bluuebunny/crossref_metadata_2025 huggingface dataset:
Recent trends in temporal and geographical variation in blubber thickness of common Minke whales (Balaenoptera acutorostrata acutorostrata) in the Northeast Atlantic
Authors: Solvang Hiroko , Haug Tore , Øien Nils
Published: September 2022

The common minke whale (Balaenoptera acutorostrata acutorostrata) is a migratory species, and the summer period is generally characterized by intensive feeding and consequently seasonal fattening at high latitudes. The fat deposited is stored as energy reserves for overwintering at lower latitudes where feeding is supposed to be greatly reduced. It is therefore expected that their body condition on the summer feeding grounds will reflect foraging success during their most intensive feeding period and thus indicate how well the high latitude ecosystems can support the populations. During the commercial catch operations on feeding grounds in Norwegian waters, body condition data (blubber thickness and girth) have been collected from 13 937 common minke whales caught during the period 1993-2020. To investigate associations between body condition and area usage in minke whales, we applied three statistical approaches: regressions, canonical correlations, and spatiotemporal effect estimations. The analyses revealed a significant negative trend in blubber thickness from 1993 until 2015. After 2015, the trend was reversed, and blubber thickness values increased significantly. It has previously been suggested that there may be a link between the decreased minke whale blubber thickness and the abundance of the Northeast Arctic cod (Gadus morhua) stock which increased to a record high level between 2006 and 2013. Recruitment to the cod stock in more recent years has been low with a subsequent and continuous decrease in the total stock after 2013 to a current level which is presumably approximately 60% of the 2013 level. Interestingly, the observed common minke whale body condition was at its lowest in 2015, after which it has increased. This may support a connection between cod abundance and common minke whale body condition.
Prescriptive process monitoring: Quo vadis?
Authors: Kubrak Kateryna , Milani Fredrik , Nolte Alexander , Dumas Marlon
Published: September 2022

Prescriptive process monitoring methods seek to optimize a business process by recommending interventions at runtime to prevent negative outcomes or address poorly performing cases. In recent years, various prescriptive process monitoring methods have been proposed. This article studies existing methods in this field via a systematic literature review (SLR). In order to structure the field, this article proposes a framework for characterizing prescriptive process monitoring methods according to their performance objective, performance metrics, intervention types, modeling techniques, data inputs, and intervention policies. The SLR provides insights into challenges and areas for future research that could enhance the usefulness and applicability of prescriptive process monitoring methods. This article highlights the need to validate existing and new methods in real-world settings, extend the types of interventions beyond those related to the temporal and cost perspectives, and design policies that take into account causality and second-order effects.
Mode-specific effects of concentric and eccentric isokinetic training of the hamstring muscle at slow angular velocity on the functional hamstrings-to-quadriceps ratio-a randomized trial
Authors: Sharma Kushla Nand , Quddus Nishat , Hameed Unaise Abdul , Khan Sohrab Ahmad , Kumari Anita , Alghadir Ahmad H. , Khan Masood
Published: September 2022

Background

Previous studies have examined the mode specificity of eccentric and concentric isokinetic training, but have reported conflicting results. Few studies have reported that eccentric and concentric isokinetic training are mode-specific, i.e., they will increase only the eccentric or concentric strength, respectively. Other studies have reported that mode specificity does not exist. Therefore, this study aimed to assess the mode-specific effects of eccentric and concentric isokinetic training of the hamstring muscle at slow angular velocity on eccentric peak torque of the hamstring (PTecc), concentric peak torque of the quadriceps (PTcon), acceleration time of the hamstring (AThams) and quadriceps (ATquad), deceleration time of the hamstring (DThams) and quadriceps (DTquad), time to peak torque of the hamstring (TPThams) and quadriceps (TPTquad), and functional Hamstring-to-Quadriceps ratio (PTecc/PTcon).

Subjects

A total of 30 participants were randomly divided into eccentric and concentric groups.

Methods

Two groups pre-test-post-test experimental design was used. In the eccentric and concentric groups, eccentric and concentric isokinetic training of hamstring muscle was performed respectively, at an angular velocity of 60°/s for 6 weeks duration. PTecc, PTcon, AThams, ATquad, DThams, DTquad, TPThams, TPTquad, and PTecc/PTcon were measured before and after the completion of training.

Results

In the eccentric group, a significant difference (p < 0.05) was observed in PTecc (increased by 21.55%), AThams (decreased by 42.33%), ATquad (decreased by 28.74%), and PTecc/PTcon (increased by 17.59%). No significant difference (p > 0.05) was observed in PTcon, TPThams, TPTquad, DThams, and DTquad. In the concentric group, a significant difference (p < 0.05) was observed in PTecc (increased by 12.95%), AThams (decreased by 27.38%) ATquad (decreased by 22.08%), DTquad (decreased by 26.86%), and PTecc/PTcon (increased by 8.35%). No significant difference (p > 0.05) was observed in PTquad, TPThams, TPTquad, and DThams. Between-group analysis revealed a significant difference (p < 0.05) only in TPTquad; otherwise, in the rest of the parameters, no significant difference (p > 0.05) was observed.

