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Public Understanding of Science... May 2024Despite scientific consensus on climate change, climate denial is still widespread. While much research has characterised climate denial, comparatively fewer studies...
Despite scientific consensus on climate change, climate denial is still widespread. While much research has characterised climate denial, comparatively fewer studies have systematically examined how to counteract it. This review fills this gap by exploring the research about counteracting climate denial, the effectiveness and the intentions behind intervention. Through a systematic selection and analysis of 65 scientific articles, this review finds multiple intervention forms, including education, message framing and inoculation. The intentions of intervening range from changing understanding of climate science, science advocacy, influencing mitigation attitudes and counteracting vested industry. A number of divergent findings emerge: whether to separate science from policy; the disputed effects of emotions and the longitudinal impacts of interventions. The review offers guiding questions for those interested in counteracting denialism, the answers to which indicate particular strategies: identify the form of climate denial; consider the purpose of intervention and recognise one's relationship to their audiences.
Topics: Attitude; Climate Change; Denial, Psychological; Public Opinion
PubMed: 38243813
DOI: 10.1177/09636625231223425 -
Social Science & Medicine (1982) May 2022Gaslighting is a type of abuse aimed at making victims question their sanity as well as the veracity and legitimacy of their own perspectives and feelings. In this...
Gaslighting is a type of abuse aimed at making victims question their sanity as well as the veracity and legitimacy of their own perspectives and feelings. In this article, we show how gaslighting can operate as a key, yet underexamined strategy of obstetric violence, or the institutional and interpersonal violation of women's rights during pregnancy, childbirth, and postpartum. We draw on forty-six in-depth, semi-structured interviews with mothers who experienced a traumatic childbirth to examine how obstetric providers gaslight mothers before, during and after childbirth when they deny - and thereby destabilize - mothers' realities. We identify and examine four core types of denials: denials of 1) mothers' humanity, 2) mothers' knowledge as valid, 3) mothers' judgements as rational and 4) mothers' feelings as legitimate. All four denials work to render mothers noncredible and their claims illegible within clinical encounters. In explicitly naming, theorizing, and examining obstetric gaslighting, our aims are threefold: 1) to uncover and theorize an underexamined mechanism of obstetric violence through a sociological lens, 2) to offer a typology of obstetric gaslighting's manifestations to aid scholars and practitioners in recognizing when obstetric gaslighting is occurring and 3) to advance a growing research program on gaslighting in medicine.
Topics: Delivery, Obstetric; Female; Gaslighting; Humans; Mothers; Parturition; Pregnancy; Violence
PubMed: 35395611
DOI: 10.1016/j.socscimed.2022.114938 -
Plastic and Reconstructive Surgery.... Oct 2023Despite evidence documenting the physical and psychological benefits of breast reduction, third-party payer approval remains a cumbersome process. The objective of this...
BACKGROUND
Despite evidence documenting the physical and psychological benefits of breast reduction, third-party payer approval remains a cumbersome process. The objective of this study was to assess differences in medical necessity criteria for reduction mammaplasty among US insurance carriers while analyzing trends in claim denials and appeals.
METHODS
The medical necessity criteria for reduction mammaplasty were retrieved from seven large health insurance carriers. Data were extracted from each policy, including claim requirements for approval. Additionally, prospective data on claims and denials submitted from January through August 2022 were collected from The Auctus Group, a medical consulting firm.
RESULTS
All the policies have been updated since January 2020. Five of the seven policies specifically listed what documentation was required for preauthorization approval, with five third-party payers requiring photograph documentation. Policies required documentation of one to three symptoms lasting from 6 weeks to 1 year. All companies reported a tissue resection estimate threshold, but cutoffs varied. Of 380 reduction mammaplasties performed, 158 (41.6%) received a denial on initial insurance submission. Considering appeals, a total of 216 denials were reviewed with an average of 1.37 denials per patient. Of the 158 initial denials, 104 (65.8%) of these were from claims that received preauthorization. In 12 cases, third-party payers stated that no prior authorization was necessary yet still denied the claim.
CONCLUSIONS
Wide variability exists in medical necessity criteria for reduction mammaplasty policies among major insurance carriers. These nuances introduce inefficiencies for practices contributing to high denial and appeal rates while delaying surgical care for patients.
