A Psychoneuroimmunological Reading of Jane Austen's Persuasion in the Context of Bodily Aging.

Jane Austen normally avoids discussing appearance throughout her works. Persuasion constitutes the exception to the rule, as the story focuses on the premature aging experienced by her protagonist, Anne Elliot, seemingly due to disappointed love. Much has been written about Anne's "loss of bloom," but never from the perspective of psychoneuroimmunology, the field that researches the interrelation between psychological processes and the nervous and immune systems. In this paper, we adopt a perspective of psychoneuroimmunology to argue that Austen established a connection between psychological distress, specifically lovesickness, and the development of early senescence signs, and vice versa, since the recovery of love is associated with happiness and physical glow. From a gender perspective, we discuss how Austen brightly reflected these interrelationships through the story of Anne, when the latest psychoneuroimmunological research has actually shown that women age earlier than men as a consequence of psychological turmoil.

Exploring the Use of Persuasive System Design Principles to Enhance Medication Incident Reporting and Learning Systems: Scoping Reviews and Persuasive Design Assessment.

BACKGROUND: Medication incidents (MIs) causing harm to patients have far-reaching consequences for patients, pharmacists, public health, business practice, and governance policy. Medication Incident Reporting and Learning Systems (MIRLS) have been implemented to mitigate such incidents and promote continuous quality improvement in community pharmacies in Canada. They aim to collect and analyze MIs for the implementation of incident preventive strategies to increase safety in community pharmacy practice. However, this goal remains inhibited owing to the persistent barriers that pharmacies face when using these systems. OBJECTIVE: This study aims to investigate the harms caused by medication incidents and technological barriers to reporting and identify opportunities to incorporate persuasive design strategies in MIRLS to motivate reporting. METHODS: We conducted 2 scoping reviews to provide insights on the relationship between medication errors and patient harm and the information system-based barriers militating against reporting. Seven databases were searched in each scoping review, including PubMed, Public Health Database, ProQuest, Scopus, ACM Library, Global Health, and Google Scholar. Next, we analyzed one of the most widely used MIRLS in Canada using the Persuasive System Design (PSD) taxonomy-a framework for analyzing, designing, and evaluating persuasive systems. This framework applies behavioral theories from social psychology in the design of technology-based systems to motivate behavior change. Independent assessors familiar with MIRLS reported the degree of persuasion built into the system using the 4 categories of PSD strategies: primary task, dialogue, social, and credibility support. RESULTS: Overall, 17 articles were included in the first scoping review, and 1 article was included in the second scoping review. In the first review, significant or serious harm was the most frequent harm (11/17, 65%), followed by death or fatal harm (7/17, 41%). In the second review, the authors found that iterative design could improve the usability of an MIRLS; however, data security and validation of reports remained an issue to be addressed. Regarding the MIRLS that we assessed, participants considered most of the primary task, dialogue, and credibility support strategies in the PSD taxonomy as important and useful; however, they were not comfortable with some of the social strategies such as cooperation. We found that the assessed system supported a number of persuasive strategies from the PSD taxonomy; however, we identified additional strategies such as tunneling, simulation, suggestion, praise, reward, reminder, authority, and verifiability that could further enhance the perceived persuasiveness and value of the system. CONCLUSIONS: MIRLS, equipped with persuasive features, can become powerful motivational tools to promote safer medication practices in community pharmacies. They have the potential to highlight the value of MI reporting and increase the readiness of pharmacists to report incidents. The proposed persuasive design guidelines can help system developers and community pharmacy managers realize more effective MIRLS.

Predicting Family Implementation of Complementary and Alternative Medicine in Autism Online Communities.

Complementary and alternative medicine (CAM) is widely adopted by families with autistic children. This study aims to predict family caregivers' CAM implementation in Autism online communities. Dietary interventions were reported as a case study. We extracted behavioral (degree and betweenness), environmental (positive feedback and social persuasion), and personal features (language style) of family caregivers in online communities. The results of the experiment showed that random forests performed well in predicting families' tendency to implement CAM (AUC=0.887). It is promising to use machine learning to predict and intervene in the CAM implementation by family caregivers.