Conclusions

Both eccentric and concentric isokinetic training of the hamstring for 6 weeks increased PTecc, PTecc/PTcon, and decreased AThams and ATquad. The effects of eccentric and concentric isokinetic training of the hamstring on PTecc, PTecc/PTcon, AThams, and ATquad were not mode specific.
The preclinical pharmacological study of a novel intravenous anesthetic, ET-26 hydrochloride, in aged rats
Authors: Chang Pan , Su YongWei , Gong DeYing , Kang Yi , Liu Jin , Zhang YuJun , Zhang Wen-sheng
Published: September 2022

Background

ET-26 hydrochloride (ET-26HCl) is a novel analogue of etomidate approved for clinical trials. However, all results from recent studies were accomplished in young adult animals. The objective of this study was to evaluate the efficacy and safety of ET-26HCl in aged rats.

Methods

Aged Sprague-Dawley rats were randomly divided into three groups (three males and three females in each group) were given dose of two-fold of median effective dose (ED50) of ET-26HCl, etomidate and propofol: the measurements of loss of the righting reflex (LORR) and cardiovascular and respiratory function after injection at the two-fold dose of the median effective dose were used for evaluation of effectiveness and safety, and the modified adrenocorticotropic hormone-stimulation experiment was used to evaluate the inhibition effect of the drugs on the synthesis of adrenal cortical hormones.

Results

There was no significant difference in the onset time among propofol, etomidate and ET-26HCl. The duration of propofol (850.5 ± 77.4 s) was significantly longer than that caused by etomidate (489.8 ± 77.0 s, p = 0.007) and ET-26HCl (347.3 ± 49.0 s, p = 0.0004). No significant difference was observed in the time to stand and normal activity among drugs. A total of 66.7% of rats in the ET-26HCl group were evaluated to have mild hematuria. Then, etomidate and ET-26HCl had a milder blood pressure inhibition effect than propofol. Apnea was observed in all rats administered propofol and the duration for this side effect was 45.0 ± 9.0 s. For etomidate and ET-26HCl, no apnea was observed. No other clinical signs of side-effect were observed, and no rats died. No significant difference was observed in corticosterone concentrations between ET-26HCl and solvent group. However, rats administered etomidate had lower corticosterone concentrations than those administered ET-26HCl at 15, 30, and 60 min.

Conclusions

Our results indicate ET-26HCl in aged rats is an effective sedative-hypnotic with stable myocardial and respiratory performance and also have mild adrenocortical suppression. Thus, these findings increase the potential for the clinical use of ET-26HCl in the elderly population.
Fatty Acids Composition of Two Commonly Consumed Freshwater Fishes (Clarias gariepinus and Chrysichthyes nigrodigitatus) from the Cross River at Ahaha, Obubra, Nigeria
Authors: Okey Irom Bassey
Published: September 2022

Fish oils are good sources of essential fatty acids beneficial to human health by helping the body in preventing diseases and enhancing proper growth and development. This study is aimed at investigating the quantitative and qualitative composition of fatty acids in two commonly consumed and most abundant freshwater fishes (Clarias gariepinus and Chrysichthyes nigrodigitatus) from the Cross River at Ahaha, Obubra. The oil was converted to fatty acids methyl esters (FAME) and the fatty acids evaluated by gas chromatography – mass spectrometry using retention time method. The fatty acids profiles include saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs). The composition varied from 0.06 – 24.00% of SFAs, 0.23 – 21.40% of MUFAs and 0.23 – 12.22% of PUFAs in the both species. The major SFAs were palmitic (C16:0) and stearic (C18:0) acids while the most abundant MUFA was oleic (C18:1) acid. Dominant PUFAs in the both specie were linoleic (C18:2), eicosapentaenoic (EPA, C20:5) and docosahexaenoic (DHA, C22:6) acids. Quantitatively the composition of various fatty acids was in the order SFAs < MUFAs < PUFAs although not significantly different (p< 0.05) in the species. Chrysichthys nigrodigitatus had higher total fatty acids (TFA), PUFAs and omega –3 / omega –6 ratio than C. gariepinus with higher levels omega -6 fatty acids. The ratios of PUFA/SFA were higher in C. nigrodigitatus although both were greater than the minimum value (0.4) recommended by World Health Organization. The result indicates that the species had high quality essential fatty acids especially DHA and EPA although relatively higher in C. nigrodigitatus. Hence these species have the potentials to serve as the natural dietary supplement for all important omega -3 fatty  acids.
Decongesting NH-57 via Nayagarh Town by Bypass, Odisha, India
Authors: Sahoo Suresh Chandra , Mishra Siba Prasad , Panda Rakesh Kumar
Published: September 2022

