Negative language use of the physiotherapist in low back pain education impacts anxiety and illness beliefs: A randomised controlled trial in healthy respondents.

OBJECTIVE: This study aimed to determine the effect of physiotherapists' negative language use on nocebo effects of state anxiety and illness beliefs. METHODS: A web-based randomised controlled trial included adults without recent musculoskeletal pain. The intervention was a short educational video about low back pain using negative language (nocebo condition: n = 87) versus a video using neutral or positive language (control condition: n = 82). State anxiety was assessed using the State-Trait Anxiety Inventory. Illness beliefs were assessed using the Illness Perception Questionnaire. RESULTS: Nocebo and control groups differed in outcome measures (MANOVA Pillai's trace = 0.22, F = 4.98; df = (9,159), p < 0.001). Post-hoc analyses showed a medium to large effect for the nocebo condition on anxiety (d = 0.71, 95% CI 0.4 -1.0). The nocebo group also had higher scores in three illness beliefs: beliefs on timeline (d = 0.45, 95% CI 0.14 - 0.75), treatment control (d = 0.43, 95% CI 0.12 - 0.74) and concern (d = 0.47, 95% CI 0.16 - 0.78). CONCLUSION: Physiotherapists' use of negative language contributes directly to a higher state anxiety and illness beliefs that can trigger the nocebo effects in the recipient PRACTICE IMPLICATIONS: Negative language use should be avoided.

Possible alleviation of symptoms and side effects through clinicians' nocebo information and empathy in an experimental video vignette study.

To alleviate anti-cancer treatment burden in advanced breast cancer, patient-clinician communication strategies based on nocebo-effect mechanisms are promising. We assessed distinct/combined effects on psychological outcomes (e.g. anxiety; main outcome) and side-effect expectations of (1) nocebo information about the (non)pharmacological origin of side effects, and (2) clinician-expressed empathy through reassurance of continuing support. Furthermore, we explored whether information and empathy effects on side-effect expectations were mediated by decreased anxiety. In a two-by-two experimental video-vignette design, 160 cancer patients/survivors and healthy women watched one of four videos differing in level of nocebo information (±) and empathy (±). Regression and mediation analysis were used to determine effects of information/empathy and explore anxiety's mediating role. Anxiety was not influenced by empathy or information (Stai-state: p = 0.295; p = 0.390, VAS p = 0.399; p = 0.823). Information improved (specific) side-effect coping expectations (p < 0.01). Empathy improved side-effect intensity expectations (p < 0.01 = specific; p < 0.05 = non-specific/partial) and specific side-effect probability expectations (p < 0.01), and increased satisfaction, trust, and self-efficacy (p < 0.001). No mediating effects were found of anxiety on expectations. Mainly empathy, but also nocebo information improved psychological outcomes and-mainly specific-side-effect expectations. Exploring the power of these communication elements in clinical practice is essential to diminish the anti-cancer treatment burden in advanced breast cancer.

Clinical evidence vs preliminary speculation in newspaper coverage of diabetes innovations: a quantitative analysis.

OBJECTIVES: Researchers have discussed that journalistic reporting of medical developments is often characterised by exaggeration or lack of context, but additional quantitative evidence to support this claim is needed. This study introduces a quantitative approach to assessing coverage of medical innovations, by aiming at provided references to observed clinical effects. Although observed clinical effects reflect increased chances for future medical applications, it is unknown to which extent newspaper articles refer to it when spreading health information. We aimed to assess, over a 6-year period, newspaper publication characteristics of diabetes innovations, arising from all scientific areas of interest, regarding the total count and the proportion of articles that provide references to demonstrated clinical efficacy. STUDY DESIGN: Quantitative content analysis of newspaper articles covering innovative treatments for diabetes. METHODS: We performed a systematic review of newspaper articles between 2011 and 2016 printed in the largest six Dutch newspapers. By assessing in-article references, it was possible to quickly distinguish between (1) articles that referred to actual clinical efficacy demonstrated in a scientific setting and (2) articles that presented either predictions, fundamental research, preclinical research or personal experiences and recommendations. Proportion differences between scientific areas of interest were analysed using the chi-squared test. RESULTS: A total of 613 articles were categorised. Total newspaper publication frequency increased with 9.9 articles per year (P = .031). In total, 17% of the articles contained a reference to any proven clinical efficacy. Articles about human nutrition science (7%; P = .001) and (neuro)psychology (4.3%; P = .014) less frequently provided a reference to actual clinical efficacy. CONCLUSIONS: Our findings show that less than one in five newspaper articles about diabetes research contains a reference to relevant clinical effects, while the publication count is increasing. These statistics may contribute to feelings of false hope and confusion in patients.

