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From its beginning, Critical Theory aimed to explore the laws governing social life as a formational totality and the forces shaping and driving its historical evolution. So the attempt to develop a comprehensive conception of 'society' encompassing both its structural as well as its cultural components can be considered one of the defining hallmarks of Critical Theory through all its theoretical and generational variations. But what, then, is Critical Theory's conception of society? To answer this question, the authors make use of a three-tiered heuristic model distinguishing synthesis (what is society?), dynamis (what are the driving forces of social change?) and praxis ((how) can social change be motivated or influenced by social actors?). In this way, they are able to reconstruct not only the divergences and controversies between the different versions and approaches in Critical Theory across the four generations of authors writing in this tradition, but also four core points of convergence which can serve to differentiate between Critical Theory in the Frankfurt School tradition and other critical theories. These four points, we suggest, should be seen to form the backbone of any valid conception of society in contemporary Critical Theory. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic hit Italy much harder than South Korea. As a way of explaining the different impact in the two countries, this study examines the moderating role of social support on the relationship between perceived susceptibility and preventive behaviors in the two countries. Methods: Surveys were conducted in South Korea (n = 1396) and Italy (n = 487) of participants aged 50 to 89 years. Results: South Koreans felt higher levels of perceived social support than their Italian counterparts. As would be expected, greater perceived susceptibility was associated with increased preventive behavior. Furthermore, a significant three-way interaction effect was found for perceived susceptibility, social support, and country. For Italians, a person who feels him/herself highly susceptible will increase preventive behaviors, if there is a lot of social support. On the other hand, for South Koreans, those with a low level of susceptibility perform more preventive measures than people with a high level of susceptibility if there is a lot of social support. Conclusions: This study provides insights into how cognitive factors, such as susceptibility and severity, as well as social and environmental factors can be taken into account, and the public be told the real risk and given behavioral guidelines when a pandemic is approaching. Given the critical role of social support as a coping mechanism in crisis situations, societies should mull over ways to increase emotional and instrumental support. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic hit Italy much harder than South Korea. As a way of explaining the different impact in the two countries, this study examines the moderating role of social support on the relationship between perceived susceptibility and preventive behaviors in the two countries. Methods: Surveys were conducted in South Korea (n = 1396) and Italy (n = 487) of participants aged 50 to 89 years. Results: South Koreans felt higher levels of perceived social support than their Italian counterparts. As would be expected, greater perceived susceptibility was associated with increased preventive behavior. Furthermore, a significant three-way interaction effect was found for perceived susceptibility, social support, and country. For Italians, a person who feels him/herself highly susceptible will increase preventive behaviors, if there is a lot of social support. On the other hand, for South Koreans, those with a low level of susceptibility perform more preventive measures than people with a high level of susceptibility if there is a lot of social support. Conclusions: This study provides insights into how cognitive factors, such as susceptibility and severity, as well as social and environmental factors can be taken into account, and the public be told the real risk and given behavioral guidelines when a pandemic is approaching. Given the critical role of social support as a coping mechanism in crisis situations, societies should mull over ways to increase emotional and instrumental support. [ABSTRACT FROM AUTHOR]

To understand the development of cyber aggression during adolescence, it is important to consider the temporal variability of its potential predictors. This study uses a four-wave survey to investigate how changes in peer norms, parental norms, and parental communication are associated with two-year trajectories of online peer aggression. The sample includes 1521 Swiss middle school students (Mage T1 = 11.54, SD = 0.40; 48% female). The results showed that over time a better parental communication quality and anti-aggression norms predicted lower rates and slower development of cyber aggression. Moreover, parental variables emerged as a quite stable deterrent of aggressive conduct. Although entrance into adolescence is characterized by the rise of peer influence, results from this study suggest that parents maintain an important protective role. [ABSTRACT FROM AUTHOR]

Amid ongoing medication safety concerns in China and limited research on public perceptions, this study investigates the correlations between media exposure, healthcare experiences, and individuals' perceptions of medication safety. It also examines individuals' reliance on information sources during safety crises. A multistage stratified random sampling was employed with the gross sample containing 3090 Chinese adults aged 18–60 years. Data were analyzed using multiple linear regression. Social media exposure was found to negatively correlate with perceptions of current medication safety and its perceived improvement, while exposure to television and print media showed positive correlations. Positive healthcare experiences were associated with improved medication safety perceptions. Among various information sources, healthcare professionals were deemed most trustworthy during medication safety incidents. Media exposure and personal healthcare experiences significantly shape individuals' perceptions of medication safety in China, with healthcare professionals playing a crucial role in this context. Practiceimplications: Effective health crisis communication in China needs to be multifaceted, integrating traditional media and social media platforms to disseminate accurate information broadly. Additionally, healthcare professionals should be actively involved in crisis communication. Their role as trusted sources can be leveraged to clarify misconceptions, and reassure the public during medication safety incidents. • TV/print media exposure is linked to better medication safety perceptions. • Social media exposure is linked to poorer medication safety perceptions. • Satisfactory healthcare experiences are linked to better medication safety perceptions. • Healthcare professionals are the most trusted source of information during medication safety crises. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate whether a self-report measurement instrument (the Brief Health Literacy Screen, BHLS) correctly identifies healthcare consumers with inadequate health literacy. The yardstick for assessing the tool was the Newest Vital Sign (NVS).Methods: The study used baseline data from the Västerbotten Intervention Programme - VIsualiZation of Asymptomatic Atherosclerotic disease for Optimum Cardiovascular Prevention (VIPVIZA), a randomized controlled trial that is nested within the Västerbotten Intervention Program (VIP) in Sweden. Our analyses were computed on a subsample of 460 persons who underwent the measure of both health literacy scales. ROC analysis was used for the crucial computations.Results: The potential of the BHLS to identify healthcare consumers with inadequate health literacy remained unsatisfying for the complete sample, but reached an acceptable level for women and persons with only basic education.Conclusions: The relationship is somewhat weaker than in comparable research in various other European countries. The differences might partly have been caused by the use of self-perception questions. Self-delusions, invariably a part of self-perception, may have affected the respective measure.Practice Implications: Caution is advised when patients' health literacy is assessed by only a few questions for self-report. [ABSTRACT FROM AUTHOR]

Protection Motivation Theory (PMT) holds that individuals under threat base their protection decisions on threat and coping appraisals. In the case of preventable communicable diseases, the theory holds that motivation for vaccination will be higher the more alarming a person's threat appraisals and the more promising her coping appraisals are. This study aims at describing how the influence model of PMT accommodates different changes and conditions: the addition of new factors such as knowledge, health literacy, and attitudes, and the inclusion of several highly similar threats in the form of different communicable diseases. The question raised is: Do people, when making vaccination decisions, think of vaccination as a unified entity or as separate units? In the first case, they would show similar factors across different vaccinations, probably thinking of the common biomedical functioning of vaccination. In the latter case, the predictors would change from vaccination to vaccination, and people might have different treatments of the subject in public communication on their minds. Data came from a representative survey among adult Swiss residents. Among the results are the following: PMT is affirmed; people show a unified way of determining their motivation to vaccinate; knowledge contributes strongly to protection motivation; and neither public discussion of threats nor experiences among acquaintances shows much of an impact. [ABSTRACT FROM AUTHOR]

