was to gain an in-depth understanding of how working adults in Hawaii perceive diabetes, barriers to disease management, and the services needed to keep people healthy and working. From November 2008 through March 2009, we conducted focus group interviews with 74 employed adults with diabetes enrolled in the Hawaii Demonstration to Maintain Independence and Employment project. Responses to questions were analyzed within and across groups to identify recurring themes. A third layer of analysis examined themes across responses to all questions, specifically, how barriers related to identified service needs. Employed participants with diabetes experienced pervasive effects on their lives as a result of the disease, although they interpreted these effects positively or negatively. Barriers to disease management, such as additional health issues, social prejudice, and lack of social support, indicated a need to educate the general public about the disease. Participants identified needing social support from other people with diabetes, psychological support to address the emotional side of diabetes, and coordinated teams of specialists to address medication side effects and other health-related barriers to disease management. Many participants discussed the challenge of integrating diabetes management with work and family responsibilities and the need for monetary support. This study provides insight into how employed adults perceived their disease and what they perceived as challenges to successfully managing diabetes. The findings provide future directions for community and workplace diabetes initiatives.

  2. The Social Side Effects of Acetaminophen

    NASA Astrophysics Data System (ADS)

    Mischkowski, Dominik

    About 23% of all adults in the US take acetaminophen during an average week (Kaufman, Kelly, Rosenberg, Anderson, & Mitchell, 2002) because acetaminophen is an effective physical painkiller and easily accessible over the counter. The physiological side effects of acetaminophen are well documented and generally mild when acetaminophen is consumed in the appropriate dosage. In contrast, the psychological and social side effects of acetaminophen are largely unknown. Recent functional neuroimaging research suggests that the experience of physical pain is fundamentally related to the experience of empathy for the pain of other people, indicating that pharmacologically reducing responsiveness to physical pain also reduces cognitive, affective, and behavioral responsiveness to the pain of others. I tested this hypothesis across three double-blind between-subjects drug intervention studies. Two experiments showed that acetaminophen had moderate effects on empathic affect, specifically personal distress and empathic concern, and a small effect on empathic cognition, specifically perceived pain, when facing physical and social pain of others. The same two experiments and a third experiment also showed that acetaminophen can increase the willingness to inflict pain on other people, i.e., actual aggressive behavior. This effect was especially pronounced among people low in dispositional empathic concern. Together, these findings suggest that the physical pain system is more involved in the regulation of social cognition, affect, and behavior than previously assumed and that the experience of physical pain and responsiveness to the pain of others share a common neurochemical basis. Furthermore, these findings suggest that acetaminophen has unappreciated but serious social side effects, and that these side effects may depend on psychological characteristics of the drug consumer. This idea is consistent with recent theory and research on the context-dependency of neurochemical processes. Finally, public health and legal implications of the social side effects of acetaminophen are discussed.

  3. Young adults' medicine use for headache: the combined effect of socioeconomic position and perceived stress, and the contribution of sense of coherence.

    PubMed

    Koushede, Vibeke; Hansen, Ebba Holme; Andersen, Anette; Holstein, Bjørn E

    2012-01-01

    Over-the-counter analgesic (OTCA) use is increasingly common and may have potential harmful side effects. The primary reason for using analgesics is headache symptoms. Whether OTCA use for headache is sensitive to psychosocial and social circumstances is an understudied topic. The purpose of this study was to examine the combined effect of socioeconomic position (SEP) and perceived stress on OTCA use for headache. An additional objective was to determine whether sense of coherence (SOC) modifies the association. Data derived from the cross-sectional "Danish Lifestyle and Medicine Use Study," 2009. The study population consisted of men and women ages 25-44 years (n = 955). The dependent variable was OTCA use for headache within the past 14 days. The independent variables were SEP, perceived stress, and SOC. Gender, headache prevalence, and response method were included as covariates. Associations were examined by means of logistic regression analyses, and reported as odds ratios (ORs) with 95% confidence intervals. The OR for OTCA use was 1.42 (0.94-2.14) (statistically nonsignificant) among participants with low SEP but no perceived stress (reference high SEP, no perceived stress), 2.09 (1.53-2.85) for participants with perceived stress and high SEP, and 2.65 (1.66-4.25) among participants with perceived stress and low SEP. In analysis, stratified by SOC associations were stronger among participants with low SOC than among those with high SOC. Individuals exposed to both low SEP and high perceived stress have high odds for using OTCA for headache, apparently higher than participants only exposed to 1 of these factors. SOC may act as a buffer against the harmful effects of perceived stress and low SEP on OTCA use. Health care professionals and policymakers need to be aware of the sensitivity of OTCA use to psychosocial and social circumstances. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Fluency of pharmaceutical drug names predicts perceived hazardousness, assumed side effects and willingness to buy.

    PubMed

    Dohle, Simone; Siegrist, Michael

    2014-10-01

    The impact of pharmaceutical drug names on people's evaluations and behavioural intentions is still uncertain. According to the representativeness heuristic, evaluations should be more positive for complex drug names; in contrast, fluency theory suggests that evaluations should be more positive for simple drug names. Results of three experimental studies showed that complex drug names were perceived as more hazardous than simple drug names and negatively influenced willingness to buy. The results are of particular importance given the fact that there is a worldwide trend to make more drugs available for self-medication. © The Author(s) 2013.

  5. Predictors of long-term compliance in attending a worksite hypertension programme.

    PubMed

    Landers, R; Riccobene, A; Beyreuther, M; Neusy, A J

    1993-12-01

    Variables such as patient's anxiety, knowledge, number of medication changes, medication-induced side-effects and programme-derived benefits and conveniences have been reported or theorised to be important determinants of patient's attendance at worksite hypertension programmes. This study investigates whether these variables have predictive value in differentiating compliers from noncompliers attending a union-sponsored worksite hypertension programme for at least five years. Scores were created from a questionnaire distributed to 243 patients with a response rate of 98%. Compliance was defined as missing < or = 25% of scheduled clinic appointments. By discriminant statistical analysis scores for patient's anxiety, knowledge, number of medication changes, medication side-effects, perceived benefits and conveniences failed to show any predictive value for patient's compliance with appointment keeping.

  6. Physicians' perspectives of pharmacist-physician collaboration in the United Arab Emirates: Findings from an exploratory study.

    PubMed

    Hasan, S; Stewart, K; Chapman, C B; Kong, D C M

    2018-03-28

    Interprofessional collaborative care has been shown to improve patient outcomes. Physicians' views on collaboration with pharmacists give an insight into what contributes to a well-functioning team. Little is known about these views from low and ​middle-income countries and nothing from the United Arab Emirates (UAE). The purpose of this study is to investigate physicians' opinions on collaborative relationships with community pharmacists in the UAE. Semi-structured individual interviews and group discussions are conducted with a purposive sample of physicians. Thematic analysis based on the framework approach is used to generate themes. A total of 53 physicians participated. Three themes about collaboration emerged: perceived benefits of collaboration, facilitators of collaboration and perceived barriers to collaboration. Perceived benefits include reducing the burden on physicians, having the pharmacist as an extra safety check within the system, having the pharmacist assist patients to manage their medications: coping with side effects, reducing drug waste and costs, and attaining professional and health-system gains. Perceived facilitators included awareness and trust building, professional role definition, pharmacists' access to patient records and effective communication. Perceived barriers included patient and physician acceptance, logistic and financial issues and perceived pharmacist competence. This study has, for the first time, provided useful information to inform the future development of pharmacist-physician collaboration in the UAE and other countries with similar healthcare systems.

  7. Processing spatial layout by perception and sensorimotor interaction.

    PubMed

    Bridgeman, Bruce; Hoover, Merrit

    2008-06-01

    Everyone has the feeling that perception is usually accurate - we apprehend the layout of the world without significant error, and therefore we can interact with it effectively. Several lines of experimentation, however, show that perceived layout is seldom accurate enough to account for the success of visually guided behaviour. A visual world that has more texture on one side, for example, induces a shift of the body's straight ahead to that side and a mislocalization of a small target to the opposite side. Motor interaction with the target remains accurate, however, as measured by a jab with the finger. Slopes of hills are overestimated, even while matching the slopes of the same hills with the forearm is more accurate. The discrepancy shrinks as the estimated range is reduced, until the two estimates are hardly discrepant for a segment of a slope within arm's reach. From an evolutionary standpoint, the function of perception is not to provide an accurate physical layout of the world, but to inform the planning of future behaviour. Illusions - inaccuracies in perception - are perceived as such only when they can be verified by objective means, such as measuring the slope of a hill, the range of a landmark, or the location of a target. Normally such illusions are not checked and are accepted as reality without contradiction.

  8. Acceptability of Daily Use of Free Oral Pre-exposure Prophylaxis (PrEP) Among Transgender Women Sex Workers in Shenyang, China.

    PubMed

    Wang, Zixin; Lau, Joseph T F; Yang, Xueying; Cai, Yong; Gross, Danielle L; Ma, Tiecheng; Liu, Yan

    2017-12-01

    This study investigated the acceptability of daily use of free oral pre-exposure prophylaxis (PrEP) and associated factors among transgender women sex workers in Shenyang, China, following a briefing on PrEP. A total of 183 HIV negative or sero-status unknown participants completed the cross-sectional survey. The prevalence of acceptability of daily use of free oral PrEP was 61.2%. Adjusting for education level and monthly income, variables on negative attitudes toward PrEP (i.e., having concerns about the side-effects of PrEP) [Adjusted odds ratios (AOR): 0.26], perceived subjective norms (i.e., perceiving support from male partners to take PrEP) (AOR: 2.08), and perceived behavioral control (e.g., perceiving complete control over using PrEP) (AOR: 2.10-16.72) were significantly associated with acceptability of daily use of free oral PrEP. In addition, experiencing violence during sex work, perceived risk of contracting HIV from clients and probable anxiety were also significant. Future PrEP promotion campaigns should consider these factors.

  9. Applying the concept of consumer confusion to healthcare: development and validation of a patient confusion model.

    PubMed

    Gebele, Christoph; Tscheulin, Dieter K; Lindenmeier, Jörg; Drevs, Florian; Seemann, Ann-Kathrin

    2014-01-01

    As patient autonomy and consumer sovereignty increase, information provision is considered essential to decrease information asymmetries between healthcare service providers and patients. However, greater availability of third party information sources can have negative side effects. Patients can be confused by the nature, as well as the amount, of quality information when making choices among competing health care providers. Therefore, the present study explores how information may cause patient confusion and affect the behavioral intention to choose a health care provider. Based on a quota sample of German citizens (n = 198), the present study validates a model of patient confusion in the context of hospital choice. The study results reveal that perceived information overload, perceived similarity, and perceived ambiguity of health information impact the affective and cognitive components of patient confusion. Confused patients have a stronger inclination to hastily narrow down their set of possible decision alternatives. Finally, an empirical analysis reveals that the affective and cognitive components of patient confusion mediate perceived information overload, perceived similarity, and perceived ambiguity of information. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  10. Good for God? Religious motivation reduces perceived responsibility for and morality of good deeds.

    PubMed

    Gervais, Will M

    2014-08-01

    Many people view religion as a crucial source of morality. However, 6 experiments (total N = 1,078) revealed that good deeds are perceived as less moral if they are performed for religious reasons. Religiously motivated acts were seen as less moral than the exact same acts performed for other reasons (Experiments 1-2 and 6). Religious motivations also reduced attributions of intention and responsibility (Experiments 3-6), an effect that fully mediated the effect of religious motivations on perceived morality (Experiment 6). The effects were not explained by different perceptions of motivation orientation (i.e., intrinsic vs. extrinsic) across conditions (Experiment 4) and also were evident when religious upbringing led to an intuitive moral response (Experiment 5). Effects generalized across religious and nonreligious participants. When viewing a religiously motivated good deed, people infer that actually helping others is, in part, a side effect of other motivations rather than an end in itself. Thus, religiously motivated actors are seen as less responsible than secular actors for their good deeds, and their helping behavior is viewed as less moral than identical good deeds performed for either unclear or secular motivations. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  11. Medication adherence in schizophrenia: The role of insight, therapeutic alliance and perceived trauma associated with psychiatric care.

    PubMed

    Tessier, Arnaud; Boyer, Laurent; Husky, Mathilde; Baylé, Franck; Llorca, Pierre-Michel; Misdrahi, David

    2017-11-01

    Medication non adherence in schizophrenia is a major cause of relapse and hospitalization and remains for clinicians an important challenge. This study investigates the associations between insight, therapeutic alliance, perceived trauma related to psychiatric treatment and medication adherence in patients with schizophrenia. In this multicenter study, 72 patients were assessed regarding symptomatology, self-reported adherence with medication, insight, medication side-effects, therapeutic alliance and perceived trauma related to psychiatric treatment. Structural Equation Modeling (SEM) was used to test predicted paths among these variables. The data fit a model in which medication adherence was directly predicted by insight, therapeutic alliance and perceived trauma related to psychiatric treatment. Perceived trauma moderates the role of insight on medication adherence. The final model showed good fit, based on four reliable indices. Greater adherence was correlated with higher insight, higher therapeutic alliance and lower perceived trauma. These three variables appear to be important determinants of patient's medication adherence. Medication adherence could be enhanced by reducing perceived trauma and by increasing insight. The need for mental health providers to acknowledge patients' potentially traumatic experience with psychiatric treatment and the need to encourage greater involvement in care are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Research for assessment, not deployment, of Climate Engineering: The German Research Foundation's Priority Program SPP 1689

    NASA Astrophysics Data System (ADS)

    Oschlies, Andreas; Klepper, Gernot

    2017-01-01

    The historical developments are reviewed that have led from a bottom-up responsibility initiative of concerned scientists to the emergence of a nationwide interdisciplinary Priority Program on the assessment of Climate Engineering (CE) funded by the German Research Foundation (DFG). Given the perceived lack of comprehensive and comparative appraisals of different CE methods, the Priority Program was designed to encompass both solar radiation management (SRM) and carbon dioxide removal (CDR) ideas and to cover the atmospheric, terrestrial, and oceanic realm. First, key findings obtained by the ongoing Priority Program are summarized and reveal that, compared to earlier assessments such as the 2009 Royal Society report, more detailed investigations tend to indicate less efficiency, lower effectiveness, and often lower safety. Emerging research trends are discussed in the context of the recent Paris agreement to limit global warming to less than two degrees and the associated increasing reliance on negative emission technologies. Our results show then when deployed at scales large enough to have a significant impact on atmospheric CO2, even CDR methods such as afforestation—often perceived as "benign"—can have substantial side effects and may raise severe ethical, legal, and governance issues. We suppose that before being deployed at climatically relevant scales, any negative emission or CE method will require careful analysis of efficiency, effectiveness, and undesired side effects.

  13. Deconstructing Decisions to Initiate, Maintain, or Discontinue Adjuvant Endocrine Therapy in Breast Cancer Survivors: A Mixed-Methods Study

    PubMed Central

    Bluethmann, Shirley M.; Murphy, Caitlin C.; Tiro, Jasmin A.; Mollica, Michelle A.; Vernon, Sally W.; Bartholomew, Leona Kay

    2017-01-01

    Purpose/Objectives Adjuvant endocrine therapy (AET) has been shown to improve survival in hormone receptor–positive breast cancer survivors, but as many as half do not complete recommended treatment. Management of medication-related side effects and engagement with providers are two potentially modifiable factors, but their associations with adherence are not well understood. The aims were to build on survey results to qualitatively explore survivors’ experiences with prescribed AET to (a) describe appraisal and management of AET side effects and (b) deconstruct decisions to initiate, discontinue, or maintain AET. Research Approach The authors used a mixed-methods explanatory sequence research design with a qualitative emphasis. Setting Survivors were recruited from a clinical cancer registry maintained at the University of Texas Southwestern Medical Center, which includes the Harold C. Simmons Comprehensive Cancer Center (National Cancer Institute–designated), in Dallas. Participants 452 survivors completed a survey, and 30 took part in telephone interviews. Methodologic Approach Qualitative methods were used in which the authors recorded and transcribed interviews for analysis and used open coding to reduce data into themes. Findings Among adherent survivors, the themes of tolerance of side effects and perseverance were strong. Nonadherent survivors expressed more difficulty managing side effects and perceived fewer benefits when side effects were bothersome. The most common side effects mentioned by all survivors were menopausal symptoms and joint pain; less common side effects were cognitive decline and cardiac distress. Some sought advice from their oncology team. Nonadherent survivors appeared initially motivated to maintain AET but identified a tolerance limit for side effects after which a provider’s recommendation was less influential in their decision to maintain or discontinue AET. Interpretation This study elucidated adherence as a complex continuum of behaviors, appraisals, and decision points. These insights may be particularly useful in counseling survivors taking AET and promoting timely delivery of clinical interventions to enhance adherence. Implications for Nursing Nurses should be involved in the planning and implementation of clinical interventions to manage side effects and other barriers to AET adherence. PMID:28635973

  14. Oncology providers' perspectives on endocrine therapy prescribing and management.

    PubMed

    Wheeler, Stephanie B; Roberts, Megan C; Bloom, Diane; Reeder-Hayes, Katherine E; Espada, Maya; Peppercorn, Jeffrey; Golin, Carol E; Earp, Jo Anne

    2016-01-01

    Adjuvant endocrine therapy (ET) can reduce the risk of recurrence among females with hormone receptor-positive breast cancer. Overall, initiation and adherence to ET are suboptimal, though reasons are not well described. The study's objective was to better understand ET decision making, prescribing, and patient management from oncology providers' perspectives. Using purposive sampling, we recruited oncology providers who saw five or more breast cancer patients per week (n=20). We conducted 30-45-minute telephone interviews, using a semistructured guide to elicit perspectives on ET use. We used thematic content analysis to systematically identify categories of meaning and double-coded transcripts using Atlas.ti. Providers recommend ET to all eligible patients except those with contraindications or other risk factors. Providers base their ET prescribing decisions on the patient's menopausal status, side effects, and comorbidities. ET is typically discussed multiple times: at the onset of breast cancer treatment and in more detail after other treatment completion. Providers felt that the associated recurrence risk reduction is the most compelling argument for patients during ET decision making. While providers rarely perceived noninitiation as a problem, nonadherence was prevalent, often due to unresolvable side effects. From the clinicians' perspectives, side effects from ET are the dominant factor in nonadherence. Efforts to improve adherence should focus on strategies to minimize side effects and ensure clinicians and patients are well informed regarding optimal side effect management. This finding has important implications for novel endocrine regimens that offer improved outcomes through longer duration or more intensive therapy.

  15. Medication non-adherence and uncertainty: Information-seeking and processing in the Danish LIFESTAT survey.

    PubMed

    Kriegbaum, Margit; Lau, Sofie Rosenlund

    2017-09-23

    Statins are widely prescribed to lower cardiovascular morbidity and mortality. However, statin non-adherence is very high. The aim of this paper was to investigate reasons for stopping statin treatment in the general population and to study how aspects of information-seeking and processing is associated with statin non-adherence. This study used a population survey on 3050 Danish residents aged 45-65 years. Reasons for statin discontinuation was studied among those who were previous statin users. The association between information seeking and processing and statin discontinuation were analysed using multivariate logistical regression models. Experience of side effects and fear of side effects played an important role in the discontinuation of statin treatment. Feelings of uncertainty and confusion regarding information on statins predicted statin discontinuation. This applied to information from both mass media and from general practitioners. There was no clear pattern of information seeking and statin non-adherence. The article point to the impact of information-seeking on the decision to take cholesterol-lowering medication. This included contributions from information disseminated by media outlets. Side effects and fear of side effects should be addressed in clinical practice. Health care professionals should pay attention to emotional aspects of how information is disseminated and perceived by statin users. Copyright © 2017. Published by Elsevier Inc.

  16. Development and evaluation of an audiovisual information resource to promote self-management of chemotherapy side-effects.

    PubMed

    Carey, Mariko; Jefford, Michael; Schofield, Penelope; Kelly, Siobhan; Krishnasamy, Meinir; Aranda, Sanchia

    2006-04-01

    Based on a theoretical framework, we developed an audiovisual resource to promote self-management of eight common chemotherapy side-effects. A patient needs analysis identified content domains, best evidence for preparing patients for threatening medical procedures and a systematic review of effective self-care strategies informed script content. Patients and health professionals were invited to complete a written evaluation of the video. A 25-min video was produced. Fifty health professionals and 37 patients completed the evaluation. All considered the video informative and easy to understand. The majority believed the video would reduce anxiety and help patients prepare for chemotherapy. Underpinned by a robust theoretical framework, we have developed an evidence-based resource that is perceived by both patients and health professionals as likely to enhance preparedness for chemotherapy.

  17. Opiate Users' Perceived Barriers Against Attending Methadone Maintenance Therapy: A Qualitative Study in China

    PubMed Central

    Lin, Chunqing; Wu, Zunyou; Detels, Roger

    2012-01-01

    Methadone maintenance therapy (MMT) in China is facing challenges such as high relapse rates and low coverage. The study assessed factors influencing MMT utilization among opiate users. In-depth interviews were conducted among 30 opiate users in 2008 to ascertain the barriers against seeking MMT. Data were analyzed using ATLAS.ti. Barriers to the treatment included requirement of registration with police, perceived discrimination, logistic difficulties, side effects, fear of being addicted to another drug, lack of additional services, and economic burden. The result suggests the need for structural changes such as improving comprehensive services, simplifying application procedure, and enhancing referral system. The study's limitations are noted. PMID:21417558

  18. Knowledge and Preferences of Primary Care Providers in Delivering Head and Neck Cancer Survivorship Care.

    PubMed

    Berkowitz, Callie; Allen, Deborah H; Tenhover, Jennifer; Zullig, Leah L; Ragsdale, John; Fischer, Jonathan E; Pollak, Kathryn I; Koontz, Bridget F

    2017-07-14

    Long-term care for head and neck cancer (HNC) survivors is complex and requires coordination among multiple providers. Clinical practice guidelines highlight the role of primary care providers (PCPs) in screening for secondary cancer/recurrence, assessment of late/long-term side effects, and referrals for appropriate specialty management of toxicity. However, these responsibilities may be difficult to meet within the scope of primary care practice. We conducted this study to explore preferences, comfort, and knowledge of PCPs in the care of HNC survivors. We piloted a 40-item web-based survey developed with oncologist and PCP input targeted for family medicine and internal medicine providers. Responses were collected within a single university health system over 2 months. PCPs (n = 28; RR = 11.3%) were interested in learning about health promotion after cancer treatment (89%) and generally agree that their current practice patterns address healthy lifestyle behaviors (82%). However, only 32% of PCPs felt confident they could manage late/long-term side effects of chemotherapy, radiation, or surgery. Only 29% felt confident they could provide appropriate cancer screening. Looking at shared care responsibilities with oncology providers, PCPs perceived being responsible for 30% of care in the first year after treatment and 81% of care after 5 years. Seventy-one percent of PCPs agreed that oncologists provided them necessary information, yet 32% of PCPs found it difficult to coordinate with cancer providers. While these PCPs perceive increased care responsibility for long-term survivors, most are uncomfortable screening for recurrence and managing late/long-term side effects. Education and mutual coordination between PCPs and oncology providers may improve survivor care.

  19. How do parents of children with juvenile idiopathic arthritis (JIA) perceive their therapies?

    PubMed

    Rouster-Stevens, Kelly; Nageswaran, Savithri; Arcury, Thomas A; Kemper, Kathi J

    2008-06-02

    Complementary and alternative medical (CAM) therapies are commonly used by pediatric patients with chronic medical conditions. Little is known about parents' perceptions of these therapies. This study describes the views of parents of patients with juvenile idiopathic arthritis (JIA) regarding conventional and CAM therapies. Parents of children with JIA seen at a pediatric rheumatology clinic were surveyed between June 1 and July 31, 2007. Questionnaires asked about patients' use of over 75 therapies in the past 30 days, their perceived helpfulness (0 = not helpful; 3 = very helpful), perceived side effects (0 = none; 3 = severe), and whether each therapy would be recommended to other patients with JIA (Yes, No, Not sure). Questionnaires were returned by 52/76 (68%) parents; patients' average age was 10.9 years and 87% were Caucasian. Medications were used by 45 (88%) patients; heat (67%) and extra rest (54%) were also commonly used. CAM therapies were used by 48 (92%), e.g., massage (54%), vitamins and other supplements (54%), avoiding foods that worsened pain (35%) and stress management techniques (33%). Among the therapies rated by 3 or more parents, those that scored 2.5 or higher on helpfulness were: biologic medications, methotrexate, naproxen, wheelchairs, orthotics, heat, vitamins C and D, music, support groups and prayer. CAM therapies had 0 median side effects and parents would recommend many of them to other families. JIA patients use diverse therapies. Parents report that many CAM therapies are helpful and would recommend them to other parents. These data can be used in counseling patients and guiding future research.

  20. Patient perceptions about illness self-management in ANCA-associated small vessel vasculitis.

    PubMed

    Thorpe, C T; DeVellis, R F; Blalock, S J; Hogan, S L; Lewis, M A; DeVellis, B M

    2008-06-01

    To characterize patient perceptions, related to eight self-management behaviours relevant for adults with ANCA-associated small vessel vasculitis (ANCA-SVV), and to determine if these perceptions were associated with performance of each behaviour. Adults with ANCA-SVV (n = 202) completed a self-administered questionnaire that assessed eight self-management behaviours (adherence to recommendations for medication, health service use, diet, exercise, infection avoidance and symptom monitoring; prompt reporting of symptoms and side effects; and adjusting activities in response to symptoms), perceptions about these behaviours, socio-demographics, clinical factors and social desirability bias. Descriptive statistics were generated to characterize patients' perceptions about difficulty of, importance of, and specific barriers to performing each behaviour. Regression analyses explored whether these variables were associated with performing each behaviour, controlling for potential confounders. With few exceptions, higher perceived importance and lower perceived difficulty of each behaviour were associated with more frequent performance of the behaviour. For each behaviour, several specific barriers were frequently endorsed by patients and a number of these were associated with lower levels of self-management. This study reveals that patient perceptions about the illness and its treatment influence ANCA-SVV self-management. Perceived barriers to medication, health services, diet and exercise adherence were similar to those in other illnesses. This study also provides insight into barriers experienced by patients in performing behaviours (infection avoidance, symptom monitoring, reporting symptoms and side-effects and adjusting activities) not often previously studied. How the identification of these barriers can help inform future interventions for ANCA-SVV patients is to be discussed.

  1. Advantages and disadvantages of college drinking in students' own words: content analysis of the decisional balance worksheet.

    PubMed

    Collins, Susan E; Kirouac, Megan; Taylor, Emily; Spelman, Philip J; Grazioli, Véronique; Hoffman, Gail; Haelsig, Laura; Holttum, Jessica; Kanagawa, Ami; Nehru, Mayanka; Hicks, Jennifer

    2014-09-01

    The decisional balance worksheet (DBW), an open-ended measure of motivation to change, may be used to record the perceived advantages and disadvantages of substance use as well as alternative behaviors. Recent findings have indicated that the open-ended DBW can be quantified to validly reflect college students' level of motivation to reduce their drinking (Collins, Carey, & Otto, 2009). The goal of the current study was to enhance our understanding of college students' perceived advantages and disadvantages of drinking by qualitatively examining the content of their decisional balance. Participants were undergraduate college students at a 4-year university (N = 760) who participated in a randomized controlled trial of online brief motivational interventions. Using the DBW, participants recorded the advantages and disadvantages of their current drinking. Conventional content analysis methods were used to extract common themes. Social, enjoyment, and psychological reasons were the most commonly mentioned advantages of drinking, whereas physical side effects, expense and interference with goals were the most commonly mentioned disadvantages of drinking. These findings show that college students primarily use alcohol for enjoyment, particularly in social situations, as well as for coping with stress and social anxiety. On the other hand, many college students report having physical side effects from drinking as well as other kinds of concerns (e.g., expense, calories). Findings suggest that using the open-ended DBW may result in a more client-centered and accurate representation of what college students perceive as advantages and disadvantages to drinking than established, Likert-scale measures of decisional balance.

  2. Grounding the figure: surface attachment influences figure-ground organization.

    PubMed

    Vecera, Shaun P; Palmer, Stephen E

    2006-08-01

    We investigated whether the lower region effect on figure-ground organization (Vecera, Vogel, and Woodman, 2002) would generalize to contextual depth planes in vertical orientations, as is predicted by a theoretical analysis based on the ecological statistics of edges arising from objects that are attached to surfaces of support. Observers viewed left/right ambiguous figure-ground displays that occluded middle sections of four types of contextual inducers: two types of attached, receding, vertical planes (walls) that used linear perspective and/or texture gradients to induce perceived depth and two types of similar trapezoidal control figures that used either uniform color or random texture to reduce or eliminate perceived depth. The results showed a reliable bias toward seeing as "figure" the side of the figure-ground display that was attached to the receding depth plane, but no such bias for the corresponding side in either of the control conditions. The results are interpreted as being consistent with the attachment hypothesis that the lower region cue to figure-ground organization results from ecological biases in edge interpretation that arise when objects are attached to supporting surfaces in the terrestrial gravitational field.

  3. Knowledge, Practices, and Perceived Barriers Regarding Cancer Pain Management Among Physicians and Nurses In Korea: A Nationwide Multicenter Survey

    PubMed Central

    Jho, Hyun Jung; Kim, Yeol; Kong, Kyung Ae; Kim, Dae Hyun; Choi, Jin Young; Nam, Eun Jeong; Choi, Jin Young; Koh, Sujin; Hwang, Kwan Ok; Baek, Sun Kyung; Park, Eun Jung

    2014-01-01

    Purpose Medical professionals’ practices and knowledge regarding cancer pain management have often been cited as inadequate. This study aimed to evaluate knowledge, practices and perceived barriers regarding cancer pain management among physicians and nurses in Korea. Methods A nationwide questionnaire survey was administered to physicians and nurses involved in the care of cancer patients. Questionnaire items covered pain assessment and documentation practices, knowledge regarding cancer pain management, the perceived barriers to cancer pain control, and processes perceived as the major causes of delay in opioid administration. Results A total of 333 questionnaires (149 physicians and 284 nurses) were analyzed. Nurses performed pain assessment and documentation more regularly than physicians did. Although physicians had better knowledge of pain management than did nurses, both groups lacked knowledge regarding the side effects and pharmacology of opioids. Physicians working in the palliative care ward and nurses who had received pain management education obtained higher scores on knowledge. Physicians perceived patients’ reluctance to take opioids as a barrier to pain control, more so than did nurses, while nurses perceived patients’ tendency to under-report of pain as a barrier, more so than did physicians. Physicians and nurses held different perceptions regarding major cause of delay during opioid administration. Conclusions There were differences between physicians and nurses in knowledge and practices for cancer pain management. An effective educational strategy for cancer pain management is needed in order to improve medical professionals’ knowledge and clinical practices. PMID:25144641

  4. Parent and family stress factors predict health-related quality in pediatric patients with new-onset epilepsy.

    PubMed

    Wu, Yelena P; Follansbee-Junger, Katherine; Rausch, Joseph; Modi, Avani

    2014-06-01

    To examine the influence of parent and family general and epilepsy-related stress on longitudinal generic and epilepsy-specific health-related quality of life (HRQOL) for children with new-onset epilepsy, while controlling for demographic characteristics, disease factors, and antiepileptic drug (AED) adherence. This prospective, longitudinal study included 124 children with new-onset epilepsy (mean age 7.2 years, standard deviation [SD] 2.9 years). Parents completed questionnaires on parenting stress, perceived stigma, fears and concerns, and HRQOL at 1, 13, and 25 months after diagnosis. Adherence to AEDs was assessed using electronic monitors. A medical chart review was conducted at each visit to obtain seizure and side effect data. Higher levels of general and epilepsy-specific parent and family stress, fears and concerns, and perceived stigma negatively affected child generic and epilepsy-specific HRQOL, above and beyond disease and demographic factors. General parenting and family stress affected child generic and epilepsy-specific HRQOL more in the first year of disease management than at 2 years after diagnosis. Higher fears and concerns predicted higher epilepsy-specific HRQOL at 13 months postdiagnosis, whereas 2 years postdiagnosis, higher fears and concerns predicted lower epilepsy-specific HRQOL. Several demographic (i.e., age) and disease-related variables (i.e., side effects and AED adherence) influenced child generic and epilepsy-specific HRQOL. Although some findings were consistent across generic and epilepsy-specific HRQOL measures, others were unique. Modifiable parent factors (i.e., general and disease-specific parent and family stress, perceived stigma) impact HRQOL for children with new-onset epilepsy differently over the first 2 years postdiagnosis. Psychosocial interventions to improve HRQOL within the first year postdiagnosis should address parenting and family stress, overall coping, and anticipatory guidance on managing epilepsy. Interventions targeting adherence, perceived stigma, and fears and concerns could improve HRQOL. Promoting parent management of stress, fears/concerns, and perceived stigma may lead to improved child HRQOL outcomes. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  5. Motivators and barriers of tamoxifen use as risk-reducing medication amongst women at increased breast cancer risk: a systematic literature review.

    PubMed

    Meiser, B; Wong, W K T; Peate, M; Julian-Reynier, C; Kirk, J; Mitchell, G

    2017-01-01

    Selective estrogen receptor modulators, such as tamoxifen, reduce breast cancer risk by up to 50% in women at increased risk for breast cancer. Despite tamoxifen's well-established efficacy, many studies show that most women are not taking up tamoxifen. This systematic literature review aimed to identify the motivators and barriers to tamoxifen use 's amongst high-risk women. Using MEDLINE, PsycINFO, and Embase plus reviewing reference lists of relevant articles published between 1995 and 2016, 31 studies (published in 35 articles) were identified, which addressed high-risk women's decisions about risk-reducing medication to prevent breast cancer and were peer-reviewed primary clinical studies. A range of factors were identified as motivators of, and barriers to, tamoxifen uptake including: perceived risk, breast-cancer-related anxiety, health professional recommendation, perceived drug effectiveness, concerns about side-effects, knowledge and access to information about side-effects, beliefs about the role of risk-reducing medication, provision of a biomarker, preference for other forms of breast cancer risk reduction, previous treatment experience, concerns about randomization in clinical trial protocols and finally altruism. Results indicate that the decision for high-risk women regarding tamoxifen use or non-use as a risk-reducing medication is not straightforward. Support of women making this decision is essential and needs to encompass the full range of factors, both informational and psychological.

  6. [Feeling of Liberty and Internalized Stigma: Comparison of Inpatient and Outpatient Cases Receiving Psychiatric Treatment].

    PubMed

    Kamışlı, Songül; Dil, Satı; Daştan, Leyla; Eni, Nurhayat

    2016-01-01

    In this study, we investigated whether liberty-restricting and other factors can predict internalized stigma among psychiatric inpatients and outpatients. The study sample comprised of 129 inpatients, admitted at least once to psychiatry ward, and 100 outpatients who have never been hospitalized, receiving psychiatric treatment. In addition to demographic and clinical features, patients were evaluated for perceived deprivation of liberty and internalized stigma levels. Patients stated that their liberty was restrained mostly due to involuntary treatment, communication problems, side effects of medical treatment and inability to choose their treatment team. Regression analysis showed that internalized stigma was predicted by perceived deprivation of liberty, marital status and number of admissions to ward. Stigma was related to marital status and admissions to the psychiatry ward. Perceived deprivation of liberty predicts stigma regardless of the disease severity CONCLUSION: Perception of stigma leads to self-isolation, behavioral avoidance and refusal of aid-seeking. Our study indicated that perceived deprivation of liberty is one of the most important factors that lead to increased stigma. Based on our findings, we can say that as patients experience less perceived deprivation of liberty, they would have less stigma and thus, their compliance would increase.

  7. Survey of Conventional and Complementary and Alternative Therapy in Patients With Low Back Pain.

    PubMed

    O'Gara, Tadhg; Kemper, Kathi J; Birkedal, John; Curl, Walton; Miller, Neal; Abadie, Bryan

    2016-01-01

    Both conventional and alternative medical therapies are used by patients to treat low back pain, a condition that affects approximately 33% of the U.S. Little is known about patients' perceptions of conventional versus alternative therapies. Patients recruited from an orthopedic spine clinic completed surveys containing questions about their use of many conventional and alternative therapies. Patients rated perceived helpfulness, side effects, and their recommendation for each therapy. They also completed a questionnaire that detailed demographic information, stress, and pain. Questionnaires were completed by 166 patients. Conventional medications were used by 154 (95%) patients, most commonly acetaminophen and opioid derivatives. Alternative therapies were used by 159 (96%) patients, including therapeutic exercises, salves, supplements, and stress management techniques. Generally, patients reported that alternative therapies are more effective and have fewer side effects and would more likely recommend their use. These data can be used to counsel patients and guide future research.

  8. Depth Structure from Asymmetric Shading Supports Face Discrimination

    PubMed Central

    Chen, Chien-Chung; Chen, Chin-Mei; Tyler, Christopher W.

    2013-01-01

    To examine the effect of illumination direction on the ability of observers to discriminate between faces, we manipulated the direction of illumination on scanned 3D face models. In order to dissociate the surface reflectance and illumination components of front-view face images, we introduce a symmetry algorithm that can separate the symmetric and asymmetric components of the face in both low and high spatial frequency bands. Based on this approach, hybrid faces stimuli were constructed with different combinations of symmetric and asymmetric spatial content. Discrimination results with these images showed that asymmetric illumination information biased face perception toward the structure of the shading component, while the symmetric illumination information had little, if any, effect. Measures of perceived depth showed that this property increased systematically with the asymmetric but not the symmetric low spatial frequency component. Together, these results suggest that (1) the asymmetric 3D shading information dramatically affects both the perceived facial information and the perceived depth of the facial structure; and (2) these effects both increase as the illumination direction is shifted to the side. Thus, our results support the hypothesis that face processing has a strong 3D component. PMID:23457484

  9. Bilateral pneumothorax, surgical emphysema and pneumomediastinum in a young male patient following MDMA intake.

    PubMed

    Obiechina, Nonyelum Evangeline; Jayakumar, Ahrane; Khan, Yusra; Bass, James

    2018-04-07

    MDMA (3,4-methylenedioxymethamphetamine) or 'Ecstasy' is an illicit drug frequently used by young people at parties and 'raves'. It is readily available in spite of the fact that it is illegal. 1 It is perceived by a lot of young people as being 'harmless', but there have been a few high-profile deaths associated with its use. 2 Known side effects of MDMA include hyperthermia, rhabdomyolysis, coagulopathy and cardiac arrhythmias. 3 Rarer side effects include surgical emphysema and pneumomediastinum, which have been better described with cocaine abuse. 4-6 We present a case of bilateral pneumothorax, surgical emphysema and pneumomediastinum in a young man after taking ecstasy. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Emergency Physician and Stroke Specialist Beliefs and Expectations Regarding Telestroke

    PubMed Central

    Moskowitz, Ari; Chan, Yu-Feng Yvonne; Bruns, John; Levine, Steven R.

    2010-01-01

    Background Telestroke has been effective in the management of acute ischemic stroke (AIS). This study characterizes and compares Stroke Specialist (SS) and Emergency Physician (EP) perceptions of telestroke and identifies barriers preventing increased implementation. Methods A survey was developed and distributed nationwide to 382 SSs via an online survey-system and in paper form to 226 EPs attending the 2008 American College of Emergency Physicians (ACEP) national conference. Results Stroke specialists perceived themselves to be more knowledgeable about telemedicine and telestroke (p<0.001 and p=0.010). A large majority of physicians in both specialties either strongly agreed or agreed that telestroke will reduce geographical differences in stroke management and that it is superior to telephone consultation. EPs perceived patient preference (p<0.001), rt-PA side effects (p<0.001), level of technology (p=0.005), and rt-PA not the standard of care (p<0.001) to be more significant obstacles to increased implementation of telestroke than SSs. However, SSs found increased personal work to be a greater barrier than EPs (p<0.001). Conclusion SSs and EPs report positive beliefs regarding telestroke, however perceived obstacles exist to implementation. Differences between barriers perceived by EPs and SSs need to be addressed to enhance AIS treatment. PMID:20167910

  11. Emergency physician and stroke specialist beliefs and expectations regarding telestroke.

    PubMed

    Moskowitz, Ari; Chan, Yu-Feng Yvonne; Bruns, John; Levine, Steven R

    2010-04-01

    Telestroke has been effective in the management of acute ischemic stroke. This study characterizes and compares stroke specialist (SS) and emergency physician (EP) perceptions of telestroke and identifies barriers preventing increased implementation. A survey was developed and distributed nationwide to 382 SSs through an online survey system and in paper form to 226 EPs attending the 2008 American College of Emergency Physicians national conference. Stroke specialists perceived themselves to be more knowledgeable about telemedicine and telestroke (P<0.001 and P=0.010, respectively). A large majority of physicians in both specialties either strongly agreed or agreed that telestroke will reduce geographical differences in stroke management and that it is superior to telephone consultation. EPs perceived patient preference (P<0.001), recombinant tissue plasminogen activator side effects (P<0.001), level of technology (P=0.005), and recombinant tissue plasminogen activator not the standard of care (P<0.001) to be more significant obstacles to increased implementation of telestroke than SSs. However, SSs found increased personal work to be a greater barrier than EPs (P<0.001). SSs and EPs report positive beliefs regarding telestroke; however, perceived obstacles exist to implementation. Differences between barriers perceived by EPs and SSs need to be addressed to enhance acute ischemic stroke treatment.

  12. Semantic access occurs outside of awareness for the ground side of a figure.

    PubMed

    Cacciamani, Laura; Mojica, Andrew J; Sanguinetti, Joseph L; Peterson, Mary A

    2014-11-01

    Traditional theories of vision assume that figures and grounds are assigned early in processing, with semantics being accessed later and only by figures, not by grounds. We tested this assumption by showing observers novel silhouettes with borders that suggested familiar objects on their ground side. The ground appeared shapeless near the figure's borders; the familiar objects suggested there were not consciously perceived. Participants' task was to categorize words shown immediately after the silhouettes as naming natural versus artificial objects. The words named objects from the same or from a different superordinate category as the familiar objects suggested in the silhouette ground. In Experiment 1, participants categorized words faster when they followed silhouettes suggesting upright familiar objects from the same rather than a different category on their ground sides, whereas no category differences were observed for inverted silhouettes. This is the first study to show unequivocally that, contrary to traditional assumptions, semantics are accessed for objects that might be perceived on the side of a border that will ultimately be perceived as a shapeless ground. Moreover, although the competition for figural status results in suppression of the shape of the losing contender, its semantics are not suppressed. In Experiment 2, we used longer silhouette-to-word stimulus onset asynchronies to test whether semantics would be suppressed later in time, as might occur if semantics were accessed later than shape memories. No evidence of semantic suppression was observed; indeed, semantic activation of the objects suggested on the ground side of a border appeared to be short-lived. Implications for feedforward versus dynamical interactive theories of object perception are discussed.

  13. Women in Military Aircrews: Possible Outlooks for the French Air Force

    DTIC Science & Technology

    1989-05-01

    carefully implemented, because the current all-male environment is likely to be phychologically hostile. However, the system works very well in the... phychological barrier might be as much on the female side (for parochialistic reasons) as on the male side (who would perceive it as "downgrading" to join a

  14. Interest, views and perceived barriers to bariatric surgery in patients with morbid obesity.

    PubMed

    Wharton, S; Serodio, K J; Kuk, J L; Sivapalan, N; Craik, A; Aarts, M-A

    2016-04-01

    The objective of the study was to assess the interest, views and patient-perceived barriers to bariatric surgery among surgery-eligible patients. Surveys were completed at a weight management clinic and local hospital in Ontario, Canada. Patients were ≥18 years of age with a body mass index (BMI) >40 kg m(-2) or BMI > 35 kg m(-2) with ≥1 comorbidity. The sample included 105 participants, 73.3% female, with a mean BMI of 46.6 ± 7.1 kg m(-2) . Only 33.3% of participants were interested in surgery; 50.5% of participants were not interested and 16.2% had mixed feelings. Participants identified risks (69.5%) and side effects (57.1%) as significant surgical barriers. Interested participants were more likely to perceive themselves as obese, were unhappy with their current weight loss method and were less likely to fear surgery (P < 0.05). The prevalence of comorbidities was not different by surgical interest (P = 0.17). Despite the effectiveness of bariatric surgery, the majority of qualified patients are not interested in surgery mainly due to the perceived risk of surgery in general and satisfaction with current non-surgical weight loss efforts. The self-perception of obesity, as opposed to medical comorbidities, may be a stronger driver of the decision to have bariatric surgery. It is unclear if patients are aware of the effectiveness of bariatric surgery to help improve comorbidities or if bariatric surgery is perceived as being more cosmetic in nature. © 2016 World Obesity.

  15. Facility based cross-sectional study of self stigma among people with mental illness: towards patient empowerment approach

    PubMed Central

    2013-01-01

    Background Self stigma among people with mental illness results from multiple cognitive and environmental factors and processes. It can negatively affect adherence to psychiatric services, self esteem, hope, social integration and quality of life of people with mental illness. The purpose of this study was to measure the level of self stigma and its correlates among people with mental illness at Jimma University Specialized Hospital, Psychiatry clinic in southwest Ethiopia. Methods Facility based cross-sectional study was conducted on 422 consecutive samples of people with mental illness using interviewer administered and pretested internalized stigma of mental illness (ISMI) scale. Data was entered using EPI-DATA and analysis was done using STATA software. Bivariate and multivariate linear regressions were done to identify correlates of self stigma. Results On a scale ranging from 1 to 4, the mean self stigma score was 2.32 (SD = 0.30). Females had higher self stigma (std. β = 0.11, P < 0.05) than males. Patients with a history of traditional treatment had higher self stigma (std. β = 0.11, P < 0.05). There was an inverse relationship between level of education and self-stigma (std. β = −0.17, P < 0.01). Perceived signs (std. β = 0.13, P < 0.05) and supernatural causes of mental illness (std. β = 0.16, P < 0.01) were positively correlated with self stigma. Higher number of drug side effects were positively correlated (std. β = 0.15, P < 0.05) while higher self esteem was negatively correlated (std. β = −0.14, P < 0.01) with self stigma. Conclusions High feeling of inferiority (alienation) but less agreement with common stereotypes (stereotype endorsement) was found. Female showed higher self stigma than male. History of traditional treatment and higher perceived supernatural explanation of mental illness were associated with higher self stigma. Drug side effects and perceived signs of mental illness were correlated with increased self stigma while education and self esteem decreased self stigma among people with mental illness. Patient empowerment psychosocial interventions and strategies to reduce drug side effects can be helpful in reducing self stigma among people with mental illnesses. PMID:24004512

  16. Detecting "Infant-Directedness" in Face and Voice

    ERIC Educational Resources Information Center

    Kim, Hojin I.; Johnson, Scott P.

    2014-01-01

    Five- and 3-month-old infants' perception of infant-directed (ID) faces and the role of speech in perceiving faces were examined. Infants' eye movements were recorded as they viewed a series of two side-by-side talking faces, one infant-directed and one adult-directed (AD), while listening to ID speech, AD speech, or in silence. Infants…

  17. Anthropomorphic Bias Found in Typically Developing Children Is Not Found in Children with Autistic Spectrum Disorder

    ERIC Educational Resources Information Center

    Chaminade, Thierry; Rosset, Delphine; Da Fonseca, David; Hodgins, Jessica K.; Deruelle, Christine

    2015-01-01

    The anthropomorphic bias describes the finding that the perceived naturalness of a biological motion decreases as the human-likeness of a computer-animated agent increases. To investigate the anthropomorphic bias in autistic children, human or cartoon characters were presented with biological and artificial motions side by side on a touchscreen.…

  18. Predictors of statin adherence, switching, and discontinuation in the USAGE survey: understanding the use of statins in America and gaps in patient education.

    PubMed

    Wei, Melissa Y; Ito, Matthew K; Cohen, Jerome D; Brinton, Eliot A; Jacobson, Terry A

    2013-01-01

    Although statins have been shown to reduce cardiovascular disease mortality, less than half of U.S. adults achieve their low-density lipoprotein cholesterol goal. In many patients initiated on a statin, adherence rates decrease over time. To characterize current and former statin users, identify reasons for the discontinuation or switching of statins, and identify factors associated with adherence. The USAGE survey is a cross-sectional, self-administered Internet-based survey of 10,138 U.S. adults fielded September to October 2011. The following statin users were identified and compared: adherent nonswitchers, adherent switchers, non-adherent switchers, and discontinuers. Univariate and multivariate models using a priori covariates for adherence and discontinuation were examined. Most participants were current statin users who adhered with their prescribed statin (82.5%, n = 8371). Former statin users or discontinuers (12%, n = 1220) cited muscle pain, a side effect, as the primary reason for discontinuation (60%), followed by cost (16%), and then perceived lack of efficacy (13%). Discontinuers were less satisfied with their physicians' explanation of cholesterol treatment, more likely to use the Internet to research statins, and less likely to undergo frequent cholesterol monitoring. Among adherent statin users, the primary reasons for switching were muscle side effects (33%) and cost (32%). Individuals at risk for non-adherence included those with low household income, those who experienced muscle pain as a side effect while on statin therapy, and those taking medication for cardiovascular disease. Statin-related muscle side effects are common and contribute significantly to rates of discontinuation, switching, and non-adherence. Improved physician patient communication about side effects and benefits of statins are necessary to improve both adherence and outcomes. Copyright © 2013 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  19. Modafinil and zolpidem use by emergency medicine residents.

    PubMed

    McBeth, Brian D; McNamara, Robert M; Ankel, Felix K; Mason, Emily J; Ling, Louis J; Flottemesch, Thomas J; Asplin, Brent R

    2009-12-01

    The objective was to assess the prevalence and patterns of modafinil and zolpidem use among emergency medicine (EM) residents and describe side effects resulting from use. A voluntary, anonymous survey was distributed in February 2006 to EM residents nationally in the context of the national American Board of Emergency Medicine in-training examination. Data regarding frequency and timing of modafinil and zolpidem use were collected, as well as demographic information, reasons for use, side effects, and perceived dependence. A total of 133 of 134 residency programs distributed the surveys (99%). The response rate was 56% of the total number of EM residents who took the in-training examination (2,397/4,281). Past modafinil use was reported by 2.4% (57/2,372) of EM residents, with 66.7% (38/57) of those using modafinil having initiated their use during residency. Past zolpidem use was reported by 21.8% (516/2,367) of EM residents, with 15.3% (362/2,367) reporting use in the past year and 9.3% (221/2,367) in the past month. A total of 324 of 516 (62.8%) of zolpidem users initiated use during residency. Side effects were commonly reported by modafinil users (31.0%)-most frequent were palpitations, insomnia, agitation, and restlessness. Zolpidem users reported side effects (22.6%) including drowsiness, dizziness, headache, hallucinations, depression/mood lability, and amnesia. Zolpidem use is common among EM residents, with most users initiating use during residency. Modafinil use is relatively uncommon, although most residents using have also initiated use during residency. Side effects are commonly reported for both of these agents, and long-term safety remains unclear.

  20. The Effects of Man-Marking on Work Intensity in Small-Sided Soccer Games

    PubMed Central

    Ngo, Jake K.; Tsui, Man-Chung; Smith, Andrew W.; Carling, Christopher; Chan, Gar-Sun; Wong, Del P.

    2012-01-01

    The aim of this study was to examine the effect of manipulating defensive rules: with and without man-marking (MM and NMM) on exercise intensity in 3 vs. 3 small- sided games (SSGs). Twelve adolescent soccer players (age: 16.2 ± 0.7 years; body mass: 55.7 ± 6.4 kg; body height: 1.70 ± 0.07 m) participated in this repeated measures study. Each participant performed in four different SSGs formats: 3 vs. 3 MM with and without goals and 3 vs. 3 NMM with and without goals. Each SSG lasted 3 x 4 minutes interspersed with 4 minutes passive recovery. The percentage heart rate reserve (%HRreserve) was recorded continuously during SSG and session-rating of perceived exertion (session-RPE) after the SSG. MANOVA showed that defensive rule had significant effects on intensity (F = 5.37, p < 0.01). Specifically, MM during SSG induced significantly higher %HRreserve compared to NMM (Goal: 80.5 vs. 75.7%; No goal: 80.5 vs. 76.1%; p < 0.05, effect size = 0.91-1.06), irrespective of the presence or absence of goals. However, only MM with the presence of goals induced significant higher session-RPE compared to NMM (7.1 vs. 6. 0; p < 0.05, effect size = 1.36), whereas no difference in session-RPE was observed between MM and NMM (7.4 vs. 6.9; p > 0.05, effect size = 0.63) when no goals were used. Higher intra-class reliability and lower coefficient of variation values were also reported in MM as compared to NMM. This study in youth soccer players shows there is ~4.5% increase in heart rate response by using the man-marking in 3 vs. 3 SSG thus the intensity of SSG can be significantly increased when using man-marking tactics. Key pointsIntensity level of exercise during games can be raised if man-marking rule is adopted.No significant differences in perceived exertion were found in no goal SSG with and without man-marking.Adding goals in 3 vs. 3 SSG can lower perceived exertion without leading to large variations in intensity level. PMID:24149127

  1. A usability evaluation of Lazada mobile application

    NASA Astrophysics Data System (ADS)

    Hussain, Azham; Mkpojiogu, Emmanuel O. C.; Jamaludin, Nur Hafiza; Moh, Somia T. L.

    2017-10-01

    This paper reports on a usability evaluation of Lazada mobile application, an online shopping app for mobile devices. The evaluation was conducted using 12 users of ages 18 to 24. Seven (7) were expert users and the other 5 were novice users. The study objectives were to evaluate the perceived effectiveness, efficiency and satisfaction of the mobile application. The result provides a positive feedback and shows that the mobile shopping app is effective, efficient, and satisfying as perceived by the study participants. However, there are some observed usability issues with the main menu and the payment method that necessitates improvements to increase the application's effectiveness, efficiency and satisfaction. The suggested improvements include: 1) the main menu should be capitalized and place on the left side of mobile app and 2) payment method tutorial should be included as a hyperlink in the payment method page. This observation will be helpful to the owners of the application in future version development of the app.

  2. Is the treatment worse than the cure? Attitudes toward medications among persons with severe mental illness.

    PubMed

    Van Dongen, C J

    1997-03-01

    1. Patients' attitudes toward taking long-term psychotropic medications and factors that may influence drug attitudes are important factors in compliance. 2. Patients in this study had generally positive drug attitudes and perceived their medications as important in preventing relapse. 3. Attitudes toward psychotropic medications may be more positive than has been assumed by mental health professionals, as patients seem to realize that the advantages of medications outweight side effects.

  3. PrEP awareness and perceived barriers among single young men who have sex with men.

    PubMed

    Bauermeister, Jose A; Meanley, Steven; Pingel, Emily; Soler, Jorge H; Harper, Gary W

    2013-10-01

    Pre-exposure prophylaxis (PrEP) has the potential to help reduce new HIV infections among young men who have sex with men (YMSM). Using a cross-sectional survey of YMSM (N=1,507; ages 18-24), we gauged YMSM's PrEP awareness and PrEP-related beliefs regarding side effects, accessibility, and affordability. Overall, 27% of the sample had heard about PrEP; 1% reported ever using PrEP prior to sex. In a multivariate logistic regression, we found that YMSM were more likely to have heard about PrEP if they were older, more educated, were residentially unstable in the prior 30 days, had insurance, or reported having at least one sexually transmitted infection in their lifetime. We found no differences by race/ethnicity, history of incarceration, or recent sexual risk behavior. In multivariate linear regression models, Black and Latino YMSM were more likely than Whites to state they would not use PrEP because of side effect concerns. YMSM were more likely to indicate that they would not be able to afford PrEP if they did not have insurance or if they had a prior sexually transmitted infection, PrEP rollout may be hindered due to lack of awareness, as well as perceived barriers regarding its use. We propose strategies to maximize equity in PrEP awareness and access if it is to be scaled up among YMSM.

  4. Adherence issues related to sublingual immunotherapy as perceived by allergists

    PubMed Central

    Scurati, Silvia; Frati, Franco; Passalacqua, Gianni; Puccinelli, Paola; Hilaire, Cecile; Incorvaia, Cristoforo

    2010-01-01

    Objectives: Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence. Methods: We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10. Results: Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists. Conclusion: These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers. PMID:20622914

  5. Differential Patient-Caregiver Opinions of Treatment and Care For Advanced Lung Cancer Patients

    PubMed Central

    Zyzanski, Stephen J; Siminoff, Laura A

    2010-01-01

    This study examined the differences of opinion between cancer patients and caregivers with regard to treatment and care decisions. 184 advanced lung cancer patients and 171 primary caregivers were recruited as a convenience sample from clinics in Cleveland, Ohio. A telephone interview was conducted to collect data using a semi-structured questionnaire. Nonparametric tests and regression analysis were performed. The findings showed that patients and caregivers reported significant disagreement on three main issues: trade-off between treatment side effects and benefits; reporting treatment side effects to physicians, and hospice care. Caregivers were more concerned about patient’s quality of life and more willing to discuss hospice issues than were patients. Perceived family disagreement is associated with depression in both patients and caregivers. The study provided empirical evidence for patient-caregiver disagreement about treatment and care decisions and its significant adverse impact on both patients and caregivers. PMID:20137849

  6. Therapeutic Massage During Chemotherapy and/or Biotherapy Infusions: Patient Perceptions of Pain, Fatigue, Nausea, Anxiety, and Satisfaction.

    PubMed

    Robison, Jeanene G; Smith, Cheryl L

    2016-04-01

    Patients with cancer commonly experience disease or treatment side effects, including pain, fatigue, nausea, and anxiety. An expanding body of literature supports the use of therapeutic massage (TM) as an adjunct to conventional therapies to manage these side effects. This article describes patients' perceptions of pain, fatigue, nausea, and anxiety and their overall satisfaction with TM provided concurrently with chemotherapy and/or biotherapy. In an academic outpatient comprehensive cancer center, consenting patients were asked to identify massage site preference (hands and/or feet). The licensed massage therapist delivered TM for 20 minutes to patients concurrently receiving chemotherapy and/or biotherapy. Patients rated their pain, fatigue, nausea, and anxiety pre- and post-TM using a Likert-type scale. Qualitative and quantitative data related to patients' perceived value of TM were obtained postintervention. Participants (N = 58) reported a statistically significant reduction in each of the following variables.

  7. HPV Vaccine Awareness, Barriers, Intentions, and Uptake in Latina Women.

    PubMed

    Lechuga, Julia; Vera-Cala, Lina; Martinez-Donate, Ana

    2016-02-01

    Latina women are at heightened risk of cervical cancer incidence and mortality. The human papillomavirus (HPV) is the principal cause of the majority of cervical cancer cases. A vaccine that protects against HPV was licensed in 2006. Eight years post-licensure, mixed research findings exist regarding the factors that predict vaccine uptake in Latinas. We conducted a population-based phone survey with a random sample of 296 Latinas living in a Midwestern U.S. City. Intention to vaccinate was significantly associated with health care provider recommendations, worry about side effects, knowing other parents have vaccinated, perceived severity of HPV, and worry that daughter may become sexually active following vaccination. Worry that daughter may become sexually active was the only factor related to vaccine uptake. Findings suggest that training providers to discuss the low risk of severe side effects, consequences of persistent HPV, and sexuality related concerns with Latino women may encourage vaccination.

  8. HPV Vaccine Awareness, Barriers, Intentions, and Uptake in Latina Women

    PubMed Central

    Lechuga, Julia; Vera-Cala, Lina; Martinez-Donate, Ana

    2014-01-01

    Latina women are at heightened risk of cervical cancer incidence and mortality. The Human Papillomavirus (HPV) is the principal cause of the majority of cervical cancer cases. A vaccine that protects against HPV was licensed in 2006. Eight years post-licensure, mixed research findings exist regarding the factors that predict vaccine uptake in Latinas. We conducted a population-based phone survey with a random sample of 296 Latinas living in a Midwestern U.S. city. Intention to vaccinate was significantly associated with health care provider recommendations, worry about side effects, knowing other parents have vaccinated, perceived severity of HPV, and worry that daughter may become sexually active following vaccination. Worry that daughter may become sexually active was the only factor related to vaccine uptake. Findings suggest that training providers to discuss the low risk of severe side effects, consequences of persistent HPV, and sexuality related concerns with Latino women may encourage vaccination. PMID:25432149

  9. How doctors communicate the initial diagnosis of cancer matters: cancer disclosure and its relationship with Patients' hope and trust.

    PubMed

    Cao, Weidan; Qi, Xiaona; Yao, Ting; Han, Xuanye; Feng, Xujing

    2017-05-01

    The study is to examine the relationships between perceived initial cancer disclosure communication with doctors, levels of hope, and levels of trust in doctors among cancer patients in China. A total number of 192 cancer inpatients in a cancer hospital in China were surveyed. Perceived disclosure strategies, levels of hope, levels of trust in their doctors, as well as the demographic information were obtained from the participants. In addition to age, patients who had higher levels of perceived emotional support from doctors, or higher levels of perceived personalized disclosure from doctors, or higher levels of perceived discussion of multiple treatment plans with doctors were more likely to have higher levels of trust in doctors. In addition to perceived health status, perceived emotional support from doctors significantly predicted participants' levels of hope. That is, patients who had higher higher levels of perceived doctors' emotional support were more likely to have higher levels of hope. Key disclosure person was a marginally significant variable, that is, patients who were mainly disclosed by family members might have higher levels of hope compared with patients who were mainly disclosed by doctors. When communicating with a cancer patient, doctors might not ignore the importance of emotional support during cancer diagnosis communication. Doctors might want to involve family and collaborate with family to find out ways of personalized disclosure. During the communication process, doctors could provide their patients with multiple treatment options and discuss the benefits and side effects of each treatment. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  10. LACTIC ACIDOSIS: A RARE MANIFESTATION OF SYNTHETIC MARIJUANA INTOXICATION.

    PubMed

    Antill, T; Jakkoju, A; Dieguez, J; Laskhmiprasad, L

    2015-01-01

    Synthetic cannabinoids are designer drugs that mimic the effect of cannabis, which has become popular with young drug users. These drugs have a similar chemical structure and pharmacologic effects as marijuana, but seem to be more potent. These substances have been banned by the US Drug Enforcement Agency in 2010. Prior to 2010, these drugs were perceived as "safer" by the general population. Synthetic cannabinoids cause effects similar to marijuana making the subjects euphoric. However, they act as full, rather than partial, agonist at the receptor sites causing more severe side effects such as severe agitation, seizures, acute renal failure, and lactic acidosis.

  11. The influence of narrative v. statistical information on perceiving vaccination risks.

    PubMed

    Betsch, Cornelia; Ulshöfer, Corina; Renkewitz, Frank; Betsch, Tilmann

    2011-01-01

    Health-related information found on the Internet is increasing and impacts patient decision making, e.g. regarding vaccination decisions. In addition to statistical information (e.g. incidence rates of vaccine adverse events), narrative information is also widely available such as postings on online bulletin boards. Previous research has shown that narrative information can impact treatment decisions, even when statistical information is presented concurrently. As the determinants of this effect are largely unknown, we will vary features of the narratives to identify mechanisms through which narratives impact risk judgments. An online bulletin board setting provided participants with statistical information and authentic narratives about the occurrence and nonoccurrence of adverse events. Experiment 1 followed a single factorial design with 1, 2, or 4 narratives out of 10 reporting adverse events. Experiment 2 implemented a 2 (statistical risk 20% vs. 40%) × 2 (2/10 vs. 4/10 narratives reporting adverse events) × 2 (high vs. low richness) × 2 (high vs. low emotionality) between-subjects design. Dependent variables were perceived risk of side-effects and vaccination intentions. Experiment 1 shows an inverse relation between the number of narratives reporting adverse-events and vaccination intentions, which was mediated by the perceived risk of vaccinating. Experiment 2 showed a stronger influence of the number of narratives than of the statistical risk information. High (vs. low) emotional narratives had a greater impact on the perceived risk, while richness had no effect. The number of narratives influences risk judgments can potentially override statistical information about risk.

  12. 'My wig has been my journey's companion': perceived effects of an aesthetic care programme for Italian women suffering from chemotherapy-induced alopecia.

    PubMed

    Zannini, L; Verderame, F; Cucchiara, G; Zinna, B; Alba, A; Ferrara, M

    2012-09-01

    This study explored the perceived effects of an aesthetic care/wig programme for Italian women suffering from chemotherapy-induced alopecia. Despite advances in the treatment of many side effects of chemotherapy, alopecia remains difficult to resolve. Literature suggests that patients' reactions to alopecia and camouflaging strategies depend on their gender, individual characteristics, social context, and culture. A qualitative study was designed involving 20 patients from Sicily (Italy), who participated in an aesthetic care programme. Data were collected through semi-structured interviews, and an Interpretative Phenomenological Analysis was conducted on transcriptions. Our findings showed that, even if expected, alopecia is experienced as a traumatic event that challenges a woman's femininity, as reported by many other enquiries. Diverging from other studies, the wig is perceived as very helpful, since it camouflages baldness and reduces the 'sick aspect' related to alopecia. Patients consider their wig to be a 'friend', and it appears that through the aesthetic care programme they received support they otherwise would not have sought. We conclude that aesthetic care/wig programmes can help women affected by alopecia to cope with cancer 'stigma', especially in those rural contexts where psychosocial programmes are not frequently embraced by patients due to environmental and cultural barriers. © 2012 Blackwell Publishing Ltd.

  13. Long term unemployment, income, poverty, and social public expenditure, and their relationship with self-perceived health in Spain (2007-2011).

    PubMed

    López Del Amo González, M Puerto; Benítez, Vivian; Martín-Martín, José J

    2018-01-15

    There is scant research that simultaneously analyzes the joint effects of long-term unemployment, poverty and public expenditure policies on poorer self-perceived health during the financial crisis. The aim of the study is to analyze the joint relationship between long-term unemployment, social deprivation, and regional social public expenditure on one side, and self-perceived health in Spain (2007-2011) on the other. Longitudinal data were extracted from the Survey on Living Conditions, 2007-2010 and 2008-2011 (9105 individuals and 36,420 observations), which were then used to estimate several random group effects in the constant multilevel logistic longitudinal models (level 1: year; level 2: individual; level 3: region). The dependent variable was self-perceived health. Individual independent interest variables were long and very long term unemployment, available income, severe material deprivation and regional variables were per capita expenditure on essential public services and per capita health care expenditure. All of the estimated models show a robust association between bad perceived health and the variables of interest. When compared to employed individuals, long term unemployment increases the odds of reporting bad health by 22% to 67%; very long-term unemployment (24 to 48 months) increases the odds by 54% to 132%. Family income reduces the odds of reporting bad health by 16% to 28% for each additional percentage point in income. Being a member of a household with severe material deprivation increases the odds of perceiving one's health as bad by between 70% and 140%. Regionally, per capita expenditure on essential public services increases the odds of reporting good health, although the effect of this association was limited. Long and very long term unemployment, available income and poverty were associated to self-perceived bad health in Spain during the financial crisis. Regional expenditure on fundamental public services is also associated to poor self-perceived health, although in a more limited fashion. Results suggest the positive role in health of active employment and redistributing income policies.

  14. [The perceived burden of care and its correlates in schizophrenia].

    PubMed

    Gülseren, Leyla; Cam, Birmay; Karakoç, Berna; Yiğit, Tamer; Danacı, Ayşen Esen; Cubukçuoğlu, Zeynep; Taş, Cumhur; Gülseren, Seref; Mete, Levent

    2010-01-01

    The present study aimed to investigate the perceived level of burden of care and its correlates in family members of schizophrenia patients. The study included 239 schizophrenic patients that were followed-up at the psychiatric outpatient clinics of Izmir Ataturk Education and Research Hospital, and Celal Bayar University Medical School, and 239 of their primary caregivers. Patients were assessed using the Positive and Negative Syndrome Scale (PANNS), Global Assessment of Functioning Scale (GAF), Social Functioning Scale (SFS), Brief Cognitive State Examination (BCE), and UKU Side Effect Rating Scale. Their primary caregivers were assessed using the Perceived Family Burden Scale (PFBS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Caregiver PFBS scores ere correlated with male patients, female caregivers, inadequate social support, economic difficulty, the presence of chronic physical disorder in the caregivers, patient violence toward the caregivers, total duration of illness, the number of patient hospitalizations, PANNS total and subscale scores, and SFS, BDI, and BAI scores. Perceived burden of care was predicted by the severity of the patients' positive symptoms, SFS independence/competence and interpersonal functioning subscale scores, and caregivers' anxiety and depression levels. In order to decrease the burden of care in schizophrenia we recommend effective management of patient symptoms, enhancement of patient social functioning, interventions that target caregivers with high levels anxiety and depression, and social support provided by healthcare professionals.

  15. Patient-perceived barriers to a screening program for depression: a patient opinion survey of hemodialysis patients

    PubMed Central

    Beanlands, Heather; Logan, Alexander; Kurdyak, Paul; Jassal, Sarbjit Vanita

    2017-01-01

    Abstract Background Depression is a prevalent, yet underdiagnosed, psychiatric disorder among patients with end-stage renal disease. Active case identification through routine screening is suggested; however, patient-related barriers may reduce the effectiveness of screening for, and treating, depression. This study aimed to explore the perceived barriers that limit patients from participating in screening and treatment programs for depression. Methods In a cross-sectional study of chronic maintenance hemodialysis patients, the Perceived Barriers to Psychological Treatment questionnaire, adapted to include screening, was used to measure perceived barriers. The two-item Patient Health Questionnaire was used to identify patients with depressive symptoms. Results Of 160 participants, 73.1% reported at least one barrier preventing them from participation [95% confidence interval (95% CI) 66.2–80.0%]. Patients with depressive symptoms were more likely to perceive at least one barrier to a screening program for depression compared with those without depressive symptoms (96% versus 68.9%, respectively; odds ratio = 10.8; 95% CI 1.4–82.8; P = 0.005). The association of the barrier scores with depressive symptoms remained significant after adjustment for patient’s characteristics. The most common barriers that patients expressed were concerns about the side effects of any antidepressant medications that may be prescribed (40%), concerns about having more medications (32%), feeling that the problem is not severe enough (23%) and perceiving no risk of depression (23%). Conclusions Negative perceptions about depression and its treatment among hemodialysis patients constitute an important barrier to identifying this condition and first need to be addressed before implementing a screening program in this population. PMID:29225813

  16. Interaction of Perceptual Grouping and Crossmodal Temporal Capture in Tactile Apparent-Motion

    PubMed Central

    Chen, Lihan; Shi, Zhuanghua; Müller, Hermann J.