Effect of Extraneous Affect on Health Message Reception.

People often avoid paying attention to health messages. One reason is that health messages can evoke negative affect, which produces avoidance. Prior efforts to reduce disengagement focused on changing message content or buffering the self from threat, producing mixed effects. The present studies test whether inducing positively valenced, low-arousal affect independently of the message or the self, labeled extraneous affect, promotes health message receptivity. Across four studies (total N = 1,447), participants who briefly meditated (vs. a control listening task) paid more attention to messages (Study 1). Increased positive valence facilitated attention, which subsequently increased message comprehension (Studies 2-4), whereas reduced arousal directly increased message comprehension. These effects generalized across extraneous affect manipulations, settings, information domains, and levels of message threat. Taken together, extraneous affect can be leveraged to promote message receptivity. This contributes to a theoretical understanding of how affect impacts persuasion.

Persuasive design features within a consumer-focused eHealth intervention integrated with the electronic health record: A mixed methods study of effectiveness and acceptability.

INTRODUCTION: eHealth strategies targeting health-related behaviour often incorporate persuasive software design. To further engage patients with their overall health management, consumer-facing web portals may be integrated with data from one or more care providers. This study aimed to explore effectiveness for healthier behaviour of persuasive design characteristics within a web application integrated with the primary health care electronic record; also patient and general practitioner (GP) preferences for future integrated records. METHODS: Mixed methods study within the Consumer Navigation of Electronic Cardiovascular Tools randomised controlled trial. Participants were patients with moderate-high risk of cardiovascular disease, and their GPs. Survey and web analytic data were analysed with descriptive statistics. Interview and focus group transcripts were recorded, transcribed, coded and analysed for themes. RESULTS: Surveys (n = 397) received from patients indicated improved medication adherence (31.8%); improved mental health and well-being (40%); higher physical activity (47%); and healthier eating (61%). Users of the interactive features reported benefiting from personalised cardiovascular disease risk score (73%); goal tracking (69%); risk factor self-monitoring (52%) and receipt of motivational health tips (54%). Focus group and interview participants (n = 55) described customisations that would increase portal appeal and relevance, including more provider interaction. Of the GP survey respondents (n = 38), 74% reported increased patient attendance and engagement with their care. For future integrated portals, 94% of GPs were in favour and key themes among interviewees (n = 17) related to design optimisation, impact on workflow and data security. CONCLUSION: Intervention features reflecting the persuasive design categories of Primary Task support, Dialogue support and System Credibility support facilitated healthier lifestyle behaviour. Patients valued customisable functions and greater patient-provider interactivity. GPs identified system challenges but saw advantages for patients and the health care relationship. Future studies could further elucidate the persuasive design principles that are at play and which may promote adoption of EHR-integrated consumer portals.

A test of positive suggestions about side effects as a way of enhancing the analgesic response to NSAIDs.

Side effects are frequent in pharmacological pain management, potentially preceding analgesia and limiting drug tolerability. Discussing side effects is part of informed consent, yet can favor nocebo effects. This study aimed to test whether a positive suggestion regarding side effects, which could act as reminders of the medication having been absorbed, might favor analgesia in a clinical interaction model. Sixty-six healthy males participated in a study "to validate pupillometry as an objective measure of analgesia". Participants were unknowingly randomized double-blind to positive vs control information about side effects embedded in a video regarding the study drugs. Sequences of moderately painful heat stimuli applied before and after treatment with diclofenac and atropine served to evaluate analgesia. Atropine was deceptively presented as a co-analgesic, but used to induce side effects. Adverse events (AE) were collected with the General Assessment of Side Effects (GASE) questionnaire prior to the second induced pain sequence. Debriefing fully informed participants regarding the purpose of the study and showed them the two videos.The combination of medication led to significant analgesia, without a between-group difference. Positive information about side effects increased the attribution of AE to the treatment compared to the control information. The total GASE score was correlated with analgesia, i.e., the more AEs reported, the stronger the analgesia. Interestingly, there was a significant between-groups difference on this correlation: the GASE score and analgesia correlated only in the positive information group. This provides evidence for a selective link between AEs and pain relief in the group who received the suggestion that AEs could be taken as a sign "that help was on the way". During debriefing, 65% of participants said they would prefer to receive the positive message in a clinical context. Although the present results cannot be translated immediately to clinical pain conditions, they do indicate the importance of testing this type of modulation in a clinical context.

