Fear appeals are a polarizing issue, with proponents confident in their efficacy and opponents confident that they backfire. We present the results of a comprehensive meta-analysis investigating fear ...appeals' effectiveness for influencing attitudes, intentions, and behaviors. We tested predictions from a large number of theories, the majority of which have never been tested meta-analytically until now. Studies were included if they contained a treatment group exposed to a fear appeal, a valid comparison group, a manipulation of depicted fear, a measure of attitudes, intentions, or behaviors concerning the targeted risk or recommended solution, and adequate statistics to calculate effect sizes. The meta-analysis included 127 articles (9% unpublished) yielding 248 independent samples (NTotal = 27,372) collected from diverse populations. Results showed a positive effect of fear appeals on attitudes, intentions, and behaviors, with the average effect on a composite index being random-effects d¯ = 0.29. Moderation analyses based on prominent fear appeal theories showed that the effectiveness of fear appeals increased when the message included efficacy statements, depicted high susceptibility and severity, recommended one-time only (vs. repeated) behaviors, and targeted audiences that included a larger percentage of female message recipients. Overall, we conclude that (a) fear appeals are effective at positively influencing attitude, intentions, and behaviors; (b) there are very few circumstances under which they are not effective; and (c) there are no identified circumstances under which they backfire and lead to undesirable outcomes.
E. O. Wilson proposed in Sociobiology that similarities between human and animal societies reflect common mechanistic and evolutionary roots. When introduced in 1975, this controversial hypothesis ...was beyond science’s ability to test. We used genomic analyses to determine whether superficial behavioral similarities in humans and the highly social honey bee reflect common molecular mechanisms. Here, we report that gene expression signatures for individual bees unresponsive to various salient social stimuli are significantly enriched for autism spectrum disorder-related genes. These signatures occur in the mushroom bodies, a high-level integration center of the insect brain. Furthermore, our finding of enrichment was unique to autism spectrum disorders; brain gene expression signatures from other honey bee behaviors do not show this enrichment, nor do datasets from other human behavioral and health conditions. These results demonstrate deep conservation for genes associated with a human social pathology and individual differences in insect social behavior, thus providing an example of how comparative genomics can be used to test sociobiological theory.
Autoantibodies against interleukin-12 (anti-interleukin-12) are often identified in patients with thymoma, but opportunistic infections develop in only some of these patients. Interleukin-12 (with ...subunits p40 and p35) shares a common subunit with interleukin-23 (subunits p40 and p19). In a patient with disseminated
infection, the identification of both anti-interleukin-23 and anti-interleukin-12 prompted further investigation.
Among the patients (most of whom had thymoma) who were known to have anti-interleukin-12, we screened for autoantibodies against interleukin-23 (anti-interleukin-23). To validate the potential role of anti-interleukin-23 with respect to opportunistic infection, we tested a second cohort of patients with thymoma as well as patients without either thymoma or known anti-interleukin-12 who had unusual infections.
Among 30 patients with anti-interleukin-12 who had severe mycobacterial, bacterial, or fungal infections, 15 (50%) also had autoantibodies that neutralized interleukin-23. The potency of such neutralization was correlated with the severity of these infections. The neutralizing activity of anti-interleukin-12 alone was not associated with infection. In the validation cohort of 91 patients with thymoma, the presence of anti-interleukin-23 was associated with infection status in 74 patients (81%). Overall, neutralizing anti-interleukin-23 was detected in 30 of 116 patients (26%) with thymoma and in 30 of 36 patients (83%) with disseminated, cerebral, or pulmonary infections. Anti-interleukin-23 was present in 6 of 32 patients (19%) with severe intracellular infections and in 2 of 16 patients (12%) with unusual intracranial infections, including
and
complex.
Among patients with a variety of mycobacterial, bacterial, or fungal infections, the presence of neutralizing anti-interleukin-23 was associated with severe, persistent opportunistic infections. (Funded by the National Institute of Allergy and Infectious Diseases and others.).
Background There is limited information regarding the clinical use and effectiveness of IV sotalol in pediatric patients and patients with congenital heart disease, including those with severe ...myocardial dysfunction. A multicenter registry study was designed to evaluate the safety, efficacy, and dosing of IV sotalol. Methods and Results A total of 85 patients (age 1 day-36 years) received IV sotalol, of whom 45 (53%) had additional congenital cardiac diagnoses and 4 (5%) were greater than 18 years of age. In 79 patients (93%), IV sotalol was used to treat supraventricular tachycardia and 4 (5%) received it to treat ventricular arrhythmias. Severely decreased cardiac function by echocardiography was seen before IV sotalol in 7 (9%). The average dose was 1 mg/kg (range 0.5-1.8 mg/kg/dose) over a median of 60 minutes (range 30-300 minutes). Successful arrhythmia termination occurred in 31 patients (49%, 95% CI 37%-62%) with improvement in rhythm control defined as rate reduction permitting overdrive pacing in an additional 18 patients (30%, 95% CI 19%-41%). Eleven patients (16%) had significant QTc prolongation to >465 milliseconds after the infusion, with 3 (4%) to >500 milliseconds. There were 2 patients (2%) for whom the infusion was terminated early. Conclusions IV sotalol was safe and effective for termination or improvement of tachyarrhythmias in 79% of pediatric patients and patients with congenital heart disease, including those with severely depressed cardiac function. The most common dose, for both acute and maintenance dosing, was 1 mg/kg over ~60 minutes with rare serious complications.