    2011-01-01

    Previous studies have shown that in tasks requiring participants to report the direction of apparent motion, task-irrelevant mono-beeps can “capture” visual motion perception when the beeps occur temporally close to the visual stimuli. However, the contributions of the relative timing of multimodal events and the event structure, modulating uni- and/or crossmodal perceptual grouping, remain unclear. To examine this question and extend the investigation to the tactile modality, the current experiments presented tactile two-tap apparent-motion streams, with an SOA of 400 ms between successive, left-/right-hand middle-finger taps, accompanied by task-irrelevant, non-spatial auditory stimuli. The streams were shown for 90 seconds, and participants' task was to continuously report the perceived (left- or rightward) direction of tactile motion. In Experiment 1, each tactile stimulus was paired with an auditory beep, though odd-numbered taps were paired with an asynchronous beep, with audiotactile SOAs ranging from −75 ms to 75 ms. Perceived direction of tactile motion varied systematically with audiotactile SOA, indicative of a temporal-capture effect. In Experiment 2, two audiotactile SOAs—one short (75 ms), one long (325 ms)—were compared. The long-SOA condition preserved the crossmodal event structure (so the temporal-capture dynamics should have been similar to that in Experiment 1), but both beeps now occurred temporally close to the taps on one side (even-numbered taps). The two SOAs were found to produce opposite modulations of apparent motion, indicative of an influence of crossmodal grouping. In Experiment 3, only odd-numbered, but not even-numbered, taps were paired with auditory beeps. This abolished the temporal-capture effect and, instead, a dominant percept of apparent motion from the audiotactile side to the tactile-only side was observed independently of the SOA variation. These findings suggest that asymmetric crossmodal grouping leads to an attentional modulation of apparent motion, which inhibits crossmodal temporal-capture effects. PMID:21383834

  17. How can hospitals better protect the privacy of electronic medical records? Perspectives from staff members of health information management departments.

    PubMed

    Sher, Ming-Ling; Talley, Paul C; Cheng, Tain-Junn; Kuo, Kuang-Ming

    2017-05-01

    The adoption of electronic medical records (EMR) is expected to better improve overall healthcare quality and to offset the financial pressure of excessive administrative burden. However, safeguarding EMR against potentially hostile security breaches from both inside and outside healthcare facilities has created increased patients' privacy concerns from all sides. The aim of our study was to examine the influencing factors of privacy protection for EMR by healthcare professionals. We used survey methodology to collect questionnaire responses from staff members in health information management departments among nine Taiwanese hospitals active in EMR utilisation. A total of 209 valid responses were collected in 2014. We used partial least squares for analysing the collected data. Perceived benefits, perceived barriers, self-efficacy and cues to action were found to have a significant association with intention to protect EMR privacy, while perceived susceptibility and perceived severity were not. Based on the findings obtained, we suggest that hospitals should provide continuous ethics awareness training to relevant staff and design more effective strategies for improving the protection of EMR privacy in their charge. Further practical and research implications are also discussed.

  18. Clinical and Laboratory Evaluation of Peripheral Prism Glasses for Hemianopia

    PubMed Central

    Giorgi, Robert G.; Woods, Russell L.; Peli, Eli

    2008-01-01

    Purpose Homonymous hemianopia (the loss of vision on the same side in each eye) impairs the ability to navigate and walk safely. We evaluated peripheral prism glasses as a low vision optical device for hemianopia in an extended wearing trial. Methods Twenty-three patients with complete hemianopia (13 right) with neither visual neglect nor cognitive deficit enrolled in the 5-visit study. To expand the horizontal visual field, patients’ spectacles were fitted with both upper and lower Press-On™ Fresnel prism segments (each 40 prism diopters) across the upper and lower portions of the lens on the hemianopic (“blind”) side. Patients were asked to wear these spectacles as much as possible for the duration of the study, which averaged 9 (range: 5 to 13) weeks. Clinical success (continued wear, indicating perceived overall benefit), visual field expansion, perceived direction and perceived quality of life were measured. Results Clinical Success: 14 of 21 (67%) patients chose to continue to wear the peripheral prism glasses at the end of the study (2 patients did not complete the study for non-vision reasons). At long-term follow-up (8 to 51 months), 5 of 12 (42%) patients reported still wearing the device. Visual Field Expansion: Expansion of about 22 degrees in both the upper and lower quadrants was demonstrated for all patients (binocular perimetry, Goldmann V4e). Perceived Direction: Two patients demonstrated a transient adaptation to the change in visual direction produced by the peripheral prism glasses. Quality of Life: At study end, reduced difficulty noticing obstacles on the hemianopic side was reported. Conclusions The peripheral prism glasses provided reported benefits (usually in obstacle avoidance) to 2/3 of the patients completing the study, a very good success rate for a vision rehabilitation device. Possible reasons for long-term discontinuation and limited adaptation of perceived direction are discussed. PMID:19357552

  19. Playing with fire - What is influencing horse owners' decisions to not vaccinate their horses against deadly Hendra virus infection?

    PubMed

    Goyen, Kailiea Arianna; Wright, John David; Cunneen, Alexandra; Henning, Joerg

    2017-01-01

    Hendra virus is a zoonotic paramyxovirus, which causes severe respiratory and neurological disease in horses and humans. Since 2012, the Hendra virus sub-unit G vaccine has been available for horse vaccination in Australia. Uptake of the vaccine has been limited and spill-over events of Hendra virus infection in horses continue to occur. We conducted an online, questionnaire-based cross-sectional study of 376 horse owners belonging to a variety of different equestrian clubs in Queensland, Australia, to identify risk factors for non-vaccination against Hendra virus. A total of 43.1% (N = 162) of horse owners indicated that they currently did not vaccinate against Hendra virus infection, while 56.9% (N = 214) currently vaccinated against Hendra virus infection. A total of 52 risk factors were evaluated relating to equestrian activities, horse management, perceived risk and severity of horse and human infection with Hendra virus, side effects of Hendra vaccination, other vaccinations conducted by horse owners and horse owners' attitudes towards veterinarians. The final multivariable logistics regression model identified the following risk factors associated with increased odds of non-vaccination against Hendra virus: 1) perceived low risk (compared to high) of Hendra virus infection to horses (considering the horse owners' location and management practices) or horse owners were unsure about the risk of infection, 2) perceived moderate severity (compared to very severe or severe) of Hendra virus infection in humans, 3) horse owners non-vaccination of their pets, 4) horse owners non-vaccination against strangles disease in horses, 5) handling of more than three horses per week (compared to one horse only) and 6) perceived attitude that veterinarians had a high motivation of making money from Hendra virus vaccination (compared to veterinarians having a low motivation of making money from Hendra virus vaccination). Horse owners were more likely to vaccinate against Hendra virus if horses were used for dressage, show jumping or eventing. The study also identified horse owners' concerns about side-effects and about the lack of evidence on vaccine efficacy.

  20. Playing with fire – What is influencing horse owners’ decisions to not vaccinate their horses against deadly Hendra virus infection?

    PubMed Central

    Goyen, Kailiea Arianna; Wright, John David; Cunneen, Alexandra

    2017-01-01

    Hendra virus is a zoonotic paramyxovirus, which causes severe respiratory and neurological disease in horses and humans. Since 2012, the Hendra virus sub-unit G vaccine has been available for horse vaccination in Australia. Uptake of the vaccine has been limited and spill-over events of Hendra virus infection in horses continue to occur. We conducted an online, questionnaire-based cross-sectional study of 376 horse owners belonging to a variety of different equestrian clubs in Queensland, Australia, to identify risk factors for non-vaccination against Hendra virus. A total of 43.1% (N = 162) of horse owners indicated that they currently did not vaccinate against Hendra virus infection, while 56.9% (N = 214) currently vaccinated against Hendra virus infection. A total of 52 risk factors were evaluated relating to equestrian activities, horse management, perceived risk and severity of horse and human infection with Hendra virus, side effects of Hendra vaccination, other vaccinations conducted by horse owners and horse owners’ attitudes towards veterinarians. The final multivariable logistics regression model identified the following risk factors associated with increased odds of non-vaccination against Hendra virus: 1) perceived low risk (compared to high) of Hendra virus infection to horses (considering the horse owners’ location and management practices) or horse owners were unsure about the risk of infection, 2) perceived moderate severity (compared to very severe or severe) of Hendra virus infection in humans, 3) horse owners non-vaccination of their pets, 4) horse owners non-vaccination against strangles disease in horses, 5) handling of more than three horses per week (compared to one horse only) and 6) perceived attitude that veterinarians had a high motivation of making money from Hendra virus vaccination (compared to veterinarians having a low motivation of making money from Hendra virus vaccination). Horse owners were more likely to vaccinate against Hendra virus if horses were used for dressage, show jumping or eventing. The study also identified horse owners’ concerns about side-effects and about the lack of evidence on vaccine efficacy. PMID:28636633

  1. Perceiving numbers does not cause automatic shifts of spatial attention.

    PubMed

    Fattorini, Enrico; Pinto, Mario; Rotondaro, Francesca; Doricchi, Fabrizio

    2015-12-01

    It is frequently assumed that the brain codes number magnitudes according to an inherent left-to-right spatial organization. In support of this hypothesis it has been reported that in humans, perceiving small numbers induces automatic shifts of attention toward the left side of space whereas perceiving large numbers automatically shifts attention to the right side of space (i.e., Attentional SNARC: Att-SNARC; Fischer, Castel, Dodd, & Pratt, 2003). Nonetheless, the Att-SNARC has been often not replicated and its reliability never tested. To ascertain whether the mere perception of numbers causes shifts of spatial attention or whether number-space interaction takes place at a different stage of cognitive processing, we re-assessed the consistency and reliability of the Att-SNARC and investigated its role in the production of SNARC effects in Parity Judgement (PJ) and Magnitude Comparison (MC) tasks. In a first study in 60 participants, we found no Att-SNARC, despite finding strong PJ- and MC-SNARC effects. No correlation was present between the Att-SNARC and the SNARC. Split-half tests showed no reliability of the Att-SNARC and high reliability of the PJ- and MC-SNARC. In a second study, we re-assessed the Att-SNARC and tested its direct influence on a MC-SNARC task with laterally presented targets. No Att-SNARC and no influence of the Att-SNARC on the MC-SNARC were found. Also in this case, the SNARC was reliable whereas the Att-SNARC task was not. Finally, in a third study we observed a significant Att-SNARC when participants were asked to recall the position occupied on a ruler by the numbers presented in each trial: however the Att-SNARC task was not reliable. These results show that perceiving numbers does not cause automatic shifts of spatial attention and that whenever present, these shifts do not modulate the SNARC. The same results suggest that numbers have no inherent mental left-to-right organization and that, whenever present, this organization can have both response-related and strategically driven memory-related origins. Nonetheless, response-related factors generate more reliable and stable spatial representations of numbers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Edge-region grouping in figure-ground organization and depth perception.

    PubMed

    Palmer, Stephen E; Brooks, Joseph L

    2008-12-01

    Edge-region grouping (ERG) is proposed as a unifying and previously unrecognized class of relational information that influences figure-ground organization and perceived depth across an edge. ERG occurs when the edge between two regions is differentially grouped with one region based on classic principles of similarity grouping. The ERG hypothesis predicts that the grouped side will tend to be perceived as the closer, figural region. Six experiments are reported that test the predictions of the ERG hypothesis for 6 similarity-based factors: common fate, blur similarity, color similarity, orientation similarity, proximity, and flicker synchrony. All 6 factors produce the predicted effects, although to different degrees. In a 7th experiment, the strengths of these figural/depth effects were found to correlate highly with the strength of explicit grouping ratings of the same visual displays. The relations of ERG to prior results in the literature are discussed, and possible reasons for ERG-based figural/depth effects are considered. We argue that grouping processes mediate at least some of the effects we report here, although ecological explanations are also likely to be relevant in the majority of cases.

  3. Edge-Region Grouping in Figure-Ground Organization and Depth Perception

    PubMed Central

    Palmer, Stephen E.; Brooks, Joseph L.

    2008-01-01

    Edge-region grouping (ERG) is proposed as a unifying and previously unrecognized class of relational information that influences figure-ground organization and perceived depth across an edge. ERG occurs when the edge between two regions is differentially grouped with one region based on classic principles of similarity grouping. The ERG hypothesis predicts that the grouped side will tend to be perceived as the closer, figural region. Six experiments are reported that test the predictions of the ERG hypothesis for six similarity-based factors: common fate, blur similarity, color similarity, orientation similarity, proximity, and flicker synchrony. All six factors produce the predicted effects, although to different degrees. In the seventh experiment, the strengths of these figural/depth effects were found to correlate highly with the strength of explicit grouping ratings of the same visual displays. The relations of ERG to prior results in the literature are discussed, and possible reasons for ERG-based figural/depth effects are considered. We argue that grouping processes mediate at least some of the effects we report here, although ecological explanations are also likely to be relevant in the majority of cases. PMID:19045980

  4. Heuristics of reasoning and analogy in children's visual perspective taking.

    PubMed

    Yaniv, I; Shatz, M

    1990-10-01

    We propose that children's reasoning about others' visual perspectives is guided by simple heuristics based on a perceiver's line of sight and salient features of the object met by that line. In 3 experiments employing a 2-perceiver analogy task, children aged 3-6 were generally better able to reproduce a perceiver's perspective if a visual cue in the perceiver's line of sight sufficed to distinguish it from alternatives. Children had greater difficulty when the task hinged on attending to configural cues. Availability of distinctive cues affixed on the objects' sides facilitated solution of the symmetrical orientations. These and several other related findings reported in the literature are traced to children's reliance on heuristics of reasoning.

  5. A new tool for the assessment of satisfaction with iron chelation therapy (ICT-Sat) for patients with β-thalassemia major.

    PubMed

    Elalfy, Mohsen S; Massoud, Walid; Elsherif, Nayera H; Labib, Jonair H; Elalfy, Omar M; Elaasar, Safaa; von Mackensen, Sylvia

    2012-06-01

    High satisfaction with iron chelation is a major determinant for adherence to ICT in beta-thalassaemia major (β-TM) patients. In this study, a new tool to assess different domains of satisfaction for available forms of ICT was developed and validated. The impact of patients' satisfaction with ICT has been tested. Items were generated via focus groups and a preliminary version with 24 items (ICT-Sat) with an additional item for treatment preference and a knowledge questionnaire (KQ) was developed. 170 β-TM patients from three Thalassaemia centers in Egypt, aged 2-32 years received three questionnaires to fill in; the new ICT-Sat, a KQ, and a previously validated tool for satisfaction with ICT (SICT) and retested 4-6 weeks later to ensure re-test reliability. Type of chelation, drug related adverse events, compliance with ICT, and serum ferritin level (SF) during the year prior to the study as well as available cardiac T2*data were recorded. One hundred and fifty two β-TM patients completed all questionnaires; median age was 12 years. The final 15 remaining ICT-Sat items, yielding to four domain scores, explained 70.6% of the total variance. The "perceived effectiveness" and "fear and worries" domains of the ICT-Sat correlated significantly with the domains "perceived effectiveness" and "acceptance" of the SICT. Patients treated with oral ICT were more satisfied with perceived effectiveness, and their side effects. A new clinically based ICT-Sat tool was developed and revealed good psychometric characteristics. Adherence to ICT was better correlated with "perceived effectiveness" and SF level. Copyright © 2012 Wiley Periodicals, Inc.

  6. Comparıson of the Heart Rate and Blood Lactate Responses of Different Small Sided Games in Young Soccer Players.

    PubMed

    Köklü, Yusuf; Alemdaroğlu, Utku

    2016-09-29

    The purpose of this study was to compare the percentage of maximum heart rate (%HRmax), blood lactate (La - ), and rating of perceived exertion (RPE, CR-10) responses across different formats of small-sided games (SSG) in elite young soccer players. Fourteen players (average age 16.7 ± 0.6 years; height 177.6 ± 4.1 cm; body mass 66.3 ± 4.7 kg; average training age 6.7 ± 1.6 years; percentage of body fat 8.4 ± 2.6%) volunteered to perform the YoYo intermittent recovery test (level 1) and eight bouts of soccer drills including 2-a-side, 3-a-side, and 4-a-side games without goalkeepers in random order at two-day intervals. Heart rates were monitored throughout the SSGs, whereas the RPE and venous blood lactate were determined at the end of the last bout of each SSG. The differences in La - , %HRmax, and RPE either across the different SSGs or between the bouts were identified using 3 × 8 (games × exercise bouts) two-way analysis of variance with repeated measures. Significant differences were found in terms of La - , RPE, and %HRmax among the different types of SSG ( p ≤ 0.05). 3-a-side and 4-a-side games elicited significantly higher responses than 2-a-side games in terms of %HRmax ( p ≤ 0.05), whereas 4-a-side games resulted in significantly lower La - and RPE responses compared to 2-a-side and 3-a-side games. The results of this study show that physiological responses differ according to the numbers of players involved in small-sided games. Therefore, it can be concluded that 3-a-side and 4-a-side games could be more effective in improving high intensity aerobic performance than 2-a-side games, which in turn are more appropriate for developing anaerobic performance.

  7. Changes in Morphological and Elastic Properties of Patellar Tendon in Athletes with Unilateral Patellar Tendinopathy and Their Relationships with Pain and Functional Disability

    PubMed Central

    Zhang, Zhi Jie; Ng, Gabriel Yin-fat; Lee, Wai Chun; Fu, Siu Ngor

    2014-01-01

    Background Patellar tendinopathy (PT) is one of the most common knee disorders among athletes. Changes in morphology and elasticity of the painful tendon and how these relate to the self-perceived pain and dysfunction remain unclear. Objectives To compare the morphology and elastic properties of patellar tendons between athlete with and without unilateral PT and to examine its association with self-perceived pain and dysfunction. Methods In this cross-sectional study, 33 male athletes (20 healthy and 13 with unilateral PT) were enrolled. The morphology and elastic properties of the patellar tendon were assessed by the grey and elastography mode of supersonic shear imaging (SSI) technique while the intensity of pressure pain, self-perceived pain and dysfunction were quantified with a 10-lb force to the most painful site and the Victorian Institute of Sport Assessment-patella (VISA-P) questionnaire, respectively. Results In athletes with unilateral PT, the painful tendons had higher shear elastic modulus (SEM) and larger tendon than the non-painful side (p<0.05) or the dominant side of the healthy athletes (p<0.05). Significant correlations were found between tendon SEM ratio (SEM of painful over non-painful tendon) and the intensity of pressure pain (rho  = 0.62; p = 0.024), VISA-P scores (rho  = −0.61; p = 0.026), and the sub-scores of the VISA-P scores on going down stairs, lunge, single leg hopping and squatting (rho ranged from −0.63 to −0.67; p<0.05). Conclusions Athletes with unilateral PT had stiffer and larger tendon on the painful side than the non-painful side and the dominant side of healthy athletes. No significant differences on the patellar tendon morphology and elastic properties were detected between the dominant and non-dominant knees of the healthy control. The ratio of the SEM of painful to non-painful sides was associated with pain and dysfunction among athletes with unilateral PT. PMID:25303466

  8. Perception of Multisensory Gender Coherence in 6- and 9-month-old Infants

    PubMed Central

    de Boisferon, Anne Hillairet; Dupierrix, Eve; Quinn, Paul C.; Lœvenbruck, Hélène; Lewkowicz, David J.; Lee, Kang; Pascalis, Olivier

    2015-01-01

    One of the most salient social categories conveyed by human faces and voices is gender. We investigated the developmental emergence of the ability to perceive the coherence of auditory and visual attributes of gender in 6- and 9-month-old infants. Infants viewed two side-by-side video clips of a man and a woman singing a nursery rhyme and heard a synchronous male or female soundtrack. Results showed that 6-month-old infants did not match the audible and visible attributes of gender, and 9-month-old infants matched only female faces and voices. These findings indicate that the ability to perceive the multisensory coherence of gender emerges relatively late in infancy and that it reflects the greater experience that most infants have with female faces and voices. PMID:26561475

  9. Six Months of Diazoxide Treatment at Bedtime in Newly Diagnosed Subjects With Type 1 Diabetes Does Not Influence Parameters of β-Cell Function and Autoimmunity but Improves Glycemic Control

    PubMed Central

    Radtke, Maria Anita; Nermoen, Ingrid; Kollind, Magnus; Skeie, Svein; Sørheim, Jan Inge; Svartberg, Johan; Hals, Ingrid; Moen, Torolf; Dørflinger, Gry Høst; Grill, Valdemar

    2010-01-01

    OBJECTIVE Continuous β-cell rest with diazoxide preserves residual endogenous insulin production in type 1 diabetes. However, side effects have hampered therapeutic usefulness. In a double-blind study, we tested whether lower, intermittent dosing of diazoxide had beneficial effects on insulin production, metabolic control, and autoimmunity markers in the absence of side effects. RESEARCH DESIGN AND METHODS Forty-one newly diagnosed type 1 diabetic patients were randomized to 6 months of treatment with placebo or 100 mg diazoxide at bedtime. A1C, C-peptide (fasting and glucagon stimulated), and FoxP3+ regulatory T-cells (Tregs) were measured. Patients were followed for 6 months after intervention. RESULTS Of six dropouts, three were due to perceived side effects; one subject in the diazoxide group experienced rash, another dizziness, and one in the placebo group sleep disturbance. Adverse effects in others were absent. Diazoxide treatment reduced A1C from 8.6% at baseline to 6.0% at 6 months and 6.5% at 12 months. Corresponding A1C value in the placebo arm were 8.3, 7.3, and 7.5% (P < 0.05 for stronger reduction in the diazoxide group). Fasting and stimulated C-peptide decreased during 12 months similarly in both arms (mean −0.30 and −0.18 nmol/l in the diazoxide arm and −0.08 and −0.09 nmol/l in the placebo arm). The proportion of Tregs was similar in both arms and remained stable during intervention but was significantly lower compared with nondiabetic subjects. CONCLUSIONS Six months of low-dose diazoxide was without side effects and did not measurably affect insulin production but was associated with improved metabolic control. PMID:20028939

  10. The characteristics of effective secondary math and science instructional facilitators and the necessary support structures as perceived by practitioners and principals

    NASA Astrophysics Data System (ADS)

    Mahagan, Vikki Lynn

    Instructional facilitators are known by a variety of titles depending on the school district in which they are employed. They are sometimes called instructional coaches, teacher leaders, lead teachers, and instructional specialist (Denton & Hasbrouck, 2009). Throughout this study, the title instructional facilitator was used and will refer to secondary math or science instructional facilitators who are housed at least one day per week on a campus. This study is a mixed-methods descriptive study which has identified character traits, specials skill, and talents possessed by effective secondary math and science instructional facilitators as perceived by practicing facilitators and principals and assistant principals who work along side instructional facilitators. Specific job training to help ensure the success of a facilitator was identified as viewed by both facilitators and principals. Additionally, this study compared the perceptions of practicing facilitators and principals to determine if significant differences exist with respect to perceptions of staff development opportunities, support structures, and resources available for instructional facilitators.

  11. Implementing Recommendations From Web Accessibility Guidelines: A Comparative Study of Nondisabled Users and Users With Visual Impairments.

    PubMed

    Schmutz, Sven; Sonderegger, Andreas; Sauer, Juergen

    2017-09-01

    The present study examined whether implementing recommendations of Web accessibility guidelines would have different effects on nondisabled users than on users with visual impairments. The predominant approach for making Web sites accessible for users with disabilities is to apply accessibility guidelines. However, it has been hardly examined whether this approach has side effects for nondisabled users. A comparison of the effects on both user groups would contribute to a better understanding of possible advantages and drawbacks of applying accessibility guidelines. Participants from two matched samples, comprising 55 participants with visual impairments and 55 without impairments, took part in a synchronous remote testing of a Web site. Each participant was randomly assigned to one of three Web sites, which differed in the level of accessibility (very low, low, and high) according to recommendations of the well-established Web Content Accessibility Guidelines 2.0 (WCAG 2.0). Performance (i.e., task completion rate and task completion time) and a range of subjective variables (i.e., perceived usability, positive affect, negative affect, perceived aesthetics, perceived workload, and user experience) were measured. Higher conformance to Web accessibility guidelines resulted in increased performance and more positive user ratings (e.g., perceived usability or aesthetics) for both user groups. There was no interaction between user group and accessibility level. Higher conformance to WCAG 2.0 may result in benefits for nondisabled users and users with visual impairments alike. Practitioners may use the present findings as a basis for deciding on whether and how to implement accessibility best.

  12. Colloidal drug delivery system: amplify the ocular delivery.

    PubMed

    Ali, Javed; Fazil, Mohd; Qumbar, Mohd; Khan, Nazia; Ali, Asgar

    2016-01-01

    The ocular perceivers are the most voluntarily accessible organs in terms of location in the body, yet drug distribution to these tissues is one of the most intriguing and challenging endeavors and problematic to the pharmaceutical scientist. The most of ocular diseases are treated with topical application of conventional formulation, i.e. solutions, suspensions and ointment. Typically on installation of these conventional formulations, only <5% of the applied dose penetrates the cornea and reaches intraocular tissues, while a major fraction of the instilled dose is wastage due to the presence of many ocular barriers like external barriers, rapid loss of the instilled solution from the precorneal area and nasolacrimal drainage system. Systemic absorption caused systemic side effects varying from mild to life-threatening events. The main objective of this review is to explore the role of colloidal delivery of drug to minimize the drawbacks associated with them. This review provides an insight into the various constraints associated with ocular drug delivery, summarizes recent findings and applications of colloidal delivery systems, i.e. nanoparticles, nanosuspensions, liposomes, niosomes, dendrimers and contact lenses containing nanoparticles have the capacity to distribute ocular drugs to categorical target sites and hold promise to revolutionize the therapy of many ocular perceiver diseases and minimized the circumscription of conventional delivery. Form the basis of literature review, it has been found that the novel delivery system have greater impact to maximize ocular drug absorption, and minimize systemic absorption and side effects.

  13. Determinants of compliance to antenatal micronutrient supplementation and women's perceptions of supplement use in rural Nepal.

    PubMed

    Kulkarni, Bharati; Christian, Parul; LeClerq, Steven C; Khatry, Subarna K

    2010-01-01

    We examined factors affecting compliance to antenatal micronutrient supplementation and women's perceptions of supplement use. Randomized controlled supplementation trial of four alternative combinations of micronutrients given during pregnancy through to 3 months postpartum. Women were visited twice weekly to monitor compliance and to replenish tablets by female study workers. At 6 weeks postpartum women with live births (n 4096) were interviewed regarding their perceptions of the supplement. Median compliance calculated as percentage of total eligible doses received by women was high (84 %). Rural southern Nepal. Pregnant women. Women with high compliance (above the median of 84 %) were likely to be older, less educated, poorer, undernourished, belong to lower caste and of Pahadi (hill) ethnicity compared with women with low compliance (at or below the median of 84 %). Smoking and drinking alcohol in the past week during pregnancy were strongly associated with low compliance. The major reason for irregular intake was forgetting to take supplements. A higher proportion of the high compliers liked taking the supplements but only half of them were willing to purchase them in the future. A large proportion of women (91 %) perceived a benefit from taking the supplement such as improved strength and health, whereas only about 10 % perceived any side-effects which were not a major barrier to compliance. The present analysis highlights that poor, undernourished, uneducated women can have high compliance to antenatal supplementation if they are supplied with the tablets and reminded to take them regularly, and counselled about side-effects.

  14. Effects of the number of players and game type constraints on heart rate, rating of perceived exertion, and technical actions of small-sided soccer games.

    PubMed

    Abrantes, Catarina I; Nunes, Marta I; Maçãs, Victor M; Leite, Nuno M; Sampaio, Jaime E

    2012-04-01

    The purpose of this study was to identify the variation of heart rate (HR), rating of perceived exertion (RPE), and technical actions between 2 soccer small-sided games (SSGs; 3 × 3 and 4 × 4) in 3 game type constraints (when playing only offense [OFF], playing only defense [DEF], and both situations [GAME]). Sixteen high-level young male players were analyzed (age 15.75 ± 0.45 years; height 172.4 ± 4.83 cm; body mass 64.5 ± 6.44 kg; HRmax199.1 ± 9.08 b·min(-1); and 8.06 ± 1.98 years of soccer practice). All tasks were performed in 4 periods of 4 minutes interspersed with 2 minutes of active recovery. The HR was measured continuously and then analyzed by the time spent into 4 training zones according to individual %HRmax (zone 1 <75%; zone 2 75-84.9%; zone 3 85-89.9%; and zone 4 ≥90%). Results identified that players were most frequently in zones 2 and 3. The 3 × 3 SSGs elicited higher HR and RPE and the most intense situation was GAME. Despite the known higher frequencies from technical actions in SSGs with fewer players, player effectiveness in 3 × 3 and 4 × 4 was identical. The use of GAME, OFF, and DEF game type constraints should be carefully planned. Using the 3 × 3 format seems more adequate when aiming for aerobic performance optimal effects; however, DEF situations should only be used to promote aerobic recovery effects. The inclusion of an additional player in SSGs had different interactions in game type constraints, and only GAME presented adequate intensity.

  15. The influence of the playing surface on the exercise intensity of small-sided recreational soccer games.

    PubMed

    Brito, João; Krustrup, Peter; Rebelo, António

    2012-08-01

    This study aimed to analyze the influence of the playing surface on movement pattern, physical loading, perceived exertion, and fatigue development during small-sided recreational soccer games. Time-motion, heart rate, blood lactate, and perceived exertion were measured for 16 recreational players aged 22 (range: 19-35) yrs. During 5-a-side soccer games on 3 different field surfaces: sand, artificial turf, and asphalt. Jump and sprint tests were performed prior to and after each game. Total distance covered was higher on asphalt and turf than on sand (3.89±0.04 and 3.73±0.12 vs. 2.59±0.21 km; p<.01), and the number of high-intensity runs was higher on asphalt than on turf (55±3 vs. 43±3; p<.05), but not sand (46±6). Mean heart rate (means±SEM, 160±3 vs. 171±1 b.p.m.) and time>90% HR(max) (20.8±5.1% vs. 44.1±5.0%) were lower (p<.05) on asphalt than on turf, with intermediate values for sand. Blood lactate was lower on asphalt than on sand (2.8±0.3 vs. 4.7±0.6 mmolL(-1); p<.05). Perceived exertion was lower on asphalt than on turf and sand (VAS 0-100: 52±3 vs. 72±3 and 72±3; p<.01). After the game, squat and countermovement jump performances were lower (4.9-8.1%, and 1.9-6.4%, respectively; p<.001) for all field surfaces, but no changes were observed in 5- and 30-m sprint performance. Small-sided recreational soccer games elicit high heart rates, multiple intense actions, and decreased jump performance for all the investigated playing surfaces, suggesting that multiple fitness and health benefits can be achieved through soccer on sand, artificial turf and asphalt. Nonetheless, locomotor activities, heart rate, blood lactate levels, and perceived exertion differ between surfaces. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. To Strike a Pose: No Stereotype Backlash for Power Posing Women

    PubMed Central

    Rennung, Miriam; Blum, Johannes; Göritz, Anja S.

    2016-01-01

    Power posing, the adoption of open and powerful postures, has effects that parallel those of actual social power. This study explored the social evaluation of adopting powerful vs. powerless body postures in men and women regarding perceived warmth, competence, and the likelihood of eliciting admiration, envy, pity, and contempt. Previous findings suggest that the display of power by women may have side effects due to gender stereotyping, namely reduced warmth ratings and negative emotional reactions. An experiment (N = 2,473) asked participants to rate pictures of men and women who adopted high-power or low-power body postures. High-power posers were rated higher on competence, admiration, envy, and contempt compared to low-power posers, whereas the opposite was true for pity. There was no impact of power posing on perceived warmth. Contrary to expectations, the poser’s gender did not moderate any of the effects. These findings suggest that non-verbal displays of power do influence fundamental dimensions of social perception and their accompanying emotional reactions but result in comparably positive and negative evaluations for both genders. PMID:27729887

  17. Arthropod Pest Control for UK Oilseed Rape - Comparing Insecticide Efficacies, Side Effects and Alternatives.

    PubMed

    Zhang, Han; Breeze, Tom; Bailey, Alison; Garthwaite, David; Harrington, Richard; Potts, Simon G

    2017-01-01

    Oilseed rape (Brassica napus) is an important combinable break crop in the UK, which is largely protected from arthropod pests by insecticidal chemicals. Despite ongoing debate regarding the use of neonicotinoids, the dominant seed treatment ingredients used for this crop, there is little publicly available data comparing the efficacy of insecticides in controlling key arthropod pests or comparing the impacts on non-target species and the wider environment. To provide an insight into these matters, a UK-wide expert survey targeting agronomists and entomologists was conducted from March to June 2015. Based on the opinions of 90 respondents, an average of 20% yield loss caused by the key arthropod pests was expected to have occurred in the absence of insecticide treatments. Relatively older chemical groups were perceived to have lower efficacy for target pests than newer ones, partly due to the development of insecticide resistance. Without neonicotinoid seed treatments, a lack of good control for cabbage stem flea beetle was perceived. Wide spectrum foliar insecticide sprays were perceived to have significantly greater negative impacts than seed treatments on users' health, natural enemies, pollinators, soil and water, and many foliar active ingredients have had potential risks for non-target arthropod species in UK oilseed rape fields for the past 25 years. Overall, 72% of respondents opposed the neonicotinoid restriction, while 10% supported it. Opposition and support of the restriction were largely based on concerns for pollinators and the wider environment, highlighting the uncertainty over the side effects of neonicotinoid use. More people from the government and research institutes leaned towards neutrality over the issue, compared to those directly involved in growing the crop. Neonicotinoid restriction was expected to result in greater effort and expenditure on pest control and lower production (0-1 t/ha less). Alternatives for future oilseed rape protection were then discussed.

  18. Arthropod Pest Control for UK Oilseed Rape – Comparing Insecticide Efficacies, Side Effects and Alternatives

    PubMed Central

    Breeze, Tom; Bailey, Alison; Garthwaite, David; Harrington, Richard; Potts, Simon G.

    2017-01-01

    Oilseed rape (Brassica napus) is an important combinable break crop in the UK, which is largely protected from arthropod pests by insecticidal chemicals. Despite ongoing debate regarding the use of neonicotinoids, the dominant seed treatment ingredients used for this crop, there is little publicly available data comparing the efficacy of insecticides in controlling key arthropod pests or comparing the impacts on non-target species and the wider environment. To provide an insight into these matters, a UK-wide expert survey targeting agronomists and entomologists was conducted from March to June 2015. Based on the opinions of 90 respondents, an average of 20% yield loss caused by the key arthropod pests was expected to have occurred in the absence of insecticide treatments. Relatively older chemical groups were perceived to have lower efficacy for target pests than newer ones, partly due to the development of insecticide resistance. Without neonicotinoid seed treatments, a lack of good control for cabbage stem flea beetle was perceived. Wide spectrum foliar insecticide sprays were perceived to have significantly greater negative impacts than seed treatments on users’ health, natural enemies, pollinators, soil and water, and many foliar active ingredients have had potential risks for non-target arthropod species in UK oilseed rape fields for the past 25 years. Overall, 72% of respondents opposed the neonicotinoid restriction, while 10% supported it. Opposition and support of the restriction were largely based on concerns for pollinators and the wider environment, highlighting the uncertainty over the side effects of neonicotinoid use. More people from the government and research institutes leaned towards neutrality over the issue, compared to those directly involved in growing the crop. Neonicotinoid restriction was expected to result in greater effort and expenditure on pest control and lower production (0–1 t/ha less). Alternatives for future oilseed rape protection were then discussed. PMID:28076392

  19. Hemispheric Asymmetries in Price Estimation: Do Brain Hemispheres Attribute Different Monetary Values?

    PubMed Central

    Giuliani, Felice; D’Anselmo, Anita; Tommasi, Luca; Brancucci, Alfredo; Pietroni, Davide

    2017-01-01

    The Spatial Numerical Association of Response Codes (SNARC) effect has been associated with a wide range of magnitude processing. This effect is due to an implicit relationship between numbers and horizontal space, according to which weaker magnitudes and smaller numbers are represented on the left, whereas stronger magnitudes and larger numbers are represented on the right. However, for some particular type of magnitudes such as price, judgments may be also influenced by perceived quality and thus involving valence attribution biases driven by brain asymmetries. In the present study, a lateralized tachistoscopic presentation was used in a price estimation task, using a weight estimation task as a control, to assess differences in asymmetries between these two attributes. Results show a side bias in the former condition but not in the latter, thus indicating that other non-numerical mechanisms are involved in price estimation. Specifically, prices were estimated lower in the left visual field than in the right visual field. The proposed explanation is that price appraisal might involve a valence attribution mechanism leading to a better perceived quality (related to higher prices) when objects are processed primarily in the left hemisphere, and to a lower perceived quality (related to lower prices) when objects are processed primarily in the right hemisphere. PMID:29213252

  20. Hemispheric Asymmetries in Price Estimation: Do Brain Hemispheres Attribute Different Monetary Values?

    PubMed

    Giuliani, Felice; D'Anselmo, Anita; Tommasi, Luca; Brancucci, Alfredo; Pietroni, Davide

    2017-01-01

    The Spatial Numerical Association of Response Codes (SNARC) effect has been associated with a wide range of magnitude processing. This effect is due to an implicit relationship between numbers and horizontal space, according to which weaker magnitudes and smaller numbers are represented on the left, whereas stronger magnitudes and larger numbers are represented on the right. However, for some particular type of magnitudes such as price, judgments may be also influenced by perceived quality and thus involving valence attribution biases driven by brain asymmetries. In the present study, a lateralized tachistoscopic presentation was used in a price estimation task, using a weight estimation task as a control, to assess differences in asymmetries between these two attributes. Results show a side bias in the former condition but not in the latter, thus indicating that other non-numerical mechanisms are involved in price estimation. Specifically, prices were estimated lower in the left visual field than in the right visual field. The proposed explanation is that price appraisal might involve a valence attribution mechanism leading to a better perceived quality (related to higher prices) when objects are processed primarily in the left hemisphere, and to a lower perceived quality (related to lower prices) when objects are processed primarily in the right hemisphere.

  1. Efficacy of cevimeline vs. pilocarpine in the secretion of saliva: a pilot study.

    PubMed

    Brimhall, Jae; Jhaveri, Malhar A; Yepes, Juan F

    2013-01-01

    To determine the efficacy and compare the side-effects of cevimeline and pilocarpine in the secretion of saliva in patients with xerostomia. A randomized, cross-over, double blind study was designed. Fifteen patients with diagnosis of xerostomia were assigned to take either 5 mg of pilocarpine or 30 mg of cevimeline three times a day for four weeks. Salivary flow rates were measured during the initial baseline, first and second month appointments. Statistical analysis was carried out with ANOVA and post hoc t-tests. Twelve patients completed both medication treatments. Although both medications proved to increase salivary secretion, there was no significant difference between pilocarpine and cevimeline. Also, the perceived side-effects between the two medications were similar. Both medications increased the secretion of saliva at the end of four weeks. However, there was a slightly higher increment in saliva with pilocarpine. However, the difference was not statistically significant. ©2013 Special Care Dentistry Association and Wiley Periodicals, Inc.

  2. Effect of Weakening of Ipsilateral Depressor Anguli Oris on Smile Symmetry in Postparalysis Facial Palsy.

    PubMed

    Jowett, Nate; Malka, Ronit; Hadlock, Tessa A

    2017-01-01

    Aberrant depressor anguli oris (DAO) activity may arise after recovery from acute facial paralysis and restrict movement of the oral commissure. To quantify the degree to which DAO inhibition affects smile dynamics and perceived emotional state. In this prospective, pretest-posttest study performed at an academic tertiary referral hospital, patients with unilateral postparalysis facial palsy were studied from January 16 through April 30, 2016. Local anesthetic injection into the ipsilateral DAO. Healthy- and paretic-side commissure displacements from the midline lower vermillion border referenced to the horizontal plane were calculated from random-ordered photographs of full-effort smile before and after injection, and random-ordered hemifacial photographs of the paretic side were assessed as expressing positive, negative, or indiscernible emotion. Twenty patients were identified as having unilateral postparalysis facial palsy with marked synkinesis of the ipsilateral DAO. Patient mean age was 46 years (range, 24-67 years), with a male to female ratio of 1:3. Mean paretic-side commissure displacement increased from 27.45 mm at 21.65° above the horizontal plane to 29.35 mm at 23.58° after DAO weakening (mean difference, 1.90 mm; 95% CI, 1.26-2.54 mm; and 1.93°; 95% CI, 0.34°-3.51°; P < .001 and P = .20, respectively). Symmetry of excursion between sides improved by 2.00 mm (95% CI, 1.16-2.83 mm; P < .001) and 2.71° (95% CI, 1.38°-4.03°; P < .001). At baseline, observers assessed 7 of 20 paretic hemifaces (35%) as expressing positive emotion; this proportion increased to 13 of 20 (65%) after DAO weakening (P = .03). Ipsilateral DAO weakening results in significant improvements in smile dynamics and perceived expression of positive emotion on the paretic hemiface in postparalysis facial palsy. A trial of DAO weakening should be offered to patients with this disfiguring complication of Bell palsy and similar facial nerve insults. 3.

  3. General practitioners' beliefs about effectiveness and intentions to prescribe smoking cessation medications: qualitative and quantitative studies

    PubMed Central

    Vogt, Florian; Hall, Sue; Marteau, Theresa M

    2006-01-01

    Background General practitioners' (GPs) negative beliefs about nicotine dependence medications may act as barriers to prescribing them. Methods Study1: Twenty-five GPs from 16 practices across London were interviewed in this qualitative study. Framework analysis was used to identify key themes. Study 2: A convenience sample of 367 GPs completed an internet-based survey. Path-analysis was used to examine the relations between beliefs and intentions to prescribe smoking cessation medications. Results Study 1: Whilst nicotine replacement therapy (NRT) and bupropion were generally perceived as effective and cost-effective, the effectiveness of NRT was seen as critically dependent on behavioural support for smoking cessation. This dependence appeared to be influenced by perceptions that without support smokers would neglect psychological aspects of smoking and use NRT incorrectly. GPs perceived bupropion as dangerous and were concerned about its side-effects. Study 2: GPs' beliefs had medium (NRT, f2 = .23) to large (bupropion, f2=.45; NRT without support, f2=.59) effects on their intentions to prescribe medications. Beliefs about effectiveness of NRT and bupropion and the perceived danger of bupropion were the key predictors of intentions to prescribe NRT and bupropion, respectively. Beliefs about neglecting psychological aspects of smoking and incorrect use had indirect effects on intentions to prescribe NRT without support, operating via beliefs about effectiveness. Conclusion GPs vary in their beliefs about the effectiveness and safety of smoking cessation medications. Their intentions to prescribe these medications vary in line with these beliefs. Interventions aimed at increasing the likelihood with which GPs prescribe these medications may be more effective if they addressed these beliefs. PMID:17092346

  4. Look good feel better workshops: a "big lift" for women with cancer.

    PubMed

    Taggart, Linda R; Ozolins, Laura; Hardie, Heather; Nyhof-Young, Joyce

    2009-01-01

    Look Good Feel Better (LGFB) aims to help women manage appearance-related side effects of cancer and its treatment. In this pilot study, we assessed the impact of LGFB workshops on self-image, social interactions, perceived social support, and anxiety. We administered scales preworkshop and postworkshop participation. We conducted semistructured telephone interviews following attendance. Statistically and qualitatively, subjects experienced significant improvement in self-image, social interaction, and anxiety. Participant anxiety decreased, but greater social support was anticipated than actually obtained. LGFB workshops increase self-image, improve social interactions, and reduce anxiety.

  5. Yet another dark side of chivalry: Benevolent sexism undermines and hostile sexism motivates collective action for social change.

    PubMed

    Becker, Julia C; Wright, Stephen C

    2011-07-01

    The current research tests a model for understanding how benevolent sexism undermines, whereas hostile sexism promotes, social change. Study 1 (N = 99) and Study 2 (N = 92) demonstrate that exposing women to benevolent sexism decreases their engagement in collective action, whereas exposure to hostile sexism increases it. Both effects were mediated by gender-specific system justification and perceived advantages of being a woman. In Study 2, positive and negative affect also mediated these relationships. Results from Studies 3 and 4 (N = 68 and N = 37) support the causal chain described in the mediational models tested in Studies 1 and 2. Manipulations that increased gender-specific system justification (Study 3) and perceived advantages of being a woman (Study 4) reduced intentions to participate in collective action. PsycINFO Database Record (c) 2011 APA, all rights reserved.

  6. Vaccine hesitancy among healthcare workers in Europe: A qualitative study.

    PubMed

    Karafillakis, Emilie; Dinca, Irina; Apfel, Franklin; Cecconi, Sabrina; Wűrz, Andrea; Takacs, Judit; Suk, Jonathan; Celentano, Lucia Pastore; Kramarz, Piotr; Larson, Heidi J

    2016-09-22

    Healthcare workers (HCWs) are often referred to as the most trusted source of vaccine-related information for their patients. However, the evidence suggests that a number of HCWs are vaccine-hesitant. This study consists of 65 semi-structured interviews with vaccine providers in Croatia, France, Greece, and Romania to investigate concerns HCWs might have about vaccination. The results revealed that vaccine hesitancy is present in all four countries among vaccine providers. The most important concern across all countries was the fear of vaccine side effects. New vaccines were singled out due to perceived lack of testing for vaccine safety and efficacy. Furthermore, while high trust in health authorities was expressed by HCWs, there was also strong mistrust of pharmaceutical companies due to perceived financial interests and lack of communication about side effects. The notion that it is a doctor's responsibility to respond to hesitant patients was reported in all countries. Concerns were also seen to be country- and context-specific. Strategies to improve confidence in vaccines should be adapted to the specific political, social, cultural and economic context of countries. Furthermore, while most interventions focus on education and improving information about vaccine safety, effectiveness, or the need for vaccines, concerns raised in this study identify other determinants of hesitancy that need addressing. The representativeness of the views of the interviewed HCWs must be interpreted with caution. This a qualitative study with a small sample size that included geographical areas where vaccination uptake was lower or where hesitancy was more prevalent and it reflects individual participants' beliefs and attitudes toward the topic. As HCWs have the potential of influencing patient vaccination uptake, it is crucial to improve their confidence in vaccination and engage them in activities targeting vaccine hesitancy among their patients. Copyright © 2016. Published by Elsevier Ltd.

  7. Competition-strength-dependent ground suppression in figure-ground perception.

    PubMed

    Salvagio, Elizabeth; Cacciamani, Laura; Peterson, Mary A

    2012-07-01

    Figure-ground segregation is modeled as inhibitory competition between objects that might be perceived on opposite sides of borders. The winner is the figure; the loser is suppressed, and its location is perceived as shapeless ground. Evidence of ground suppression would support inhibitory competition models and would contribute to explaining why grounds are shapeless near borders shared with figures, yet such evidence is scarce. We manipulated whether competition from potential objects on the ground side of figures was high (i.e., portions of familiar objects were potentially present there) or low (novel objects were potentially present). We predicted that greater competition would produce more ground suppression. The results of two experiments in which suppression was assessed via judgments of the orientation of target bars confirmed this prediction; a third experiment showed that ground suppression is short-lived. Our findings support inhibitory competition models of figure assignment, in particular, and models of visual perception entailing feedback, in general.

  8. Attribution-Based Nocebo Effects. Perceived Effects of a Placebo Pill and a Sham Magnetic Field on Cognitive Performance and Somatic Symptoms.

    PubMed

    Szemerszky, Renáta; Dömötör, Zsuzsanna; Berkes, Tímea; Köteles, Ferenc

    2016-04-01

    Negative non-specific (nocebo-like) effects of medications and electromagnetic fields are often described as results of mistaken attribution. The current study aimed to find empirical evidence supporting this theory. Participants completed questionnaires assessing modern health worries, health anxiety, and somatosensory amplification, were assigned to one of three conditions (placebo pill with sedative information, sham magnetic field, or control), and completed a 14-min vigilance task. Changes in physiological arousal (heart rate, heart rate variability, and skin conductance) and reported symptoms were also measured. Finally, causal attributions concerning cognitive performance and reported symptoms were assessed. No increase in symptom reports and physiological arousal was measured in the two intervention groups. A perceived negative effect on cognitive performance was attributed to both sham conditions, and attributions were connected to modern health worries. A proportion of reported symptoms was ascribed to the placebo pill but not to the sham magnetic field. Symptom attributions were not related to any assessed psychological variables. An aroused physiological state is not necessary for the automatic causal attribution process. Negative effects attributed to medication and environmental factors can be regarded as unavoidable side effects of human cognitive-emotional functioning; they might be alleviated, but cannot be completely eradicated.

  9. Safety of a topical insect repellent (picaridin) during community mass use for malaria control in rural Cambodia

    PubMed Central

    Heng, Somony; Sluydts, Vincent; Durnez, Lies; Mean, Vanna; Polo, Koh; Tho, Sochantha; Coosemans, Marc; van Griensven, Johan

    2017-01-01

    Background While community distribution of topical repellents has been proposed as an additional malaria control intervention, the safety of this intervention at the population level remains poorly evaluated. We describe the safety of mass distribution of the picaridin repellent during a cluster-randomised trial in rural Cambodia in 2012–2013. Methods The repellent was distributed among 57 intervention villages with around 25,000 inhabitants by a team of village distributors. Information on individual adverse events, reported by phone by the village distributors, was obtained through home visits. Information on perceived side effects, reported at the family level, was obtained during two-weekly bottle exchange. Adverse events were classified as adverse reactions (events likely linked to the repellent), cases of repellent abuse and events not related to the repellent use, and classified as per Common Terminology Criteria for Adverse Events. Findings Of the 41 adverse events notified by phone by the village distributors, there were 22 adverse reactions, 11 cases of repellent abuse (6 accidental, 5 suicide attempts) and 8 non-related events. All adverse reactions were mild, occurred in the first few months of use, and mainly manifested as skin conditions. Of the 11 cases of abuse, 2 were moderate and 2 life-threatening. All cases with adverse reactions and repellent abuse recovered completely. 20% of families reported perceived side effects, mainly itching, headache, dizziness and bad smell, but few discontinued repellent use. Conclusions Adverse reactions and abuse during mass use of picaridin were uncommon and generally mild, supporting the safety of the picaridin repellent for malaria control. PMID:28339462

  10. Safety of a topical insect repellent (picaridin) during community mass use for malaria control in rural Cambodia.

    PubMed

    Heng, Somony; Sluydts, Vincent; Durnez, Lies; Mean, Vanna; Polo, Koh; Tho, Sochantha; Coosemans, Marc; van Griensven, Johan

    2017-01-01

    While community distribution of topical repellents has been proposed as an additional malaria control intervention, the safety of this intervention at the population level remains poorly evaluated. We describe the safety of mass distribution of the picaridin repellent during a cluster-randomised trial in rural Cambodia in 2012-2013. The repellent was distributed among 57 intervention villages with around 25,000 inhabitants by a team of village distributors. Information on individual adverse events, reported by phone by the village distributors, was obtained through home visits. Information on perceived side effects, reported at the family level, was obtained during two-weekly bottle exchange. Adverse events were classified as adverse reactions (events likely linked to the repellent), cases of repellent abuse and events not related to the repellent use, and classified as per Common Terminology Criteria for Adverse Events. Of the 41 adverse events notified by phone by the village distributors, there were 22 adverse reactions, 11 cases of repellent abuse (6 accidental, 5 suicide attempts) and 8 non-related events. All adverse reactions were mild, occurred in the first few months of use, and mainly manifested as skin conditions. Of the 11 cases of abuse, 2 were moderate and 2 life-threatening. All cases with adverse reactions and repellent abuse recovered completely. 20% of families reported perceived side effects, mainly itching, headache, dizziness and bad smell, but few discontinued repellent use. Adverse reactions and abuse during mass use of picaridin were uncommon and generally mild, supporting the safety of the picaridin repellent for malaria control.

  11. The inferior colliculus encodes the Franssen auditory spatial illusion

    PubMed Central

    Rajala, Abigail Z.; Yan, Yonghe; Dent, Micheal L.; Populin, Luis C.

    2014-01-01

    Illusions are effective tools for the study of the neural mechanisms underlying perception because neural responses can be correlated to the physical properties of stimuli and the subject’s perceptions. The Franssen illusion (FI) is an auditory spatial illusion evoked by presenting a transient, abrupt tone and a slowly rising, sustained tone of the same frequency simultaneously on opposite sides of the subject. Perception of the FI consists of hearing a single sound, the sustained tone, on the side that the transient was presented. Both subcortical and cortical mechanisms for the FI have been proposed, but, to date, there is no direct evidence for either. The data show that humans and rhesus monkeys perceive the FI similarly. Recordings were taken from single units of the inferior colliculus in the monkey while they indicated the perceived location of sound sources with their gaze. The results show that the transient component of the Franssen stimulus, with a shorter first spike latency and higher discharge rate than the sustained tone, encodes the perception of sound location. Furthermore, the persistent erroneous perception of the sustained stimulus location is due to continued excitation of the same neurons, first activated by the transient, by the sustained stimulus without location information. These results demonstrate for the first time, on a trial-by-trial basis, a correlation between perception of an auditory spatial illusion and a subcortical physiological substrate. PMID:23899307

  12. Human tolerance to a single, high dose of D-tagatose.

    PubMed

    Buemann, B; Toubro, S; Raben, A; Astrup, A

    1999-04-01

    The addition of 29 g D-tagatose added as a sweetener to a continental breakfast was tested for the appearance of gastrointestinal side effects in a double-blind randomized cross-over study with 29 g sucrose as a control treatment. The subjects reported the side effects during 72 h following the test meal on a questionnaire grading the symptoms on a five-level scale ranging from "none" to "very strong." Although "rumbling in the stomach," "distention," "nausea," "rumbling in the gut," "flatulence, " and "diarrhea" scored significantly higher with D-tagatose, the sugar otherwise was well tolerated in most of the subjects. Two cases of vomiting after D-tagatose were recorded but in one of the cases its relation to the D-tagatose intake was questionable. Only the "distention" score remained higher with D-tagatose for more than 24 h. Nausea, vomiting, and perceived distension may be due to an osmotic effect in the small intestine of unabsorbed D-tagatose. The increased flatus is caused by D-tagatose being fermented in the large intestine. Diarrhea may be explained by osmotic effects in the colon from nondegraded D-tagatose or nonabsorbed short-chain fatty acids produced by the increased fermentation. Copyright 1999 Academic Press.

  13. Factors associated with the uptake of seasonal influenza vaccination in older and younger adults: a large, population-based survey in Beijing, China.

    PubMed

    Wu, Shuangsheng; Su, Jianting; Yang, Peng; Zhang, Haiyan; Li, Hongjun; Chu, Yanhui; Hua, Weiyu; Li, Chao; Tang, Yaqing; Wang, Quanyi

    2017-09-25

    The present study aimed to estimate the influenza vaccination coverage rate in Beijing, China, and identify its determinants in older and younger adults. A survey was conducted among Chinese adults using a self-administered, anonymous questionnaire in May-June 2015. The main outcome was seasonal influenza vaccination uptake. Multivariate logistic regression models were performed to identify factors associated with uptake. A total of 7106 participants completed the questionnaire. The overall coverage rate was 20.6% (95% CI 19.7% to 21.5%) in the 2014/2015 influenza season. Lower education (older adults: OR 1.6; 95% CI 1.2 to 2.1; younger adults: OR 1.9; 95% CI 1.4 to 2.6), having a chronic illness (older adults: OR 1.9; 95% CI 1.5 to 2.4; younger adults: OR 1.4; 95% CI 1.2 to 1.7) and recommendations from healthcare workers (older adults: OR 5.4; 95% CI 3.9 to 7.4; younger adults: OR 4.5; 95% CI 3.7 to 5.4) were positively associated with uptake; perceived side effects of vaccination had a negative impact (older adults: OR 0.6; 95% CI 0.4 to 0.7; younger adults: OR 0.8; 95% CI 0.7 to 1.0). Perceived susceptibility to influenza (OR 1.5; 95% CI 1.2 to 2.0) and awareness of the free influenza vaccine policy (OR 1.9; 95% CI 1.2 to 2.9) were only associated with vaccine uptake in older adults, while perceived effectiveness of vaccination (OR 2.2; 95% CI 1.7 to 2.8) was only a predictor for younger adults. Older adults were more likely to receive recommendations from healthcare professionals and perceive the severity of seasonal influenza, and less likely to worry about side effects of vaccination. The influenza vaccination coverage rate was relatively low in Beijing. Apart from free vaccinations for older adults, age disparity in the rate between older and younger adults (48.7% vs 16.0%) may be explained by differing professional recommendations and public perceptions. Vaccination campaigns targeting increasing professional recommendations and public perceptions should be implemented in the coming years. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. A border-ownership model based on computational electromagnetism.

    PubMed

    Zainal, Zaem Arif; Satoh, Shunji

    2018-03-01

    The mathematical relation between a vector electric field and its corresponding scalar potential field is useful to formulate computational problems of lower/middle-order visual processing, specifically related to the assignment of borders to the side of the object: so-called border ownership (BO). BO coding is a key process for extracting the objects from the background, allowing one to organize a cluttered scene. We propose that the problem is solvable simultaneously by application of a theorem of electromagnetism, i.e., "conservative vector fields have zero rotation, or "curl." We hypothesize that (i) the BO signal is definable as a vector electric field with arrowheads pointing to the inner side of perceived objects, and (ii) its corresponding scalar field carries information related to perceived order in depth of occluding/occluded objects. A simple model was developed based on this computational theory. Model results qualitatively agree with object-side selectivity of BO-coding neurons, and with perceptions of object order. The model update rule can be reproduced as a plausible neural network that presents new interpretations of existing physiological results. Results of this study also suggest that T-junction detectors are unnecessary to calculate depth order. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Sugar substitutes: Health controversy over perceived benefits

    PubMed Central

    Tandel, Kirtida R.

    2011-01-01

    Sugar is an inseparable part of the food we consume. But too much sugar is not ideal for our teeth and waistline. There have been some controversial suggestions that excessive sugar may play an important role in certain degenerative diseases. So artificial sweeteners or artificially sweetened products continue to attract consumers. A sugar substitute (artificial sweetener) is a food additive that duplicates the effect of sugar in taste, but usually has less food energy. Besides its benefits, animal studies have convincingly proven that artificial sweeteners cause weight gain, brain tumors, bladder cancer and many other health hazards. Some kind of health related side effects including carcinogenicity are also noted in humans. A large number of studies have been carried out on these substances with conclusions ranging from “safe under all conditions” to “unsafe at any dose”. Scientists are divided in their views on the issue of artificial sweetener safety. In scientific as well as in lay publications, supporting studies are often widely referenced while the opposing results are de-emphasized or dismissed. So this review aims to explore the health controversy over perceived benefits of sugar substitutes. PMID:22025850

  16. Volvo and Infiniti drivers' experiences with select crash avoidance technologies.

    PubMed

    Braitman, Keli A; McCartt, Anne T; Zuby, David S; Singer, Jeremiah

    2010-06-01

    Vehicle-based crash avoidance systems can potentially reduce crashes, but success depends on driver acceptance and understanding. This study gauged driver use, experience, and acceptance among early adopters of select technologies. Telephone interviews were conducted in early 2009 with 380 owners of Volvo vehicles equipped with forward collision warning with autobrake, lane departure warning, side-view assist, and/or active bi-xenon headlights and 485 owners of Infiniti vehicles with lane departure warning/prevention. Most owners kept systems turned on most of the time, especially forward collision warning with autobrake and side-view assist. The exception was lane departure prevention; many owners were unaware they had it, and the system must be activated each time the vehicle is started. Most owners reported being safer with the technologies and would want them again on their next vehicles. Perceived false or unnecessary warnings were fairly common, particularly with side-view assist. Some systems were annoying, especially lane departure warning. Many owners reported safer driving behaviors such as greater use of turn signals (lane departure warning), increased following distance (forward collision warning), and checking side mirrors more frequently (side-view assist), but some reported driving faster at night (active headlights). Despite some unnecessary or annoying warnings, most Volvo and Infiniti owners use crash avoidance systems most of the time. Among early adopters, the first requirement of effective warning systems (that owners use the technology) seems largely met. Systems requiring activation by drivers for each trip are used less often. Owner experience with the latest technologies from other automobile manufacturers should be studied, as well as for vehicles on which technologies are standard (versus optional) equipment. The effectiveness of technologies in preventing and mitigating crashes and injuries, and user acceptance of interfaces, should be examined as more vehicles with advanced technologies penetrate the fleet.

  17. HIV vaccine trial participation among ethnic minority communities: barriers, motivators, and implications for recruitment.

    PubMed

    Newman, Peter A; Duan, Naihua; Roberts, Kathleen J; Seiden, Danielle; Rudy, Ellen T; Swendeman, Dallas; Popova, Svetlana

    2006-02-01

    Underrepresentation of ethnic minority communities limits the generalizability of HIV vaccine trial results. We explored perceived barriers and motivators regarding HIV vaccine trial participation among low-socioeconomic ethnic minority respondents at risk for HIV. Six focus group interviews were conducted using a semistructured interview guide. Participants (N = 58, mean age = 36 years, 37% female, and 56% Latino/a and 35% African American) were recruited using venue-based sampling in Los Angeles. Data were analyzed using narrative thematic analysis and Ethnograph qualitative software. Perceived barriers to HIV vaccine trial participation, in rank order, were (1) vaccine-induced HIV infection, (2) physical side effects, (3) uncertainty about vaccine efficacy, (4) uncertainty about other vaccine characteristics, (5) mistrust, (6) low perceived HIV risk, (7) study demands, (8) stigma, and (9) vaccine-induced HIV seropositivity. Motivators were (1) protection against HIV infection, (2) free insurance and/or medical care, (3) altruism, and (4) monetary incentives. Population-specific HIV vaccine trial recruitment and implementation strategies should address trial risks from a family perspective, cultural gender norms, mistrust, low perceived HIV risk, the importance of African-American and Latino/a community participation in HIV vaccine trials, and misconceptions about gaining protection against HIV infection. Increasing the cultural relevance of trial recruitment and implementation should facilitate the participation of Latinos/as and African Americans in HIV vaccine trials.

  18. Moving the needle: a retrospective pre- and post-analysis of improving perceived abilities across 20 leadership skills.

    PubMed

    Fernandez, Claudia S P; Noble, Cheryl C; Jensen, Elizabeth; Steffen, David

    2015-02-01

    To assess the influence of intensive focused leadership training on self-evaluation of leadership skills among Maternal and Child Health (MCH) professionals enrolled in the Maternal and Child Health Public Health Leadership Institute (MCH PHLI). Senior-level MCH leaders (n = 54) participated in the first two cohorts of the MCH PHLI, a senior-level training program funded through the Maternal and Child Health Bureau. Participants were asked to complete a retrospective pre- and post-test rating inventory at program completion. Participants self-identified their skill level across 20 leadership skills that were the focus of the training program. These skills were derived from the MCH Leadership Competencies, 3.0 and literature reviews, and then divided into two domains: Core leadership skills and Organizational/Institutional leadership skills. Data were analyzed to determine whether participants perceived skill level increased by the end of their training year. A one-sided (upper) paired T Test and a Wilcoxen Signed Rank Sum Test were used to determine statistical significance. Increases in perceived skill levels were found to be statistically significant at the alpha = .01 level for all 20 target skills. The MCH PHLI model of intensive leadership development, incorporating a hybrid approach of onsite and distance-based learning, was broadly effective in building targeted leadership skills as perceived by participants.

  19. Knowledge, attitudes, and beliefs related to hypertension and hyperlipidemia self-management among African-American men living in the southeastern United States.

    PubMed

    Long, Everett; Ponder, Monica; Bernard, Stephanie

    2017-05-01

    Perceptions of illness affect cardiovascular disease (CVD) self-management. This study explores knowledge, attitudes, and beliefs regarding hypertension and hyperlipidemia management among 34 African-American men with hypertension and/or hyperlipidemia, age 40-65, living in the Southeastern United States. In-person focus groups were conducted using semi-structured interview questions informed by the Health Belief Model (HBM). Participants had a high level of knowledge about hypertension self-management, but less about cholesterol self-management. Perceived severity of both conditions was acknowledged, though participants perceived hypertension as more severe. Barriers to self-management included medication side effects and unhealthy dietary patterns. Facilitators included social support, positive healthcare experiences, and the value placed on family. Cultural implications highlighted the importance of food in daily life and social settings. Participants expressed how notions of masculinity affected self-management-noting the impact of feelings of vulnerability and perceived lack of control stemming from diagnosis and treatment expectations. The findings highlight gaps in knowledge of hyperlipidemia versus hypertension, and the impact of cultural context and perceptions on engagement in self-management behaviors. Public health practitioners and healthcare providers serving African-American men should address cultural factors and notions of masculinity which can hinder effective disease management among this population. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Factors associated with parents' attitudes to the HPV vaccination of their adolescent sons : A systematic review.

    PubMed

    Radisic, Gorjana; Chapman, Janine; Flight, Ingrid; Wilson, Carlene

    2017-02-01

    The objective of the study was to identify factors associated with human papilloma virus (HPV) vaccine acceptability in parents of adolescent boys. This information is critical to the development of approaches to optimise HPV vaccine uptake among this population group. We performed a systematic search of the literature in addressing factors influencing parental attitudes to and beliefs about HPV vaccine and its acceptability for use. The findings were organised within the framework of the Health Belief Model (HBM) and summarised using a semi quantitative method. Eighteen studies met the inclusion criteria. Parental decisions were predominantly shaped by the perceived benefits of the vaccine; perceived risk of sons contracting the HPV infection, and having recommendations from health care providers. Fear of side effects and uncertainty about vaccine effectiveness, as well as cost and lack of healthcare, were barriers to HPV vaccination. Other factors such as knowledge, family characteristics, parent-child dialogue and egalitarian values appeared to be important when deciding whether to vaccinate boys. HPV vaccine uptake among male adolescents is suboptimal. Future programs need to address the predictors of uptake by educating parents about the boys' high susceptibility to infection, the benefits of vaccination, and reduce concerns regarding perceived barriers. Additionally, uptake may be facilitated by encouraging health care provider endorsement, particularly in countries without government-funded immunisation programs. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. To be seen, confirmed and involved - a ten year follow-up of perceived health and cardiovascular risk factors in a Swedish community intervention programme

    PubMed Central

    Emmelin, Maria; Weinehall, Lars; Stenlund, Hans; Wall, Stig; Dahlgren, Lars

    2007-01-01

    Background Public health interventions are directed towards social systems and it is difficult to foresee all consequences. While targeted outcomes may be positively influenced, interventions may at worst be counterproductive. To include self-reported health in an evaluation is one way of addressing possible side-effects. This study is based on a 10 year follow-up of a cardiovascular community intervention programme in northern Sweden. Methods Both quantitative and qualitative approaches were used to address the interaction between changes in self-rated health and risk factor load. Qualitative interviews contributed to an analysis of how the outcome was influenced by health related norms and attitudes. Results Most people maintained a low risk factor load and a positive perception of health. However, more people improved than deteriorated their situation regarding both perceived health and risk factor load. "Ideal types" of attitude sets towards the programme, generated from the interviews, helped to interpret an observed polarisation for men and the lower educated. Conclusion Our observation of a socially and gender differentiated intervention effect suggests a need to test new intervention strategies. Future community interventions may benefit from targeting more directly those who in combination with high risk factor load perceive their health as bad and to make all participants feel seen, confirmed and involved. PMID:17672911

  2. The 'balance intervention' for promoting caloric compensatory behaviours in response to overeating: a formative evaluation.

    PubMed

    Wammes, Birgitte; Breedveld, Boudewijn; Kremers, Stef; Brug, Johannes

    2006-08-01

    To help people prevent weight gain, the Netherlands Nutrition Centre initiated the 'balance intervention', which promotes moderation of food intake and/or increased physical activity in response to occasions of overeating. The aim of this study was to determine whether intervention materials were appreciated, encouraged information seeking and increased motivation and caloric compensatory behaviours. A three-group randomized trial with pre-intervention measures (n = 963, response 86%) and post-intervention measures (n = 857) using electronic questionnaires was conducted among participants aged 25-40 years, recruited from an Internet research panel. The first group received a printed brochure and electronic newsletters (print group), the second group was exposed to radio advertisements (radio group) and the third group was the control group. Multiple regression analyses were used to investigate the impact of the materials on self-reported prevalence of overeating, attitudes, perceived behavioural control, intentions and compensatory behaviours. At follow-up, we found significantly more positive attitudes, intentions and dietary action in the print and radio groups. However, participants who received the radio advertisement had a significantly lower perceived behavioural control. No effects were found on the prevalence of overeating. The results indicate that the intervention materials have potential for increasing people's attitudes, motivation and self-reported behaviour actions, with a possible negative side-effect on perceived behavioural control.

  3. Good Outcomes with the Intraventricular Vancomycin Therapy in a Patient with Ruptured Brain Abscesses

    PubMed Central

    Doan, Ninh; Nguyen, Ha; Luyuan, Li; Shabani, Saman; Gelsomino, Michael; Johnson, Vijay

    2018-01-01

    Brain abscesses are associated with high morbidity and mortality rates. In particular, patients with intraventricular rupture of brain abscess (IVROBA) exhibit mortality rates up to 85%. Treatment options are lacking for IVROBA, once patients become refractory to intravenous antibiotics and surgical drainage. Limited data exist regarding the risks and benefits of intraventricular therapy in such a scenario. We report a patient with IVROBA, who deteriorated while on systemic antibiotics; once intraventricular vancomycin was employed, the patient demonstrated remarkable improvement without perceivable side effects. This case suggests that intraventricular vancomycin may be a safe, effective, and viable option for the treatment of IVROBA, especially for patients becoming refractory to systemic antibiotics. PMID:29682042

  4. Real-world health outcomes in adults with moderate-to-severe psoriasis in the United States: a population study using electronic health records to examine patient-perceived treatment effectiveness, medication use, and healthcare resource utilization.

    PubMed

    Armstrong, April W; Foster, Shonda A; Comer, Brian S; Lin, Chen-Yen; Malatestinic, William; Burge, Russel; Goldblum, Orin

    2018-06-28

    Little is known regarding real-world health outcomes data among US psoriasis patients, but electronic health records (EHR) that collect structured data at point-of-care may provide opportunities to investigate real-world health outcomes among psoriasis patients. Our objective was to investigate patient-perceived treatment effectiveness, patterns of medication use (duration, switching, and/or discontinuation), healthcare resource utilization, and medication costs using real-world data from psoriasis patients. Data for adults (≥18-years) with a dermatology provider-given diagnosis of psoriasis from 9/2014-9/2015 were obtained from dermatology practices using a widely used US dermatology-specific EHR containing over 500,000 psoriasis patients. Disease severity was captured by static physician's global assessment and body surface area. Patient-perceived treatment effectiveness was assessed by a pre-defined question. Treatment switching and duration were documented. Reasons for discontinuations were assessed using pre-defined selections. Healthcare resource utilization was defined by visit frequency and complexity. From 82,621 patients with psoriasis during the study period, patient-perceived treatment effectiveness was investigated in 2200 patients. The proportion of patients reporting "strongly agree" when asked if their treatment was effective was highest for biologics (73%) and those reporting treatment adherence (55%). In 16,000 patients who received oral systemics and 21,087 patients who received biologics, median treatment duration was longer for those who received biologics (160 vs. 113 days, respectively). Treatment switching was less frequent among patients on systemic monotherapies compared to those on combination therapies. The most common reason for discontinuing biologics was loss of efficacy; the most common reason for discontinuing orals was side effects. In 28,754 patients, higher disease severity was associated with increased healthcare resource utilization (increased visit frequency and complexity). When compared between treatment groups (n = 10,454), healthcare resource utilization was highest for phototherapy. Annual medication costs were higher for biologics ($21,977) than oral systemics ($3413). Real-world research using a widely implemented dermatology EHR provided valuable insights on patient perceived treatment effectiveness, patterns of medication usage, healthcare resource utilization, and medication costs for psoriasis patients in the US. This study and others utilizing EHRs for real-world research may assist clinical and payer decisions regarding the management of psoriasis.