How do users adopt health information from social media? The narrative paradigm perspective.

INTRODUCTION: A recent trend in health information seeking and sharing is the use of social media. Although there are several benefits to the use of social media for health communication, the quality of health information exchanged on social media is troubling due to its informal, unregulated mechanisms for information collection, sharing and promotion. Therefore, it is important to understand how users adopt health information from social media. METHOD: Considering the user-generated and storytelling nature of social media messages, this research employed the narrative paradigm perspective to explain the social media health information adoption phenomenon. Specifically, narrative coherence (NC) and narrative fidelity (NF) were hypothesised to have positive effects on the intention to adopt (IA). Additionally, socio-economic status (SES) was viewed as a proxy variable to cognitive capability and was hypothesised to moderate the effects of NC and NF. A scenario-based survey was conducted to test the proposed research model. RESULTS: We obtained a total of 257 valid questionnaires. The results indicated that NF (p < 0.001) had a positive effect on the IA social media health information. The NC (p < 0.01) had no impact on the low SES users but a positive impact on the high SES users. Further, the effect of NF (p < 0.01) on the IA was higher for high SES users than low SES users. CONCLUSIONS: NC and NF are two major driving forces in social media health information adoption, and the effect of both narrative paradigm variables depends on the SES users. IMPLICATIONS: Results of this study show how the narrative paradigm, with a focus on the storytelling method of communication rather than logical scientific argument, can not only explain the uptake of health messages from social media, but also provide guidance as to how to create health messages on social media that more effectively target end users.

Estrategias de persuasión percibidas por adolescentes en situaciones de engaño pederasta por Internet (online grooming) / Persuasion strategies perceived by adolescents in situations of online grooming

El engaño pederasta por Internet (online grooming) es el proceso por el cual un adulto consigue victimizar sexualmente a un menor valiéndose de los medios que ofrece Internet. El objetivo de este estudio fue analizar la prevalencia de las estrategias de persuasión e influencia utilizadas por adultos para manipular e involucrar a menores en el engaño pederasta por Internet, así como las diferencias atendiendo al sexo. Inicialmente, 2731 adolescentes de entre 12 y 15 años (50,6% chicas) completaron un cuestionario sobre solicitudes e interacciones sexuales con adultos y otro sobre persuasión basado en los principios de influencia de Cialdini (2001). 408 Menores (14,9%) se vieron implicados en el engaño pederasta durante el último año (61,3% mujeres; edad media= 14,23; DT= 0,92). Se encontró una utilización altamente frecuente de los principios de influencia, siendo el más experimentado el principio de simpatía (hasta un 50,9%). Las chicas experimentaron más frecuentemente todos los principios excepto el de autoridad, en el que no hubo diferencias. Estos hallazgos proporcionan información útil para entender y prevenir la victimización sexual de los menores en Internet

Online grooming is the process by which an adult sexually victimizes a minor using the means offered by the Internet. The objective of this study was to analyze the prevalence of persuasion and influence strategies used by aggressors to manipulate and involve minors in online grooming, as well as gender differences. The initial sample consisted of 2731 adolescents between 12 and 15 years of age (50.6% girls) who completed a questionnaire on sexual solicitations and interactions with adults and another on persuasion based on the principles of influence of Cialdini (2001). 408 Minors (14.9%) were involved in grooming during the previous year (61.3% girls, mean age= 14.23, DT= 0.92). It was found a highly frequent use of the principles of influence, being the principle of sympathy the most experienced (up to 50.9%). Girls experienced more frequently all the principles of influence except the principle of authority, in which there were no gender differences. These findings provide useful information for understanding and preventing sexual victimization of minors on the Internet

Opportunities and challenges of behavior change support systems for enhancing habit formation: A qualitative study.

