Misinformation and public opinion of science and health: Approaches, findings, and future directions.

A summary of the public opinion research on misinformation in the realm of science/health reveals inconsistencies in how the term has been defined and operationalized. A diverse set of methodologies have been employed to study the phenomenon, with virtually all such work identifying misinformation as a cause for concern. While studies completely eliminating misinformation impacts on public opinion are rare, choices around the packaging and delivery of correcting information have shown promise for lessening misinformation effects. Despite a growing number of studies on the topic, there remain many gaps in the literature and opportunities for future studies.

The narrative truth about scientific misinformation.

Science and storytelling mean different things when they speak of truth. This difference leads some to blame storytelling for presenting a distorted view of science and contributing to misinformation. Yet others celebrate storytelling as a way to engage audiences and share accurate scientific information. This review disentangles the complexities of how storytelling intersects with scientific misinformation. Storytelling is the act of sharing a narrative, and science and narrative represent two distinct ways of constructing reality. Where science searches for broad patterns that capture general truths about the world, narratives search for connections through human experience that assign meaning and value to reality. I explore how these contrasting conceptions of truth manifest across different contexts to either promote or counter scientific misinformation. I also identify gaps in the literature and identify promising future areas of research. Even with their differences, the underlying purpose of both science and narrative seeks to make sense of the world and find our place within it. While narrative can indeed lead to scientific misinformation, narrative can also help science counter misinformation by providing meaning to reality that incorporates accurate science knowledge into human experience.

Misinformation in and about science.

Humans learn about the world by collectively acquiring information, filtering it, and sharing what we know. Misinformation undermines this process. The repercussions are extensive. Without reliable and accurate sources of information, we cannot hope to halt climate change, make reasoned democratic decisions, or control a global pandemic. Most analyses of misinformation focus on popular and social media, but the scientific enterprise faces a parallel set of problems-from hype and hyperbole to publication bias and citation misdirection, predatory publishing, and filter bubbles. In this perspective, we highlight these parallels and discuss future research directions and interventions.

Ethical Issues in COVID-19 Communication to Mitigate the Pandemic: Dilemmas and Practical Implications.

Communication plays a critical role in all stages of a pandemic. From the moment it is officially declared governments and public health organizations aim to inform the public about the risk from the disease and to encourage people to adopt mitigation practices. The purpose of this article is to call attention to the multiple types and the complexity of ethical challenges in COVID-19 communication. Different types of ethical issues in COVID-19 communication are presented in four main sections. The first deals with ethical issues in informing the public about the risk of the pandemic and dilemmas regarding communicating uncertainty, using threats and scare tactics, and framing the pandemic as a war. The second concerns unintended consequences that relate to increasing inequities, stigmatization, ageism, and delaying medical care. The third raises ethical issues in communicating about specific mitigation practices: contact tracing, wearing face masks, spatial (also referred to as social) distancing, and handwashing or sanitizing. The fourth concerns appealing to positive social values associated with solidarity and personal responsibility, and ethical challenges when using these appeals. The article concludes with a list of practical implications and the importance of identifying ethical concerns, which necessitate interdisciplinary knowledge, cross-disciplinary collaborations, public discourse and advocacy.

Communicating health risks in science publications: time for everyone to take responsibility.

Research that is poorly communicated or presented is as potentially damaging as research that is poorly conducted or fraudulent. Recent examples illustrate how the problem often lies with researchers, not press officers or journalists. The quest for publication and 'impact' must not outweigh the importance of accurate representation of science; herein, we suggest steps that researchers, journalists and press officers can take to help ensure this.

How to clarify the aims of empathy in medicine.

This paper argues that enthusiasm for empathy has grown to the point at which empathy has taken on the status of an "ideal" in modern medicine. We need to pause and scrutinize this ideal before moving forward with empathy training programs for medical students. Taking empathy as an ideal obscures the distinction between the multiple aims that calls for empathy seek to achieve. While these aims may work together, they also come apart and yield different recommendations about the sort of behavior physicians should cultivate in a given situation. I begin by demonstrating how enthusiasm for empathy has increased dramatically. I then specify precisely what I mean in calling empathy an "ideal." I then describe some dangers associated with taking empathy to be an ideal unreflectively. I discuss the merits of works that provide conceptualizations of empathy that are specifically tailored for the medical domain and conclude that although these works move discussions about empathy in medical care forward, they could do more to foreground the goals and aims underlying calls for increased empathy. I provide specific suggestions as to how exactly we might foreground these goals and aims to further avoid conceptual confusion about empathy in medical education.