  5. Informing patients: the influence of numeracy, framing, and format of side effect information on risk perceptions.

    PubMed

    Peters, Ellen; Hart, P Sol; Fraenkel, Liana

    2011-01-01

    Given the importance of effective patient communication, findings about influences on risk perception in nonmedical domains need replication in medical domains. To examine whether numeracy influences risk perceptions when different information frames and number formats are used to present medication risks. The authors manipulated the frame and number format of risk information in a 3 (frame: positive, negative, combined) × 2 (number format: frequency, percentage) design. Participants from an Internet sample (N = 298), randomly assigned to condition, responded to a single, hypothetical scenario. The main effects and interactions of numeracy, framing, and number format on risk perception were measured. Participants given the positive frame perceived the medication as less risky than those given the negative frame. Mean risk perceptions for the combined frame fell between the positive and negative frames. Numeracy did not moderate these framing effects. Risk perceptions also varied by number format and numeracy, with less-numerate participants given risk information in a percentage format perceiving the medication as less risky than when given risk information in a frequency format; highly numerate participants perceived similar risks in both formats. The generalizability of the findings is limited due to the use of non-patients, presented a hypothetical scenario. Given the design, one cannot know whether observed differences would translate into clinically significant differences in patient behaviors. Frequency formats appear to increase risk perceptions over percentage formats for less-numerate respondents. Health communicators need to be aware that different formats generate different risk perceptions among patients varying in numeracy.

  6. Knowledge and perceptions of the intrauterine device among family planning providers in Nepal: a cross-sectional analysis by cadre and sector.

    PubMed

    Chakraborty, Nirali M; Murphy, Caitlin; Paudel, Mahesh; Sharma, Sriju

    2015-01-28

    Nepal has high unmet need for family planning and low use of intrauterine devices (IUDs). While clients' attitudes toward the IUD are known in a variety of contexts, little is known about providers' knowledge and perceptions of the IUD in developing countries. Nepal's liberal IUD service provision policies allow the opportunity to explore provider knowledge and perceptions across cadres and sectors. This research contributes to an understanding of providers' IUD perceptions in low-resource environments, and increases evidence for IUD task-sharing and private sector involvement. A questionnaire was administered to 345 nurses and auxiliary nurse midwives (ANMs) affiliated with the private Mahila Swastha Sewa (MSS) franchise, public sector, or private non-franchise sector. All providers had been trained in TCu 380A IUD insertion and removal. The questionnaire captured providers' IUD experience, knowledge, and perceived barriers to recommendation. Descriptive, multivariate linear, and multinomial logistic regression was conducted, comparing providers between cadre and sector. On average, providers answered 21.5 of 35 questions correctly, for a score of 61.4%. Providers scored the lowest on IUD medical eligibility, answering 5.9 of 14 questions correctly. Over 50% of providers were able to name the four side effects most frequently associated with the IUD; however, one-third of all providers found at least one of these side effects unacceptable. Adjusted results show that cadre does not significantly impact provider's IUD knowledge scores or side effect perceptions. Public sector affiliation was associated with higher knowledge scores regarding personal characteristic eligibility and more negative perceptions of two normal IUD side effects. IUD knowledge is significantly associated with provider's recent training and employment at multiple facilities, and side effect perceptions are significantly associated with client volume, range of family planning methods, and region. Provider knowledge and attitudes towards IUD provision are similar across cadre and sector, supporting WHO task-sharing guidelines and validating Nepal's family planning policies. However, overall provider knowledge is low. We recommend that providers need to receive further training and support to improve knowledge, manage side effects, and recognize women in periods of high unmet need--such as post-partum or post-abortion women--as suitable candidates for IUDs.

  7. Neuropsychology: the touchy, feely side of vision.

    PubMed

    Walsh, V

    2000-01-13

    Some visual attributes, such as colour, are purely visual, but others, such as orientation and movement, can be perceived by touch or audition. A magnetic stimulation study has now shown that the perception of tactile orientation may be influenced by visual Information.

  8. Same gain, less pain: potential patient preferences for adjuvant treatment in premenopausal women with early breast cancer.

    PubMed

    Fallowfield, Lesley; McGurk, Rhona; Dixon, Michael

    2004-11-01

    The aim of this study was to determine the treatment preferences (adjuvant goserelin or cyclophosphamide, methotrexate and fluorouracil (CMF) chemotherapy) of healthy premenopausal women should they hypothetically develop oestrogen-receptor (ER) positive early breast cancer. Two hundred pre or peri-menopausal women read two scenarios describing goserelin or chemotherapy. Information included: How and where treatments were administered, side-effects, their likely persistence and impact on fertility. Women stated their unprompted initial and final preferences with reasons for the choices made. Respondents showed an overwhelming preference for goserelin. 156 (78%) women favoured goserelin, 22 (11%) chemotherapy and 22 (11%) remained undecided (P<0.0001). Primary reasons for preferring goserelin for were 105 (71%) avoidance of chemotherapy side-effects, especially hair loss, perceived convenience and less disruption to normal life 54 (36%). The minority who preferred chemotherapy, valued the treatment finishing more quickly. These results together with clinical trial data showing equivalence of goserelin with CMF regimens suggest that premenopausal women with ER-positive tumours should at least be offered the choice of either adjuvant hormone therapy or chemotherapy.

  9. Perceptions of coping behaviors by persons with cancer and health care providers.

    PubMed

    Merluzzi, T V; Martinez Sanchez, M A

    1997-09-01

    We studied perceptions of the importance and difficulty of coping behaviors, from the perspectives of cancer patients (n = 33) and health care providers (i.e. nursing and technical personnel, n = 24). They rated the importance and difficulty of 43 behaviors that correspond to six domains of coping with cancer. Generally, ratings of importance were similar for both patients and providers. However, patients rated the domains of Coping with Treatment Related Side Effects and Seeking Support as less important than staff. Ratings of difficulty were quite divergent. Patients perceived coping as less difficult than the medical staff in the following domains: Maintenance of Activity and Independence, Coping With Treatment-Related Side-Effects, Accepting Cancer/Maintaining Positive Attitude, and Seeking Support. These differences in difficulty ratings between patients and health care providers may reflect distinct perspectives or schemas about coping. That is, patients may hold 'positive illusions' about their coping capacity and, therefore, rate coping as less difficult. Health care providers may overestimate patients' distress and, therefore, underestimate patients' coping capacity. An understanding of these different perspectives may assist medical staff in fostering self-efficacy expectations for coping behaviors.

  10. Is Mixed Practice More Effective than Physical Practice Alone for the Acquisition of Non-dominant Side Kicking Performance?

    PubMed Central

    Steel, Kylie A.; Ellem, Eathan

    2016-01-01

    Perceiving and executing unfamiliar movements, such as left handed/footed movement skills in sports, places additional demands on the perceptual-cognitive system of players that may increase errors. The video self-modeling (VSM) method may provide an accessible solution to this issue, therefore the purpose of this study was to investigate the effect of the VSM method on the improvement of a non-preferred side kicking task. N = 28 participants engaged in one of three conditions; Mirror reversed/ physical practice (PP), best-of/ PP, or physical practice only. Though not significant, data analysis indicated improved kicking accuracy for all groups, with VSM groups showing the most improvement. However, qualitative data revealed the “best-of” group demonstrated more positive views toward their progress compared to other groups, and both VSM groups were more likely to attend to movement cues than target based cues. These trends may suggest merit for the use of VSM techniques, though its application and the source of mechanistic factors warrant further investigation. PMID:27826280

  11. Anti-Diabetic Potential of Noni: The Yin and the Yang.

    PubMed

    Nerurkar, Pratibha V; Hwang, Phoebe W; Saksa, Erik

    2015-09-25

    Escalating trends of chronic diseases such as type-2 diabetes (T2D) have sparked a renewed interest in complementary and alternative medicine, including herbal products. Morinda citrifolia (noni) has been used for centuries by Pacific Islanders to treat various ailments. Commercial noni fruit juice has been marketed as a dietary supplement since 1996. In 2003, the European Commission approved Tahitian noni juice as a novel food by the Health and Consumer Protection Directorate General. Among noni's several health benefits, others and we have demonstrated the anti-diabetic effects of fermented noni fruit juice in animal models. Unfortunately, noni's exciting journey from Polynesian medicine to the research bench does not reach its final destination of successful clinical outcomes when translated into commercial products. Noni products are perceived to be safe due to their "natural" origin. However, inadequate evidence regarding bioactive compounds, molecular targets, mechanism of action, pharmacokinetics, long-term safety, effective dosages, and/or unanticipated side effects are major roadblocks to successful translation "from bench side to bedside". In this review we summarize the anti-diabetic potential of noni, differences between traditional and modern use of noni, along with beneficial clinical studies of noni products and challenges in clinical translation of noni's health benefits.

  12. The Rhizobium sp. strain NGR234 systemically suppresses arbuscular mycorrhizal root colonization in a split-root system of barley (Hordeum vulgare).

    PubMed

    Khaosaad, Thanasan; Staehelin, Christian; Steinkellner, Siegrid; Hage-Ahmed, Karin; Ocampo, Juan Antonio; Garcia-Garrido, Jose Manuel; Vierheilig, Horst

    2010-11-01

    Nitrogen-fixing bacteria (rhizobia) form a nodule symbiosis with legumes, but also induce certain effects on non-host plants. Here, we used a split-root system of barley to examine whether inoculation with Rhizobium sp. strain NGR234 on one side of a split-root system systemically affects arbuscular mycorrhizal (AM) root colonization on the other side. Mutant strains of NGR234 deficient in Nod factor production (strain NGRΔnodABC), perception of flavonoids (strain NGRΔnodD1) and secretion of type 3 effector proteins (strain NGRΩrhcN) were included in this study. Inoculation resulted in a systemic reduction of AM root colonization with all tested strains. However, the suppressive effect of strain NGRΩrhcN was less pronounced. Moreover, levels of salicylic acid, an endogenous molecule related to plant defense, were increased in roots challenged with rhizobia. These data indicate that barley roots perceived NGR234 and that a systemic regulatory mechanism of AM root colonization was activated. The suppressive effect appears to be Nod factor independent, but enhanced by type 3 effector proteins of NGR234. Copyright © Physiologia Plantarum 2010.

  13. Perceived HIV risk, actual sexual HIV risk and willingness to take pre-exposure prophylaxis among men who have sex with men in Toronto, Canada.

    PubMed

    Kesler, Maya A; Kaul, Rupert; Myers, Ted; Liu, Juan; Loutfy, Mona; Remis, Robert S; Gesink, Dionne

    2016-11-01

    Pre-exposure prophylaxis (PrEP) reduces HIV acquisition. Our goal was to determine the willingness of men who have sex with men (MSM) to take PrEP given perceived and actual HIV risk. HIV-negative MSM were recruited from September 2010 to June 2012 and asked about PrEP willingness and perceived HIV risk. Actual sexual HIV risk was measured by three condom-use components generated through principal components analysis. General HIV risk was measured using the HIV Incidence Risk Index for MSM (HIRI-MSM). Model 1 measured PrEP willingness given perceived and actual sexual HIV risk. Model 2 included actual HIV sexual risk, perceived HIV risk and general HIV risk. Model 3 removed actual sexual HIV risk. We recruited 150 HIV-negative MSM. About 55% were willing to take PrEP. Reasons for PrEP unwillingness were: low perceived risk (64%), side-effect concerns (44%), daily pill burden (16%) and efficacy concerns (4%). Model 1: MSM with high compared to low actual sexual HIV risk were more willing to use PrEP (OR 27.11, 95% CI 1.33-554.43) after adjusting for perceived risk, which was not significantly associated with PrEP willingness (OR 4.79, 95% CI 0.72-31.96). Model 2: MSM with high compared to low actual sexual HIV risk were more willing to use PrEP (OR 29.85, 95% CI 1.39-640.53) after adjusting for perceived and general HIV risk, neither of which was significantly associated with PrEP willingness (OR 5.07, 95% CI 0.73-35.09) and (OR 1.58, 95% CI 0.37-6.79), respectively. Model 3: After removing actual sexual HIV risk, MSM with high compared to low perceived risk were more willing to use PrEP (OR 6.85, 95% CI 1.23-38.05), and the HIRI-MSM general risk index was not associated with PrEP willingness (OR 1.87, 95% CI 0.54-6.54). Therefore, actual sexual HIV risk was the best predictor of PrEP willingness and general HIV risk did not inform PrEP willingness.

  14. Geometric and perceptual effects of the location of the observer vantage point for linear-perspective images.

    PubMed

    Todorović, Dejan

    2005-01-01

    New geometric analyses are presented of three impressive examples of the effects of location of the vantage point on virtual 3-D spaces conveyed by linear-perspective images. In the 'egocentric-road' effect, the perceived direction of the depicted road is always pointed towards the observer, for any position of the vantage point. It is shown that perspective images of real-observer-aimed roads are characterised by a specific, simple pattern of projected side lines. Given that pattern, the position of the observer, and certain assumptions and perspective arguments, the perceived direction of the virtual road towards the observer can be predicted. In the 'skewed balcony' and the 'collapsing ceiling' effects, the position of the vantage point affects the impression of alignment of the virtual architecture conveyed by large-scale illusionistic paintings and the real architecture surrounding them. It is shown that the dislocation of the vantage point away from the viewing position prescribed by the perspective construction induces a mismatch between the painted vanishing point of elements in the picture and the real vanishing point of corresponding elements of the actual architecture. This mismatch of vanishing points provides visual information that the elements of the two architectures are not mutually parallel.

  15. Developing effective messages about potable recycled water: The importance of message structure and content

    NASA Astrophysics Data System (ADS)

    Price, J.; Fielding, K. S.; Gardner, J.; Leviston, Z.; Green, M.

    2015-04-01

    Community opposition is a barrier to potable recycled water schemes. Effective communication strategies about such schemes are needed. Drawing on social psychological literature, two experimental studies are presented, which explore messages that improve public perceptions of potable recycled water. The Elaboration-Likelihood Model of information processing and attitude change is tested and supported. Study 1 (N = 415) premeasured support for recycled water, and trust in government information at Time 1. Messages varied in complexity and sidedness were presented at Time 2 (3 weeks later), and support and trust were remeasured. Support increased after receiving information, provided that participants received complex rather than simple information. Trust in government was also higher after receiving information. There was tentative evidence of this in response to two-sided messages rather than one-sided messages. Initial attitudes to recycled water moderated responses to information. Those initially neutral or ambivalent responded differently to simple and one-sided messages, compared to participants with positive or negative attitudes. Study 2 (N = 957) tested the effectiveness of information about the low relative risks, and/or benefits of potable recycled water, compared to control groups. Messages about the low risks resulted in higher support when the issue of recycled water was relevant. Messages about benefits resulted in higher perceived issue relevance, but did not translate into greater support. The results highlight the importance of understanding people's motivation to process information, and need to tailor communication to match attitudes and stage of recycled water schemes' development.

  16. Technology versus humanism: how patients perceive the use of electronic health records in physicians' offices--a qualitative study.

    PubMed

    Mwachofi, Ari K; Khaliq, Amir A; Carrillo, Estevan R; Winfree, William

    2016-01-01

    Electronic Health Records (EHRs) have the potential to improve the quality of care. In view of the accelerated adoption of EHRs, there is a need to understand conditions necessary for their effective use. Patients are the focus of healthcare and their perceptions and expectations need to be included in developing and implementing EHRs. The purpose of this study was to gather exploratory qualitative information from patients about their experiences and perceptions regarding the effects of EHRs on healthcare quality in physicians' offices. We conducted five focus groups with patients representing a random mix of diverse socio-demographic backgrounds in Oklahoma. Related to EHRs, patients reported improvements on the technical side of care but no change on the human side. They expressed concerns about the potential for breach of confidentiality and security of medical records. They were also concerned about the possibility of governmental agencies or insurance companies having unauthorized access to patient records. Patients differentiated between the human and technical sides of care and reported no change or improvement in the doctor-patient interaction. Patients have an important perspective on the use of EHRs and their perceptions and experiences should be considered in the development, adoption and implementation of EHRs. Otherwise, the use of EHRs may not be fully effective. There is also a need to educate patients about the potential benefits and risks of EHRs and the steps being taken to mitigate such risks.

  17. Correlates of video games playing among adolescents in an Islamic country

    PubMed Central

    2010-01-01

    Background No study has ever explored the prevalence and correlates of video game playing among children in the Islamic Republic of Iran. This study describes patterns and correlates of excessive video game use in a random sample of middle-school students in Iran. Specifically, we examine the relationship between video game playing and psychological well-being, aggressive behaviors, and adolescents' perceived threat of video-computer game playing. Methods This cross-sectional study was performed with a random sample of 444 adolescents recruited from eight middle schools. A self-administered, anonymous questionnaire covered socio-demographics, video gaming behaviors, mental health status, self-reported aggressive behaviors, and perceived side effects of video game playing. Results Overall, participants spent an average of 6.3 hours per week playing video games. Moreover, 47% of participants reported that they had played one or more intensely violent games. Non-gamers reported suffering poorer mental health compared to excessive gamers. Both non-gamers and excessive gamers overall reported suffering poorer mental health compared to low or moderate players. Participants who initiated gaming at younger ages were more likely to score poorer in mental health measures. Participants' self-reported aggressive behaviors were associated with length of gaming. Boys, but not girls, who reported playing video games excessively showed more aggressive behaviors. A multiple binary logistic regression shows that when controlling for other variables, older students, those who perceived less serious side effects of video gaming, and those who have personal computers, were more likely to report that they had played video games excessively. Conclusion Our data show a curvilinear relationship between video game playing and mental health outcomes, with "moderate" gamers faring best and "excessive" gamers showing mild increases in problematic behaviors. Interestingly, "non-gamers" clearly show the worst outcomes. Therefore, both children and parents of non-game players should be updated about the positive impact of moderate video gaming. Educational interventions should also be designed to educate adolescents and their parents of the possible harmful impact of excessive video game playing on their health and psychosocial functioning. PMID:20507610

  18. Correlates of video games playing among adolescents in an Islamic country.

    PubMed

    Allahverdipour, Hamid; Bazargan, Mohsen; Farhadinasab, Abdollah; Moeini, Babak

    2010-05-27

    No study has ever explored the prevalence and correlates of video game playing among children in the Islamic Republic of Iran. This study describes patterns and correlates of excessive video game use in a random sample of middle-school students in Iran. Specifically, we examine the relationship between video game playing and psychological well-being, aggressive behaviors, and adolescents' perceived threat of video-computer game playing. This cross-sectional study was performed with a random sample of 444 adolescents recruited from eight middle schools. A self-administered, anonymous questionnaire covered socio-demographics, video gaming behaviors, mental health status, self-reported aggressive behaviors, and perceived side effects of video game playing. Overall, participants spent an average of 6.3 hours per week playing video games. Moreover, 47% of participants reported that they had played one or more intensely violent games. Non-gamers reported suffering poorer mental health compared to excessive gamers. Both non-gamers and excessive gamers overall reported suffering poorer mental health compared to low or moderate players. Participants who initiated gaming at younger ages were more likely to score poorer in mental health measures. Participants' self-reported aggressive behaviors were associated with length of gaming. Boys, but not girls, who reported playing video games excessively showed more aggressive behaviors. A multiple binary logistic regression shows that when controlling for other variables, older students, those who perceived less serious side effects of video gaming, and those who have personal computers, were more likely to report that they had played video games excessively. Our data show a curvilinear relationship between video game playing and mental health outcomes, with "moderate" gamers faring best and "excessive" gamers showing mild increases in problematic behaviors. Interestingly, "non-gamers" clearly show the worst outcomes. Therefore, both children and parents of non-game players should be updated about the positive impact of moderate video gaming. Educational interventions should also be designed to educate adolescents and their parents of the possible harmful impact of excessive video game playing on their health and psychosocial functioning.

  19. Mental Fatigue: Impairment of Technical Performance in Small-Sided Soccer Games.

    PubMed

    Badin, Oliver O; Smith, Mitchell R; Conte, Daniele; Coutts, Aaron J

    2016-11-01

    To assess the effects of mental fatigue on physical and technical performance in small-sided soccer games. Twenty soccer players (age 17.8 ± 1.0 y, height 179 ± 5 cm, body mass 72.4 ± 6.8 kg, playing experience 8.3 ± 1.4 y) from an Australian National Premier League soccer club volunteered to participate in this randomized crossover investigation. Participants played 15-min 5-vs-5 small-sided games (SSGs) without goalkeepers on 2 occasions separated by 1 wk. Before the SSG, 1 team watched a 30-min emotionally neutral documentary (control), while the other performed 30 min of a computer-based Stroop task (mental fatigue). Subjective ratings of mental and physical fatigue were recorded before and after treatment and after the SSG. Motivation was assessed before treatment and SSG; mental effort was assessed after treatment and SSG. Player activity profiles and heart rate (HR) were measured throughout the SSG, whereas ratings of perceived exertion (RPEs) were recorded before the SSG and immediately after each half. Video recordings of the SSG allowed for notational analysis of technical variables. Subjective ratings of mental fatigue and effort were higher after the Stroop task, whereas motivation for the upcoming SSG was similar between conditions. HR during the SSG was possibly higher in the control condition, whereas RPE was likely higher in the mental-fatigue condition. Mental fatigue had an unclear effect on most physical-performance variables but impaired most technical-performance variables. Mental fatigue impairs technical but not physical performance in small-sided soccer games.

  20. Differential auditory-oculomotor interactions in patients with right vs. left sided subjective tinnitus: a saccade study

    PubMed Central

    Lang, Alexandre; Vernet, Marine; Yang, Qing; Orssaud, Christophe; Londero, Alain; Kapoula, Zoï

    2013-01-01

    Subjective tinnitus (ST) is a frequent but poorly understood medical condition. Recent studies demonstrated abnormalities in several types of eye movements (smooth pursuit, optokinetic nystagmus, fixation, and vergence) in ST patients. The present study investigates horizontal and vertical saccades in patients with tinnitus lateralized predominantly to the left or to the right side. Compared to left sided ST, tinnitus perceived on the right side impaired almost all the parameters of saccades (latency, amplitude, velocity, etc.) and noticeably the upward saccades. Relative to controls, saccades from both groups were more dysmetric and were characterized by increased saccade disconjugacy (i.e., poor binocular coordination). Although the precise mechanisms linking ST and saccadic control remain unexplained, these data suggest that ST can lead to detrimental auditory, visuomotor, and perhaps vestibular interactions. PMID:23550269

  1. Determinants of contraceptives use amongst youth: an exploratory study with family planning service providers in Karachi Pakistan.

    PubMed

    Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Hasnain, Farid Ul

    2013-01-05

    In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers' perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived. Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers' improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area. Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods.

  2. Usability and acceptance evaluation of ACESO: a Web-based breast cancer survivorship tool.

    PubMed

    Kapoor, Akshat; Nambisan, Priya

    2018-06-01

    The specific objective of this research is to design and develop a personalized Web application to support breast cancer survivors after treatment, as they deal with post-treatment challenges, such as comorbidities and side effects of treatment. A mixed-methods approach, utilizing a combination of think-aloud analysis, personal interviews, and surveys, was adopted for user acceptance and usability testing among a group of breast cancer survivors. User feedback was gathered on their perceived value of the application, and any user-interface issues that may hinder the overall usability were identified. The application's portability and capability of organizing their entire breast cancer-related medical history as well as tracking various quality of life indicators were perceived to be valuable features. The application had an overall high usability; however, certain sections of the application were not as intuitive to locate. Visual elements of the website were appreciated; however, overall experience would benefit from incorporating more sociable elements that exhibit positive re-enforcement within the end user and provide a friendlier experience. The results of the study showcase the need for more personalized tools and resources to support survivors in self-management. It also demonstrates the ability to integrate breast cancer survivorship care plans from diverse providers and paves the way to add further value-added features in consumer health applications, such as personal decision support. Using a personal decision support-based tool can serve as a training tool and resource, providing these patients with pertinent information about the various aspects of their long-term health, while educating them about any related side effects and symptoms. It is hoped that making such tools more accessible could help in engaging survivors to play an active role in managing their health and encourage shared decision-making with their providers.

  3. Barriers to Medication Decision Making in Women with Lupus Nephritis: A Formative Study using Nominal Group Technique.

    PubMed

    Singh, Jasvinder A; Qu, Haiyan; Yazdany, Jinoos; Chatham, Winn; Dall'era, Maria; Shewchuk, Richard M

    2015-09-01

    To assess the perspectives of women with lupus nephritis on barriers to medication decision making. We used the nominal group technique (NGT), a structured process to elicit ideas from participants, for a formative assessment. Eight NGT meetings were conducted in English and moderated by an expert NGT researcher at 2 medical centers. Participants responded to the question: "What sorts of things make it hard for people to decide to take the medicines that doctors prescribe for treating their lupus kidney disease?" Patients nominated, discussed, and prioritized barriers to decisional processes involving medications for treating lupus nephritis. Fifty-one women with lupus nephritis with a mean age of 40.6 ± 13.3 years and disease duration of 11.8 ± 8.3 years participated in 8 NGT meetings: 26 African Americans (4 panels), 13 Hispanics (2 panels), and 12 whites (2 panels). Of the participants, 36.5% had obtained at least a college degree and 55.8% needed some help in reading health materials. Of the 248 responses generated (range 19-37 responses/panel), 100 responses (40%) were perceived by patients as having relatively greater importance than other barriers in their own decision-making processes. The most salient perceived barriers, as indicated by percent-weighted votes assigned, were known/anticipated side effects (15.6%), medication expense/ability to afford medications (8.2%), and the fear that the medication could cause other diseases (7.8%). Women with lupus nephritis identified specific barriers to decisions related to medications. Information relevant to known/anticipated medication side effects and medication cost will form the basis of a patient guide for women with systemic lupus erythematosus, currently under development.

  4. Determinants of Contraceptives Use amongst Youth: An Exploratory Study with Family Planning Service Providers in Karachi Pakistan

    PubMed Central

    Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Farid-Ul-Hasnain

    2013-01-01

    Introduction: In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers’ perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Method: Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived. Results: Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers’ improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area. Conclusion: Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods. PMID:23618469

  5. The efficacy of a lidocaine-infused pain pump for postoperative analgesia following elective augmentation mammaplasty or abdominoplasty.

    PubMed

    Chavez-Abraham, Victor; Barr, Jason S; Zwiebel, Paul C

    2011-08-01

    Postoperative pain management following aesthetic plastic surgery traditionally has been achieved by systemic administration of several narcotic pain medications. Because this method can lead to undesirable side effects such as sedation, nausea, vomiting, and respiratory depression, a more efficacious method of postoperative analgesia with fewer side effects needs to be implemented in outpatient cosmetic surgery. From March of 2003 until December of 2008, 690 patients underwent augmentation mammaplasty and 215 patients underwent abdominoplasty. All of these patients were equipped with an elastomeric continuous infusion pump postoperatively and were prescribed oral narcotics. Prior to 2003, patients were prescribed only oral narcotics postoperatively. A retrospective chart review of patients before and after implementation of the pain pump was undertaken to review the perceived pain patients experienced postoperatively with and without the pump. The self-administration of oral narcotics was also assessed. Patients equipped with the pain pump experienced a statistically significant decrease in perceived pain compared to those without the pump (augmentation mammaplasty: 2.27 vs. 3.68, p < 0.05; abdominoplasty: 2.81 vs. 4.32, p < 0.05). Similarly, patients with the pump saw a statistically significant decrease in the use of the oral narcotic Vicodin™ at 72 h postoperatively (5 mg hydrocodone/500 mg acetaminophen, Abbott Laboratories, Abbott Park, IL) (augmentation mammaplasty: 26.5 mg/2650 mg vs. 49 mg/4900 mg, p < 0.01; abdominoplasty: 29.5 mg/2950 mg vs. 56.5 mg/5650 mg, p < 0.01). The utilization of a continuous-infusion pain pump following augmentation mammaplasty or abdominoplasty is an efficacious method to significantly reduce both the amount of pain patients experience and the quantity of narcotics used postoperatively.

  6. Periodic Fluctuation of Perceived Duration

    PubMed Central

    Shima, Shuhei; Murai, Yuki; Yuasa, Kenichi; Hashimoto, Yuki

    2018-01-01

    In recent years, several studies have reported that the allocation of spatial attention fluctuates periodically. This periodic attention was revealed by measuring behavioral performance as a function of cue-to-target interval in the Posner cueing paradigm. Previous studies reported behavioral oscillations using target detection tasks. Whether the influence of periodic attention extends to cognitively demanding tasks remains unclear. To assess this, we examined the effects of periodic attention on the perception of duration. In the experiment, participants performed a temporal bisection task while a cue was presented with various cue-to-target intervals. Perceived duration fluctuated rhythmically as a function of cue-to-target interval at a group level but not at an individual level when the target was presented on the same side as the attentional cue. The results indicate that the perception of duration is influenced by periodic attention. In other words, periodic attention can influence the performance of cognitively demanding tasks such as the perception of duration. PMID:29755719

  7. Flu vaccines and patient decision making: what we need to know.

    PubMed

    Mayo, Ann M; Cobler, Steffanie

    2004-09-01

    To describe and compare patient-perceived barriers and motivators and decision-making conflict between two groups of hospitalized patients, those who received flu vaccines and those who did not. Data collection included extracting data from databases and mailing two surveys to 436 discharged patients. One hundred eight patients participated in the study. Top motivators for obtaining a flu vaccine included previous vaccination (93%) and provider recommendation (62%). Top barriers included fear of side effects from the vaccine (35%) and fear of contracting the flu (30%). Motivators, barriers, and patient decisional conflict differed depending upon the patient's vaccination status. Given the potential negative consequences of contracting the flu, prevention is the best strategy. Prevention is contingent upon motivating patients to obtain an annual flu vaccine. Recommending flu vaccinations, offering vaccinations in convenient locations free of charge, and discussing perceived barriers with patients may increase vaccinations among high-risk patients. Helping to clarify the advantages and disadvantages from the patient's perspective may decrease decisional conflict and increase vaccination rates.

  8. The one that does, leads: action relations influence the perceived temporal order of graspable objects.

    PubMed

    Roberts, Katherine L; Humphreys, Glyn W

    2010-06-01

    Perception and action are influenced by the "possibilities for action" in the environment. Neuropsychological studies (e.g., Riddoch, Humphreys, Edwards, Baker, & Willson, 2003) have demonstrated that objects that are perceived to be interacting (e.g., a corkscrew going toward the top of a wine bottle) are perceptually integrated into a functional unit, facilitating report of both objects. In addition, patients with parietal damage tend to report the "active" item of the pair (the corkscrew in the above example) when the objects are positioned for action, overriding their spatial bias toward the ipsilesional side. Using a temporal order judgment task we show for the first time that normal viewers judge that active objects appear earlier when they are positioned correctly for action. This effect is not dependent on a learned relationship between objects, or on the active object being integrated at a perceptual level with the object it is paired with. The data suggest that actions afforded by a correctly positioned active object permeate normal perceptual judgments.

  9. Acceptability of robotic manipulators in shared working environments through human-like redundancy resolution.

    PubMed

    Zanchettin, Andrea Maria; Bascetta, Luca; Rocco, Paolo

    2013-11-01

    Next generation robotic manipulators are expected to resemble a human-like behavior at kinematic level, in order to reach the same level of dexterity of humans in operations like assembly of small pieces. These manipulators are also expected to share the same working environments with humans without artificial barriers. In this work we conjecture that making robots not only kinematically similar but also able to move and act in the same way as humans do, might facilitate their social acceptance. For this the kinematic redundancy of such new generation manipulators can be exploited. An experimental campaign has been organized to assess the physiological comfort/discomfort perceived by humans working side-by-side with robots. For comparison, a human-like and two alternative redundancy resolution strategies have been implemented. The analysis confirmed the hypothesis that a human-like motion of the robot helps in facilitating social acceptance, by reducing the perceived stress by humans in human-robot coexistence. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  10. Concerns with AED conversion: comparison of patient and physician perspectives.

    PubMed

    Smith, Brien J; St Louis, Erik K; Stern, John M; Green, Chad; Bramley, Thomas

    2009-06-01

    When discussing AED conversion in the clinic, both the patient and physician perspectives on the goals and risks of this change are important to consider. To identify patient-reported and clinician-perceived concerns, a panel of epilepsy specialists was questioned about the topics discussed with patients and the clinician's perspective of patient concerns. Findings of a literature review of articles that report patient-expressed concerns regarding their epilepsy and treatment were also reviewed. Results showed that the specialist panel appropriately identified patient-reported concerns of driving ability, medication cost, seizure control, and medication side effects. Additionally, patient-reported concerns of independence, employment issues, social stigma, medication dependence, and undesirable cognitive effects are important to address when considering and initiating AED conversion.

  11. The other side of the coin: perceived positive effects of illness in women following acute myocardial infarction.

    PubMed

    Norekvål, Tone M; Moons, Philip; Hanestad, Berit R; Nordrehaug, Jan E; Wentzel-Larsen, Tore; Fridlund, Bengt

    2008-03-01

    Although myocardial infarction (MI) is linked with both physical and psychological impairments, the possibility of patients also experiencing positive outcomes of MI has received far less attention in research and in clinical practice. In particular, this aspect has been under-investigated in older persons and in women. The purpose of this study was to investigate possible positive effects of illness, describe the patient characteristics and explore the nature and frequency of these effects in older women after MI. A cross-sectional postal survey was conducted in 145 women aged 62-80 years, three months to five years after MI. Self-reported socio-demographic and clinical data, in addition to data from medical records, were collected. A single-item question--"All in all, was there anything positive about experiencing an MI?"--was used to assess positive effects of illness, in addition to an open-ended question on the nature of possible positive effects. A majority of the women (65%) reported positive effects from their MI experience. The women perceiving positive effects did not differ from those who did not on socio-demographic and clinical variables, except for being older (p=0.007) and less often readmitted (p=0.029). The groups did not differ significantly as to disease severity and time since MI. Four themes emerged from the open-ended questioning on the nature of perceived positive effects of the illness: Appreciating Life (55%), Getting Health Care (42%), Making Lifestyle Changes (36%), and Taking More Care of Self and Others (29%). The findings contribute to a more complete picture of psychosocial issues in women after MI by providing evidence that positive effects are often experienced despite physical limitations. Nurses may use this knowledge as a tool in patient education and communication, although further research is needed to determine the most optimal interventions for MI patients.

  12. Are perceived stress, depressive symptoms and religiosity associated with alcohol consumption? A survey of freshmen university students across five European countries

    PubMed Central

    2012-01-01

    Background The aim of this study was to investigate the association of perceived stress, depressive symptoms and religiosity with frequent alcohol consumption and problem drinking among freshmen university students from five European countries. Methods 2529 university freshmen (mean age 20.37, 64.9% females) from Germany (n = 654), Poland (n = 561), Bulgaria (n = 688), the UK (n = 311) and Slovakia (n = 315) completed a questionnaire containing the modified Beck Depression Inventory for measuring depressive symptoms, the Cohen’s perceived stress scale for measuring perceived stress, the CAGE-questionnaire for measuring problem drinking and questions concerning frequency of alcohol use and the personal importance of religious faith. Results Neither perceived stress nor depressive symptoms were associated with a high frequency of drinking (several times per week), but were associated with problem drinking. Religiosity (personal importance of faith) was associated with a lower risk for both alcohol-related variables among females. There were also country differences in the relationship between perceived stress and problem drinking. Conclusion The association between perceived stress and depressive symptoms on the one side and problem drinking on the other demonstrates the importance of intervention programs to improve the coping with stress. PMID:22640549

  13. Perceived Risks Associated with Contraceptive Method Use among Men and Women in Ibadan and Kaduna, Nigeria.

    PubMed

    Schwandt, Hilary M; Skinner, Joanna; Hebert, Luciana E; Saad, Abdulmumin

    2015-12-01

    Research shows that side effects are often the most common reason for contraceptive non-use in Nigeria; however, research to date has not explored the underlying factors that influence risk and benefit perceptions associated with specific contraceptive methods in Nigeria. A qualitative study design using focus group discussions was used to explore social attitudes and beliefs about family planning methods in Ibadan and Kaduna, Nigeria. A total of 26 focus group discussions were held in 2010 with men and women of reproductive age, disaggregated by city, sex, age, marital status, neighborhood socioeconomic status, and--for women only--family planning experience. A discussion guide was used that included specific questions about the perceived risks and benefits associated with the use of six different family planning methods. A thematic content analytic approach guided the analysis. Participants identified a spectrum of risks encompassing perceived threats to health (both real and fictitious) and social concerns, as well as benefits associated with each method. By exploring Nigerian perspectives on the risks and benefits associated with specific family planning methods, programs aiming to increase contraceptive use in Nigeria can be better equipped to highlight recognized benefits, address specific concerns, and work to dispel misperceptions associated with each family planning method.

  14. Informed consent procedures: responsibilities of researchers in developing countries.

    PubMed

    Sanchez, S; Salazar, G; Tijero, M; Diaz, S

    2001-10-01

    We describe the informed consent procedures in a research clinic in Santiago, Chile, and a qualitative study that evaluated these procedures. The recruitment process involves information, counseling and screening of volunteers, and three or four visits to the clinic. The study explored the decision-making process of women participating in contraceptive trials through 36 interviews. Women understood the research as experimentation or progress. The decision to participate was facilitated by the information provided; time to consider it and to discuss it with partners or relatives; and perceived benefits such as quality of care, non-cost provision of methods and medical care. For some women, participation was an opportunity to express altruism. The main obstacles for participation were perceived side effects or risks. The final risk-benefit balance was strongly influenced by women's needs. Women perceived that the consent form benefited the clinic, proving that participants had made a free decision, and benefited the volunteers by warranting their right to free medical care. The most important problem detected was occasional misunderstanding of the information given on the form. We concluded that a full decision-making process enhances women's ability to exercise their right to choose, and assures research institutions that trials are conducted without coercion and that the participants are committed to the study. Researchers have the responsibility of conducting this process.

  15. I Am Right, You Are Wrong: How Biased Assimilation Increases the Perceived Gap between Believers and Skeptics of Violent Video Game Effects

    PubMed Central

    Greitemeyer, Tobias

    2014-01-01

    Background Despite hundreds of studies, there is continuing debate about the extent to which violent video games increase aggression. Believers argue that playing violent video games increases aggression, but this stance is disputed by skeptics. The present study addressed believers' and skeptics' responses to summaries of scientific studies that do or do not present evidence for increased aggression after violent video game play. Methods/Principal Findings Participants (N = 662) indicated whether they believed that violent video games increase aggression. Afterwards, they evaluated two opposing summaries of fictitious studies on the effects of violent video play. They also reported whether their initial belief had changed after reading the two summaries and indicated again whether they believed that violent video games increase aggression. Results showed that believers evaluated the study showing an effect more favorably than a study showing no effect, whereas the opposite was observed for skeptics. Moreover, both believers and skeptics reported to become more convinced of their initial view. In contrast, for actual attitude change, a depolarization effect was found. Conclusions/Significance These results suggest that biased assimilation of new information leads believers and skeptics to become more rather than less certain of their views. Hence, even when confronted with mixed and inconclusive evidence, the perceived gap between both sides of the argument increases. PMID:24722467

  16. I am right, you are wrong: how biased assimilation increases the perceived gap between believers and skeptics of violent video game effects.

    PubMed

    Greitemeyer, Tobias

    2014-01-01

    Despite hundreds of studies, there is continuing debate about the extent to which violent video games increase aggression. Believers argue that playing violent video games increases aggression, but this stance is disputed by skeptics. The present study addressed believers' and skeptics' responses to summaries of scientific studies that do or do not present evidence for increased aggression after violent video game play. Participants (N = 662) indicated whether they believed that violent video games increase aggression. Afterwards, they evaluated two opposing summaries of fictitious studies on the effects of violent video play. They also reported whether their initial belief had changed after reading the two summaries and indicated again whether they believed that violent video games increase aggression. Results showed that believers evaluated the study showing an effect more favorably than a study showing no effect, whereas the opposite was observed for skeptics. Moreover, both believers and skeptics reported to become more convinced of their initial view. In contrast, for actual attitude change, a depolarization effect was found. These results suggest that biased assimilation of new information leads believers and skeptics to become more rather than less certain of their views. Hence, even when confronted with mixed and inconclusive evidence, the perceived gap between both sides of the argument increases.

  17. Health and doping in elite-level cycling.

    PubMed

    Lentillon-Kaestner, V; Hagger, M S; Hardcastle, S

    2012-10-01

    The protection of the health of athletes is one of the three criteria taken into account when registering a substance in the World Anti-Doping Agency prohibited list. Nevertheless, in elite-level cycling, banned substance use is widespread. The present research adopted a psychological approach to examine how or whether perceived health risks influence elite-level cyclists' decisions to use banned substances. Sixteen semi-structured interviews were conducted with cyclists hoping to join a professional team (n=6), neo-professional cyclists (n=2), and former professional cyclists (n=8). Although an evolution was observed in the organization of doping and perceptions of doping over the last decade, the perceived health hazards did not influence, most of the time, decisions to use banned substances among the sample of cyclists. There was a systematization of exogenous substance use in the cycling environment and a trivialization of the side effects of the banned substances. Finally, younger cyclists were not concerned about the long-term health consequences of banned substances; they were more focused on the short-term performance-enhancing benefits. There is a need to implement more effective preventive programs to change athletes' attitudes toward doping and its health risks. © 2011 John Wiley & Sons A/S.

  18. Neural evidence for competition-mediated suppression in the perception of a single object.

    PubMed

    Cacciamani, Laura; Scalf, Paige E; Peterson, Mary A

    2015-11-01

    Multiple objects compete for representation in visual cortex. Competition may also underlie the perception of a single object. Computational models implement object perception as competition between units on opposite sides of a border. The border is assigned to the winning side, which is perceived as an object (or "figure"), whereas the other side is perceived as a shapeless ground. Behavioral experiments suggest that the ground is inhibited to a degree that depends on the extent to which it competed for object status, and that this inhibition is relayed to low-level brain areas. Here, we used fMRI to assess activation for ground regions of task-irrelevant novel silhouettes presented in the left or right visual field (LVF or RVF) while participants performed a difficult task at fixation. Silhouettes were designed so that the insides would win the competition for object status. The outsides (grounds) suggested portions of familiar objects in half of the silhouettes and novel objects in the other half. Because matches to object memories affect the competition, these two types of silhouettes operationalized, respectively, high competition and low competition from the grounds. The results showed that activation corresponding to ground regions was reduced for high- versus low-competition silhouettes in V4, where receptive fields (RFs) are large enough to encompass the familiar objects in the grounds, and in V1/V2, where RFs are much smaller. These results support a theory of object perception involving competition-mediated ground suppression and feedback from higher to lower levels. This pattern of results was observed in the left hemisphere (RVF), but not in the right hemisphere (LVF). One explanation of the lateralized findings is that task-irrelevant silhouettes in the RVF captured attention, allowing us to observe these effects, whereas those in the LVF did not. Experiment 2 provided preliminary behavioral evidence consistent with this possibility. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. The Effect of Recovery Duration on Vastus Lateralis Oxygenation, Heart Rate, Perceived Exertion and Time Motion Descriptors during Small Sided Football Games.

    PubMed

    McLean, Scott; Kerhervé, Hugo; Lovell, Geoff P; Gorman, Adam D; Solomon, Colin

    2016-01-01

    Small sided games (SSG) of football are an effective and efficient format to simultaneously train the physiological, technical, and tactical components of football. The duration of the recovery period between bouts of SSG will affect the physiological response to subsequent bouts. It was hypothesised that decreasing the duration of recovery periods separating serial SSG bouts would increase physiological, and perceptual responses, and decrease high speed running, and distance during SSG bouts. Twelve experienced footballers (mean ± SD; age 21 ± 3 yrs; VO2peak 64 ± 7 ml·min·kg-1; playing experience 15 ± 3 yrs) completed two SSG sessions. Each SSG consisted of 3 vs. 3 players and 6 bouts of 2 min duration, with bouts separated by either 30 s recovery (REC-30) or 120 s recovery (REC-120). Deoxygenated haemoglobin (HHb) in the vastus lateralis (VL) (using near infrared spectroscopy), heart rate (HR) and time motion descriptors (TMD) (speed and distance) were measured continuously during the SSG sessions and perceived exertion (RPE) was measured for each bout. During the recovery periods, in REC-30 compared to REC-120, there was a significant (p < 0.05) main effect of a higher HHb and HR. During the bouts, in REC-30 compared to REC-120, there were no significant differences in HHb, HR, RPE, or TMD, but within both REC-30 and REC-120 there were significant increases as a function of bout number in RPE. Although a four-fold increase in recovery period allowed a significant increase in the recovery of HHb and HR, this did not increase the physiological, and perceptual responses, or time motion descriptors during the bouts. These results could have been due to the regulation of effort (pacing), in these experienced players performing an exercise task to which they were well adapted.

  20. Awareness of preventive medication among women at high risk for breast cancer and their willingness to consider transdermal or oral tamoxifen: a focus group study.

    PubMed

    Karavites, Lindsey C; Allu, Subhashini; Khan, Seema A; Kaiser, Karen

    2015-11-09

    Despite demonstrated efficacy, acceptance of selective estrogen receptor modulators (SERMs), such as tamoxifen, for breast cancer risk reduction remains low. Delivering SERMs via local transdermal therapy (LTT) could significantly reduce systemic effects and therefore may increase acceptance. We aim to assess women's knowledge of breast cancer prevention medications and views on LTT of SERMs. Focus groups were conducted with healthy women identified through the comprehensive breast center of a large urban cancer institution. Group discussions covered risk perceptions, knowledge of and concerns about risk reducing medications. Participants reported their perceived risk for breast cancer (average, below/above average), preference for SERMs in a pill or gel form, risk factors, and prior physician recommendations regarding risk-reducing medicines. Participants' breast cancer risk was estimated using tools based on the Gail Model. Trained personnel examined all qualitative results systematically; risk perceptions and preferred method of medication delivery were tallied quantitatively. Four focus groups (N = 32) were conducted. Most participants had at least a college degree (78.2 %) and were of European (50 %) or African ancestry (31 %). The majority (72 %) were at elevated risk for breast cancer; approximately half of these women perceived themselves to be at elevated risk. Few participants had prior knowledge of preventive medications. The women noted a number of concerns about LTT, including dosage, impact on day-to-day life, and side effects; nonetheless, over 90 % of the women stated they would prefer LTT to a pill. Awareness of preventive medications was low even in a highly educated sample of high-risk women. If given a choice in the route of administration, most women preferred a gel to a pill, anticipating fewer side effects. Future work should focus on demonstrating equivalent efficacy and reduced toxicity of topical over oral medications and on raising awareness of chemopreventive options for breast cancer.

  1. The Effect of Recovery Duration on Vastus Lateralis Oxygenation, Heart Rate, Perceived Exertion and Time Motion Descriptors during Small Sided Football Games

    PubMed Central

    McLean, Scott; Kerhervé, Hugo; Lovell, Geoff P.; Gorman, Adam D.; Solomon, Colin

    2016-01-01

    Purpose Small sided games (SSG) of football are an effective and efficient format to simultaneously train the physiological, technical, and tactical components of football. The duration of the recovery period between bouts of SSG will affect the physiological response to subsequent bouts. It was hypothesised that decreasing the duration of recovery periods separating serial SSG bouts would increase physiological, and perceptual responses, and decrease high speed running, and distance during SSG bouts. Methods Twelve experienced footballers (mean ± SD; age 21 ± 3 yrs; VO2peak 64 ± 7 ml·min·kg−1; playing experience 15 ± 3 yrs) completed two SSG sessions. Each SSG consisted of 3 vs. 3 players and 6 bouts of 2 min duration, with bouts separated by either 30 s recovery (REC-30) or 120 s recovery (REC-120). Deoxygenated haemoglobin (HHb) in the vastus lateralis (VL) (using near infrared spectroscopy), heart rate (HR) and time motion descriptors (TMD) (speed and distance) were measured continuously during the SSG sessions and perceived exertion (RPE) was measured for each bout. Results During the recovery periods, in REC-30 compared to REC-120, there was a significant (p < 0.05) main effect of a higher HHb and HR. During the bouts, in REC-30 compared to REC-120, there were no significant differences in HHb, HR, RPE, or TMD, but within both REC-30 and REC-120 there were significant increases as a function of bout number in RPE. Conclusions Although a four-fold increase in recovery period allowed a significant increase in the recovery of HHb and HR, this did not increase the physiological, and perceptual responses, or time motion descriptors during the bouts. These results could have been due to the regulation of effort (pacing), in these experienced players performing an exercise task to which they were well adapted. PMID:26919064

  2. A pharmacy student's role as a teaching assistant in an undergraduate medicinal chemistry course - Implementation, evaluation, and unexpected opportunities for educational outreach.

    PubMed

    DellaVecchia, Matthew J; Claudio, Alyssa M; Fairclough, Jamie L

    2017-11-01

    To describe 1) a pharmacy student's teaching assistant (TA) role in an undergraduate medicinal chemistry course, 2) an active learning module co-developed by the TA and instructor, and 3) the unexpected opportunities for pharmacy educational outreach that resulted from this collaboration. Medicinal Chemistry (CHM3413) is an undergraduate course offered each fall at Palm Beach Atlantic University (PBA). As a TA for CHM3413, a pharmacy student from the Gregory School of Pharmacy (GSOP) at PBA co-developed and implemented an active learning module emphasizing foundational medicinal chemistry concepts as they pertain to performance enhancing drugs (PEDs). Surveys assessed undergraduate students' perceived knowledge of medicinal chemistry concepts, PEDs, and TA involvement. Students' (total n = 60, three fall semesters) perceived confidence in knowledge of medicinal chemistry concepts and PEDs increased significantly (p < 0.001) after the TA's module. Nearly 93% of students acknowledged this was their first interaction with a TA at PBA, ~ 82% "agreed/strongly agreed" that the TA provided effective instruction, and ~ 62% "agreed/strongly agreed" that TA availability raised overall confidence in CHM3413. Unexpected "side-effects" of this collaboration included opportunities for the TA and instructor to discuss health risks associated with PED usage with student-athletes and coaches at PBA. This collaboration developed the pharmacy student's teaching skills and reinforced knowledge of foundational pharmaceutical science concepts for both the TA and undergraduate students. Unexpected "side-effects" that resulted from this collaboration included opportunities for the TA and instructor to discuss health risks associated with PED usage with student-athletes in PBA's athletic department. Educational/interprofessional outreach opportunities resulted from a pharmacy student TA's involvement in an undergraduate medicinal chemistry course. An advanced pharmacy practice experience elective in sports pharmacy (based on Ambrose's model) begins Fall 2017. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Towards large-scale deployment of bifacial photovoltaics

    NASA Astrophysics Data System (ADS)

    Kopecek, R.; Libal, J.

    2018-06-01

    Low photovoltaic module costs imply that increasing the energy yield per module area is now a priority. We argue that modules harvesting sunlight from both sides will strongly penetrate the market but that more field data, better simulation tools and international measurement standards are needed to overcome perceived investment risks.

  4. Lack of body positional effects on paresthesias when stimulating the dorsal root ganglion (DRG) in the treatment of chronic pain.

    PubMed

    Kramer, Jeffery; Liem, Liong; Russo, Marc; Smet, Iris; Van Buyten, Jean-Pierre; Huygen, Frank

    2015-01-01

    One prominent side effect from neurostimulation techniques, and in particular spinal cord stimulation (SCS), is the change in intensity of stimulation when moving from an upright (vertical) to a recumbent or supine (horizontal) position and vice versa. It is well understood that the effects of gravity combined with highly conductive cerebrospinal fluid provide the mechanism by which changes in body position can alter the intensity of stimulation-induced paresthesias. While these effects are well established for leads that are placed within the more medial aspects of the spinal canal, little is known about these potential effects in leads placed in the lateral epidural space and in particular within the neural foramina near the dorsal root ganglion (DRG). We prospectively validated a newly developed paresthesia intensity rating scale and compared perceived paresthesia intensities when subjects assumed upright vs. supine bodily positions during neuromodulation of the DRG. On average, the correlation coefficient between stimulation intensity (pulse amplitude) and perceived paresthesia intensity was 0.83, demonstrating a strong linear relationship. No significant differences in paresthesia intensities were reported within subjects when moving from an upright (4.5 ± 0.14) to supine position 4.5 (± 0.12) (p > 0.05). This effect persisted through 12 months following implant. Neuromodulation of the DRG produces paresthesias that remain consistent across body positions, suggesting that this paradigm may be less susceptible to positional effects than dorsal column stimulation. © 2014 International Neuromodulation Society.

  5. Innovative approach to the design and evaluation of treatment adherence interventions for drug-resistant TB.

    PubMed

    Alegria-Flores, K; Weiner, B J; Wiesen, C A; Lich, K L H; Van Rie, A; Paul, J E; Tovar, M A

    2017-11-01

    Drug-resistant tuberculosis (DR-TB) treatment is expensive, lengthy, and can cause severe side effects. Patients face socio-economic, psychosocial, and systemic barriers to adherence; poor adherence results in poor treatment outcomes. To estimate the effects of the components of the information-motivation-behavioral skills model on DR-TB treatment adherence. We recruited 326 adults receiving DR-TB treatment and 86 of their health care service providers from 40 health centers in Lima, Peru. The main outcome was adherence (i.e., the proportion of prescribed doses taken by a patient). Exposure measures were adherence information, motivation, and behavioral skills; loss to follow-up during previous TB treatment(s); providers' work engagement; and patient-perceived support from his/her social network. Structural equation modeling revealed that adherence information and motivation had positive effects on adherence, but only if mediated through behavioral skills (β = 0.02, P < 0.01 and β = 0.07, P < 0.001, respectively). Behavioral skills had a direct positive effect on adherence (β = 0.27, P < 0.001). Loss to follow-up during previous treatment had a direct negative effect, providers' work engagement had a direct positive effect, and perceived support had indirect positive effects on adherence. The model's overall R2 was 0.76. The components of the information-motivation-behavioral skills model were associated with adherence and could be used to design, monitor, and evaluate interventions targeting adherence to DR-TB treatment.

  6. Treatment hurts: Lay theories of graded exposure in the treatment of four anxiety disorders

    PubMed Central

    Furnham, Adrian; Wilson, Emma; Chapman, Amy; Persuad, Raj

    2013-01-01

    Objective This paper concerned the perceived suffering/side effects caused by various well-known treatments for personal problems. It looked at whether people understood whether potentially painful treatments that confront negative aversive affect were effective or not. Method In total, 106 participants completed a long questionnaire assessing the ‘psychological pain’ ratings of 30 psychotherapy treatments, varying in fear exposure, for four relatively common anxiety disorders: social phobia, agoraphobia, post-traumatic stress disorder, and obsessive compulsive disorder. Results Factor analytic results revealed four clear factors underlying lay efficacy beliefs of psychotherapy interventions, varying in fear exposure: talking therapies, fear confrontation, fear avoidance, and alternative therapies. Talking therapies were rated the most effective across all disorders, but also the most painful. Fear avoidance therapies were rated the least effective and, along with alternative medicine, the least painful. Treatments involving fear exposure were rated the most painful. Regression analysis revealed talking therapies to be rated more efficacious by younger subjects than older subjects. Conclusion Most people seem able to differentiate between the efficacies of interventions for different anxiety disorders and hold consensually held optimistic conceptions about the usefulness of psychotherapy treatments and counseling that involve fear exposure, despite knowledge of the psychophysical side effects that these therapies often entail. They favored talking cures over others, but that may have been due to misleading items in the questionnaire. PMID:26405431

  7. Central nervous system stimulants and sport practice

    PubMed Central

    Avois, L; Robinson, N; Saudan, C; Baume, N; Mangin, P; Saugy, M

    2006-01-01

    Background and objectives Central nervous system (CNS) stimulants may be used to reduce tiredness and increase alertness, competitiveness, and aggression. They are more likely to be used in competition but may be used during training to increase the intensity of the training session. There are several potential dangers involving their misuse in contact sports. This paper reviews the three main CNS stimulants, ephedrine, amfetamine, and cocaine, in relation to misuse in sport. Methods Description of the pharmacology, actions, and side effects of amfetamine, cocaine, and ephedrine. Results CNS stimulants have psychotropic effects that may be perceived to be ergogenic. Some are prescription drugs, such as Ephedra alkaloids, and there are issues regarding their appropriate therapeutic use. Recently attention has been given to their widespread use by athletes, despite the lack of evidence regarding any ergogenic or real performance benefit, and their potentially serious side effects. Recreational drugs, some of which are illegal (cocaine, amfetamines), are commonly used by athletes and cause potential ergolytic effects. Overall, these drugs are important for their frequent use and mention in anti‐doping laboratories statistics and the media, and their potentially serious adverse effects. Conclusions Doping with CNS stimulants is a real public health problem and all sports authorities should participate in its prevention. Dissemination of information is essential to prevent doping in sport and to provide alternatives. Adequate training and education in this domain should be introduced. PMID:16799095

  8. Complementary therapy use by women's health clinic clients.

    PubMed

    Pettigrew, Amy C; King, Margaret O'Brien; McGee, Karen; Rudolph, Connie

    2004-01-01

    While it is known that more women than men use complementary and alternative therapies, it is important to look at women who are pregnant or possibly receiving hormonal therapy, as side effects and consequences of these therapies may have a significant effect on their health status. To assess women's knowledge, perceived effectiveness and use of 20 complementary and alternative therapies. Descriptive four-page questionnaire to obtain data on the use, reason for use, knowledge, perceived effectiveness, and sources of information of twenty complementary and alternative therapies. Women's Health Center at a large Midwestern hospital. A convenience sample of 250 women waiting to be seen by either a nurse midwife or obstetrician/gynecologist at an outpatient clinic. Sixty-nine percent of the participants used one or more complementary therapy. The most frequently used therapies included prayer, vitamins, massage, diet, and aromatherapy. The best predictor of use of each therapy was the participant's knowledge of the therapy. Participants generally rated the efficacy of the therapies higher than their knowledge level. Frequently cited sources of information were popular media and family. The least common information sources were nurse-midwives, drug stores, Internet, and other professional healthcare providers. Women in this setting use complementary therapies at a rate greater than the general population. The participants obtained a great deal of their information about the therapies from popular press, media, friends, and family members rather than from licensed healthcare providers.

  9. Horizontally progressive mirror for blind spot detection in automobiles.

    PubMed

    Lee, Hocheol; Kim, Dohyun; Yi, Sung

    2013-02-01

    The blind spot of automobiles has been a critical issue in driving safety performance. Side mirrors that use an aspheric shape to achieve a wider angle rather than conventional spherical or flat mirrors have been recently permitted from European Union safety regulations. However, these mirrors also cause difficulty in perceiving the speed and distance of an approaching vehicle in the aspheric mirror zones with their decreasing radii of curvature. We demonstrated new side mirrors showing a stable vehicle image by inserting a horizontally progressive zone between the two outer spherical zones used for the far and near views.

  10. Knowledge and perceptions of the risks of non-steroidal anti-inflammatory drugs among orthopaedic patients in Thailand.

    PubMed

    Phueanpinit, Pacharaporn; Pongwecharak, Juraporn; Krska, Janet; Jarernsiripornkul, Narumol

    2016-10-01

    Background There is a high incidence of adverse effects from non-steroidal antiinflammatory drugs (NSAIDs) in Thailand, but patients' perceptions and knowledge of NSAID risks is unknown. Objective This study aims to assess patients' perceptions and knowledge of NSAID risks and factors affecting them. Setting University hospital in North-East of Thailand. Method A Cross-sectional study conducted over 4 months, using a self-administered questionnaire. Patients prescribed NSAIDs for at least one month duration from orthopaedic clinic were recruited using systematic random sampling. Main outcome measure Patients' perceptions on NSAID risks, knowledge on risk factors, and their associated factors. Results A total of 474 questionnaires were assessed. Overall perceptions of risks was low (scoring below five on a 0-10 visual analogue scale), with risks associated with the renal system scoring highest. Perceived risk of gastrointestinal problems differed between patients using non-selective and selective NSAIDs (3.47 ± 2.75 vs 2.06 ± 2.98; P < 0.001). Receiving side effect information from a health professional was associated with higher risk perception. Most patients (80 %) identified high doses, renal disease and gastrointestinal ulcer increased risks of NSAIDs, but fewer than half recognized that use in the elderly, multiple NSAID use, drinking, hypertension and cardiovascular disease also increased risk of adverse events. Having underlying diseases and receiving side effect information were associated with 1.6-2.0 fold increased knowledge of NSAID risks. Conclusion Perceptions and knowledge concerning NSAID risks was generally low in Thai patients, but higher in those who had received side effect information. Risk-related information should be widely provided, especially in high-risk patients.

  11. Orienting attention in visual space by nociceptive stimuli: investigation with a temporal order judgment task based on the adaptive PSI method.

    PubMed

    Filbrich, Lieve; Alamia, Andrea; Burns, Soline; Legrain, Valéry

    2017-07-01

    Despite their high relevance for defending the integrity of the body, crossmodal links between nociception, the neural system specifically coding potentially painful information, and vision are still poorly studied, especially the effects of nociception on visual perception. This study investigated if, and in which time window, a nociceptive stimulus can attract attention to its location on the body, independently of voluntary control, to facilitate the processing of visual stimuli occurring in the same side of space as the limb on which the visual stimulus was applied. In a temporal order judgment task based on an adaptive procedure, participants judged which of two visual stimuli, one presented next to either hand in either side of space, had been perceived first. Each pair of visual stimuli was preceded (by 200, 400, or 600 ms) by a nociceptive stimulus applied either unilaterally on one single hand, or bilaterally, on both hands simultaneously. Results show that, as compared to the bilateral condition, participants' judgments were biased to the advantage of the visual stimuli that occurred in the same side of space as the hand on which a unilateral, nociceptive stimulus was applied. This effect was present in a time window ranging from 200 to 600 ms, but importantly, biases increased with decreasing time interval. These results suggest that nociceptive stimuli can affect the perceptual processing of spatially congruent visual inputs.

  12. Objective and subjective methods for quantifying training load in wheelchair basketball small-sided games.

    PubMed

    Iturricastillo, Aitor; Granados, Cristina; Los Arcos, Asier; Yanci, Javier

    2017-04-01

    The aim of the present study was to analyse the training load in wheelchair basketball small-sided games and determine the relationship between heart rate (HR)-based training load and perceived exertion (RPE)-based training load methods among small-sided games bouts. HR-based measurements of training load included Edwards' training load and Stagno's training impulses (TRIMP MOD ) while RPE-based training load measurements included cardiopulmonary (session RPEres) and muscular (session RPEmus) values. Data were collected from 12 wheelchair basketball players during five consecutive weeks. The total load for the small-sided games sessions was 67.5 ± 6.7 and 55.3 ± 12.5 AU in HR-based training load (Edwards' training load and TRIMP MOD ), while the RPE-based training loads were 99.3 ± 26.9 (session RPEres) and 100.8 ± 31.2 AU (session RPEmus). Bout-to-bout analysis identified greater session RPEmus in the third [P < 0.05; effect size (ES) = 0.66, moderate] and fourth bouts (P < 0.05; ES = 0.64, moderate) than in the first bout, but other measures did not differ. Mean correlations indicated a trivial and small relationship among HR-based and RPE-based training loads. It is suggested that HR-based and RPE-based training loads provide different information, but these two methods could be complementary because one method could help us to understand the limitations of the other.

  13. Clashing Views on Controversial Bioethical Issues. Third Edition. Taking Sides.

    ERIC Educational Resources Information Center

    Levine, Carol, Ed.

    The student who has thoughtfully examined opposing viewpoints on an issue should perceive what other position can be occupied on that issue and should learn to carefully consider antithetical viewpoints. The development of this critical approach is the purpose of this book. An introduction, postscript summary, and two articles or published…

  14. Clashing Views on Controversial Environmental Issues. Third Edition. Taking Sides.

    ERIC Educational Resources Information Center

    Goldfarb, Theodore D., Ed.

    The student who has thoughtfully examined opposing viewpoints on an issue should perceive what other position can be occupied on that issue and should learn to carefully consider antithetical viewpoints. The development of this critical approach is the purpose of this book. An introduction, postscript summary, and pro and con articles or published…

  15. The Dark Side of Motivation: Teachers' Perspectives on "Unmotivation"

    ERIC Educational Resources Information Center

    Sakui, Keiko; Cowie, Neil

    2012-01-01

    Motivation is a well-researched construct; however, few studies have investigated how teachers perceive and make sense of situations in which learners are not motivated to learn. Thirty-two EFL teachers working in Japanese universities were surveyed and interviews with three of these teachers were conducted to reveal their perceptions of student…

  16. A Bright Side to the Work-Family Interface: Husbands' Support as a Resource in Double-and-Triple-Duty Caregiving Wives' Work Lives.

    PubMed

    DePasquale, Nicole; Polenick, Courtney A; Davis, Kelly D; Berkman, Lisa F; Cabot, Thomas D

    2017-06-16

    This study examined how women who combine long-term care employment with unpaid, informal caregiving roles for children (double-duty-child caregivers), older adults (double-duty-elder caregivers), and both children and older adults (triple-duty caregivers) differed from their workplace-only caregiving counterparts on workplace factors related to job retention (i.e., job satisfaction and turnover intentions) and performance (i.e., perceived obligation to work while sick and emotional exhaustion). The moderating effects of perceived spouse support were also examined. Regression analyses were conducted on survey data from 546 married, heterosexual women employed in U.S.-based nursing homes. Compared to workplace-only caregivers, double-duty-elder and triple-duty caregivers reported more emotional exhaustion. Double-duty-child caregivers reported lower turnover intentions and both double-and-triple-duty caregivers felt less obligated to work while sick when perceiving greater support from husbands. Results indicate that double-and-triple-duty caregiving women's job retention and obligation to work while sick may depend on perceived spouse support, highlighting the important role husbands play in their wives' professional lives. Findings also lend support to the emerging literature on marriage-to-work positive spillover, and suggest that long-term care organizations should target marital relationships in family-friendly initiatives to retain and engage double-and-triple-duty caregiving employees. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Consumer Perception of Inpatient Medical Services

    PubMed Central

    Takase, Kozo

    2016-01-01

    Although it is currently popular to reflect consumers’ perspectives to medical service management, insufficient attempts have been made to understand detailed perception of the consumer side of medical services to promote medical services’ evaluation from the consumer viewpoint. The aim of this study was to descriptively reveal how consumers perceive medical services that they receive, focusing on inpatient medical services. We conducted semi-structured interviews with 10 adults who experienced hospitalization of five or more days. Constant comparative analysis was performed on the obtained descriptive data. We identified 1) medical procedures, 2) explanations from medical professionals, 3) behavior of medical service providers, 4) somatic sensations, and 5) self-perceived physical conditions as target factors that medical service consumers perceived during hospitalization. The response to the perceived target factors, “compared with the expectation that the consumer had before the hospitalization,” suggests that it is an important medical service consumer reaction to check if the service met their expectations for perceived factors. The response to the medical services perception targets suggested that medical service consumers are involved in medical services and interested in various perception targets. The expectations that medical service consumers have prior to hospitalization can largely influence inpatient medical services evaluation. PMID:27832165

  18. Network and User-Perceived Performance of Web Page Retrievals

    NASA Technical Reports Server (NTRS)

    Kruse, Hans; Allman, Mark; Mallasch, Paul

    1998-01-01

    The development of the HTTP protocol has been driven by the need to improve the network performance of the protocol by allowing the efficient retrieval of multiple parts of a web page without the need for multiple simultaneous TCP connections between a client and a server. We suggest that the retrieval of multiple page elements sequentially over a single TCP connection may result in a degradation of the perceived performance experienced by the user. We attempt to quantify this perceived degradation through the use of a model which combines a web retrieval simulation and an analytical model of TCP operation. Starting with the current HTTP/l.1 specification, we first suggest a client@side heuristic to improve the perceived transfer performance. We show that the perceived speed of the page retrieval can be increased without sacrificing data transfer efficiency. We then propose a new client/server extension to the HTTP/l.1 protocol to allow for the interleaving of page element retrievals. We finally address the issue of the display of advertisements on web pages, and in particular suggest a number of mechanisms which can make efficient use of IP multicast to send advertisements to a number of clients within the same network.

  19. Perceived face size in healthy adults.

    PubMed

    D'Amour, Sarah; Harris, Laurence R

    2017-01-01

    Perceptual body size distortions have traditionally been studied using subjective, qualitative measures that assess only one type of body representation-the conscious body image. Previous research on perceived body size has typically focused on measuring distortions of the entire body and has tended to overlook the face. Here, we present a novel psychophysical method for determining perceived body size that taps into implicit body representation. Using a two-alternative forced choice (2AFC), participants were sequentially shown two life-size images of their own face, viewed upright, upside down, or tilted 90°. In one interval, the width or length dimension was varied, while the other interval contained an undistorted image. Participants reported which image most closely matched their own face. An adaptive staircase adjusted the distorted image to hone in on the image that was equally likely to be judged as matching their perceived face as the accurate image. When viewed upright or upside down, face width was overestimated and length underestimated, whereas perception was accurate for the on-side views. These results provide the first psychophysically robust measurements of how accurately healthy participants perceive the size of their face, revealing distortions of the implicit body representation independent of the conscious body image.

  20. Consumer Perception of Inpatient Medical Services.

    PubMed

    Izugami, Satoko; Takase, Kozo

    2016-01-01

    Although it is currently popular to reflect consumers' perspectives to medical service management, insufficient attempts have been made to understand detailed perception of the consumer side of medical services to promote medical services' evaluation from the consumer viewpoint. The aim of this study was to descriptively reveal how consumers perceive medical services that they receive, focusing on inpatient medical services. We conducted semi-structured interviews with 10 adults who experienced hospitalization of five or more days. Constant comparative analysis was performed on the obtained descriptive data. We identified 1) medical procedures, 2) explanations from medical professionals, 3) behavior of medical service providers, 4) somatic sensations, and 5) self-perceived physical conditions as target factors that medical service consumers perceived during hospitalization. The response to the perceived target factors, "compared with the expectation that the consumer had before the hospitalization," suggests that it is an important medical service consumer reaction to check if the service met their expectations for perceived factors. The response to the medical services perception targets suggested that medical service consumers are involved in medical services and interested in various perception targets. The expectations that medical service consumers have prior to hospitalization can largely influence inpatient medical services evaluation.

  1. Role of the nurse immuniser in implementing and maintaining the National Human Papillomavirus 'Cervical Cancer' Vaccine rollout through a school-based program in Victoria.

    PubMed

    Kent, Helen; Heffernan, Margaret E; Silvers, Julie; Moore, Elya; Garland, Suzanne M

    2010-09-01

    In an effort to understand the strengths and limitations of current approaches to human papillomavirus vaccine (HPV) delivery in schools, we conducted an audit of nurse immunisers (NI). In this survey of 159 Victorian NI, the NI perceived that knowledge, safety and side effects were among the most important issues raised by parents, schoolgirls, and teachers in the school setting. The most common concern identified by NIs was the physical layout of the vaccination setting (41%), followed by safety, then knowledge of the vaccine. There is a need for ongoing assessment of factors that improve or impede the delivery of HPV vaccines.