The Nayagarh Township is one of the developing areas in the state of Odisha nowadays. The population growth rate in the decade 2011-2021 is 14 %. It involves various famous temples, government offices, and interconnecting districts Khordha and Boudh. Due to the population growth and to avoid road congestion the new By-pass is introduced with the help of different structures involved in it. The objectives are to find the data required, various appurtenant structures with their pros and cons, locational appropriateness choice for the correct positioning, and benefits received from their housing. The construction of a bypass from Nayagarh from the left fringe of the town to the left edge avoiding intermediate hills has been approved by MoRT&H considering the continuous traffic congestion in heart of the town. The By-pass of the length of about 17km is proposed of two lanes with paved shoulders only involving a built-up area over the agricultural area. The bypass shall decongest the present traffic jam on the main road of Nayagarh town during the peak traffic period.
Effect of Different Level of NPK and CRF for Plant Growth and Rhizome Yield in Arrowroot (Maranta arundinacea L.)
Authors: Babu Arya C. , Kerketta Anita , Topno Sameer E.
Published: September 2022

The present investigation was carried out to Effect of different level of NPK and CRF for plant growth and rhizome yield in Arrowroot (Maranta arundinacea L.) was conducted in the horticulture Research Farm, Department of Horticulture, Naini Agricultural Institute, Sam Higgin bottom University of Agriculture Technology and Sciences, Prayagraj (U.P.) during July 2021- April 2022. The experiment was laid out in RBD with 11 Treatments with 3 replications. The results revealed that the treatment T10 100% CRF(Control Release Fertilizer)performed the best in terms in Plant height (140.22), leaf length (49.06), leaf width (19.10), No. of tillers(14.33), fresh weight per plant (736.33), Number of rhizomes per plant (11.33), yield of rhizomes per plant (11.78), yield of rhizomes per hectare (81.81), Maximum cost benefit (3.50). Therefore, the treatment T10 100% CRF is the best when compared to other treatments. As, the highest benefit cost ratio was observed in T10 100% CRF. i.e. (3.50).
Optimization Studies on Extracellular Protease Production by Aspergillus niger and Aspergillus terreus Using Skim Milk Casein as Substrate
Authors: Ekedegba F. E. , Ogbonna A. I. , Okoye C. T. , Ogbonna U. S. A. , Onyimba I. A. , Madu J. M.
Published: September 2022

Aim: Proteases are proteolytic enzymes that have a wide range of applications in the industrial sectors. This study investigated the production and optimization of protease by protease-producing fungi, (Aspergillus niger and A. terreus) using skim milk casein as substrate.

Materials and Methods: Aspergillus terreus and A. niger obtained from the Department of Plant Science and Biotechnology, University of Jos, Nigeria were screened for extracellular protease on skim milk agar medium. Optimization studies across different parameters: temperatures (30-80oC), pH (3-10), substrate Concentration (0.25-2 %), and incubation period (6 days) using submerged fermentation were done for maximum protease activity.

Results: The maximum temperature of protease activity was 50oC (116.5 IU/ml) for Aspergillus niger and 40oC (121.86 IU/ml) for Aspergillus terreus. The Optimum pH for protease activity was pH 9 (106.85 IU/ml) for Aspergillus niger and pH 8 (107.90 IU/ml) for Aspergillus terreus. Optimum protease activity (29.36 IU/ml) at an incubation period of 48 hours was recorded for Aspergillus niger and 72 hours (182.2 IU/ml) for Aspergillus terreus. At 2% substrate concentration a maximum activity of 87.21 IU/ml and 76.5 IU/ml was recorded for Aspergillus niger and A. terreus, respectively.

Conclusion: The test fungi Aspergillus niger and Aspergillus terreus exhibited maximum hydrolytic potential for protease production which has a vast application in different industries.
Treating Cancer in Pregnant Patients After Roe v Wade Overturned
Authors: Suran Melissa
Published: September 2022

This medical news feature discusses the challenges of treating pregnant patients diagnosed with cancer following the reversal of Roe v Wade.
Association Between Parental Leave and Ophthalmology Resident Physician Performance
Authors: Huh Dana D. , Wang Jiangxia , Fliotsos Michael J. , Beal Casey J. , Boente Charline S. , Wisely C. Ellis , De Andrade Lindsay M. , Lorch Alice C. , Ramanathan Saras , Reinoso Maria A. , Swamy Ramya N. , Waxman Evan L. , Woreta Fasika A. , Srikumaran Divya
Published: September 2022

Importance

Although parental leave is essential in enhancing resident wellness and fostering inclusive workplace environments, residents may often feel discouraged from using parental leave owing to perceived stigma and concerns about possible negative effects on their training.

Objective

To examine parental leave usage across multiple institutions and compare residency performance metrics between residents who took parental leave vs their peers who did not take leave.