Informed consent to HIV cure research.

Trials with highly unfavourable risk-benefit ratios for participants, like HIV cure trials, raise questions about the quality of the consent of research participants. Why, it may be asked, would a person with HIV who is doing well on antiretroviral therapy be willing to jeopardise his health by enrolling in such a trial? We distinguish three concerns: first, how information is communicated to potential participants; second, participants' motivations for enrolling in potentially high risk research with no prospect of direct benefit; and third, participants' understanding of the details of the trials in which they enrol. We argue that the communication concern is relevant to the validity of informed consent and the quality of decision making, that the motivation concern does not identify a genuine problem with either the validity of consent or the quality of decision making and that the understanding concern may not be relevant to the validity of consent but is relevant to the quality of decision making. In doing so, we derive guidance points for researchers recruiting and enrolling participants into their HIV cure trials, as well as the research ethics committees reviewing proposed studies.

The problematic messages of nutritional discourse: A case-based critical media analysis.

Nutritional science has assumed a fundamental importance in shaping food meanings and practices in the developed world. This study critically analysed the content of one weekly nutrition column written by a nutritional expert in a popular New Zealand magazine, from a social constructionist perspective, to investigate how nutritional advice constructs food, food practices and eaters. The analysis identified a range of ways in which the nutrition information communicated in the articles was potentially problematic for readers. The articles advocated eating for health with recommendations based on nutritional science, but depicted nutritional information as inconclusive, changeable and open to interpretation. Fear-based messages were used to motivate making 'healthy' food choices, through linking 'unhealthy' food choices with fatness and chronic ill health. Unhealthy foods were portrayed as more enjoyable than healthy foods, social occasions involving food were constructed as problematic, and exercise was defined only as a way to negate food consumption. Healthy eating was portrayed as a matter of personal choice, obscuring the situational factors that impact on food choice and health. We conclude that the nutritional advice analysed in this study constructs a way of understanding food that, if internalised by eaters, may evoke anxiety, confusion and dissatisfaction around food and eating.

The Public Health Impact of the So-Called "Fluad Effect" on the 2014/2015 Influenza Vaccination Campaign in Italy: Ethical Implications for Health-Care Workers and Health Communication Practitioners.

Seasonal influenza, causing complications, hospitalizations and deaths, generates a serious socio-economic burden, especially among elderly and high-risk subjects, as well as among adult individuals. Despite the availability and active free-of charge offer of influenza vaccines, vaccine coverage rates remain low and far from the target established by the Ministry of Health. Notwithstanding their effectiveness, vaccines are victims of prejudices and false myths, that contribute to the increasing phenomenon of vaccine hesitancy and loss of confidence. Media and, in particular, new media and information and communication technologies (ICTs) play a major role in disseminating health-related information. They are extremely promising devices for delivering health education and promoting disease prevention, including immunization. However, they can also have a negative impact on population's health attitudes and behaviors when channeling wrong, misleading information. During the 2014/2015 influenza vaccination campaign, the report of four deaths allegedly caused by administration of an adjuvanted influenza vaccine, Fluad - the so-called "Fluad case" - received an important media coverage, which contributed to the failure of the vaccination campaign, dramatically reducing the influenza vaccine uptake. In the extant literature, there is a dearth of information concerning the effect of the "Fluad case". The current study aims at quantifying the impact of the "Fluad effect" at the level of the Local Health Unit 3 (LHU3) ASL3 Genovese, Genoa, Italy. Ethical implications for health-care workers and health communication practitioners are also envisaged.

The Great Whoosh: Connecting an Online Personal Health Narrative and Communication Privacy Management.

This research study examined Bud Goodall's online health narrative as a case study through the use of a thematic analysis to investigate the presence of communication privacy management (CPM) theory. Emergent themes of humor as a privacy management strategy, legitimization of co-owners, shifting privacy rules at end of life, and metaphors as privacy protection were used to recount Goodall's cancer experience on his personal blog, connecting to the components of CPM. The themes the authors analyzed represent the push-pull dialectical tension experienced to reveal and conceal information, conceptualization of private information, shared boundaries, and boundary linkages.