  2. Cancer as a Criterion A Traumatic Stressor for Veterans: Prevalence and Correlates

    PubMed Central

    Mulligan, Elizabeth A.; Wachen, Jennifer Schuster; Naik, Aanand D.; Gosian, Jeffrey; Moye, Jennifer

    2015-01-01

    The diagnosis of cancer is an uncontrollable stressor posing the threat of death and disfigurement, often followed by repeated exposure to aversive reminders in the form of noxious treatments, persisting side effects, reengagement at times of surveillance, and the threat of recurrence. The phenomenon of cancer as a traumatic stressor is explored in this study, with a focus on the prevalence and correlates of posttraumatic stress disorder (PTSD) Criterion A in a sample of 170 mostly male adults who received health care at VA Medical Centers in Boston or Houston. Participants were interviewed 6 months after diagnosis with head and neck, gastro-esophageal, or colorectal cancers. Approximately half–42.9% to 65.9% depending on cut-score used—perceived cancer to be a traumatic stressor involving actual/threatened death or injury or threat to physical integrity as well as fear, helplessness, or horror. Younger veterans and those with current combat PTSD symptoms were more likely to perceive cancer as a traumatic stressor, as were those who perceived their prognosis as uncertain; 12% had PTSD symptoms above a PCLC cut score of 50, which is similar to incidence rates of PTSD associated with other traumatic stressors. Cancer, therefore, appears to be a serious and for some, traumatic stressor, suggesting the importance of screening for cancer related PTSD in cancer survivors, particularly those most at risk. PMID:25741406

  3. Killing wolves to prevent predation on livestock may protect one farm but harm neighbors.

    PubMed

    Santiago-Avila, Francisco J; Cornman, Ari M; Treves, Adrian

    2018-01-01

    Large carnivores, such as gray wolves, Canis lupus, are difficult to protect in mixed-use landscapes because some people perceive them as dangerous and because they sometimes threaten human property and safety. Governments may respond by killing carnivores in an effort to prevent repeated conflicts or threats, although the functional effectiveness of lethal methods has long been questioned. We evaluated two methods of government intervention following independent events of verified wolf predation on domestic animals (depredation) in the Upper Peninsula of Michigan, USA between 1998-2014, at three spatial scales. We evaluated two intervention methods using log-rank tests and conditional Cox recurrent event, gap time models based on retrospective analyses of the following quasi-experimental treatments: (1) selective killing of wolves by trapping near sites of verified depredation, and (2) advice to owners and haphazard use of non-lethal methods without wolf-killing. The government did not randomly assign treatments and used a pseudo-control (no removal of wolves was not a true control), but the federal permission to intervene lethally was granted and rescinded independent of events on the ground. Hazard ratios suggest lethal intervention was associated with an insignificant 27% lower risk of recurrence of events at trapping sites, but offset by an insignificant 22% increase in risk of recurrence at sites up to 5.42 km distant in the same year, compared to the non-lethal treatment. Our results do not support the hypothesis that Michigan's use of lethal intervention after wolf depredations was effective for reducing the future risk of recurrence in the vicinities of trapping sites. Examining only the sites of intervention is incomplete because neighbors near trapping sites may suffer the recurrence of depredations. We propose two new hypotheses for perceived effectiveness of lethal methods: (a) killing predators may be perceived as effective because of the benefits to a small minority of farmers, and (b) if neighbors experience side-effects of lethal intervention such as displaced depredations, they may perceive the problem growing and then demand more lethal intervention rather than detecting problems spreading from the first trapping site. Ethical wildlife management guided by the "best scientific and commercial data available" would suggest suspending the standard method of trapping wolves in favor of non-lethal methods (livestock guarding dogs or fladry) that have been proven effective in preventing livestock losses in Michigan and elsewhere.

  4. Effect of a semi-annular thermal acoustic shield on jet exhaust noise

    NASA Technical Reports Server (NTRS)

    Goodykoontz, J.

    1980-01-01

    Reductions in jet exhaust noise obtained by the use of an annular thermal acoustic shield consisting of a high temperature, low velocity gas stream surrounding a high velocity central jet exhaust appear to be limited by multiple reflections. The effect of a semi-annular shield on jet exhaust noise was investigted with the rationale that such a configuration would eliminate or reduce the multiple reflection mechanism. Noise measurements for a 10 cm conical nozzle with a semi-annular acoustic shield are presented in terms of lossless free field data at various angular locations with respect to the nozzle. Measurements were made on both the shielded and unshielded sides of the nozzle. The results are presented parametrically, showing the effects of various shield and central system velocities and temperatures. Selected results are scaled up to a typical full scale engine size to determine the perceived noise level reductions.

  5. Knowledge and Beliefs about Reproductive Anatomy and Physiology among Mexican-Origin Women in the U.S.A: Implications for Effective Oral Contraceptive Use

    PubMed Central

    Amastae, Jon; Potter, Joseph E.; Hopkins, Kristine; Grossman, Daniel

    2013-01-01

    Inherent in many reproductive health and family planning programmes is the problematic assumption that the body, its processes, and modifications to it are universally experienced in the same way. This paper addresses contraceptive knowledge and beliefs among Mexican-origin women, based upon data gathered by the qualitative component of the Border Contraceptive Access Study. Open-ended interviews explored the perceived mechanism of action of the pill, side effects, non-contraceptive benefits, and general knowledge of contraception. Findings revealed complex connections between traditional and scientific information. Use of medical terms (“hormone”) illustrated attempts to integrate new information with existing knowledge and belief systems. Conclusions address concerns that existing information and services may not be sufficient if population-specific knowledge and beliefs are not assessed and addressed. Findings can contribute to the development of effective education, screening, and reproductive health services. PMID:23464742

  6. The dark side of gloss.

    PubMed

    Kim, Juno; Marlow, Phillip J; Anderson, Barton L

    2012-11-01

    Our visual system relies on the image structure generated by the interaction of light with objects to infer their material properties. One widely studied surface property is gloss, which can provide information that an object is smooth, shiny or wet. Studies have historically focused on the role of specular highlights in modulating perceived gloss. Here we show in human observers that glossy surfaces can generate both bright specular highlights and dark specular 'lowlights', and that the presence of either is sufficient to generate compelling percepts of gloss. We show that perceived gloss declines when the image structure generated by specular lowlights is blurred or misaligned with surrounding surface shading and that perceived gloss can arise from the presence of lowlights in surface regions isolated from highlights. These results suggest that the image structure generated by specular highlights and lowlights is used to construct our experience of surface gloss.

  7. Crossing the perspectives of patients, families, and physicians on cancer treatment: A qualitative study.

    PubMed

    Orri, Massimiliano; Sibeoni, Jordan; Bousquet, Guilhem; Labey, Mathilde; Gueguen, Juliette; Laporte, Cyril; Winterman, Sabine; Picard, Camille; Nascimbeni, Clara; Verneuil, Laurence; Revah-Levy, Anne

    2017-03-28

    Patients, family members, and physicians participate in cancer care, but their perspectives about what is helpful during cancer treatment have rarely been compared. The aim of this study was to compare these three perspectives. Multicenter qualitative study (with previously published protocol) based on 90 semi-structured interviews. Participants (purposively selected until data saturation) came from three different subsamples: (i) patients with cancer (n=30), (ii) their relatives (n=30), and (iii) their referring physicians (n=10, interviewed more than once). Our analysis found 3 main axes (perceived positive effects of cancer treatment, perceived negative effects of cancer treatment, doctor-physician relationship), each composed of 2 main themes. The findings showed that patients, families, and physicians shared the long-term objective of increasing survival (while reducing side effects). However, patients and relatives also pointed out the importance of living with cancer each day and thus of factors helping them to live as well as possible in daily life. The physicians' difficulty in coping with patients' suffering may limit their access to elements that can improve patients' capacity to live as well as possible. During cancer treatment (and not only at the end of life), attention should be given to enhancing the capacity of patients to live as well as possible (not only as long as possible) to meet the goals of patient-centered care and satisfy this important need of patients and families.

  8. The impact of law enforcement activity on a heroin market.

    PubMed

    Weatherburn, D; Lind, B

    1997-05-01

    It may be argued that seizing large quantities of heroin being imported into the country should decrease its supply and hence increase its price, resulting in a reduction in the quantity of the drug being purchased or consumed. To date, however, there has been no empirical evidence that heroin seizures in Australia have any effect on the price of heroin at street level. This article describes a 2-year research study during which the price and purity of street-level heroin were regularly monitored. It was found that heroin seizures had no effect on the price, purity or perceived availability of heroin at street level. It was further found that admissions to methadone treatment were not affected by the price or perceived availability of heroin or by local arrests for heroin use/possession, nor was any relationship found between these arrests and the price of street-level heroin. Nevertheless, two-thirds of those who sought entry to local methadone programmes indicated the price as a reason for stopping using heroin. This paper argues that supply-side law enforcement should only be used as a strategy for maintaining high heroin prices if the demand for heroin can be shown to be price-elastic and, further, that the costs of such a strategy need to be weighted against the benefits.

  9. Is This Object Balanced or Unbalanced? Judgments Are on the Safe Side

    ERIC Educational Resources Information Center

    Samuel, Francoise; Kerzel, Dirk

    2011-01-01

    Do we perceive correctly whether a 2-D object is balanced or unbalanced? What would be the cause of biased equilibrium judgments? In two psychometric studies, we varied independently the characteristics of the objects and the equilibrium states. First, we observed that observers were excessively sensitive to the eccentricity of the object top.…

  10. The Relationship of Selected Supply- and Demand-Side Factors to Forms of Perceived Discrimination among Adults with Multiple Sclerosis

    ERIC Educational Resources Information Center

    Roessler, Richard T.; Neath, Jeanne; McMahon, Brian T.; Rumrill, Phillip D.

    2007-01-01

    Single-predictor and stepwise multinomial logistic regression analyses and an external validation were completed on 3,082 allegations of employment discrimination by adults with multiple sclerosis. Women filed two thirds of the allegations, and individuals between 31 and 50 made the vast majority of discrimination charges (73%). Allegations…

  11. The prevalence of dietary-related complementary and alternative therapies and their perceived usefulness among cancer patients.

    PubMed

    van Tonder, E; Herselman, M G; Visser, J

    2009-12-01

    The present study aimed to directly assess and compare the usage, benefits and side-effects of dietary-related complementary and alternative medicine (CAM) use among adult cancer patients and non-cancer adults in Norwich, UK. Self-administered questionnaires were completed by 98 cancer patients and 92 non-cancer adults to compare demographics, types of CAM usage with reasons, benefits, side-effects and CAM information sources. The groups were matched for gender, age, marital status, education and household income. The mean ages were 62.7 and 59.7 years, respectively, with slightly more female than male participants. CAM use was high in both groups (47% in cancer and 53% in non-cancer respondents, P > 0.05). The most widely-used diet-related CAM among both groups was the large intake of fruit, vegetables and juice, multivitamins, fish oils and glucosamine. Fish oil intake was significantly higher in the non-cancer group (P < 0.05), whereas selenium and beta-carotene supplements were significantly higher in the cancer group (P < 0.01 and P = 0.02, respectively). The main reasons for using CAM were to boost the immune system and to improve quality of life (P > 0.05). Reported benefits included increased optimism and hope for the cancer group and increased optimism and pain relief for the non-cancer group. Diet-related CAM is used frequently by both cancer patients and non-cancer adults, with many reported benefits and few reported side-effects. Significant differences between the groups included a higher prevalence of fish oil used by the non-cancer group, and a higher use of selenium and beta-carotene supplements in the cancer group.

  12. Impact of Perceived Stress, Anxiety-Depression and Social Support on Coping Strategies of Parents Having A Child With Gilles de la Tourette Syndrome.

    PubMed

    Goussé, Véronique; Czernecki, Virginie; Denis, Pierre; Stilgenbauer, Jean-Louis; Deniau, Emmanuelle; Hartmann, Andreas

    2016-02-01

    Previous reports have indicated that raising a child with Gilles de la Tourette syndrome (GTS) could be considered a stressful experience. Thus our study aimed to assess the impact of perceived stress (i.e. parental cognitive perception of their child's disorder) and social support (number of people surrounding the subject providing support) on coping strategies-defined as processes of restoring balance between excessive demands and inadequate resources-of parents having a child with GTS. Twenty-eight parents of 21 patients with GTS (aged 6 to 16years) completed questionnaires on perceived stress (ALE Scale), social support (SSQ6), coping strategies (WCC-R) and anxiety-depression (HAD). Principal component analysis showed a negative correlation between social support on one side and perceived stress and anxiety/depression on the other. Problem- and emotion-focused coping both correlated with social support, all of them being independent from perceived stress and anxiety/depression. Hierarchical ascendant classification showed three clusters of individuals in our parents' groups: i) those having high scores in perceived stress and anxiety-depression; ii) those having high scores in social support associated with low scores in perceived stress; iii) parents having lower than average scores on both problem- and emotion- focused coping and social support. Our results reinforce the need for developing training programs for parents with GTS children to better understand and tolerate the disorder to decrease their stress. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Parental information-seeking behaviour in childhood vaccinations

    PubMed Central

    2013-01-01

    Background People want to be well informed and ask for more information regarding their health. The public can use different sources (i.e. the Internet, health care providers, friends, family, television, radio, and newspapers) to access information about their health. Insight into the types and sources of vaccine related information that parents use, and reasons why they seek extra information is needed to improve the existing information supply about childhood vaccinations. Methods Dutch parents with one or more children aged 0–4 years received an online questionnaire (N = 4000) measuring psychosocial determinants of information-seeking behaviour and self-reports of types and sources of vaccine information searched for (response rate 14.8%). We also tested two invitation approaches (i.e., reply card versus Internet link in invitation letter) to observe the difference in response rate. Results Almost half of the parents (45.8%) searched for extra information. Of all the respondents, 13% indicated they had missed some information, particularly about side effects of vaccines (25%). Intention to search for vaccination information was influenced by positive attitude and perceived social norm towards information-seeking behaviour. There was no difference in the response rate between the two invitation approaches. Conclusions The information provided by the National Immunization Programme (NIP) might be sufficient for most parents. However, some parents mentioned that they did not receive enough information about side effects of vaccinations, which was also the topic most searched for by parents. Public Health Institutes (PHIs) and child healthcare workers should therefore be aware of the importance to mention this aspect in their communication (materials) towards parents. The PHIs must ensure that their website is easy to find with different search strategies. Since the child healthcare worker is perceived as the most reliable information source, they should be aware of their role in educating parents about the NIP. PMID:24358990

  14. Challenges from Tuberculosis Diagnosis to Care in Community-Based Active Case Finding among the Urban Poor in Cambodia: A Mixed-Methods Study.

    PubMed

    Lorent, Natalie; Choun, Kimcheng; Malhotra, Shelly; Koeut, Pichenda; Thai, Sopheak; Khun, Kim Eam; Colebunders, Robert; Lynen, Lut

    2015-01-01

    While community-based active case finding (ACF) for tuberculosis (TB) holds promise for increasing early case detection among hard-to-reach populations, limited data exist on the acceptability of active screening. We aimed to identify barriers and explore facilitators on the pathway from diagnosis to care among TB patients and health providers. Mixed-methods study. We administered a survey questionnaire to, and performed in-depth interviews with, TB patients identified through ACF from poor urban settlements in Phnom Penh, Cambodia. Additionally, we conducted focus group discussions and in-depth interviews with community and public health providers involved in ACF, respectively. Acceptance of home TB screening was strong among key stakeholders due to perceived reductions in access barriers and in direct and indirect patient costs. Privacy and stigma were not an issue. To build trust and facilitate communication, the participation of community representatives alongside health workers was preferred. Most health providers saw ACF as complementary to existing TB services; however, additional workload as a result of ACF was perceived as straining operating capacity at public sector sites. Proximity to a health facility and disease severity were the strongest determinants of prompt care-seeking. The main reasons reported for delays in treatment-seeking were non-acceptance of diagnosis, high indirect costs related to lost income/productivity and transportation expenses, and anticipated side-effects from TB drugs. TB patients and health providers considered home-based ACF complementary to facility-based TB screening. Strong engagement with community representatives was believed critical in gaining access to high risk communities. The main barriers to prompt treatment uptake in ACF were refusal of diagnosis, high indirect costs, and anticipated treatment side-effects. A patient-centred approach and community involvement were essential in mitigating barriers to care in marginalised communities.

  15. Challenges from Tuberculosis Diagnosis to Care in Community-Based Active Case Finding among the Urban Poor in Cambodia: A Mixed-Methods Study

    PubMed Central

    Malhotra, Shelly; Koeut, Pichenda; Thai, Sopheak; Khun, Kim Eam; Colebunders, Robert; Lynen, Lut

    2015-01-01

    Background While community-based active case finding (ACF) for tuberculosis (TB) holds promise for increasing early case detection among hard-to-reach populations, limited data exist on the acceptability of active screening. We aimed to identify barriers and explore facilitators on the pathway from diagnosis to care among TB patients and health providers. Methods Mixed-methods study. We administered a survey questionnaire to, and performed in-depth interviews with, TB patients identified through ACF from poor urban settlements in Phnom Penh, Cambodia. Additionally, we conducted focus group discussions and in-depth interviews with community and public health providers involved in ACF, respectively. Results Acceptance of home TB screening was strong among key stakeholders due to perceived reductions in access barriers and in direct and indirect patient costs. Privacy and stigma were not an issue. To build trust and facilitate communication, the participation of community representatives alongside health workers was preferred. Most health providers saw ACF as complementary to existing TB services; however, additional workload as a result of ACF was perceived as straining operating capacity at public sector sites. Proximity to a health facility and disease severity were the strongest determinants of prompt care-seeking. The main reasons reported for delays in treatment-seeking were non-acceptance of diagnosis, high indirect costs related to lost income/productivity and transportation expenses, and anticipated side-effects from TB drugs. Conclusions TB patients and health providers considered home-based ACF complementary to facility-based TB screening. Strong engagement with community representatives was believed critical in gaining access to high risk communities. The main barriers to prompt treatment uptake in ACF were refusal of diagnosis, high indirect costs, and anticipated treatment side-effects. A patient-centred approach and community involvement were essential in mitigating barriers to care in marginalised communities. PMID:26222545

  16. Rumor has it...: relay communication of stress cues in plants.

    PubMed

    Falik, Omer; Mordoch, Yonat; Quansah, Lydia; Fait, Aaron; Novoplansky, Ariel

    2011-01-01

    Recent evidence demonstrates that plants are able not only to perceive and adaptively respond to external information but also to anticipate forthcoming hazards and stresses. Here, we tested the hypothesis that unstressed plants are able to respond to stress cues emitted from their abiotically-stressed neighbors and in turn induce stress responses in additional unstressed plants located further away from the stressed plants. Pisum sativum plants were subjected to drought while neighboring rows of five unstressed plants on both sides, with which they could exchange different cue combinations. On one side, the stressed plant and its unstressed neighbors did not share their rooting volumes (UNSHARED) and thus were limited to shoot communication. On its other side, the stressed plant shared one of its rooting volumes with its nearest unstressed neighbor and all plants shared their rooting volumes with their immediate neighbors (SHARED), allowing both root and shoot communication. Fifteen minutes following drought induction, significant stomatal closure was observed in both the stressed plants and their nearest unstressed SHARED neighbors, and within one hour, all SHARED neighbors closed their stomata. Stomatal closure was not observed in the UNSHARED neighbors. The results demonstrate that unstressed plants are able to perceive and respond to stress cues emitted by the roots of their drought-stressed neighbors and, via 'relay cuing', elicit stress responses in further unstressed plants. Further work is underway to study the underlying mechanisms of this new mode of plant communication and its possible adaptive implications for the anticipation of forthcoming abiotic stresses by plants.

  17. Contrast of slightly complex patterns: computing the perceived contrast of Gabor patches

    NASA Astrophysics Data System (ADS)

    Peli, Eli

    1996-04-01

    The local contrast in an image may be approximated by the contrast of a Gabor patch of varying phase and bandwidth. In a search for a metric for such local contrast, perceived (apparent) contrast, as indicated by matching of such patterns, were compared here to the physical contrast calculated by a number of methods. The 2 cycles/deg 1-octave Gabor patch stimuli of different phases were presented side by side separated by 4 degrees. During each session the subjects (n equals 5) were adapted to the average luminance, and four different contrast levels (0.1, 0.3, 0.6, and 0.8) were randomly interleaved. The task was repeated at four mean luminance levels between 0.75 and 37.5 cd/m2. The subject's task was to indicate which of the two patterns was lower in contrast. Equal apparent contrast was determined by fitting a psychometric function to the data from 40 to 70 presentations. There was no effect of mean luminance on the subjects settings. The matching results rejected the hypothesis that either the Michelson formula or the King-Smith & Kulikowski contrast (CKK equals (Lmax-Laverage)/Laverage) was used by the subjects to set the match. The use of the Nominal contrast (the Michelson contrast of the underlying sinusoid) as an estimate of apparent contrast could not be rejected. In a second experiment the apparent contrast of a 1-octave Gabor patch was matched to the apparent contrast of a 2-octave Gabor patch (of Nominal contrast of 0.1, 0.3, 0.6, 0.8) using the method of adjustment. The result of this experiment rejected the prediction of the Nominal contrast definition. The local band limited contrast measure (Peli, 1990), when used with the modifications suggested by Lubin (1995), as an estimate of apparent contrast could not be rejected by the results of either experiment. These results suggest that a computational contrast measure based on multi scale bandpass filtering is a better estimate of apparent perceived contrast than any of the other measures tested.

  18. Gain versus loss framing in adherence-promoting communication targeting patients with chronic diseases: the moderating effect of individual time perspective.

    PubMed

    Zhao, Xiaoquan; Villagran, Melinda M; Kreps, Gary L; McHorney, Colleen

    2012-01-01

    This study investigated the joint effect of message framing and time perspective in adherence-promoting communication targeting patients with chronic diseases. Based on previous framing and time perspective research, it was hypothesized that the gain frame would show an advantage over the loss frame among future-oriented patients; for present-oriented patients, it was hypothesized that the framing effect would be relatively indistinct. In total, 1,108 currently nonadherent patients with chronic disease participated in an experiment where they were randomly assigned to either gain- or loss-framed messages addressing key beliefs underlying their nonadherence or a no-message control condition. Intention and attitude regarding future adherence as well as message perceptions were measured after message presentation. Results of this study generally supported the hypotheses. Message topics-whether the messages addressed patients' perceived need for medications or concerns about side effects-did not moderate the effect of framing or the interaction between framing and time perspective. Theoretical and practical implications are discussed.

  19. BORDER EFFECTS ON DSM-5 ALCOHOL USE DISORDERS ON BOTH SIDES OF THE U.S.-MEXICO BORDER

    PubMed Central

    Cherpitel, Cheryl J.; Ye, Yu; Bond, Jason; Zemore, Sarah E.; Borges, Guilherme; Greenfield, Thomas K.

    2015-01-01

    Background Little epidemiological evidence exists on alcohol use and related problems along the U.S.-Mexico border, although the borderlands have been the focus of recent media attention related to the escalating drug/violence “epidemic”. In the present study the relationship of proximity of living at the border and alcohol use disorders (AUDs) is analyzed from the U.S.-Mexico Study on Alcohol and Related Conditions (UMSARC). Methods Household surveys were conducted on 2,336 Mexican Americans in Texas (771 in a non-border city and 1,565 from three border cities located in the three poorest counties in the U.S.) and 2,460 Mexicans from the states of Nuevo Leon and Tamaulipas in Mexico (811 in a non-border city and 1,649 from three cities which are sister cities to the Texas border sites). Results Among current drinkers, prevalence of AUD was marginally greater (p<0.10) at the U.S. border compared to the non-border, but the opposite was true in Mexico (p<0.001), and these trends continued on both sides across volume and 5+ drinking days. Prevalence was greater in Laredo/Nuevo Laredo relative to their respective sister city counterparts on the same side. Border effects appeared greater for males than females in the U.S. and the opposite in Mexico. Conclusion The data suggest that border proximity may affect AUD in both the U.S. and Mexico, but in the opposite direction, and may be related to the relative perceived or actual stress of living in the respective communities. PMID:25649987

  20. Border effects on DSM-5 alcohol use disorders on both sides of the U.S.-Mexico border.

    PubMed

    Cherpitel, Cheryl J; Ye, Yu; Bond, Jason; Zemore, Sarah E; Borges, Guilherme; Greenfield, Thomas K

    2015-03-01

    Little epidemiological evidence exists on alcohol use and related problems along the U.S.-Mexico border, although the borderlands have been the focus of recent media attention related to the escalating drug/violence "epidemic". In the present study, the relationship of proximity of living at the border and alcohol use disorders (AUDs) is analyzed from the U.S.-Mexico Study on Alcohol and Related Conditions (UMSARC). Household surveys were conducted on 2336 Mexican Americans in Texas (771 in a non-border city and 1565 from three border cities located in the three poorest counties in the U.S.) and 2460 Mexicans from the states of Nuevo Leon and Tamaulipas in Mexico (811 in a non-border city and 1649 from three cities which are sister cities to the Texas border sites). Among current drinkers, prevalence of AUD was marginally greater (p<0.10) at the U.S. border compared to the non-border, but the opposite was true in Mexico (p<0.001), and these trends continued on both sides across volume and 5+ drinking days. Prevalence was greater in Laredo/Nuevo Laredo relative to their respective sister city counterparts on the same side. Border effects appeared greater for males than females in the U.S. and the opposite in Mexico. The data suggest that border proximity may affect AUD in both the U.S. and Mexico, but in the opposite direction, and may be related to the relative perceived or actual stress of living in the respective communities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Prevalence and predictors of deterioration of a trustful patient-provider relationship among HIV-infected persons treated with antiretroviral therapy.

    PubMed

    Préau, Marie; Leport, Catherine; Villes, Virginie; Michelet, Christian; Collin, Fidéline; Carrieri, Maria-Patrizia; Ragnaud, Jean-Marie; Taieb, Audrey; Raffi, François; Spire, Bruno

    2008-04-01

    We studied the evolution of the patient-provider relationship (PPR) in HIV-infected patients who reported trustful relationships at highly active antiretroviral therapy (HAART) treatment initiation. Psychosocial and clinical data were obtained from the French ANRS CO-8 cohort. Break of trust was defined using the question "How much do you trust the provider who usually treats you at this clinic?" Predictors of a possible break of trust during the 5 years after initiating treatment for those patients reporting a trustful PPR at month 0 were identified using a Cox model. During a total follow-up of 3,044 person-years, 68 (7%) patients reported having at least 1 break of trust in their PPR. Break of trust is independently associated with younger age, dissatisfaction with medical staff's explanations, cigarette smoking, and self-reported side effects and is independently inversely associated with severe HIV-related events and changes of treatment. A patient's break of trust in his provider is relatively infrequent. Accounting for the influence of immunologic status and psychosocial factors, self-reported side effects are shown to be detrimental to the PPR. Interestingly, clinical events and changes of treatment prevent a possible break of trust by reinforcing the provider's role. These results underline the importance of recognizing a patient's perceived secondary effects and developing appropriate care.

  2. How phenobarbital revolutionized epilepsy therapy: the story of phenobarbital therapy in epilepsy in the last 100 years.

    PubMed

    Yasiry, Zeid; Shorvon, Simon D

    2012-12-01

    Phenobarbital (phenobarbitone) was first used as an antiepileptic drug 100 years ago, in 1912. This article tells the story of the discovery of its antiepileptic action, its early development, and the subsequent course of its clinical use over the 100-year period. The side effects, pharmacokinetics, and misuse of barbiturates are considered, along with the more recent clinical trials and the drug's current clinical utilization. The introduction of controlled drug regulations, the comparative cost of phenobarbital, and its inclusion on the World Health Organization (WHO) essential drug list are discussed. It is one of the few drugs on the formulary in 1912 that is still listed today, and remarkably its efficacy in epilepsy has not been significantly bettered. The current recommendation by the WHO is that phenobarbital should be offered as the first option for therapy for convulsive epilepsy in adults and children if availability can be ensured. This is rated as a strong recommendation because of the proven efficacy and low cost of phenobarbital, and despite its perceived side-effect profile and the practical problems of access. Whether this recommendation puts "a hierarchy on the brain," as has been suggested, is arguable. Much still needs to be learned about the drug's effects, and the issues raised by phenobarbital have lessons for all antiepileptic drug therapy. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

  3. Cannabis Users' Recommended Warnings for Packages of Legally Sold Cannabis: An Australia-Centered Study

    PubMed Central

    Malouff, John M.; Johnson, Caitlin E.; Rooke, Sally E.

    2016-01-01

    Abstract Introduction: Although cannabis use creates health risks, governments have recently been legalizing either medical use or leisure use. These governments can mandate health warnings on cannabis packages. Prior research examined recommended warnings of cannabis experts. The aim of this study was to obtain suggested cannabis health and safety warnings from cannabis users. Methods: We used a media release, Facebook postings, and announcements in university classes to seek individuals who had used cannabis at least once according to their own report. Using online data collection software that keeps participants anonymous, we asked the individuals to suggest a warning that governments could mandate on cannabis packages. Results: In total, 288 users suggested warnings. Categorizing the warnings into content categories led to six warning topics: (1) risk of harm to mental health and psychological functioning; (2) risk of operating machinery while under the influence; (3) short-term physical side effects; (4) responsible use; (5) long-term negative physical effects; and (6) dependence, addiction, or abuse. The user-suggested warnings overlapped with six expert-recommended warnings identified in prior survey research and included two content areas that did not feature in expert-recommended warnings: short-term physical side effects and the importance of responsible use. Conclusions: The results are consistent with prior findings that some youths perceive cannabis use as potentially harmful. The current findings provide possible new content for warnings on cannabis packages. PMID:28861495

  4. On the significance of electroconvulsive therapy in the treatment of severe mental diseases.

    PubMed

    Grözinger, Michael; Smith, Elke Stefanie; Conca, Andreas

    2015-04-01

    Quite a few patients with severe mental diseases do not respond sufficiently to psychopharmacology and psychotherapy. For some of these, electroconvulsive therapy (ECT) offers a promising alternative. Erroneously, the method is being perceived as old fashioned by the lay public, but also by many doctors. Therefore, this overview aims at all colleagues who in their role as multipliers, referring physicians or ECT specialists can reduce the likelihood of mental disease to become chronic. During the last decades, numerous international medical societies including the Austrian and the German Association for Psychiatry (ÖGPP and DGPPN) have pointed to the importance of ECT as a modern medical intervention. Our overview is based on these guidelines and statements. Additionally selective literature searches have been conducted concerning some key aspects. Due to its excellent efficacy, ECT is an important option in the treatment of severe mental disease. Technological innovations and continued development in the psychiatric environment determined the evolution from the electroshock of the 1930s to the ECT of today. This process led to reduced side effects and a stronger patient-oriented praxis. ECT is a modern, highly effective and safe treatment of severe mental diseases with comparatively few side effects. The method should not be used as a last resort but in an evidence-based way. Patients should be informed timely and adequately about the therapeutic option.

  5. Cannabis Users' Recommended Warnings for Packages of Legally Sold Cannabis: An Australia-Centered Study.

    PubMed

    Malouff, John M; Johnson, Caitlin E; Rooke, Sally E

    2016-01-01

    Introduction: Although cannabis use creates health risks, governments have recently been legalizing either medical use or leisure use. These governments can mandate health warnings on cannabis packages. Prior research examined recommended warnings of cannabis experts. The aim of this study was to obtain suggested cannabis health and safety warnings from cannabis users. Methods: We used a media release, Facebook postings, and announcements in university classes to seek individuals who had used cannabis at least once according to their own report. Using online data collection software that keeps participants anonymous, we asked the individuals to suggest a warning that governments could mandate on cannabis packages. Results: In total, 288 users suggested warnings. Categorizing the warnings into content categories led to six warning topics: (1) risk of harm to mental health and psychological functioning; (2) risk of operating machinery while under the influence; (3) short-term physical side effects; (4) responsible use; (5) long-term negative physical effects; and (6) dependence, addiction, or abuse. The user-suggested warnings overlapped with six expert-recommended warnings identified in prior survey research and included two content areas that did not feature in expert-recommended warnings: short-term physical side effects and the importance of responsible use. Conclusions: The results are consistent with prior findings that some youths perceive cannabis use as potentially harmful. The current findings provide possible new content for warnings on cannabis packages.

  6. Words or numbers? Communicating risk of adverse effects in written consumer health information: a systematic review and meta-analysis.

    PubMed

    Büchter, Roland Brian; Fechtelpeter, Dennis; Knelangen, Marco; Ehrlich, Martina; Waltering, Andreas

    2014-08-26

    Various types of framing can influence risk perceptions, which may have an impact on treatment decisions and adherence. One way of framing is the use of verbal terms in communicating the probabilities of treatment effects. We systematically reviewed the comparative effects of words versus numbers in communicating the probability of adverse effects to consumers in written health information. Nine electronic databases were searched up to November 2012. Teams of two reviewers independently assessed studies. randomised controlled trials; verbal versus numerical presentation; context: written consumer health information. Ten trials were included. Participants perceived probabilities presented in verbal terms as higher than in numeric terms: commonly used verbal descriptors systematically led to an overestimation of the absolute risk of adverse effects (Range of means: 3% - 54%). Numbers also led to an overestimation of probabilities, but the overestimation was smaller (2% - 20%). The difference in means ranged from 3.8% to 45.9%, with all but one comparison showing significant results. Use of numbers increased satisfaction with the information (MD: 0.48 [CI: 0.32 to 0.63], p < 0.00001, I2 = 0%) and likelihood of medication use (MD for very common side effects: 1.45 [CI: 0.78 to 2.11], p = 0.0001, I2 = 68%; MD for common side effects: 0.90 [CI: 0.61 to 1.19], p < 0.00001, I2 = 1%; MD for rare side effects: 0.39 [0.02 to 0.76], p = 0.04, I2 = not applicable). Outcomes were measured on a 6-point Likert scale, suggesting small to moderate effects. Verbal descriptors including "common", "uncommon" and "rare" lead to an overestimation of the probability of adverse effects compared to numerical information, if used as previously suggested by the European Commission. Numbers result in more accurate estimates and increase satisfaction and likelihood of medication use. Our review suggests that providers of consumer health information should quantify treatment effects numerically. Future research should focus on the impact of personal and contextual factors, use representative samples or be conducted in real life settings, measure behavioral outcomes and address whether benefit information can be described verbally.

  7. Does small-sided-games’ court area influence metabolic, perceptual, and physical performance parameters of young elite basketball players?

    PubMed Central

    Marcelino, PR; Aoki, MS; Arruda, AFS; Freitas, CG; Mendez-Villanueva, A

    2015-01-01

    The purpose of this study was to investigate the effect of court size on physiological responses and physical performance of young elite basketball players. Twelve male basketball players (18.6 ± 0.5 years; 88.8 ± 14.5 kg; 192.6 ± 6.5 cm) from an under-19 team performed two small-sided games (matches) with different court areas (28x15 m and 28x9 m; 28x15 and 28x9 protocols). The number of players (3x3) was kept the same in each protocol. The players performed a repeated-sprint ability (RSA) test before and after each match. Blood lactate concentration was collected before (pre) and after (post) the matches, and the session rating of perceived exertion (session-RPE) was determined 30 minutes after the match. Best and mean time in the RSA test were not different between the 28x15 and the 28x9 match protocols (p > 0.05). A significant difference was observed for lactate concentration from pre- to post-match (p < 0.05) in both protocols (28x15 and 28x9); however, there was no significant interaction between protocols. A similar session-RPE mean score (28x15: 7.2 ± 1.4 and 28x9: 6.6 ± 1.4) was detected for both protocols (p > 0.05, ES=0.41). In summary, the results of the current study suggest that the different court areas induced similar responses. Although there was no significant difference in effort perception, players tended to perceive a greater effort in the larger court size. PMID:26985132

  8. Malaria Prevention Strategies: Adherence among Boston Area Travelers Visiting Malaria-Endemic Countries

    PubMed Central

    Stoney, Rhett J.; Chen, Lin H.; Jentes, Emily S.; Wilson, Mary E.; Han, Pauline V.; Benoit, Christine M.; MacLeod, William B.; Hamer, Davidson H.; Barnett, Elizabeth D.

    2016-01-01

    We conducted a prospective cohort study to assess adherence to malaria chemoprophylaxis, reasons for nonadherence, and use of other personal protective measures against malaria. We included adults traveling to malaria-endemic countries who were prescribed malaria chemoprophylaxis during a pre-travel consultation at three travel clinics in the Boston area and who completed three or more surveys: pre-travel, at least one weekly during travel, and post-travel (2–4 weeks after return). Of 370 participants, 335 (91%) took malaria chemoprophylaxis at least once and reported any missed doses; 265 (79%) reported completing all doses during travel. Adherence was not affected by weekly versus daily chemoprophylaxis, travel purpose, or duration of travel. Reasons for non adherence included forgetfulness, side effects, and not seeing mosquitoes. Main reasons for declining to take prescribed chemoprophylaxis were peer advice, low perceived risk, and not seeing mosquitoes. Of 368 travelers, 79% used insect repellent, 46% used a bed net, and 61% slept in air conditioning at least once. Because travelers may be persuaded to stop taking medication by peer pressure, not seeing mosquitoes, and adverse reactions to medications, clinicians should be prepared to address these barriers and to empower travelers with strategies to manage common side effects of antimalarial medications. PMID:26483125

  9. Development of oral immunomodulatory agents in the management of multiple sclerosis

    PubMed Central

    Nicholas, Richard; Giannetti, Paolo; Alsanousi, Ali; Friede, Tim; Muraro, Paolo A

    2011-01-01

    The emergence of oral disease-modifying therapies in multiple sclerosis (MS) will have a significant impact on the evolving scenario of immunomodulatory treatments in MS where current therapies are all injectable. Reducing relapses in trials translates for individuals with MS into a therapeutic aim of stopping future events. Thus the possible absence of any perceived benefits to the individual together with the long disease course, variable outcome, and a younger age group affected in MS makes side effects the major issue. The use of disease-modifying therapies as a whole needs to be placed in the context of a widening therapeutic indication where the use of these therapies is being justified at an increasingly early stage and in pre-MS syndromes such as clinically isolated and radiologically isolated syndromes where no fixed disability is likely to have accumulated. The five oral therapies discussed (cladribine, fingolimod, laquinimod, BG-12, and teriflunomide) have just completed Phase III studies and some have just been licensed. New oral drugs for MS need to be placed within this evolving marketplace where ease of delivery together with efficacy and side effects needs to be balanced against the known issues but also the known long-term safety of standard injectables. PMID:21625416

  10. Perceived need for information of patients with haematological malignancies: a literature review.

    PubMed

    Rood, Janneke A J; Eeltink, Corien M; van Zuuren, Florence J; Verdonck-de Leeuw, Irma M; Huijgens, Peter C

    2015-02-01

    To provide insight into the perceived need for information of patients with haematological malignancies. Providing timely and accurate information to patients diagnosed with a haematological malignancy is a challenge in clinical practice; treatment often has to start promptly, with little time to inform patients. Literature review. A comprehensive literature search was conducted from all available literature to May 2013 in the databases: Cumulative Index to Nursing and Allied Health Literature, PsycINFO and PubMed (Medline). Relevant studies were reviewed regarding the perceived need for information on various topics, sources of information and satisfaction with information provided. The initial search revealed 215 articles, fourteen of which were relevant. Patients need basic information on the disease (diagnosis and diagnostics), treatment (various treatment options, side effects and duration), prognosis (curability and prolonging life) and all other topics (recovery, self-care and psychosocial functioning). Need for detailed information varied between studies. Patients expressed a higher need for medical than for psychosocial information. Patients preferred to receive information from their doctors the most, followed by nurses. Most studies described patients' satisfaction with the information provided. Based on the limited number of data available, medical information is for patients of higher priority compared to psychosocial information. Patients need basic information on diagnosis, treatment, prognosis and all other topics. Need for detailed information varied between studies. Patients were satisfied with the provided information, preferably offered by doctors and nurses. The perceived need for information and satisfaction with the information provided differs strongly between patients. In clinical practice, more attention is needed for information tailored to the patient, taking into account important moderating factors such as age, type of cancer, time since diagnosis, treatment modality and coping style. © 2014 John Wiley & Sons Ltd.

  11. Energy expenditure and enjoyment of small-sided soccer games in overweight boys.

    PubMed

    Toh, Sharon H; Guelfi, Kym J; Wong, Patricia; Fournier, Paul A

    2011-06-01

    When space is limited, it would be preferable to play multiple small-sided soccer games (SSG) simultaneously on small courts, rather than a single game, to maximise participation. Given that the layouts of most gymnasiums incorporate several badminton courts, we examined whether energy expenditure and enjoyment of SSG on a badminton court (6.1×13.4 m) were comparable to larger court dimensions (volleyball and basketball courts; 9×18 m and 14.2×26.5 m, respectively). Twelve overweight boys played 30 min three-a-side SSG on each court in a counterbalanced design. During SSG, energy expenditure was estimated via accelerometry, heart rate was monitored and ratings of perceived exertion (RPE) and enjoyment were obtained. Energy expenditure was similar between badminton and volleyball courts, but lower than the basketball court (p<.05). Mean% HR(max) was significantly lower on the badminton court than the volleyball and basketball courts (p<.05). There was no effect of court size on RPE or enjoyment (p>.05). These results suggest that it may be preferable to play SSG on a larger court when space is available. Alternatively, when space is limited the difference in energy expenditure between court sizes can be accounted for by an additional 2.3 min of play on a badminton court. Copyright © 2010 Elsevier B.V. All rights reserved.

  12. Perceived object stability depends on multisensory estimates of gravity.

    PubMed

    Barnett-Cowan, Michael; Fleming, Roland W; Singh, Manish; Bülthoff, Heinrich H

    2011-04-27

    How does the brain estimate object stability? Objects fall over when the gravity-projected centre-of-mass lies outside the point or area of support. To estimate an object's stability visually, the brain must integrate information across the shape and compare its orientation to gravity. When observers lie on their sides, gravity is perceived as tilted toward body orientation, consistent with a representation of gravity derived from multisensory information. We exploited this to test whether vestibular and kinesthetic information affect this visual task or whether the brain estimates object stability solely from visual information. In three body orientations, participants viewed images of objects close to a table edge. We measured the critical angle at which each object appeared equally likely to fall over or right itself. Perceived gravity was measured using the subjective visual vertical. The results show that the perceived critical angle was significantly biased in the same direction as the subjective visual vertical (i.e., towards the multisensory estimate of gravity). Our results rule out a general explanation that the brain depends solely on visual heuristics and assumptions about object stability. Instead, they suggest that multisensory estimates of gravity govern the perceived stability of objects, resulting in objects appearing more stable than they are when the head is tilted in the same direction in which they fall.

  13. Sexual Assault: The Dark Side of Military Hypermasculinity

    DTIC Science & Technology

    2016-02-16

    carter- telling-military-open-all-combat-jobs- women /76720656/. 41. DMDC Human Resources Strategic Assessment Program, “2012 Workplace and...equal opportunity education and training programs and increased more combat roles to women . To provide additional oversight and management of sexual...desire for women , a perceived existential threat or challenge to one’s manhood, and the endorsement and validation of stereotypical military

  14. Reading Habits, Perceptual Learning, and Recognition of Printed Words

    ERIC Educational Resources Information Center

    Nazir, Tatjana A.; Ben-Boutayab, Nadia; Decoppet, Nathalie; Deutsch, Avital; Frost, Ram

    2004-01-01

    The present work aims at demonstrating that visual training associated with the act of reading modifies the way we perceive printed words. As reading does not train all parts of the retina in the same way but favors regions on the side in the direction of scanning, visual word recognition should be better at retinal locations that are frequently…

  15. The thinker: opposing directionality of lighting bias within sculptural artwork

    PubMed Central

    Sedgewick, Jennifer R.; Weiers, Bradley; Stewart, Aaron; Elias, Lorin J.

    2015-01-01

    Individuals tend to perceive the direction of light to come from above and slightly from the left; it has been speculated that this phenomenon is also producing similar lighting preferences within 2-dimensional artworks (e.g., paintings, advertisements). The purpose of the present study was to address if lighting bias was present in the 3-dimensional medium of sculpture by implementing a virtual art gallery lighting paradigm. Thirty-nine participants completed a computer task that consisted of 48 galleries each containing one sculpture (24 original sculptures, 24 mirror-reversed) which was surrounded by eight lights (above/below, left/right, front/back). Participants would select one light source to illuminate the sculpture in a manner they perceived to be the most aesthetically pleasing. The results indicated a significant preference for lights positioned from above and from the right, a finding that is contradictory to previous lighting bias research examining artworks. An interpretation for the rightward bias applies the perceptual concept of subjective lighting equality. Objects illuminated from the left typically appear brighter in comparison to right-side lighting; in sculpture, however, increased luminosity can reduce the sculptural detail, and may have been compensated via right-side lighting choices within the lighting task. PMID:25999840

  16. Paper trails, trailing behind: improving informed consent to IVF through multimedia applications

    PubMed Central

    Madeira, Jody Lyneé; Andraka-Christou, Barbara

    2016-01-01

    Though intended to educate patients on the risks, benefits, side effects and alternatives within medical treatment, informed consent documents may have unanticipated consequences for patients. Patients may regard these forms as little more than a ritual to access treatment. Or patients may perceive that these forms exist to protect doctors rather than to contribute to a meaningful, patient-protective educational interaction. To rehabilitate the informed consent project, this essay considers the baggage that informed consent documents have acquired through practical use, explores patients' and providers' lived experience of informed consent, and considers whether a multimedia consent application would be a viable solution to the various difficulties that currently erode perceptions of and confidence in the informed consent process. PMID:27774231

  17. Qualitative process study to explore the perceived burdens and benefits of a digital intervention for self-managing high blood pressure in Primary Care in the UK.

    PubMed

    Morton, Katherine; Dennison, Laura; Bradbury, Katherine; Band, Rebecca Jane; May, Carl; Raftery, James; Little, Paul; McManus, Richard J; Yardley, Lucy

    2018-05-08

    Digital interventions can change patients' experiences of managing their health, either creating additional burden or improving their experience of healthcare. This qualitative study aimed to explore perceived burdens and benefits for patients using a digital self-management intervention for reducing high blood pressure. A secondary aim was to further our understanding of how best to capture burdens and benefits when evaluating health interventions. Inductive qualitative process study nested in a randomised controlled trial. Primary Care in the UK. 35 participants taking antihypertensive medication and with uncontrolled blood pressure at baseline participated in semistructured telephone interviews. Digital self-management intervention to support blood pressure self-monitoring and medication change when recommended by the healthcare professional. Data were analysed using inductive thematic analysis with techniques from grounded theory. Seven themes were developed which reflected perceived burdens and benefits of using the intervention, including worry about health, uncertainty about self-monitoring and reassurance. The analysis showed how beliefs about their condition and treatment appeared to influence participants' appraisal of the value of the intervention. This suggested that considering illness and treatment perceptions in Burden of Treatment theory could further our understanding of how individuals appraise the personal costs and benefits of self-managing their health. Patients' appraisal of the burden or benefit of using a complex self-management intervention seemed to be influenced by experiences within the intervention (such as perceived availability of support) and beliefs about their condition and treatment (such as perceived control and risk of side effects). Developing our ability to adequately capture these salient burdens and benefits for patients could help enhance evaluation of self-management interventions in the future. Many participants perceived important benefits from using the intervention, highlighting the need for theory to recognise that engaging in self-management can include positive as well as negative aspects. ISRCTN13790648; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Household perceptions and subjective valuations of indoor residual spraying programmes to control malaria in northern Uganda.

    PubMed

    Brown, Zachary S; Kramer, Randall A; Ocan, David; Oryema, Christine

    2016-10-06

    Insecticide-based tools remain critical for controlling vector-borne diseases in Uganda. Securing public support from targeted populations for such tools is an important component in sustaining their long-run effectiveness. Yet little quantitative evidence is available on the perceived benefits and costs of vector control programmes among targeted households. A survey was administered to a clustered random sample of 612 households in Gulu and Oyam districts of northern Uganda during a period of very high malaria transmission and following a pilot indoor residual spray (IRS) programme. A discrete choice experiment was conducted within the survey, in which respondents indicated their preferences for different IRS programmes relative to money compensation in a series of experimentally controlled, hypothetical choice sets. The data were analysed using conditional logit regression models to estimate respondents' willingness to accept (WTA) some amount of money compensation in lieu of foregone malaria risk reductions. Latent class models were used to analyse whether respondent characteristics predicted WTA. Average WTA is estimated at $8.94 annually for a 10 % reduction in malaria risk, and additional co-benefits of IRS were estimated to be worth on average $54-$56 (depending on insecticide type) per round of IRS. Significant heterogeneity is observed: Four in five household heads in northern Uganda have high valuations for IRS programmes, while the remaining 20 % experience costly side effects of IRS (valued at between $2 and $3 per round). Statistically significant predictors of belonging to the high-value group include respondent gender, mean age of household members, participation in previous IRS, basic knowledge of mosquito reproduction, and the number of mosquito nets owned. Proxies for household income and wealth are not found to be statistically significant predictors of WTA. This study suggests that the majority of people in areas of high malaria transmission like northern Uganda place a high value on vector control programmes using IRS. However, there is significant heterogeneity in terms of the perceived side effects (positive and negative). This has implications for sustaining public support for these programmes in the long-term.

  19. Weight management practices and their relationship to knowledge, perception and health status of Saudi females attending diet clinics in Riyadh city.

    PubMed

    Albassam, Reem Suliman; Abdel Gawwad, Ensaf S; Khanam, Latifa

    2007-01-01

    The objective of the study was to identify weight management (WM) practices among women attending diet clinics in Riyadh city, assess their impact on knowledge, perceptions, nutritional and health status and define some predictors for weight reduction among these women. The pretest-posttest research design was used. All female clients attending 8 diet clinics for the first visit within 8 months period and fulfilling the study inclusion criteria (212 out of 263) were included. The results show that out of 170 females who had previously tried to lose weight, only 32.4% reported success in reducing weight, meanwhile 61.7% reported weight regain. The mean total score of dietary practices, physical activity score, self efficacy and satisfaction of self-body image were improved significantly at posttest. Analysis of 24 h. dietary recall revealed that total energy and nutrients intake were significantly reduced at posttest. Dieting related problems increased significantly at posttest. Nutritional knowledge was at moderately fair level at both pretest and posttest; however it showed a significant improvement in the posttest. Perceived severity, perceived barriers and negative modeling effect were significantly decreased at the posttest. Over expectation for weight reduction was clearly evident as posttest body mass index (BMI) revealed a wide discrepancy between the expected and final weights. However, as compared to initial and final BMI, there was an increase in women who attained normal weight and a decrease in the percentage of obese and morbid obese women. All anthropometric indices, blood pressure, biochemical investigation showed significant improvement at posttest. Among the five WM modalities studied, moderate hypo-calorie plan diet modality was the longest (chi = 5.6 month) with the least weight loss (7.8%) and the minimum side effects. Both groups under very low calorie diet and protein diet had the highest weight reduction (13.2% &12.3%), at the same time both diets exhibited the highest number of side effects. The study recommends use of the primary approach for achieving weight loss through therapeutic life style change with banning those modalities accompanied with serious health complications.

  20. An investigation of the effect of instruction in physics on the formation of mental models for problem-solving in the context of simple electric circuits

    NASA Astrophysics Data System (ADS)

    Beh, Kian Lim

    2000-10-01

    This study was designed to explore the effect of a typical traditional method of instruction in physics on the formation of useful mental models among college students for problem-solving using simple electric circuits as a context. The study was also aimed at providing a comprehensive description of the understanding regarding electric circuits among novices and experts. In order to achieve these objectives, the following two research approaches were employed: (1) A students survey to collect data from 268 physics students; and (2) An interview protocol to collect data from 23 physics students and 24 experts (including 10 electrical engineering graduates, 4 practicing electrical engineers, 2 secondary school physics teachers, 8 physics lecturers, and 4 electrical engineers). Among the major findings are: (1) Most students do not possess accurate models of simple electric circuits as presented implicitly in physics textbooks; (2) Most students display good procedural understanding for solving simple problems concerning electric circuits but have no in-depth conceptual understanding in terms of practical knowledge of current, voltage, resistance, and circuit connections; (3) Most students encounter difficulty in discerning parallel connections that are drawn in a non-conventional format; (4) After a year of college physics, students show significant improvement in areas, including practical knowledge of current and voltage, ability to compute effective resistance and capacitance, ability to identify circuit connections, and ability to solve problems; however, no significance was found in practical knowledge of resistance and ability to connect circuits; and (5) The differences and similarities between the physics students and the experts include: (a) Novices perceive parallel circuits more in terms of 'branch', 'current', and 'resistors with the same resistance' while experts perceive parallel circuits more in terms of 'node', 'voltage', and 'less resistance'; and (b) Both novices and experts use phrases such as 'side-by side' and 'one on top of the other' in describing parallel circuits which emphasize the geometry of the standard circuit drawing when describing parallel resistors.

  1. Antidepressant Prescribing by Pediatricians: A Mixed-Methods Analysis.

    PubMed

    Tulisiak, Anne K; Klein, Jillian A; Harris, Emily; Luft, Marissa J; Schroeder, Heidi K; Mossman, Sarah A; Varney, Sara T; Keeshin, Brooks R; Cotton, Sian; Strawn, Jeffrey R

    2017-01-01

    Among pediatricians, perceived knowledge of efficacy, tolerability, dosing, and side effects of antidepressants represent significant sources of variability in the use of these medications in youth with depressive and anxiety disorders. Importantly, the qualitative factors that relate to varying levels of comfort with antidepressants and willingness to prescribe are poorly understood. Using a mixed-methods approach, in-depth interviews were conducted with community-based and academic medical center-based pediatricians (N = 14). Interviews were audio recorded and iteratively coded; themes were then generated using inductive thematic analysis. The relationship between demographic factors, knowledge of antidepressants, dosing, and side effects, as well as prescribing likelihood scores for depressive disorders, anxiety disorders or co-morbid anxiety and depressive disorders, were evaluated using mixed models. Pediatricians reported antidepressants to be effective and well-tolerated. However, the likelihood of individual physicians initiating an antidepressant was significantly lower for anxiety disorders relative to depressive disorders with similar functional impairment. Pediatricians considered symptom severity/functional impairment, age and the availability of psychotherapy as they considered prescribing antidepressants to individual patients. Antidepressant choice was related to the physician׳s perceived knowledge and comfort with a particular antidepressant, financial factors, and the disorder-specific evidence base for that particular medication and consultation with mental health practitioners. Pediatricians noted similar efficacy and tolerability profiles for antidepressants in youth with depressive disorders and anxiety disorders, but tended to utilize "therapy first" approaches for anxiety disorders relative to depressive disorders. Parental and family factors that influenced prescribing of antidepressants by pediatricians included parental ambivalence, family-related dysfunction and impairment secondary to the child׳s psychopathology as well as the child׳s psychosocial milieu. Pediatricians consider patient- and family-specific challenges when choosing prescribing antidepressant medications and are, in general, less likely to prescribe antidepressants for youth with anxiety disorders compared to youth with depressive disorders. The lower likelihood of prescribing antidepressants for anxious youth is not related to perception of the efficacy or tolerability, but rather to a perception that anxiety disorders are less impairing and more appropriately managed with psychotherapy. Copyright © 2016 Mosby, Inc. All rights reserved.

  2. Perceived Dual Method Responsibilities by Relationship Type Among African-American Male Adolescents.

    PubMed

    Gilliam, Melissa; Woodhams, Elisabeth; Sipsma, Heather; Hill, Brandon

    2017-03-01

    To describe the extent to which African-American male adolescents perceive responsibility for contraception and condom use and to understand the perceived importance of dual method use for respondents in casual versus committed relationships. Data were collected using surveys informed by formative focus group sessions. Participants included African-American male high-school students aged 14-19 years from the Chicago's South Side. Respondents were surveyed regarding contraceptive behavioral intentions and perceived importance of dual method use. Responses were compared by relationship type. Logistic regression modeling was used to determine the association between contraception responsibility and perceiving dual method protection as important for each sexual relationship type. Sample included 348 young men (mean age: 16.1 years; mean age at first sex: 13.8 years). Among those who had heard of condoms (99.4%) and withdrawal (90.4%), most reported liking these methods (83.7% and 53.9%). Participants were more likely to report greater responsibility within a committed relationship for all perceived contraceptive responsibilities (e.g., going with partner to get contraception). Participants were more likely to engage in conversation about pregnancy prevention with a committed partner. Among sexually active respondents, perceived contraceptive responsibility was associated with perceiving dual protection as very important (odds ratio = 1.58; 95% confidence interval = 1.05-2.38). Respondents felt partially responsible for pregnancy prevention, particularly within committed relationships, and were open to using dual protection. However, many respondents had low levels of contraception knowledge. These findings indicate that male African-American adolescents might benefit from increased education and support around contraception methods and condom use. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  3. Detecting 'infant-directedness' in face and voice.

    PubMed

    Kim, Hojin I; Johnson, Scott P

    2014-07-01

    Five- and 3-month-old infants' perception of infant-directed (ID) faces and the role of speech in perceiving faces were examined. Infants' eye movements were recorded as they viewed a series of two side-by-side talking faces, one infant-directed and one adult-directed (AD), while listening to ID speech, AD speech, or in silence. Infants showed consistently greater dwell time on ID faces vs. AD faces, and this ID face preference was consistent across all three sound conditions. ID speech resulted in higher looking overall, but it did not increase looking at the ID face per se. Together, these findings demonstrate that infants' preferences for ID speech extend to ID faces. © 2014 John Wiley & Sons Ltd.

  4. Parents’ role in adolescent depression care: primary care provider perspectives

    PubMed Central

    Radovic, Ana; Reynolds, Kerry; McCauley, Heather L.; Sucato, Gina S.; Stein, Bradley D.; Miller, Elizabeth

    2015-01-01

    Objective To understand how primary care providers (PCPs) perceive barriers to adolescent depression care to inform strategies to increase treatment engagement. Study design We conducted semi-structured interviews with 15 PCPs recruited from community pediatric offices with access to integrated behavioral health services (i.e., low system-level barriers to care) who participated in a larger study on treating adolescent depression. Interviews addressed PCP perceptions of barriers to adolescents’ uptake of care for depression. Interviews were audio-recorded, transcribed, and coded for key themes. Results Although PCPs mentioned several adolescent barriers to care, they thought parents played a critical role in assisting adolescents in accessing mental health services. Important aspects of the parental role in accessing treatment included transportation, financial support, and social support. PCP’s perceived that parental unwillingness to accept the depression diagnosis, family dysfunction and trauma were common barriers. PCPs contrasted this with examples of good family support they believed would enable adolescents to attend follow-up appointments and have a “life coach” at home to help monitor for side effects and watch for increased suicidality when starting antidepressants. Conclusions In this PCP population, which had enhanced access to mental health specialists, PCPs primarily reported attitudinal barriers to adolescent depression treatment, focusing mainly on perceived parent barriers. The results of these qualitative interviews provide a framework for understanding PCP perceptions of parental barriers to care, identifying that addressing complex parental barriers to care may be important for future interventions. PMID:26143382

  5. Differences between novice and experienced caregivers in muscle activity and perceived exertion while repositioning bedridden patients.

    PubMed

    Daikoku, Rie; Saito, Yayoi

    2008-11-01

    The aim of this study was to investigate the impact of caregiver knowledge and experience on muscle activity and perceived exertion while repositioning bedridden patients. Subjects were 40- to 65-year-old female caregivers divided into novice and experienced groups. Subjects from both groups performed home-care repositioning techniques on bedridden patients while muscle activity was recorded via electromyogram. Recordings were made from four muscles on the subjects' dominant side: the latissimus dorsi, the biceps brachii, the erector spinae, and the rectus femoris. The subjective burden involved in repositioning was also assessed using the rate of perceived exertion (RPE) and visual analog scales (VAS). Rectus femoris percentage of maximum voluntary contraction (%MVC) values were significantly lower than latissimus dorsi, erector spinae, and biceps brachii values in the novice group. %MVC values from the latissimus dorsi and biceps brachii were significantly higher among the novice group compared to the experienced group. RPE ratings from the novice group were significantly higher than those of the experienced group, and there was a non-significant trend for higher VAS values for the low back, arms, and legs in the novice group compared to the experienced group. Novice caregivers tended to change the patient's position by pulling with the upper limbs without using the lower limbs. In contrast, experienced caregivers exerted less energy by communicating with the patient and utilizing the patient's own movements. They used large, distributed muscle groups that effectively harnessed body mechanics and prevented excess exertion.

  6. Reasons given by hypertensive patients for concurrently using traditional and Western medicine at Natalspruit Hospital in the Gauteng Province, South Africa

    PubMed Central

    Mabuza, Langalibalele H.; Okonta, Henry I.

    2013-01-01

    Abstract Background In 2007, a large number of hypertensive patients seen at Natalspruit Hospital had poor adherent to their anti-hypertension treatment which manifested itself through poor blood pressure control. On enquiry, they revealed that they were also taking traditional medicines. Objectives To explore the reasons given by hypertensive patients for concurrently using traditional and Western medicine. Methods A qualitative study was conducted amongst nine purposefully selected participants attending treatment at the hospital. Interviews were conducted in the Southern Sotho and IsiZulu languages and were audio-taped. The exploratory question was: ‘Would you tell us why you are taking traditional medicine together with the antihypertensive medicine your are receiving at this hospital?’ The transcribed and translated transcriptions were analysed using the ‘cut and paste’ method to identify themes. Results Themes that emerged were that traditional medicine was readily accessible; traditional healers displayed knowledge and confidence in their medicine; traditional medicine was perceived to counteract the side-effects of western medicine; the two streams were perceived to complement each other and both streams could lead to a ‘cure’. Patients were disappointed at the perceived bad attitude of the hospital staff. Conclusion The reasons given by hypertensive patients for their concurrent use of traditional and Western medicine centred around patients’ relatively favourable perception of traditional medicine and its practitioners. Western medicine health care practitioners should continue health education on antihypertensive medication in a manner acceptable to patients.

  7. The Research on the Factors of Purchase Intention for Fresh Agricultural Products in an E-Commerce Environment

    NASA Astrophysics Data System (ADS)

    Han, Dan; Mu, Jing

    2017-12-01

    Based on the characteristics of e-commerce of fresh agricultural products in China, and using the correlation analysis method, the relational model between product knowledge, perceived benefit, perceived risk and purchase intention is constructed. The Logistic model is used to carry in the empirical analysis. The influence factors and the mechanism of online purchase intention are explored. The results show that consumers’ product knowledge, perceived benefit and perceived risk can affect their purchase intention. Consumers’ product knowledge has a positive effect on perceived benefit and perceived benefit has a positive effect on purchase intention. Consumers’ product knowledge has a negative effect on perceived risk, and perceived profit has a negative effect on perceived risk, and perceived risk has a negative effect on purchase intention. Through the empirical analysis, some feasible suggestions for the government and electricity supplier enterprises can be provided.

  8. 'Bright side' and 'dark side' hypomania are associated with differences in psychological functioning, sleep and physical activity in a non-clinical sample of young adults.

    PubMed

    Brand, Serge; Gerber, Markus; Pühse, Uwe; Holsboer-Trachsler, Edith

    2011-06-01

    No research has yet focused on hypomanic states in non-clinical early adult populations. The aim of the present study was therefore to assess hypomania in a large non-clinical sample of young adults. A total of 862 participants (639 females and 223 males; mean age: M=24.67; SD=5.91) took part in the study. They completed a series of validated self-report questionnaires assessing hypomania (HCL-32) and other aspects of psychological functioning, sleep, stress, quality of life, cognitive-emotional elaboration of pain, self-efficacy, and physical activity. Based on the HCL-32, 19% of the participants (n=169) were categorized as currently being in a hypomanic state. Of those, 57.6% were classified as "active/elated" ('bright side'), whereas 42.4% were classified as "irritable/risk-taking" ('dark side'). Compared to non-hypomanic participants and the 'bright side' group, 'dark side' hypomanic participants reported more depressive symptoms, sleep disturbances, somatic complaints, perceived stress, negative coping strategies, and lower self-efficacy. By contrast, 'bright side' hypomanic participants had lower stress scores, more positive self-instructions, and higher levels of exploration, self-efficacy, and physical activity. A cross-sectional design was adopted, assessing university students, who may not be representative of the stage of early adulthood. The present results underscore the notion of a continuity between a mood state and both favorable ('bright side') and unfavorable ('dark side') hypomanic states. In early adulthood, 'bright' and 'dark side' hypomania differs with respect to physical activity, psychological functioning and sleep. Copyright © 2010 Elsevier B.V. All rights reserved.

  9. Effect of Court Dimensions on Players’ External and Internal Load during Small-Sided Handball Games

    PubMed Central

    Corvino, Matteo; Tessitore, Antonio; Minganti, Carlo; Sibila, Marko

    2014-01-01

    The aim of this study was to investigate the effect of three different court dimensions on the internal and external load during small-sided handball games. Six male amateur handball players took part in this study and participated in three different 8-min 3vs3 (plus goalkeepers) small-sided handball games (each repeated twice). The three court dimensions were 12×24m, 30×15m and 32×16m. Through Global Positioning System devices (SPI pro elite 15Hz, GPSports) and video analysis, the following parameters were recorded: cyclic and acyclic movements (distance covered and number of technical actions executed), heart rate, and rating of perceived exertion (RPE). Total distance travelled increased with court dimensions (885.2m ± 66.6m in 24×12m; 980.0m ± 73.4m in 30×15m; 1095.0m ± 112.9m in 32×16m, p < 0.05). The analysis of distance covered in the four speed zones (0–1.4 m·s-1; 1.4–3.4 m·s-1; 3.4–5.2 m·s-1; >5.2 m·s-1) highlighted substantial differences: playing with the 30×15m court in comparison to the 24×12m, the players covered less distance in the first speed zone (p = 0.012; ES = 0.70) and more distance in the second (p = 0.049; ES = 0.73) and third (p = 0.012; ES = 0.51) speed zones. Statistical differences were also found between the 24×12m and 32×16m courts: the players covered more distance in the second and third speed zones (p = 0.013, ES = 0.76; p = 0.023 ES = 0.69) with the 32×16m court in comparison to the 24×12m. There was no significant effect of court dimensions on the technical parameters (number of team actions, passes, piston movements toward goal and defensive activities), the number of specific handball jumps and changes of direction, and the time spent in the different heart rate zones. Considering the average data of all the experimental conditions together (24×12m, 30×15m, 32×16m), a pronounced statistical difference was highlighted between the values in first two HR zones and the last two (p < 0.05; large ES). The rating of perceived exertion was significantly higher during the drill with the 32×16m court compared with the 24×12m one (p < 0.05; ES = 2.34). Our findings indicate that changing court dimensions during small-sided handball games can be used to manipulate both external and internal loads on the players. Key points To cover the specific game demands, more specific training methodologies have been developed in many sport games. Specific game exercises may provide a useful conditioning stimulus, together with technical and tactical training components. Changing court dimensions during small-sided handball games can be used to manipulate both external and internal loads on the players. The high ratio of cyclic activity per minute and the high HR values recorded during SSHGs make this type of drills extremely useful for aerobic power training. PMID:24790482

  10. Effect of Court Dimensions on Players' External and Internal Load during Small-Sided Handball Games.

    PubMed

    Corvino, Matteo; Tessitore, Antonio; Minganti, Carlo; Sibila, Marko

    2014-05-01

    The aim of this study was to investigate the effect of three different court dimensions on the internal and external load during small-sided handball games. Six male amateur handball players took part in this study and participated in three different 8-min 3vs3 (plus goalkeepers) small-sided handball games (each repeated twice). The three court dimensions were 12×24m, 30×15m and 32×16m. Through Global Positioning System devices (SPI pro elite 15Hz, GPSports) and video analysis, the following parameters were recorded: cyclic and acyclic movements (distance covered and number of technical actions executed), heart rate, and rating of perceived exertion (RPE). Total distance travelled increased with court dimensions (885.2m ± 66.6m in 24×12m; 980.0m ± 73.4m in 30×15m; 1095.0m ± 112.9m in 32×16m, p < 0.05). The analysis of distance covered in the four speed zones (0-1.4 m·s(-1); 1.4-3.4 m·s(-1); 3.4-5.2 m·s(-1); >5.2 m·s(-1)) highlighted substantial differences: playing with the 30×15m court in comparison to the 24×12m, the players covered less distance in the first speed zone (p = 0.012; ES = 0.70) and more distance in the second (p = 0.049; ES = 0.73) and third (p = 0.012; ES = 0.51) speed zones. Statistical differences were also found between the 24×12m and 32×16m courts: the players covered more distance in the second and third speed zones (p = 0.013, ES = 0.76; p = 0.023 ES = 0.69) with the 32×16m court in comparison to the 24×12m. There was no significant effect of court dimensions on the technical parameters (number of team actions, passes, piston movements toward goal and defensive activities), the number of specific handball jumps and changes of direction, and the time spent in the different heart rate zones. Considering the average data of all the experimental conditions together (24×12m, 30×15m, 32×16m), a pronounced statistical difference was highlighted between the values in first two HR zones and the last two (p < 0.05; large ES). The rating of perceived exertion was significantly higher during the drill with the 32×16m court compared with the 24×12m one (p < 0.05; ES = 2.34). Our findings indicate that changing court dimensions during small-sided handball games can be used to manipulate both external and internal loads on the players. Key pointsTo cover the specific game demands, more specific training methodologies have been developed in many sport games.Specific game exercises may provide a useful conditioning stimulus, together with technical and tactical training components.Changing court dimensions during small-sided handball games can be used to manipulate both external and internal loads on the players.The high ratio of cyclic activity per minute and the high HR values recorded during SSHGs make this type of drills extremely useful for aerobic power training.

  11. On facial asymmetry and self-perception.

    PubMed

    Lu, Stephen M; Bartlett, Scott P

    2014-06-01

    Self-perception has been an enduring human concern since ancient times and remains a significant component of the preoperative and postoperative consultation. Despite modern technological attempts to reproduce the first-hand experience, there is no perfect substitute for human, stereoscopic, three-dimensional vision in evaluating appearance. Nowadays, however, the primary tools available to a patient for examining his or her own appearance, particularly the face, are photographs and mirrors. Patients are often unaware of how cameras and photographs can distort and degrade image quality, leading to an inaccurate representation of true appearance. Everyone knows that mirrors reverse an image, left and right, and most people recognize their own natural facial asymmetry at some level. However, few realize that emotions are not only expressed unequally by the left and right sides of the face but also perceived unequally by others. The impact and effect of this "facedness" is completely reversed by mirrors, potentially creating a significant discrepancy between what a patient perceives of himself or herself and what the surgeon or other third party sees. This article ties together the diverse threads leading to this problem and suggests several ways of mitigating the issue through technology and patient counseling.

  12. A qualitative assessment of decisions affecting contraceptive utilization and fertility intentions among HIV-positive women in Soweto, South Africa.

    PubMed

    Laher, Fatima; Todd, Catherine S; Stibich, Mark A; Phofa, Rebecca; Behane, Xoliswa; Mohapi, Lerato; Gray, Glenda

    2009-06-01

    The HIV epidemic in sub-Saharan Africa disproportionately affects women of reproductive age. The increasing provision of Highly Active Anti-Retroviral Therapy (HAART) with improved prognosis and maternal-fetal outcomes calls for an understanding of fertility planning for HIV-positive women. We describe the effect of HIV and HAART on pregnancy desires and contraceptive use among HIV-positive women in Soweto, South Africa. Focus group discussions and in-depth interviews were conducted with 42 HIV-positive women of reproductive age. Analysis was performed using ATLAS-ti (ATLAS-ti Center, Berlin). Emergent themes were impact of HIV diagnosis on pregnancy intentions; factors affecting contraceptive uptake including real and normative side effects, body image, and perceived vaginal wetness; and the mitigating influence of partnership on both pregnancy intentions and contraceptive use. Routine counseling about pregnancy desires and contraception should be offered to HIV-positive women.