This study explores the growing news coverage of e-cigarettes regarding, (a) how the arguments regarding e-cigarettes are presented in the print news media in the United States (US), United Kingdom (UK), and Korea; (b) which arguments were under-represented; and (c) to what extent scientific research shapes the arguments. Results suggest that the most salient argument in the US and UK was that e-cigarettes are less harmful (or "safer") than regular cigarettes. Although both US and UK news recognized e-cigarettes as a smoking cessation tool, US news framed e-cigarettes from a negative viewpoint. In Korean news, the dominant argument concerned e-cigarette ingredients. The public health frame competed against economic frames in Korean media coverage. With the exception of epidemiological data, scientific studies received very little media coverage in all three countries. Reports of scientific uncertainty were correlated with the level of controversy on e-cigarette issues, and limitations of scientific studies were described to highlight such controversy. Lastly, we discussed issues that were neglected in the news regarding e-cigarettes in all three countries. [ABSTRACT FROM AUTHOR]

It remains to be seen whether these factors result in capitalist growth regimes beyond liberal democracy or "only" in a permanent decoupling of profits and general welfare that is justified in the name of insubstantial democratic forms. Studies from Alain [19] analysis of "growth coalitions" to genealogies of the growth discourse ([18]) and recent critiques of growth-based capitalism ([15]) all document this entanglement. The list of post-growth scenarios also contains alternatives that have not yet taken centre-stage in the dominant struggles over hegemony - a positive design for post-growth societies and a grassroots democratic renewal of the economy and of political and social institutions. This Special Issue demonstrates that the comparative analysis of growth regimes must systematically take into account the question of economic and ecological limits to capitalist growth. [Extracted from the article]

In this work, the relevance of the article by Philip Warren Anderson, "More is different", for establishing complexety as a thematic category opposed to reductionism, is discussed, as well as his hierarchy of sciences. From a simple case in Physics, the appropriation of complexity in other sciences is illustrated by recente articles in the academic literature. [ABSTRACT FROM AUTHOR]

The majority of today's adult smokers took up the habit during adolescence. The school community and the rules it imposes are important factors that can influence adolescents' smoking intention and behaviour. Research on the effect of school tobacco policies on adolescents' smoking concludes with mixed results. Our study aims to look at the influence of these policies on the intention to smoke and to know if this relation is mediated by individual and environmental factors. The study includes information on social norms, attitude towards smoking and smoking intention from 4515 students of 32 Ticino middle schools and on the tobacco policy implemented in this school. Linear regression indicates a marginal impact of school policy on intention to smoke. Schools that strongly enforce tobacco policy obtain an increase in their students' intention to smoke, while schools that implement assistance programmes to overcome tobacco use decrease intention to smoke. Mediation models show that the influence of some of tobacco policy dimensions on the intention to smoke is mediated by personal attitudes towards smoking, beliefs about health consequences of smoking and perceived peers smoking. Increasing visibility of tobacco policies and having tobacco prevention programmes have stronger positive effects on smoking intention than other policy dimensions, but only through the mediation of individual and environmental factors. [ABSTRACT FROM AUTHOR]

This longitudinal study explores differences in Internet access and use among school-aged children in Italian-speaking Switzerland and whether and how these differences contribute to inequalities in academic performance. Applying multilevel structural equation modeling with two-wave original survey data from 843 students, their parents, as well as students' end-term school grades, we show that a family's socio-economic status indirectly affects children's school grades as lower parental income leads children to use the Internet more frequently for entertainment and online communication purposes. This form of Internet use also increases as children have more personal digital media devices. As children's increased use of the Internet for entertainment and online communication worsens their academic performance, our results suggest that social inequalities due to children's socio-economic status are reinforced by a second-order digital divide. We discuss potential reasons for our findings as well as their implications and recommendations for possible interventions. [ABSTRACT FROM AUTHOR]

In 2015, South Korea experienced the largest outbreak to date of the Middle East Respiratory Syndrome (MERS-CoV) outside the Middle East. Fears related to a potential spread of the disease led to an increased alert level as well as heightened media coverage in the neighboring Hong Kong. A cross-sectional survey (N = 533) among residents of Hong Kong was conducted to assess the relationships between the effects of outbreak-related mass media coverage, interpersonal communication, the perceived level of concern in one's close environment, and the uptake of preventive measures. A serial multiple mediator model finds that interpersonal communication and higher perceived concern indirectly influence the effects of media coverage on the engagement in preventive actions. These results expand previous research on the mediating role of interpersonal communication and support assumptions about a modified two-step flow of communication in the context of a public health emergency. [ABSTRACT FROM AUTHOR]

Objective: Synthesize quantitative empirical evidence on the role of health literacy in predicting adherence to dietary recommendations.Methods: A systematic search of 13 online databases resulted in 1498 articles eligible for screening. Of those, 20 met the predefined inclusion criteria and, together with 6 studies retrieved from their reference lists, were included for review. Screening of full-texts, data extraction and quality appraisal were independently performed by two reviewers. Inconsistencies regarding eligibility were resolved through discussion.Results: Of the 26 reviewed articles, 17 involved patients and 9 the general population. Overall, 35 associations between health literacy and various nutrition behaviours were observed. A significant direct positive association was reported in 5 cases, all of them concerning the general population. An insignificant association was reported in 20 cases, 15 of which were related to patients. The remaining associations were negative (n=2), partially mediated (n=1) or entirely mediated (n = 7).Conclusion: Health literacy was scarcely determinant of dietary adherence and other nutrition behaviours, especially among patients.Practice Implication: Patients' dietary adherence is likely to be unaffected by interventions based on health literacy. Empowering approaches are expected to be more beneficial. [ABSTRACT FROM AUTHOR]

Objective: This study aimed at investigating the association between functional health literacy and knowledge on when to seek medical help for potentially harmless (overutilization) or serious (underutilization) situations among immigrants and non-immigrants in Switzerland.Methods: Data was collected among three immigrant groups and the native population (N=1146) in the German- and Italian-speaking part of Switzerland. Health literacy was assessed with the Short Test of Functional Health Literacy (S-TOFHLA) and three Brief Health Literacy Screeners. Over- and underutilization of healthcare services was assessed with items asking participants about when to seek medical help for minor, respectively major, physical symptoms.Results: Immigrants were more likely to seek medical help when unwarranted (overutilization). Health literacy, when assessed with the S-TOFHLA, was significantly associated with over- and underutilization. Yet, once controlled for covariates, the association between health literacy and overutilization was negative. Immigration background and micro-cultural differences emerged as important predictors of utilization.Conclusions: Results suggest that functional health literacy is directly related to healthcare utilization. The effects might be amplified by (micro-)cultural differences.Practice Implications: Healthcare providers should be aware of differences in health literacy and utilization patterns among different population groups. Communication between patients and providers should be literacy and culturally sensitive. [ABSTRACT FROM AUTHOR]