The formation of healthy habits is considered to play a fundamental role in health behavior change. A variety of studies on Health Behavior Change Support Systems (HBCSS) have been conducted recently, in which individuals use such systems to influence their own attitudes or behaviors to achieve their personal goals. However, comparatively much less research has been devoted to studying how the users of these systems form habits with the help of HBCSS, or to understanding how to design these systems to support habit formation. OBJECTIVE: The objective of this article is to study HBCSS user experiences regarding habit formation through an intervention study targeted at establishing a healthier lifestyle. This study also aims to map habit formation stages, as suggested by Lally and Gardner, with the Persuasive System Design (PSD) model. The application domain is the prevention of metabolic syndrome, in which 5% weight loss can significantly reduce the prevalence of the syndrome. METHODS: This study employs a web-based HBCSS named Onnikka, a lifestyle intervention designed for the prevention of metabolic syndrome for participants who are at risk of developing a metabolic syndrome or are already suffering from it. The system under investigation was designed according to the principles of the PSD model and Behavior Change Support System framework. Lally and Gardner's research on the stages of habit formation were used to study the extent to which the Onnikka system was able to enhance the development of new habits. A total of 43 Onnikka users were interviewed for this study during and after a 52-week intervention period. The research approach employed here was hermeneutics, which leans ontologically toward the social construction of reality, gained through language, consciousness, and shared meaning. In addition, the system's login data and participants' weight measurements were utilized to build an interpretation of the results. RESULTS: The findings of this study suggest that IT habits appear to have a strong linkage with use adherence, whereas lifestyle habits did not seem to be directly related to the 5% weight loss among study participants. Moreover, habit formation stages provide a possible explanation for why self-monitoring, reminders, and tunneling were perceived as especially valuable features in this study. CONCLUSIONS: For sustainable weight management, holistic e-health interventions are required, and the PSD model offers a practical approach for designing and developing them. Recognizing the stages of habit formation provides additional valuable guidance for designing systems that help shape an individual's habits.

The evaluation of green companies changes after remembering tip of the tongue experiences / La evaluación de empresas verdes cambia a partir del recuerdo de experiencias de la punta de la lengua

Background: This research explores the extent to which attitudes towards an environmentally-friendly topic (a green company) are affected by a "tip of the tongue" (TOT) experience. Method: In this experiment, participants were first exposed to a description of a green company that elicited mostly positive or negative thoughts. As part of an apparently unrelated study, participants were then asked to describe an experience of TOT that either was or was not successfully resolved. The recalling task was independent from the thoughts about the company. Finally, participants reported their attitudes toward the green company for which they initially listed thoughts. Results: Participants who recalled resolving a TOT experience relied on their thoughts about the initial (unrelated) green company more in forming their evaluations than did participants who recalled an unresolved TOT experience. Conclusion: Attitudes can be affected by thinking about an unrelated past meta-cognitive experience (AU)

Antecedentes: la presente investigación explora en qué medida las actitudes hacia un tema relativo al medioambiente (una empresa verde) están afectadas por el recuerdo de una experiencia pasada del fenómeno de la "punta de la lengua" (tip of the tongue; TOT). Método: los participantes leyeron una descripción de una empresa ecológica diseñada para producir pensamientos positivos o pensamientos negativos hacia la misma. A continuación se pidió a los participantes que pensaran sobre situaciones pasadas en las que habían experimentado una experiencia de TOT que fueron capaces de resolver resuelta o que no pudieron resolver. Finalmente, todos los participantes indicaron sus actitudes hacia la empresa verde sobre la que habían listado pensamientos inicialmente. Resultados: los participantes que recordaron haber resuelto la experiencia pasada de TOT usaron más los pensamientos que tenían en ese momento hacia la empresa comparado con aquellos que recordaron una experiencia TOT que no fueron capaces de resolver. Conclusión: las actitudes pueden variar en función del recuerdo de experiencias meta-cognitivas pasadas, aunque sean sobre temas no relacionados (AU)

Leveraging EHRs for patient engagement: perspectives on tailored program outreach.