  13. Affective Antecedents of the Perceived Effectiveness of Antidrug Advertisements: An Analysis of Adolescents’ Momentary and Retrospective Evaluations

    PubMed Central

    Vohs, Kathleen D.; Luciana, Monica; Cuthbert, Bruce N.; MacDonald, Angus W.

    2013-01-01

    Perceived message effectiveness is often used as a diagnostic tool to determine whether a health message is likely to be successful or needs modification before use in an intervention. Yet, published research on the antecedents of perceived effectiveness is scarce and, consequently, little is known about why a message is perceived to be effective or ineffective. The present study’s aim was to identify and test the affective antecedents of perceived effectiveness of antidrug television messages in a sample of 190 adolescents in the 15–19 year age range. Factor-analytical tests of retrospective message evaluation items suggested two dimensions of perceived effectiveness, one that contained items such as convincingness whereas the other contained pleasantness items. Using retrospective data as well as real time valence and arousal ratings, we found that arousal underlies perceived convincingness and valence underlies perceived pleasantness. The results indicated activation of appetitive and defensive motivational systems, which suggests a clear motivational component to the concept of perceived message effectiveness. PMID:21499729

  14. Crossing the perspectives of patients, families, and physicians on cancer treatment: A qualitative study

    PubMed Central

    Bousquet, Guilhem; Labey, Mathilde; Gueguen, Juliette; Laporte, Cyril; Winterman, Sabine; Picard, Camille; Nascimbeni, Clara; Verneuil, Laurence; Revah-Levy, Anne

    2017-01-01

    Purpose Patients, family members, and physicians participate in cancer care, but their perspectives about what is helpful during cancer treatment have rarely been compared. The aim of this study was to compare these three perspectives. Methods Multicenter qualitative study (with previously published protocol) based on 90 semi-structured interviews. Participants (purposively selected until data saturation) came from three different subsamples: (i) patients with cancer (n=30), (ii) their relatives (n=30), and (iii) their referring physicians (n=10, interviewed more than once). Results Our analysis found 3 main axes (perceived positive effects of cancer treatment, perceived negative effects of cancer treatment, doctor-physician relationship), each composed of 2 main themes. The findings showed that patients, families, and physicians shared the long-term objective of increasing survival (while reducing side effects). However, patients and relatives also pointed out the importance of living with cancer each day and thus of factors helping them to live as well as possible in daily life. The physicians difficulty in coping with patients suffering may limit their access to elements that can improve patients capacity to live as well as possible. Conclusions During cancer treatment (and not only at the end of life), attention should be given to enhancing the capacity of patients to live as well as possible (not only as long as possible) to meet the goals of patient-centered care and satisfy this important need of patients and families. PMID:27769072

  15. Vaccine knowledge and practices of primary care providers of exempt vs. vaccinated children

    PubMed Central

    Salmon, Daniel A.; Pan, William K.Y.; Omer, Saad B.; Navar, Ann Marie; Orenstein, Walter; Marcuse, Edgar K.; Taylor, James; deHart, M. Patricia; Stokley, Shannon; Carter, Terrell; Halsey, Neal A.

    2014-01-01

    Objectives: Compare vaccine knowledge, attitudes and practices of primary care providers for fully vaccinated children and children who are exempt from school immunization requirements. Methods: We conducted a mailed survey of parent-identified primary care providers from four states to measure perceived risks and benefits of vaccination and other key immunization beliefs. Frequencies of responses were stratified by type of provider, identified by exempt versus vaccinated children. Logistic regression was used to calculate odds ratios for responses by provider type. Results: 551 surveys were completed (84.3% response rate). Providers for exempt children had similar attitudes to providers for non-exempt children. However, there were statistically significant increased concerns among providers for exempt children regarding vaccine safety and lack of perceived individual and community benefits for vaccines compared to other providers. Conclusions: The great majority of providers for exempt children had similar attitudes about vaccine safety, effectiveness and benefits as providers of non-exempt children. Although providers for exempt children were more likely to believe that multiple vaccines weaken a child’s immune system and were concerned about vaccine safety and less likely to consider vaccines were beneficial, a substantial proportion of providers of both exempt and vaccinated children have concerns about vaccine safety and believe that CDC underestimates the frequency of vaccine side effects. Effective continuing education of providers about the risks and benefits of immunization and including in vaccine recommendations more information on pre and post licensing vaccine safety evaluations may help address these concerns. PMID:18424918

  16. Medication errors: the role of the patient.

    PubMed

    Britten, Nicky

    2009-06-01

    1. Patients and their carers will usually be the first to notice any observable problems resulting from medication errors. They will probably be unable to distinguish between medication errors, adverse drug reactions, or 'side effects'. 2. Little is known about how patients understand drug related problems or how they make attributions of adverse effects. Some research suggests that patients' cognitive models of adverse drug reactions bear a close relationship to models of illness perception. 3. Attributions of adverse drug reactions are related to people's previous experiences and to their level of education. The evidence suggests that on the whole patients' reports of adverse drug reactions are accurate. However, patients do not report all the problems they perceive and are more likely to report those that they do perceive as severe. Patients may not report problems attributed to their medications if they are fearful of doctors' reactions. Doctors may respond inappropriately to patients' concerns, for example by ignoring them. Some authors have proposed the use of a symptom checklist to elicit patients' reports of suspected adverse drug reactions. 4. Many patients want information about adverse drug effects, and the challenge for the professional is to judge how much information to provide and the best way of doing so. Professionals' inappropriate emphasis on adherence may be dangerous when a medication error has occurred. 5. Recent NICE guidelines recommend that professionals should ask patients if they have any concerns about their medicines, and this approach is likely to yield information conducive to the identification of medication errors.

  17. Perceived reachability in single- and multiple-degree-of-freedom workspaces.

    PubMed

    Gabbard, Carl; Ammar, Diala; Lee, Sunghan

    2006-11-01

    In comparisons of perceived (imagined) and actual reaches, investigators consistently find a tendency to overestimate. A primary explanation for that phenomenon is that individuals reach as a "whole-body engagement" involving multiple degrees of freedom (m-df). The authors examined right-handers (N = 28) in 1-df and m-df workspaces by having them judge the reachability of targets at midline, right, and left visual fields. Response profiles were similar for total error. Both conditions reflected an overestimation bias, although the bias was significantly greater in the m-df condition. Midline responses differed (greater overestimation) from those of right and left visual fields, which were similar. Although the authors would have predicted better performance in the m-df condition, it seems plausible that if individuals think in terms of m-df, they may feel more confident in that condition and thereby exhibit greater overestimation. Furthermore, the authors speculate that the reduced bias at the side fields may be attributed to a more conservative strategy based in part on perceived reach constraints.

  18. Living on Both Sides of the Fence: A Phenomenological Study of Human Resource Development Professionals as Downsizing Survivors and Strategic Human Resource Development Facilitators

    ERIC Educational Resources Information Center

    Nackoney, Claire Kostopulos

    2012-01-01

    This phenomenological study explored how HR professionals who identified themselves as facilitators of strategic HRD (SHRD) perceived the experience of being an organizational agent-downsizing survivor. Criterion and snowball sampling were used to recruit 15 participants for this study. A semi-structured interview guide was used to interview…

  19. Preparation and Validation of Mentor Self-Efficacy and Perceived Program Support Scales (M-SEPPS): An Empirical Study in Mentoring Intervention Models

    ERIC Educational Resources Information Center

    Calvery, Suzannah Vallejo

    2013-01-01

    Mentoring research to date focuses on outcomes related to program goals and theoretical background, and almost all of these relate to the experience of the mentee. Very little research has been completed on the other side of the dyad--the mentor--despite the fact that mentor expectations and experience contribute significantly to the perceived…

  20. Crossing to the Dark Side? An Interview-Based Comparison of Traditional and For-Profit Higher Education. Private Enterprise in American Education. Special Report 4

    ERIC Educational Resources Information Center

    Wildavsky, Ben

    2011-01-01

    In the past year, for-profit higher education providers have been thrust into the spotlight. The fastest growing postsecondary sector has come under unprecedented scrutiny from policymakers, regulators, and the media. Critics have zeroed in on a range of concerns, from perceived dubious recruiting tactics and overblown promises about students'…

  1. Proceedings of the Annual Meeting of the Association for Education in Journalism and Mass Communication (86th, Kansas City, Missouri, July 30-August 2, 2003). Communication Technology and Policy Division.

    ERIC Educational Resources Information Center

    2003

    The Communication Technology and Policy Division of the proceedings contains the following 15 papers: "Both Sides of the Digital Divide in Appalachia: Uses and Perceived Benefits of Internet Access" (Daniel Riffe); "Bridging Newsrooms and Classrooms: Preparing the Next Generation of Journalists for Converged Media" (Edgar…

  2. Emotional Labor in the Dual Role of Teaching and Coaching.

    PubMed

    Lee, Ye Hoon; Chelladurai, Packianathan; Kang, Chanho

    2017-01-01

    This study investigated the emotional labor involved in two forms of sport services-teaching and coaching-as perceived by high school teacher-coaches regarding required emotional displays and the use of emotional labor strategies. A total of 403 high school teacher-coaches from 47 states in the United States completed the online questionnaires measuring their perceptions of required emotional displays and their uses of emotional labor strategies in the two occupational roles. Results showed that there was no significant difference in the perception of positive emotional displays as required among participants. However, participants perceived that the expressions of friendliness and cheerfulness were more required in teaching than in coaching. On the other side, negative emotional displays were perceived to be more required in coaching than in teaching. That is, expressing upset, disappointment, anger, unhappiness, and frustration were perceived differently among participants. Also, participants utilized more surface acting when teaching and employed more genuine expression when coaching. The findings of this study highlight that differences do exist in the perception of required emotional displays and the utilization of emotional labor strategies in the two roles of teaching and coaching. These results were discussed in light of the task and group differences between teaching and coaching.

  3. Preferences for a potential longer-acting injectable contraceptive: perspectives from women, providers, and policy makers in Kenya and Rwanda.

    PubMed

    Tolley, Elizabeth E; McKenna, Kevin; Mackenzie, Caroline; Ngabo, Fidele; Munyambanza, Emmanuel; Arcara, Jennet; Rademacher, Kate H; Lendvay, Anja

    2014-05-01

    Between 1995 and 2005, injectable use doubled worldwide. However, discontinuation rates remain high, partly because of side effects but also because of missed appointments for reinjection. A longer-acting injectable (LAI) may improve compliance by reducing the required number of reinjection visits, thereby reducing unintentional discontinuation. This study examined acceptability of LAI characteristics comprising the target product profile (TPP). In 2012, we conducted qualitative case studies in Kenya and Rwanda, consisting of 19 focus group discussions (FGDs) with 177 current, previous, or never users of injectables and 46 in-depth interviews (IDIs) with providers, program implementers, and policy makers. FGDs and IDIs assessed current injectable experiences; attitudes toward potential LAI products; and perceptions of TPP attributes, including ranking preferences for the most and least important characteristics. In addition, we obtained completed electronic surveys from 28 international family planning opinion leaders about the perceived need for an LAI, important product characteristics, and challenges to LAI development or introduction. Many FGD participants and interviewees spontaneously expressed strong interest in an LAI, but there was some variation in TPP preferences. The majority of participants ranked effectiveness as the most important TPP attribute. Providers were generally more concerned about side effects than potential users; some potential users suggested that side effects were related less to the product than to their own body chemistry and that side effects were acceptable as long as they did not last a long time or disrupt daily activities. Women and providers, especially in Kenya, preferred a method with a predictable return to fertility. Some participants associated amenorrhea with delayed or reduced fertility. Most women and providers preferred delivery of the LAI in a single, prepackaged, disposable injection system to facilitate injections by providers and to reduce the risk of pain or discomfort for women. While providers and policy makers ranked cost as one of the most important issues, it was among the least important issues for most potential users. Many Kenyan, but few Rwandan, participants appeared willing to pay for an LAI, with some presuming cost savings from reduced menstruation and fewer clinic visits. Some TPP preferences for an LAI have implications for product development decisions about formulation, delivery mechanism, or presentation, while others point to the need for tailored communication and counseling approaches to ensure acceptability and adherence within clinical trials and beyond.

  4. Killing wolves to prevent predation on livestock may protect one farm but harm neighbors

    PubMed Central

    Cornman, Ari M.; Treves, Adrian

    2018-01-01

    Large carnivores, such as gray wolves, Canis lupus, are difficult to protect in mixed-use landscapes because some people perceive them as dangerous and because they sometimes threaten human property and safety. Governments may respond by killing carnivores in an effort to prevent repeated conflicts or threats, although the functional effectiveness of lethal methods has long been questioned. We evaluated two methods of government intervention following independent events of verified wolf predation on domestic animals (depredation) in the Upper Peninsula of Michigan, USA between 1998–2014, at three spatial scales. We evaluated two intervention methods using log-rank tests and conditional Cox recurrent event, gap time models based on retrospective analyses of the following quasi-experimental treatments: (1) selective killing of wolves by trapping near sites of verified depredation, and (2) advice to owners and haphazard use of non-lethal methods without wolf-killing. The government did not randomly assign treatments and used a pseudo-control (no removal of wolves was not a true control), but the federal permission to intervene lethally was granted and rescinded independent of events on the ground. Hazard ratios suggest lethal intervention was associated with an insignificant 27% lower risk of recurrence of events at trapping sites, but offset by an insignificant 22% increase in risk of recurrence at sites up to 5.42 km distant in the same year, compared to the non-lethal treatment. Our results do not support the hypothesis that Michigan’s use of lethal intervention after wolf depredations was effective for reducing the future risk of recurrence in the vicinities of trapping sites. Examining only the sites of intervention is incomplete because neighbors near trapping sites may suffer the recurrence of depredations. We propose two new hypotheses for perceived effectiveness of lethal methods: (a) killing predators may be perceived as effective because of the benefits to a small minority of farmers, and (b) if neighbors experience side-effects of lethal intervention such as displaced depredations, they may perceive the problem growing and then demand more lethal intervention rather than detecting problems spreading from the first trapping site. Ethical wildlife management guided by the “best scientific and commercial data available” would suggest suspending the standard method of trapping wolves in favor of non-lethal methods (livestock guarding dogs or fladry) that have been proven effective in preventing livestock losses in Michigan and elsewhere. PMID:29320512

  5. Competition in the Brain. The Contribution of EEG and fNIRS Modulation and Personality Effects in Social Ranking.

    PubMed

    Balconi, Michela; Vanutelli, Maria E

    2016-01-01

    In the present study, the social ranking perception in competition was explored. Brain response (alpha band oscillations, EEG; hemodynamic activity, O2Hb), as well as self-perception of social ranking, cognitive performance, and personality trait (Behavioral Activation System, BAS) were considered during a competitive joint-action. Subjects were required to develop a strategy to obtain a better outcome than a competitor (C) (in term of error rate, and response time, RT). A pre-feedback (without a specific feedback on the performance) and a post-feedback condition (which reinforced the improved performance) were provided. It was found that higher-BAS participants responded in greater measure to perceived higher cognitive performance (post-feedback condition), with increased left prefrontal activity, higher ranking perception, and a better real performance (reduced RTs). These results were explained in term of increased sense of self-efficacy and social position, probably based on higher-BAS sensitivity to reinforcing conditions. In addition, the hemispheric effect in favor of the left side characterized the competitive behavior, showing an imbalance for high-BAS in comparison to low-BAS in the case of a rewarding (post-feedback) context. Therefore, the present results confirmed the significance of BAS in modulating brain responsiveness, self-perceived social position, and real performance during an interpersonal competitive action which is considered highly relevant for social status.

  6. The effect of visual scanning exercises integrated into physiotherapy in patients with unilateral spatial neglect poststroke: a matched-pair randomized control trial.

    PubMed

    van Wyk, Andoret; Eksteen, Carina A; Rheeder, Paul

    2014-01-01

    Unilateral spatial neglect (USN) is a visual-perceptual disorder that entails the inability to perceive and integrate stimuli on one side of the body, resulting in the neglect of one side of the body. Stroke patients with USN present with extensive functional disability and duration of therapy input. To determine the effect of saccadic eye movement training with visual scanning exercises (VSEs) integrated with task-specific activities on USN poststroke. A matched-pair randomized control trial was conducted. Subjects were matched according to their functional activity level and allocated to either a control (n = 12) or an experimental group (n = 12). All patients received task-specific activities for a 4-week intervention period. The experimental group received saccadic eye movement training with VSE integrated with task specific activities as an "add on" intervention. Assessments were conducted weekly over the intervention period. Statistical significant difference was noted on the King-Devick Test (P = .021), Star Cancellation Test (P = .016), and Barthel Index (P = .004). Intensive saccadic eye movement training with VSE integrated with task-specific activities has a significant effect on USN in patients poststroke. Results of this study are supported by findings from previously reviewed literature in the sense that the effect of saccadic eye movement training with VSE as an intervention approach has a significant effect on the visual perceptual processing of participants with USN poststroke. The significant improved visual perceptual processing translate to significantly better visual function and ability to perform activities of daily living following the stroke. © The Author(s) 2014.

  7. A qualitative assessment of the perceived risks of electronic cigarette and hookah use in pregnancy.

    PubMed

    Kahr, Maike K; Padgett, Shannon; Shope, Cindy D; Griffin, Emily N; Xie, Susan S; Gonzalez, Pablo J; Levison, Judy; Mastrobattista, Joan; Abramovici, Adi R; Northrup, Thomas F; Stotts, Angela L; Aagaard, Kjersti M; Suter, Melissa A

    2015-12-21

    Studies reveal that electronic cigarette (e-cigarette) and hookah use are increasing among adolescents and young adults. However, the long-term health effects are unknown, especially with regards to pregnancy. Because of the increased use in women of reproductive age, and the unknown long-term health risks, our primary objectives were to determine the perceived risks of e-cigarette and hookah use in pregnancy, and learn common colloquial terms associated with e-cigarettes. Furthermore, we sought to determine if there is a stigma associated with e-cigarette use in pregnancy. Eleven focus groups including 87 participants were conducted immediately following regularly scheduled CenteringPregnancy® prenatal care with women at three different clinics in the greater Houston area. A minimum of two facilitators led the groups, using ten lead-in prompts, with Spanish translation as necessary. Facilitators took notes which were compared immediately following each group discussion and each group was audio recorded and transcribed. Three facilitators utilized NVivo 9.0 software to organize the transcribed data into nodes to identify major themes. To increase rigor, transcripts were further analyzed by two obstetricians who were instructed to find the major themes. Analyses revealed contradicting themes concerning e-cigarette use. In general, e-cigarettes were perceived as safer alternatives to regular tobacco cigarettes, especially if used as smoking cessation devices. A major theme is that use in pregnancy is harmful to the fetus. However, it was perceived that use for smoking cessation in pregnancy may have fewer side effects. We found that a common term for e-cigarettes is "Blu." In our discussion of hookah use, participants perceived use as popular among teenagers and that use in pregnancy is dangerous for the fetus. Although a strong theme emerged against hookah use, we found contradicting themes in our discussions on e-cigarette use in pregnancy. It is possible that e-cigarette use will not carry the same stigma as regular cigarette smoking in pregnancy. In addition, the impression of e-cigarettes as a healthier alternative to smoking may influence use in pregnancy. Clinicians need to be prepared for questions of e-cigarette safety and efficacy as smoking cessation devices from their pregnant patients who smoke, and women who smoke and are planning to become pregnant.

  8. Variation of activity demands in small-sided soccer games.

    PubMed

    Dellal, A; Drust, B; Lago-Penas, C

    2012-05-01

    The aim of the present study was to examine the physical and technical activity during different periods within small-sided soccer games (SSGs). 20 elite players completed 3 different SSGs (2-a-side, 3-a-side and 4-a-side games) in which the number of ball touches per individual possession was fixed at a maximum of 2. The duration and the pitch size of each SSG were strictly controlled (2 min, 3 min, 4 min, respectively; 1:75 m2) with each period repeated 4 times (P1, P2, P3, P4). The physical and technical activities, heart rate responses, blood lactate concentration and rating of perceived exertion (RPE) were analysed. The results showed a decrease of high and very high-intensity activities (from - 26.2% to - 37.7%, P<0.001), an increase of blood lactate concentration (from + 28.0% to + 76.9%), RPE (from + 29.0% to + 32.8%), and heart rate responses (~ 6.6%), and a significant alteration of technical activities from P1 to P4 in each SSG. The greatest differences from P1 and P4 were observed for the 2-a-side game when compared to the 3-a-side and 4-a-side games (P<0.05) for each variable analysed . In conclusion, the variation of the player's activity throughout the periods indicates that the duration and number of exercise periods used within SSGs is an important variable in determining the training stimulus in soccer-specific training. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Two sides of the safety coin?: How patient engagement and safety climate jointly affect error occurrence in hospital units.

    PubMed

    Schiffinger, Michael; Latzke, Markus; Steyrer, Johannes

    2016-01-01

    Safety climate (SC) and more recently patient engagement (PE) have been identified as potential determinants of patient safety, but conceptual and empirical studies combining both are lacking. On the basis of extant theories and concepts in safety research, this study investigates the effect of PE in conjunction with SC on perceived error occurrence (pEO) in hospitals, controlling for various staff-, patient-, and hospital-related variables as well as the amount of stress and (lack of) organizational support experienced by staff. Besides the main effects of PE and SC on error occurrence, their interaction is examined, too. In 66 hospital units, 4,345 patients assessed the degree of PE, and 811 staff assessed SC and pEO. PE was measured with a new instrument, capturing its core elements according to a recent literature review: Information Provision (both active and passive) and Activation and Collaboration. SC and pEO were measured with validated German-language questionnaires. Besides standard regression and correlational analyses, partial least squares analysis was employed to model the main and interaction effects of PE and SC on pEO, also controlling for stress and (lack of) support perceived by staff, various staff and patient attributes, and potential single-source bias. Both PE and SC are associated with lower pEO, to a similar extent. The joint effect of these predictors suggests a substitution rather than mutually reinforcing interaction. Accounting for control variables and/or potential single-source bias slightly attenuates some effects without altering the results. Ignoring PE potentially amounts to forgoing a potential source of additional safety. On the other hand, despite the abovementioned substitution effect and conjectures of SC being inert, PE should not be considered as a replacement for SC.

  10. Temperature and color management of silicon solar cells for building integrated photovoltaic

    NASA Astrophysics Data System (ADS)

    Amara, Mohamed; Mandorlo, Fabien; Couderc, Romain; Gerenton, Félix; Lemiti, Mustapha

    2018-01-01

    Color management of integrated photovoltaics must meet two criteria of performance: provide maximum conversion efficiency and allow getting the chosen colors with an appropriate brightness, more particularly when using side by side solar cells of different colors. As the cooling conditions are not necessarily optimal, we need to take into account the influence of the heat transfer and temperature. In this article, we focus on the color space and brightness achieved by varying the antireflective properties of flat silicon solar cells. We demonstrate that taking into account the thermal effects allows freely choosing the color and adapting the brightness with a small impact on the conversion efficiency, except for dark blue solar cells. This behavior is especially true when heat exchange by convection is low. Our optical simulations show that the perceived color, for single layer ARC, is not varying with the position of the observer, whatever the chosen color. The use of a double layer ARC adds flexibility to tune the wanted color since the color space is greatly increased in the green and yellow directions. Last, choosing the accurate material allows both bright colors and high conversion efficiency at the same time.

  11. Gravitational effects on plant growth hormone concentration

    NASA Astrophysics Data System (ADS)

    Bandurski, Robert S.; Schulze, Aga

    Numerous studies, particularly those of H. Dolk in the 1930's, established by means of bio-assay, that more growth hormone diffused from the lower, than from the upper side of a gravity-stimulated plant shoot. Now, using an isotope dilution assay, with 4,5,6,7 tetradeutero indole-3-acetic acid as internal standard, and selected ion monitoring-gas chromatography-mass spectrometry as the method of determination, we have confirmed Dolk's finding and established that the asymmetrically distributed hormone is, in fact, indole-3-acetic acid (IAA). This is the first physico-chemical demonstration that there is more free IAA on the lower sides of a geo-stimulated plant shoot. We have also shown that free IAA occurs primarily in the conductive vascular tissues of the shoot, whereas IAA esters predominate in the growing cortical cells. Now, using an especially sensitive gas chromatographic isotope dilution assay we have found that the hormone asymmetry also occurs in the non-vascular tissue. Currently, efforts are directed to developing isotope dilution assays, with picogram sensitivity, to determine how this asymmetry of IAA distribution is attained so as to better understand how the plant perceives the geo-stimulus.

  12. Contraceptive practice of women with opiate addiction in a rural centre.

    PubMed

    Harding, Catherine; Ritchie, Jan

    2003-01-01

    This study aimed to explore the contraceptive practices of women in methadone treatment for opiate use in rural New South Wales and the reasons for those practices. Demographic characteristics, including age, marital status, sexual activity and contraceptive use, of all 23 women on a rural methadone program were documented. A smaller subgroup of seven women was interviewed using a semi-structured qualitative technique and issues around contraception explored in more depth. The study found that women who did not use contraception often had a low perceived risk of pregnancy for a variety of reasons including past infertility, menstrual irregularities and effect of drugs. The women had concerns about, and often felt guilty about, the effect of drug use on their children. They also had concerns about the side-effects of contraception. The study has implications for education and counselling of women when they enter drug treatment programs. Problems associated with opiate use are not just restricted to metropolitan areas but are part of rural health.

  13. Neuroprotective and anticonvulsant effects of EGIS-8332, a non-competitive AMPA receptor antagonist, in a range of animal models

    PubMed Central

    Gigler, G; Móricz, K; ágoston, M; Simó, A; Albert, M; Benedek, A; Kapus, G; Kertész, S; Vegh, M; Barkóczy, J; Markó, B; Szabó, G; Matucz, É; Gacsályi, I; Lévay, G; Hársing, L G; Szénási, G

    2007-01-01

    Background and purpose: Blockade of AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptors is a good treatment option for a variety of central nervous system disorders. The present study evaluated the neuroprotective and anticonvulsant effects of EGIS-8332, a non-competitive AMPA receptor antagonist, as a potential drug candidate. Experimental approach: AMPA antagonist effects of EGIS-8332 were measured using patch-clamp techniques. Neuroprotective and anticonvulsant effects of EGIS-8332 were evaluated in various experimental models, relative to those of GYKI 53405. Key results: EGIS-8332 inhibited AMPA currents in rat cerebellar Purkinje cells and inhibited the AMPA- and quisqualate-induced excitotoxicity in primary cultures of telencephalon neurons (IC50=5.1-9.0 μM), in vitro. Good anticonvulsant actions were obtained in maximal electroshock-, sound- and chemically-induced seizures (range of ED50=1.4-14.0 mg kg−1 i.p.) in mice. Four days after transient global cerebral ischaemia, EGIS-8332 decreased neuronal loss in the hippocampal CA1 area in gerbils and rats. EGIS-8332 dose-dependently reduced cerebral infarct size after permanent middle cerebral artery occlusion in mice and rats (minimum effective dose=3 mg kg−1 i.p.). Side effects of EGIS-8332 emerged much above its pharmacologically active doses. A tendency for better efficacy of GYKI 53405 than that of EGIS-8332 was observed in anticonvulsant tests that reached statistical significance in few cases, while the contrary was perceived in cerebral ischaemia tests. Conclusions and implications: EGIS-8332 seems suitable for further development for the treatment of epilepsy, ischaemia and stroke based on its efficacy in a variety of experimental disease models, and on its low side effect potential. PMID:17603549

  14. Extremal edges: a powerful cue to depth perception and figure-ground organization.

    PubMed

    Palmer, Stephen E; Ghose, Tandra

    2008-01-01

    Extremal edges (EEs) are projections of viewpoint-specific horizons of self-occlusion on smooth convex surfaces. An ecological analysis of viewpoint constraints suggests that an EE surface is likely to be closer to the observer than the non-EE surface on the other side of the edge. In two experiments, one using shading gradients and the other using texture gradients, we demonstrated that EEs operate as strong cues to relative depth perception and figure-ground organization. Image regions with an EE along the shared border were overwhelmingly perceived as closer than either flat or equally convex surfaces without an EE along that border. A further demonstration suggests that EEs are more powerful than classical figure-ground cues, including even the joint effects of small size, convexity, and surroundedness.

  15. Factors Affecting Adherence to Osteoporosis Medications: A Focus Group Approach Examining Viewpoints of Patients and Providers

    PubMed Central

    Iversen, Maura D; Vora, Ruchita R; Servi, Amber; Solomon, Daniel H

    2011-01-01

    This is a qualitative study using a focus group approach, conducted to determine factors influencing adherence to osteoporosis medications among older adults. Thirty-two patients aged 65 to 85 years from the greater Boston area who were prescribed an osteoporosis medication, 11 general medicine physicians and 1 nurse practitioner were recruited from Boston based hospitals affiliated with a large healthcare system. Focus groups consisting of 6 to 8 subjects including males and females were held separately for providers and patients and conducted until thematic saturation was reached. Responses were obtained from patients and providers during the focus group interviews conducted by a trained focus group moderator. All interviews were audio taped and transcribed by a medical transcriptionist. According to patients, factors affecting adherence to osteoporosis drugs included lack of knowledge about osteoporosis, dissatisfaction with their doctor visits, side effects, and difficulty or failure to remember instructions for taking medications. Physicians reported lack of patient knowledge, structural barriers, medication side effects, and the inability to track patients’ adherence to their medications as barriers to adherence. This study identifies the extent of and reasons for non-adherence as perceived by patients and providers, and provides insights into strategies to modify treatment plans to address non-adherence. The results from this study were used to develop a RCT to conduct and evaluate patient and physician targeted interventions to improve adherence to osteoporosis medications and to examine cost effectiveness of alternative strategies. PMID:21937896

  16. Action-Specific Influences on Perception and Post-Perceptual Processes: Present Controversies and Future Directions

    PubMed Central

    Philbeck, John W.; Witt, Jessica K.

    2015-01-01

    The action-specific perception account holds that people perceive the environment in terms of their ability to act in it. In this view, for example, decreased ability to climb a hill due to fatigue makes the hill visually appear to be steeper. Though influential, this account has not been universally accepted, and in fact a heated controversy has emerged. The opposing view holds that action capability has little or no influence on perception. Heretofore, the debate has been quite polarized, with efforts largely being focused on supporting one view and dismantling the other. We argue here that polarized debate can impede scientific progress and that the search for similarities between two sides of a debate can sharpen the theoretical focus of both sides and illuminate important avenues for future research. In this paper, we present a synthetic review of this debate, drawing from the literatures of both approaches, to clarify both the surprising similarities and the core differences between them. We critically evaluate existing evidence, discuss possible mechanisms of action-specific effects, and make recommendations for future research. A primary focus of future work will involve not only the development of methods that guard against action-specific post-perceptual effects, but also development of concrete, well-constrained underlying mechanisms. The criteria for what constitutes acceptable control of post-perceptual effects and what constitutes an appropriately specific mechanism vary between approaches, and bridging this gap is a central challenge for future research. PMID:26501227

  17. Effects of Small-Sided Games vs. Interval Training in Aerobic Fitness and Physical Enjoyment in Young Elite Soccer Players

    PubMed Central

    Martín, Juan; Lerga, Javier; Sánchez, Felipe; Villagra, Federico; Zulueta, Javier J.

    2015-01-01

    The purpose of this study was to compare the effects of Small-Sided Games (SSG) vs. Interval Training (IT) in soccer training on aerobic fitness and physical enjoyment in youth elite soccer players during the last 8 weeks of the season. Seventeen U-16 male soccer players (age = 15.5 ± 0.6 years, and 8.5 years of experience) of a Spanish First Division club academy were randomized to 2 different groups for 6 weeks: SSG group (n = 9) and IT group (n = 8). In addition to the usual technical and tactical sessions and competitive games, the SSG group performed 11 sessions with different SSGs, whereas the IT group performed the same number of sessions of IT. Players were tested before and after the 6-week training intervention with a continuous maximal multistage running field test and the counter movement jump test (CMJ). At the end of the study, players answered the physical activity enjoyment scale (PACES). During the study, heart rate (HR) and session perceived effort (sRPE) were assessed. SSGs were as effective as IT in maintaining the aerobic fitness in elite young soccer players during the last weeks of the season. Players in the SSG group declared a greater physical enjoyment than IT (P = 0.006; ES = 1.86 ± 1.07). Coaches could use SSG training during the last weeks of the season as an option without fear of losing aerobic fitness while promoting high physical enjoyment. PMID:26331623

  18. Split-Face Comparison of an Advanced Non-Hydroquinone Lightening Solution to 4% Hydroquinone.

    PubMed

    Schlessinger, Joel; Saxena, Subhash; Mohr, Stuart

    2016-12-01

    Hyperpigmentation is a primary concern for many cosmetic patients because of its high rate of occurrence and significant impact on perceived age. While 4% hydroquinone has been the gold-standard of treatment, there is a growing interest in non-hydroquinone solutions, however, many of these newer solutions fail to deliver equivalent improvement. This double-blind, randomized, split-face study compares the effects of a new OTC non-hydroquinone lightening product (JM) to an available 4% hydroquinone lightening solution (OB) on the appearance of hyperpigmentation, texture, and ne lines and wrinkles. Comparisons were determined by both physician assessment and subject self-assessment at baseline, 4, 8, and 12 weeks. Physician assessment showed statistically equivalent improvement on both sides of the face with the JM side showing equivalent or superior average improvement in all assessed categories. Subject self-assessment showed a significant preference for the JM product over the 4% hydroquinone and a substantially higher perception of overall improvement over 4% hydroquinone (P=0.058). Physician assessment showed equal or superior average improvement in all measured categories with no statistically significant difference between the two sides. Subject self-assessment, however, showed a significant and growing preference toward the investigated JM product over the course of the study. Overall, the results of this study show the JM product to be equivalent if not superior to 4% hydroquinone for results and patient satisfaction. J Drugs Dermatol. 2016;15(12):1571-1577.

  19. The Effect of Recovery Duration on Technical Proficiency during Small Sided Games of Football.

    PubMed

    McLean, Scott; Kerhervé, Hugo; Naughton, Mitchell; Lovell, Geoff P; Gorman, Adam D; Solomon, Colin

    2016-07-08

    The aim of this study was to determine the effect of increasing the duration of the recovery periods separating serial bouts of small sided games (SSG) of football on technical skills (TS). Twelve semi-professional footballers (mean ± SD; age 21 ± 3 years; VO 2peak 64 ± 7 mL∙min∙kg -1 ; playing experience 15 ± 3 years) completed two SSG sessions, consisting of 3 vs. 3 players and 6 bouts of 2 min, separated by either 30 s recovery (REC-30) or 120 s recovery (REC-120). Sixteen TS, including passing, possession, and defensive related variables, and exercise intensity (heart rate, rating of perceived exertion, time motion descriptors) during the bouts were measured. Repeated measures ANOVA were used to determine differences between-conditions, for TS. The number of successful tackles was significantly higher, and the average time each team maintained possession was significantly lower in REC-120 compared to REC-30. There were no significant differences for all other TS variables, or exercise intensity measures between REC-30 and REC-120. Overall, a four-fold increase in the duration of recovery separating SSG bouts did not alter the technical skill execution of players. The experience and skill level of the players, combined with an apparent regulation of effort through pacing, may have assisted in the maintenance of technical skill execution.

  20. Determinants of oral contraceptive pill use and its discontinuation among rural women in Bangladesh

    PubMed Central

    HUMBLE, MORAG ELIZABETH

    2006-01-01

    Oral contraceptive pills (OCP) contribute a major share in the current method‐mix in Bangladesh. However, multiple studies show high discontinuation rates of OCP. The present study examines the behavior and attitude towards OCP use, and investigates the determinants of its discontinuation among the rural married women of Bangladesh. The present study is based on critical analyses of the data from 24 focus group discussions and 135 in‐depth‐interviews with women, their husbands and key informants conducted over the period of 1 year. The present study shows that more than two‐thirds of married women have at one time or another used OCP as a method of family planning. However, many women did not take the pills regularly and about one‐quarter of ever users had taken, at one stage or another, a ‘short break’ from OCP use. Although nearly half of them took a break because of side effects, interestingly, 16% took a break as the result of fear of health problems that were related to ‘folk stories’ and other misconceptions. The individual assessment by users of the national family planning service delivery, perceived side effects, misconceptions about continuous use of pills, quality of counseling and information, and contraceptive behavior of the OCP users considerably influenced the decisions on contraceptive use or non‐use. (Reprod Med Biol 2006; 5: 111–121) PMID:29699243

  1. Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya.

    PubMed

    Keesara, Sirina R; Juma, Pamela A; Harper, Cynthia C

    2015-08-20

    Nearly 40% of women in developing countries seek contraceptives services from the private sector. However, the reasons that contraceptive clients choose private or public providers are not well studied. We conducted six focus groups discussions and 51 in-depth interviews with postpartum women (n = 61) to explore decision-making about contraceptive use after delivery, including facility choice. When seeking contraceptive services, women in this study preferred private over public facilities due to convenience and timeliness of services. Women avoided public facilities due to long waits and disrespectful providers. Study participants reported, however, that they felt more confident about the technical medical quality in public facilities than in private, and believed that private providers prioritized profit over safe medical practice. Women reported that public facilities offered comprehensive counseling and chose these facilities when they needed contraceptive decision-support. Provision of comprehensive counseling and screening, including side effects counseling and management, determined perception of quality. Women believed private providers offered the advantages of convenience, efficiency and privacy, though they did not consistently offer high-quality care. Quality-improvement of contraceptive care at private facilities could include technical standardization and accreditation. Development of support and training for side effect management may be an important intervention to improve perceived quality of care.

  2. Adolescents' experiences using the contraceptive patch versus pills.

    PubMed

    Sucato, Gina S; Land, Stephanie R; Murray, Pamela J; Cecchini, Reena; Gold, Melanie A

    2011-08-01

    To compare use of the weekly transdermal contraceptive patch (patch) with daily combined hormonal contraceptive pills (pills) in adolescents. Prospective longitudinal study of adolescents' self-selected (non-randomized) use of the patch or pills. Urban, university hospital-affiliated, adolescent outpatient clinic. 13-22-year-old female adolescents seeking hormonal contraception, 40 who chose the patch and 40 who chose pills. Data were collected via self-report on paper questionnaires at three-cycle intervals for a total of up to nine cycles. Method continuation, perfect use, method satisfaction, quality of life, and side effects, including menstrual changes and perceived mood changes. After nine cycles, 38% of patch users and 60% of pill users were still using the method they had chosen at enrollment. There were no significant differences between the groups in self-reported perfect use. No differences were found in quality of life or side effects. Both patch and pill users noted menses became lighter and more predictable and reported decreased depression prior to their menses; only the pill group reported improvement in premenstrual anger. Method satisfaction was similar in both groups except patch users were more likely to report that their contraceptive method improved normal daily activities. Despite apparent advantages of the patch over the pill, adolescents using both methods continue to face challenges achieving perfect and sustained contraceptive use. 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  3. "We Want No Teachers Who Say There Are Two Sides to Every Question": Conservative Women and Education in the 1930s

    ERIC Educational Resources Information Center

    Erickson, Christine K.

    2006-01-01

    This paper focuses on conservative women and education in the 1930s. Conservative women were particularly concerned, if not contentious, about the alleged state of affairs in the schools. Their ideas about education and their imperative, as they saw it, to preserve a patriotic heritage and to agitate against perceived threats to that heritage are…

  4. Learning to throw on a rotating carousel: recalibration based on limb dynamics and projectile kinematics.

    PubMed

    Bruggeman, Hugo; Pick, Herbert L; Rieser, John J

    2005-05-01

    Skilled actions exhibit adjustment in calibration to bring about their goals. The sought-after calibrations change as a function of the environmental situation that stages the actions. In these experiments participants sat on one side of a rotating carousel and threw beanbags underhanded at a target fixed on the opposite side. Logically, aimed throwing in this situation involves adjustment to fit changes in limb dynamics (originating from Coriolis forces) and changes in perceived projectile kinematics (originating from the tangential velocity of thrower and target). We studied whether such adjustment involved one or multiple components of recalibration. An initial experiment showed that exposure to rotation while throwing beanbags produced a robust recalibration in the direction of underhanded throws as manifest in throwing at stationary targets from a stationary position. Following some initial decay this recalibration persisted and approached an asymptote. Subsequent experiments suggested two independent components of recalibration. One is based on limb dynamics and accounts for the initial decay. The other is based on the perceived projectile kinematics and accounts for the stable change in throwing direction. These results raised the question of how multiple components of recalibration of an action are related. We propose that movement components are independent and calibrated separately at different levels in the organization of an action.

  5. The impact of working technique on physical loads - an exposure profile among newspaper editors.

    PubMed

    Lindegård, A; Wahlström, J; Hagberg, M; Hansson, G-A; Jonsson, P; Wigaeus Tornqvist, E

    2003-05-15

    The aim of this study was to investigate the possible associations between working technique, sex, symptoms and level of physical load in VDU-work. A study group of 32 employees in the editing department of a daily newspaper answered a questionnaire, about physical working conditions and symptoms from the neck and the upper extremities. Muscular load, wrist positions and computer mouse forces were measured. Working technique was assessed from an observation protocol for computer work. In addition ratings of perceived exertion and overall comfort were collected. The results showed that subjects classified as having a good working technique worked with less muscular load in the forearm (extensor carpi ulnaris p=0.03) and in the trapezius muscle on the mouse operating side (p=0.02) compared to subjects classified as having a poor working technique. Moreover there were no differences in gap frequency (number of episodes when muscle activity is below 2.5% of a reference contraction) or muscular rest (total duration of gaps) between the two working technique groups. Women in this study used more force (mean force p=0.006, peak force p=0.02) expressed as % MVC than the men when operating the computer mouse. No major differences were shown in muscular load, wrist postures, perceived exertion or perceived comfort between men and women or between cases and symptom free subjects. In conclusion a good working technique was associated with reduced muscular load in the forearm muscles and in the trapezius muscle on the mouse operating side. Moreover women used more force (mean force and peak force) than men when operating the click button (left button) of the computer mouse.

  6. The perception of (naked only) bodies and faceless heads relies on holistic processing: Evidence from the inversion effect.

    PubMed

    Bonemei, Rob; Costantino, Andrea I; Battistel, Ilenia; Rivolta, Davide

    2018-05-01

    Faces and bodies are more difficult to perceive when presented inverted than when presented upright (i.e., stimulus inversion effect), an effect that has been attributed to the disruption of holistic processing. The features that can trigger holistic processing in faces and bodies, however, still remain elusive. In this study, using a sequential matching task, we tested whether stimulus inversion affects various categories of visual stimuli: faces, faceless heads, faceless heads in body context, headless bodies naked, whole bodies naked, headless bodies clothed, and whole bodies clothed. Both accuracy and inversion efficiency score results show inversion effects for all categories but for clothed bodies (with and without heads). In addition, the magnitude of the inversion effect for face, naked body, and faceless heads was similar. Our findings demonstrate that the perception of faces, faceless heads, and naked bodies relies on holistic processing. Clothed bodies (with and without heads), on the other side, may trigger clothes-sensitive rather than body-sensitive perceptual mechanisms. © 2017 The British Psychological Society.

  7. Consumer Acceptance of Population-Level Intervention Strategies for Healthy Food Choices: The Role of Perceived Effectiveness and Perceived Fairness.

    PubMed

    Bos, Colin; Lans, Ivo Van Der; Van Rijnsoever, Frank; Van Trijp, Hans

    2015-09-15

    The present study investigates acceptance of intervention strategies for low-calorie snack choices that vary regarding the effect they have on consumers' freedom of choice (providing information, guiding choice through (dis)incentives, and restricting choice). We examine the mediating effects of perceived effectiveness and perceived fairness, and the moderating effects of barriers to choose low-calorie snacks and perceived responsibility for food choice. Data was collected through an online survey, involving three waves that were completed over a seven week timespan. Information was collected on barriers and perceived responsibility, and evaluations of a total of 128 intervention strategies with varying levels of intrusiveness that were further systematically varied in terms of source, location, approach/avoidance, type, and severity. A total of 1173 respondents completed all three waves. We found that the effect of intervention intrusiveness on acceptance was mediated by the perceived personal- and societal effectiveness, and the perceived fairness of interventions. For barriers and perceived responsibility, only main effects on intervention-specific beliefs were found. Government interventions were accepted less than interventions by food manufacturers. In conclusion, the present study shows that acceptance of interventions depends on perceptions of personal- and societal effectiveness and fairness, thereby providing novel starting points for increasing acceptance of both existing and new food choice interventions.

  8. The influence of weight-of-evidence strategies on audience perceptions of (un)certainty when media cover contested science.

    PubMed

    Kohl, Patrice Ann; Kim, Soo Yun; Peng, Yilang; Akin, Heather; Koh, Eun Jeong; Howell, Allison; Dunwoody, Sharon

    2016-11-01

    Controversy in science news accounts attracts audiences and draws attention to important science issues. But sometimes covering multiple sides of a science issue does the audience a disservice. Counterbalancing a truth claim backed by strong scientific support with a poorly backed argument can unnecessarily heighten audience perceptions of uncertainty. At the same time, journalistic norms often constrain reporters to "get both sides of the story" even when there is little debate in the scientific community about which truth claim is most valid. In this study, we look at whether highlighting the way in which experts are arrayed across truth claims-a strategy we label "weight-of-evidence reporting"-can attenuate heightened perceptions of uncertainty that can result from coverage of conflicting claims. The results of our study suggest weight-of-evidence strategies can indeed play a role in reducing some of the uncertainty audiences may perceive when encountering lop-sided truth claims. © The Author(s) 2015.

  9. Skin Color, Cultural Capital, and Beauty Products: An Investigation of the Use of Skin Fairness Products in Mumbai, India

    PubMed Central

    Shroff, Hemal; Diedrichs, Phillippa C.; Craddock, Nadia

    2018-01-01

    The use of skin fairness products that frequently contain toxic ingredients is associated with significant adverse health side effects. Due to the high prevalence of use in Asian and African countries, skin fairness product use is recognized as a growing public health concern. The multi-million-dollar skin fairness product industry has also been criticized for perpetuating racism and social inequalities by reinforcing beliefs about the benefits of skin fairness for cultural capital. No quantitative studies have assessed people’s beliefs about fairness and reasons for using or not using these products in India, one of the largest global markets for skin fairness products. The current study explored skin fairness product use among 1,992 women and men aged 16–60 years in the city of Mumbai, India using a self-report questionnaire. A total of 37.6% of the sample reported currently using skin fairness products, with women being two times more likely to use these products. Among current users, 17% reported past experiences of adverse side effects, and “Media/TV/Adverts” were the most common prompts for using fairness products, followed by “Friends” and “Family.” Men were significantly more likely than women to endorse beliefs about fairness being more attractive and were more likely to perceive family and peers as viewing fairness as beneficial for cultural capital. There were no differences between women and men currently using products in their desire to look as fair as media celebrities. Among non-users, women were significantly more likely than men to report concerns about product efficacy and side effects as reasons for non-use, while men were significantly more likely to report socioeconomic reasons for non-use. Implications of these findings are discussed in light of growing public health concerns about the use of fairness products, and potential for advocacy and public health interventions to address the use of skin fairness products. PMID:29410952

  10. Skin Color, Cultural Capital, and Beauty Products: An Investigation of the Use of Skin Fairness Products in Mumbai, India.

    PubMed

    Shroff, Hemal; Diedrichs, Phillippa C; Craddock, Nadia

    2017-01-01

    The use of skin fairness products that frequently contain toxic ingredients is associated with significant adverse health side effects. Due to the high prevalence of use in Asian and African countries, skin fairness product use is recognized as a growing public health concern. The multi-million-dollar skin fairness product industry has also been criticized for perpetuating racism and social inequalities by reinforcing beliefs about the benefits of skin fairness for cultural capital. No quantitative studies have assessed people's beliefs about fairness and reasons for using or not using these products in India, one of the largest global markets for skin fairness products. The current study explored skin fairness product use among 1,992 women and men aged 16-60 years in the city of Mumbai, India using a self-report questionnaire. A total of 37.6% of the sample reported currently using skin fairness products, with women being two times more likely to use these products. Among current users, 17% reported past experiences of adverse side effects, and "Media/TV/Adverts" were the most common prompts for using fairness products, followed by "Friends" and "Family." Men were significantly more likely than women to endorse beliefs about fairness being more attractive and were more likely to perceive family and peers as viewing fairness as beneficial for cultural capital. There were no differences between women and men currently using products in their desire to look as fair as media celebrities. Among non-users, women were significantly more likely than men to report concerns about product efficacy and side effects as reasons for non-use, while men were significantly more likely to report socioeconomic reasons for non-use. Implications of these findings are discussed in light of growing public health concerns about the use of fairness products, and potential for advocacy and public health interventions to address the use of skin fairness products.

  11. Performance of HIV care decentralization from the patient's perspective: health-related quality of life and perceived quality of services in Cameroon.

    PubMed

    Boyer, Sylvie; Protopopescu, Camelia; Marcellin, Fabienne; Carrieri, Maria Patrizia; Koulla-Shiro, Sinata; Moatti, Jean-Paul; Spire, Bruno

    2012-07-01

    (i) To assess HIV care decentralization in Cameroon from the patients' point of view, in terms of health-related quality of life (HRQL) and perceived quality of services; (ii) to identify patient- and hospital-related factors undermining HRQL. Perceived quality of services was compared among 1985 HIV-infected patients treated with antiretroviral therapy (ART) for at least 6 months in 27 treatment centres at different levels of health care delivery (central, provincial and district) (EVAL-ANRS 12-116 survey, 2007) using chi-square and non-parametric tests. Correlates of the SF-12 physical (PCS) and mental (MCS) HRQL scores were identified using two-level linear models. Patients followed-up at central and district levels had similar physical HRQL, while those followed-up at the more decentralized district level reported significantly better mental HRQL. Patients at district level also expressed better relationships with caregivers, easier access to consultations and more reliable drug supply. Financial barriers to access to HIV care and self-reported side-effects were independently associated with both lower PCS and lower MCS. Caregivers' heavy workload tended to impair both PCS and MCS, while availability of counselling by social workers in the hospital was independently associated with higher MCS. Despite limited resources, the decentralization of ART delivery can improve quality of care, providing a positive impact on HIV-infected patients' well-being. The development of psychosocial support interventions is necessary but not sufficient for improving quality of care in ART scaling-up programmes, and should be related to global strengthening of health human resources.

  12. Mind the Gap: The Effects of Temporal and Spatial Separation in Localization of Dual Touches on the Hand.

    PubMed

    Sadibolova, Renata; Tamè, Luigi; Walsh, Eamonn; Longo, Matthew R

    2018-01-01

    In this study, we aimed to relate the findings from two predominantly separate streams of literature, one reporting on the localization of single touches on the skin, and the other on the distance perception of dual touches. Participants were touched with two points, delivered either simultaneously or separated by a short delay to various locations on their left hand dorsum. They then indicated on a size-matched hand silhouette the perceived locations of tactile stimuli. We quantified the deviations between the actual stimulus grid and the corresponding perceptual map which was constructed from the perceived tactile locations, and we calculated the precision of tactile localization (i.e., the variability across localization attempts). The evidence showed that the dual touches, akin to single touch stimulations, were mislocalized distally and that their variable localization error was reduced near joints, particularly near knuckles. However, contrary to single-touch localization literature, we observed for the dual touches to be mislocalized towards the ulnar side of the hand, particularly when they were presented sequentially. Further, the touches presented in a sequential order were slightly "repelled" from each other and their perceived distance increased, while the simultaneous tactile pairs were localized closer to each other and their distance was compressed. Whereas the sequential touches may have been localized with reference to the body, the compression of tactile perceptual space for simultaneous touches was related in the previous literature to signal summation and inhibition and the low-level factors, including the innervation density and properties of receptive fields (RFs) of somatosensory neurons.

  13. A unified frame of predicting side effects of drugs by using linear neighborhood similarity.

    PubMed

    Zhang, Wen; Yue, Xiang; Liu, Feng; Chen, Yanlin; Tu, Shikui; Zhang, Xining

    2017-12-14

    Drug side effects are one of main concerns in the drug discovery, which gains wide attentions. Investigating drug side effects is of great importance, and the computational prediction can help to guide wet experiments. As far as we known, a great number of computational methods have been proposed for the side effect predictions. The assumption that similar drugs may induce same side effects is usually employed for modeling, and how to calculate the drug-drug similarity is critical in the side effect predictions. In this paper, we present a novel measure of drug-drug similarity named "linear neighborhood similarity", which is calculated in a drug feature space by exploring linear neighborhood relationship. Then, we transfer the similarity from the feature space into the side effect space, and predict drug side effects by propagating known side effect information through a similarity-based graph. Under a unified frame based on the linear neighborhood similarity, we propose method "LNSM" and its extension "LNSM-SMI" to predict side effects of new drugs, and propose the method "LNSM-MSE" to predict unobserved side effect of approved drugs. We evaluate the performances of LNSM and LNSM-SMI in predicting side effects of new drugs, and evaluate the performances of LNSM-MSE in predicting missing side effects of approved drugs. The results demonstrate that the linear neighborhood similarity can improve the performances of side effect prediction, and the linear neighborhood similarity-based methods can outperform existing side effect prediction methods. More importantly, the proposed methods can predict side effects of new drugs as well as unobserved side effects of approved drugs under a unified frame.

  14. Drug side effect extraction from clinical narratives of psychiatry and psychology patients

    PubMed Central

    Kocher, Jean-Pierre A; Chute, Christopher G; Savova, Guergana K

    2011-01-01

    Objective To extract physician-asserted drug side effects from electronic medical record clinical narratives. Materials and methods Pattern matching rules were manually developed through examining keywords and expression patterns of side effects to discover an individual side effect and causative drug relationship. A combination of machine learning (C4.5) using side effect keyword features and pattern matching rules was used to extract sentences that contain side effect and causative drug pairs, enabling the system to discover most side effect occurrences. Our system was implemented as a module within the clinical Text Analysis and Knowledge Extraction System. Results The system was tested in the domain of psychiatry and psychology. The rule-based system extracting side effects and causative drugs produced an F score of 0.80 (0.55 excluding allergy section). The hybrid system identifying side effect sentences had an F score of 0.75 (0.56 excluding allergy section) but covered more side effect and causative drug pairs than individual side effect extraction. Discussion The rule-based system was able to identify most side effects expressed by clear indication words. More sophisticated semantic processing is required to handle complex side effect descriptions in the narrative. We demonstrated that our system can be trained to identify sentences with complex side effect descriptions that can be submitted to a human expert for further abstraction. Conclusion Our system was able to extract most physician-asserted drug side effects. It can be used in either an automated mode for side effect extraction or semi-automated mode to identify side effect sentences that can significantly simplify abstraction by a human expert. PMID:21946242

  15. The conditional indirect effect model of women's union participation: the moderating effect of perceived union tolerance for sexual harassment.

    PubMed

    Mellor, Steven; Golay, Leslie M

    2014-01-01

    We tested a theoretically trimmed model of union participation presented by Tetrick, Shore, McClurg, and Vandenberg (2007), in which perceived union instrumentality is expected to influence participation through perceived union support. This testing was accomplished as a precursor to testing a conditional indirect effect model of women's participation--in which perceived union tolerance for sexual harassment was expected to moderate the influence of perceived support on willingness to participate in union activities. In a sample of 326 women from multiple unions, we found support for the conditional model; the influence of perceived instrumentality on willingness to participate through perceived support was moderated by perceived tolerance for harassment; specifically, the influence through perceived support was weak when perceived tolerance was high. The implications of our results are discussed in reference to need support and women's participation.

  16. Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study

    PubMed Central

    Haas, Marion; Viney, Rosalie; Pearson, Sallie-Anne; Haywood, Philip; Brown, Chris; Ward, Robyn

    2017-01-01

    Aim Chemotherapy side effects are often reported in clinical trials; however, there is little evidence about their incidence in routine clinical care. The objective of this study was to describe the frequency and severity of patient-reported chemotherapy side effects in routine care across treatment centres in Australia. Methods We conducted a prospective cohort study of individuals with breast, lung or colorectal cancer undergoing chemotherapy. Side effects were identified by patient self-report. The frequency, prevalence and incidence rates of side effects were calculated by cancer type and grade, and cumulative incidence curves for each side effect computed. Frequencies of side effects were compared between demographic subgroups using chi-squared statistics. Results Side effect data were available for 449 eligible individuals, who had a median follow-up of 5.64 months. 86% of participants reported at least one side effect during the study period and 27% reported a grade IV side effect, most commonly fatigue or dyspnoea. Fatigue was the most common side effect overall (85%), followed by diarrhoea (74%) and constipation (74%). Prevalence and incidence rates were similar across side effects and cancer types. Age was the only demographic factor associated with the incidence of side effects, with older people less likely to report side effects. Conclusion This research has produced the first Australian estimates of self-reported incidence of chemotherapy side effects in routine clinical care. Chemotherapy side effects in routine care are common, continue throughout chemotherapy and can be serious. This work confirms the importance of observational data in providing clinical practice-relevant information to decision-makers. PMID:29016607

  17. Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study.

    PubMed

    Pearce, Alison; Haas, Marion; Viney, Rosalie; Pearson, Sallie-Anne; Haywood, Philip; Brown, Chris; Ward, Robyn

    2017-01-01

    Chemotherapy side effects are often reported in clinical trials; however, there is little evidence about their incidence in routine clinical care. The objective of this study was to describe the frequency and severity of patient-reported chemotherapy side effects in routine care across treatment centres in Australia. We conducted a prospective cohort study of individuals with breast, lung or colorectal cancer undergoing chemotherapy. Side effects were identified by patient self-report. The frequency, prevalence and incidence rates of side effects were calculated by cancer type and grade, and cumulative incidence curves for each side effect computed. Frequencies of side effects were compared between demographic subgroups using chi-squared statistics. Side effect data were available for 449 eligible individuals, who had a median follow-up of 5.64 months. 86% of participants reported at least one side effect during the study period and 27% reported a grade IV side effect, most commonly fatigue or dyspnoea. Fatigue was the most common side effect overall (85%), followed by diarrhoea (74%) and constipation (74%). Prevalence and incidence rates were similar across side effects and cancer types. Age was the only demographic factor associated with the incidence of side effects, with older people less likely to report side effects. This research has produced the first Australian estimates of self-reported incidence of chemotherapy side effects in routine clinical care. Chemotherapy side effects in routine care are common, continue throughout chemotherapy and can be serious. This work confirms the importance of observational data in providing clinical practice-relevant information to decision-makers.

  18. Consumer Acceptance of Population-Level Intervention Strategies for Healthy Food Choices: The Role of Perceived Effectiveness and Perceived Fairness

    PubMed Central

    Bos, Colin; Van Der Lans, Ivo; Van Rijnsoever, Frank; Van Trijp, Hans

    2015-01-01

    The present study investigates acceptance of intervention strategies for low-calorie snack choices that vary regarding the effect they have on consumers’ freedom of choice (providing information, guiding choice through (dis)incentives, and restricting choice). We examine the mediating effects of perceived effectiveness and perceived fairness, and the moderating effects of barriers to choose low-calorie snacks and perceived responsibility for food choice. Data was collected through an online survey, involving three waves that were completed over a seven week timespan. Information was collected on barriers and perceived responsibility, and evaluations of a total of 128 intervention strategies with varying levels of intrusiveness that were further systematically varied in terms of source, location, approach/avoidance, type, and severity. A total of 1173 respondents completed all three waves. We found that the effect of intervention intrusiveness on acceptance was mediated by the perceived personal- and societal effectiveness, and the perceived fairness of interventions. For barriers and perceived responsibility, only main effects on intervention-specific beliefs were found. Government interventions were accepted less than interventions by food manufacturers. In conclusion, the present study shows that acceptance of interventions depends on perceptions of personal- and societal effectiveness and fairness, thereby providing novel starting points for increasing acceptance of both existing and new food choice interventions. PMID:26389949

  19. Comparison of the benefits of cochlear implantation versus contra-lateral routing of signal hearing aids in adult patients with single-sided deafness: study protocol for a prospective within-subject longitudinal trial.

    PubMed

    Kitterick, Pádraig T; O'Donoghue, Gerard M; Edmondson-Jones, Mark; Marshall, Andrew; Jeffs, Ellen; Craddock, Louise; Riley, Alison; Green, Kevin; O'Driscoll, Martin; Jiang, Dan; Nunn, Terry; Saeed, Shakeel; Aleksy, Wanda; Seeber, Bernhard U

    2014-01-01

    Individuals with a unilateral severe-to-profound hearing loss, or single-sided deafness, report difficulty with listening in many everyday situations despite having access to well-preserved acoustic hearing in one ear. The standard of care for single-sided deafness available on the UK National Health Service is a contra-lateral routing of signals hearing aid which transfers sounds from the impaired ear to the non-impaired ear. This hearing aid has been found to improve speech understanding in noise when the signal-to-noise ratio is more favourable at the impaired ear than the non-impaired ear. However, the indiscriminate routing of signals to a single ear can have detrimental effects when interfering sounds are located on the side of the impaired ear. Recent published evidence has suggested that cochlear implantation in individuals with a single-sided deafness can restore access to the binaural cues which underpin the ability to localise sounds and segregate speech from other interfering sounds. The current trial was designed to assess the efficacy of cochlear implantation compared to a contra-lateral routing of signals hearing aid in restoring binaural hearing in adults with acquired single-sided deafness. Patients are assessed at baseline and after receiving a contra-lateral routing of signals hearing aid. A cochlear implant is then provided to those patients who do not receive sufficient benefit from the hearing aid. This within-subject longitudinal design reflects the expected care pathway should cochlear implantation be provided for single-sided deafness on the UK National Health Service. The primary endpoints are measures of binaural hearing at baseline, after provision of a contra-lateral routing of signals hearing aid, and after cochlear implantation. Binaural hearing is assessed in terms of the accuracy with which sounds are localised and speech is perceived in background noise. The trial is also designed to measure the impact of the interventions on hearing- and health-related quality of life. This multi-centre trial was designed to provide evidence for the efficacy of cochlear implantation compared to the contra-lateral routing of signals. A purpose-built sound presentation system and established measurement techniques will provide reliable and precise measures of binaural hearing. Current Controlled Trials http://www.controlled-trials.com/ISRCTN33301739 (05/JUL/2013).

  20. Optimising technical skills and physical loading in small-sided basketball games.

    PubMed

    Klusemann, Markus J; Pyne, David B; Foster, Carl; Drinkwater, Eric J

    2012-01-01

    Differences in physiological, physical, and technical demands of small-sided basketball games related to the number of players, court size, and work-to-rest ratios are not well characterised. A controlled trial was conducted to compare the influence of number of players (2v2/4v4), court size (half/full court) and work-to-rest ratios (4x2.5 min/2x5 min) on the demands of small-sided games. Sixteen elite male and female junior players (aged 15-19 years) completed eight variations of a small-sided game in randomised order over a six-week period. Heart rate responses and rating of perceived exertion (RPE) were measured to assess the physiological load. Movement patterns and technical elements were assessed by video analysis. There were ∼60% more technical elements in 2v2 and ∼20% more in half court games. Heart rate (86 ± 4% & 83 ± 5% of maximum; mean ± SD) and RPE (8 ± 2 & 6 ± 2; scale 1-10) were moderately higher in 2v2 than 4v4 small-sided games, respectively. The 2v2 format elicited substantially more sprints (36 ±12%; mean ±90% confidence limits) and high intensity shuffling (75 ±17%) than 4v4. Full court games required substantially more jogging (9 ±6%) compared to half court games. Fewer players in small-sided basketball games substantially increases the technical, physiological and physical demands.

  1. The next generation of iron fertilization experiments in the Southern Ocean.

    PubMed

    Smetacek, V; Naqvi, S W A

    2008-11-13

    Of the various macro-engineering schemes proposed to mitigate global warming, ocean iron fertilization (OIF) is one that could be started at short notice on relevant scales. It is based on the reasoning that adding trace amounts of iron to iron-limited phytoplankton of the Southern Ocean will lead to blooms, mass sinking of organic matter and ultimately sequestration of significant amounts of atmospheric carbon dioxide (CO2) in the deep sea and sediments. This iron hypothesis, proposed by John Martin in 1990 (Martin 1990 Paleoceanography 5, 1-13), has been tested by five mesoscale experiments that provided strong support for its first condition: stimulation of a diatom bloom accompanied by significant CO2 drawdown. Nevertheless, a number of arguments pertaining to the fate of bloom biomass, the ratio of iron added to carbon sequestered and various side effects of fertilization, continue to cast doubt on its efficacy. The idea is also unpopular with the public because it is perceived as meddling with nature. However, this apparent consensus against OIF is premature because none of the published experiments were specifically designed to test its second condition pertaining to the fate of iron-induced organic carbon. Furthermore, the arguments on side effects are based on worst-case scenarios. These doubts, formulated as hypotheses, need to be tested in the next generation of OIF experiments. We argue that such experiments, if carried out at appropriate scales and localities, will not only show whether the technique will work, but will also reveal a wealth of insights on the structure and functioning of pelagic ecosystems in general and the krill-based Southern Ocean ecosystem, in particular. The outcomes of current models on the efficacy and side effects of OIF differ widely, so data from adequately designed experiments are urgently needed for realistic parametrization. OIF is likely to boost zooplankton stocks, including krill, which could have a positive effect on recovery of the great whale populations. Negative effects of possible commercialization of OIF can be controlled by the establishment of an international body headed by scientists to supervise and monitor its implementation.

  2. Side effects associated with anti-HIV drugs.

    PubMed

    Highleyman, L

    1998-04-01

    Many side effects are associated with the use of anti-HIV drugs, impacting the development of drug resistance and the quality of life for HIV-patients. Concern about side effects is a primary factor in deterring people from beginning HIV therapy. Frequency and severity of side effects vary greatly, but they are frequently more common and severe in people who are taking a new drug or who have advanced HIV disease. Information on side effects comes largely from clinical trials; however, many side effects are not discovered until the drug has been approved and used by larger numbers of people. Side effects vary from serious toxicities that require stopping treatment to uncomfortable or annoying side effects that interfere with daily life. A table categorizes the four major side effects (nausea, fever, skin rash, and fatigue) and divides them into grades that describe their intensity. A chart lists the side effects associated with specific anti-HIV drugs. Suggestions for managing side effects are included.

  3. Factors Affecting the Perceived Effectiveness of Pictorial Health Warnings on Cigarette Packages in Gulf Countries: A Cross-sectional Study.

    PubMed

    Mansour, Ameerah Y; Bakhsh, Zuhair

    2017-01-01

    To explore the perceived effectiveness of pictorial health warning (PHW) labels required by the Gulf Cooperation Council, to compare them with the Food and Drug Administration-approved PHW labels, and to determine factors affecting their perceived effectiveness. A cross-sectional study using a convenience sample of adult smokers and nonsmokers was conducted. The data were collected through a self-administered online questionnaire. The perceived effectiveness scores of PHW labels were calculated and compared among different subgroups using the Kruskal-Wallis test and the Dunn multiple comparison test at a .05 significance level. Of the 90 people invited to participate in the survey, 77 (86%) completed it, with 39 (50%) nonsmokers, 22 (29%) smokers, and 16 (21%) former smokers. Overall, labels having graphic images of illness or pathology are perceived to be most effective. Smokers generally perceived labels significantly less effective compared with former smokers and nonsmokers. Also, 55 respondents (71%) suggested that the presence of a telephone quit-line would be effective. Smoking status and image type had the most effect on the perceived effectiveness of the PHW labels on cigarette packs. Pictorial health warning labels with graphic images of pathology and a telephone quit-line are perceived to be most effective.

  4. Perceiver and relationship effects on perceptions of HIV status: A naturalistic study in a high drug use sample.

    PubMed

    Montoya, Isaac D; Bell, David C

    2006-11-01

    This article examines the effect of target, perceiver, and relationship characteristics on the perceiver's assessment that the target may be HIV seropositive (HIV+). A sample of 267 persons was recruited from low income, high drug use neighborhoods. Respondents (perceivers) were asked to name people (targets) with whom they had a social, drug sharing, or sexual relationship. Perceivers described 1,640 such relationships. Perceivers were asked about the targets' age, gender, and race/ethnicity, whether the targets were good-looking, their level of trust with the target, and how long they had known them. Perceivers were then asked to evaluate the chances that the target mentioned was HIV+. Two regression models were estimated on the 1,640 relationships mentioned. Model 1 included variables reflecting only target characteristics as independent variables. Model 2 included variables reflecting target characteristics as well as variables reflecting perceivers and perceiver-target relationship characteristics. The results showed that targets that were female, younger, and good-looking were perceived as being less likely to be HIV+. However, when accounting for perceiver and relationship effects, some of the target characteristic effects disappeared. Copyright 2006 APA, all rights reserved.

  5. How Ghanaian, African-Surinamese and Dutch patients perceive and manage antihypertensive drug treatment: a qualitative study.

    PubMed

    Beune, Erik J A J; Haafkens, Joke A; Agyemang, Charles; Schuster, John S; Willems, Dick L

    2008-04-01

    To explore and compare how Ghanaian, African-Surinamese (Surinamese), and White-Dutch patients perceive and manage antihypertensive drug treatment in Amsterdam, the Netherlands. Qualitative study was conducted using detailed interviews with a purposive sample of 46 hypertensive patients without comorbidity who were prescribed antihypertensives. Patients in all the ethnic groups actively decided how to manage their prescribed antihypertensive regimens. In all the groups, confidence in the doctor and beneficial effects of medication were reasons for taking prescribed antihypertensive dosage. Particularly, ethnic-minority patients reported lowering or leaving off the prescribed medication dosage. Explanations for altering prescribed dosage comprised disliking chemical medications, fear of side effects and preference for alternative treatment. Surinamese and Ghanaian men also worried about the negative effects of antihypertensives on their sexual performance. Some Ghanaians mentioned fear of addiction or lack of money as explanations for altering prescribed dosage. Surinamese and Ghanaians often discontinued medication when visiting their homeland. Some respondents from all ethnic groups preferred natural treatments although treatment type varied. Patients' explanations for their decisions regarding the use of antihypertensives are often influenced by sociocultural issues and in ethnic-minority groups also by migration-related issues. Self-alteration of prescribed medication among Surinamese and Ghanaians may contribute to the low blood pressure (BP) control rate and high rate of malignant hypertension reported among these populations in the Netherlands. This study provides new information, which can help clinicians to understand how patients of diverse ethnic populations think about managing antihypertensive drug treatment and to address ethnic disparities in medication adherence and BP control.