Background: Systematic reviews call for well-designed trials with clearly described intervention components to support the effectiveness of educational campaigns to reduce patient delay in stroke presentation. We herein describe the systematic development process of a campaign aimed to increase stroke awareness and preparedness.Methods: Campaign development followed Intervention Mapping (IM), a theory- and evidence-based tool, and was articulated in two phases: needs assessment and intervention development. In phase 1, two cross-sectional surveys were performed, one aiming to measure stroke awareness in the target population and the other to analyze the behavioral determinants of prehospital delay. In phase 2, a matrix of proximal program objectives was developed, theory-based intervention methods and practical strategies were selected and program components and materials produced.Results: In phase 1, the survey on 202 citizens highlighted underestimation of symptom severity, as in only 44% of stroke situations respondents would choose to call the emergency service (EMS). In the survey on 393 consecutive patients, 55% presented over 2 hours after symptom onset; major determinants were deciding to call the general practitioner first and the reaction of the first person the patient called. In phase 2, adult individuals were identified as the target of the intervention, both as potential "patients" and witnesses of stroke. The low educational level found in the patient survey called for a narrative approach in cartoon form. The family setting was chosen for the message because 42% of patients who presented within 2 hours had been advised by a family member to call EMS. To act on people's tendency to view stroke as an untreatable disease, it was decided to avoid fear-arousal appeals and use a positive message providing instructions and hope. Focus groups were used to test educational products and identify the most suitable sites for message dissemination.Conclusions: The IM approach allowed to develop a stroke campaign integrating theories, scientific evidence and information collected from the target population, and enabled to provide clear explanations for the reasons behind key decisions during the intervention development process.Trial Registration: NCT01881152 . Retrospectively registered June 7 2013. [ABSTRACT FROM AUTHOR]

Objectives: To compare functional health literacy (HL) levels in three immigrant groups to those of the German- and Italian-speaking non-immigrant population in Switzerland. Moreover, to investigate whether language-independent, respectively language-dependent, functional HL and variables of acculturation were associated with self-reported health status among immigrants.Methods: Language-independent HL was assessed with the Short Test of Functional Health Literacy (S-TOFHLA) in the respective native languages. Language-dependent HL was measured using Brief Health Literacy Screeners (BHLS) asking about participants' confidence in understanding medical information in the language of the host country. Measures of acculturation included length of stay and age when taking residency in Switzerland.Results: In particular Albanian- and Portuguese-speaking immigrants had lower levels of functional HL. In unadjusted analysis "age when taking residency in Switzerland" was associated with the BHLS. Adjusted analysis showed that the BHLS were significantly associated with self-reported health among all immigrant groups (p≤0.01).Conclusions: Functional HL that is dependent on understanding of medical information in the language of the new host country is a better predictor for self-reported health status among immigrants than language-independent HL.Practice Implications: In the clinical setting limited functional HL might be a significant obstacle to successful disease treatment and prevention in immigrants. [ABSTRACT FROM AUTHOR]

Background and Method: Adolescents observe and imitate people to whom they are associated in their social context, and the normative factors sent out by reference groups are crucial determinants of their decision to smoke. The aim of the study is to investigate how adolescents' smoking changes when they are exposed to factors of pro-smoking normative influence by parents and peers, and how age moderate this relation. A cross sectional survey collected data from 5657 students, aged between 11 and 14, from public and private middle schools in the Italian region of Switzerland (Ticino) on their smoking habits, perceived parents' and peers' approval and smoking.Results: Multinomial logistic regression show that, as adolescents get older, more of the pro-smoking factors come from peers and parents, the higher the risk gets of being a "heavy smoker" has compared against having no experience with smoking. Living in a context with no factor of normative influence toward smoking play a protective role against smoking, and this effect becomes more important than more harmful the smoking behavior in question is. Furthermore, peers' descriptive norms are more influential for adolescents to become "light" and "heavy smokers", while smoking being approved by peers is important for adolescents to become accustomed to smoking.Conclusions: Findings support the different influence of parents' and peers' norms on adolescents' smoking, and highlight the importance of peers' model behavior as the most important factor influencing smoking during adolescence. Such results have implications for programs that aim to prevent or reduce smoking in early adolescence when friendship choice starts to become crucial. [ABSTRACT FROM AUTHOR]

Individuals' perception of medication safety affects their medication adherence, and through adherence their health. A person may reject a doctor's recommendation to take antibiotics if they believe antibiotics are not safe. Media and personal experiences shape individual judgments. Misleading online information may damage people's trust in drugs, see Covid-19 vaccine. The experience of adverse events can harm people's confidence in healthcare. Will unfavorable experience of healthcare in general affect drug perception? Will one effect moderate the other? We barely know that. Data from HINTS-China 2017 contains 3090 adults. Drug safety perception was indicated by drug safety status quo (The current state of drug safety is good) and drug safety amelioration (Drug safety has gradually improved in recent years) with 5-category scales from strongly disagree to strongly disagree. Media exposure was divided into traditional media (4 items) and the Internet (8 items, frequency measure, averaged); healthcare experience asks respondents satisfaction with received healthcare. We applied a multiple linear regression. We found weight-loss pills, antibiotics and vaccines were perceived the most unsafe. Besides, traditional media exposure was positively associated with drug safety status quo (? =.256**) and amelioration (? =.136**). However, Internet exposure significantly damaged people's perception of drug safety status quo (? = -.165**) and showed potential negative impact on drug safety amelioration (? = -.073). Satisfaction of healthcare services was also correlated with drug safety status quo (? =.265**) and amelioration (? =.189**) positively. Our study draws attention to how Chinese people's medicine safety perceptions are shaped by media exposure and healthcare experience. Favorable healthcare experience contributes to better medicine perception. The contrary impacts between old and new media is consistent with previous studies. This indicates drug and vaccine communications should exploit traditional communication channel and address negative perceptions on online media to promote appropriate uptake. [ABSTRACT FROM AUTHOR]

Health literacy tests in the Chinese-speaking parts of the world have been mainly developed in traditional Chinese to be used in Hong Kong or Taiwan. So far no validated tool in simplified Chinese to assess functional health literacy in Mainland China has been developed. The aim of the study was to validate the simplified Chinese version of the Short Test of Functional Health Literacy in Adults (S-TOFHLA). The traditional Chinese version was translated into simplified Chinese and 150 interviews in an outpatient department of a public hospital in Mainland China were conducted. Predictive validity was assessed by known predictors for health literacy and convergent validity by three health literacy screening questions. The Cronbach's a for the reading comprehension part was 0.94 and 0.90 for the numeracy items. Participants with lower education and men had significantly lower levels of health literacy. The reading comprehension part was significantly correlated with two of the health literacy screening questions. Our results indicate that the simplified Chinese version of the S-TOFHLA is a reliable measure of health literacy to be used in Mainland China. [ABSTRACT FROM AUTHOR]