[Ethical and communicative significance of "personalised medicine"]. / Ethische und kommunikative Bedeutung der "personalisierten Medizin"

The first aim of the paper is to analyse in a culture-theoretical perspective those characteristic semantic markers that permit "personalized" medicine (PM) to figure as a prestigious seminal trend of future medicine. In fact, there is evidence that the ambiguity of the favourite semantic markers of PM engenders a conception of PM that is analogous to the tailoring of services to customers. There is an air of paradox: while patients are supposed to be the key beneficiaries of PM, their genuine preferences, at present, are seriously underarticulated. The second aim of the paper is to focus attention on some highlights within the multifarious ethical discourse that accompanies the development of PM. As a result, valuable methodological options are outlined that support a consistently ethical analysis of ethical value-conflicts pertaining to the rise of PM.

Fighting obesity or obese persons? Public perceptions of obesity-related health messages.

OBJECTIVE: This study examined public perceptions of obesity-related public health media campaigns with specific emphasis on the extent to which campaign messages are perceived to be motivating or stigmatizing. METHOD: In summer 2011, data were collected online from a nationally representative sample of 1014 adults. Participants viewed a random selection of 10 (from a total of 30) messages from major obesity public health campaigns from the United States, the United Kingdom and Australia, and rated each campaign message according to positive and negative descriptors, including whether it was stigmatizing or motivating. Participants also reported their familiarity with each message and their intentions to comply with the message content. RESULTS: Participants responded most favorably to messages involving themes of increased fruit and vegetable consumption, and general messages involving multiple health behaviors. Messages that have been publicly criticized for their stigmatizing content received the most negative ratings and the lowest intentions to comply with message content. Furthermore, messages that were perceived to be most positive and motivating made no mention of the word 'obesity' at all, and instead focused on making healthy behavioral changes without reference to body weight. CONCLUSION: These findings have important implications for framing messages in public health campaigns to address obesity, and suggest that certain types of messages may lead to increased motivation for behavior change among the public, whereas others may be perceived as stigmatizing and instill less motivation to improve health.

Risk terminology in biobanking and genetic research: what's in a name?

It is well established that the general public has varying interpretations of the term "risk" and the qualifiers associated with it, such as low, moderate, or high. What is less well known is how definition and application of this term impacts recruitment of individuals, particularly for biomedical and behavioral research designed to improve knowledge of and access to innovations in cancer genetics. This Commentary discusses the nomenclature used in bio-behavioral research and the potential for confusion due to divergent meanings of risk and its associated categorizations. We discuss both our experience with recruitment of familial cancer families for a study on perceptions of biobanking as well as lessons learned from published examples where divergent understanding of risk levels, genetic research processes, and interpretation of results between community members and researchers result in misunderstandings for both parties. Ultimately, a critical challenge remains to ensure that accurate and mutually relevant risk terms are used in recruiting research participants and providing genetic results. Achieving this goal requires that regulations, policy, education, and practice change in step with rapid discoveries in genetic research to reduce misinterpretations resulting from lack of common understanding and specificity in risk terminology.

Communication in NICUs.

In a Neonatal Intensive Care Unit (NICU) counseling should be a shared culture for all the care givers: it should be developed by all the professionals, to face up to parents' needs of information, explanations, facility of decisions, finding of resources, agreement, help, reassurance, attention. The first essential aspect is the training in counseling skills, by periodic courses for all professionals of the department (physicians, nurses, and physiotherapists). In our department, a professional counselor is present, assisting the medical staff in direct counseling. The counselor's intervention allows a better parent orientation in the situation. A more effective sharing of these rules also facilitates the communication among parents and medical staff. Periodic meetings are established among the medical staff, in which the professional counselor discusses difficult situations to share possible communicative strategies. We wanted to have not only a common communicative style, but also common subjects, independent from the characteristics of each of us. Individuals are often faced with different situations. For every setting that we more frequently face in communication (for example the first interview with a parent of a very preterm infant) we have built an 'algorithm' that follows a pattern: (1) information always given; (2) frequent questions from parents; and (3) frequent difficulties in the communication. Counselling is also a tool to face some critical issue, such as the decision to open the department to parents 24 h on 24, or the promotion of mother's milk use in Very Low Birth Weight Infants (VLBWI).