  6. D-ribose--an additive with caffeine.

    PubMed

    Herrick, Jim; Shecterle, L M; St Cyr, J A

    2009-05-01

    Caffeine acts as a stimulant, in which approximately 90% of people in the United States consume daily. Besides its beneficial effects, many individuals have experienced unpleasant reactions following the consumption of caffeine: such as insomnia, an increase in heart rate, feelings of nervousness, headaches, occasional lightheadedness, a state of "jitters," and a potential "crash" state following its metabolism. Researchers have proposed mechanisms responsible for caffeine's interactions, which include its blocking capacity of adenosine receptors, its role with the pituitary gland, increasing levels of dopamine, and its role with the intracellular release of calcium from the sarcoplasmic reticulum, which is dependent on intracellular adenosine triphosphate levels. Specific substrates have been investigated to lessen the undesirable effects of caffeine and still preserve its stimulatory benefits. The results of these investigations have produced no positive consensus. However, D-ribose, an important pentose carbohydrate in the energy molecule of adenosine triphosphate, as well as our genetic code and other cellular processes, could offer such a solution to this problem. D-ribose could potentially aid in maintaining or potentially lowering extra-cellular adenosine concentrations, aid in the flux of intracellular calcium, aid in intracellular energy production, and potentially lessen the perceived "crash" state felt by many. Every cell requires adequate levels of energy to maintain its integrity and function. Caffeine has the potential to task this energy equilibrium. D-ribose with caffeine may be the substrate to aid in the potential intracellular energy demand, aid in lessening the perceived unpleasant side effects of caffeine, and still preserving the desired benefits of this stimulant consumed by all of us daily.

  7. Public perceptions of risk to forest biodiversity.

    PubMed

    McFarlane, Bonita L

    2005-06-01

    This study examines the perceived risks to forest biodiversity and perceived effectiveness of biodiversity conservation strategies among the general public. It tests the hypotheses that perceived risk to forest biodiversity is influenced by cognitive factors (value orientation and knowledge) and social-cultural factors (such as gender and environmental membership) and that risk perceptions influence other cognitive constructs such as support for natural resource policy and management. Data were collected from a sample of the general public (n= 596) in British Columbia, Canada by mail survey in 2001. Results show that insects and disease were perceived as the greatest risk. Educating the public and industry about biodiversity issues was perceived as a more effective conservation strategy than restricting human uses of the forest. Value orientation was a better predictor of perceptions of risk and perceived effectiveness of conservation strategies than knowledge indicators or social-cultural variables. Examining the indirect effects of social-cultural variables, however, revealed that value orientation may amplify the effect of these variables and suggests that alternative paths of influence should be included. Perceived risk showed an inconsistent association with perceived effectiveness of conservation strategies.

  8. Pleasant music as a countermeasure against visually induced motion sickness.

    PubMed

    Keshavarz, Behrang; Hecht, Heiko

    2014-05-01

    Visually induced motion sickness (VIMS) is a well-known side-effect in virtual environments or simulators. However, effective behavioral countermeasures against VIMS are still sparse. In this study, we tested whether music can reduce the severity of VIMS. Ninety-three volunteers were immersed in an approximately 14-minute-long video taken during a bicycle ride. Participants were randomly assigned to one of four experimental groups, either including relaxing music, neutral music, stressful music, or no music. Sickness scores were collected using the Fast Motion Sickness Scale and the Simulator Sickness Questionnaire. Results showed an overall trend for relaxing music to reduce the severity of VIMS. When factoring in the subjective pleasantness of the music, a significant reduction of VIMS occurred only when the presented music was perceived as pleasant, regardless of the music type. In addition, we found a gender effect with women reporting more sickness than men. We assume that the presentation of pleasant music can be an effective, low-cost, and easy-to-administer method to reduce VIMS. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  9. Perceptions of human papillomavirus vaccination of adolescent schoolgirls in western Uganda and their implications for acceptability of HPV vaccination: a qualitative study.

    PubMed

    Turiho, Andrew Kampikaho; Okello, Elialilia Sarikieli; Muhwezi, Wilson Winstons; Katahoire, Anne Ruhweza

    2017-08-30

    Human papillomavirus (HPV) vaccination has been perceived in diverse ways some of which encourage its uptake while others could potentially deter its acceptability. This study explored community member's perceptions about HPV vaccination in Ibanda district and the implications of the perceptions for acceptability of HPV vaccination. The study was conducted following initial vaccination of adolescent schoolgirls in the district between 2008 and 2011. This qualitative study employed focus group discussions (FGDs) and key informant interviews (KIIs). FGDs were conducted with schoolgirls and parents/guardians and KIIs were conducted with school teachers, health workers and community leaders. Transcripts from the FGDs and KIIs were coded and analyzed thematically using ATLAS.ti (v. 6). The HPV vaccination was understood to safely prevent cervical cancer, which was perceived to be a severe incurable disease. Vaccinations were perceived as protection against diseases like measles and polio that were known to kill children. These were major motivations for girls' and parents' acceptance of HPV vaccination. Parents' increased awareness that HPV is sexually transmitted encouraged their support for vaccination of their adolescent daughters against HPV. There were reports however of some initial fears and misconceptions about HPV vaccination especially during its introduction. These initially discouraged some parents and girls but over the years with no major side effects reported, girls reported that they were willing to recommend the vaccination to others and parents also reported their willingness to get their daughters vaccinated without fear. Health workers and teachers interviewed however explained that, some concerns stilled lingered in the communities. The perceived benefits and safety of HPV vaccination enhanced girls' and parents' acceptability of HPV vaccination. The initial rumors, fears and concerns about HPV vaccination that reportedly discouraged some girls and parents, seemed to have waned with time giving way to more favourable perceptions regarding HPV vaccination although the study still found that a few concerns still lingered on and these have implications for HPV vaccination acceptability.

  10. Perceived discrimination and health among Puerto Rican and Mexican Americans: buffering effect of the Lazo matrimonial?

    PubMed

    Lee, Min-Ah; Ferraro, Kenneth F

    2009-06-01

    An emerging body of research shows that perceived discrimination adversely influences the mental health of minority populations, but is it also deleterious to physical health? If yes, can marriage buffer the effect of perceived discrimination on physical health? We address these questions with data from Puerto Rican and Mexican American residents of Chicago. Multivariate regression analyses reveal that perceived discrimination is associated with more physical health problems for both Puerto Rican and Mexican Americans. In addition, an interaction effect between marital status and perceived discrimination was observed: married Mexican Americans with higher perceived discrimination had fewer physical health problems than their unmarried counterparts even after adjusting for differential effects of marriage by nativity. The findings reveal that perceived discrimination is detrimental to the physical health of both Puerto Rican and Mexican Americans, but that the stress-buffering effect of marriage on physical health exists for Mexican Americans only.

  11. Effect of Communication Style on Perceptions of Medication Side Effect Risk among Pharmacy Students.

    PubMed

    Sawant, Ruta V; Beatty, Collin R; Sansgiry, Sujit S

    2016-10-25

    Objective. To assess the effect of communication style, and frequency and severity of medication side-effects, on pharmacy students' perception of risk of experiencing side effects. Methods. One hundred responses from pharmacy students were obtained using an online survey. Participants were presented with a drug information box containing drug name, drug usage, and one side-effect associated with the drug. Information on side-effect for each drug was presented in one of eight experimental conditions, in a 2 (side-effect frequency: low, high), X2 (side-effect severity: mild, severe) X2 (communication style: verbal, verbal + natural frequency) factorial design. Risk perception of experiencing side effects was measured. Results. Communication style was found to have a significant impact on risk perception depending on the context of frequency and severity associated with the side effect. Conclusion. Communication style plays a significant role in formulating risk perceptions of medication side effects. Training in pharmaceutical counseling should include special emphasis on effective language use.

  12. Attitudes and Perceptions of Biomedical HIV Prevention Methods: Voices from Young Men who Have Sex with Men

    PubMed Central

    Kubicek, Katrina; Arauz-Cuadra, Cesar; Kipke, Michele D.

    2015-01-01

    In the third decade of the HIV/AIDS epidemic in the United States, the prevalence rates of new HIV infections among young men who have sex with men (YMSM) continue to increase. As new and emerging HIV prevention method are developed, it is important to understand the perceptions of this vulnerable population –as they may be an ideal target for these intervention methods. This pilot study provides an overview of YMSM of color’s awareness and perceptions of pre-exposure prophylaxis (PrEP) and rectal microbicides (RM). A total of 6 focus groups were convened with 53 YMSM (23 Latino/Hispanic and 30 Black/African American). Findings indicate a lack of knowledge of biomedical interventions and high perceived acceptability. Concerns regarding PrEP included potential side effects, potential for misinterpretation of its use and cost. RMs were perceived to be more acceptable than PrEP, but the limited knowledge about their potential was emphasized by YMSM. Results are discussed in relation to the need for providers to continue to provide general health education about safe sexual practices. As PrEP and other biomedical interventions are introduced into community settings, caution should be taken with regards to determining the appropriate target user and sufficient education. PMID:25633499

  13. Barriers and facilitators of adherence to antidepressants among outpatients with major depressive disorder: A qualitative study.

    PubMed

    Ho, Siew Ching; Jacob, Sabrina Anne; Tangiisuran, Balamurugan

    2017-01-01

    One of the major challenges in treating major depressive disorder (MDD) is patients' non-adherence to medication. This study aimed to explore the barriers and facilitators of patients' adherence to antidepressants among outpatients with MDD. Semi-structured and individual in-depth interviews were conducted among patients with MDD who were taking antidepressants, in the psychiatric clinic of a government-run hospital in Malaysia. Participants were purposively sampled from different genders and ethnicities. Interviews were conducted using a validated topic guide, and responses were audio-recorded, transcribed verbatim, checked, and analyzed using the grounded theory approach. A total of 30 patients were interviewed. Forty different themes and sub-themes were identified which were conceptually divided into two distinct categories related to barriers and facilitators to adherence. The barriers were: patient-specific, medication-specific, healthcare provision and system, social-cultural, and logistics. The facilitators were: having insight, perceived health benefits, regular activities, patient-provider relationship, reminders, and social support networks. Patient-specific barriers and medication side effects were the major challenges for adhering to treatment. Perceived health benefits and having insight on the need for treatment were the most frequently cited facilitators. Targeted interventions should be developed to address the key barriers, and promote measures to facilitate adherence in this group of patients.

  14. Attitudes and perceptions of biomedical HIV prevention methods: voices from young men who have sex with men.

    PubMed

    Kubicek, Katrina; Arauz-Cuadra, Cesar; Kipke, Michele D

    2015-02-01

    In the third decade of the HIV/AIDS epidemic in the United States, the prevalence rates of new HIV infections among young men who have sex with men (YMSM) continue to increase. As new and emerging HIV prevention methods are developed, it is important to understand the perceptions of this vulnerable population-as they may be an ideal target for these intervention methods. This pilot study provides an overview of YMSM of color's awareness and perceptions of pre-exposure prophylaxis (PrEP) and rectal microbicides (RM). A total of 6 focus groups were convened with 53 YMSM (23 Latino/Hispanic and 30 Black/African American). Findings indicate a lack of knowledge of biomedical interventions and high perceived acceptability. Concerns regarding PrEP included potential side effects, potential for misinterpretation of its use and cost. RMs were perceived to be more acceptable than PrEP, but the limited knowledge about their potential was emphasized by YMSM. Results are discussed in relation to the need for providers to continue to provide general health education about safe sexual practices. As PrEP and other biomedical interventions are introduced into community settings, caution should be taken with regards to determining the appropriate target user and sufficient education.

  15. Perceived reciprocity and well-being at work in non-professional employees: fairness or self-interest?

    PubMed

    Moliner, Carolina; Martínez-Tur, Vicente; Peiró, José M; Ramos, José; Cropanzano, Russell

    2013-02-01

    This article assesses the links between non-professional employees' perceptions of reciprocity in their relationships with their supervisors and the positive and negative sides of employees' well-being at work: burnout and engagement. Two hypotheses were explored. First, the fairness hypothesis assumes a curvilinear relationship where balanced reciprocity (when the person perceives that there is equilibrium between his/her efforts and the benefits he/she receives) presents the highest level of well-being. Second, the self-interest hypothesis proposes a linear pattern where over-benefitted situations for employees (when the person perceives that he/she is receiving more than he/she deserves) increase well-being. One study with two independent samples was conducted. The participants were 349 employees in 59 hotels (sample 1) and 690 employees in 89 centres providing attention to people with mental disabilities (sample 2). Linear and curvilinear regression models supported the self-interest hypothesis for the links from reciprocity to burnout and engagement. We conclude with theoretical implications and opportunities for future research. Copyright © 2012 John Wiley & Sons, Ltd.

  16. Perceived benefits and barriers to exercise for recently treated patients with multiple myeloma: a qualitative study.

    PubMed

    Craike, Melinda J; Hose, Kaye; Courneya, Kerry S; Harrison, Simon J; Livingston, Patricia M

    2013-07-01

    Understanding the physical activity experiences of patients with multiple myeloma (MM) is essential to inform the development of evidence-based interventions and to quantify the benefits of physical activity. The aim of this study was to gain an in-depth understanding of the physical activity experiences and perceived benefits and barriers to physical activity for patients with MM. This was a qualitative study that used a grounded theory approach. Semi-structured interviews were conducted in Victoria, Australia by telephone from December 2011-February 2012 with patients who had been treated for MM within the preceding 2-12 months. Interviews were transcribed and analysed using the constant comparison coding method to reduce the data to themes. Gender differences and differences between treatment groups were explored. Twenty-four interviews were completed. The sample comprised 13 females (54%), with a mean age of 62 years (SD = 8.8). Sixteen (67%) participants had received an autologous stem cell transplant (ASCT). All participants currently engaged in a range of light to moderate intensity physical activity; walking and gardening were the most common activities. Recovery from the symptoms of MM and side effects of therapy, psychological benefits, social factors and enjoyment were important benefits of physical activity. Barriers to physical activity predominately related to the symptoms of MM and side effects of therapy, including pain, fatigue, and fear of infection. Low self- motivation was also a barrier. Women participated in a more diverse range of physical activities than men and there were gender differences in preferred type of physical activity. Women were more likely to report psychological and social benefits; whereas men reported physical activity as a way to keep busy and self-motivation was a barrier. Patients treated with an ASCT more often reported affective benefits of participation in physical activity and fatigue as a barrier. Patients treated with other therapies (e.g., chemotherapy, radiotherapy) were more likely to report pain as a barrier. Patients with MM experience debilitating effects of their condition and therapy, which influences their level and intensity of physical activity participation. Physical activity programs should be individualised; take into consideration gender differences and the impact of different types of therapy on physical activity; and focus on meeting the psychological, coping and recovery needs of patients.

  17. Perceptions of pharmacists and patients on information provision and their influence on patient satisfaction in Japanese community pharmacies.

    PubMed

    Takaki, Hiroko; Abe, Takeru; Hagihara, Akihito

    2015-12-01

    The provision of information is now considered a major area in pharmacist-patient interactions. However, few reports have simultaneously evaluated patient and pharmacist perceptions with regard to the pharmacist's information provision. The aims were to clarify the perceptions of pharmacists and patients regarding information provision and the level of influence of those perceptions on patient satisfaction. A cross-sectional survey with respect to information provision was conducted for patients and pharmacists in community pharmacies in Fukuoka Prefecture, Japan. In total, 407 patient-pharmacist pairs were included in a t-test and multilevel analysis. The levels of patient perception regarding information provision were significantly higher than the levels of pharmacist perception in all variables. The pharmacists' perceived level of information provision concerning medication effects had a negative and significant association with patient satisfaction, while the patients' perceived level of information provision by the pharmacist had a positive and significant association with patient satisfaction. Higher patient expectations regarding the level of information provision concerning medication side effects and older age of the pharmacist were adversely related to patient satisfaction. Both pharmacist and patient perceptions of the information provision by pharmacists personalized to the patient had positive associations with patient satisfaction. Pharmacist perceptions related to the information provision were not associated with patient satisfaction. The present study highlights accurate information provision, building good patient-pharmacist relationships, and improving pharmaceutical care in community pharmacy settings. © 2015 John Wiley & Sons, Ltd.

  18. Why parents refuse childhood vaccination: a qualitative study using online focus groups

    PubMed Central

    2013-01-01

    Background In high income countries, vaccine-preventable diseases have been greatly reduced through routine vaccination programs. Despite this success, many parents question, and a small proportion even refuse vaccination for their children. As no qualitative studies have explored the factors behind these decisions among Dutch parents, we performed a study using online focus groups. Methods In total, eight online focus groups (n = 60) which included Dutch parents with at least one child, aged 0–4 years, for whom they refused all or part of the vaccinations within the National Immunization Program (NIP). A thematic analysis was performed to explore factors that influenced the parents’ decisions to refuse vaccination. Results Refusal of vaccination was found to reflect multiple factors including family lifestyle; perceptions about the child’s body and immune system; perceived risks of disease, vaccine efficacy, and side effects; perceived advantages of experiencing the disease; prior negative experience with vaccination; and social environment. The use of online focus groups proved to be an effective qualitative research method providing meaningful data. Conclusion Information provided by the NIP turned out to be insufficient for this group of parents. More trust in the NIP and deliberate decisions might result from increased parental understanding of lifestyle and disease susceptibility, the impact of vaccinations on the immune system, and the relative risks of diseases and their vaccines. The public health institute should also inform parents that the NIP is recommended but non-mandatory. PMID:24341406

  19. Testing whether barriers to a hypothetical screening test affect unrelated perceived benefits and vice versa: A randomised, experimental study.

    PubMed

    Ghanouni, Alex; Nuttall, Ella; Wardle, Jane; von Wagner, Christian

    2017-02-01

    Determine whether (fictitious) health screening test benefits affect perceptions of (unrelated) barriers, and barriers affect perceptions of benefits. UK adults were recruited via an online survey panel and randomised to receive a vignette describing a hypothetical screening test with either high or low benefits (higher vs. lower mortality reduction) and high or low barriers (severe vs. mild side-effects; a 2×2 factorial design). ANOVAs compared mean perceived benefits and barriers scores. Screening 'intentions' were compared using Pearson's χ 2 test. Benefits were rated less favourably when barriers were high (mean: 27.4, standard deviation: 5.3) than when they were low (M: 28.5, SD: 4.8; p=0.010, partial η 2 =0.031). Barriers were rated more negatively when benefits were low (M: 17.1, SD: 7.6) than when they were high (M: 15.7, SD: 7.3; p=0.023, partial η 2 =0.024). Most intended to have the test in all conditions (73-81%); except for the low benefit-high barrier condition (37%; p<0.0005; N=218). Perceptions of test attributes may be influenced by unrelated characteristics. Reducing screening test barriers alone may have suboptimal effects on perceptions of barriers if benefits remain low; increasing screening benefits may not improve perceptions of benefits if barriers remain high. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  20. UMTS base station-like exposure, well-being, and cognitive performance.

    PubMed

    Regel, Sabine J; Negovetic, Sonja; Röösli, Martin; Berdiñas, Veronica; Schuderer, Jürgen; Huss, Anke; Lott, Urs; Kuster, Niels; Achermann, Peter

    2006-08-01

    Radio-frequency electromagnetic fields (RF EMF) of mobile communication systems are widespread in the living environment, yet their effects on humans are uncertain despite a growing body of literature. We investigated the influence of a Universal Mobile Telecommunications System (UMTS) base station-like signal on well-being and cognitive performance in subjects with and without self-reported sensitivity to RF EMF. We performed a controlled exposure experiment (45 min at an electric field strength of 0, 1, or 10 V/m, incident with a polarization of 45 degrees from the left back side of the subject, weekly intervals) in a randomized, double-blind crossover design. A total of 117 healthy subjects (33 self-reported sensitive, 84 nonsensitive subjects) participated in the study. We assessed well-being, perceived field strength, and cognitive performance with questionnaires and cognitive tasks and conducted statistical analyses using linear mixed models. Organ-specific and brain tissue-specific dosimetry including uncertainty and variation analysis was performed. In both groups, well-being and perceived field strength were not associated with actual exposure levels. We observed no consistent condition-induced changes in cognitive performance except for two marginal effects. At 10 V/m we observed a slight effect on speed in one of six tasks in the sensitive subjects and an effect on accuracy in another task in nonsensitive subjects. Both effects disappeared after multiple end point adjustment. In contrast to a recent Dutch study, we could not confirm a short-term effect of UMTS base station-like exposure on well-being. The reported effects on brain functioning were marginal and may have occurred by chance. Peak spatial absorption in brain tissue was considerably smaller than during use of a mobile phone. No conclusions can be drawn regarding short-term effects of cell phone exposure or the effects of long-term base station-like exposure on human health.

  1. UMTS Base Station-like Exposure, Well-Being, and Cognitive Performance

    PubMed Central

    Regel, Sabine J.; Negovetic, Sonja; Röösli, Martin; Berdiñas, Veronica; Schuderer, Jürgen; Huss, Anke; Lott, Urs; Kuster, Niels; Achermann, Peter

    2006-01-01

    Background Radio-frequency electromagnetic fields (RF EMF) of mobile communication systems are widespread in the living environment, yet their effects on humans are uncertain despite a growing body of literature. Objectives We investigated the influence of a Universal Mobile Telecommunications System (UMTS) base station-like signal on well-being and cognitive performance in subjects with and without self-reported sensitivity to RF EMF. Methods We performed a controlled exposure experiment (45 min at an electric field strength of 0, 1, or 10 V/m, incident with a polarization of 45° from the left back side of the subject, weekly intervals) in a randomized, double-blind crossover design. A total of 117 healthy subjects (33 self-reported sensitive, 84 nonsensitive subjects) participated in the study. We assessed well-being, perceived field strength, and cognitive performance with questionnaires and cognitive tasks and conducted statistical analyses using linear mixed models. Organ-specific and brain tissue–specific dosimetry including uncertainty and variation analysis was performed. Results In both groups, well-being and perceived field strength were not associated with actual exposure levels. We observed no consistent condition-induced changes in cognitive performance except for two marginal effects. At 10 V/m we observed a slight effect on speed in one of six tasks in the sensitive subjects and an effect on accuracy in another task in nonsensitive subjects. Both effects disappeared after multiple end point adjustment. Conclusions In contrast to a recent Dutch study, we could not confirm a short-term effect of UMTS base station-like exposure on well-being. The reported effects on brain functioning were marginal and may have occurred by chance. Peak spatial absorption in brain tissue was considerably smaller than during use of a mobile phone. No conclusions can be drawn regarding short-term effects of cell phone exposure or the effects of long-term base station-like exposure on human health. PMID:16882538

  2. Patient specific actual size 3D printed models for patient education in glioma treatment: first experiences.

    PubMed

    van de Belt, Tom H; Nijmeijer, Hugo; Grim, David; Engelen, Lucien Jlpg; Vreeken, Rinaldo; van Gelder, Marleen Mmj; Laan, Mark Ter

    2018-06-02

    Cancer patients need high quality information about the disease stage, treatment options and side effects. High quality information can also improve health literacy, shared decision-making and satisfaction. We created patient-specific 3D models of tumours including surrounding functional areas, and assessed what patients with glioma actually value (or fear) about these models when they are used to educate them about the relation between their tumour and specific brain parts, the surgical procedure, and risks. We carried out an explorative study with adult glioma patients, who underwent functional MRI and DTi as part of the pre-operative work-up. All participants received an actual size 3D model, printed based on fMRI and DTi imaging. Semi-structured interviews were held to identify facilitators and barriers for using the model, and perceived effects. A model was successfully created for all 11 participants. A total of 18 facilitators and 8 barriers were identified. The model improved patients' understanding about their situation, that it was easier to ask questions to their neurosurgeon based on their model and that it supported their decision about the preferred treatment. A perceived barrier for using the 3D model was that it could be emotionally confronting, particularly in an early phase of the disease process. Positive effects were related to psychological domains including coping, learning effects and communication. Patient-specific 3D models are promising and simple tools that could help patients with glioma to better understand their situation, treatment options and risks. They have the potential to improve shared decision-making. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

  3. 'Sorry, I meant the patient's left side': impact of distraction on left-right discrimination.

    PubMed

    McKinley, John; Dempster, Martin; Gormley, Gerard J

    2015-04-01

    Medical students can have difficulty in distinguishing left from right. Many infamous medical errors have occurred when a procedure has been performed on the wrong side, such as in the removal of the wrong kidney. Clinicians encounter many distractions during their work. There is limited information on how these affect performance. Using a neuropsychological paradigm, we aim to elucidate the impacts of different types of distraction on left-right (LR) discrimination ability. Medical students were recruited to a study with four arms: (i) control arm (no distraction); (ii) auditory distraction arm (continuous ambient ward noise); (iii) cognitive distraction arm (interruptions with clinical cognitive tasks), and (iv) auditory and cognitive distraction arm. Participants' LR discrimination ability was measured using the validated Bergen Left-Right Discrimination Test (BLRDT). Multivariate analysis of variance was used to analyse the impacts of the different forms of distraction on participants' performance on the BLRDT. Additional analyses looked at effects of demographics on performance and correlated participants' self-perceived LR discrimination ability and their actual performance. A total of 234 students were recruited. Cognitive distraction had a greater negative impact on BLRDT performance than auditory distraction. Combined auditory and cognitive distraction had a negative impact on performance, but only in the most difficult LR task was this negative impact found to be significantly greater than that of cognitive distraction alone. There was a significant medium-sized correlation between perceived LR discrimination ability and actual overall BLRDT performance. Distraction has a significant impact on performance and multifaceted approaches are required to reduce LR errors. Educationally, greater emphasis on the linking of theory and clinical application is required to support patient safety and human factor training in medical school curricula. Distraction has the potential to impair an individual's ability to make accurate LR decisions and students should be trained from undergraduate level to be mindful of this. © 2015 John Wiley & Sons Ltd.

  4. Australian Undergraduate Biotechnology Student Attitudes towards the Teaching of Ethics

    NASA Astrophysics Data System (ADS)

    Lysaght, Tamra; Rosenberger, Philip J., III; Kerridge, Ian

    2006-08-01

    In recent years, ethics has become part of most tertiary biotechnology curricula. There is, however, considerable variation in the extent and manner of ethics education provided to students in different institutions. In addition, the perceived need that students and employers have regarding ethics education, and the aims and expected outcomes of ethics education, are rarely made clear. This research reports the findings of a questionnaire administered to 375 undergraduate biotechnology students from 19 Australian universities to determine their attitudes towards the teaching of ethics. The results suggest that undergraduate biotechnology students generally regard ethics education to be important and that ethics should be included in undergraduate biotechnology curricula. Students tended, however, to emphasize the professional and industrial side of ethics and not to recognize the personal effects of morals and behaviour. We provide suggestions for rethinking how ethics should be taught.

  5. Health Related Quality of Life in Patients with Side-Effects after Antimuscarinic Treatment for Overactive Bladder.

    PubMed

    Kim, Aram; Lee, Kyu-Sung; Jung, Rangrhee; Na, Selee; Kim, Joon-Chul; Kim, Hyeong Gon; Choo, Myung-Soo

    2017-09-01

    Drug therapy is the mainstay of treatment for overactive bladder (OAB), but antimuscarinic agents possess side-effects. These side-effects decrease the patients' quality of life. We therefore assessed the impact of side-effects on health-related quality of life (HR-QoL) through an analysis of EQ-5D questionnaire. This study was designed to investigate the patients' satisfaction by quality weight of health status as affected by the side-effects of OAB medications. Patients who had OAB symptoms lasting longer than 3 months and have experienced side-effects after any antimuscarinic treatments filled in the EQ-5D questionnaire. The enrolled patients had two EQ-5D questionnaires for two different health statuses, i.e., presence or absence of side-effects. Quality weight was calculated using the ED-5D health status score with Korean tariff. One hundred patients were enrolled and completed the HR-QoL questionnaire. The most prevalent side-effect was dry mouth (61%) and 28% patients had dry mouth and constipation concurrently. Most of the patients with side-effects tried to endure and overcome these side-effects (79%), but 10% desired a change in medication, and 6% stopped medication altogether. The quality weight of EQ-5D without side-effects was 0.863, while the quality weight with side-effects was 0.666 (P < 0.001). The VAS score was 79 in patient without side-effects and 57 in those with side-effects, supporting the results of quality weight assessment. Overactive bladder patients may enjoy a better quality of life if side-effects associated with antimuscarinic therapy are fewer. © 2016 John Wiley & Sons Australia, Ltd.

  6. Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es Salaam.

    PubMed

    Makungu, Christina; Stephen, Stephania; Kumburu, Salome; Govella, Nicodem J; Dongus, Stefan; Hildon, Zoe Jane-Lara; Killeen, Gerry F; Jones, Caroline

    2017-10-11

    The effectiveness of malaria prevention with long-lasting insecticidal nets and indoor residual spraying is limited by emerging insecticide resistance, evasive mosquito behaviours that include outdoor biting, sub-optimal implementation and inappropriate use. New vector control interventions are required and their potential effectiveness will be enhanced if existing household perceptions and practices are integrated into intervention design. This qualitative descriptive study used focus groups discussions, in-depth interviews and photovoice methods to explore mosquito control perceptions and practices among residents in four study sites in Dar es Salaam, Tanzania. Mosquitoes were perceived as a growing problem, directly attributed to widespread environmental deterioration and lack of effective mosquito control interventions. Malaria and nuisance biting were perceived as the main problem caused by mosquitoes. Breeding sites were clearly distinguished from resting sites but residents did not differentiate between habitats producing malaria vector mosquitoes and others producing mostly nuisance mosquitoes. The most frequently mentioned protection methods in the wealthiest locations were bed nets, aerosol insecticide sprays, window screens, and fumigation, while bed nets were most frequently mentioned and described as 'part of the culture' in the least wealthy locations. Mosquito-proofed housing was consistently viewed as desirable, but considered unaffordable outside wealthiest locations. Slapping and covering up with clothing were most commonly used to prevent biting outdoors. Despite their utility outdoors, topical repellents applied to the skin were considered expensive, and viewed with suspicion due to perceived side effects. Improving the local environment was the preferred method for preventing outdoor biting. Affordability, effectiveness, availability, practicality, as well as social influences, such as government recommendations, socialization and internalization (familiarization and habit) were described as key factors influencing uptake. Outdoor transmission is widely accepted as an obstacle to malaria elimination. Larval source management, targeting both malaria vectors and nuisance-biting mosquitoes, is the preferred method for mosquito control among the residents of Dar es Salaam and should be prioritized for development alongside new methods for outdoor personal protection. Even if made available, effective and affordable, these additional interventions may require time and user experience to achieve positive reputations and trustworthiness.

  7. The Sidebar Computer Program, a seismic-shaking intensity meter: users' manual and software description

    USGS Publications Warehouse

    Evans, John R.

    2003-01-01

    The SideBar computer program provides a visual display of seismic shaking intensity as recorded at one specific seismograph. This software allows a user to tap into the seismic data recorded on that specific seismograph and to display the overall level of shaking at the single location where that seismograph resides (usually the same place the user is). From this shaking level, SideBar also estimates the potential for damage nearby. SideBar cannot tell you the “Richter magnitude” of the earthquake (see box), only how hard the ground shook locally and this estimate of how much damage is likely in the neighborhood. This combination of local effects is called the “seismic intensity”. SideBar runs on a standard desktop or laptop PC, and is intended for the media, schools, emergency responders, and any other group hosting a seismograph and who want to know immediately after an earthquake the levels of shaking measured by that instrument. These local values can be used to inform the public and help initiate appropriate local emergency response activities in the minutes between the earthquake and availability of the broader coverage provided by the USGS over the Web, notably by ShakeMap. For example, for instruments installed in schools, the level of shaking and likely damage at the school could immediately be Web broadcast and parents could quickly determine the likely safety of their children—their biggest postearthquake concern. Also, in the event of a Web outage, SideBar may be a continuing primary source of local emergency response information for some additional minutes. Specifically, SideBar interprets the peak level of acceleration (that is, the force of shaking, as a percentage of the force of gravity) as well as the peak velocity, or highest speed, at which the ground moves. Using these two basic measurements, SideBar computes what is called Instrumental Intensity—a close approximation of the Modified Mercalli Intensity scale, or “MMI” (using the Wald et al., 1999a, relationships between acceleration, velocity, and shaking intensity). Intensity is a measure of local shaking strength and the potential for damage—of how bad the earthquake effects were locally. The intensity level is what SideBar displays most prominently on the PC monitor. Intensity is shown as a large, colored bar that gets taller and changes color up a rainbow from blues toward reds as the shaking level increases. As opposed to earthquake magnitudes, which are reported as decimal values (like “7.6”), intensity is traditionally given as a Roman numeral, with “I” to “X+” assigned to levels of potential damage and perceived shaking strength. For good measure, SideBar shows the actual values of the force of shaking (peak ground acceleration as a percentage of gravity) and the speed of ground motion (peak ground velocity in inches per second, by default, or in centimeters per second, if you wish), both these values as decimal numbers. SideBar also remembers the most recent earthquakes (for up to one week), and can store as many of these previous earthquakes as the user allows (and as the user’s PC has room for)—typically thousands. SideBar also remembers forever the three largest earthquakes it has seen and all earthquakes over intensity IV so that one never loses particularly important events.

  8. Is the perceived placebo effect comparable between adults and children? A meta-regression analysis.

    PubMed

    Janiaud, Perrine; Cornu, Catherine; Lajoinie, Audrey; Djemli, Amina; Cucherat, Michel; Kassai, Behrouz

    2017-01-01

    A potential larger perceived placebo effect in children compared with adults could influence the detection of the treatment effect and the extrapolation of the treatment benefit from adults to children. This study aims to explore this potential difference, using a meta-epidemiological approach. A systematic review of the literature was done to identify trials included in meta-analyses evaluating a drug intervention with separate data for adults and children. The standardized mean change and the proportion of responders (binary outcomes) were used to calculate the perceived placebo effect. A meta-regression analysis was conducted to test for the difference between adults and children of the perceived placebo effect. For binary outcomes, the perceived placebo effect was significantly more favorable in children compared with adults (β = 0.13; P = 0.001). Parallel group trials (β = -1.83; P < 0.001), subjective outcomes (β = -0.76; P < 0.001), and the disease type significantly influenced the perceived placebo effect. The perceived placebo effect is different between adults and children for binary outcomes. This difference seems to be influenced by the design, the disease, and outcomes. Calibration of new studies for children should consider cautiously the placebo effect in children.

  9. Role of the Cotyledons in the Phototropic Response of Lavatera cretica Seedlings.

    PubMed

    Schwartz, A; Koller, D

    1980-07-01

    Young seedlings of Lavatera cretica L. exhibit positive phototropism. The hypocotyl perceives unilateral illumination with blue light and curves towards the light source by unequal growth. In addition, the cotyledonary laminas perceive the vectorial component of unilateral illumination with blue light and reorient normal to the beam by creating a turgor differential in their pulvini. Excision of one cotyledon resulted in negative organotropic curvature of the hypocotyl, away from the remaining cotyledon. Illumination of the cotyledonary lamina did not participate in the phototropic curvature of the hypocotyl, so long as the lamina was free to reorient to face the beam. When the lamina was continuously exposed to vectorial photoexcitation, elongation of the hypocotyl on the side carrying the cotyledon could be enhanced, or inhibited, depending on the direction of the beam striking its lamina.

  10. Explanations for side effect aversion in preventive medical treatment decisions

    PubMed Central

    Waters, Erika A.; Weinstein, Neil D.; Colditz, Graham A.; Emmons, Karen

    2008-01-01

    Objective Many laypeople demonstrate excessive sensitivity to negative side effects of medical treatments, which may lead them to refuse beneficial therapies. This Internet-based experiment investigated three possible explanations for such “side effect aversion.” One was derived from mental accounting, one examined the mere presence of a side effect, and one focused on computational difficulties. Design Participants (N = 5,379) were presented with a hypothetical cancer preventive treatment situation that was or was not accompanied by one or two small side effects. The side effects were either beneficial or harmful. In all conditions the net absolute risk reduction associated with the treatment was 15%. Main Outcome Measures Participants indicated their willingness to accept treatment and their perceptions of the treatment’s effects on their overall cancer risk. Results Data were consistent only with the “mere presence” explanation of side effect aversion, the idea that side effects act as a strong negative cue that directly affects treatment appraisal. The number of negative side effects did not influence treatment willingness. Conclusion Side effect aversion is a challenge to informed decision making. Specific mechanisms that produce side effect aversion should be identified. PMID:19290712

  11. Couple adjustment to a stressful life event: a dyadic investigation of the roles of positive reframing and perceived benefits.

    PubMed

    Samios, Christina; Baran, Shayne

    2018-03-01

    This study examines positive reframing (a form of meaning making), perceived benefits (a form of meanings made) and adjustment in couples who experienced a stressful life event in the past year. This study tested whether couple members' scores were nonindependent and whether one's own perceived benefits was predicted by their own positive reframing (actor effect) as well as their partner's positive reframing (partner effect). Further, this study tested actor and partner effects for the link between perceived benefits and adjustment and whether positive reframing (the initial variable) works through perceived benefits (the mediator) to affect adjustment (the outcome) at the dyadic level. A standard dyadic design was used. Eighty couples completed measures of positive reframing, perceived benefits, and adjustment (depression, anxiety, positive affect, life satisfaction, and relationship satisfaction). Partners' scores on study variables were related, and although only actor effects were found for the path between positive reframing and perceived benefits, both actor and partner effects were found for the path between perceived benefits and adjustment. Mediation was found for actor-actor and actor-partner indirect effects. Results indicate that a greater focus on interpersonal factors is needed to further meaning-making theory and inform practice.

  12. Perceived School Effectiveness: Case Study of a Liverpool College

    ERIC Educational Resources Information Center

    Samy, M.; Cook, K.

    2009-01-01

    Purpose: A quantitative effectiveness measurement based on the perceptions of the local community has been established as an effective mode of evaluating the level of satisfaction or perceived effectiveness of a school. In order to measure the level of effectiveness as perceived by their communities, educational institutions could use this…

  13. Consequences, control and appraisal: cues and barriers to engaging in self-management among people affected by colorectal cancer - a secondary analysis of qualitative data.

    PubMed

    Kidd, Lisa A

    2014-08-01

    Little is known about peoples' self-management experiences and their desires or expectations to engage in self-management. As such, there is little understanding about individuals' perceived cues and barriers to engagement in self-management, particularly in people affected by cancer. To understand cues and barriers to people's engagement in self-management during chemotherapy treatment for colorectal cancer. Secondary analysis of qualitative data from mixed methods, longitudinal study. Eleven participants undergoing treatment for colorectal cancer. Semi-structured interviews were conducted twice with each participant, at the start and end of a 6-month course of chemotherapy treatment in a Scottish cancer centre. Cues and barriers to engagement in self-management appeared to stem from perceptions of the impact and associated severity of side effects experiences as well as the perceptions about the efficacy of chosen self-management activities and perceptions of control in minimizing the consequences of cancer treatment. Severe, episodic or unexpected side effects coupled with perceptions of uncertainty, lack of control and lack of adequate preparation to engage in self-management were identified as key barriers to engagement. Participants' reflection on, or appraisal of, their treatment-related experiences and personal abilities, confidence and preferences to manage the impact of these shaped their subsequent engagement in self-management. The findings highlight the importance of understanding individual's self-management experiences, perceptions, preferences, priorities and needs to help support, prepare and enable them to feel capable and confident to engage actively and effectively in self-management. © 2012 John Wiley & Sons Ltd.

  14. Narrowing the creativity gap: the moderating effects of perceived support for creativity.

    PubMed

    DiLiello, Trudy C; Houghton, Jeffery D; Dawley, David

    2011-01-01

    This article examines the role of 3 types of perceived support for creativity in moderating the relation between creative self-efficacy and self-perceived creativity. The findings suggest significant interaction effects for perceived work-group support and supervisor support, but not for perceived organizational support. This study is among the first to (a) examine the importance of perceived support for creativity in unlocking creative potential and increasing creativity in organizations and (b) use interaction terms in structural equation modeling (SEM) to investigate moderator effects in an applied research setting. These results imply that organizational interventions focused on training supervisors and work-group members to support creativity in the workplace may be more effective than broader and less focused interventions at the organizational level.

  15. A qualitative exploration of emergency contraception users' willingness to select the copper IUD.

    PubMed

    Wright, Rachel L; Frost, Caren J; Turok, David K

    2012-01-01

    The copper T intrauterine device (IUD) is an effective but underutilized method of emergency contraception (EC). This study investigates the factors influencing a woman's decision around which method of EC to select. In-depth interviews with 14 IUD and 14 oral EC users aged 18-30 years accessing public health clinics. Emergency contraception users associated long-term methods of contraception with long-term sexual relationships. Women were not aware of the possibility of using the copper IUD for EC. Cost was identified as a major barrier to accessing IUDs. Perceived side effects and impact on future pregnancies further influenced the EC method a participant selected. Women think about contraception in the context of each separate relationship and not as a long-term individual plan. Most women were unaware of the copper IUD for EC. Furthermore, there is little discussion between women and their health-care providers around EC. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Household responses to malaria and their costs: a study from rural Sri Lanka.

    PubMed

    Konradsen, F; van der Hoek, W; Amerasinghe, P H; Amerasinghe, F P; Fonseka, K T

    1997-01-01

    A study of the cost of malaria at the household level, community perceptions, preventive measures and illness behaviour linked to the disease was undertaken in 5 villages in the dry zone of Sri Lanka. The surveyed community had a high knowledge of malaria, although side effects of antimalarial drugs were often confused with symptoms of the disease. The community sought prompt diagnosis and treatment at 'western-type' facilities, with 84% making use of government facilities as their first choice and 16% preferring private facilities. The preventive measures used were burning coils (54% of families) and special leaves (69% of families), and 93% of the families had their houses sprayed with insecticides. Average direct expenditure on a single malaria episode was $3 US, with some families spending more than 10% of the annual household net income per episode. The highest expenditure was on special diets for the sick person, to neutralize the perceived heating effect of the disease and its treatment.

  17. Teriflunomide for the treatment of relapsing-remitting multiple sclerosis: patient preference and adherence.

    PubMed

    Bayas, Antonios; Mäurer, Mathias

    2015-01-01

    Multiple sclerosis (MS), a chronic demyelinating neuroinflammatory disease of the central nervous system, is the most common neurological disorder leading to disability in young adulthood. In the last 2 decades, numerous treatments for relapsing-remitting MS have been approved with eleven treatment options available worldwide. One of the determinants in treatment selection is disease activity in the individual patient. However, patient preferences play an increasingly major role in treatment decision making. With teriflunomide, a reversible inhibitor of the enzyme dihydroorotate dehydrogenase, a new oral therapeutic option, given once daily, has been approved within the last 2 years by the regulatory agencies. The current review focuses on characteristics of the drug relevant for patients' preferences in the treatment decision process in the light of the available medications. Perceiving and considering patients' preferences will have an effect on treatment adherence, which is known to be often low in MS patients. Teriflunomide-related adherence issues will also be discussed regarding mode of application, dosing, and potential side effects.

  18. Complete dislocation of the ulnar nerve at the elbow: a protective effect against neuropathy?

    PubMed

    Leis, A Arturo; Smith, Benn E; Kosiorek, Heidi E; Omejec, Gregor; Podnar, Simon

    2017-08-01

    Recurrent complete ulnar nerve dislocation has been perceived as a risk factor for development of ulnar neuropathy at the elbow (UNE). However, the role of dislocation in the pathogenesis of UNE remains uncertain. We studied 133 patients with complete ulnar nerve dislocation to determine whether this condition is a risk factor for UNE. In all, the nerve was palpated as it rolled over the medial epicondyle during elbow flexion. Of 56 elbows with unilateral dislocation, UNE localized contralaterally in 17 elbows (30.4%) and ipsilaterally in 10 elbows (17.9%). Of 154 elbows with bilateral dislocation, 26 had UNE (16.9%). Complete dislocation decreased the odds of having UNE by 44% (odds ratio = 0.475; P =  0.028), and was associated with less severe UNE (P = 0.045). UNE occurs less frequently and is less severe on the side of complete dislocation. Complete dislocation may have a protective effect on the ulnar nerve. Muscle Nerve 56: 242-246, 2017. © 2016 Wiley Periodicals, Inc.

  19. Knowledge and perceptions of HIV-infected patients regarding HIV transmission and treatment in Ho Chi Minh City, Vietnam.

    PubMed

    Hoang, Don; Dinh, An T; Groce, Nora; Sullivan, Lynn E

    2015-03-01

    Patient education concerning HIV and antiretroviral (ARV) medications is important for optimal outcomes. The authors assessed the knowledge and perceptions of HIV-infected patients in an ARV education program in Ho Chi Minh City, Vietnam. Of 185 patients, 64 (35%) receiving ARV medications, nearly 80% correctly answered questions regarding HIV. Correct responses were associated with higher education (P < .05) and longer duration of HIV diagnosis (P < .05). A lack of knowledge was observed in 40% of respondents who believed HIV and AIDS were the same and 70% of respondents who believed ARV medications cured HIV. Greater embarrassment of living with HIV was associated with female gender (P < .05) and lower education (P < .05). Patients were concerned over ARV medication use (27%) and its side effects (38%). The study population's knowledge of HIV/AIDS and ARV medications, perceived stigmatization, and areas of knowledge deficits underscore the need for effective patient education programs addressing poorly understood issues around HIV/AIDS. © 2011 APJPH.

  20. Self-controlled video feedback on tactical skills for soccer teams results in more active involvement of players.

    PubMed

    van Maarseveen, Mariëtte J J; Oudejans, Raôul R D; Savelsbergh, Geert J P

    2018-02-01

    Many studies have shown that self-controlled feedback is beneficial for learning motor tasks, and that learners prefer to receive feedback after supposedly good trials. However, to date all studies conducted on self-controlled learning have used individual tasks and mainly relatively simple skills. Therefore, the aim of this study was to examine self-controlled feedback on tactical skills in small-sided soccer games. Highly talented youth soccer players were assigned to a self-control or yoked group and received video feedback on their offensive performance in 3 vs. 2 small-sided games. The results showed that the self-control group requested feedback mostly after good trials, that is, after they scored a goal. In addition, the perceived performance of the self-control group was higher on feedback than on no-feedback trials. Analyses of the conversations around the video feedback revealed that the players and coach discussed good and poor elements of performance and how to improve it. Although the coach had a major role in these conversations, the players of the self-control group spoke more and showed more initiative compared to the yoked group. The results revealed no significant beneficial effect of self-controlled feedback on performance as judged by the coach. Overall, the findings suggest that in such a complex situation as small-sided soccer games, self-controlled feedback is used both to confirm correct performance elements and to determine and correct errors, and that self-controlled learning stimulates the involvement of the learner in the learning process. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Adult norms of the perceptual threshold of touch (PTT) in the hands and feet in relation to age, gender, and right and left side using transcutaneous electrical nerve stimulation.

    PubMed

    Eek, Elsy; Holmqvist, Lotta Widén; Sommerfeld, Disa K

    2012-07-01

    There is a lack of standardized and quantifiable measures of touch function, for clinical work. Furthermore, it is not possible to make accurate diagnostic judgments of touch function before normative values are estimated. The objectives of this study were to establish adult norms of the perceptual threshold of touch (PTT) for the hands and feet according to age and gender and to determine the effect of right/left side, handedness, height, weight, and body mass index (BMI) on the PTT. The PTT was assessed by using a high-frequency transcutaneous electrical nerve stimulator (Hf/TENS) with self-adhesive skin electrodes in 346 adults. The PTT was identified as the level registered in mA at which the participants perceived a tingling sensation. The PTT for all participants was a median of 3.75 mA (range 2.50-7.25) in the hands and a median of 10.00 (range 5.00-30.00) in the feet. With increasing age an increase of the PTT was found. Men reported higher PTT than women. The right hand had higher PTT than the left. Handedness, height, weight, and BMI did not affect the PTT. Adult norms of the PTT in the hands for age, gender, and right/left side are presented for four age groups. The present study's estimate of the PTT in the hands could be used as adult norms. Adult norms for the feet could not be estimated because the PTT values in the feet showed a great variance.

  2. A Twin Study on Perceived Stress, Depressive Symptoms, and Marriage.

    PubMed

    Beam, Christopher R; Dinescu, Diana; Emery, Robert; Turkheimer, Eric

    2017-03-01

    Marriage is associated with reductions in both perceived stress and depressive symptoms, two constructs found to be influenced by common genetic effects. A study of sibling twins was used to test whether marriage decreases the proportion of variance in depressive symptoms accounted for by genetic and environmental effects underlying perceived stress. The sample consisted of 1,612 male and female twin pairs from the University of Washington Twin Registry. The stress-buffering role of marriage was tested relative to two unmarried groups: the never married and the divorced. Multivariate twin models showed that marriage reduced genetic effects of perceived stress on depressive symptoms but did not reduce environmental effects. The findings suggest a potential marital trade-off for women: access to a spouse may decrease genetic effects of perceived stress on depressive symptoms, although marital and family demands may increase environmental effects of perceived stress on depressive symptoms.

  3. A Twin Study on Perceived Stress, Depressive Symptoms, and Marriage

    PubMed Central

    Beam, Christopher R.; Dinescu, Diana; Emery, Robert E.; Turkheimer, Eric

    2017-01-01

    Marriage is associated with reductions in both perceived stress and depressive symptoms, two constructs found to be influenced by common genetic effects. A study of sibling twins was used to test whether marriage decreases the proportion of variance in depressive symptoms accounted for by genetic and environmental effects underlying perceived stress. The sample consisted of 1,612 male and female twin pairs from the University of Washington Twin Registry. The stress-buffering role of marriage was tested relative to two unmarried groups: the never married and the divorced. Multivariate twin models showed that marriage reduced genetic effects of perceived stress on depressive symptoms, but did not reduce environmental effects. The findings suggest a potential marital trade-off for women: Access to a spouse may decrease genetic effects of perceived stress on depressive symptoms, although marital and family demands may increase environmental effects of perceived stress on depressive symptoms. PMID:28661771

  4. Speech intelligibility and subjective benefit in single-sided deaf adults after cochlear implantation.

    PubMed

    Finke, Mareike; Strauß-Schier, Angelika; Kludt, Eugen; Büchner, Andreas; Illg, Angelika

    2017-05-01

    Treatment with cochlear implants (CIs) in single-sided deaf individuals started less than a decade ago. CIs can successfully reduce incapacitating tinnitus on the deaf ear and allow, so some extent, the restoration of binaural hearing. Until now, systematic evaluations of subjective CI benefit in post-lingually single-sided deaf individuals and analyses of speech intelligibility outcome for the CI in isolation have been lacking. For the prospective part of this study, the Bern Benefit in Single-Sided Deafness Questionnaire (BBSS) was administered to 48 single-sided deaf CI users to evaluate the subjectively perceived CI benefit across different listening situations. In the retrospective part, speech intelligibility outcome with the CI up to 12 month post-activation was compared between 100 single-sided deaf CI users and 125 bilaterally implanted CI users (2nd implant). The positive median ratings in the BBSS differed significantly from zero for all items suggesting that most individuals with single-sided deafness rate their CI as beneficial across listening situations. The speech perception scores in quiet and noise improved significantly over time in both groups of CI users. Speech intelligibility with the CI in isolation was significantly better in bilaterally implanted CI users (2nd implant) compared to the scores obtained from single-sided deaf CI users. Our results indicate that CI users with single-sided deafness can reach open set speech understanding with their CI in isolation, encouraging the extension of the CI indication to individuals with normal hearing on the contralateral ear. Compared to the performance reached with bilateral CI users' second implant, speech reception threshold are lower, indicating an aural preference and dominance of the normal hearing ear. The results from the BBSS propose good satisfaction with the CI across several listening situations. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Subjective Report of Side Effects of Prescribed and Nonprescribed Psychostimulant Use in Young Adults.

    PubMed

    Smith, Tess E; Martel, Michelle M; DeSantis, Alan D

    2017-03-21

    Side effects of prescribed and nonprescribed psychostimulant use are understudied. The study examined side effects of prescribed and nonprescribed psychostimulant use in a college sample with attention to possible gender differences. 2716 undergraduates (1448 male) between the ages of 17 and 57 years (M = 19.43 years, SD = 1.7 years) completed an online survey that included questions about the subjective side effects of prescribed and nonprescribed psychostimulant use. Results suggested that prescribed users more frequently reported side effects, compared to nonprescribed users. For prescribed users, females more frequently reported appetite, somatic, and anxiety-related side effects compared to males. For nonprescribed users, while females reported more somatic and anxiety-related side effects, males more frequently reported loss of sex drive and sweating as side effects. Conclusions/Importance: These findings suggest prescribed users of psychostimulants more frequently report side effects with prominent gender differences in line with gender roles.

  6. Sexual side effects associated with conventional and atypical antipsychotics.

    PubMed

    Compton, M T; Miller, A H

    2001-01-01

    The sexual side effects of psychotropic medications are becoming increasingly recognized in clinical psychiatry. The magnitude of the problem of sexual side effects associated with antipsychotic medications has yet to be fully elucidated, but a multitude of references in the literature demonstrate the importance of these side effects in both men and women. All currently used antipsychotic medications are associated with sexual side effects of various types. Although each antipsychotic medication may have a specific side effect profile determined by its various receptor affinities and by the degree to which it elevates serum prolactin, there is currently no evidence that specific side effects can be predicted. Sexual side effects can be categorized according to the phase of the sexual response cycle with which they interfere. Suggestions for clinical evaluation and treatment options are provided, including risk factor modification, dose reduction, switching agents, and addition of other agents. Sexual side effects associated with conventional and atypical antipsychotic medications represent an underestimated and understudied set of side effects that may diminish a patient's quality of life and lead to treatment noncompliance. Clinicians prescribing antipsychotic medications should be familiar with the classification, evaluation, and treatment of these side effects.

  7. [Working environment and educational environment are two sides of the same coin].

    PubMed

    Kannegaard, Pia Nimann; Holm, Ellen Astrid

    2014-01-20

    Educational environment is of major importance for job satisfaction and it consists of several components including curriculum and values of the organization. Educational climate is the environment, as the individual physicians perceive it. Motivation is important for job satisfaction as well as for learning. Autonomy, responsibility, supervision, feedback are all important factors influencing motivation and learning. These factors must be supported through appropriate organization of work in hospital departments and in general practice.

  8. Geometric figure–ground cues override standard depth from accretion-deletion

    PubMed Central

    Tanrıkulu, Ömer Dağlar; Froyen, Vicky; Feldman, Jacob; Singh, Manish

    2016-01-01

    Accretion-deletion is widely considered a decisive cue to surface depth ordering, with the accreting or deleting surface interpreted as behind an adjoining surface. However, Froyen, Feldman, and Singh (2013) have shown that when accretion-deletion occurs on both sides of a contour, accreting-deleting regions can also be perceived as in front and as self-occluding due to rotation in three dimensions. In this study we ask whether geometric figure–ground cues can override the traditional “depth from accretion-deletion” interpretation even when accretion-deletion takes place only on one side of a contour. We used two tasks: a relative-depth task (front/back), and a motion-classification task (translation/rotation). We conducted two experiments, in which texture in only one set of alternating regions was moving; the other set was static. Contrary to the traditional interpretation of accretion-deletion, the moving convex and symmetric regions were perceived as figural and rotating in three dimensions in roughly half of the trials. In the second experiment, giving different motion directions to the moving regions (thereby weakening motion-based grouping) further weakened the traditional accretion-deletion interpretation. Our results show that the standard “depth from accretion-deletion” interpretation is overridden by static geometric cues to figure–ground. Overall, the results demonstrate a rich interaction between accretion-deletion, figure–ground, and structure from motion that is not captured by existing models of depth from motion. PMID:26982528

  9. Is our brain hardwired to produce God, or is our brain hardwired to perceive God? A systematic review on the role of the brain in mediating religious experience.

    PubMed

    Fingelkurts, Alexander A; Fingelkurts, Andrew A

    2009-11-01

    To figure out whether the main empirical question "Is our brain hardwired to believe in and produce God, or is our brain hardwired to perceive and experience God?" is answered, this paper presents systematic critical review of the positions, arguments and controversies of each side of the neuroscientific-theological debate and puts forward an integral view where the human is seen as a psycho-somatic entity consisting of the multiple levels and dimensions of human existence (physical, biological, psychological, and spiritual reality), allowing consciousness/mind/spirit and brain/body/matter to be seen as different sides of the same phenomenon, neither reducible to each other. The emergence of a form of causation distinctive from physics where mental/conscious agency (a) is neither identical with nor reducible to brain processes and (b) does exert "downward" causal influence on brain plasticity and the various levels of brain functioning is discussed. This manuscript also discusses the role of cognitive processes in religious experience and outlines what can neuroscience offer for study of religious experience and what is the significance of this study for neuroscience, clinicians, theology and philosophy. A methodological shift from "explanation" to "description" of religious experience is suggested. This paper contributes to the ongoing discussion between theologians, cognitive psychologists and neuroscientists.

  10. Perceived Effectiveness of Principals of Seventh-day Adventist Boarding Schools.

    ERIC Educational Resources Information Center

    Hutchinson, Malcom E., Jr.

    2001-01-01

    Investigated the effectiveness of Seventh-day Adventist boarding high school principals as perceived by school staff, superintendents, and principals. Survey data indicated that respondents perceived principals to be highly effective in maintenance and integration and moderately effective in adaptation and goal attainment. Respondents' perceptions…

  11. Correlations between state anxiety and quality of life in metastatic breast cancer patients.

    PubMed

    Dragomir, Bianca-Iasmina; Fodoreanu, Liana

    2013-01-01

    to evaluate the correlations between perceived state anxiety during chemotherapy and quality of life in metastatic breast cancer patients. 62 metastatic breast cancer patients were evaluated during chemotherapy concerning age, living environment, marital status, social support and preexisting financial difficulties, the histological type of cancer, the site of the metastasis, the time from diagnosis, the type of surgical intervention, dexamethasone use, somatic comorbidities and the radiotherapy. The STAI-X1, BDI- IIA and the QLQ 30 (Quality of Life Questionnaire 30) plus BR 23 (Breast 23) questionnaires were applied. For the statistical analysis we used the SPSS 13 package. 24 subjects were experiencing low state anxiety (< or =39), whilst 38 had significant state anxiety (>39). Statistically significant differences were encountered between the two compared subgroups concerning the living environment, the type of surgical intervention, the marital status, the social support and the mean BDI scores, adjusted means were calculated for the items considered to potentially influence quality of life. Social, emotional and role functioning had lower scores in the low state anxiety group. Fatigue, future perspective, chemotherapy induced side effects, breast symptoms, upset by hair loss and sexual functioning were more disturbing in the high state anxiety group. The general health/quality of life mean score was lower in the low state anxiety group. Higher state anxiety correlates with certain quality of life items, suggesting that psychological counselling and appropriate therapy induced side effects management should be a priority in the palliative care for metastatic breast cancer patients.

  12. Adherence to Attention-Deficit/Hyperactivity Disorder Medication During the Transition to College.

    PubMed

    Schaefer, Megan R; Rawlinson, Alana Resmini; Wagoner, Scott T; Shapiro, Steven K; Kavookjian, Jan; Gray, Wendy N

    2017-06-01

    The present study explores the medication self-management experiences of adolescents with attention-deficit/hyperactivity disorder (ADHD) during their transition to young adulthood in college. Participants were college freshmen with ADHD prescribed daily medication for their condition. Ten individual interviews were conducted using a semistructured interview script. Measures related to ADHD medication management were also completed. Qualitative data were analyzed via directed content analysis and quantitative data via descriptive statistics. Five themes emerged from interviews: (1) transitions to independence are often abrupt, and many adolescents lack critical self-management skills; (2) volitional nonadherence is high due to inaccurate disease beliefs, perceived academic demands, and medication side effects; (3) poor self-management negatively impacts school performance; (4) peer pressure to share medication affects social functioning and adherence; and (5) social support is greatly needed. Common barriers to adherence included "don't feel like taking medication" (90%) and "difficulties in sticking to a fixed medication schedule" (80%). Participants with ADHD were not prepared to manage their chronic illness independently in context of increased demands and newfound freedom, resulting in negative academic consequences. Social factors also play an influential role in ADHD self-management, particularly related to the isolation associated with sharing the medication and its side effects. Intervention programs targeting medication self-management during the transition to independence are greatly needed for young adults with ADHD as high academic performance in college is critical for future success. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. Effect of pre-cooling injection site on pain perception in pediatric dentistry: “A randomized clinical trial”

    PubMed Central

    Ghaderi, Faezeh; Banakar, Shahin; Rostami, Shima

    2013-01-01

    Background: Injection of local anesthesia is one of the most important reasons for development of avoidance behavior in children. Efforts have been performed to decrease pain perception of injection. The present research evaluated the effect of cooling the injection site on pain perception before infiltration of local anesthetics. Materials and Methods: A prospective single-blind crossover clinical trial was used to investigate pain perception in 50 healthy pediatric patients who needed bilateral buccal infiltration of local anesthetics for dental treatment. They received a topical anesthetic agent (Benzocaine) on one side (control) for 1 min and topical anesthetic agent plus one minute of ice pack on the other side (trial) prior to the injection. A dentist blind to the study assessed the patients’ reaction during injection. Wilcoxon and Mann-Whitney U tests were used for statistical analysis. Statistical significance was defined at P < 0.05. Results: The means of sound, eye, and motor scales (SEM) were 4.06 ± 1.32 and 5.44 ± 1.79 for the study and control groups, respectively. The means of visual analogue scales (VAS) for the study and control groups were 42.20 ± 12.70 and 58.40 ± 16.83, respectively; with statistically significant differences between the two groups (P < 0.05). Conclusion: Cooling the injection site before infiltration of local anesthetics in the buccal mucosa for 1 min, reduced pain perceived by pediatric patients. PMID:24379869

  14. Content validity of the NCCN-FACT ovarian symptom index-18 (NFOSI-18).

    PubMed

    Jensen, Sally E; Kaiser, Karen; Lacson, Leilani; Schink, Julian; Cella, David

    2015-02-01

    This study examined the content validity of the NCCN-FACT Ovarian Symptom Index-18 (NFOSI-18), an advanced ovarian cancer symptom index comprised of symptoms perceived as most important by clinical experts and women with advanced ovarian cancer. Eighteen women with advanced ovarian cancer completed the NFOSI-18 and participated in cognitive interviews to assess: (a) the understandability of the NFOSI-18; and (b) the things patients have in mind when responding to the item, "I am bothered by side effects of treatment;" and (c) the interpretation patients place on items relating to fatigue and lack of energy. Interviews were recorded and transcribed for qualitative analysis. All but 2 (89%) participants indicated that each item was clear and understandable and the same proportion (89%) stated they were "very confident" or "confident" about providing accurate answers to all but one item. When responding to the item, "I am bothered by side effects of treatment," fatigue, nausea, and neuropathy constituted the most frequently mentioned concerns. Among the participants who were asked, eight participants responded that "fatigue" and "lack of energy" were the same concept and nine responded they were different. Participants associated "fatigue" with tiredness and associated "lack of energy" with the inability to perform daily tasks and activities. The findings support the content validity of the NFOSI-18. Item revisions, deletions or additions do not appear warranted. Future research can address the reliability and validity of the NFOSI-18 in clinical research. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Perceptions of and barriers to family planning services in the poorest regions of Chiapas, Mexico: a qualitative study of men, women, and adolescents.

    PubMed

    Dansereau, Emily; Schaefer, Alexandra; Hernández, Bernardo; Nelson, Jennifer; Palmisano, Erin; Ríos-Zertuche, Diego; Woldeab, Alex; Zúñiga, Maria Paola; Iriarte, Emma Margarita; Mokdad, Ali H; El Bcheraoui, Charbel

    2017-10-17

    In the poorest regions of Chiapas, Mexico, 50.2% of women in need of contraceptives do not use any modern method. A qualitative study was needed to design effective and culturally appropriate interventions. We used purposive maximum-variation sampling to select eight municipalities with a high proportion of residents in the poorest wealth quintile, including urban, rural, indigenous, and non-indigenous communities. We conducted 44 focus group discussions with 292 women, adolescent women, and men using semi-structured topic guides. We analyzed the data through recursive abstraction. There were intergenerational and cultural gaps in the acceptability of family planning, and in some communities family planning use was greatly limited by gender roles and religious objections to contraception. Men strongly influenced family planning choices in many households, but were largely unreached by outreach and education programs due to their work hours. Respondents were aware of many modern methods but often lacked deeper knowledge and held misconceptions about long-term fertility risks posed by some hormonal methods. Acute physical side effects also dissuaded use. The implant was a new and highly acceptable method due to ease of use, low upkeep, and minimal side effects; however, it was perceived as subject to stock-outs. Adolescent women reported being refused services at health facilities and requested more reproductive health information from their parents and schools. Mass and social media are growing sources of reproductive health information. Our study identifies a number of barriers to family planning that have yet to be adequately addressed by existing programs in Chiapas' poorest regions, and calls for reinvigorated efforts to provide effective, acceptable, and culturally appropriate interventions for these communities.

  16. What are the odds? How demographic similarity affects the prevalence of perceived employment discrimination.

    PubMed

    Avery, Derek R; McKay, Patrick F; Wilson, David C

    2008-03-01

    Because research is needed to identify the conditions that facilitate or impede the prevalence of perceived workplace discrimination, the authors examined the effects of demographics and demographic similarity on the prevalence of sex- and race/ethnicity-based perceived workplace discrimination. Results from a national survey of 763 full-time, United States employees show perceived sex-based discrimination at work was more prevalent among female than male employees, and perceived race-based discrimination at work was more prevalent among Black and Hispanic than White employees. Additionally, perceived racial/ethnic discrimination was less prevalent among those with same-race/ethnicity supervisors. The effect of employee-coworker sex similarity on perceived sex discrimination was significant only for women, and the effects of supervisor-subordinate racial similarity on the prevalence of perceived racial discrimination varied between Black and White respondents, depending on employee-residential-community racial similarity. Copyright 2008 APA

  17. Organizational culture predicts job satisfaction and perceived clinical effectiveness in pediatric primary care practices.

    PubMed

    Brazil, Kevin; Wakefield, Dorothy B; Cloutier, Michelle M; Tennen, Howard; Hall, Charles B

    2010-01-01

    In recent years, there has been a growing understanding that organizational culture is related to an organization's performance. However, few studies have examined organizational culture in medical group practices. The purpose of this study was to examine the relationship of organizational culture on provider job satisfaction and perceived clinical effectiveness in primary care pediatric practices. This cross-sectional study included 36 primary care pediatric practices located in Connecticut. There were 374 participants in this study, which included 127 clinicians and 247 nonclinicians. Office managers completed a questionnaire that recorded staff and practice characteristics; all participants completed the Organizational Culture Scale, a questionnaire that assessed the practice on four cultural domains (i.e., group, developmental, rational, and hierarchical), and the Primary Care Organizational Questionnaire that evaluated perceived effectiveness and job satisfaction. Hierarchical linear models using a restricted maximum likelihood estimation method were used to evaluate whether the practice culture types predicted job satisfaction and perceived effectiveness. Group culture was positively associated with both satisfaction and perceived effectiveness. In contrast, hierarchical and rational culture were negatively associated with both job satisfaction and perceived effectiveness. These relationships were true for clinicians, nonclinicians, and the practice as a whole. Our study demonstrates that practice culture is associated with job satisfaction and perceived clinical effectiveness and that a group culture was associated with high job satisfaction and perceived effectiveness.

  18. Communicating the risks of fetal alcohol spectrum disorder: effects of message framing and exemplification.

    PubMed

    Yu, Nan; Ahern, Lee A; Connolly-Ahern, Colleen; Shen, Fuyuan

    2010-12-01

    Health messages can be either informative or descriptive, and can emphasize either potential losses or gains. This study, guided by message framing theory and exemplification theory, specifically investigated the combined effects of messages with loss-gain frames mixed with statistics or exemplar appeals. The findings revealed a series of main effects and interactions for loss-gain frames and statistics-exemplar appeals on fetal alcohol spectrum disorder (FASD) prevention intention, intention to know more, perceived severity, perceived fear, perceived external efficacy, and perceived internal efficacy. The gain-statistics appeal showed an advantage in promoting perceived efficacy toward FASD, while the loss-exemplar appeal revealed an advantage in increasing prevention intention, perceived severity, and perceived fear toward FASD. Limitations and implications for future research are discussed.

  19. Intraoperative Comparison of Anatomical versus Round Implants in Breast Augmentation: A Randomized Controlled Trial.

    PubMed

    Hidalgo, David A; Weinstein, Andrew L

    2017-03-01

    The purpose of this randomized controlled trial was to determine whether anatomical implants are aesthetically superior to round implants in breast augmentation. Seventy-five patients undergoing primary breast augmentation had a round silicone implant of optimal volume, projection, and diameter placed in one breast and an anatomical silicone device of similar volume and optimal shape placed in the other. After intraoperative photographs were taken, the anatomical device was replaced by a round implant to complete the procedure. A survey designed to measure breast aesthetics was administered to 10 plastic surgeon and 10 lay reviewers for blind evaluation of the 75 cases. No observable difference in breast aesthetics between anatomical and round implants was reported by plastic surgeons in 43.6 percent or by lay individuals in 29.2 percent of cases. When a difference was perceived, neither plastic surgeons nor lay individuals preferred the anatomical side more often than the round side. Plastic surgeons judged the anatomical side superior in 51.1 percent of cases and the round side superior in 48.9 percent of cases (p = 0.496). Lay individuals judged the anatomical side superior in 46.7 percent of cases and the round side superior in 53.3 percent (p = 0.140). Plastic surgeons identified implant shape correctly in only 26.5 percent of cases. This study provides high-level evidence supporting no aesthetic superiority of anatomical over round implants. Given that anatomical implants have important and unique disadvantages, a lack of proven aesthetic superiority argues against their continued use in breast augmentation. Therapeutic, I.

  20. Multiple Effects of Messages with Multiple Goals: Some Perceived Outcomes of Responses to Sexual Harassment.

    ERIC Educational Resources Information Center

    Bingham, Shereen G.; Burleson, Brant R.

    1989-01-01

    Tests the perceived effectiveness of different messages responding to sexual harassment in the organizational environment. Finds that none of the messages were perceived as being particularly effective at stopping the harasser's offensive conduct. (MM)

  1. Barriers to physicians' adoption of healthcare information technology: an empirical study on multiple hospitals.

    PubMed

    Lin, Chihung; Lin, I-Chun; Roan, Jinsheng

    2012-06-01

    Prior research on technology usage had largely overlooked the issue of user resistance or barriers to technology acceptance. Prior research on the Electronic Medical Records had largely focused on technical issues but rarely on managerial issues. Such oversight prevented a better understanding of users' resistance to new technologies and the antecedents of technology rejection. Incorporating the enablers and the inhibitors of technology usage intention, this study explores physicians' reactions towards the electronic medical record. The main focus is on the barriers, perceived threat and perceived inequity. 115 physicians from 6 hospitals participated in the questionnaire survey. Structural Equation Modeling was employed to verify the measurement scale and research hypotheses. According to the results, perceived threat shows a direct and negative effect on perceived usefulness and behavioral intentions, as well as an indirect effect on behavioral intentions via perceived usefulness. Perceived inequity reveals a direct and positive effect on perceived threat, and it also shows a direct and negative effect on perceived usefulness. Besides, perceived inequity reveals an indirect effect on behavioral intentions via perceived usefulness with perceived threat as the inhibitor. The research finding presents a better insight into physicians' rejection and the antecedents of such outcome. For the healthcare industry understanding the factors contributing to physicians' technology acceptance is important as to ensure a smooth implementation of any new technology. The results of this study can also provide change managers reference to a smooth IT introduction into an organization. In addition, our proposed measurement scale can be applied as a diagnostic tool for them to better understand the status quo within their organizations and users' reactions to technology acceptance. By doing so, barriers to physicians' acceptance can be identified earlier and more effectively before leading to technology rejection.