Growing patient empowerment and the deluge of health information and misinformation have highlighted the importance of health literacy. Unfortunately, public information and literacy programmes often fail to counter the effect of misinformation. Successfully countering misinformation presents distinctive challenges beyond patient education, and may require trust built on collaborative patient–clinician relationships. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed at investigating the relationship between causal attributions and coping maxims in people suffering from back pain. Further, it aimed at identifying in how far causal attributions and related coping maxims would defer between immigrants and non-immigrants in Switzerland. Methods: Data for this study came from a larger survey study that was conducted among immigrant populations in the German- and Italian-speaking part of Switzerland. Included in the analyses were native Swiss participants, as well as Albanian- and Serbian-speaking immigrants, who had indicated to have suffered from back pain within the last 12 months prior to the study. Data was analyzed for overall 495 participants. Items for causal attributions and coping maxims were subject to factor analyses. Cultural differences were assessed with ANOVA and regression analyses. Interaction terms were included to investigate whether the relationship between causal attributions and coping maxims would differ with cultural affiliation. Results: For both immigrant groups the physician’s influence on the course of their back pain was more important than for Swiss participants (p <.05). With regard to coping, both immigrant groups were more likely to agree with maxims that were related to the improvement of the back pain, as well as the acceptance of the current situation (p <.05). The only consistent interaction effect that was found indicated that being Albanian-speaking negatively moderated the relationship between physical activity as an attributed cause of back pain and all three identified coping maxims. Conclusion: The study shows that differences in causal attribution and coping maxims between immigrants and non-immigrants exist. Further, the results support the assumption of an association between causal attribution and coping maxims. However cultural affiliation did not considerably moderate this relationship. [ABSTRACT FROM AUTHOR]

This study aimed to validate a Turkish version of the Short Test of Functional Health Literacy (S-TOFHLA) (Baker et al., Development of a brief test to measure functional health literacy. Patient Educ Counsel 1999;38:33-42) and a Turkish version of the Chew self-report scale (Chew et al., Brief questions to identify patients with inadequate health literacy. Family Med, 2004;36:588-94) for measuring functional health literacy. The original English version of the S-TOFHLA and the Chew items were translated by applying standardized translation methods and cultural adaptations, and both were administered to a sample of diabetes patients (N=302) in two diabetes clinics in one of the major cities in Turkey. Self-administered paper-pencil questionnaires were distributed to eligible outpatients who had a clinic appointment. In addition to the S-TOFHLA measurement and the Chew screening questions, gender, age, educational attainment, income, marital status and diabetes knowledge were obtained. The Turkish version of S-TOFHLA showed high internal consistency. Both S-TOFHLA and the Chew screening scale correlated significantly with known predictors of health literacy: age, education and income. The Chew scale was also related weakly but significantly with general diabetes knowledge. It is expected that the Turkish versions of S-TOFHLA and the Chew scale will be used in Turkey as well as in other countries with large Turkish communities. [ABSTRACT FROM AUTHOR]

Objectives: To explore micro-cultural differences in patients' need for information provision, perceived participation in decision making, and related concepts during the doctor-patient consultation between French- and Italian-speaking patients in Switzerland.Methods: In 2012, 153 French- and 120 Italian-speaking patients with chronic low back pain (cLBP) were surveyed on their need for information provision, perceived participation in decision making, cLBP knowledge, psychological empowerment, and trust in their doctor. T-tests and regression analyses with interaction terms were performed.Results: Results show that French- and Italian-speaking patients significantly differed in their participation in decision making, with French-speaking patients reporting higher involvement. Need for information provision was related to empowerment among French- and to trust among Italian-speaking patients. For participation in decision making, trust was the only related concept among French-, and cLBP knowledge among Italian-speaking patients. Significant interaction terms indicate a moderation of micro-cultural background.Conclusion: Findings point towards differences in the relationships between individual patient characteristics (i.e. knowledge, empowerment) and relational doctor-patient characteristics (i.e. trust) and patients' need for information provision and participation in decision making between French- and Italian-speaking patients in Switzerland.Practice Implications: Doctors should be aware of these differences when dealing with patients of different micro-cultural backgrounds. [ABSTRACT FROM AUTHOR]

Objective Studies have shown that people with lower levels of health literacy create higher emergency, inpatient and total healthcare costs, yet little is known about how health literacy may affect medication costs. This cross-sectional study aims at investigating the relationship between health literacy and three years of medication costs (2009–2011) in a sample of patients with type 2 diabetes. Methods 391 patients from the German-speaking part of Switzerland who were insured with the same health insurer were interviewed. Health literacy was measured by a validated screening question and interview records were subsequently matched with data on medication costs. A bootstrap regression analysis was applied to investigate the relationship between health literacy and medication costs. Results In 2010 and 2011 lower levels of health literacy were significantly associated with higher medication costs ( p < .05). Conclusion The results suggest that diabetic patients with lower health literacy will create higher medication costs. Practice implications Besides being sensitive towards patients’ health literacy levels, healthcare providers may have to take into account its potential impact on patients’ medication regimen, misuse and healthcare costs. [ABSTRACT FROM AUTHOR]

Aim: Misconceptions and non‐evidence‐based practices toward childhood fever are reported worldwide. Medical students might be ideal candidates to introduce long‐lasting changes in clinical practice. However, no study has gauged the effectiveness of an educational intervention to improve fever management in this population. We conducted an educational, interventional study on childhood fever among final‐year medical students. Methods: We conducted a prospective, multicentre interventional study employing a pre/post‐test design. Participants from three Italian Universities filled in a questionnaire just before the intervention (T0), immediately after (T1) and 6 months later (T2) in 2022. The intervention was a two‐hour lecture focused on the pathophysiology of fever, recommendations for its treatment and risks associated with improper management. Results: 188 final‐year medical students (median age of 26 years, 67% females) were enrolled. Relevant improvements in the criterion for treating fever and conceptions about the beneficial effects of fever were observed at T1 and T2. Similar data were found for the reduction of physical methods advice to decrease body temperature and concerns for brain damage from fever. Conclusion: This study shows for the first time that an educational intervention is effective in changing students' conceptions and attitudes toward fever both in the short and medium term. [ABSTRACT FROM AUTHOR]