Design, Setting, and Participants

This was a retrospective cross-sectional analysis conducted from April 1, 2020, to July 28, 2022, of educational records. Multicenter data were obtained from 10 Accreditation Council for Graduate Medical Education (ACGME)–accredited ophthalmology programs across the US. Included ophthalmology residents graduated between 2015 and 2019. Data were analyzed from August 15, 2021, to July 25, 2022.

Exposures

Performance metrics of residents who used parental leave during residency were compared with those of residents who did not take parental leave.

Main Outcomes and Measures

Measures of performance included the Ophthalmic Knowledge Assessment Program (OKAP) scores, ACGME milestones scores, board examination pass rates, research activity, and surgical volumes.

Results

Of the 283 ophthalmology residents (149 male [52.7%]) included in the study, 44 (15.5%) took a median (IQR) parental leave of 4.5 (2-6) weeks. There were no differences in average OKAP percentiles, research activity, average ACGME milestones scores, or surgical volume between residents who took parental leave and those who did not. Residents who pursued fellowship were less likely to have taken parental leave (odds ratio [OR], 0.43; 95% CI, 0.27-0.68; P < .001), and residents who practiced in private settings after residency were more likely to have taken parental leave (OR, 3.56; 95% CI, 1.79-7.08; P < .001). When stratified by sex, no differences were identified in performance between female residents who took parental leave compared with residents who did not take leave, except a mild surgical number difference in 1 subspecialty category of keratorefractive procedures (difference in median values, −2; 95% CI, −3.7 to −0.3; P = .03).

Conclusions and Relevance

In this multicenter cross-sectional study, no differences in performance metrics were identified between residents taking parental leave compared with their peers. These findings may provide reassurance to trainees and program directors regarding the unlikelihood, on average, that taking adequate parental leave will affect performance metrics adversely.
Indigenous Research Methods
Authors: Anderson Jenn
Published: September 2022

Hótȟaŋiŋpimeans “rising voices” in Lakota, the language spoken by many from the Lakota Sioux Tribe, located in what is now South Dakota. In this entry, the voices of Indigenous peoples are centered and amplified, so that as readers/listeners, we can begin to understand how we might take our place in the stories of knowledge co‐creation with Indigenous peoples. Health communication researchers and practitioners are always seeking to better connect with audiences and communities in order to find ways that communication can enhance health. This entry offers a glimpse into the power of storytelling as a framework for methodology as well as a way of co‐constructing meaning from lived experiences. Indigenous research methods do not follow the linear, prescriptive pattern of westernized knowledge creation; rather, they emerge from relationships where Indigenous ways of knowing are adopted. Whether you are new to Indigenous research methods, or are already engaged with them, this entry also challenges us to further interrogate the individual and systemic ways that our research, and the larger scholarly community, undermine, erase, or ignore Indigenous ways of knowing and being. As Stó:lō scholar Q'um Q'um Xiiem puts it, “My dear ones, our work is about to begin.”
Photovoice
Authors: Wiley Marissa L. , Gist‐Mackey Angela N.
Published: September 2022

Photovoice is a participatory visual research methodology that was developed to foster social change and privilege the voices of marginalized populations. It has been widely used in health communication research. First, an overview of photovoice as a methodology is presented, sharing key definitions, attributes, and uses. Second, this entry highlights a number of photovoice studies to illustrate its widespread use in studying a variety of different healthcare contexts and health conditions. Next, this entry addresses research design considerations before employing this methodology, including: (i) identifying audiences; (ii) participant confidentiality; (iii) use of technology; (iv) participant direction for photography; (v) copyright legalities; and (vi) the role of interviews. In closing, future directions for photovoice methodology are proposed.
Expert Patient
Authors: Davis Daniel Cochece
Published: September 2022

This entry provides an overview of the “expert patient” concept, some of its different applications in health contexts, critiques of its effectiveness, and the communication challenges associated with its different applications. An expert patient can mean someone who communicates aspects of their health condition to others experiencing the same condition, someone experiencing a health condition who is communicating with their clinician at an elevated level of knowledge and/or experience, or someone with a health condition engaged to provide feedback on revising health procedures and policies pertinent to that condition. Expert patients create unique and sometimes challenging communication situations for clinicians.
Healthcare Burnout
Authors: Vasquez Taylor S. , Vasquez Robert S. , Bylund Carma L.
Published: September 2022

Burnout is a syndrome of emotional exhaustion, a sense of detachment from others, and reduced personal accomplishment caused by prolonged high levels of occupational stress and is prevalent within the healthcare profession. Higher burnout levels have been shown to impact communication skills, patient‐centeredness, and patients' health outcomes. Many scales exist to measure burnout, with the Maslach Burnout Inventory used most frequently. Several descriptive studies have attempted to better understand healthcare burnout, and the scholarship in this area has begun to shift toward addressing, reducing, and preventing burnout among clinicians. Further program development and control trials are needed to effectively reduce burnout for prolonged amounts of time.
Nonverbal Communication
Authors: Hamel Lauren M. , Eggly Susan
Published: September 2022