PubMed: 37900990
DOI: 10.1097/GOX.0000000000005361 -
Jornal Brasileiro de Pneumologia :... 2022To investigate factors that influence or promote disbelief and negative attitudes toward COVID-19.
OBJECTIVE
To investigate factors that influence or promote disbelief and negative attitudes toward COVID-19.
METHODS
This was cross-sectional study involving 544 males and females ≥ 18 years of age in Greece between December of 2020 and January of 2021. All participants were informed about the purpose of the study, protection of anonymity, and volunteer participation. Participants completed an online anonymous 40-item questionnaire. Analysis of data included the identification of correlations and use of t-tests and ANOVA.
RESULTS
The level of knowledge regarding COVID-19 transmission routes, manifestations, and prevention was high in our sample. Women appeared to have a more positive attitude toward COVID-19 prevention and management than did men (p = 0.032 and p = 0.018, respectively). Younger people (18-30 years of age) seemed to deny the validity of scientific data and mass media reports about ways to deal with the pandemic more commonly than did those > 30 years of age (p = 0.003 and p = 0.001, respectively). People who resided in cities more commonly believed in scientific announcements than did those living in villages (p = 0.029).
CONCLUSIONS
In order to minimize cases of denial of and disbelief in COVID-19 and to promote vaccination, a series of actions are required. Governments should implement a series of measures to contain the disease, taking into consideration the psychological and social aspects of those policies.
Topics: Adult; COVID-19; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Pandemics; SARS-CoV-2; Surveys and Questionnaires
PubMed: 36169560
DOI: 10.36416/1806-3756/e20220228 -
Annual Review of Public Health Apr 2021Climate change presents a challenge at multiple levels: It challenges our cognitive abilities because the effect of the accumulation of emissions is difficult to... (Review)
Review
Climate change presents a challenge at multiple levels: It challenges our cognitive abilities because the effect of the accumulation of emissions is difficult to understand. Climate change also challenges many people's worldview because any climate mitigation regime will have economic and political implications that are incompatible with libertarian ideals of unregulated free markets. These political implications have created an environment of rhetorical adversity in which disinformation abounds, thus compounding the challenges for climate communicators. The existing literature on how to communicate climate change and dispel misinformation converges on several conclusions: First, providing information about climate change, in particular explanations of why it occurs, can enhance people's acceptance of science. Second, highlighting the scientific consensus can be an effective means to counter misinformation and raise public acceptance. Third, culturally aligned messages and messengers are more likely to be successful. Finally, climate misinformation is best defanged, through a process known as inoculation, before it is encountered, although debunking techniques can also be successful.
Topics: Climate Change; Communication; Humans
PubMed: 33355475
DOI: 10.1146/annurev-publhealth-090419-102409 -
Neuropsychiatric Disease and Treatment 2017Interest in assessing denial is still present, despite the criticisms concerning its definition and measurement. We tried to develop a questionnaire (Illness Denial...
PURPOSE
Interest in assessing denial is still present, despite the criticisms concerning its definition and measurement. We tried to develop a questionnaire (Illness Denial Questionnaire, IDQ) assessing patients' and caregivers' denial in relation to their illness/disturbance.
PATIENTS AND METHODS
After a preliminary study, a final version of 24 dichotomous items (true/false) was selected. We hypothesized a theoretical model with three dimensions: denial of negative emotions, resistance to change, and conscious avoidance, the first two composing the actual Denial and the last representing an independent component of the illness denial behavior. The IDQ was administered to 400 subjects (219 patients and 181 caregivers) together with the Anxiety-Depression Questionnaire - Reduced form (AD-R), in order to assess concurrent validity. Confirmatory factor analysis (CFA), internal consistency indices (Cronbach's α and McDonald's ω), and test-retest analysis were performed.
RESULTS
CFA and internal consistency indices (Cronbach's α: 0.87-0.96) indicated a clear and meaningful three-factor structure of IDQ, for both patients and caregivers. Further analyses showed good concurrent validity, with Denial and its subscale negatively associated with anxiety and depression and avoidance positively associated with anxiety and depression. The IDQ also showed a good stability ( from 0.71 to 0.87).
CONCLUSION
The IDQ demonstrated good psychometric properties. Denial of negative emotions and resistance to change seem to contribute to a real expression of denial, and conscious avoidance seems to constitute a further step in the process of cognitive-affective elaboration of the illness.