There are opposing views on the relationship between adolescents' use of the Internet and their well-being, e.g. the Internet-enhanced self-disclosure hypothesis and the Evolutionary mismatch model, which give an opposite picture of the dynamics that may lead to positive versus adverse effects, respectively. Hence, the present paper aims to shed light on the bidirectional longitudinal relationships between the duration of Internet use, social connections, and depression. Data were collected at four time points, each one year apart, in 37 Swiss middle schools. The analytical sample includes a large sample of 981 early adolescents (M = 11.37, SD = 0.55; 53.9% females). All measures are self-report and comprise depression, duration of internet use, and social connection. Data were analyzed by applying an extension of the Random Intercept-Cross Lagged Panel Model, which includes the role of covariates, i.e. as gender, quality of family relations, ownership of personal Internet-enabled devices, and social desirability, in predicting the random intercepts. Results showed that, at the within-person level, a higher duration of Internet use increased depression, and, to a lower extent, higher depression levels increased the duration of Internet use. These effects were not mediated by more offline time spent with peers. At the between-person level, heavier Internet users reported higher levels of social connections with friends. Being female and possessing Internet-enabled mobile devices contributed to higher levels of initial depressive symptoms, whereas having a good family relationship was a protective factor. Results partly sustain both theoretical models and underline the importance of including contextual factors in explaining such relationships. • The study aims to investigate the bidirectional effects among Internet use, social connections, and depression. • Data collected over three years from 981 adolescents were analyzed with an extension of the Random Intercept-Cross Lagged Panel Model. • At the within -person level, higher duration of Internet use increased depression, and, to a lower extent, also the opposite was found. •At the between-person level, heavier Internet users reported higher levels of social connections with friends [ABSTRACT FROM AUTHOR]

In recent years, general practice consultation has often been characterized as an argumentative activity. It has been argued that, guided by the ethical and legal principle of informed consent and the ideal standards of participatory and evidence-based medicine, doctors should provide argumentative support for their recommendations in order to encourage patients to actively take part in the treatment decision-making discussion. Thus far, however, it has remained unclear what causal effect general practitioners’ provision of argumentation may have on consultation outcomes, such as patients’ perceptions of their doctors’ decision-making style and credibility, their acceptance and recall of the medical advice, and subsequently their intention to adhere to the advice. In this study, therefore, the effect of general practitioners’ argumentative support for their treatment recommendations is studied experimentally using scripted video-vignettes. Moreover, rather than focusing merely on the presence of argumentation, the role of the pragma-dialectical reasonableness of general practitioners’ argumentation is also taken into account. [ABSTRACT FROM PUBLISHER]

Aim The present pilot study assesses the possibility of using messages framed under the construal level theory for improving the intentions of brushing, flossing, and visiting the dentist. The theory states that individuals create mental construals about intangible situations; such construals will be abstract or concrete depending on the perceived distance from that situation. Materials and methods A longitudinal post-test-only quantitative experiment was conducted with 90 participants randomly allocated into three experimental groups, who received information on oral health framed in abstract, abstract with a self-reminder or concrete terms. Measures of intention, attitudes, perceived message cognition value, and past behavior were obtained through an online survey at two different points in time. Results Contrary to expectations, individuals exposed to the concrete message showed higher intention to brush and to visit the dentist. In general, attitude towards the oral self-care behavior was a good predictor of the intention to perform. Past behavior is a better predictor for intention than message framing and attitudes. Conclusions The results of this exploratory research might aid the development of future studies aimed at further understanding the use of the construal level theory in the field of oral self-care. When aiming at changing an oral self-care behavior, it is crucial to understand past behavior. Messages framed under this theory could be successful at improving brushing and visiting the dentist intentions. [ABSTRACT FROM AUTHOR]

Asthma self-management has been recognized as an essential factor for the improvement of asthma outcomes and patients’ quality of life (WHO, 2013). Likewise, empowerment and health literacy have been noted as important elements for the management of chronic diseases. Objective To study the influence of health literacy and empowerment on asthma self-management. Methods This cross-sectional study used a self-reported questionnaire assessing health literacy, judgment skills, empowerment, and asthma self-management; 236 patients were recruited from medical offices in Switzerland and Italy. Results Judgment skills ( B = 2.28, p < 0.001) and empowerment ( B = 0.19, p < 0.05) have a significant and positive influence on several asthma self-management practices such as use of medicines, timely medical consultation, and asthma triggers control whereas health literacy ( B = −0.15, p < 0.175) appeared to have a negative effect on self-management practices. However, this was not significant. Conclusions These findings suggest that empowered patients with adequate judgment skills carry out key self-management tasks more appropriately, which in turn will potentially result in better asthma control. Practice implications This study recommends that both empowerment and judgment skills should be addressed in patient education as they serve as essential motivators to engage patients in these behaviors. [ABSTRACT FROM AUTHOR]

Objective: General practitioners' medical recommendations are not always accepted by their patients. As patients bring their own beliefs, knowledge, and preferences to the medical encounter, their opinions concerning diagnosis and treatment may deviate from their doctors'. Aiming to convince their patients of the acceptability of their advice, doctors can advance arguments. Few quantitative studies have been conducted focusing on general practitioners' provision of argumentation and little is known about the relationship between the use of argumentation and characteristics of the medical visit, such as (participatory) decision-making and visit duration. This study seeks to explore these relationships.Methods: An observational study of seventy, randomly drawn videos of general practice consultations was conducted. A theory-based codebook was developed. Two independent coders analyzed doctors' provision of argumentation, their decision-making style, and the duration of each visit.Results: General practitioners' provision of argumentation was found to be associated with lengthier visits and a more participatory decision-making style. In addition, visit duration and participatory decision-making appeared associated.Conclusion: These results suggest that the use of argumentation may contribute toward achieving patient-centered care through communication.Practice Implications: As a result, the findings underscore the potential relevance of developing courses focusing on doctors' argumentation skills. [ABSTRACT FROM AUTHOR]

Objective General practitioners’ medical recommendations are not always accepted by their patients. As patients bring their own beliefs, knowledge, and preferences to the medical encounter, their opinions concerning diagnosis and treatment may deviate from their doctors’. Aiming to convince their patients of the acceptability of their advice, doctors can advance arguments. Few quantitative studies have been conducted focusing on general practitioners’ provision of argumentation and little is known about the relationship between the use of argumentation and characteristics of the medical visit, such as (participatory) decision-making and visit duration. This study seeks to explore these relationships. Methods An observational study of seventy, randomly drawn videos of general practice consultations was conducted. A theory-based codebook was developed. Two independent coders analyzed doctors’ provision of argumentation, their decision-making style, and the duration of each visit. Results General practitioners’ provision of argumentation was found to be associated with lengthier visits and a more participatory decision-making style. In addition, visit duration and participatory decision-making appeared associated. Conclusion These results suggest that the use of argumentation may contribute toward achieving patient-centered care through communication. Practice implications As a result, the findings underscore the potential relevance of developing courses focusing on doctors’ argumentation skills. [ABSTRACT FROM AUTHOR]

Introduction Information campaigns on breast cancer screening need to convince women above 50 years of age to have biannual mammograms, and women below 50 years of age that regular mammograms are not recommended for them. Earlier experiments in the Netherlands showed that type of evidence (statistical vs. anecdotal) and message framing (gain vs. loss) had no effects on attitudes to breast cancer screening. It also emerged that screening was widely accepted for women above 50, but women were reluctant to accept the exclusion of women under 50 from routine screening, although many and good arguments for this were presented. Aim This study aims at finding out whether these results are specific to the Dutch culture by replicating the experiments in Ticino, Switzerland. Methods A leaflet, constructed for the purposes of the study and informing women about breast cancer screening, served as the experimental stimulus in a pre-post-test design. Results Findings show that in Ticino gain-framing appeared to be systematically more persuasive than loss-framing. Moreover, Ticino women were more willing than the Dutch to accept that women under the age threshold of 50 are not recommended routine mammography every 2 years. Borrowing from reactance theory, the higher acceptance of an age threshold in Ticino is explained by differences in the regulations. Lower attention to the issue there as well as the broader context of culturally tailored health communication also play a role. [ABSTRACT FROM AUTHOR]