This entry provides an overview of research on nonverbal communication in healthcare with a focus on patient–physician nonverbal communication. The entry summarizes patterns of findings, influential theoretical frameworks and observational coding systems, the influence of patient and physician gender and race/ethnicity, and major critiques of the field and ideas for future directions. Nonverbal communication between patients and their clinicians is instrumental in establishing trust, rapport, and many other important patient outcomes related to high‐quality patient care. Much of this research has focused on the individual (typically the physician), global assessments, and associations, rather than on the dyad, specific discrete behaviors, and methods that can assess the dynamics of the interpersonal communication process. We summarize ideas for future research and recent examples that have employed more sophisticated methods to model the reciprocal nature of nonverbal communication between diverse patient populations and their clinicians.
Pain
Authors: Thompson Charee M. , Pulido Manuel D.
Published: September 2022

Chronic pain is predicted and compounded by interpersonal factors, particularly within the patient–clinician relationship. However, current approaches to pain management in the United States do not sufficiently emphasize the importance of patient–clinician communication and relationships, despite ample evidence that these interactions and relationships are often difficult and dissatisfying in the context of chronic pain. This entry provides an overview of the literature on: philosophical underpinnings of pain communication; tools for communicating pain; factors that influence pain communication in the clinical setting; and the potential and promise of the patient–clinician relationship for pain communication.
Patient Communication Skills Training
Authors: B. Taylor Greenberry , Bylund Carma L.
Published: September 2022

Patient skills training programs have been developed to help individuals communicate more effectively with clinicians. These programs and interventions educate patients about different behavioral strategies such as asking questions and expressing concerns that can be used to enhance communication with clinicians. Patients possessing these skills feel empowered and are able to be actively engaged in conversations. Research has shown that patients who have gone through training report higher levels of satisfaction and care compared to those who have not. Lack of training can affect patients' confidence in engaging with clinicians. While most communication skills training research has focused on physician skills training and outcomes, it is essential that patient skills training and outcomes are also understood. When both clinicians and patients have the necessary tools to communicate effectively, they are able to form a shared understanding, which can increase quality of care and patient experience.
Trust in Physician
Authors: Richards Sharlene T.
Published: September 2022

This entry introduces the reader to research on trust in physician–patient communication. Characteristics of the patient, such as gender, age, education, ethnicity, income, and self‐efficacy, all relate to trust in one's physician. The use of patient‐centered communication increases trust in physicians. When physicians provide emotional and informational support, this increases trust. Engaging in shared decision making with the patient increases trust. When trust is present, it facilitates interpersonal communication and decision making, reduces emotional distress, and increases adherence to medical advice.
Pharmaceutical Lobbying
Authors: Dan Viorela
Published: September 2022

Pharmaceutical lobbying refers to the activities carried out by pharmaceutical companies to influence policymaking. Sometimes, lobbying is understood as the core subfunction of
public affairs
, the latter defined as the activities devoted to the management of organizations' relationships with policymakers and with other organizations. The lobbying expenditures of pharmaceutical companies are exorbitant and exceed those by any other industry. The tactics employed are numerous, and can be classified in two groups: direct versus indirect. Direct tactics include participation in parliamentary hearings, and the establishment and maintenance of amiable relationships with policymakers and their staff (e.g., through party donations). Indirect tactics entail issue advertising, the involvement of patients (i.e., grassroots lobbying; astroturfing), and the involvement of key opinion leaders (KOL). The legitimacy of pharmaceutical lobbying is a matter of scholarly dispute. Advocates believe that lobbying allows policymakers to ensure that the legitimate concerns of all societal groups affected by a piece of legislation are being heard when that legislation is being drafted or revised. Challengers point out that not every societal group affected by a legislation is equally skilled in lobbying and has equal resources. Various regulations have been proposed in an attempt to increase transparency. Most importantly, it was suggested that several years should serve as a “cooling period” before somebody is allowed to switch sides between politics and lobbying. It is hoped that this would prevent what is known as the revolving door of influence. The effectiveness of this and other suggestions for increasing transparency is questionable.
Human–Animal Interaction
Authors: Yamasaki Jill
Published: September 2022