If we keep on doing what we have been doing, we are going to keep on getting what we have been getting
. Concerns about the gap between science and practice are longstanding. There is a need for new ...approaches to supplement the existing approaches of
research to practice
models and the evolving
community-centered
models for bridging this gap. In this article, we present the Interactive Systems Framework for Dissemination and Implementation (ISF) that uses aspects of research to practice models and of community-centered models. The framework presents three systems: the Prevention Synthesis and Translation System (which distills information about innovations and translates it into user-friendly formats); the Prevention Support System (which provides training, technical assistance or other support to users in the field); and the Prevention Delivery System (which implements innovations in the world of practice). The framework is intended to be used by different types of stakeholders (e.g., funders, practitioners, researchers) who can use it to see prevention not only through the lens of their own needs and perspectives, but also as a way to better understand the needs of other stakeholders and systems. It provides a heuristic for understanding the needs, barriers, and resources of the different systems, as well as a structure for summarizing existing research and for illuminating priority areas for new research and action.
Acute care nurses may suffer substantial fatigue if working night shift or if assigned a shift contrasting their preferred sleep-wake patterns, called chronotype. Nurses are at higher risk for ...diet-related, metabolic diseases compared to other healthcare professionals. Yet, the impact of preferred chronotype and mismatch to assigned shift on nutritional intake and risk for metabolic disease among acute care nurses is unclear. This observational study analyzed dietary data from 52 acute care nurses. Participants completed the revised morningness-eveningness questionnaire which gives a total score between 4 and 26. Lower scores (<12) were flagged as evening type (E-type), higher scores (>17) defined as morning type (M-type), and scores between 12 and 17 were categorized as neither types (N-type). N-type participants were considered chronotype matched when assigned to either shift, whereas E-types were only considered matched if assigned to night shift, and M-types matched only if assigned to day shift. Participants also recorded all dietary intake for 7 d (reflecting a typical workweek) in the MyFitnessPal phone application. Findings indicated that eveningness nurses had markers of MetS, including a significantly larger body mass index and waist circumference than N-types (
< 0.05). E-types also consumed, on average, more calories than other chronotypes (
= 1833.7 kcal), although this was not a statistically significant finding. Mismatched day (
= 7, 13.4%) and night (
= 5, 9.6%) nurses in our sample consumed, on average, more calories (
= 1935.1 kcal,
= 1981.2 kcal, respectively) than matched day (
= 24, 46.2%,
= 1642.6 kcal) or night (
= 16, 30.8%,
= 1599.1 kcal) nurses, although this finding was not statistically significant. Mismatched day nurses consumed significantly less fiber than day matched nurses (median = 10.9 g versus median = 18.5 g,
= 0.04), while night mismatched consumed significantly more fiber compared to night matched (median = 21 g versus median = 12.2 g,
= 0.05) nurses. Participant diets overall did not follow recommendations by the United States Department of Agriculture (USDA), who consumed a higher percentage of calories from saturated fats and a smaller percentage of calories from fiber, habits which increase risk for metabolic syndrome. Further research surrounding nutritional pathways utilizing larger samples is needed to uncover relationships with metabolic syndrome especially for eveningness-type nurses or if working a shift mismatched with preferred chronotype.
The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, ...the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers. To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed “how to” and description of individual point-of-care ultrasound examinations. Pediatric emergency medicine providers should refer to this paper as reference for published research, objectives for learners, and standardized reporting guidelines.
Mediterranean environments are biodiversity hotspots in which strongly seasonal winter rainfall regimes and fire play major roles in driving ecosystem dynamics. Global predictions forecast ...unreliability of winter rainfall and increases in summer rainfall that are expected to result in major changes in community structure. Mediterranean systems are difficult to model, and although ecophysiological responses can be studied at observational timescales, a long-term understanding is necessary to address uncertainties and refine predictive models at landscape scales. Here we provide a ∼ 1100 year-long palaeoecological reconstruction of vegetation (palynology), fire (sedimentary charcoal) and sedimentological change at a site adjacent to a multi-annual rainfall manipulation experiment designed to test plant population and community responses to altered seasonal regimes in the Greater Cape Floristic Region hotspot (southwestern Africa). We use these data to test whether long-term vegetation dynamics are controlled by changes in rainfall seasonality. We conclude that vegetation dynamics correlate with centennial-scale seasonality fluctuations, with transitions between two ecologically distinct fine-leaved shrub communities. These transitions are consistent with results of responses to experimental manipulations of summer rainfall. This study demonstrates the value of ecophysiological research in interpreting palaeoecological reconstructions and scaling up the results of observational research to answer long-term questions about environmental change.
•Projections for Mediterranean areas forecast unreliable winter rainfall.•A 1100 year-long sequence informs of palaeoecological change in the Cape Region.•Vegetation dynamics correlate with centennial seasonality fluctuations.•Landscape dynamics can be predicted from responses at observational timescales.
Given the inherent variability in pain responding, using an "average" pain score may pose serious threats to internal and external validity. Using growth mixture modeling (GMM), this article first ...examines whether infants can be differentiated into stable groups based on their pain response patterns over a 2-minute post-needle period. Secondary analyses, to specifically address the issue of averaging pain scores to represent a sample, qualitatively described clinically meaningful differences between pain scores of the discerned groups and the overall mean (irrespective of groups). Infants were part of Canadian longitudinal cohort naturalistically observed during their 2-, 4-, 6-, and/or 12-month immunization appointments (N=458 to 574) at 3 pediatrician clinics between 2007 and 2012. At every age, GMM analyses discerned distinct groups of infants with significantly variable patterns of pain responding over the 2minutes post-needle. Our secondary suggested that the overall mean pain score immediately post-needle reflected most groups well at every age. However, for older infants (6 and 12months, especially), the overall mean pain responses at 1 and 2minutes post-needle significantly over or underestimated groups that contained 48% to 100% of the sample. These results combined highlight the significant variability of infant pain responding patterns between groups of infants and furthermore, calls into question the validity of using an overall mean in research with older infants during the regulatory phase post-needle.
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