Many of today's threats to public health arise from people's lifestyle. Hence, the public's compliance with advice given for health promotion and disease prevention has to be enhanced. Much research traces back the efficacy of health promotion messages to message qualities, while other work focuses on recipient qualities. Regulatory focus theory posits inter-individual differences in motivational orientation, namely a promotion or prevention focus, and offers a unique chance to look at message and recipient variables at the same time ( Higgins, 1997 ). Whereas a promotion-focused individual tries to achieve desired end-states, someone with a prevention focus is rather vigilant. If individuals' goal pursuit strategies match their regulatory orientation, they experience regulatory fit, which increases the perceived persuasiveness of health messages ( Higgins, 2000 ). Such a match can be evoked by particularly framed messages that highlight a person's regulatory orientation. Thus, the assumption of regulatory fit goes beyond the concept of gain- and loss-framing. To assess whether regulatory fit contributes to the effectiveness of health communication, a systematic review was conducted. An extensive systematic search led to the inclusion of 30 studies, for which data were extracted and quality appraised. Findings were summarized using narrative synthesis. Most studies (n = 23) were conducted in the USA and assessed the effects of regulatory fit on behavioral intention (n = 21). Nineteen experiments used samples of university students, and the health context chosen most often was a healthy diet (n = 7). Sixteen experiments manipulated regulatory orientation whereas chronic regulatory focus was measured ten times. The majority of studies confirmed that regulatory fit enhanced the effectiveness of health messages, which did not vary much across different health domains or outcomes. Regulatory fit is a promising approach for tailoring health messages as the synergy effects of regulatory fit increase their effectiveness. [ABSTRACT FROM AUTHOR]

Objectives: While health literacy has been widely considered key to patient empowerment, an alternative approach separates both concepts and distinguishes between dif-ferent types of patients according to their levels of health literacy and empowerment. These types are deemed to vary in their health-related actions and outcomes. In this study, we exam-ine the relationship between health literacy and patient empowerment and compare socio-demographic characteristics, health-related activities, and health outcomes in four types of pa-tients suffering from chronic low back pain (cLBP). Methods: In a cross-sectional study, 273 cLBP patients from four Swiss can-tons (Vaud, Geneva, Fribourg, Ticino) and Lombardy (Italy) were invited by their healthcare providers to complete a self-administered paper-and-pencil questionnaire which assessed pa-tients’ health literacy, empowerment, involvement in the medical encounter, medication non-adherence, and perceived pain and functionality as a measure of health outcomes. Results: Health literacy and patient empowerment were not significantly correlated with each other, r(271) = .09, p > .05, allowing to differentiate be-tween four types of patients based on their levels of health literacy and patient empowerment. Subsequent chi-square tests and analyses of variances revealed significant differences among patients that could, however, only be attributed to health literacy, as in the case of age and ed-ucational attainment, or patient empowerment, as in the case of patients’ involvement in the medical encounter. No significant differences were evident for gender, medication non-adherence, and health outcomes. Conclusion: The study provides empirical evidence for the need to consider health literacy and patient empowerment as independent concepts in the context of cLBP but calls for further studies to be able to conclude on how the two concepts interact and determine health-related activities and outcomes. [ABSTRACT FROM AUTHOR]

Type 1 diabetes is one of the most common chronic childhood diseases, while type 2 diabetes in children is increasing at alarming rates globally. Against this backdrop, the school is a critical environment for children with diabetes. They continue to face barriers to education that may lead to depression, poor academic performance, and poor quality of life. To address these challenges, diabetes interventions have been implemented in school and the goal was to systematically review these interventions and their outcomes between 2000 and 2013. Fifteen studies were included in the narrative synthesis. Education of school personnel was the main focus before 2006. Studies reported gains in knowledge and perceived confidence of school staff. Since 2006, more comprehensive interventions have been developed to promote better care coordination and create a safe school environment. These studies reported improved diabetes management and quality of life of students. Assessment tools varied and study design included randomized controlled trials, quantitative and qualitative methods. Although many of the studies reported a significant difference in the parameters measured, it was not possible to determine optimal ways to improve the health, quality of life and academic performance of children with diabetes, given the disparity in scope, assessment tools and measured outcomes. Experimental designs, longer follow-up studies, larger sample sizes, and a higher number of participating schools are critical issues to consider in future studies. Most of the research was conducted in North America and further research is needed in other parts of the world. [ABSTRACT FROM AUTHOR]

In view of a growing interest in argumentative discourse in the context of patient-centered consultation and shared decision making, this article explores the role that argumentation has been attributed in the literature on doctor–patient consultation so far. It studies to what extent theories and concepts of argumentation have been applied by scholars from various fields in order to analyze, understand, facilitate, and improve the argumentative nature of medical consultation. It reports on an extensive and systematic literature search—using eight online databases, expert suggestions, and a manual search—and the subsequent evaluation of 1,330 abstracts on the basis of strict inclusion and exclusion criteria. Forty relevant scientific contributions are grouped into four main categories and discussed accordingly: (a) argumentation theory, (b) discourse analysis, (c) medical informatics, and (d) medical ethics. Because of its systematic approach, this study forms a solid starting point for further integration of argumentation theoretical insights into contemporary views of patient-centered medicine and evidence-based medicine. It provides suggestions for further interdisciplinary and theory-driven research with a strong focus on empirical reality. Doing so, a preliminary model is proposed that outlines the potential effects of the quality of doctors’ communication on proximal, intermediate, and long-term consultation outcomes. [ABSTRACT FROM AUTHOR]

Background. The majority of current health literacy tools assess functional skills including reading, writing, and numeracy. Although these tools have been able to underline the impact of such skills on individuals' health behaviour, there is a need for comprehensive measures to examine more advanced skills. The individual's ability to use health-related information considering his/her own health context, and judging positive and negative consequences of their decisions has been conceptualized as judgment skills. The present study used a newly developed judgment skills tool to explore asthma selfmanagement practices. Design and methods. Eighty asthma patients were recruited from medical offices during the year 2013. The questionnaire was selfadministered and contained health literacy questions, the judgment skill tool, the Asthma Control Test, and several self-management questions. Results. Sixty-nine percent of participants had adequate health literacy, while 24% and 5% had marginal and inadequate levels, respectively. The high-judgment group referred more to their doctor when experiencing asthma problems t(76)=-2.18, P<0.032; complied more with the use of their control medicine t(77)=-3.24, P<0.002 and went more regularly to the doctor t(78)=-1.80, P<0.038 (one-tailed) than the low-judgment group. Conclusions. The judgment skills tool can help identify asthma patients' health information use and reveal how this use may affect some self-management practices. [ABSTRACT FROM AUTHOR]