Human–animal interaction (HAI) constitutes an important source of companionship, comfort, and support during times of illness, stress, loneliness, isolation, and trauma. Worldwide, research documents ways in which HAI stimulates verbal communication, increases empathy and morale, and facilitates social connections for support, belonging, recognition, and status. Researchers have also found positive associations between HAI and physical health. Pet ownership and/or engagement with therapeutic animals in animal‐assisted interventions (AAI) helps promote physical fitness, attachment, and the production of oxytocin while also lowering blood pressure, stress, and even mortality following a heart attack. Evidence also suggests HAI may contribute to reduced depression, anxiety, and loneliness for improved well‐being across the lifespan. Although interdisciplinary, most HAI research originates from outside of the health communication discipline. Scholars and practitioners interested in HAI hail from a variety of fields such as psychology, medicine, sociology, nursing, social work, and veterinary medicine. As interdisciplinary scholars and practitioners continue to solidify and clarify the benefits of AAI for people and animals, the HAI field will continue to flourish. Health communication scholars can contribute to this meaningful growth by developing evidence‐based interventions, advocating for AAI in public policy, and promoting professionalization of the field as a valued treatment modality.
Communication Accommodation Theory
Authors: Sheeran Nicola , Jin Ying , Pines Rachyl , Jones Liz
Published: September 2022

Communication accommodation theory (CAT) has been used in health contexts to explain and predict when, why, and how people adjust (or not) to other people's communication language and style. By considering a range of micro‐ and macro‐level factors, CAT highlights the way that health systems, such as hospitals, prime a range of group identities, including roles (e.g., patient, clinician), professions (e.g., doctor, nurse), and/or specialties (surgical nurse, cardiologist). Communication encounters in healthcare settings are influenced by these group identities, whereby interactants use a range of strategies to adjust their communication either to be more like their communication partner (i.e., accommodation) or to be less similar (nonaccommodation). Communication can be more interpersonal or intergroup depending on a range of factors, such as sociocultural norms, relationships between the groups, and the history between the interactants. CAT addresses a key criticism of communication research by highlighting the intergroup nature of health communication. The model lends itself to understanding patient–clinician communication, interprofessional communication, and health communication interventions, which may improve health service delivery and patient safety.
Discrete Choice Experiments
Authors: Folkvord Frans , Lupiáñez‐Villanueva Francisco , Febrer Nuria , Gunderson Laura
Published: September 2022

Due to increasing healthcare costs across the world, limited resources have to be spent wisely. Considering the necessary, optimal provision financing of healthcare, economic techniques have a great potential to provide additional evidence to more traditional methodologies. One recently developed and adopted approach in health economics is the discrete choice experiment (DCE), which assumes that individual decisions with regard to a good or a service are determined by the attributes and characteristics of that good or service. DCE is a quantitative methodology for valuing different factors that are assumed to affect an outcome. DCE describes, explains, and predicts choices among people between two or more discrete alternatives. Unlike traditional ranking and rating exercises, DCE provides information on the strength of preference, trade‐offs, or probability of take‐up. Discrete choice models statistically relate the choice made by each participant to the attributes of that person as well as the attributes of the alternatives made available to that participant. In general, the models are often used to investigate how people's choices differ among participants with different backgrounds or between experimental manipulations.
Reactance Theory
Authors: Reynolds‐Tylus Tobias , Gonzalez Andrea Martinez
Published: September 2022

Psychological reactance is a motivational state driven by the removal of a valued personal freedom. Psychological reactance theory is routinely used in health communication research to explain how persuasive messages may fail to achieve their intended objectives. This entry begins with an overview of psychological reactance theory and the measurement and modeling of reactance. Following this, research on message features, source factors, and individual characteristics associated with reactance are discussed.
Caregiver–clinician Communication
Authors: Kerr Anna M.
Published: September 2022

This entry describes caregiver communication with clinicians. Caregiver involvement in patient care can lead to improved health outcomes and higher patient and caregiver satisfaction. However, caregivers often experience caregiver burden due to the toll caregiving can take on their emotional, social, financial, physical, and spiritual well‐being. One of the most demanding tasks caregivers take on is communicating with clinicians. Health communication scholars have examined the challenges caregivers face when communicating with clinicians and the factors that shape caregiver communication, such as family communication patterns. This research has led to evidence‐based recommendations to help clinicians tailor their communication to meet the unique needs and preferences of individual caregivers. Yet, more interventions are needed to improve caregiver–clinician communication and institutional changes also need to take place to guarantee that the needs of caregivers are prioritized in all healthcare systems. This entry concludes with a description of areas for future research.
Empowerment
Authors: Atanasova Sara , Koinig Isabell
Published: September 2022

This entry provides an overview of the concept of empowerment in health communication, introducing the most established definitions of empowerment, its dimensions, and domains. In the health communication field, individual and collective empowerment are commonly discussed. Individual empowerment is presented in its two main domains: (i) empowerment that focuses on individuals' personal health outcomes and their health‐related personal transformation (i.e., patient empowerment and self‐empowerment), and (ii) empowerment that occurs in realms of the health professional–patient relationship (i.e., functional and dysfunctional empowerment). Compared to the individual dimension of psychological empowerment, collective empowerment has received less attention in health communication research. However, this entry demonstrates the importance of collective empowerment and its crucial role in the development of collective bottom‐up engagements of individuals or groups interested in health‐related topics. The entry concludes with a critical reflection of empowerment and the related concept of disempowerment.
Genetic Counseling
Authors: Scherr Courtney L.
Published: September 2022

