Normative Influence of the Stars: The Relative Indirect Effects of Celebrity Exemplars on Vaping Norm Perceptions Through Liking, Parasocial Relationship Strength, and Wishful Identification.

Although the influence of celebrities on public health-related attitudes and behaviors is well established, the specific role that celebrity examples play in shaping health-related social norm perceptions is not well understood. To examine the effect of celebrities on social norm perceptions, young adults were randomly assigned to read news articles about vaping that either featured one of four film stars using a vape pen or did not contain any celebrity exemplar. The presence or absence of a celebrity exemplar did not affect readers' perceptions of vaping social norms. However, three types of audience involvement with the celebrities - liking, parasocial relationship strength, and wishful identification, were examined as mediators of the relative effects of the different celebrities on vaping norm perceptions. The results suggest that celebrities who people like more and those who they wishfully identify with less can wield a greater influence on social norms. PSR strength did not mediate indirect effects of celebrity on social norm perceptions. These findings indicate that celebrities can shape public perceptions of social norms through some types of involvement.

Right hemidiaphragmatic paralysis after cervical transforaminal epidural steroid injection: illustrative case.

BACKGROUND: Cervical radiculopathy is a common cause of neck pain, with radiation into the upper extremity in a dermatomal pattern. Corticosteroid injection is a conservative management option with a low risk of major adverse events. No reviewed literature or case reports have implicated phrenic nerve injury secondary to cervical transforaminal epidural steroid injection (CTFESI). OBSERVATIONS: A 45-year-old man with severe right C6 radiculopathy secondary to a large right-sided C5-6 herniated intervertebral disc presented to the pain management clinic, where he received a right-sided C6 CTFESI. An hour after injection, the patient experienced shortness of breath, which was found to be caused by right diaphragmatic paralysis. The patient underwent a C5-6 anterior cervical discectomy and fusion, which provided complete relief of his radicular symptoms. However, the right hemidiaphragmatic paralysis remained at the 1-year postoperative visit. LESSONS: Thorough literature review showed no established explanations for phrenic nerve injury after CTFESI. In this study, the authors explored the suspected mechanisms of possible injury to the phrenic nerve. Epidural corticosteroid injection is considered to be a safe option for conservative management of cervical radiculopathy. This study unveiled a unique and important adverse event that should be considered before a patient receives CTFESI.

To Refer or Not to Refer: Exploring Family Therapists' Beliefs and Practices Related to the Referral of Lesbian, Gay, and Bisexual Clients.

This study explored how negative beliefs toward lesbian, gay, and bisexual (LGB) individuals and LGB clinical competence influenced family therapists' beliefs and practices regarding referring based on the sexual orientation of the client. The sample consisted of 741 experienced clinicians. The results of this study indicated that the majority of the participants believe it is ethical to refer LGB clients; however, most had never made such a referral. Furthermore, participants who had referred based solely on the client's sexual orientation reported higher levels of negative beliefs toward LGB individuals and lower levels of LGB clinical competence. Finally, negative beliefs toward LGB persons not only predicted the practice of referring, but also the belief that it is ethical to refer an LGB client.

TBIs: an emerging risk for health systems.

Healthcare providers should take eight steps to ensure their organizations are prepared for the potential risks associated with traumatic brain injuries: Review current procedures. Educate parents and caregivers. Create targeted programs for seniors. Adopt standard written protocols for providers for identification and treatment. Ensure proper and periodic follow-up with all patients at risk. Add a question about recent falls and head injuries to the patient intake discussion sheet. Conduct thorough debriefings and analyses following confirmed TBIs. Evaluate the organization's current insurance policy to ensure it provides the coverage needed.