Objective Understanding what motivates patients to seek or avoid information beyond the medical consultation is essential for effective information provision that will be relevant to patients' needs and preferences. We conducted a synthesis of published qualitative research to provide insight into patients' motivations for cancer information seeking and avoidance. Methods We searched five electronic databases: Medline, CINAHL, PsycINFO, Communication and Mass Media Complete, and Sociological Abstracts. We complemented this process by reviewing reference lists of relevant articles and searching in Google Scholar. We independently assessed the quality of selected studies and used the technique of meta-ethnography to synthesize available findings. Results Eighteen articles that reported the information-seeking experiences of 650 patients diagnosed with more than 20 different types of cancer were included. Key concepts were experience of diagnosis, sense of control, trust in medical expertise, hope and fear, and need to resume normality. The synthesis revealed the fluid boundaries existing between information seeking and avoidance throughout the cancer journey and pointed toward the exploration of factors that could influence patients' motivations to engage in information seeking. Patient characteristics, disease characteristics, characteristics of incoming information, and the context of cancer care were found to facilitate or hinder individuals' willingness and potential to assume the role of 'informed patient'. Conclusions This meta-ethnography suggests that information seeking and avoidance should not be necessarily considered as two distinct behaviors pertaining to different groups of patients; rather, a number of personal and contextual characteristics should be taken into account when evaluating patient desire for information. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Neuroscientific buzzwords, such as 'brain hacks', have become commonplace when discussing social media (SM)-platform engineering. Despite societal debates, few studies have used neuroscientific approaches to validate the claims empirically. We call here for a transformative shift engaging scientists and other stakeholders to address this critical knowledge gap. [ABSTRACT FROM AUTHOR]

Background: The proliferation of health misinformation on social media is a growing public health concern. Online communities for mental health (OCMHs) are also considered an outlet for exposure to misinformation. This study explored the impact of the self-reported volume of exposure to mental health misinformation in misinformation agreement and the moderating effects of depression literacy and type of OCMHs participation (expert vs. peer-led). Methods: Participants (n = 403) were recruited in Italian-speaking OCMHs on Facebook. We conducted regression analyses using PROCESS macro (moderated moderation, Model 3). Measures included: the Depression Literacy Questionnaire (Griffiths et al., 2004), the self-reported misinformation exposure in the OCMHs (3 items), and misinformation agreement with the exposure items (3 items). Whether participants were members of expert or peer-led OCMHs was also investigated. Results: The final model explained the 12% variance in the agreement. There was a positive and significant relationship between misinformation exposure and misinformation agreement (β = 0.3221, p <.001), a significant two-way interaction between misinformation exposure and depression literacy (β = − 0.2179, p =.0014), and between self-reported misinformation exposure and type of OCMH (β = − 0.2322, p =.0254), such that at higher levels of depression literacy and in case of participation to expert-led OCMHs, the relationship misinformation exposure-misinformation agreement was weaker. Finally, a three-way interaction was found (β = 0.2497, p =.0144) that showed that depression literacy moderated the positive relationship between misinformation exposure and misinformation agreement such that the more misinformation participants were exposed to, the more they agreed with it unless they had higher levels of depression literacy; this, however, occurred only if they participated in peer-led groups. Conclusions: Results provide evidence that the more members reported being exposed to mental health misinformation, the more they tended to agree with it, however this was only visible when participants had lower depression literacy and were participating in peer-led OCMHs. Results of this study suggest that both internal factors (i.e., high depression literacy) and external factors (the type of online community individuals were participating in) can buffer the negative effects of misinformation exposure. It also suggests that increasing depression literacy and expert community moderation could curb the negative consequences of misinformation exposure related to mental health. Results will guide interventions to mitigate the effects of misinformation in OCMHs, including encouraging health professionals in their administration and implementing health education programs. [ABSTRACT FROM AUTHOR]

Background. This paper details the role of different dimensions of health literacy in the relationship between health literacy and cancerrelated health behaviours. In particular, Cancer Literacy is studied as an exemplar of a dimension of health literacy beyond basic reading and writing skills. The link between functional health literacy, Cancer Literacy and cancer-related health behaviours is investigated in a sample of Ticino (Switzerland) residents (n=639). Design and methods. Detailed data is collected about respondents' functional health literacy, Cancer Literacy, cancer information seeking behaviour, engagement in cancer preventive behaviours, participation to cancer screenings, and intention to adhere to current screening recommendations. Results. Results confirm the added value of Cancer Literacy – compared to functional health literacy – in explaining people's cancer information seeking behaviour, their participation to several cancer screenings and their screening intention, underscoring the need to take into account dimensions of health literacy beyond basic functional skills. Conclusions. From a public health perspective, findings provide further evidence on the importance of adapting informational and educational communication intervention designed to improve cancer prevention and screening to different audiences. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study is to investigate how adolescents' perception of parents' and peers' smoking approval influences adolescent smoking intention, and how age affects this influence in a Swiss sample of adolescents. To know the influence of age can help to develop specific prevention programs tailored to the age groups needs. Method: in a cross sectional survey, students aged between 11 and 14 from public and private middle schools in the Italian region of Switzerland (Ticino) answered questions on smoking habits, parents' and peers' approval and intention to smoke. Results: peers' and parents' approval significantly influence students' smoking intention, and students' age significantly moderates this relation: the effect of parents' approval decreases for older adolescents, while the effect of peers' approval increases with age. No difference is found between girls and boys, while non-Swiss are more likely to smoke than Swiss students. Conclusions: as literature suggests, results evidence the role parents play during early adolescence. Prevention programs targeting parent-child communication in early adolescence for preventing children's tobacco consumption are strongly supported. [ABSTRACT FROM AUTHOR]

Abstract: The relevant interactions between the organic ions of ionic liquids (ILs) include van der Waals forces, hydrogen bonding and coulombic interactions. In solutions these interactions lead to the formation of aggregates. Depending on the strength of the interactions and the concentration of the IL in the solvent, different aggregates are formed with ion-pairs being the dominant species at low concentrations. A probe for investigating these interactions is the enantioselectivity of a reaction carried out on a prochiral ion in presence of its chiral counter-ion. As asymmetric induction requires structurally well-defined interactions, the induced enantioselectivity can be correlated to ion aggregate formation. The first proof of this concept was provided by the asymmetric hydrogenation of [N-(3′-oxobutyl)-N-methylimidazolium]-[(R)-camphorsulfonate] and -[(S)-camphorsulfonate] using a heterogeneous Ru on C contact. Depending on the substrate IL concentration an enantioselectivity of up to 94% could be realized. The catalytic results were linked to the probability of the ion pair formation as evidenced by DOSY-NMR measurements and dielectric relaxation spectroscopy. The expansion of this principle to chiral ionic liquids that can be easily decomposed to chiral building blocks of synthetic relevance led us to the development of two approaches: a) the application of an IL substrate consisting of a chiral cation and a keto-functionalized, prochiral carboxylate counter-ion allowing for the synthesis of chiral esters in the sequence of IL hydrogenation and esterification; and b) reversible binding of a prochiral substrate to the cation of an IL with a chiral, enantiopure anion allowing the synthesis of neutral chiral building blocks in a sequence of binding, hydrogenation and splitting. The latter approach was tested for two ILs based on the hydroxyl-functionalized cation cholinium to which a prochiral keto functionalized carboxylic acids was reversibly attached via esterification. The hydrogenation of such prochiral ester cation in the presence of enantiopure anions resulted in ees of up to 63%. [Copyright &y& Elsevier]

