Reactance and Coping Responses to Tobacco Counter-Advertisements.

Tobacco prevention messages generally take one of three tactics: They can be educational, attack the tobacco industry, or attack particular brands. Being a smoker and smoking a particular brand may form an essential part of a person's self-identity. As such, reactance theory suggests that attack messages can unintentionally attack smokers' self-image. A 2 × 2 × 2 × 2 experiment using six different messages and 260 respondents tested whether smokers have different reactions to tobacco counter-advertisements than nonsmokers. It also examined whether attacking a smoker's brand leads to greater reactance and other maladaptive responses compared to attacking other brands. Consistent with predictions, smokers reported more maladaptive coping responses and fewer adaptive coping responses to tobacco counter-ads than nonsmokers. The study also reveals differences attributable to brand identification. These findings suggest that interventions should consider different counter-advertising tactics for smokers and nonsmokers. Similar admonitions may apply to counter-advertising strategies on other health issues.

Epigenetics and family-centered developmental care for the preterm infant.

Adverse experiences early in life have the potential to disrupt normal brain development and create stress response channels in preterm infants that are different from those observed in term infants. Animal models show that epigenetic modifications mediate the effects of maternal separation and environmental stress on susceptibility to disease and psychobehavioral problems later in life. Epigenetic research has the potential to lead to the identification of biological markers, gene expression profiles, and profile changes that occur overtime in response to early-life experiences. Combined with knowledge gained through the use of advanced technologies, epigenetic studies have the promise to refine our understanding about how the brain matures and functions from multiple perspectives including the effect of the environment on brain growth and maturation. Such an understanding will pave the way for care practices that will allow the premature brain to develop to its full capacity and will lead to the best possible outcomes. Neonatal epigenetic research is emerging and rapidly advancing. As scientists overcome biological, technical, and cost-related challenges, such research has a great potential in determining key environmental factors that affect the preterm genome, allowing for targeted interventions. The purpose of this article is to explore existing literature related to epigenetic mechanisms that potentially mediate the effects of the environment on preterm infant brain development.

An integrated review of developmental outcomes and late-preterm birth.

OBJECTIVE: To evaluate existing evidence on long-term developmental outcomes of late-preterm infants (LPI; infants born 34-36 6/7 weeks gestation). DATA SOURCES: Computerized bibliographic databases and hand search for English language articles published between January 1995 and November 2010 yielded 817 articles. STUDY SELECTION: Twelve studies (10 cohort and two cross-sectional) were identified that defined late-preterm (LP) birth as 34 to 36 6/7 weeks gestation and addressed growth and neurodevelopmental outcomes in LPI. DATA EXTRACTION: Using a modified Downs and Black scale for assessing the quality of experimental and observational studies, two reviewers who were blind to each other's ratings assessed study quality. Ratings ranged from 12.5 to 14 with moderate to very good interrater agreement. Kappa (κ) values were 0.83 (reporting), 0.63 (external validity), 0.73 (internal validity), and 0.83 (design) for the four subscales and 0.56 for the whole scale, with no major systematic disagreements between reviewers. DATA SYNTHESIS: Studies were divided into five categories to include the following developmental outcomes: neurodevelopment, behavioral, cognitive, growth, and function. Using the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines, synthesis of the findings is provided as an integrative review. CONCLUSION: Significant variations in study populations, methodology, and definition of LP exist. Due to paucity and heterogeneity of the existing data especially in infants born 34 to 36 6/7 weeks, there is no clear characterization of the long-term risks, and future research is needed.