OBJECTIVES: Electronic health records (EHRs) present healthcare delivery systems with scalable, cost-effective opportunities to promote lifestyle programs among patients at high risk for type 2 diabetes, yet little consensus exists on strategies to enhance patient engagement. We explored patient perspectives on program outreach messages containing content tailored to EHR-derived diabetes risk factors-a theory-driven strategy to increase the persuasiveness of health communications. STUDY DESIGN: Convergent mixed methods. METHODS: Within an integrated healthcare delivery system, women with a history of gestational diabetes participated in 1 of 6 ethnic-specific focus groups to elicit diverse perspectives and a survey yielding quantitative data to contextualize qualitative responses. RESULTS: The sample included 35 participants (80% racial/ethnic minorities; mean age = 36 years). Themes regarding tailored messages centered on diabetes risk communication (opposing attitudes about whether to feature diabetes risk factors), privacy (how and whether patient data should be accessed), authenticity (perceiving messages as personalized vs generically computer generated), and preferences for messages sent by one's personal physician. Trust in the medical profession and perceived risk for diabetes were similar to levels reported in comparable samples. CONCLUSIONS: Patient reactions highlight the challenges of leveraging EHRs for tailored messages. Some viewed messages as caring reminders to take preventive action and others raised concerns over intrusiveness. Optimal lifestyle program outreach to improve quality of care for women at high risk for diabetes may require communication from personal physicians, careful development to mitigate concerns over privacy and authenticity, and techniques to counteract the threatening nature of personalized risk communication.

Maximizing the persuasiveness of a salesperson: an exploratory study of the effects of nonverbal immediacy and language power on the extent of persuasion / Cómo maximizar la capacidad de persuasión de un vendedor: estudio exploratorio de los efectos de la cercanía no verbal y el poder del lenguaje en el grado de persuasión

The present study investigated the effects of a salesperson’s use of language power and nonverbal immediacy on the persuasiveness of the salesperson. A high level of language power and a high level of nonverbal immediacy were hypothesized to singularly and jointly increase a salesperson’s level of persuasiveness. A sample of 211 undergraduate students voluntarily completed an online survey, which displayed a video clip of a sales presentation. Each participant randomly viewed one of four video clips, which differed in terms of the salesperson’s levels of language power (powerful vs. powerless) and nonverbal immediacy (high vs. low). A three-way ANOVA indicated that language power had a significant main effect on persuasion in the expected direction, and also revealed a significant interaction between nonverbal immediacy and participant biological sex. However, there were no main effects for nonverbal immediacy and participant biological sex, and no interaction effect was found between language power and nonverbal immediacy. Subsequent data analysis revealed that the perceived power of the speaker mediated the relationship between language power and the extent of persuasion. We conclude the article with a discussion of the implications of our findings for both researchers and practitioners (AU)

Este estudio investiga los efectos de la utilización por parte de los vendedores del poder del lenguaje y de la cercanía no verbal en la persuasión del vendedor. Se postula que un grado elevado de poder del lenguaje y de cercanía no verbal aumentarán tanto individualmente como conjuntamente el nivel de persuasión del vendedor. Una muestra compuesta por 211 estudiantes universitarios cumplimentó voluntariamente una encuesta online que mostraba un video de una presentación de ventas. Cada participante vio al azar uno de los cuatro videos, que se diferenciaban en el grado de poder del lenguaje (poderoso vs. incapaz) y de cercanía (elevada vs. baja) no verbal del vendedor. Un ANOVA de tres factores indicaba que el poder del lenguaje tenía un efecto principal significativo en la persuasión en la dirección esperada, así como una interacción significativa entre la proximidad no verbal y el sexo biológico de los participantes. No obstante, no había efectos principales para la cercanía no verbal o el sexo biológico de los participantes ni se encontró interacción entre el poder del lenguaje y la proximidad no verbal. Un análisis de datos posterior reveló que el poder percibido del hablante mediatizaba la relación entre el poder del lenguaje y el grado de persuasión. El artículo finaliza con un debate sobre las implicaciones de los resultados para investigadores y los profesionales (AU)

Laughing in the Face of Fear (of Disease Detection): Using Humor to Promote Cancer Self-Examination Behavior.