PubMed: 28356745
DOI: 10.2147/NDT.S128622 -
Psychotherapy and Psychosomatics 2023Illness denial pertains to medical patients who do not acknowledge the presence or severity of their disease or the need of treatment. (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Illness denial pertains to medical patients who do not acknowledge the presence or severity of their disease or the need of treatment.
OBJECTIVE
This systematic review was performed to clarify the clinical role and manifestations of illness denial, its impact on health attitudes and behavior, as well as on short- and long-term outcomes in patients with medical disorders.
METHODS
The systematic search according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines was conducted on PubMed, Scopus, and Web of Science.
RESULTS
The initial search yielded a total of 14,098 articles; 176 studies met the criteria for inclusion. Illness denial appeared to be a relatively common condition affecting a wide spectrum of health attitudes and behavior. In some cases, it may help a person cope with various stages of illness and treatment. In other situations, it may determine delay in seeking treatment, impaired adherence, and reduced self-management, leading to adverse outcomes. The Diagnostic Criteria for Psychosomatic Research (DCPR) were found to set a useful severity threshold for the condition. An important clinical distinction can also be made based on the DCPR for illness denial, which require the assessment of whether the patient has been provided with an adequate appraisal of the medical situation.
CONCLUSIONS
This systematic review indicates that patients with medical disorders experience and express illness denial in many forms and with varying degrees of severity. The findings suggest the need for a multidimensional assessment and provide challenging insights into the management of medical disorders.
Topics: Humans; Psychophysiologic Disorders; Denial, Psychological
PubMed: 37429268
DOI: 10.1159/000531260 -
The Journal of Physiology Jan 2022Locomotion on complex terrains often requires vision. However, how vision serves locomotion is not well understood. Here, we asked when visual information necessary for...
Locomotion on complex terrains often requires vision. However, how vision serves locomotion is not well understood. Here, we asked when visual information necessary for accurate stepping is collected and how its acquisition relates to the step cycle. In cats of both sexes, we showed that a brief (200-400 ms) interruption of visual input can rapidly influence cat's walking along a horizontal ladder. Depending on the phase within the step cycle, a 200 ms period of darkness could be tolerated fully without any changes to the strides or could lead to minor increases of stride duration. The effects of 300-400 ms of visual input denial, which typically prolonged stances and/or swings, also depended on the phase of the darkness onset. The increase of the duration of strides was always shorter than the duration of darkness. We conclude that visual information for planning a swing is collected starting from the middle of the preceding stance until the beginning of the current swing. For a stance (and/or a swing of the other paw), visual information is collected starting from the end of the previous stance and until the middle of the current stance. Acquisition of visual information during these windows is not uniform but depends on the phase of the step cycle. Notably, both the extension of these windows and their non-homogeneity are closely related to the pattern of gaze behaviour in cats, described previously. This new knowledge will help to guide research and understanding of neuronal mechanisms of visuomotor integration and modulation of visual function by strides during locomotion. KEY POINTS: Cats, like humans, rely on vision to navigate in complex environments. In cats walking along a horizontally placed ladder, we show that visual information required for accurate stepping is collected in a non-uniform manner throughout the stride cycle. Brief denial of visual input during a swing prolongs the next stance of that forelimb. Denial of visual input during a stance prolongs this stance, as well as the next swing and stance. Denial during the first half of a stance has a greater effect than during the second half. The phase dependence of the use of vision for accurate stepping and the pattern of affected swings and stances are closely related to the previously described pattern of gaze behaviour in cats. This new knowledge opens new perspectives for research into neuronal mechanisms of visuomotor coordination and visual function during walking and for understanding related disorders.
Topics: Animals; Cats; Darkness; Electromyography; Female; Forelimb; Locomotion; Male; Walking
PubMed: 34761816
DOI: 10.1113/JP282255 -
BMC Geriatrics May 2016There has been a substantial number of systematic reviews of stress, coping and interventions for people with dementia and their caregivers. This paper provides a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
There has been a substantial number of systematic reviews of stress, coping and interventions for people with dementia and their caregivers. This paper provides a meta-review of this literature 1988-2014.
METHOD
A meta-review was carried out of systematic reviews of stress, coping and interventions for people with dementia and their caregivers, using SCOPUS, Google Scholar and CINAHL Plus databases and manual searches.