Boomerang effects are changes caused by persuasive communication against the intentions of the communicator. In risk communication, boomerang effects have so far been primarily addressed and shown for warnings in fields such as alcohol, nicotine, and drug use prevention. Boomerang effects of all-clear messages on environmental risks have so far not been demonstrated. Based on this observation, this article essentially makes three points. First, the most prominent theoretical explanations for boomerang effects do not preclude all-clear messages to have this type of effect. Second, it presents an experiment that demonstrates the existence of a boomerang effect of an all-clear message on the risk from cell phone tower radiation. Respondents who were very worried about this risk before the experiment said on average that reading a short all-clear messageincreasedtheir worries. Third, if this type of boomerang effect is also found for other than radiation risks, people worried about environmental risks (including those worried without a reasonable cause) would be hard to convince they need not worry. This impedes reasonable public risk communication in the long run and creates a social group of people who harbor fears and anxieties not grounded in reality, but are immune against correction. [ABSTRACT FROM AUTHOR]

Evidence from previous research indicates that media exposure can contribute to the development of aggressive behaviors, even in online contexts. However, media effects are known to depend on various dispositional, developmental, and contextual factors. The present study investigates in a longitudinal perspective whether social norms deriving from both parents and peers can reinforce or mitigate the impact of exposure to media content on cyber aggression. A multilevel model for change is applied to data resulting from four waves (six-months intervals) of a Swiss longitudinal survey involving 101 randomly selected middle school classes (N = 1459, M age at T1 = 11.53, SD = 0.41). Results show that a more frequent exposure to antisocial media content is significantly associated with higher rates of individual cyber aggression and that peer behavior (collective descriptive norm) significantly moderates this relation. No significant interaction effects with media exposure were found for perceived injunctive norms of peers and parents. • Exposure to antisocial media content affects the development of cyber aggression. • Parental injunctive norms can slow down the development of cyber aggression. • Peers' behavior reinforce the impact of media exposure on cyber aggression. • No interaction effect between media exposure and parental norms. • No interaction effect between media exposure and peer injunctive norms. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To design a measure of judgment skills (a dimension within the wider concept of health literacy) that assesses patient decisions with a scenario-based measure in the context of sleeping disorders; more specifically to provide a basis for the professional medical evaluation of patient decisions to be employed in the measure; and in a wider sense to explore in which way knowledge about insomnia, self-management and autonomous decision-making are affecting insomnia patients and their health outcomes. Methods: A three-round Delphi-study was conducted with an expert panel of three sleep specialists and 26 general practitioners to rate scenarios of patient decision problems and find a consensus in ranking the answer options from a medical perspective. Results: A consensus emerged among the medical experts about the measure, which could be further improved with regard to the scenarios and the answer options. Scenarios were rated as realistic and the answer options ranked with a high agreement. Conclusion: The 16 scenarios with four ranked answer options each provide a valid measure for patients’ judgment skills within the wider concept of health literacy. Practical implications: The proposed judgment skills measure is ready to be pre-tested with insomnia patients, and a validation study can be conducted. [Copyright &y& Elsevier]

Introduction: This study intends to contribute to a research tradition that asks how causal attributions of illnesses affect coping behavior. Causal attributions are understood as the most important element of illness representations and coping as a means to preserve quality of life. The issue is applied to a condition so far often neglected in research on illness representations–back pain–and a third concept is added to the picture: culture. Aim: The aim of this study is (a) to explore the causal factors to which persons with back pain attribute the further course of their illness, (b) to find out whether the attributed causes are predictors of coping maxims, and (c) to find out whether cultural factors affect attributions and coping and moderate the relationship between the two. Methods: A total of 1259 gainfully employed or self-employed persons with recent episodes of back pain were recruited in the three language regions of Switzerland. They were asked to complete a structured online interview, measuring among many other variables attributed causes, coping maxims, and affiliation to one of the Swiss micro-cultures (German-, French- or Italian-speaking). Results: Attributed causes of the illness that can be influenced by a patient go along with more active coping styles. Cultural affiliation impacts on coping maxims independently, but culture moderates the relationship of attributed causes and coping maxims only in two of twenty possible cases. Implications: The results show that cultural differences can be analytically incorporated in the models of illness representations. Results may help to improve healthcare providers’ communication with patients and plan public health campaigns. The approach to micro-cultural differences and the substantive relationships between alterability of causes and activity in coping may help the further development of models of illness representations. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Artificial intelligence can provide important support of patient health. However, limits to realized benefits can arise as patients assume an active role in their health decisions. METHODS: Distinguishing the concepts of health literacy and patient empowerment, we analyze conditions that bias patient use of the Internet and limit access to and impact of artificial intelligence. RESULTS: Improving health literacy in the face of the Internet requires significant guidance. Patients must be directed toward the appropriate tools and also provided with key background knowledge enabling them to use the tools and capitalize on the artificial intelligence technology. CONCLUSION: Benefits of tools employing artificial intelligence to promote health cannot be realized without recognizing and addressing the patients' desires, expectations, and limitations that impact their Internet behavior. In order to benefit from artificial intelligence, patients need a substantial level of background knowledge and skill in information use-i.e., health literacy. PRACTICE IMPLICATIONS: It is critical that health professionals respond to patient search for information on the Internet, first by guiding their search to relevant, authoritative, and responsive sources, and second by educating patients about how to interpret the information they are likely to encounter. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Artificial intelligence can provide important support of patient health. However, limits to realized benefits can arise as patients assume an active role in their health decisions. Methods: Distinguishing the concepts of health literacy and patient empowerment, we analyze conditions that bias patient use of the Internet and limit access to and impact of artificial intelligence. Results: Improving health literacy in the face of the Internet requires significant guidance. Patients must be directed toward the appropriate tools and also provided with key background knowledge enabling them to use the tools and capitalize on the artificial intelligence technology. Conclusion: Benefits of tools employing artificial intelligence to promote health cannot be realized without recognizing and addressing the patients’ desires, expectations, and limitations that impact their Internet behavior. In order to benefit from artificial intelligence, patients need a substantial level of background knowledge and skill in information use—i.e., health literacy. Practice implications: It is critical that health professionals respond to patient search for information on the Internet, first by guiding their search to relevant, authoritative, and responsive sources, and second by educating patients about how to interpret the information they are likely to encounter. [Copyright &y& Elsevier]