This research examines the possible benefit of using humor to reduce anxiety associated with performing cancer self-examination behaviors. In Study 1, 187 undergraduates read a humorous public service announcement (PSA) script promoting either breast or testicular self-exams. Results suggest that perception of humor reduced anxiety about self-exams, which, in turn, related to more positive self-exam attitudes. Simultaneously, humor perception associated with greater message processing motivation, which, in turn, associated with more supportive self-exam attitudes. Self-exam attitudes also positively associated with self-exam intentions. These results were largely replicated in Study 2. Further, self-exam intentions predicted self-exam behavior 1 week later. However, consistent with past research, the humorous and serious messages did not generate differences in subsequent self-exam behavior, though the intention-behavior relationship was stronger and significant for those exposed to the humorous versus the serious messages. In light of these findings, and given that humor has the advantage of attracting and holding attention in real message environments, the use of carefully constructed humor appeals may be a viable message strategy to promote health detection behaviors.

When Different Message Frames Motivate Different Routes to the Same Health Outcome.

BACKGROUND: Message framing is an effective strategy for promoting health behavior. PURPOSE: We examined the relative effectiveness of framed messages that simultaneously promoted two different health behaviors-eating a calcium-rich diet and taking calcium supplements-for preventing osteoporosis. Because those behaviors are associated with different perceptions of risk, we predicted that gain- and loss-framed messages would have opposite effects. METHODS: In two experiments, participants (N1 = 69; N2 = 219) were randomly assigned to a gain- or loss-framed message presenting two osteoporosis prevention behaviors. RESULTS: A gain-framed advantage was observed for dietary calcium consumption, but the opposite-a loss-framed advantage-was observed for use of calcium supplements. Message frame interacted with baseline calcium consumption behavior for some outcomes. CONCLUSIONS: Both gain- and loss-framed messages increased osteoporosis prevention behavior, but their relative effectiveness depended on the type of behavior. Framed messages can have opposite effects on different behaviors used to achieve a common health goal.

Research on Psychiatric Treatment by Psychiatrists of Chosun-Governor Hospital and Keijo Imperial University Hospital in Korea during Japanese Colonial Rule / 신경정신의학

This review describes the types of psychiatric treatment studied during the Japanese colonial period of 1910–1945 in Korea, known at the time as Chosun. Twenty-nine research papers and abstracts on psychiatric treatment were reviewed, which were published in the Shinkeigaku-zassi (Neurologia), the Seishin-shinkei-gaku zassi (Psychiatria Et Neurologia Japonica) and the Journal of Chosun Medical Association, by faculty members of the department of neuropsychiatry, Chosun-Governor Hospital and Keijo (Seoul) Imperial University School of Medicine. The major research area was biological psychiatry and biological treatment, as Japanese pioneers in psychiatry at that time had introduced German psychiatry into Japan. Professor Kubo published the most papers, followed by Dr. Hattori, Dr. Hikari, and Professor Suits. In Chosun-Governor Hospital, research on prolonged sleep therapy was an active field. In the Imperial University Hospital, malarial fever therapy, sulphur-induced fever therapy, and insulin shock treatment were the most frequent research topics. Some were tried for the first time in the Japanese Empire, which reflected the pioneering position of the university. These achievements are attributed to Professor Kubo. Six papers on psychotherapy were published. Among them, two papers were on persuasion therapy, three papers were case reports of psychoanalytic therapy, and one paper on Freud. However, this psychoanalytic therapy research seemed to be limited trials conducted following literal guidance, and no further development was noted. Generally, research was characterized by simple design, small numbers of subjects, lack of objective evaluation method, lack of statistical treatment, and especially lack of ethical consideration comparing with today's standard.