  2. Gastrointestinal Side Effects of Antiarrhythmic Medications: A Review of Current Literature.

    PubMed

    Amjad, Waseem; Qureshi, Waqas; Farooq, Ali; Sohail, Umair; Khatoon, Salma; Pervaiz, Sarah; Narra, Pratyusha; Hasan, Syeda M; Ali, Farman; Ullah, Aman; Guttmann, Steven

    2017-09-03

    Antiarrhythmic drugs are commonly prescribed cardiac drugs. Due to their receptor mimicry with several of the gastrointestinal tract receptors, they can frequently lead to gastrointestinal side effects. These side effects are the most common reasons for discontinuation of these drugs by the patients. Knowledge of these side effects is important for clinicians that manage antiarrhythmic drugs. This review focuses on the gastrointestinal side effects of these drugs and provides a detailed up-to-date literature review of the side effects of these drugs. The review provides case reports reported in the literature as well as possible mechanisms that lead to gastrointestinal side effects.

  3. Memory for Medication Side Effects in Younger and Older Adults: The Role of Subjective and Objective Importance

    PubMed Central

    Friedman, Michael C.; McGillivray, Shannon; Murayama, Kou; Castel, Alan D.

    2014-01-01

    Older adults often experience memory impairments, but can sometimes use selective processing and schematic support to remember important information. The current experiments investigate to what degree younger and healthy older adults remember medication side effects that were subjectively or objectively important to remember. Participants studied a list of common side effects, and rated how negative these effects were if they were to experience them, and were then given a free recall test. In Experiment 1, the severity of the side effects ranged from mild (e.g., itching) to severe (e.g., stroke), and in Experiment 2, certain side effects were indicated as critical to remember (i.e., “contact your doctor if you experience this”). There were no age differences in terms of free recall of the side effects, and older adults remembered more severe side effects relative to mild effects. However, older adults were less likely to recognize critical side effects on a later recognition test, relative to younger adults. The findings suggest that older adults can selectively remember medication side effects, but have difficulty identifying familiar but potentially critical side effects, and this has implications for monitoring medication use in older age. PMID:25331278

  4. [The effect of humor in the workplace on mental/physical health and self-evaluation of job performance].

    PubMed

    Maruyama, Junichi; Fuji, Kei

    2016-04-01

    In this study we aimed to examine the contents of humor in the Japanese workplace and to understand the effects of humor on mental/physical health and self-evaluation of job performance. Japanese workers (N = 436) responded to questionnaires addressing workplace humor, feelings about workplace, workplace communication, mental/physical health, and perceived job performance. An exploratory factor analysis indicated that there are five types of workplace humor: norm-violating humor, experience-sharing humor workplace-enjoying humor, people-recalling humor, and outside-mocking humor. A covariance structural analysis showed that norm-violating humor and workplace-enjoying humor decreased mental and physical health by promoting both negative feelings in the workplace and self-disclosure about the negative side of work. Results also revealed that experience-sharing humor, people-recalling humor, and outside-mocking humor had a positive effect on the self-evaluation of job performance as well as mental and physical health, by promoting both positive feelings and mutual communication in the workplace. Results suggest that humor in the workplace has various influences on workers depending on the type of workplace humor.

  5. The 'side effects' of medicalization: a meta-analytic review of how biogenetic explanations affect stigma.

    PubMed

    Kvaale, Erlend P; Haslam, Nick; Gottdiener, William H

    2013-08-01

    Reducing stigma is crucial for facilitating recovery from psychological problems. Viewing these problems biomedically may reduce the tendency to blame affected persons, but critics have cautioned that it could also increase other facets of stigma. We report on the first meta-analytic review of the effects of biogenetic explanations on stigma. A comprehensive search yielded 28 eligible experimental studies. Four separate meta-analyses (Ns=1207-3469) assessed the effects of biogenetic explanations on blame, perceived dangerousness, social distance, and prognostic pessimism. We found that biogenetic explanations reduce blame (Hedges g=-0.324) but induce pessimism (Hedges g=0.263). We also found that biogenetic explanations increase endorsement of the stereotype that people with psychological problems are dangerous (Hedges g=0.198), although this result could reflect publication bias. Finally, we found that biogenetic explanations do not typically affect social distance. Promoting biogenetic explanations to alleviate blame may induce pessimism and set the stage for self-fulfilling prophecies that could hamper recovery from psychological problems. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Long-acting Reversible Contraception for Adolescents and Young Adults: Patient and Provider Perspectives

    PubMed Central

    Kavanaugh, Megan L.; Frohwirth, Lori; Jerman, Jenna; Popkin, Ronna; Ethier, Kathleen

    2013-01-01

    Study objective To describe and explore provider- and patient-level perspectives regarding long-acting reversible contraception (LARC) for teens and young adults (ages 16-24). Methods Data collection occurred between June – December 2011. We first conducted telephone interviews with administrative directors at 20 publicly funded facilities that provide family planning services. At six of these sites, we conducted a total of six focus group discussions (FGDs) with facility staff and forty-eight in-depth interviews (IDIs) with facility clients ages 16-24. Results Staff in the FGDs did not generally equate being a teen with ineligibility for IUDs. In contrast to staff, one quarter of the young women did perceive young age as rendering them ineligible. Clients and staff agreed that the “forgettable” nature of the methods and their duration were some of LARC’s most significant advantages. They also agreed that fear of pain associated with both insertion and removal and negative side effects were disadvantages. Some aspects of IUDs and implants were perceived as advantages by some clients but disadvantages by others. Common challenges to providing LARC-specific services to younger patients included extra time required to counsel young patients about LARC methods, outdated clinic policies requiring multiple visits to obtain IUDs, and a perceived higher removal rate among young women. The most commonly cited strategy for addressing many of these challenges was securing supplementary funding to support the provision of these services to young patients. Conclusion Incorporating young women’s perspectives on LARC methods into publicly funded family planning facilities’ efforts to provide these methods to a younger population may increase their use among young women. PMID:23287602

  7. Perceived communication between physicians and breast cancer patients as a predicting factor of patients' health-related quality of life: a longitudinal analysis.

    PubMed

    Trudel, Julie G; Leduc, Nicole; Dumont, Serge

    2014-05-01

    Communication between cancer patients and healthcare providers is recognized as an important aspect of these patients' health-related quality of life (HRQOL). Nevertheless, no study has examined whether perceived communication between physicians and breast cancer patients is a determining factor in their HRQOL along the disease's trajectory. This longitudinal study aimed to ascertain whether such communication influenced the HRQOL of such women at three points in time. The sample consisted of 120 French-speaking women with stage I or II breast cancer aged 18 years or over (mean = 55 years) who underwent a lumpectomy with adjuvant treatment. The women filled out questionnaires at three different times: around the time of diagnosis, halfway through radiotherapy and at follow-up. Either at the hospital or at home, they completed demographic and medical data questionnaires, the Medical Outcomes Study-Social Support Survey, an HRQOL questionnaire (EORTC QLQ-C30/BR23) and the Medical Communication Competence Scale. Generalized estimated equations analyses indicated that the women's perceptions of their own communication skills towards physicians had a greater impact on their HRQOL than the women's perception of physicians' communication skills. The women had better global health and better role, emotional, cognitive and sexual functioning as well as fewer side effects and symptoms during radiotherapy and at follow-up when they perceived themselves as competent communicators at diagnosis and during radiotherapy. The results underscore the importance for breast cancer patients of being proactive in information seeking and in the socio-emotional aspect of their relationship with physicians to enhance their HRQOL. Copyright © 2013 John Wiley & Sons, Ltd.

  8. Pulse Width Affects Scalp Sensation of Transcranial Magnetic Stimulation.

    PubMed

    Peterchev, Angel V; Luber, Bruce; Westin, Gregory G; Lisanby, Sarah H

    Scalp sensation and pain comprise the most common side effect of transcranial magnetic stimulation (TMS), which can reduce tolerability and complicate experimental blinding. We explored whether changing the width of single TMS pulses affects the quality and tolerability of the resultant somatic sensation. Using a controllable pulse parameter TMS device with a figure-8 coil, single monophasic magnetic pulses inducing electric field with initial phase width of 30, 60, and 120 µs were delivered in 23 healthy volunteers. Resting motor threshold of the right first dorsal interosseus was determined for each pulse width, as reported previously. Subsequently, pulses were delivered over the left dorsolateral prefrontal cortex at each of the three pulse widths at two amplitudes (100% and 120% of the pulse-width-specific motor threshold), with 20 repetitions per condition delivered in random order. After each pulse, subjects rated 0-to-10 visual analog scales for Discomfort, Sharpness, and Strength of the sensation. Briefer TMS pulses with amplitude normalized to the motor threshold were perceived as slightly more uncomfortable than longer pulses (with an average 0.89 point increase on the Discomfort scale for pulse width of 30 µs compared to 120 µs). The sensation of the briefer pulses was felt to be substantially sharper (2.95 points increase for 30 µs compared to 120 µs pulse width), but not stronger than longer pulses. As expected, higher amplitude pulses increased the perceived discomfort and strength, and, to a lesser degree the perceived sharpness. Our findings contradict a previously published hypothesis that briefer TMS pulses are more tolerable. We discovered that the opposite is true, which merits further study as a means of enhancing tolerability in the context of repetitive TMS. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Pulse width affects scalp sensation of transcranial magnetic stimulation

    PubMed Central

    Peterchev, Angel V.; Luber, Bruce; Westin, Gregory G.; Lisanby, Sarah H.

    2016-01-01

    Background Scalp sensation and pain comprise the most common side effect of transcranial magnetic stimulation (TMS), which can reduce tolerability and complicate experimental blinding. Objective We explored whether changing the width of single TMS pulses affects the quality and tolerability of the resultant somatic sensation. Methods Using a controllable pulse parameter TMS device with a figure-8 coil, single monophasic magnetic pulses inducing electric field with initial phase width of 30, 60, and 120 µs were delivered in 23 healthy volunteers. Resting motor threshold of the right first dorsal interosseus was determined for each pulse width, as reported previously. Subsequently, pulses were delivered over the left dorsolateral prefrontal cortex at each of the three pulse widths at two amplitudes (100% and 120% of the pulse-width-specific motor threshold), with 20 repetitions per condition delivered in random order. After each pulse, subjects rated 0-to-10 visual analog scales for Discomfort, Sharpness, and Strength of the sensation. Results Briefer TMS pulses with amplitude normalized to the motor threshold were perceived as slightly more uncomfortable than longer pulses (with an average 0.89 points increase on the Discomfort scale for pulse width of 30 µs compared to 120 µs). The sensation of the briefer pulses was felt to be substantially sharper (2.95 point increase for 30 µs compared to 120 µs pulse width), but not stronger than longer pulses. As expected, higher amplitude pulses increased the perceived discomfort and strength, and, to a lesser degree the perceived sharpness. Conclusions Our findings contradict a previously published hypothesis that briefer TMS pulses are more tolerable. We discovered that the opposite is true, which merits further study as a means of enhancing tolerability in the context of repetitive TMS. PMID:28029593

  10. The Dampening Effects of Perceived Teacher Enthusiasm on Class-Related Boredom: The Mediating Role of Perceived Autonomy Support and Task Value

    PubMed Central

    Cui, Guanyu; Yao, Meilin; Zhang, Xia

    2017-01-01

    Class-related boredom is commonly experienced by students and it has an impact on their learning engagement and achievements. Previous research has found that perceived teacher enthusiasm might contribute to reducing students’ class-related boredom. However, the mechanism through which perceived teacher enthusiasm affects class-related boredom remains unexplored. The purpose of the present study was to investigate the mediating role of perceived autonomy support and task value in the relationship between teacher enthusiasm and class-related boredom. College students (N = 734) completed questionnaires on perceived teacher enthusiasm, boredom proneness, perceived task difficulty, perceived autonomy support, perceived task value, and class-related boredom. Results showed that after controlling for the effects of demographic variables, boredom proneness, and perceived task difficulty, both perceived autonomy support and task value fully mediated the relationship between perceived teacher enthusiasm and class-related boredom. These findings suggest that students who perceive more teacher enthusiasm might perceive more autonomy support and task value, which in turn reduce the students’ class-related boredom. Limitations in the present study have also been discussed. PMID:28367134

  11. The Dampening Effects of Perceived Teacher Enthusiasm on Class-Related Boredom: The Mediating Role of Perceived Autonomy Support and Task Value.

    PubMed

    Cui, Guanyu; Yao, Meilin; Zhang, Xia

    2017-01-01

    Class-related boredom is commonly experienced by students and it has an impact on their learning engagement and achievements. Previous research has found that perceived teacher enthusiasm might contribute to reducing students' class-related boredom. However, the mechanism through which perceived teacher enthusiasm affects class-related boredom remains unexplored. The purpose of the present study was to investigate the mediating role of perceived autonomy support and task value in the relationship between teacher enthusiasm and class-related boredom. College students ( N = 734) completed questionnaires on perceived teacher enthusiasm, boredom proneness, perceived task difficulty, perceived autonomy support, perceived task value, and class-related boredom. Results showed that after controlling for the effects of demographic variables, boredom proneness, and perceived task difficulty, both perceived autonomy support and task value fully mediated the relationship between perceived teacher enthusiasm and class-related boredom. These findings suggest that students who perceive more teacher enthusiasm might perceive more autonomy support and task value, which in turn reduce the students' class-related boredom. Limitations in the present study have also been discussed.

  12. Anthropomorphic bias found in typically developing children is not found in children with autistic spectrum disorder.

    PubMed

    Chaminade, Thierry; Rosset, Delphine; Da Fonseca, David; Hodgins, Jessica K; Deruelle, Christine

    2015-02-01

    The anthropomorphic bias describes the finding that the perceived naturalness of a biological motion decreases as the human-likeness of a computer-animated agent increases. To investigate the anthropomorphic bias in autistic children, human or cartoon characters were presented with biological and artificial motions side by side on a touchscreen. Children were required to touch one that would grow while the other would disappear, implicitly rewarding their choice. Only typically developing controls depicted the expected preference for biological motion when rendered with human, but not cartoon, characters. Despite performing the task to report a preference, children with autism depicted neither normal nor reversed anthropomorphic bias, suggesting that they are not sensitive to the congruence of form and motion information when observing computer-animated agents' actions. © The Author(s) 2014.

  13. Assessing demand-side barriers to uptake of intermittent preventive treatment for malaria in pregnancy: a qualitative study in two regions of Uganda.

    PubMed

    Rassi, Christian; Graham, Kirstie; King, Rebecca; Ssekitooleko, James; Mufubenga, Patrobas; Gudoi, Sam Siduda

    2016-11-04

    To prevent malaria infection during pregnancy in endemic areas in Africa, the World Health Organization recommends the administration of intermittent preventive treatment in pregnancy (IPTp) as part of the focused antenatal care package. However, IPTp uptake in most countries remains low despite generally high antenatal care coverage and increased efforts by governments to address known bottlenecks such as drug stock-outs. The study explored factors that continue to impede uptake of IPTp among women who attend antenatal care. This paper focuses on demand-side barriers with regard to accessibility, affordability and acceptability. The research was conducted in 2013/2014 and involved 46 in-depth interviews with four types of respondents: (i) seven district health officials; (ii) 15 health workers; (iii) 19 women who attended antenatal care; (iv) five opinion leaders. Interviews were conducted in Eastern and West Nile regions of Uganda. Data was analysed by thematic analysis. District health officials and health workers cited a range of barriers relating to knowledge and attitudes among pregnant women, including lack of awareness of pregnancy-related health risks, a tendency to initiate antenatal care late, reluctance to take medication and concerns about side effects of IPTp. However, women and opinion leaders expressed very positive views of antenatal care and IPTp. They also reported that the burden of travel and cost associated with antenatal care attendance was challenging, but did not keep them from accessing a service they perceived as beneficial. The role of trust in health workers' expertise was highlighted by all respondents and it was reported that women will typically accept IPTp if encouraged by a health worker. Given the positive views of antenatal care and IPTp, high antenatal care coverage and reported low refusal rates for IPTp, supply-side issues are likely to account for the majority of missed opportunities for the provision of IPTp when women attend antenatal care. However, to increase uptake of IPTp on the demand side, health workers should be encouraged to reassure eligible women that IPTp is safe.

  14. “So far it’s been choosing which side effects I want or I can deal with”: A grounded theory of HIV treatment side effects among people living with HIV

    PubMed Central

    Holmes, Dave

    2016-01-01

    Despite the availability of new antiretroviral drugs and the simplification of treatment options, side effects continue to affect people living with HIV. In this paper, we present the findings of a grounded theory study designed to gain a critical understanding of the experience of side effects. Three main categories emerged from the data: the side effects, the experience, and the connections. The first category suggests that we need to change how we think about side effects in order to take into account the context in which they are experienced as well as the types and nature of side effects. The second category puts forward the idea that the experience of side effects is composed of three interrelated processes: becoming with, living with, and dealing with. Finally, the third category points to new connections that are formed with people, things and systems in the presence of side effects. PMID:27867446

  15. Perception and Needs in Health Education Curriculum among School Nurses as Health Teachers in Korea

    ERIC Educational Resources Information Center

    Lee, Gyu Young; Ham, Ok Kyung

    2013-01-01

    The study investigated perceived effectiveness and perceived barriers to health education curriculum targeting school nurses as health teachers in Korea. A total of 741 health teachers participated. The questionnaire included perceived effectiveness and perceived barriers to health education curriculum, future roles of health teachers, and needs…

  16. Relation between therapeutic response and side effects induced by methylphenidate as observed by parents and teachers of children with ADHD.

    PubMed

    Lee, James; Grizenko, Natalie; Bhat, Venkataramana; Sengupta, Sarojini; Polotskaia, Anna; Joober, Ridha

    2011-04-21

    The desired (therapeutic) and undesired (side) effects of methylphenidate might have underlying correlations. The aim of this study was to explore the strength and the possible sources of these correlations. One hundred and fifty-seven children with ADHD (6-12 years) were administered placebo and methylphenidate (0.5 mg/kg in a divided b.i.d. dose), each for a one-week period, in a double-blind, crossover trial. Therapeutic response was assessed using the Conners' Global Index for parents (CGI-Parents) and teachers (CGI-Teachers), while side effects were assessed using the Barkley Side Effects Rating Scale (SERS). The side effect profile as assessed by the SERS was similar to that of previous studies with insomnia, decreased appetite, and headaches showing significant treatment effects (p < 0.005). These "somatic/physical" side effects did not correlate with CGI-Parents or CGI-Teachers. However, the side effects of "irritability", "proneness to crying", and "anxiousness" showed significant relationships with CGI-Parents. These "mood/anxiety" side effects showed no significant correlations with the CGI-Teachers. The greater "mood/anxiety" side effects on methylphenidate and placebo, the less the parents observe improvement of their children while treated with methylphenidate. This suggests that the correlations between "mood/anxiety" side effects and poor response to treatment may be driven by observer effects rather than biological commonalities between therapeutic and side effects of methylphenidate.

  17. Electronic magnification and perceived contrast of video

    PubMed Central

    Haun, Andrew; Woods, Russell L; Peli, Eli

    2012-01-01

    Electronic magnification of an image results in a decrease in its perceived contrast. The decrease in perceived contrast could be due to a perceived blur or to limited sampling of the range of contrasts in the original image. We measured the effect on perceived contrast of magnification in two contexts: either a small video was enlarged to fill a larger area, or a portion of a larger video was enlarged to fill the same area as the original. Subjects attenuated the source video contrast to match the perceived contrast of the magnified videos, with the effect increasing with magnification and decreasing with viewing distance. These effects are consistent with expectations based on both the contrast statistics of natural images and the contrast sensitivity of the human visual system. We demonstrate that local regions within videos usually have lower physical contrast than the whole, and that this difference accounts for a minor part of the perceived differences. Instead, visibility of ‘missing content’ (blur) in a video is misinterpreted as a decrease in contrast. We detail how the effects of magnification on perceived contrast can be measured while avoiding confounding factors. PMID:23483111

  18. Work-family conflict and enrichment in nurses: between job demands, perceived organisational support and work-family backlash.

    PubMed

    Ghislieri, Chiara; Gatti, Paola; Molino, Monica; Cortese, Claudio G

    2017-01-01

    This study investigated how work relationships (perceived organisational support, supervisor and co-worker work-family backlash) and job demands (workload, emotional dissonance) can interact with work-family conflict and work-family enrichment. Despite the extensive literature on the work-family interface, few studies on the nursing profession have considered the role of job demands and work relationships, focusing on both the positive and negative side of the work-family interface. The study involved a sample of 500 nurses working in an Italian hospital. Hierarchical multiple regression analyses were used to test hypotheses. Analyses showed that work-family conflict has a positive relationship with job demands and supervisor backlash, and a negative relationship with perceived organisational support. Work-family enrichment was found to have a negative relationship with job demands and a positive relationship with perceived organisational support. No significant relationships were found between work-family enrichment and both backlash dimensions. The study confirmed the importance of promoting a balance between job demands and resources in order to create favourable conditions for work-family enrichment and to prevent work-family conflict. The findings suggest that it may be advisable for health-care organisations to invest in measures at individual, team and organisational levels, specifically in training and counselling for nurses and supervisors. © 2016 John Wiley & Sons Ltd.

  19. Side Effects

    Cancer.gov

    Side effects are problems that occur when cancer treatment affects healthy tissues or organs. Learn about side effects caused by cancer treatment. Know what signs and symptoms to call your doctor about. Learn about treatments for side effects.

  20. User evaluations of design complexity: the impact of visual perceptions for effective online health communication.

    PubMed

    Lazard, Allison; Mackert, Michael

    2014-10-01

    This paper highlights the influential role of design complexity for users' first impressions of health websites. An experimental design was utilized to investigate whether a website's level of design complexity impacts user evaluations. An online questionnaire measured the hypothesized impact of design complexity on predictors of message effectiveness. Findings reveal that increased design complexity was positively associated with higher levels of perceived design esthetics, attitude toward the website, perceived message comprehensibility, perceived ease of use, perceived usefulness, perceived message quality, perceived informativeness, and perceived visual informativeness. This research gives further evidence that design complexity should be considered an influential variable for health communicators to effectively reach their audiences, as it embodies the critical first step for message evaluation via electronic platforms. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Side Effects of HIV Medicines: HIV and Lactic Acidosis

    MedlinePlus

    ... Drugs Clinical Trials Apps skip to content Side Effects of HIV Medicines Home Understanding HIV/AIDS Fact ... and Immunizations What is a Drug Interaction? Side Effects of HIV Medicines HIV Medicines and Side Effects ...

  2. Musical agency reduces perceived exertion during strenuous physical performance

    PubMed Central

    Fritz, Thomas Hans; Hardikar, Samyogita; Demoucron, Matthias; Niessen, Margot; Demey, Michiel; Giot, Olivier; Li, Yongming; Haynes, John-Dylan; Villringer, Arno; Leman, Marc

    2013-01-01

    Music is known to be capable of reducing perceived exertion during strenuous physical activity. The current interpretation of this modulating effect of music is that music may be perceived as a diversion from unpleasant proprioceptive sensations that go along with exhaustion. Here we investigated the effects of music on perceived exertion during a physically strenuous task, varying musical agency, a task that relies on the experience of body proprioception, rather than simply diverting from it. For this we measured psychologically indicated exertion during physical workout with and without musical agency while simultaneously acquiring metabolic values with spirometry. Results showed that musical agency significantly decreased perceived exertion during workout, indicating that musical agency may actually facilitate physically strenuous activities. This indicates that the positive effect of music on perceived exertion cannot always be explained by an effect of diversion from proprioceptive feedback. Furthermore, this finding suggests that the down-modulating effect of musical agency on perceived exertion may be a previously unacknowledged driving force for the development of music in humans: making music makes strenuous physical activities less exhausting. PMID:24127588

  3. Musical agency reduces perceived exertion during strenuous physical performance.

    PubMed

    Fritz, Thomas Hans; Hardikar, Samyogita; Demoucron, Matthias; Niessen, Margot; Demey, Michiel; Giot, Olivier; Li, Yongming; Haynes, John-Dylan; Villringer, Arno; Leman, Marc

    2013-10-29

    Music is known to be capable of reducing perceived exertion during strenuous physical activity. The current interpretation of this modulating effect of music is that music may be perceived as a diversion from unpleasant proprioceptive sensations that go along with exhaustion. Here we investigated the effects of music on perceived exertion during a physically strenuous task, varying musical agency, a task that relies on the experience of body proprioception, rather than simply diverting from it. For this we measured psychologically indicated exertion during physical workout with and without musical agency while simultaneously acquiring metabolic values with spirometry. Results showed that musical agency significantly decreased perceived exertion during workout, indicating that musical agency may actually facilitate physically strenuous activities. This indicates that the positive effect of music on perceived exertion cannot always be explained by an effect of diversion from proprioceptive feedback. Furthermore, this finding suggests that the down-modulating effect of musical agency on perceived exertion may be a previously unacknowledged driving force for the development of music in humans: making music makes strenuous physical activities less exhausting.

  4. Perceptions of physical and social environment variables and self-efficacy as correlates of self-reported physical activity among adolescent girls.

    PubMed

    Motl, Robert W; Dishman, Rod K; Saunders, Ruth P; Dowda, Marsha; Pate, Russell R

    2007-01-01

    This cross-sectional study examined the direct and indirect effects of perceived equipment accessibility, neighborhood safety, and social support on self-reported physical activity among older adolescent girls. Adolescent girls (n = 1,655) who were in the 12th grade completed a battery of questionnaires that included self-report measures of the perceived physical environment, social support, barriers self-efficacy, and physical activity. Perceived neighborhood safety did not exhibit direct or indirect effects on self-reported physical activity. Perceived equipment accessibility exhibited an indirect effect on self-reported physical activity that was accounted for by barriers self-efficacy. Perceived social support exhibited direct and indirect effects on self-reported physical activity; the indirect effect was accounted for by barriers self-efficacy. The relationships were independent of parental education and body mass index (BMI). Perceived physical environmental factors indirectly influenced self-reported physical activity, and perceived social environmental factors both directly and indirectly influenced self-reported physical activity in this sample of older adolescent girls.

  5. Students' Beliefs About and Perceived Effectiveness of a Tobacco-Free Campus Policy.

    PubMed

    Ickes, Melinda J; Rayens, Mary Kay; Wiggins, Amanda; Hahn, Ellen J

    2017-02-01

    Tobacco-free (TF) college campus policies have potential to be a high-impact tobacco control strategy. The purposes of the study presented here were to (a) determine the demographic and personal characteristics associated with students' beliefs about and perceived effectiveness of a TF campus policy and (b) assess whether tobacco use status and exposure to secondhand smoke (SHS) predicted beliefs and perceived effectiveness. Five thousand randomly selected students from a large southeastern university were invited by e-mail to participate in an online survey in April 2013, three and a half years after policy implementation. Students held positive beliefs about the policy (average rating 84% of the maximum possible score). Sixty-one percent believed that the policy was successful at reducing SHS exposure; and 40% thought the policy encouraged quitting. Males were less likely than females to believe the policy was effective in reducing SHS exposure and encouraging quitting. Lower undergraduates were more likely to perceive the policy as less effective in reducing SHS exposure; international students were more likely than domestic students to perceive the policy as more effective at encouraging quitting. Students most exposed to SHS were less likely to perceive the policy was effective. Compared with nonusers, those who smoked cigarettes were less likely to perceive the policy as effective in encouraging quitting. Tailored messaging regarding policy benefits are necessary. Perceived effectiveness of TF policies may be related to compliance with the policy and should be further investigated. Objective measures of effectiveness and tobacco use behaviors are needed to fully measure the success of TF campus policies.

  6. Social relationships, depressive symptoms and suicidality in Korea: Examining mediating and moderating effects in men and women.

    PubMed

    Lee, Min-Ah

    2016-02-01

    It has been widely recognized that social relationships and depressive symptoms predict suicidality. However, there are few empirical studies examining relationships among these three factors using an integrative approach. This study aimed to examine the effects of perceived quality of social relationships and depressive symptoms on suicidality and to analyze whether the effect of perceived quality of social relationships on suicidality is mediated by depressive symptoms or whether the perceived quality of social relationships has a moderating effect on the relationship between depressive symptoms and suicidality in men and women. The data were drawn from the 2012 Korean General Social Survey, a nationally representative survey. Multiple regression models and subsample analyses were conducted according to gender. A higher perceived quality of social relationships decreased suicidality while depressive symptoms increased suicidality. The effect of perceived quality of social relationships was partially mediated by depressive symptoms. Perceived quality of social relationships also significantly interacted with depressive symptoms, suggesting that the harmful effect of depressive symptoms was ameliorated as perceived quality of social relationships increased. A subsample analysis according to gender, however, indicated a significant gender difference in that the perceived quality of social relationships moderated the effect of depressive symptoms only in women. The findings suggest that enhanced quality of social relationships can protect people from suicidal risk and are more effective for women with depressive symptoms than for men with the same symptoms. © The Author(s) 2015.

  7. Perceived Social Support Mediating the Relationship between Perceived Stress and Job Satisfaction

    ERIC Educational Resources Information Center

    Sultan, Sarwat; Rashid, Safia

    2015-01-01

    This research was conducted to examine the mediating effect of perceived social support between perceived stress and job satisfaction among employees. A conveniently selected sample of 280 employees provided the information on Perceived Social Support Scale, Perceived Stress Scale, and Job Satisfaction Survey. Employing Regression analyses,…

  8. A Cost-Benefit Analysis for Revision and Reimplementation of the Office Paper Recycling Program at the Naval Postgraduate School, Monterey

    DTIC Science & Technology

    1992-12-01

    whether they will accept out-of- state waste. Residents of these states complain that they are becoming a dumping ground . Without legislation, these...reducing paper coffee cups or mandating two-sided copying, not only save money but are perceived by the population as a job well done. F. CURRENT...reduction, recycling and composting activities. Under some conditions, these goals can be modified. These conditions are fairly specific. First, the

  9. The Military Dimensions of U.S.-China Security Cooperation: Retrospective and Future Prospects

    DTIC Science & Technology

    2010-09-01

    the island a focal point of their attention.17 The PLA’s renewed focus on Taiwan was endorsed, if not driven, by the top leadership of the CCP. On 13...34incidents." The ,0 For details of this incident from an American perspective, see John Keefe , Anatomy of the EP-3 Incident, April 2001 (Alexandria, VA...relationship been subjected to this on-again-off- again cycle? One reason is that both sides have perceived the costs of suspending military contacts

  10. Framing effects on expectations, decisions, and side effects experienced: the case of influenza immunization.

    PubMed

    O'Connor, A M; Pennie, R A; Dales, R E

    1996-11-01

    To examine the effects of using positive or negative frames to describe influenza vaccine benefits and side effects on patients' expectations, decisions, decisional conflict, and reported side effects. 292 previously unimmunized patients with chronic respiratory or cardiac disease were randomly assigned to receive benefit/risk information that was framed: (1) positively as the percentage who remain free of influenza and have no vaccine side effects, or (2) negatively as the percentage who acquire influenza and have vaccine side effects. Questionnaires elicited expectations, decisions, and decisional conflict. Vaccines were telephoned 3 days later for a self-report of local and systemic side effects and work absenteeism. Both groups had similar immunization rates and decisional conflict scores. The positive frame group had lower and more realistic expectations of vaccine side effects, fewer systemic side effects, and less work absenteeism (p < 0.05). In contrast to previous studies of health care workers, framing did not influence patients' decisions, possibly due to the patients' awareness of their higher risk of influenza complications and greater desire to follow recommendations. The common practice of using negative frames when describing probabilities of side effects may need to be reexamined, considering its deleterious influence on self-reported side effects and work absenteeism.

  11. Side Effects of Leukotriene Receptor Antagonists in Asthmatic Children.

    PubMed

    Erdem, Semiha Bahceci; Nacaroglu, Hikmet Tekin; Unsal Karkiner, Canan Sule; Gunay, Ilker; Can, Demet

    2015-10-01

    Leukotriene receptor antagonists (LTRAs) are drugs which have been widely used more than ten years. As the use of LTRAs increases, our knowledge with respect to their side effects increases as well. The objective of our study was to evaluat the observed side effects of LTRAs used in patients with astma. 1024 patients treated only with LTRAs owing to asthma or early wheezing were included in the study for a five-year period. The observed side effects of LTRAs in these patients were retrospectively investigated. The side effects were divided into two parts as psychiatric and non-psychiatric. Among the 1024 cases included in the study, 67.5% of the patients out of 41 with side effects were male, 32.5% were female and the average age was 6.5 years. The rate of patients with asthma was 63.41% and 36.58% of the patients had early wheezing. It was determined that sex, age and diagnosis (early wheezing or asthma) of the patients were ineffective in the emergence of side effects. The average period for the emergence of side effects was the first month. It was observed that hyperactivity was the most frequently observed psychiatric side effect and that abdominal pain was the non-psychiatric side effect. The side effects of LTRAs were common in children. Therefore, patients must be informed at the beginning of the treatment and they must be evaluated at certain intervals.

  12. The Temporal Effect of Training Utility Perceptions on Adopting a Trained Method: The Role of Perceived Organizational Support

    ERIC Educational Resources Information Center

    Madera, Juan M.; Steele, Stacey T.; Beier, Margaret

    2011-01-01

    The current study examined the temporal effect of perceived training utility on adoption of a trained method and how perceived organizational support influences the relationship between perceived training utility perceptions and adoption of a trained method. With the use of a correlational-survey-based design, this longitudinal study required…

  13. Music evokes vicarious emotions in listeners

    PubMed Central

    Kawakami, Ai; Furukawa, Kiyoshi; Okanoya, Kazuo

    2014-01-01

    Why do we listen to sad music? We seek to answer this question using a psychological approach. It is possible to distinguish perceived emotions from those that are experienced. Therefore, we hypothesized that, although sad music is perceived as sad, listeners actually feel (experience) pleasant emotions concurrent with sadness. This hypothesis was supported, which led us to question whether sadness in the context of art is truly an unpleasant emotion. While experiencing sadness may be unpleasant, it may also be somewhat pleasant when experienced in the context of art, for example, when listening to sad music. We consider musically evoked emotion vicarious, as we are not threatened when we experience it, in the way that we can be during the course of experiencing emotion in daily life. When we listen to sad music, we experience vicarious sadness. In this review, we propose two sides to sadness by suggesting vicarious emotion. PMID:24910621

  14. Perceived Parent-Adolescent Relationship, Perceived Parental Online Behaviors and Pathological Internet Use among Adolescents: Gender-Specific Differences

    PubMed Central

    Liu, Qin-Xue; Fang, Xiao-Yi; Zhou, Zong-Kui; Zhang, Jin-Tao; Deng, Lin-Yuan

    2013-01-01

    This study examined the associations between adolescents’ perceived relationships with their parents, perceived parental online behaviors, and Pathological Internet Use (PIU) among adolescents. Additional testing was carried out to determine the effect of different genders (parent and adolescent). Cross-sectional data was collected from 4,559 students aged 12 to 21 years in the cities of Beijing and Jinan, People’s Republic of China. Participants responded to an anonymous questionnaire concerning their Internet use behavior, perceived parental Internet use behaviors, and perceived parent-adolescent relationship. Hierarchical linear regressions controlling for adolescents’ age were conducted. Results showed different effects of parent and adolescent gender on perceived parent-adolescent relationship and parent Internet use behavior, as well as some other gender-specific associations. Perceived father-adolescent relationship was the most protective factor against adolescent PIU with perceived maternal Internet use positively predicting PIU for both male and female adolescents. However, perceived paternal Internet use behaviors positively predicted only female adolescent PIU. Results indicated a different effect pathway for fathers and mothers on boys and girls, leading to discussion of the implications for prevention and intervention. PMID:24098710

  15. A Glossy Simultaneous Contrast: Conjoint Measurements of Gloss and Lightness

    PubMed Central

    Mamassian, Pascal

    2017-01-01

    Interactions between the albedo and the gloss on a surface are commonplace. Darker surfaces are perceived glossier (contrast gloss) than lighter surfaces and darker backgrounds can enhance perceived lightness of surfaces. We used maximum likelihood conjoint measurements to simultaneously quantify the strength of those effects. We quantified the extent to which albedo can influence perceived gloss and physical gloss can influence perceived lightness. We modeled the contribution of lightness and gloss and found that increasing lightness reduced perceived gloss by about 32% whereas gloss had a much weaker influence on perceived lightness of about 12%. Moreover, we also investigated how different backgrounds contribute to the perception of lightness and gloss of a surface placed in front. We found that a glossy background reduces slightly perceived lightness of the center and simultaneously enhances its perceived gloss. Lighter backgrounds reduce perceived gloss and perceived lightness. Conjoint measurements lead us to a better understanding of the contextual effects in gloss and lightness perception. Not only do we confirm the importance of contrast in gloss perception and the reduction of the simultaneous contrast with glossy backgrounds, but we also quantify precisely the strength of those effects. PMID:28203352

  16. Getting even for customer mistreatment: the role of moral identity in the relationship between customer interpersonal injustice and employee sabotage.

    PubMed

    Skarlicki, Daniel P; van Jaarsveld, Danielle D; Walker, David D

    2008-11-01

    Research on the "dark side" of organizational behavior has determined that employee sabotage is most often a reaction by disgruntled employees to perceived mistreatment. To date, however, most studies on employee retaliation have focused on intra-organizational sources of (in)justice. Results from this field study of customer service representatives (N = 358) showed that interpersonal injustice from customers relates positively to customer-directed sabotage over and above intra-organizational sources of fairness. Moreover, the association between unjust treatment and sabotage was moderated by 2 dimensions of moral identity (symbolization and internalization) in the form of a 3-way interaction. The relationship between injustice and sabotage was more pronounced for employees high (vs. low) in symbolization, but this moderation effect was weaker among employees who were high (vs. low) in internalization. Last, employee sabotage was negatively related to job performance ratings.

  17. Potential of insects as food and feed in assuring food security.

    PubMed

    van Huis, Arnold

    2013-01-01

    With a growing world population and increasingly demanding consumers, the production of sufficient protein from livestock, poultry, and fish represents a serious challenge for the future. Approximately 1,900 insect species are eaten worldwide, mainly in developing countries. They constitute quality food and feed, have high feed conversion ratios, and emit low levels of greenhouse gases. Some insect species can be grown on organic side streams, reducing environmental contamination and transforming waste into high-protein feed that can replace increasingly more expensive compound feed ingredients, such as fish meal. This requires the development of cost-effective, automated mass-rearing facilities that provide a reliable, stable, and safe product. In the tropics, sustainable harvesting needs to be assured and rearing practices promoted, and in general, the food resource needs to be revalorized. In the Western world, consumer acceptability will relate to pricing, perceived environmental benefits, and the development of tasty insect-derived protein products.

  18. GPS as a tool used in tourism as illustrated by selected mobile applications

    NASA Astrophysics Data System (ADS)

    Szark-Eckardt, Mirosława

    2017-11-01

    Mobile technologies have permanently changed our way of life. Their availability, common use and introducing to virtually all areas of human activity means that we can call present times the age of mobility [1]. Mobile applications based on the GPS module belong to the most dynamically developing apps as particularly reflected in tourism. A multitude of applications dedicated to different participants of tourism, which can be operated by means of smartphones or simple GPS trackers, are encouraging more people to reach for this kind of technology perceiving it as a basic tool used in today's tourism. Due to an increasingly wider access to mobile applications, not only more dynamic development of tourism itself can be noticed, but also the growth of healthy behaviours that comprise a positive "side effect" of tourism based on mobile technology. This article demonstrates a correlation between health and physical condition of the population and the use of mobile applications.

  19. With God on our side: Religious primes reduce the envisioned physical formidability of a menacing adversary.

    PubMed

    Holbrook, Colin; Fessler, Daniel M T; Pollack, Jeremy

    2016-01-01

    The imagined support of benevolent supernatural agents attenuates anxiety and risk perception. Here, we extend these findings to judgments of the threat posed by a potentially violent adversary. Conceptual representations of bodily size and strength summarize factors that determine the relative threat posed by foes. The proximity of allies moderates the envisioned physical formidability of adversaries, suggesting that cues of access to supernatural allies will reduce the envisioned physical formidability of a threatening target. Across two studies, subtle cues of both supernatural and earthly social support reduced the envisioned physical formidability of a violent criminal. These manipulations had no effect on the perceived likelihood of encountering non-conflictual physical danger, raising the possibility that imagined supernatural support leads participants to view themselves not as shielded from encountering perilous situations, but as protected should perils arise. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Parkinson's disease: carbidopa, nausea, and dyskinesia.

    PubMed

    Hinz, Marty; Stein, Alvin; Cole, Ted

    2014-01-01

    When l-dopa use began in the early 1960s for the treatment of Parkinson's disease, nausea and reversible dyskinesias were experienced as continuing side effects. Carbidopa or benserazide was added to l-dopa in 1975 solely to control nausea. Subsequent to the increasing use of carbidopa has been the recognition of irreversible dyskinesias, which have automatically been attributed to l-dopa. The research into the etiology of these phenomena has identified the causative agent of the irreversible dyskinesias as carbidopa, not l-dopa. The mechanism of action of the carbidopa and benserazide causes irreversible binding and inactivation of vitamin B6 throughout the body. The consequences of this action are enormous, interfering with over 300 enzyme and protein functions. This has the ability to induce previously undocumented profound antihistamine dyskinesias, which have been wrongly attributed to l-dopa and may be perceived as irreversible if proper corrective action is not taken.

  1. Parkinson’s disease: carbidopa, nausea, and dyskinesia

    PubMed Central

    Hinz, Marty; Stein, Alvin; Cole, Ted

    2014-01-01

    When l-dopa use began in the early 1960s for the treatment of Parkinson’s disease, nausea and reversible dyskinesias were experienced as continuing side effects. Carbidopa or benserazide was added to l-dopa in 1975 solely to control nausea. Subsequent to the increasing use of carbidopa has been the recognition of irreversible dyskinesias, which have automatically been attributed to l-dopa. The research into the etiology of these phenomena has identified the causative agent of the irreversible dyskinesias as carbidopa, not l-dopa. The mechanism of action of the carbidopa and benserazide causes irreversible binding and inactivation of vitamin B6 throughout the body. The consequences of this action are enormous, interfering with over 300 enzyme and protein functions. This has the ability to induce previously undocumented profound antihistamine dyskinesias, which have been wrongly attributed to l-dopa and may be perceived as irreversible if proper corrective action is not taken. PMID:25484598

  2. Knowledge and attitudes toward hookah usage among university students.

    PubMed

    Holtzman, Adam L; Babinski, Dara; Merlo, Lisa J

    2013-01-01

    Hookah smoking is a popular form of tobacco use on university campuses. This study documented use, attitudes, and knowledge of hookah smoking among college students. The sample included 943 university students recruited between February 2009 and January 2010. Respondents (M age = 20.02) included 376 males, 533 females, and 34 who did not report sex. An anonymous online questionnaire was completed by respondents. In this sample, 42.9% of college students had tried hookah, and 40% of those individuals had used it in the past 30 days. Students perceived fewer negative consequences of hookah smoking compared with cigarette smoking. Age, sex, racial background, marijuana/cigarette use, and perceptions of side effects were significantly associated with hookah use. University students are misinformed regarding the health consequences of hookah smoking. Programs aimed at education, prevention, and intervention for hookah use are needed to address this growing public health concern.

  3. Managing menopause: a critical feminist engagement.

    PubMed

    Guillemin, M N

    1999-12-01

    Feminist critiques of menopause have been beneficial in opening up important public health debates around menopause. One of the most contentious public health issues concerns the use of Hormone Replacement Therapy (HRT) for the prevention of osteoporosis, heart disease and, more recently, Alzheimer's disease, in postmenopausal women. For preventive purposes, it is recommended that women should take HRT for 10-15 years and preferably remain on the therapy for the remainder of their lives. This is despite reported increased cancer risks associated with HRT, side effects and considerable cost of the therapy. Various studies have shown that up to 50% of women stop taking HRT after 9-12 months. These figures are used in the medical literature as an indication of women's non-compliance. Extending earlier feminist critiques around menopause and HRT, this paper discusses a critical feminist engagement around issues of women's perceived non-compliance with HRT.

  4. Correlates of oral contraception continuation.

    PubMed

    Ewer, P A; Gibbs, J O

    1971-05-01

    A sample of 139 predominantly black, young, low-income patients who had accepted oral contraception at a publicly supported family planning clinic has been analyzed for correlates of oral contraception continuation. Interviews were conducted 10-12 months after the clinic visit; at this time 38% of the patients continued taking oral contraceptives. It was found that patients with the highest continuation rates were 18-24 years old, in the 2-3 parity group, living with their husbands, had low-parity mothers, and were able to fill prescriptions in less time with more convenient methods of transportation. Discontinuers tended to have high-parity mothers, live with parents or head their own households, and to be in the 13-17 or 25-45 year old age groups. Fear of long-term use of oral contraceptives and perceived side effects appeared to be implicated in discontinuation. The rate of discontinuation may be associated with irregular coital experience and less consistent exposure to pregnancy.

  5. Terrorism and dispelling the myth of a panic prone public.

    PubMed

    Sheppard, Ben; Rubin, G James; Wardman, Jamie K; Wessely, Simon

    2006-01-01

    Governments and commentators perceive the public to be prone to panic in response to terrorist attacks--conventional or involving chemical, biological or radiological weapons. Evidence from five such incidents suggests that the public is not prone to panic, although people can change their behaviours and attitudes to reduce the risk of themselves being exposed to a terrorist incident. Behavioural responses may be divided into acts of omission, such as not making unnecessary journeys, and acts of commission, such as taking prophylactic medication despite the inherent risk of side effects. Evidence suggests that the public are aware of these differences, and tend to adopt responses proportionate to the risk. Drawing upon the literature in the social and natural sciences, our discussion encompasses differing risk perceptions of terrorist threats and consequences of attacks. How do fear and anxiety interact with behavioural responses to amplify or attenuate perceptions that can be modified through risk communication undertaken by authorities?

  6. Moving beyond Green: Exploring the Relationship of Environment Type and Indicators of Perceived Environmental Quality on Emotional Well-Being following Group Walks

    PubMed Central

    Marselle, Melissa R.; Irvine, Katherine N.; Lorenzo-Arribas, Altea; Warber, Sara L.

    2014-01-01

    Against the backdrop of increasing interest in the relationship between Nature and health, this study examined the effect of perceived environment type and indicators of perceived environmental quality on short-term emotional well-being following outdoor group walks. Participants (n = 127) of a national group walk program completed pre- and post-walk questionnaires for each walk attended (n = 1009) within a 13-week study period. Multilevel linear modelling was used to examine the main and moderation effects. To isolate the environmental from the physical activity elements, analyses controlled for walk duration and perceived intensity. Analyses revealed that perceived restorativeness and perceived walk intensity predicted greater positive affect and happiness following an outdoor group walk. Perceived restorativeness and perceived bird biodiversity predicted post-walk negative affect. Perceived restorativeness moderated the relationship between perceived naturalness and positive affect. Results suggest that restorative quality of an environment may be an important element for enhancing well-being, and that perceived restorativeness and naturalness of an environment may interact to amplify positive affect. These findings highlight the importance of further research on the contribution of environment type and quality on well-being, and the need to control for effects of physical activity in green exercise research. PMID:25546275

  7. Moving beyond green: exploring the relationship of environment type and indicators of perceived environmental quality on emotional well-being following group walks.

    PubMed

    Marselle, Melissa R; Irvine, Katherine N; Lorenzo-Arribas, Altea; Warber, Sara L

    2014-12-23

    Against the backdrop of increasing interest in the relationship between Nature and health, this study examined the effect of perceived environment type and indicators of perceived environmental quality on short-term emotional well-being following outdoor group walks. Participants (n = 127) of a national group walk program completed pre- and post-walk questionnaires for each walk attended (n = 1009) within a 13-week study period. Multilevel linear modelling was used to examine the main and moderation effects. To isolate the environmental from the physical activity elements, analyses controlled for walk duration and perceived intensity. Analyses revealed that perceived restorativeness and perceived walk intensity predicted greater positive affect and happiness following an outdoor group walk. Perceived restorativeness and perceived bird biodiversity predicted post-walk negative affect. Perceived restorativeness moderated the relationship between perceived naturalness and positive affect. Results suggest that restorative quality of an environment may be an important element for enhancing well-being, and that perceived restorativeness and naturalness of an environment may interact to amplify positive affect. These findings highlight the importance of further research on the contribution of environment type and quality on well-being, and the need to control for effects of physical activity in green exercise research.

  8. Perceived discrimination and poor health: Accounting for self-blame complicates a well-established relationship.

    PubMed

    Blodorn, Alison; Major, Brenda; Kaiser, Cheryl

    2016-03-01

    Past research has reliably demonstrated that both perceiving oneself as a target of discrimination and a tendency to blame negative events on oneself undermine psychological and physical health. These two literatures, however, have evolved largely independently of one another. The present research sought to develop a deeper understanding of the health effects of perceived discrimination by taking into account the relationship between perceived discrimination and self-blame. In two correlational studies, we examined perceived ethnic-based discrimination, self-blame, and psychological and physical health among White and ethnic minority adults residing in the United States. Contrary to the hypothesis that attributing negative events to discrimination leads to the discounting of self-blame, perceived discrimination and self-blame were positively related. Replicating past research, perceived discrimination was negatively related to health when examined as an independent predictor. When perceived discrimination and self-blame were examined as simultaneous predictors of health, however, the negative health effects of perceived discrimination were weakened. Furthermore, an alternative model revealed that perceived discrimination indirectly predicted decreased health through increased self-blame. The present findings highlight the importance of taking self-blame into account when assessing and interpreting the negative health effects of perceived discrimination. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. The Different Roles of Perceived Stress in the Association Between Older Adults’ Physical Activity and Physical Health

    PubMed Central

    Rueggeberg, Rebecca; Wrosch, Carsten; Miller, Gregory E.

    2011-01-01

    This 4-yr longitudinal study examined the different roles of perceived stress in the association between older adults’ physical activities and physical health. We hypothesized that physical activities would exert beneficial effects on physical health by preventing chronically high levels of perceived stress. Design and Measures We assessed baseline levels of physical activities and repeated measures of perceived stress and physical symptoms in three waves of data from a sample of 157 older adults. Results Among participants with high (but not low) baseline levels of perceived stress, physical activity predicted a 2-yr reduction of perceived stress and a 4-yr prevention of physical health symptoms. Moreover, the interaction effect on 4-yr changes in physical symptoms was mediated by 2-yr changes in perceived stress. Conclusions Physical health benefits of physical activity are particularly pronounced among older adults who perceive high levels of stress, and this effect is mediated by a prevention of chronically high perceptions of stress. PMID:21875206

  10. The association of optimism and perceived discrimination with health care utilization in adults with sickle cell disease.

    PubMed

    Stanton, Michael V; Jonassaint, Charles R; Bartholomew, Frederick B; Edwards, Christopher; Richman, Laura; DeCastro, Laura; Williams, Redford

    2010-11-01

    We evaluated the effect of perceived discrimination, optimism, and their interaction on health care utilization among African American adults with sickle cell disease (SCD). Measures of optimism and perceived discrimination were obtained in 49 African American SCD patients. Multiple regression analyses controlling for sex and age tested effects of optimism and perceived discrimination on the number of emergency department visits (ED) and number and duration of hospitalizations over the past year. A perceived discrimination-optimism interaction was associated with number of emergency departments visits (b = .29, p = .052), number of hospitalizations (b = .36, p = .019), and duration of hospitalizations (b = .30, p = .045) such that those with high perceived discrimination/high optimism had the greatest health care utilization. African American SCD patients with high perceived discrimination/high optimism had greater health care utilization than patients who reported either low perceived discrimination or low optimism. This study suggests that patient personality and coping styles should be considered when evaluating the effects of stress on SCD-related outcomes.

  11. A Comparison of Sexual Side Effects of Antidepressants With and Without Naltrexone.

    PubMed

    Thapa, Mona; Petrakis, Ismene; Ralevski, Elizabeth

    2017-01-01

    The aim of the study was to compare the rate of sexual side effects of the selective serotonin reuptake inhibitor paroxetine versus the tricyclic antidepressant desipramine and to examine the effect of co-prescription of naltrexone on sexual side effects among participants in a randomized clinical trial. This was a secondary analysis (N = 88) of veterans who participated in a 12-week trial. All veterans were randomized into one of four treatment groups: (a) desipramine/naltrexone, (b) desipramine/placebo, (c) paroxetine/naltrexone, and (d) paroxetine/placebo. The main outcome measure was the frequency of sexual side effects consisting of "decreased sex drive" and/or "impotence" reported by veterans at each weekly visit. Approximately 61% of the veterans reported sexual side effects at least once during the trial, and 26.4% reported sexual side effects throughout the study. There were no significant differences in the frequency of sexual side effects among the four treatment groups. The results were similar when the comparison was made between the two antidepressant groups. There were no significant differences in the reporting of sexual side effects between those receiving desipramine and paroxetine. Also, the comparison between naltrexone and placebo did not alter the results. This is the first study to compare frequency of sexual side effect reporting between paroxetine and desipramine. We found no statistically significant differences in sexual side effect reporting between the two antidepressants. Also, the addition of naltrexone did not show any beneficial effect on the sexual side effect profile.

  12. An evaluation of public, private, and mobile health clinic usage for children under age 5 in Aceh after the tsunami: implications for future disasters

    PubMed Central

    Rassekh, Bahie Mary; Shu, Winnie; Santosham, Mathuram; Burnham, Gilbert; Doocy, Shannon

    2014-01-01

    Background: Aceh, Indonesia, was the hardest-hit area in the 26 December 2004 Indian Ocean earthquake and tsunami, with more than 500,000 people displaced, 120,000 people dead, and total damages and losses estimated at $4.5 billion. The relief effort following the tsunami was also immense. Objectives: This study aimed to determine and assess utilization patterns of formal public versus private and mobile health services for children under age 5 with diarrhea, cough and difficulty breathing, fever, or skin disease and to identify determinants of care usage. Methods: A household survey of 962 households was administered to caretakers of children aged 1–5 years. A sample of clusters within Banda Aceh and Aceh Besar were selected and those caretakers within the cluster who fit the inclusion criteria were interviewed. Results: Of those caretakers who utilized formal health services as the first line of care for their sick child, 62% used a public health facility, 30% used a private health facility, and 8% used a mobile clinic. In terms of significant factors associated with public, private, and mobile care utilization, mobile clinics were at one side of the spectrum and private clinics were at the other side overall, with public care somewhere in between. This was true for several variables. Mobile clinic users reported the lowest cost of services and medicine and the highest perceived level of accessibility, and private care users reported the highest perceived level of satisfaction. Conclusions: Utilization of formal health services for children was quite high after the tsunami. The caretaker's perceived satisfaction with public health services could have been improved. Mobile clinics were an accessible source of health care and could be used in future disaster relief efforts to target those populations that seek less care for their sick children, including displaced populations, and those children whose parents have died. PMID:25750788

  13. Mediating effects of self-stigma on the relationship between perceived stigma and psychosocial outcomes among psychiatric outpatients: findings from a cross-sectional survey in Singapore

    PubMed Central

    Picco, Louisa; Lau, Ying Wen; Pang, Shirlene; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Chong, Siow Ann; Subramaniam, Mythily

    2017-01-01

    Objectives To examine whether self-stigma mediates the relationship between perceived stigma and quality of life, self-esteem and general functioning among outpatients with depression, schizophrenia, anxiety and obsessive-compulsive disorder (OCD). Design Cross-sectional survey. Setting Outpatient clinics at a tertiary psychiatric hospital in Singapore. Participants 280 outpatients with a primary clinical diagnosis of either schizophrenia, depression, anxiety or OCD. Methods Data were collected in relation to self-stigma, perceived stigma, self-esteem, functioning and quality of life. In order to examine the mediating role of self-stigma on the relationship between perceived stigma and psychosocial outcomes, bootstrapping mediation analyses were used. Results Mediation analyses revealed that the relationship between perceived stigma and psychosocial outcomes was subject to the effects of self-stigma among the overall sample. Separate mediation analyses were conducted by diagnoses and showed differences in the mediating effects of self-stigma. Among the whole sample and the subsample with OCD, self-stigma mediated the relationship between perceived stigma and all psychosocial outcomes. For those with anxiety, depression and schizophrenia, the mediating effects of self-stigma were present in all relationships except (1) perceived stigma with physical health in the anxiety sample, (2) perceived stigma with social relationships in the depression sample and (3) perceived stigma with physical health in the schizophrenia sample. Conclusions The mediating effects of self-stigma on the relationship between perceived stigma and various psychosocial outcomes are evident and differ across diagnoses. Interventions to address and reduce the effects of self-stigma along with targeted treatments and psychoeducation to assist people with mental illness overcome or better manage self-stigma while providing them the skills to counteract public stigma are needed. PMID:28851803

  14. Comparison of the benefits of cochlear implantation versus contra-lateral routing of signal hearing aids in adult patients with single-sided deafness: study protocol for a prospective within-subject longitudinal trial

    PubMed Central

    2014-01-01

    Background Individuals with a unilateral severe-to-profound hearing loss, or single-sided deafness, report difficulty with listening in many everyday situations despite having access to well-preserved acoustic hearing in one ear. The standard of care for single-sided deafness available on the UK National Health Service is a contra-lateral routing of signals hearing aid which transfers sounds from the impaired ear to the non-impaired ear. This hearing aid has been found to improve speech understanding in noise when the signal-to-noise ratio is more favourable at the impaired ear than the non-impaired ear. However, the indiscriminate routing of signals to a single ear can have detrimental effects when interfering sounds are located on the side of the impaired ear. Recent published evidence has suggested that cochlear implantation in individuals with a single-sided deafness can restore access to the binaural cues which underpin the ability to localise sounds and segregate speech from other interfering sounds. Methods/Design The current trial was designed to assess the efficacy of cochlear implantation compared to a contra-lateral routing of signals hearing aid in restoring binaural hearing in adults with acquired single-sided deafness. Patients are assessed at baseline and after receiving a contra-lateral routing of signals hearing aid. A cochlear implant is then provided to those patients who do not receive sufficient benefit from the hearing aid. This within-subject longitudinal design reflects the expected care pathway should cochlear implantation be provided for single-sided deafness on the UK National Health Service. The primary endpoints are measures of binaural hearing at baseline, after provision of a contra-lateral routing of signals hearing aid, and after cochlear implantation. Binaural hearing is assessed in terms of the accuracy with which sounds are localised and speech is perceived in background noise. The trial is also designed to measure the impact of the interventions on hearing- and health-related quality of life. Discussion This multi-centre trial was designed to provide evidence for the efficacy of cochlear implantation compared to the contra-lateral routing of signals. A purpose-built sound presentation system and established measurement techniques will provide reliable and precise measures of binaural hearing. Trial registration Current Controlled Trials http://www.controlled-trials.com/ISRCTN33301739 (05/JUL/2013) PMID:25152694

  15. An Investigation of the Interaction Effects of Acute Self-Esteem and Perceived Competence on Conformity.

    DTIC Science & Technology

    1978-12-22

    a demonstration of the interaction effects of acute self - esteem and perceived competence. Acute self - esteem manipulations (high, low or no) were...On the basis of previous research on conformity it was predicted that subjects who were subjected to acute self - esteem manipulations and perceived...role in conformity. The main effect of self - esteem and the interaction of self - esteem and perceived competence did not prove significant. Results were

  16. The effect of positive emotion and perceived risk on usage intention to online decision aids.

    PubMed

    Ma, Qing-guo; Wang, Kai

    2009-10-01

    Although perceived risk has a negative effect on usage intention toward new information technology, both perceived risk and usage intention are the results of cognitive processes, so they are inevitably influenced by emotion. Based on positive mood theory and the appraisal-tendency framework (ATF), a laboratory experiment using online decision aids with 126 participants was conducted. The results indicate that positive emotion (happy emotion in the current study) can increase usage intention and decrease perceived risk, while perceived risk decreases usage intention. Further investigation finds that perceived risk is a mediator between emotion and usage intention.

  17. Do hedonic motives moderate regulatory focus motives? Evidence from the framing of persuasive messages.

    PubMed

    Malaviya, Prashant; Brendl, C Miguel

    2014-01-01

    Research on regulatory focus has established a regulatory matching effect: The persuasiveness of a message is enhanced when regulatory orientations of message and perceiver match (i.e., both are promotion or both are prevention). We report evidence that varying the hedonic outcome reverses this effect. We manipulated hedonic outcome by explicitly stating pleasurable versus painful outcomes as part of the message frame as well as by priming perceivers to focus on either pleasurable or painful outcomes. When both message and perceiver were focused on pleasurable outcomes, we replicated the regulatory matching effect. However, the matching effect reversed when the hedonic outcome of the message was opposed to that of the perceiver (i.e., one was pleasurable and the other painful). Under these conditions, messages that mismatched the perceivers' regulatory orientation were more persuasive (i.e., promotion message for a prevention oriented perceiver or vice versa). We also examined the persuasion effects when both message and perceiver were focused on painful outcomes and found that the regulatory matching effect re-emerged. The reversal of the regulatory matching effect by hedonic outcome strongly suggests that hedonic motives (approach of pleasure vs. avoidance of pain) and regulatory focus motives are distinct constructs. This is important because contrary to theoretical statements these constructs have often been confounded.

  18. Being and feeling liked by others: how social inclusion impacts health.

    PubMed

    Hartung, Freda-Marie; Sproesser, Gudrun; Renner, Britta

    2015-01-01

    This study examined the effects of perceived and actual social inclusion on health across and within individuals from a network perspective. During the first semester, 75 freshmen students provided bi-weekly ratings on their perceived social inclusion and health. To capture actual social inclusion, each student nominated liked and disliked fellow students. Perceived social inclusion mediated the effect of actual social inclusion on health. Specifically, students with more 'likes' perceived more social inclusion and those with higher perceived inclusion reported a better health status (between-person effect). In addition, at time points, when students received more 'likes' they also perceived more social inclusion. They reported better health at times when they felt more included (within-person effect). Thus, the perception of social inclusion is rooted in reality and actual social inclusion has an impact on health when passing the filter of perception.

  19. Side Effects to Antidepressant Treatment in Patients With Depression and Comorbid Panic Disorder.

    PubMed

    Shankman, Stewart A; Gorka, Stephanie M; Katz, Andrea C; Klein, Daniel N; Markowitz, John C; Arnow, Bruce A; Manber, Rachel; Rothbaum, Barbara O; Thase, Michael E; Schatzberg, Alan F; Keller, Martin B; Trivedi, Madhukar H; Kocsis, James H

    2017-04-01

    Side effects to antidepressant medication can affect the efficacy of treatment, but few predictors foretell who experiences side effects and which side effects they experience. This secondary data analysis examined whether depressed patients with comorbid panic disorder were more likely to experience side effects than those without panic disorder. The study also examined whether greater burden of side effects predicted a poorer treatment course for patients with panic disorder than those without panic disorder. To examine the specificity of these effects, analyses also examined 2 other anxiety disorders-social phobia and generalized anxiety disorder (GAD). Between 2002 and 2006, a large sample (N = 808) of chronically depressed individuals (assessed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders [SCID-IV]) received antidepressants according to a predetermined algorithm for 12 weeks. Every 2 weeks, depressive symptoms (per the Hamilton Depression Rating Scale) and side effects (specific side effects as well as several indicators of side effect burden) were assessed. Lifetime diagnosis of panic disorder (assessed using the SCID-IV) at baseline was associated with higher likelihood of gastrointestinal (OR = 1.6 [95% CI, 1.0-2.6]), cardiac (OR = 1.8 [95% CI, 1.1-3.1]), neurologic (OR = 2.6 [95% CI, 1.6-4.2]), and genitourinary side effects (OR = 3.0 [95% CI, 1.7-5.3]) during treatment. Increases in side effect frequency, intensity, and impairment over time were more strongly associated with increases in depressive symptoms for patients with panic disorder compared to those without panic disorder. Neither social phobia nor GAD was associated with these effects. Potentially due to heighte​ned interoceptive awareness of changes in their body, chronically depressed individuals with panic disorder may be at greater risk than those without panic disorder for antidepressant side effects and to experience a worsening of depressive symptoms as a result of these side effects over time. ClinicalTrials.gov identifier: NCT00057551​. © Copyright 2017 Physicians Postgraduate Press, Inc.

  20. Medications and Side Effects

    MedlinePlus

    ... to fully work. You might feel some side effects of your medication before your feel the benefits – ... as sleepiness, anxiety or headache) is a side effect or a symptom of your illness. Many side ...

  1. Cancer Treatment for Women: Possible Sexual Side Effects

    MedlinePlus

    ... the clitoris. These play a major part in sexual arousal in women. Removing the vulva and the clitoris ... www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-women-with-cancer.html. ...

  2. "There is a chain of connections": using syndemics theory to understand HIV treatment side effects.

    PubMed

    Gagnon, Marilou

    2018-03-12

    Side effects are central to the experience of living longer with HIV but rarely have they been studied alone. Unlike other aspects of that experience, like quality of life, treatment adherence, chronicity, episodic disability, aging, health, and viral load suppression, side effects have not benefited from the same level of empirical and theoretical engagement from qualitative researchers. In this paper, we draw on syndemics theory and 50 qualitative interviews to better understand the experience of HIV treatment side effects. Two main categories were identified in the data: side effects as a product and side effects as a risk factor. The first category suggests that side effects are not just the product of taking antiretroviral drugs. They are also the product of particular conditions and tend to cluster with other health problems. The second category puts forward the idea that side effects can act as a syndemic risk factor by exposing PLWH to a greater risk of developing health problems and creating conditions in which psychosocial issues are more likely to emerge. The paper concludes by calling for more research on the complex nature of side effects and for the development of comprehensive approaches for the assessment and management of side effects.

  3. Patient-provider communication and hormonal therapy side effects in breast cancer survivors.

    PubMed

    Lin, Jenny J; Chao, Jennifer; Bickell, Nina A; Wisnivesky, Juan P

    2017-09-01

    Side effects from hormonal therapy (HT) for breast cancer treatment occur frequently and are associated with worse quality of life and HT non-adherence. Whether improved patient-physician communication is associated with patients' reporting of side effects is unknown. We undertook this study to assess factors associated with women's reports of HT side effects. Between December 2012 and April 2013, we conducted a cross-sectional survey of breast cancer patients undergoing HT in an urban medical center. Descriptive statistics, univariate analyses, and multivariate analyses were used to evaluate associations. Of the 100 participants, 67% reported having HT side effects. However, when prompted, an additional 9% reported experiencing specific HT-related symptoms. Despite very high communication scores, one-third of participants reported they had not discussed side effects with providers. Multivariate analysis showed that after controlling for age, education, race, and medication beliefs, women who had difficulty asking providers for more information were more likely to report side effects (odds ratio 8.27, 95% confidence interval 1.01-69.88). Although HT side effects often occur and are bothersome, patient-provider discussions about side effects remain suboptimal. Providers should actively ask patients about medication side effects so that they can be addressed to improve quality of life and potentially, medication adherence.

  4. Mind-Matter Interactions and the Frontal Lobes of the Brain: A Novel Neurobiological Model of Psi Inhibition.

    PubMed

    Freedman, Morris; Binns, Malcolm; Gao, Fuqiang; Holmes, Melissa; Roseborough, Austyn; Strother, Stephen; Vallesi, Antonino; Jeffers, Stanley; Alain, Claude; Whitehouse, Peter; Ryan, Jennifer D; Chen, Robert; Cusimano, Michael D; Black, Sandra E

    Despite a large literature on psi, which encompasses a range of experiences including putative telepathy (mind-mind connections), clairvoyance (perceiving distant objects or events), precognition (perceiving future events), and mind-matter interactions, there has been insufficient focus on the brain in relation to this controversial phenomenon. In contrast, our research is based on a novel neurobiological model suggesting that frontal brain systems act as a filter to inhibit psi and that the inhibitory mechanisms may relate to self-awareness. To identify frontal brain regions that may inhibit psi. We used mind-matter interactions to study psi in two participants with frontal lobe damage. The experimental task was to influence numerical output of a Random Event Generator translated into movement of an arrow on a computer screen to the right or left. Brain MRI was analyzed to determine frontal volume loss. The primary area of lesion overlap between the participants was in the left medial middle frontal region, an area related to self-awareness, and involved Brodmann areas 9, 10, and 32. Both participants showed a significant effect in moving the arrow to the right, i.e., contralateral to the side of primary lesion overlap. Effect sizes were much larger compared to normal participants. The medial frontal lobes may act as a biological filter to inhibit psi through mechanisms related to self-awareness. Neurobiological studies with a focus on the brain may open new avenues of research on psi and may significantly advance the state of this poorly understood field. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Medication persistence in Turkish children and adolescents with attention-deficit/hyperactivity disorder.

    PubMed

    Ayaz, Muhammed; Ayaz, Ayşe Burcu; Soylu, Nusret; Yüksel, Serhat

    2014-10-01

    The aim of this study was to investigate medication persistence in Turkish children and adolescents with attention-deficit/hyperactivity disorder (ADHD). The effects of sociodemographic characteristics, symptom severity of ADHD, comorbidity, and treatment-related factors influencing medication persistence in children diagnosed with ADHD were studied. Medication persistence over a continuous 12 month period was evaluated for 877 children and adolescents between 6 and 18 years of age, who were diagnosed with ADHD for the first time and started to receive medication. Medication persistence was determined according to whether or not taking the prescribed medication continued for 12 months after the initiation of treatment. Whereas the symptom severity of ADHD was assessed by using the Turgay Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV)-based Child and Adolescent Behaviour Disorders Screening and Rating Scale-Parents Form (T-DSM-IV-S), perceived medication efficacy after the first treatment was evaluated by the Clinical Global Impressions-Improvement Scale (CGI-I). In this study, medication persistence over a continuous 12 month period occurred at a rate of 30.2% (n=265) in the subjects studied. The hierarchical regression analysis conducted in this research revealed that younger age, higher hyperactivity/impulsivity symptom severity, use of long-acting methylphenidate, addition of another ADHD medication, addition of other psychotropic medications, absence of side effects, and perceived medication efficacy were associated with successful medication persistence over a continuous 12 month period. Understanding the factors that affect medication persistence in ADHD may improve treatment efficacy and symptom control, while minimizing future risks.