Clinical genetic counseling is provided through communication between the genetic counselor and the patient. Genetic counseling can support decision making about genetic testing, but genetic counseling may also occur in the absence of testing. For example, genetic counselors can provide psychotherapeutic support for patients who are at risk for, or who are living with, a genetic condition. While many genetic counselors practice genetic counseling clinically, others work in public health, education, research, and commercial settings, including commercial laboratories. Clinically practicing genetic counselors in the United States are masters trained and board certified by the American Board of Genetic Counseling. Evaluations of genetic counseling have been primarily outcome focused and fewer studies have examined communication processes and strategies within counseling sessions. Recent rapid advancements in genetic technologies have led to proposals and implementation of alternate service delivery models. Assessing general communication processes and outcomes, and those supported by these alternative delivery models and digital platforms, is necessary work to identify which of these models is appropriate, or at least as effective as usual care.
Motivational Interviewing
Authors: Oetzel Keri Bolton
Published: September 2022

An overburdened healthcare system equates to overworked clinicians, reduced face‐to‐face time with patients, and increased disease. Patients are frustrated by lack of attentiveness and repeat office visits because health concerns have not been resolved. Change is needed; both clinicians and patients need change, yet change is hard. Motivational interviewing (MI) is a brief, directive style of communication that is useful in exploring and resolving ambivalence toward changing one's behavior. This extensively validated modality is used in medical settings to improve patient–clinician communication by engaging in thoughtful, empathic, and reflective listening. In doing so, patients are offered the opportunity to explore and enhance their intrinsic motivation for change.
Patient–Oncologist Interactions
Authors: Beach Wayne A.
Published: September 2022

Oncology interviews are designed to diagnose and treat cancer as a complex disease defined by cellular degeneration. Left untreated, cancer is capable of progressive growth, excessive harm, and possible death. Recurrent tensions and trusting partnerships exist between clinicians and patients as lay persons. Medical experts rely on their authority to diagnose, treat, and minimize cancer health threats. Patients are typically not trained to understand technical cancer details yet can claim knowledge about bodily and subjective illness experiences. A primary goal of health communication research is to observe how clinicians enact medical authority and impacts on patient participation. Effectively addressing the emotional concerns and well‐being of cancer patients is also essential if positive clinical outcomes are to be achieved. Across phases of medical interviews, patients have been shown to be passive and defer to clinicians' pursuit of agendas. Yet, close examinations of oncology interviews reveal that cancer patients can proactively, directly and indirectly, align with or resist those agendas. A related and predominant cancer research focus has been on dying and death, including delivering and receiving bad news and delicate end‐of‐life discussions. Recent research emphasizes how patients pursue wellness rather than sickness, life‐affirming impacts of hope and perseverance, and relationships between good and bad news. Discovering basic patterns about the interactional organization of oncology interviews can have direct implications for enhancing the quality of care provided. Significant findings are reviewed offering new knowledge that can be translated into best practices for creating informed, personalized, and compassionate care environments.
Veterinary Communication
Authors: Peters Grace E. , Shaw Jane R.
Published: September 2022

Health communication in veterinary medicine centers on interactions between veterinarians, animal caregivers, and animals with medical, ethical, and professional complexities. Veterinary medicine is inherently goal‐directed with the purpose of promoting animal, human, and environmental health. Yet communication in veterinary contexts varies based on animal type, function, and the nature of the human–animal bond. The differences between a client's knowledge of the animal and the veterinarian's biomedical expertise can be a source of tension because animals cannot speak for themselves. Interactions in veterinary medicine are further complicated by explicit discussions of euthanasia and cost, which are recognized as the loss of a family member or impacting one's livelihood. Veterinarians work in interprofessional teams with technicians, client care professionals, or specialists. As veterinarians manage difficult medical and ethical situations, the profession is plagued by high levels of burnout and suicide. Communication skills training aims to mitigate these professional challenges, equipping veterinarians with the abilities to strategically navigate conversations with clients and colleagues. Many opportunities exist for health communication research that deepens the contextual understanding of veterinary practice.
Health Occupations and Role Performance
Authors: Leach Rebecca B. , Zanin Alaina C.
Published: September 2022

This entry provides a brief overview of research on role performance in healthcare, with an emphasis on how role expectations are socially constructed and negotiated in varying healthcare occupations. The entry begins by defining role performance and sharing common expectations for clinician role performance. Next, the entry discusses a communication perspective of role performance, highlighting how role tensions are negotiated and managed in group communication. Finally, the entry closes with recommendations for future research on healthcare roles.
Patient‐Reported Outcomes (PROM, PROMIS)
Authors: Pel‐Littel Ruth E. , Hofman Cynthia S.
Published: September 2022