RESULTS
The meta-review identified 45 systematic reviews, of which 15 were meta-analyses. Thirty one reviews addressed the effects of interventions and 14 addressed the results of correlational studies of factors associated with stress and coping. Of the 31 systematic reviews dealing with intervention studies, 22 focused on caregivers, 6 focused on people with dementia and 3 addressed both groups. Overall, benefits in terms of psychological measures of mental health and depression were generally found for the use of problem focused coping strategies and acceptance and social-emotional support coping strategies. Poor outcomes were associated with wishful thinking, denial, and avoidance coping strategies. The interventions addressed in the systematic reviews were extremely varied and encompassed Psychosocial, Psychoeducational, Technical, Therapy, Support Groups and Multicomponent interventions. Specific outcome measures used in the primary sources covered by the systematic reviews were also extremely varied but could be grouped into three dimensions, viz., a broad dimension of "Psychological Well-Being v. Psychological Morbidity" and two narrower dimensions of "Knowledge and Coping" and of "Institutionalisation Delay".
CONCLUSIONS
This meta-review supports the conclusion that being a caregiver for people with dementia is associated with psychological stress and physical ill-health. Benefits in terms of mental health and depression were generally found for caregiver coping strategies involving problem focus, acceptance and social-emotional support. Negative outcomes for caregivers were associated with wishful thinking, denial and avoidance coping strategies. Psychosocial and Psychoeducational interventions were beneficial for caregivers and for people with dementia. Support groups, Multicomponent interventions and Joint Engagements by both caregivers and people with dementia were generally found to be beneficial. It was notable that virtually all reviews addressed very general coping strategies for stress broadly considered, rather than in terms of specific remedies for specific sources of stress. Investigation of specific stressors and remedies would seem to be a useful area for future research.
Topics: Adaptation, Psychological; Caregivers; Dementia; Depression; Emotions; Humans; Mental Health; Social Support; Stress, Psychological
PubMed: 27193287
DOI: 10.1186/s12877-016-0280-8 -
Orphanet Journal of Rare Diseases Oct 2022Severe combined immunodeficiency (SCID) is a group of rare genetic disorders that cause disruption in immune system functioning. Parents of children with SCID experience...
BACKGROUND
Severe combined immunodeficiency (SCID) is a group of rare genetic disorders that cause disruption in immune system functioning. Parents of children with SCID experience many uncertainties related to their child's diagnosis, treatment, recovery, and quality of life. To fully understand parents' experiences throughout their SCID journey, it is important to explore the stressors generated by such uncertainties and how parents cope with these stressors.
METHODS
We conducted 26 in-depth interviews with parents whose child was diagnosed with SCID or a SCID-like condition through newborn screening. The interviews explored uncertainties related to their child's diagnosis and how parents coped with these uncertainties. Transcripts were generated from the interviews and analyzed using an inductive content analysis approach which included data immersion, generation and assignment of codes, and interpretation.
RESULTS
Parents used a variety of behavioral, cognitive, and affective coping strategies which evolved throughout their SCID journeys. Some parents reported coping by playing an active role in their child's treatment, which included reaching out to other SCID parents or seeking second medical opinions. Other types of coping included establishing house hygiene rules, thinking positively about the child's treatment progress, and relying on family members for help. These coping strategies were both deliberate and intuitive. Participants also described their struggles in coping with stressors related to their child's health and survival. They reported difficulty in processing their emotions and experiencing denial and guilt related to their child's diagnosis. Some parents adapted to ongoing uncertainties through such strategies as positive thinking, self-reflection, and relying on family and community. With successful adaptation, parents emphasized that they continue to use these strategies today.
CONCLUSION
Our assessment revealed that parents of children diagnosed with SCID use a variety of behavioral, cognitive, and affective approaches to cope with SCID uncertainties. Although parents reported challenges in coping with SCID uncertainties, they also reported finding ways to overcome these stressors and establish patterns of effective coping. Findings from our study can serve as a guide for parents whose child was newly diagnosed with SCID and for providers such as social workers, genetic counselors, and psychologists.
Topics: Child; Infant, Newborn; Humans; Quality of Life; Severe Combined Immunodeficiency; Stress, Psychological; Adaptation, Psychological; Parents
PubMed: 36303152
DOI: 10.1186/s13023-022-02554-9