  6. Sustainability of outdoor school ground smoking bans at secondary schools: a mixed-method study

    PubMed Central

    Rozema, A D; Mathijssen, J J P; Jansen, M W J; van Oers, J A M

    2018-01-01

    Abstract Background Although increasing numbers of countries are implementing outdoor school ground smoking bans at secondary schools, less attention is paid to the post-implementation period even though sustainability of a policy is essential for long-term effectiveness. Therefore, this study assesses the level of sustainability and examines perceived barriers/facilitators related to the sustainability of an outdoor school ground smoking ban at secondary schools. Methods A mixed-method design was used with a sequential explanatory approach. In phase I, 438 online surveys were conducted and in phase II, 15 semi-structured interviews were obtained from directors of relevant schools. ANOVA (phase I) and a thematic approach (phase II) were used to analyze data. Results Level of sustainability of an outdoor school ground smoking ban was high at the 48% Dutch schools with an outdoor smoking ban. Furthermore, school size was significantly associated with sustainability. The perceived barriers/facilitators fell into three categories: (i) smoking ban implementation factors (side-effects, enforcement, communication, guidelines and collaboration), (ii) school factors (physical environment, school culture, education type and school policy) and (iii) community environment factors (legislation and social environment). Conclusions Internationally, the spread of outdoor school ground smoking bans could be further promoted. Once implemented, the ban has become ‘normal’ practice and investments tend to endure. Moreover, involvement of all staff is important for sustainability as they function as role models, have an interrelationship with students, and share responsibility for enforcement. These findings are promising for the sustainability of future tobacco control initiatives to further protect against the morbidity/mortality associated with smoking. PMID:29016786

  7. Primary Care Physician Perspectives about Antipsychotics and Other Medications for Symptoms of Dementia.

    PubMed

    Kerns, J William; Winter, Jonathan D; Winter, Katherine M; Boyd, Terry; Etz, Rebecca S

    2018-01-01

    Guidelines, policies, and warnings have been applied to reduce the use of medications for behavioral and psychological symptoms of dementia (BPSD). Because of rare dangerous side effects, antipsychotics have been singled out in these efforts. However, antipsychotics are still prescribed "off label" to hundreds of thousands of seniors residing in nursing homes and communities. Our objective was to evaluate how and why primary-care physicians (PCPs) employ nonpharmacologic strategies and drugs for BPSD. Semi-structured interviews analyzed via template, immersion and crystallization, and thematic development of 26 PCPs (16 family practice, 10 general internal medicine) in full time primary-care practice for at least 3 years in Northwestern Virginia. PCPs described 4 major themes regarding BPSD management: (1) nonpharmacologic methods have substantial barriers; (2) medication use is not constrained by those barriers and is perceived as easy, efficacious, reasonably safe, and appropriate; (3) pharmacologic policies decrease the use of targeted medications, including antipsychotics, but also have unintended consequences such as increased use of alternative risky medications; and (4) PCPs need practical evidence-based guidelines for all aspects of BPSD management. PCPs continue to prescribe medications because they meet patient-oriented goals and because PCPs perceive drugs, including antipsychotics and their alternatives, to be more effective and less dangerous than evidence suggests. To optimally treat BPSD, PCPs need supportive verified prescribing guidelines and access to nonpharmacologic modalities that are as affordable, available, and efficacious as drugs; these require and deserve significant additional research and payer support. Community PCPs should be included in BPSD policy and guideline development. © Copyright 2018 by the American Board of Family Medicine.

  8. Prevalence, patterns, and perceived value of complementary and alternative medicine among cancer patients: a cross-sectional, descriptive study.

    PubMed

    Bahall, Mandreker

    2017-06-30

    Sophisticated conventional medicine (CM) has brought significant advances to cancer prevention, detection, and treatment. However, many cancer patients still turn to complementary and alternative medicine (CAM) treatment. This study explored the prevalence, patterns, and perceived value of CAM among cancer patients. This quantitative descriptive study was conducted between March 1, 2015, and July 31, 2015, among a cross-sectional, convenience sample of patients from the Oncology Department of San Fernando General Hospital in Trinidad and Tobago. Face-to-face interviews were conducted at the oncology clinic and treatment suite after obtaining informed consent. Data analysis included descriptive analysis, chi-square tests, and binary logistic regression analysis. The prevalence of CAM use among a sample of 350 cancer patients was 39.1% (39.6% for breast cancer, 44.4% for prostate cancer, 37% for ovarian cancer, and 38.7% for colon cancer patients). Herbs were the most common type of CAM used (93.4%), followed by spiritual therapy (73.7%). CAM use was more prevalent among females (68.6%), Indo-Trinidadians (63.5%), and patients aged 41-50 years (37.2%). The majority (70%-80%) rated CAM efficacy on perceived value. CAM was used mainly because of a desire to try anything that might help (67.6%), followed by it being congruent with the patients' beliefs (59.1%). Patients knew about CAM mainly through friends (69.3%) and family (69.3%). Most patients were generally satisfied (93.6%) and considered CAM helpful (89.8%), but the majority never informed their health care provider of CAM use (78.8%). Patients reported the simultaneous use of more than one type of CAM, without considering or knowing of possible side-effects. The perceived value of CAM included empowerment, control, cure, and improved quality of life. CAM use was associated with age, but no predictors of CAM use could be identified. Medicinal herbs and spiritual therapy are commonly used among cancer patients because of perceived benefits and satisfaction. CAM use is more prevalent among females, Indo-Trinidadians, and patients aged 41-50 years old. There are no useful predictors of CAM use. More than one type of CAM is commonly used simultaneously without disclosure to health care providers.

  9. Links between inflammation, amygdala reactivity, and social support in breast cancer survivors

    PubMed Central

    Muscatell, Keely A.; Eisenberger, Naomi I.; Dutcher, Janine M.; Cole, Steven W.; Bower, Julienne E.

    2017-01-01

    Psychosocial stress can affect inflammatory processes that have important consequences for cancer outcomes and the behavioral side effects of cancer treatment. To date, however, little is known about the upstream neural processes that may link psychosocial stressors and inflammation in cancer patients and survivors. To address this issue, 15 women who had been diagnosed with early-stage breast cancer and completed cancer treatment and 15 age- and ethnicity-matched women with no cancer history were recruited for a neuroimaging study. Participants provided a blood sample for levels of circulating inflammatory markers (CRP and IL-6), underwent an fMRI scan in which they completed a threat reactivity task designed to elicit activity in the amygdala, and reported their levels of perceived social attachment/ support. There were no significant differences between cancer survivors and controls in levels of CRP or IL-6, in amygdala reactivity to the socially threatening images, or in levels of perceived social support. However, results showed a strong, positive correlation between CRP concentration and left amygdala reactivity in the survivor group that was not apparent in controls. Higher levels of social support in the survivor group were also associated with reduced amygdala reactivity and CRP. These data suggest the possibility of a stronger “neural-immune pipeline” among breast cancer survivors, such that peripheral inflammation is more strongly associated with neural activity in threat-related brain regions. PMID:26384778

  10. Barriers and facilitators of adherence to antidepressants among outpatients with major depressive disorder: A qualitative study

    PubMed Central

    Jacob, Sabrina Anne; Tangiisuran, Balamurugan

    2017-01-01

    Background One of the major challenges in treating major depressive disorder (MDD) is patients’ non-adherence to medication. This study aimed to explore the barriers and facilitators of patients’ adherence to antidepressants among outpatients with MDD. Methods Semi-structured and individual in-depth interviews were conducted among patients with MDD who were taking antidepressants, in the psychiatric clinic of a government-run hospital in Malaysia. Participants were purposively sampled from different genders and ethnicities. Interviews were conducted using a validated topic guide, and responses were audio-recorded, transcribed verbatim, checked, and analyzed using the grounded theory approach. Results A total of 30 patients were interviewed. Forty different themes and sub-themes were identified which were conceptually divided into two distinct categories related to barriers and facilitators to adherence. The barriers were: patient-specific, medication-specific, healthcare provision and system, social-cultural, and logistics. The facilitators were: having insight, perceived health benefits, regular activities, patient-provider relationship, reminders, and social support networks. Conclusions Patient-specific barriers and medication side effects were the major challenges for adhering to treatment. Perceived health benefits and having insight on the need for treatment were the most frequently cited facilitators. Targeted interventions should be developed to address the key barriers, and promote measures to facilitate adherence in this group of patients. PMID:28614368

  11. Microscopic morphological changes of the tooth surface in relation to fixed orthodontic treatment.

    PubMed

    Preoteasa, Cristina Teodora; NiŢoi, Dan Florin; Preoteasa, Elena

    2015-01-01

    Orthodontic treatment has, as any other medical intervention, in addition to its benefits, side effects, some of them being perceived as unavoidable. The aim of this case series was to microscopically evaluate the changes of the tooth surface in relation to fixed orthodontic treatment. A case series study was implemented by the usage of four extracted first maxillary premolars, from patients with previous orthodontic treatment, of 12 and 23 months. Analysis was performed using the high precision stereomicroscope (Axiovert, Carl Zeiss, Germany), at magnifications from 10× to 50×. The tooth surface corresponding to the bracket bonding area registered numerous disorderly grooves and cracks, with various directions and depths, and was flattened, having lower convexity compared to teeth surfaces where brackets were not bonded. Root resorption lacunae were more frequently observed in teeth under orthodontic treatment, these having various depths, and sizes considerably larger than those observed in teeth without orthodontic treatment. Following orthodontic treatment, teeth exhibit changes that can be perceived as being directly linked to this medical intervention. These teeth changes usually have low or moderate severity, which can be influenced at some degree by the clinical conduct of the orthodontic treatment. The stereomicroscope proved to be a high sensitivity tool for the analysis of morphological changes of teeth in relation to the fixed orthodontic treatment.

  12. Perspectives on biomedical HIV prevention options among women who inject drugs in Kenya.

    PubMed

    Bazzi, Angela Robertson; Yotebieng, Kelly A; Agot, Kawango; Rota, Grace; Syvertsen, Jennifer L

    2018-03-01

    Due to heightened vulnerability to HIV from frequent engagement in sex work and overlapping drug-using and sexual networks, women who inject drugs should be a high priority population for pre-exposure prophylaxis (PrEP) and other biomedical HIV prevention tools. Kenya is one of the first African countries to approve oral PrEP for HIV prevention among "key populations," including people who inject drugs and sex workers. The objective of this study was to explore preferences and perceived challenges to PrEP adoption among women who inject drugs in Kisumu, Kenya. We conducted qualitative interviews with nine HIV-uninfected women who inject drugs to assess their perceptions of biomedical HIV interventions, including oral PrEP, microbicide gels, and intravaginal rings. Despite their high risk and multiple biomedical studies in the region, only two women had ever heard of any of these methods. All women were interested in trying at least one biomedical prevention method, primarily to protect themselves from partners who were believed to have multiple other sexual partners. Although women shared concerns about side effects and product efficacy, they did not perceive drug use as a significant deterrent to adopting or adhering to biomedical prevention methods. Beginning immediately and continuing throughout Kenya's planned PrEP rollout, efforts are urgently needed to include the perspectives of high risk women who use drugs in biomedical HIV prevention research and programing.

  13. Cognitive binding in schizophrenia: weakened integration of temporal intersensory information.

    PubMed

    Tschacher, Wolfgang; Bergomi, Claudia

    2011-09-01

    Cognitive functioning is based on binding processes, by which different features and elements of neurocognition are integrated and coordinated. Binding is an essential ingredient of, for instance, Gestalt perception. We have implemented a paradigm of causality perception based on the work of Albert Michotte, in which 2 identical discs move from opposite sides of a monitor, steadily toward, and then past one another. Their coincidence generates an ambiguous percept of either "streaming" or "bouncing," which the subjects (34 schizophrenia spectrum patients and 34 controls with mean age 27.9 y) were instructed to report. The latter perception is a marker of the binding processes underlying perceived causality (type I binding). In addition to this visual task, acoustic stimuli were presented at different times during the task (150 ms before and after visual coincidence), which can modulate perceived causality. This modulation by intersensory and temporally delayed stimuli is viewed as a different type of binding (type II). We show here, using a mixed-effects hierarchical analysis, that type II binding distinguishes schizophrenia spectrum patients from healthy controls, whereas type I binding does not. Type I binding may even be excessive in some patients, especially those with positive symptoms; Type II binding, however, was generally attenuated in patients. The present findings point to ways in which the disconnection (or Gestalt) hypothesis of schizophrenia can be refined, suggesting more specific markers of neurocognitive functioning and potential targets of treatment.

  14. Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women.

    PubMed

    Browall, Maria; Ahlberg, Karin; Karlsson, Per; Danielson, Ella; Persson, Lars-Olof; Gaston-Johansson, Fannie

    2008-07-01

    The purpose of the present study was twofold: first, to describe changes of Health-Related Quality of Life (HRQoL) during the adjuvant treatment among postmenopausal women with breast cancer; second, in the same population to identify the best predictors of Overall Quality of Life (QoL) after treatment, from perceived functioning, symptoms, emotional distress and clinical/demographic variables measured at baseline. The study group was 150 women (> or = 55 years of age) scheduled for adjuvant chemotherapy (CT, n=75) or radiotherapy (RT, n=75). They were examined before (baseline), during and after completing the treatment. Data about QoL, perceived functioning, symptoms and emotional distress were collected with the European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30, BR23 and Hospital Anxiety and Depression Scale (HADS) questionnaires. The general finding was that the adjuvant treatments were associated with decrease in overall QoL, physical and role functioning, anxiety and body image, as well as with increase in fatigue, dyspnoea, pain, nausea/vomiting, constipation and systemic therapy side effects measured over time. For women receiving CT, better emotional functioning and less pain at baseline predicted better overall QoL at the end of the treatment. For women receiving RT, better physical and emotional functioning, less breast symptoms and lower tumour stage at baseline predicted better overall QoL at the end of the treatment.

  15. Perceptions of teachers' general and informational feedback and intrinsic motivation in physical education: two-year effects.

    PubMed

    Koka, Andre; Hein, Vello

    2006-10-01

    Relative change or stability of perceived positive general feedback and perceived informational feedback and their influence on students' intrinsic motivation in physical education over two years were examined. 302 students, ages 11 to 15 years, responded to the Perception of Teacher's Feedback questionnaire. Two years later, these students filled out the questionnaire again, along with a modified version of the Sport Motivation Scale. Analysis showed that both types of perceived feedback exhibited moderate stability over the two years. Perceived positive general feedback demonstrated a significant direct effect on students' intrinsic motivation measured concurrently in physical education. Further, fixing to zero the effect of perceived positive general feedback on intrinsic motivation measured concurrently, an effect emerged over the two years.

  16. The Glasgow antipsychotic side-effects scale for clozapine in inpatients and outpatients with schizophrenia or schizoaffective disorder.

    PubMed

    Ignjatović Ristić, Dragana; Cohen, Dan; Obradović, Andrea; Nikić-Đuričić, Katarina; Drašković, Marija; Hinić, Darko

    2018-02-01

    The inconsistency in clinician and patient ratings of clozapine-induced side effects underscore the need to supplement clinician-based estimates of side effects with patient-reported ones. The main aims of the study are validation of the Glasgow antipsychotic side-effects scale for clozapine (GASS-C) in Serbian inpatients/outpatients with schizophrenia or schizo-affective disorder and recommendations for its future use, based on common and rare clozapine-associated side-effects. The GASS-C was administered to 95 outpatients/inpatients diagnosed with schizophrenia, schizoaffective, or chronic psychotic disorder. The scale showed good overall reliability, with an internal consistency coefficient of α = 0.84, an average retest coefficient of rho = 0.76, and a Spearman-Brown coefficient of validity of 0.81. Side effects were absent or mild in 64.2% of the patients, moderate in 31.6%, severe in 4.2%; 14% of the subjects considered their symptoms distressing. The most commonly reported side-effects were drowsiness, thirst, frequent urination, and dry mouth. Women reported more side effects than men, and patients not in a relationship reported significantly fewer side effects than patients in a relationship. Results indicate a weak positive correlation (rho = 0.231; p = .025) between severity of side effects and clozapine dose. The GASS-C showed good psychometric characteristics in clinical population of patients on clozapine. In future studies, clozapine serum concentrations should be measured when using the GASS-C to monitor side effects.

  17. Learning to experience side effects after antidepressant intake - Results from a randomized, controlled, double-blind study.

    PubMed

    Rheker, Julia; Winkler, Alexander; Doering, Bettina K; Rief, Winfried

    2017-02-01

    Side effects play a key role in patients' failure to take antidepressants. There is evidence that verbal suggestions and informed consent elicit expectations that can in turn trigger the occurrence of side effects. Prior experience or learning mechanisms are also assumed to contribute to the development of side effects, although their role has not been thoroughly investigated. In this study, we examined whether an antidepressant's side effects can be learned via Pavlovian conditioning. Participants (n = 39) were randomly allocated to one of two groups and were exposed to a classical conditioning procedure. During acquisition, 19 participants received amitriptyline and 20 participants received a placebo pill. Pills were taken for four nights together with a novel-tasting drink. After a washout phase, both groups received a placebo pill together with the novel-tasting drink (evocation). Side effects were assessed via the Generic Assessment of Side Effects Scale prior to acquisition (baseline), after acquisition, and after evocation. A score of antidepressant-specific side effects was calculated. Participants taking amitriptyline reported significantly more antidepressant-specific side effects after acquisition compared to both baseline and the placebo group. After evocation, participants who underwent the conditioning procedure with amitriptyline reported significantly more antidepressant-specific side effects than those who never received amitriptyline, even though both groups received a placebo. Our results indicate that antidepressant side effects can be learned using a conditioning paradigm and evoked via a placebo pill when applied with the same contextual factors as the verum.

  18. The association of HIV/AIDS treatment side effects with health status, work productivity, and resource use.

    PubMed

    daCosta DiBonaventura, Marco; Gupta, Shaloo; Cho, Michelle; Mrus, Joseph

    2012-01-01

    Due to stable incidence and improved survival rates, there are an increasing number of patients living with HIV/AIDS in the USA. Although highly effective, current antiretroviral therapies are associated with a variety of side effects. The role side effects play on health outcomes has not been fully examined. The current study assessed the association of medication side effects with (1) self-assessed health status; (2) work productivity and activity impairment; and (3) healthcare resource utilization. Data were from a cross-sectional patient-reported survey fielded in the USA using a dual methodology of Internet and paper questionnaires. A total of 953 patients living with HIV/AIDS who were currently taking a medication for their condition were included in the analyses. The most frequent side effects reported by patients were fatigue (70.72%), diarrhea (62.96%), insomnia (58.97%), dizziness (52.78%), neuropathy (52.68%), joint pain (52.36%), nausea (51.63%), and abdominal pain (50.37%). The presence of each side effect was associated with reduced self-assessed health status, increased productivity loss, increased activity impairment, and increased healthcare resource use. Controlling for CD4 cell counts in regression modeling did little to diminish the impact of side effects. Although not all side effects were associated with all outcomes, every side effect was associated with worse health status, some measure of increased work productivity loss, and/or some measure of increased healthcare resource use. Patients are living longer with HIV and, therefore, spending a greater length of time on treatment. The results of the current study suggest that many of these patients are experiencing a wide array of side effects from these therapies. These side effects have demonstrated a profound association with self-assessed health, work productivity, and healthcare resource use. Improved management of these side effects or development of treatments with a better side effect profile may have a substantial humanistic and economic benefit.

  19. Labor productivity, perceived effectiveness, and sustainability of innovative projects.

    PubMed

    Makai, Peter; Cramm, Jane M; van Grotel, Marloes; Nieboer, Anna P

    2014-01-01

    To assess labor productivity, perceived effectiveness, and sustainability of a national quality program that sought to stimulate efficiency gains through increased labor productivity while maintaining quality through implementing small-scale innovation projects. Longitudinal measures of labor productivity and quality were collected at baseline and after completion of the innovation projects. Perceived effectiveness and sustainability (measured by routinization) were assessed cross-sectionally after project completion. This study was conducted in The Netherlands. Ninety-eight improvement projects in long-term care organizations. A national quality program to stimulate innovative approaches in long-term care. Labor productivity, perceived effectiveness, and sustainability were the main outcome measures. Labor productivity data were available for only 37 (38%) of the 98 projects, 33 (89%) of which demonstrated significantly improved efficiency. Perceived effectiveness was significantly associated with sustainability (0.29; p < .05), but not labor productivity. To achieve sustainability in long-term care, developers of innovative projects must collect better quality information on efficiency gains in terms of labor productivity and focus more on efficiency improvement. More research is necessary to explore relationships between labor productivity, perceived effectiveness, and sustainability. © 2012 National Association for Healthcare Quality.

  20. The effects of therapeutic instrumental music performance on endurance level, self-perceived fatigue level, and self-perceived exertion of inpatients in physical rehabilitation.

    PubMed

    Lim, Hayoung A; Miller, Karen; Fabian, Chuck

    2011-01-01

    The present study investigated the effects of a Neurologic Music Therapy (NMT) sensory-motor rehabilitation technique, Therapeutic Instrumental Music Performance (TIMP) as compared to Traditional Occupational Therapy (TOT), on endurance, self-perceived fatigue, and self-perceived exertion of 35 hospitalized patients in physical rehabilitation. The present study attempted to examine whether an active musical experience such as TIMP with musical cueing (i.e., rhythmic auditory cueing) during physical exercises influences one's perception of pain, fatigue, and exertion. All participants were diagnosed with a neurologic disorder or had recently undergone orthopedic surgery. Investigators measured the effects of TOT and TIMP during upper extremity exercise of the less affected or stronger upper extremity. Results showed no significant difference on endurance measures between the 2 treatment conditions (TIMP and TOT). Statistically significant differences were found between TIMP and TOT when measuring their effects on perceived exertion and perceived fatigue. TIMP resulted in significantly less perception of fatigue and exertion levels than TOT. TIMP can be used foran effective sensory-motor rehabilitation technique to decrease perceived exertion and fatigue level of inpatients in physical rehabilitation.

  1. Role of information in preparing men for transrectal ultrasound guided prostate biopsy: a qualitative study embedded in the ProtecT trial.

    PubMed

    Wade, Julia; Rosario, Derek J; Howson, Joanne; Avery, Kerry N L; Salter, C Elizabeth; Goodwin, M Louise; Blazeby, Jane M; Lane, J Athene; Metcalfe, Chris; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L

    2015-02-28

    The histological diagnosis of prostate cancer requires a prostate needle biopsy. Little is known about the relationship between information provided to prepare men for transrectal ultrasound guided biopsy (TRUS-Bx) and how men experience biopsy. The objectives were a) to understand men's experiences of biopsy as compared to their expectations; and b) to propose current evidence-based information for men undergoing TRUS-Bx. Between February 2006 and May 2008, 1,147 men undergoing a standardised 10-core transrectal ultrasound guided biopsy protocol under antibiotic cover following a PSA 3.0-19.9 ng/ml in the Prostate Testing for Cancer and Treatment (ProtecT) trial, completed questionnaires about biopsy symptoms. In this embedded qualitative study, in-depth interviews were undertaken with 85 men (mean age 63.6 yrs, mean PSA 4.5 ng/ml) to explore men's experiences of prostate biopsy and how the experience might be improved. Interview data were analysed thematically using qualitative research methods. Findings from the qualitative study were used to guide selection of key findings from the questionnaire study in developing a patient information leaflet preparing men for biopsy. Although most men tolerated TRUS-Bx, a quarter reported problematic side-effects and anxiety. Side effects were perceived as problematic and anxiety arose most commonly when experiences deviated from information provided. Men who were unprepared for elements of TRUS-Bx procedure or its sequelae responded by contacting health professionals for reassurance and voiced frustration that pre-biopsy information had understated the possible severity or duration of pain/discomfort and bleeding. Findings from questionnaire and interview data were combined to propose a comprehensive, evidence-based patient information leaflet for TRUS-Bx. Men reported anxiety associated with TRUS-Bx or its side-effects most commonly if they felt inadequately prepared for the procedure. Data from this qualitative study and the previous questionnaire study have been used to propose an updated, comprehensive evidence-based set of information for men undergoing TRUS-Bx.

  2. The social context for psychological distress from iatrogenic gynecomastia with suggestions for its management.

    PubMed

    Wassersug, Richard J; Oliffe, John L

    2009-04-01

    Gynecomastia (breast development in males) is a side effect of androgen deprivation therapy (ADT) for prostate cancer (PCa). Medical interventions to prevent or treat gynecomastia carry risk of additional detrimental side effects. However, untreated gynecomastia can be physically uncomfortable and psychologically distressing. Shame from gynecomastia can lead patients to stop otherwise beneficial exercise. Our first aim is to explore the social context for gynecomastia and how it is interpreted by men with the condition, as well as by others, both male and female. Subsequently, we use our understanding of why gynecomastia is psychologically distressing to propose psychosocial interventions that could help men accept this side effect of ADT. We draw on academic literature, media accounts, and web-based testimonials from men with gynecomastia, to understand how gynecomastia is perceived by both patients and the medical community. We examine these resources in light of gynecomastia's impact on sex roles, sexuality, and gender identity issues. By exploring what breasts in a male mean to the individual, we produce an understanding of the social context for distress from gynecomastia. From this understanding, we derive hypotheses about who might be most distressed from gynecomastia and strategies for alleviating this distress. The shame and stigma of gynecomastia is linked to the objectification of women. We suggest that men fear that their breasts will marginalize and subordinate them within gender hierarchies. There is little evidence that breasts on a male erotically attract either men or women. Novel options for living with gynecomastia are contrasted with medicalized strategies including mastectomy. Assessment instruments need to be developed to identify patients most likely to experience distress from gynecomastia and seek out medical interventions. Surgical, radiological, or pharmacological interventions may not be universally necessary if greater acceptance of gynecomastia is made available through psychosocial support programs. For example, PCa patients may learn to accept gynecomastia through reconceptualizing their breasts as autoerotic. Support programs modeled on those of the breast cancer community, including Encore and dragon boat racing, may also help to build communities to serve patients with gynecomastia while defending individuals against shame, isolation, and loss of self-esteem.

  3. Elite Youth Soccer Players' Physiological Responses, Time-Motion Characteristics, and Game Performance in 4 vs. 4 Small-Sided Games: The Influence of Coach Feedback.

    PubMed

    Brandes, Mirko; Elvers, Sebastian

    2017-10-01

    The purpose of this study was to determine the impact of mild vs. strongly pushed coach feedback on the physiological response, ratio of perceived exertion (RPE), and time-motion characteristics in soccer training with small-sided games (SSGs). Sixteen elite youth soccer players (aged 17.2 ± 0.7 years, V[Combining Dot Above]O2max 62.1 ± 3.8 ml·kg·min) played two 4 vs. 4 small-sided games each. In random order, the coach provided a mild, unobtrusive, or a strongly pushed feedback throughout the game. Physiological measurements included heart rate expressed in mean values and intensity zones, blood lactate concentration, and RPE. The distance traveled, number of sprints, and work:rest ratio were captured by global positioning systems at 5 Hz. Game performance, such as volume of play and efficacy index, was estimated using the Team Sports Assessment Procedure. No differences were found for the physiological response and time-motion characteristics, but effect sizes demonstrated an increase in RPE (+0.4, p = 0.27) and a decrease in game performance (e.g., volume of play, -2.5, p = 0.08) under pushed feedback. Although a pushed feedback raises RPE, it negatively affected the players' game performance, without necessarily provoking higher physiological responses. These results should help coaches to understand that modifying the type of feedback provided during SSG does not impact the physiological response if SSG are already played with high intensity but that the feedback affects RPE and game performance. To keep a better game performance, soccer coaches are encouraged to provide smooth feedback during SSG.

  4. Treatment factors affecting longitudinal quality of life in new onset pediatric epilepsy.

    PubMed

    Modi, Avani C; Ingerski, Lisa M; Rausch, Joseph R; Glauser, Tracy A

    2011-05-01

    Recognizing the importance of patient-reported outcomes, this longitudinal, prospective study examined: Changes in health-related quality of life (HRQOL) over seven months following antiepileptic drug (AED) initiation and the relationship of seizures, AED side-effects, and AED type to HRQOL. Parents of 124 children with newly diagnosed epilepsy completed measures of HRQOL and side-effects at each clinic visit. Treatment information was also collected. HRQOL remained stable over time; however, seizures and AED side-effects significantly affected multiple HRQOL domains. Higher seizure activity was associated with decreased Physical HRQOL. Side-effects were negatively associated with all HRQOL domains. Children taking carbamazepine who experienced higher side-effects early in therapy demonstrated declining emotional functioning compared to children experiencing no/some side-effects. AED side-effects, AED type, and seizure frequency were associated with longitudinal HRQOL in children with newly-diagnosed epilepsy. Routine assessment of AED side-effects and HRQOL may be useful for clinical decision making.

  5. YouTube Video as Health Literacy Tool: A Test of Body Image Campaign Effectiveness.

    PubMed

    Meng, Juan; Bissell, Kim L; Pan, Po-Lin

    2015-01-01

    This study examined the effectiveness of four media campaigns about disordered eating behaviors. It investigated possible factors that affected females' perceived effectiveness of four campaign videos. Results indicated that health campaign about a celebrity's struggle with extreme thinness proved to be the least effective of four campaign videos, whereas the video presenting solid facts about the dangers of extreme dieting was perceived as the most effective campaign. Self-discrepancy was not a significant predictor to females' perceived effectiveness of campaign videos. Similarly, the frequency of Internet usage was proved as a weak predictor of their perceived effectiveness. These findings and the possible rationale for the lack of support with regard to the correlates of campaign effectiveness were also discussed.

  6. Acceptability of a novel vaginal microbicide during a safety trial among low-risk women.

    PubMed

    Bentley, M E; Morrow, K M; Fullem, A; Chesney, M A; Horton, S D; Rosenberg, Z; Mayer, K H

    2000-01-01

    The increasing recognition that women who are unable or unwilling to discuss or use condoms with their sexual partners need female-controlled methods for preventing sexually transmitted diseases (STDs), including HIV, has led to considerable focus on the development of vaginal microbicides. While many such products are being tested for safety and effectiveness, clinical trials generally overlook another key factor in a product's impact on infection rates-its acceptability to users. A Phase I clinical trial of a microbicidal gel included an assessment of the product's acceptability among 27 low-risk participants. Information on acceptability was gathered from structured interviews, participants' daily diaries and unstructured exit interviews. Participants reported only minor side effects of product use, such as itching, burning and difficulty urinating; two women developed candida infections while participating in the study. None of the side effects could be conclusively linked to use of the gel. Some women noted product discharge and messiness as drawbacks of the method, but this experience varied according to how often the women applied the gel. For example, one-third of those who used it once daily said that at least some of the time, it was too "wet or drippy," compared with two-thirds of women who inserted the gel twice a day. However, participants considered these "nuisance factors" that could be outweighed by the potential protective characteristics of the product. The majority reported that they would use the product if it were available and proven efficacious, and if they perceived that they were at risk of STD infection. Additional testing of this product is urgently needed. Furthermore, as other products approach Phase I testing, acceptability assessments should be a key component of clinical trials.

  7. Perceived Discrimination and Health: A Meta-Analytic Review

    PubMed Central

    Pascoe, Elizabeth A.; Richman, Laura Smart

    2009-01-01

    Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study’s contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes. PMID:19586161

  8. Effect of colour of drugs: systematic review of perceived effect of drugs and of their effectiveness.

    PubMed

    de Craen, A J; Roos, P J; de Vries, A L; Kleijnen, J

    To assess the impact of the colour of a drug's formulation on its perceived effect and its effectiveness and to examine whether antidepressant drugs available in the Netherlands are different in colour from hypnotic, sedative, and anxiolytic drugs. Systematic review of 12 published studies. Six studies examined the perceived action of different coloured drugs and six the influence of the colour of a drug on its effectiveness. The colours of samples of 49 drugs affecting the central nervous system were assessed using a colour atlas. Perceived stimulant action versus perceived depressant action of colour of drugs; the trials that assessed the effect of drugs in different colours were done in patients with different diseases and had different outcome measures. The studies on perceived action of coloured drugs showed that red, yellow, and orange are associated with a stimulant effect, while blue and green are related to a tranquillising effect. The trials that assessed the impact of the colour of drugs on their effectiveness showed inconsistent differences between colours. The quality of the methods of these trials was variable. Hypnotic, sedative, and anxiolytic drugs were more likely than antidepressants to be green, blue, or purple. Colours affect the perceived action of a drug and seem to influence the effectiveness of a drug. Moreover, a relation exists between the colouring of drugs that affect the central nervous system and the indications for which they are used. Research contributing to a better understanding of the effect of the colour of drugs is warranted.

  9. Perceived causality, force, and resistance in the absence of launching.

    PubMed

    Hubbard, Timothy L; Ruppel, Susan E

    2017-04-01

    In the launching effect, a moving object (the launcher) contacts a stationary object (the target), and upon contact, the launcher stops and the target begins moving in the same direction and at the same or slower velocity as previous launcher motion (Michotte, 1946/1963). In the study reported here, participants viewed a modified launching effect display in which the launcher stopped before or at the moment of contact and the target remained stationary. Participants rated perceived causality, perceived force, and perceived resistance of the launcher on the target or the target on the launcher. For launchers and for targets, increases in the size of the spatial gap between the final location of the launcher and the location of the target decreased ratings of perceived causality and ratings of perceived force and increased ratings of perceived resistance. Perceived causality, perceived force, and perceived resistance exhibited gradients or fields extending from the launcher and from the target and were not dependent upon contact of the launcher and target. Causal asymmetries and force asymmetries reported in previous studies did not occur, and this suggests that such asymmetries might be limited to typical launching effect stimuli. Deviations from Newton's laws of motion are noted, and the existence of separate radii of action extending from the launcher and from the target is suggested.

  10. The mediating role of self-efficacy in the relationship between premotivational cognitions and engagement in multiple health behaviors: a theory-based cross-sectional study among township residents in South Africa

    PubMed Central

    Tshuma, Ndumiso; Muloongo, Keith; Nkwei, Emile S; Alaba, Olufunke A; Meera, Maheedhariah S; Mokgobi, Maboe G; Nyasulu, Peter S

    2017-01-01

    Background Noncommunicable diseases (NCDs) are one of the major global health challenges in developed countries and are rapidly increasing globally. Perception of self-efficacy is important for complex activities and long-term changes in health behavior. This study aimed to determine whether self-efficacy mediates the effect of individual beliefs (perceived severity, susceptibility, benefits and barriers) among informal settlement residents’ health behavior in relation to the prevention and management of NCDs. Methods A cross-sectional survey was conducted using a closed-ended questionnaire among informal settlement residents in Diepsloot, Johannesburg. The proposed model was tested using structural equation modeling (AMOS software). Results A total of 2,277 participants were interviewed during this survey, consisting of 1,236 (54.3%) females, with the majority of them aged between 20 and 29 years. All constructs in the questionnaire had a good reliability with a Cronbach’s alpha of >0.7. Perceived benefits and perceived barriers were the strongest predictors of self-efficacy, with the highest beta values of 0.14 and 0.15, respectively. Once associated with perceived self-efficacy, the direct effect of perceived susceptibility and perceived benefits on health behavior was statistically nonsignificant (P=0.0894 and P=0.2839, respectively). Perceived benefits and perceived susceptibility were totally mediated by self-efficacy. The indirect effects of perceived severity and perceived barriers (through self-efficacy) on health behavior were significant. Thus, perceived severity and perceived barriers were partially mediated by self-efficacy. Conclusion Perceived susceptibility and perceived benefits did not affect health behavior unless associated with self-efficacy. In contrast, individual perception of the seriousness of NCDs and perceived barriers might still have a direct influence on health behavior even if the person does not feel able to prevent NCDs. However, this influence would be more significant when perceived severity and perceived barriers of NCDs are associated with self-efficacy. PMID:28176923

  11. The mediating role of self-efficacy in the relationship between premotivational cognitions and engagement in multiple health behaviors: a theory-based cross-sectional study among township residents in South Africa.

    PubMed

    Tshuma, Ndumiso; Muloongo, Keith; Nkwei, Emile S; Alaba, Olufunke A; Meera, Maheedhariah S; Mokgobi, Maboe G; Nyasulu, Peter S

    2017-01-01

    Noncommunicable diseases (NCDs) are one of the major global health challenges in developed countries and are rapidly increasing globally. Perception of self-efficacy is important for complex activities and long-term changes in health behavior. This study aimed to determine whether self-efficacy mediates the effect of individual beliefs (perceived severity, susceptibility, benefits and barriers) among informal settlement residents' health behavior in relation to the prevention and management of NCDs. A cross-sectional survey was conducted using a closed-ended questionnaire among informal settlement residents in Diepsloot, Johannesburg. The proposed model was tested using structural equation modeling (AMOS software). A total of 2,277 participants were interviewed during this survey, consisting of 1,236 (54.3%) females, with the majority of them aged between 20 and 29 years. All constructs in the questionnaire had a good reliability with a Cronbach's alpha of >0.7. Perceived benefits and perceived barriers were the strongest predictors of self-efficacy, with the highest beta values of 0.14 and 0.15, respectively. Once associated with perceived self-efficacy, the direct effect of perceived susceptibility and perceived benefits on health behavior was statistically nonsignificant ( P =0.0894 and P =0.2839, respectively). Perceived benefits and perceived susceptibility were totally mediated by self-efficacy. The indirect effects of perceived severity and perceived barriers (through self-efficacy) on health behavior were significant. Thus, perceived severity and perceived barriers were partially mediated by self-efficacy. Perceived susceptibility and perceived benefits did not affect health behavior unless associated with self-efficacy. In contrast, individual perception of the seriousness of NCDs and perceived barriers might still have a direct influence on health behavior even if the person does not feel able to prevent NCDs. However, this influence would be more significant when perceived severity and perceived barriers of NCDs are associated with self-efficacy.

  12. [Treatment side effects and compliance in patients with depression].

    PubMed

    Petrova, N N; Kucher, E O

    2012-01-01

    The impact of treatment side-effects on the compliance was studied in 85 depressive patients with different mental disorders - recurrent depressive disorder, postschizophrenic depression and organic affective disorder. The comparison of objective and subjective evaluations of compliance and a comparative analysis of the level of compliance, with its dependence on the treatment specifics, in different diseases were done. A significant role of efficacy and treatment side-effects was identified. The levels of "mental" and "autonomous" side-effects were highest in the treatment of depression: patients with postschizophrenic depression had the highest risk in respect of maintenance treatment; patients with recurrent depressive disorder and organic (affective) disorder were more tolerant to the treatment side-effects and their treatment, including the maintenance therapy, was rather effective. The compliance of all patients with depression was negatively correlated with the severity of side-effects of pharmacotherapy. The greatest side-effects and the lowest level of compliance were observed in the complex treatment with antidepressants and atypical neuroleptics. The effect of side-effects on the compliance was dependent on their severity and subjective tolerability and, to a lesser extent, on the amount of drugs.

  13. Determining the orientation of depth-rotated familiar objects.

    PubMed

    Niimi, Ryosuke; Yokosawa, Kazuhiko

    2008-02-01

    How does the human visual system determine the depth-orientation of familiar objects? We examined reaction times and errors in the detection of 15 degrees differences in the depth orientations of two simultaneously presented familiar objects, which were the same objects (Experiment 1) or different objects (Experiment 2). Detection of orientation differences was best for 0 degrees (front) and 180 degrees (back), while 45 degrees and 135 degrees yielded poorer results, and 90 degrees (side) showed intermediate results, suggesting that the visual system is tuned for front, side and back orientations. We further found that those advantages are due to orientation-specific features such as horizontal linear contours and symmetry, since the 90 degrees advantage was absent for objects with curvilinear contours, and asymmetric object diminished the 0 degrees and 180 degrees advantages. We conclude that the efficiency of visually determining object orientation is highly orientation-dependent, and object orientation may be perceived in favor of front-back axes.

  14. Polarization Perception Device

    NASA Technical Reports Server (NTRS)

    Whitehead, Victor S. (Inventor); Coulson, Kinsell L. (Inventor)

    1997-01-01

    A polarization perception device comprises a base and a polarizing filter having opposite broad sides and a centerline perpendicular thereto. The filter is mounted on the base for relative rotation and with a major portion of the area of the filter substantially unobstructed on either side. A motor on the base automatically moves the filter angularly about its centerline at a speed slow enough to permit changes in light transmission by virtue of such movement to be perceived as light-dark pulses by a human observer, but fast enough so that the light phase of each such pulse occurs prior to fading of the light phase image of the preceding pulse from the observer's retina. In addition to an observer viewing a scene in real time through the filter while it is so angularly moved, or instead of such observation, the scene can be photographed, filmed or taped by a camera whose lens is positioned behind the filter.

  15. Polarization perception device

    NASA Technical Reports Server (NTRS)

    Whitehead, Victor S. (Inventor); Coulson, Kinsel L. (Inventor)

    1992-01-01

    A polarization perception device comprises a base and a polarizing filter having opposite broad sides and a centerline perpendicular thereto. The filter is mounted on the base for relative rotation and with a major portion of the area of the filter substantially unobstructed on either side. A motor on the base automatically moves the filter angularly about its centerline at a speed slow enough to permit changes in light transmission by virtue of such movement to be perceived as light-dark pulses by a human observer, but fast enough so that the light phase of each such pulse occurs prior to fading of the light phase image of the preceding pulse from the observer's retina. In addition to an observer viewing a scene in real time through the filter while it is so angularly moved, or instead of such observation, the scene can be photographed, filmed or taped by a camera whose lens is positioned behind the filter.

  16. Synergistic effect of interaction between perceived health and social activity on depressive symptoms in the middle-aged and elderly: a population-based longitudinal study.

    PubMed

    Chun, Sung-Youn; Han, Kyu-Tae; Lee, Seo Yoon; Kim, Chan Ok; Park, Eun-Cheol

    2015-03-13

    To examine the synergistic effect of interaction between perceived health and social activity on depressive symptoms. We investigated whether the interaction between perceived health and social activity has a synergistic effect on depressive symptoms in the middle-aged and elderly using data from 6590 respondents aged 45 and older in the Korean Longitudinal Study on Aging (KLoSA), 2006-2012. A generalised linear mixed-effects model was used to investigate the association in a longitudinal data form. Depressive symptoms were measured using the Center for Epidemiological Studies Depression 10 Scale (CES-D10). Perceived health and level of social activity were categorical variables with three values. Participation in six social activities was assessed. Interactions between perceived health status and social activity were statistically significant for almost all social activity/perceived health combinations. Addition of the interaction term significantly decreased CES-D10 scores, confirming the synergistic effect of the interaction between perceived health status and social activity ('normal×moderate', β=-0.1826; 'poor×moderate', β=-0.5739; 'poor×active', β=-0.8935). In addition, we performed stratified analyses by region: urban or rural. In urban respondents, the additional effect of the interaction term decreased CES-D10 scores and all social activity/perceived health combinations were statistically significant ('normal×moderate', β=-0.2578; 'normal×active', β=-0.3945; 'poor×moderate', β=-0.5739; 'poor×active', β=-0.8935). In rural respondents, only one social activity/perceived health combination was statistically significant, and the additional effect of the interaction term showed no consistent trend on CES-D10 scores. The interaction between perceived health and social activity has a synergistic effect on depressive symptoms; the additional effect of the interaction term significantly decreased CES-D10 scores in our models. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Exploring the associations between drug side-effects and therapeutic indications.

    PubMed

    Wang, Fei; Zhang, Ping; Cao, Nan; Hu, Jianying; Sorrentino, Robert

    2014-10-01

    Drug therapeutic indications and side-effects are both measurable patient phenotype changes in response to the treatment. Inferring potential drug therapeutic indications and identifying clinically interesting drug side-effects are both important and challenging tasks. Previous studies have utilized either chemical structures or protein targets to predict indications and side-effects. In this study, we compared drug therapeutic indication prediction using various information including chemical structures, protein targets and side-effects. We also compared drug side-effect prediction with various information sources including chemical structures, protein targets and therapeutic indication. Prediction performance based on 10-fold cross-validation demonstrates that drug side-effects and therapeutic indications are the most predictive information source for each other. In addition, we extracted 6706 statistically significant indication-side-effect associations from all known drug-disease and drug-side-effect relationships. We further developed a novel user interface that allows the user to interactively explore these associations in the form of a dynamic bipartitie graph. Many relationship pairs provide explicit repositioning hypotheses (e.g., drugs causing postural hypotension are potential candidates for hypertension) and clear adverse-reaction watch lists (e.g., drugs for heart failure possibly cause impotence). All data sets and highly correlated disease-side-effect relationships are available at http://astro.temple.edu/∼tua87106/druganalysis.html. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Does age affect the stress and coping process? Implications of age differences in perceived control.

    PubMed

    Aldwin, C M

    1991-07-01

    The perceived controllability of situations is thought to influence the types of coping strategies used, and thus is important in adaptive processes. Elderly individuals are widely perceived to have less control over their environment than other adults. This lack of perceived control should have adverse affects on how they cope with stressful situations. However, most studies have shown that older adults differ little from younger adults in their approaches to coping with stress. This contradiction was investigated in a sample of 228 community-residing adults with a mean age of 42.16 (SD = 14.88). Path analysis revealed that appraisals and attributions do affect the use of coping strategies such as instrumental action and escapism in the expected directions, and age is negatively associated with perceived control. However, there was an independent and negative relationship between age and the reported use of escapist coping strategies, which mitigated the adverse effects of perceived lack of control. Neither age nor perceived controllability had direct effects on depression, but they had indirect effects through their influence on the use of coping strategies and perceived efficacy.

  19. Pharmacogenomic and clinical data link non-pharmacokinetic metabolic dysregulation to drug side effect pathogenesis

    PubMed Central

    Zielinski, Daniel C.; Filipp, Fabian V.; Bordbar, Aarash; Jensen, Kasper; Smith, Jeffrey W.; Herrgard, Markus J.; Mo, Monica L.; Palsson, Bernhard O.

    2015-01-01

    Drug side effects cause a significant clinical and economic burden. However, mechanisms of drug action underlying side effect pathogenesis remain largely unknown. Here, we integrate pharmacogenomic and clinical data with a human metabolic network and find that non-pharmacokinetic metabolic pathways dysregulated by drugs are linked to the development of side effects. We show such dysregulated metabolic pathways contain genes with sequence variants affecting side effect incidence, play established roles in pathophysiology, have significantly altered activity in corresponding diseases, are susceptible to metabolic inhibitors and are effective targets for therapeutic nutrient supplementation. Our results indicate that metabolic dysregulation represents a common mechanism underlying side effect pathogenesis that is distinct from the role of metabolism in drug clearance. We suggest that elucidating the relationships between the cellular response to drugs, genetic variation of patients and cell metabolism may help managing side effects by personalizing drug prescriptions and nutritional intervention strategies. PMID:26055627

  20. Radiation Therapy Side Effects

    Cancer.gov

    Radiation therapy has side effects because it not only kills or slows the growth of cancer cells, it can also affect nearby healthy cells. Many people who get radiation therapy experience fatigue. Other side effects depend on the part of the body that is being treated. Learn more about possible side effects.

  1. Influence of opioid-related side effects on disability, mood, and opioid misuse risk among patients with chronic pain in primary care.

    PubMed

    Jamison, Robert N; Dorado, Kathleen; Mei, Anna; Edwards, Robert R; Martel, Marc O

    2017-03-01

    There is increasing concern among primary care practitioners about the use of opioids for chronic pain, including their adverse effects, but little attention has been given to how reports of side effects from prescription medication can contribute to outcomes among patients with chronic pain. The aim of this study was to investigate the impact of frequently reported side effects on mood, disability, and opioid misuse in patients with chronic pain prescribed opioids within primary care. Two hundred (N = 200) patients with chronic pain taking opioids for pain were recruited into the study. All patients completed baseline measures and a monthly side effects checklist once a month for 6 months. Patients were divided evenly based on a median split of the number of endorsed side effects over 6 months. The subjects repeated the baseline measures at the end of the study period. Over time, reports of medication side effects tended to decrease, but differences in frequency of reported side effects from baseline to follow-up (6-month time) were not significant, and the order of the frequency of the reported side effects remained similar. Patients who reported significant medication-related adverse effects reported significantly greater activity interference, negative affect, and catastrophizing compared with those with fewer side effects ( P < 0.01). In addition, those patients with pain who reported more side effects showed significantly higher scores on opioid misuse risk ( P < 0.001). This study demonstrates the important role of monitoring medication-related side effects among patients with chronic pain who are prescribed opioid medication for pain within primary care.

  2. Influence of opioid-related side effects on disability, mood, and opioid misuse risk among patients with chronic pain in primary care

    PubMed Central

    Jamison, Robert N.; Dorado, Kathleen; Mei, Anna; Edwards, Robert R.; Martel, Marc O.

    2017-01-01

    Abstract Background: There is increasing concern among primary care practitioners about the use of opioids for chronic pain, including their adverse effects, but little attention has been given to how reports of side effects from prescription medication can contribute to outcomes among patients with chronic pain. The aim of this study was to investigate the impact of frequently reported side effects on mood, disability, and opioid misuse in patients with chronic pain prescribed opioids within primary care. Methods: Two hundred (N = 200) patients with chronic pain taking opioids for pain were recruited into the study. All patients completed baseline measures and a monthly side effects checklist once a month for 6 months. Patients were divided evenly based on a median split of the number of endorsed side effects over 6 months. The subjects repeated the baseline measures at the end of the study period. Results: Over time, reports of medication side effects tended to decrease, but differences in frequency of reported side effects from baseline to follow-up (6-month time) were not significant, and the order of the frequency of the reported side effects remained similar. Patients who reported significant medication-related adverse effects reported significantly greater activity interference, negative affect, and catastrophizing compared with those with fewer side effects (P < 0.01). In addition, those patients with pain who reported more side effects showed significantly higher scores on opioid misuse risk (P < 0.001). Discussion: This study demonstrates the important role of monitoring medication-related side effects among patients with chronic pain who are prescribed opioid medication for pain within primary care. PMID:29392205

  3. Effect of perceived organizational support on suicidal ideation of young employees: The mediator role of self-esteem.

    PubMed

    Sang, Jinyan; Ji, Yongbao; Li, Ping; Zhao, Hao

    2017-09-01

    This study aimed to explore the relationships among perceived organizational support, self-esteem, and suicidal ideation of young employees. A total of 447 unmarried employees completed the survey of perceived organizational support, Rosenberg self-esteem scale, and suicide ideation scale. The results revealed that perceived organizational support, self-esteem, and suicidal ideation were significantly correlated with each other. Stepwise regression analysis and path analysis both indicated that self-esteem partially mediated the effect of perceived organizational support on suicidal ideation.

  4. Performing well in an evaluative situation: the roles of perceived competence and task-irrelevant interfering thoughts.

    PubMed

    Van Yperen, Nico W

    2007-12-01

    This research expands on previous research by arguing and demonstrating that high perceived competence buffers the detrimental effects of an evaluative situation. In Study 1 (n=75, 38.7% male), the situation (evaluative vs. non-evaluative) and perceived competence (high vs. low) were manipulated, whereas in Study 2 (n=42, 33.3% male), perceived competence relied on naturally occurring differences in perceived competence. The results of Study 1 indicate that people may underachieve in an evaluative situation. More importantly, in Study 2 it was demonstrated that such an evaluative situation had only a negative effect on test performance among individuals low in perceived competence. The occurrence of task-irrelevant interfering thoughts during task completion accounted for this inimical effect of an evaluative situation on test performance among these individuals.

  5. Side effects of low-dose pyridostigmine bromide are not related to cholinesterase inhibition.

    PubMed

    Cook, M R; Gerkovich, M M; Sastre, A; Graham, C

    2001-12-01

    Pretreatment with pyridostigmine bromide (PB) has become part of standard military procedures for protection against the effects of possible chemical warfare attack. The purpose of the work reported here was to quantify the type, intensity and frequency of side effects of low-dose PB, and to examine factors that predict the intensity and frequency of side effects. A double-blind, cross-over, placebo (PL)-controlled design was used. Of the 67 subjects, 33 received 30 mg PB every 8 h for 13 doses, and 34 received 60 mg on the same schedule. Order of PB and PL administration was counterbalanced. Overall, side effects were mild, even at the 60-mg dose level. More side effects were reported when volunteers were taking PB than when they were taking placebo. Women reported more symptoms than men. Neither cholinesterase inhibition nor plasma levels of PB predicted side effect scores during the PB week; the best predictor of side effect scores during the PB week was side effect scores during the PL week. PB is well tolerated by healthy young people, even when twice the recommended military dose is administered.

  6. Effectiveness of the 4-H Program as Perceived by Parents of 4-H Participants

    ERIC Educational Resources Information Center

    Radhakrishna, Rama; Foley, Caitlin; Ingram, Patreese; Ewing, John C.

    2013-01-01

    The study reported here examined the effectiveness of 4-H program as perceived by parents of program participants. Descriptive-correlational design was employed, with data collected using a mail survey. Parents perceived 4-H as an effective organization in teaching life skills to youth. Significant relationships were found between parents' skills…

  7. Two sides to the story: Adolescent and parent views on harmful intention in defining school bullying.

    PubMed

    Thomas, Hannah J; Connor, Jason P; Baguley, Chantelle M; Scott, James G

    2017-07-01

    Bullying is defined as repeated negative actions involving a power differential, and intention to harm. There is limited research on harmful intention as a definitional component. This study explored the role of the perpetrator's harmful intention and the target's perception of harmful intention. Some 209 students (M = 14.5 years; 66.5% female) and 447 parents (M = 46.4 years; 86.4% female) were randomly assigned in an online survey. Participants assessed the likelihood of bullying in five hypothetical scenarios (physical, verbal, rumor, exclusion, and cyber) across five intention conditions, that also involved repetition and a power differential. The five intention conditions were: 1) harm intended by perpetrator (I) and perceived as intended to harm by target (I) [II condition]; 2) harm not intended by perpetrator (N) but perceived as intended to harm by target (I) [NI condition]; 3) harm intended by perpetrator (I) but not perceived as intended to harm by target (N) [IN condition]; 4) harm not intended by perpetrator (N) and not perceived as intended to harm by target N [NN condition]; and 5) a control which did not state any actual or perceived harmful intention [C condition]. For students and parents, the perpetrator's harmful intention and the target's perception of harmful intention were important when considering whether a peer interaction constituted bullying. These findings confirm the applicability of the three-part definition of bullying, and highlight the importance of assessing these two dimensions of harmful intention when determining whether a problematic peer interaction should be regarded as bullying. Aggr. Behav. 43:352-363, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  8. Chinese Migrant Adolescents' Perceived Discrimination and Psychological Well-Being: The Moderating Roles of Group Identity and the Type of School.

    PubMed

    Liu, Xia; Zhao, Jingxin

    2016-01-01

    Perceived discrimination can be harmful to migrant adolescents in China. However, little is known about the processes through which discrimination may be linked to decreased well-being in Chinese migrant adolescents. This study examined the relationship between perceived discrimination and three indices of psychological well-being (self-esteem, life satisfaction, collective self-esteem) in 798 Chinese migrant adolescents (49.4% from public schools). Group identity affirmation and belonging (GIAB) was examined as a protective factor that was expected to alleviate the negative effects of perceived discrimination on well-being, and the type of school was investigated as a potential moderator of the associations of interest. The results indicate that perceived discrimination was negatively linked to the three indices of psychological well-being and that the negative effects of perceived discrimination on psychological well-being were particularly salient for migrant adolescents attending public schools. Additionally, GIAB emerged as a protective buffer against perceived discrimination's negative effects on collective well-being.

  9. Chinese Migrant Adolescents’ Perceived Discrimination and Psychological Well-Being: The Moderating Roles of Group Identity and the Type of School

    PubMed Central

    Liu, Xia; Zhao, Jingxin

    2016-01-01

    Perceived discrimination can be harmful to migrant adolescents in China. However, little is known about the processes through which discrimination may be linked to decreased well-being in Chinese migrant adolescents. This study examined the relationship between perceived discrimination and three indices of psychological well-being (self-esteem, life satisfaction, collective self-esteem) in 798 Chinese migrant adolescents (49.4% from public schools). Group identity affirmation and belonging (GIAB) was examined as a protective factor that was expected to alleviate the negative effects of perceived discrimination on well-being, and the type of school was investigated as a potential moderator of the associations of interest. The results indicate that perceived discrimination was negatively linked to the three indices of psychological well-being and that the negative effects of perceived discrimination on psychological well-being were particularly salient for migrant adolescents attending public schools. Additionally, GIAB emerged as a protective buffer against perceived discrimination’s negative effects on collective well-being. PMID:26731529

  10. Crack in the Pipeline: Why Female Underrepresented Racial Minority College Students Leave Engineering

    NASA Astrophysics Data System (ADS)

    Vazquez-Akim, Jenny Amanda

    Female and underrepresented racial minority (URM) students are indicating their interest in STEM fields at increasing rates, yet when examining the engineering discipline specifically disparities in degree completion rates between female URM students and others in the racial or gender majority are even more severe. This study explored female URM college student perceptions of school and classroom climate and the impact these factors had on their decision to persist or to leave engineering. Through a qualitative interview methodology grounded in Social Cognitive Career Theory (SCCT), this study explored factors including self-efficacy, perceived barriers and supports, other-group orientation and outcome expectations that influenced students' academic decision-making. Interview participants consisted of 5 female URM students that matriculated into an engineering major at a top tier, private university but subsequently left the discipline in pursuit of another field of study. The perceptions of this target population were juxtaposed with interview data from 4 male non-URM, 4 female non-URM, and 4 male URM leavers in addition to 7 female URM engineering persisters. As a final component in the research design, 9 undergraduate engineering faculty were interviewed to understand their perceptions of why female URM students leave engineering in pursuit of other disciplines. With faculty being a central component of the academic environment, their perceptions of female URM students, as well as how they view their role in these students' retention, provided insight on this other side of retention question. Salient findings emerged that differentiated female URM leavers' experiences in engineering from other student populations. Female URM leavers were less likely to call upon self-directed learning strategies in response to academic challenges. Perceived academic barriers such as heavy course loads, lack of connection between material and application, and perceived academic deficits deterred these students from persisting in the field. A perceived lack of academic preparation also inhibited female URM students from participating actively in class. Additionally, while targeted support programs were effective in connecting female URM students with their peers and such programs contributed to an overall sense of diversity at the school, a lack of diversity was felt when inside the classroom.

  11. The Effect of a Web Seal's Placement, Color, and Size, and the E-Retailer's Name on Intention to Purchase Online as Mediated by Perceived Trust and Perceived Risk

    ERIC Educational Resources Information Center

    Stewart, Roy

    2012-01-01

    This study investigates the effects of the e-retailer's "Website Name," and a third party assurance seal's position, color, and size on "Intention to Purchase Online". Since "Intention to Purchase Online" is influenced by both "Perceived Trust" and "Perceived Risk," and since…

  12. Factors affecting patient's perception of anticancer treatments side-effects: an observational study.

    PubMed

    Russo, Stefania; Cinausero, Marika; Gerratana, Lorenzo; Bozza, Claudia; Iacono, Donatella; Driol, Pamela; Deroma, Laura; Sottile, Roberta; Fasola, Gianpiero; Puglisi, Fabio

    2014-02-01

    Analysis of relative importance of side effects of anticancer therapy is extremely useful in the process of clinical decision making. There is evidence that patients' perception of the side effects of anticancer treatments changes over time. Aim of this study was to evaluate the cancer patients' perceptions of physical and non-physical side effects of contemporary anticancer therapy. Four hundred and sixty-four patients entered the study (153 men and 311 women). Participants were asked to rank their side effects in order of distress by using two sets of cards naming physical and non-physical effects, respectively. Influencing factors, including treatment and patient characteristics, were also analysed. Patients ranked the non-physical side effect 'Affects my family or partner' first. 'Constantly tired' and 'Loss of hair' were ranked second and third, respectively. Significant differences from previous studies on this topic emerged. In particular, 'Vomiting', a predominant concern in previous studies, almost disappeared, whereas 'Nausea' and 'Loss of hair' remained important side effects in the patients' perception. Interestingly, marital status was predominant in driving patients' perception, being associated with several side effects ('Constantly tired', 'Loss of appetite', 'Affects my work/Home duties', 'Affects my social activities', 'Infertility'). Other significant factors influencing patient's perception of side effects included age, disease characteristics and ongoing anticancer therapy. This study provided information on current status of patients' perceptions of side effects of anticancer treatment. These results could be used in pre-treatment patient education and counselling.

  13. Addressing changed sexual functioning in cancer patients: A cross-sectional survey among Dutch oncology nurses.

    PubMed

    Krouwel, E M; Nicolai, M P J; van Steijn-van Tol, A Q M J; Putter, H; Osanto, S; Pelger, R C M; Elzevier, H W

    2015-12-01

    In most types of cancer, the disease and its treatment can result in altered sexual function (SF). Oncology nurses are strategically placed to address SF since they have frequent patient interaction. Our aim was to establish their knowledge about and attitudes to SF in oncology care and identify their perceived barriers to addressing the subject. A 37-item questionnaire was administered during the 2012 Dutch Oncology Nursing Congress and mailed to 241 Dutch oncology nursing departments. The majority of 477 nurses (87.6%) agreed that discussing SF is their responsibility. Discussing SF routinely is performed by 33.4% of these nurses, consultations mainly consisted of mentioning treatment side-effects affecting SF (71.3%). There were significant differences depending on experience, knowledge, age, academic degree and department policy. Nurses ≤44 years old (p < 0.001), with <10 years oncology experience (p = 0.001), insufficient knowledge (p < 0.001), no academic degree (p < 0.001), and in whose department policy was lacking or inadequate (p < 0.001), were less comfortable discussing SF. Barriers included lack of training, presence of a third party and no angle or motive for initiating discussion. Findings suggest oncology nurses consider counselling on sexual issues to be an important responsibility, in line with discussing other side-effects caused by the disease or its treatment. Nevertheless, cancer patients may not routinely be receiving a sexual health evaluation by oncology nurses. Results emphasize the potential benefit of providing knowledge, including practical training and a complete department protocol. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts.

    PubMed

    Cahill, Sean; Taylor, S Wade; Elsesser, Steven A; Mena, Leandro; Hickson, DeMarc; Mayer, Kenneth H

    2017-11-01

    Gay and bisexual men and other men who have sex with men (MSM) account for more than two thirds of new HIV infections in the U.S., with Black MSM experiencing the greatest burden. Antiretroviral pre-exposure prophylaxis (PrEP) can reduce MSM's vulnerability to HIV infection. Uptake of PrEP has been limited, particularly among racial and ethnic minority MSM. Four semi-structured focus groups with gay and bisexual men and other MSM at risk for HIV infection were convened in Boston and Jackson in late 2013. The analysis plan utilized a within-case, across-case approach to code and analyze emerging themes, and to compare results across the two cities. Participants recruited in Jackson were primarily Black gay men, while Boston participants were mostly non-Hispanic White gay men. Participants in both sites shared concerns about medication side effects and culturally insensitive health care for gay men. Jackson participants described stronger medical mistrust, and more frequently described experiences of anti-gay and HIV related stigma. Multiple addressable barriers to PrEP uptake were described. Information about side effects should be explicitly addressed in PrEP education campaigns. Providers and health departments should address medical mistrust, especially among Black gay and bisexual men and other MSM, in part by training providers in how to provide affirming, culturally competent care. Medicaid should be expanded in Mississippi to cover low-income young Black gay and bisexual men and other MSM.

  15. Depressed mood in breast cancer survivors: associations with physical activity, cancer-related fatigue, quality of life, and fitness level.

    PubMed

    Galiano-Castillo, Noelia; Ariza-García, Angelica; Cantarero-Villanueva, Irene; Fernández-Lao, Carolina; Díaz-Rodríguez, Lourdes; Arroyo-Morales, Manuel

    2014-04-01

    One out of five cancer survivors suffer from depression after oncology treatment. The aim of this study was to examine the relationship between depression and quality of life (QoL), cancer-related symptoms, physical activity level, health-related fitness, and salivary flow rate in breast cancer survivors. 108 breast cancer survivors in the year after the conclusion of treatment were included in this cross-sectional study. Demographic and clinically relevant information, cancer-related fatigue (Piper Fatigue Scale), QoL (QLQ-Br23 module), pain intensity VAS scale, salivary flow rate, physical activity level (Minnesota Leisure Time Physical Activity Questionnaire), and health-related fitness were assessed in all participants. Depressed mood was measured with the Profile of Mood States (POMS) Depression subscale. Significant positive correlations between depressed mood and fatigue, systemic side effects, perceived shoulder pain, and breast-arms symptoms (r ranged between .57 and .28, P < .01) were found. In addition, significant negative correlations between depressed mood and body image, future perspective, force handgrip, and physical activity level (r ranged between -.41 and -.19; p < .05) were found. Regression analyses revealed that cancer-related fatigue, physical activity level, systemic side effects, and body image were significant predictors of depressed mood, and when combined, they explained 39.6% of the variance in depressed mood. Cancer-related fatigue, physical activity level, and QoL partially explain the variability of depressed mood in breast cancer survivors. This paper facilitates a better understanding of the relationship between depressed mood and possible factors associated with it. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Malaria Chemoprophylaxis: Strategies for Risk Groups

    PubMed Central

    Schlagenhauf, Patricia; Petersen, Eskild

    2008-01-01

    The risk of malaria for travelers varies from region to region and depends on the intensity of transmission, the duration of the stay in the area of endemicity, the style of travel, and the efficacy of preventive measures. The decision to recommend chemoprophylaxis to travelers to areas with a low risk of malarial infection is especially difficult because the risk of infection must be balanced with the risk of experiencing side effects. If the risk of side effects by far exceeds the risk of infection, the traveler needs information on measures against mosquito bites and advice on prompt diagnosis and self-treatment. The risk is difficult to quantify, and the absolute risk for travelers to most areas is not known, especially because the populations at risk are unknown. We propose here that the best approximation of the risk to the traveler to a specific area is to use the risk to the indigenous population as a guideline for the risk to the traveler, and we provide examples on how risk in the indigenous population can be used for the estimation of risk of malarial infection for travelers. Special groups are long-term visitors and residents, who often perceive risk differently, cease using chemoprophylaxis, and rely on self-diagnosis and treatment. For long-term visitors, the problem of fake drugs needs to be discussed. Strategies for chemoprophylaxis and self-treatment of pregnant women and small children are discussed. So far, malaria prophylaxis is recommended to prevent Plasmodium falciparum infections, and primaquine prophylaxis against persistent Plasmodium vivax and Plasmodium ovale infections in travelers is not recommended. PMID:18625682

  17. Safety, acceptability, and feasibility of a single-visit approach to cervical-cancer prevention in rural Thailand: a demonstration project.

    PubMed

    Gaffikin, L; Blumenthal, P D; Emerson, M; Limpaphayom, K

    2003-03-08

    To increase screening and treatment coverage, innovative approaches to cervical-cancer prevention are being investigated in rural Thailand. We assessed the value of a single-visit approach combining visual inspection of the cervix with acetic acid wash (VIA) and cryotherapy. 12 trained nurses provided services in mobile (village health centre-based) and static (hospital-based) teams in four districts of Roi-et Province, Thailand. Over 7 months, 5999 women were tested by VIA. If they tested positive, after counselling about the benefits, potential risks, and probable side-effects they were offered cryotherapy. Data measuring safety, acceptability, feasibility, and effort to implement the programme were gathered. The VIA test-positive rate was 13.3% (798/5999), and 98.5% (609/618) of those eligible accepted immediate treatment. Overall, 756 women received cryotherapy, 629 (83.2%) of whom returned for their first follow-up visit. No major complications were recorded, and 33 (4.4%) of those treated returned for a perceived problem. Only 17 (2.2%) of the treated women needed clinical management other than reassurance about side-effects. Both VIA and cryotherapy were highly acceptable to the patients (over 95% expressed satisfaction with their experience). At their 1-year visit, the squamocolumnar junction was visible to the nurses, and the VIA test-negative rate was 94.3%. A single-visit approach with VIA and cryotherapy seems to be safe, acceptable, and feasible in rural Thailand, and is a potentially efficient method of cervical-cancer prevention in such settings.

  18. Pilot study: whole body manual subcutaneous adipose tissue (SAT) therapy improved pain and SAT structure in women with lipedema.

    PubMed

    Herbst, Karen L; Ussery, Christopher; Eekema, Alyna

    2017-09-20

    Background Lipedema is a common painful subcutaneous adipose tissue (SAT) disorder in women affecting the limbs. SAT therapy is a manual therapy to improve soft tissue quality. Objective Determine if SAT therapy improves pain and structure of lipedema SAT. Design Single arm prospective pilot study. Setting Academic medical center. Patients Seven women, 46 ± 5 years, weight 90 ± 19 kg, with lipedema. Intervention Twelve 90-min SAT therapy sessions over 4 weeks. Outcomes Dual X-ray absorptiometry (DXA) scans, SAT ultrasound (Vevo 2100), leg volumetrics, skin caliper assessment, tissue exam, weight, resting metabolic rate, pain assessment, lower extremity functional scale (LEFS) and body shape questionnaire (BSQ) at baseline and end of study. Results Weight, resting metabolic rate and BSQ did not change significantly. Limb fat over total body fat mass (p = 0.08) and trunk fat over total body mass trended down from baseline (p = 0.08) by DXA. Leg volume and caliper assessments in eight of nine areas (p < 0.007), LEFS (p = 0.002) and average pain (p = 0.007) significantly decreased from baseline. Fibrosis significantly decreased in the nodules, hips and groin. Ultrasound showed improved SAT structure in some subjects. Side effects included pain, bruising, itching, swelling and gastroesophageal reflux disease. All women said they would recommend SAT therapy to other women with lipedema. Limitations Small number of subjects. Conclusion SAT therapy in 4 weeks improved tissue structure, perceived leg function, and volume although shape was not affected. While side effects of SAT therapy were common, all women felt the therapy was beneficial.

  19. Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts

    PubMed Central

    Cahill, Sean; Taylor, S. Wade; Elsesser, Steven A.; Mena, Leandro; Hickson, DeMarc; Mayer, Kenneth H.

    2017-01-01

    Gay and bisexual men and other men who have sex with men (MSM) account for more than two thirds of new HIV infections in the U.S., with Black MSM experiencing the greatest burden. Antiretroviral pre-exposure prophylaxis (PrEP) can reduce MSM's vulnerability to HIV infection. Uptake of PrEP has been limited, particularly among racial and ethnic minority MSM. Four semi-structured focus groups with gay and bisexual men and other MSM at risk for HIV infection were convened in Boston and Jackson in late 2013. The analysis plan utilized a within-case, across-case approach to code and analyze emerging themes, and to compare results across the two cities. Participants recruited in Jackson were primarily Black gay men, while Boston participants were mostly non-Hispanic White gay men. Participants in both sites shared concerns about medication side effects and culturally insensitive health care for gay men. Jackson participants described stronger medical mistrust, and more frequently described experiences of anti-gay and HIV related stigma. Multiple addressable barriers to PrEP uptake were described. Information about side effects should be explicitly addressed in PrEP education campaigns. Providers and health departments should address medical mistrust, especially among Black gay and bisexual men and other MSM, in part by training providers in how to provide affirming, culturally competent care. Medicaid should be expanded in Mississippi to cover low-income young Black gay and bisexual men and other MSM. PMID:28286983

  20. Reasons for non-compliance among patients with hypertension at Vanga Hospital, Bandundu Province, Democratic Republic of Congo: A qualitative study

    PubMed Central

    Mabuza, Langalibalele; Malete, Nomsa; Maduna, Patrick; Ndimande, John V.

    2009-01-01

    ABSTRACT Background Hypertension is a serious public health challenge in both economically developing and developed countries. Patients on outpatient medication for hypertension at Vanga Hospital in the Democratic Republic of Congo (DRC) often present with uncontrolled hypertension and some with hypertension emergencies. On enquiry, the problem appeared to revolve around compliance. Method The study was a qualitative, descriptive study using the focus group interview technique for data collection. Subjects were purposely selected. Interviews were conducted from 23 March to 19 July 2006. Three focus groups were formed: The first was heterogeneous in terms of gender (five males and three females), the second homogeneous (six males) and the last also homogeneous (six females). The group members varied with respect to characteristics such as place of residence, occupation and educational standard. The data collected were analysed using the thematic analysis method within grounded theory. Results Five themes emerged as possible explanations for non-compliance: Side effects discouraged patients from taking medication; patients took medication only when they experienced perceived symptoms of hypertension; poor knowledge of the disease and the medication used; lack of support by family members; and difficulty in obtaining antihypertensive medication. Conclusion Side effects of the medication, lack of information and support, difficulty in obtaining the medication and the fact that the disease is mainly silent played a major role in the poor adherence to hypertension medication. Sustained health promotion and education should be undertaken at all levels of patient contact to ensure good compliance.

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