This entry provides an introduction to patient‐reported outcomes (PROs) and their significance. Different types of patient‐reported outcome measures (PROMs) are introduced, such as generic and specific PROMs, as well as the progression, evaluation, and future directions for their use. Even though there are various challenges with the implementation and use of PROMs (such as patients' motivation to complete a PROM and the shift from a disease/problem‐oriented approach in the healthcare conversations to an outcome/goal‐based approach), they can be overcome. PROMs are well established in their use for screening, monitoring, and improving communication at the individual (micro) level, and to aid in decision making, monitoring populations, and assessing quality at the aggregated (meso) level.
Clinician–Patient Communication about Online Health Information
Authors: J. Linn Annemiek , Kwakman Pascale
Published: September 2022

Increasing numbers of patients bring online health information into the consultation room. As a result, the communication between clinicians and patients has undergone a major transition. The use of the Internet and its impact on patients and patient–clinician communication have become important challenges that health systems need to address. Online health information requires guidance from a clinician, especially if positive outcomes should be reinforced and negative consequences avoided. Not all patients discuss online health information with their clinicians. Communication barriers relate to the healthcare system, the information itself, the clinician, the patient, and the clinician–patient relationship. If patients discuss online health information with their clinician, they use many different communication strategies such as paraphrasing online information, asking additional questions, or expressing concerns about the information found online. When clinicians discuss online information, communication strategies vary from clinician‐centered to patient‐centered. These strategies are shaped by clinicians' attitude toward patients seeking online health information. When clinicians endorse patients' online efforts, positive patient‐reported outcomes are reported. To date, health education has been slow to acknowledge that patients seek online health information before their consultation. Clinicians must be trained to use patient‐centered communication strategies to discuss online health information with their patients.
Discourse/Conversation Analysis
Authors: Koenig Christopher J.
Published: September 2022

The study of discourse has a long history in health communication, healthcare, and medical communication. This entry pairs conversation analysis and discourse analysis. While each approach has a unique history, methods, and aims, both approaches have a broad scope, and both approaches obscure the lines between theory and method traditionally drawn by social science methodology. This overview first synthesizes key similarities and differences of conversation analysis and discourse analysis as distinct qualitative research methods focused on language, language use, and language‐in‐action as constitutive of social life related to health communication. Separate sections highlight unique contributions for a diverse range and scope of studies using each approach. Conversation analysis typically uses audio and especially video recordings of medical encounters and other health‐related contexts and contributes understandings of turn design, action sequences, and overall occasions of medical and health interaction. Discourse analysis employs a variety of analytic methods and data types ranging from audio‐ or videorecorded interactions or texts on one end of the spectrum to a wide array of texts and images that are sometimes used together in a single analysis. This section uses the framework of macro, meso, and micro levels to discuss contributions to discourses of/in health communication. The entry concludes with some suggested future directions for conversation analysis and discourse analysis in health communication.
Ethnography
Authors: Clements Meredith L. , Lagomasino Adolfo , Bates Benjamin R.
Published: September 2022

Ethnography examines the symbolism of routine interaction or unique instances of communication among members of a culture or subcultures, including distinct communities or organizations, and specific places and spaces of interaction. It is both a process and a product. Key components of an ethnography include fieldwork, reflexivity, thick description, and participant observation. A central task for ethnographers is to be reflexive about the choices they make in designing their research project, selecting and interacting with participants, interpreting behaviors, and rendering findings.
Critical Discourse Analysis
Authors: Segopolo Irene M. M.
Published: September 2022

This entry conceptualizes critical discourse analysis (CDA) from the various approaches espoused by its pioneers and situates the approaches within health communication. The entry proceeds by describing CDA as a qualitative research approach and rigorous eclectic methodology that is interdisciplinary, providing the opportunity to explore in‐depth, discursive interactions and discourses often embedded in social, cultural, and institutional texts. Also it addresses the critical nature of CDA in investigating discourses within texts and their interrelatedness with contexts. Aiming to show how CDA has potential to interrogate how discourses frame health, disease and care, health institutional discourse, power relations, and knowledge, a few examples are cited to show the possibilities of various CDA approaches on health communication scholarship. There is robust research utilizing CDA to unpack discourses subsumed in health texts and interactions such as: clinician–patient interaction; representations of disease and healthcare in media and various cultural contexts; health communication interventions and campaigns and health policies. As clinicians revolutionize health through eHealth strategies and pandemics keep on breaking out, social media always seemingly taking center stage with pseudo‐scientists and the public being increasingly exposed to fake information, utilization of CDA in health communication research can provide opportunities for analysis of discourse strategies for best approaches for: health intervention; attitudes toward vaccination, treatment, use of prophylactics, and behavior change strategies to promote responsible behavior; and how pandemics can be tackled through information dissemination.