[How to convince the head of department and managing director of the importance of specialised headache clinics]. / Como convencer al jefe de servicio y al gerente de la importancia de las unidades/consultas especializadas de cefaleas.

In spite that headache is, by far, the most frequent reason for neurological consultation and that the diagnosis and treatment of some patients with headache is difficult, the number of headache clinics is scarce in our country. In this paper the main arguments which should allow us, as neurologists, to defend the necessity of implementing headache clinics are reviewed. To get this aim we should first overcome our internal reluctances, which still make headache as scarcely appreciated within our specialty. The facts that more than a quarter of consultations to our Neurology Services are due to headache, that there are more than 200 different headaches, some of them actually invalidating, and the new therapeutic options for chronic patients, such as OnabotulinumtoxinA or neuromodulation techniques, oblige us to introduce specialised headache attendance in our current neurological offer. Even though there are no definite data, available results indicate that headache clinics are efficient in patients with chronic headaches, not only in terms of health benefit but also from an economical point of view.

TITLE: Como convencer al jefe de servicio y al gerente de la importancia de las unidades/consultas especializadas de cefaleas.A pesar de que la cefalea es, con diferencia, el principal motivo neurologico de consulta, y de la complejidad diagnostica y terapeutica de algunos pacientes, el numero de consultas monograficas de cefalea (CC) y de unidades de cefalea (UC) es muy reducido en nuestro pais. En este articulo pasaremos revista a los principales argumentos que nos permitan, como neurologos, defender la necesidad de la implementacion de una CC/UC, dependiendo de la poblacion que se debe atender, en todos nuestros servicios de neurologia. Para ello deberemos, en primer lugar, vencer las reticencias internas, que hacen que la cefalea sea aun poco apreciada y atractiva dentro de nuestra especialidad. El hecho de que la cefalea justifique mas de un cuarto de las consultas a un servicio de neurologia estandar de nuestro pais y de que existan mas de 200 cefaleas diferentes, algunas de ellas realmente invalidantes, y las nuevas opciones de tratamiento para pacientes cronicos, como la OnabotulinumtoxinA para la migraña cronica o las tecnicas de neuromodulacion, obligan a introducir dentro de nuestras carteras de servicios la asistencia especializada en cefaleas. Aunque no disponemos de datos incontrovertibles, existen ya datos suficientes en la literatura que indican que esta atencion es eficiente en pacientes con cefaleas cronicas no solo en terminos de salud, sino tambien desde el punto de vista economico.

[Thought of charity-persuasion and the compilation, carving and spread of medical formulary in the Qing Dynasty].

Since the Song Dynasty, morality books aiming at guiding agaisnst evil and persuading charity, spread widely in the civil society. Many medical issues were categorized as encouraging kindness, hence, the thought of encouraging kindness was gradually infiltrated into the development of medical and health services. For the dissemination of medical knowledge, medical formulary became the favorite to well-doers because of its practicability in curing diseases and saving lives. Therefore, the thought of encouraging kindness infiltrated into the compilation, carving and spread of many medical formularies. The thought of encouraging kindness not only rendered a lot of doctors throw their whole life into the cause, but also attracted groups such as Confucian scholars, officers, scholar-officials and many organizations such as benevolent society, benevolent association, bookshop and publishing house to join in, thus increasing the entities of spreaders, expanding the range for the spread of medical knowledge and promoting the popularization and utilization of medical knowledge in grass-root society and remote area, which was helpful in dealing with the social problems such as shortage of medical resources and its uneven distribution.

Communicating eating-related rules. Suggestions are more effective than restrictions.