Increased cognitive problem reporting after information about chemotherapy-induced cognitive decline: The moderating role of stigma consciousness.

OBJECTIVE: Information about treatment side effects can increase their occurrence; breast cancer (BC) patients showed increased cognitive problem reporting (CPR) and decreased memory performance after information about cognitive side effects. The current study extends previous research on adverse information effects (AIE) by investigating (a) risk factors, (b) underlying mechanisms and (c) an intervention to reduce AIE. DESIGN: In an online experiment, 175 female BC patients were randomly assigned to one of three conditions. In the two experimental groups, patients were informed about the possible occurrence of cognitive problems after chemotherapy with (intervention group) or without (experimental group) reassuring information that 'there are still patients who score well on memory tests'. In the control group, no reference to chemotherapy-related cognitive problems was made. MAIN OUTCOME MEASURES: Main dependent measure was CPR. Four moderating and five mediating processes were examined. RESULTS: CPR increased with higher levels of stigma consciousness in the two experimental groups, but not in the no-information control group. CONCLUSION: Merely informing patients about cognitive side effects may increase their occurrence, especially among individuals vulnerable to patient stereotypes. Adding reassuring information is not sufficient to reduce AIE.

The efficacy of social role models to increase motivation to obtain vaccination against hepatitis B among men who have sex with men.

This study assessed the effects of role models in persuasive messages about risk and social norms to increase motivation to obtain hepatitis B virus (HBV) vaccination in men who have sex with men (MSM). MSM at risk for HBV in The Netherlands (N = 168) were recruited online via a range of websites and were randomly assigned to one of four conditions in a 2 (risk communication: yes and no) × 2 (social norms communication: yes and no) factorial design. In each condition, participants subsequently provided self-completed assessments of their perceived risk of HBV infection, perceived social norms regarding HBV vaccination and their intention to obtain vaccination against HBV. Risk communication and social norms communication that used social role models were effective in significantly increasing men's intention to obtain vaccination against HBV. No additive effect was found for a combined message. Mediation analyses showed that communications influenced intention via perceived risk and social norms. Findings extend previous theorizing and research and show that both role model-based risk communication and social norms communication can be effective in increasing intentions to obtain HBV vaccination in MSM. This knowledge contributes to the development of effective health promotion to increase HBV vaccination in MSM.

Simple methods for disinfecting household drinking water.

BACKGROUND: The methods commonly used for disinfecting drinking water are either too expensive or impractical for use in villages and urban slums. METHODS: We have devised two simple and cost-effective methods for disinfecting drinking water using solar heat and the normally unutilized heat from the traditional Indian mud stove or chulha. RESULTS: Using these methods water temperatures of 60°C were attained which successfully disinfected water contaminated artificially with E. coli (120 organisms per ml) after 3 hours. CONCLUSION: This simple technique of disinfecting water may be acceptable on a large scale.

[Intestinal absorption of fats in children using serum turbidity and triglyceride absorption tests]. / Estudo da absorção intestinal de gorduras na infância com os testesde turvação do soro e de absorção de triglicérides.

Intestinal fat absorption was studied, using serum turbidity and serum triglyceride levels, which were determined before and after a test meal of 2 g neutral fat per kg b.w. in 33 children: 25 controls, four with cystic fibrosis, and four with celiac disease. The results proved that the easy-to-perform serum turbidity test was superior to the triglyceride absorption test in characterizing fat digestion and absorption. The most substantial increase in both tests occurred about three hours after the oral fat load.

Chloroquine-related depression.

Drugs are known to induce depressive states. Chloroquine, an antimalarial, in therapeutic doses administered for malaria therapy, may produce symptoms rather indistinguishable from endogenous depression. The possible mechanisms of production of depression related to chloroquine use are hypothesised.

Histochemistry of Centroorhynchus falconis (Das, 1950).

With a view to augment the understanding of the animal mucosubstances in general and Acanthocephalan mucosubstances in particular, Acanthocephalan worms of (Centrorhynchus falconis, Das, 1950) were investigated histochemically by employing recent techniques. Variations in the intensity of histochemical reactions in different tissues revealed a heterogenous distribution of mucosubstances. The cuticle contained a mixture of periodate reactive neutral mucosubstances and sulfomucins, whereas the subcuticle contained only glycogen. Retractor muscles contained glycogen together with some acidic mucosubstances which exhibited alcianophilia only at high pH. Cement glands elaborated a mixture of glycogen and galactogen. Histochemical methods revealed two types of acanthors: Some contained only glycogen, whereas others contained glycogen and galactogen.