BACKGROUND: A common social influence technique for curbing unhealthy eating behavior is to communicate eating-related rules (e.g. 'you should not eat unhealthy food'). Previous research has shown that such restrictive rules sometimes backfire and actually increase unhealthy consumption. In the current studies, we aimed to investigate if a milder form of social influence, a suggested rule, is more successful in curbing intake of unhealthy food. We also investigated how both types of rules affected psychological reactance. METHOD: Students (N = 88 in Study 1, N = 51 in Study 2) completed a creativity task while a bowl of M&M's was within reach. Consumption was either explicitly forbidden (restrictive rule) or mildly discouraged (suggested rule). In the control condition, consumption was either explicitly allowed (Study 1) or M&M's were not provided (Study 2). Measures of reactance were assessed after the creativity task. Subsequently, a taste test was administered where all participants were allowed to consume M&M's. RESULTS: Across both studies, consumption during the creativity task did not differ between the restrictive- and suggested-rule-conditions, indicating that both are equally successful in preventing initial consumption. Restrictive-rule-condition participants reported higher reactance and consumed more in the free-eating taste-test phase than suggested-rule-condition participants and control-group participants, indicating a negative after-effect of restriction. DISCUSSION: RESULTS show that there are more and less effective ways to communicate eating-related rules. A restrictive rule, as compared to a suggested rule, induced psychological reactance and led to greater unhealthy consumption when participants were allowed to eat freely. It is important to pay attention to the way in which eating-related rules are communicated.

Sequencing the threat and recommendation components of persuasive messages differentially improves the effectiveness of high- and low-distressing imagery in an anti-alcohol message in students.

OBJECTIVES: Distressing imagery is often used to improve the persuasiveness of mass-reach health promotion messages, but its effectiveness may be limited because audiences avoid attending to content. Prior self-affirmation or self-efficacy inductions have been shown to reduce avoidance and improve audience responsiveness to distressing messages, but these are difficult to introduce into a mass-reach context. Reasoning that a behavioural recommendation may have a similar effect, we reversed the traditional threat-behavioural recommendation health promotion message sequence. DESIGN: 2 × 2 experimental design: Factor 1, high- and low-distress images; Factor 2, threat-recommendation and recommendation-threat sequences. METHODS: Ninety-one students were exposed to an identical text message accompanied by high- or low-distress imagery presented in threat-recommendation and recommendation-threat sequences. RESULTS: For the high-distress message, greater persuasion was observed for the recommendation-threat than the threat-recommendation sequence. This was partially mediated by participants' greater self-exposure to the threat component of the message, which we attribute to the effect of sequence in reducing attentional avoidance. For the low-distress message, greater persuasion was observed for the threat-recommendation sequence, which was not mediated by reading time allocated to the threat. CONCLUSIONS: Tailoring message sequence to suit the degree of distress that message developers wish to induce provides a tool that could improve persuasive messages. These findings provide a first step in this process and discuss further steps needed to consolidate and expand these findings. Statement of contribution What is already known on this subject? Health promotion messages accompanied by distressing imagery might, under some circumstances, persuade individuals to engage in healthier behaviour. Audiences can respond defensively to distressing imagery, but may be less inclined to do so when an easily followed behavioural recommendation is presented before imagery. Current literature is divided on whether presenting a behavioural recommendation before a threat component accompanied by distressing images will improve the persuasiveness of messages. What does this study add? We show that, when a behavioural recommendation precedes a threat containing distressing images, persuasiveness of a threatening message is stronger than a threat-recommendation sequence. We show that a recommendation-threat sequence improves persuasiveness of distressing imagery because it reduces attentional avoidance.

[Mentalization and theory of mind]. / Mentalisierung und Theory of Mind.

Both concepts, mentalization and the theory of mind, describe metacognitive processes. Mentalization mainly concerns the reflection of affective mental states. In contrast, theory of mind focuses on epistemic states such as beliefs, intentions and persuasions. Gender differences have proved to be relevant for both, the development of mentalization and the theory of mind. However, there are few studies and findings are inconsistent. In an own study, we investigated the relationship between early competences in metacognition (tested in a false-belief-task second order) and narrative skills of kindergarten children. Results show that children who had successfully passed the theory of mind test tended to face conflicts more directly in the stories. In consequence, these children showed less narrative avoidance. However, differences were only found in girls and not in boys. The precise understanding of developmental differences in metacognition between girls and boys may be an important aspect with regards to improving mentalization based therapy of children.