Search

Past research has demonstrated that ultraviolet (UV) photos - which reveal skin damage as dark patches - can increase preventive behaviors. Emerging camera technology facilitates personalized UV photos for interventions, yet little is known about how personalized photos compare to other visuals and what cognitive or affective mechanism explains their persuasive impact. To engage this research line, the current study compared the impact of personalized UV (PUV), stock UV (SUV), and non-UV (NUV) photos and, to advance theorizing on fear appeals, explored underlying affective mechanisms including physiological fear. A sample of 169 undergraduate students participated in a 3 (Visual conditions: PUV, SUV, NUV) × 2 (Efficacy conditions: No efficacy and Efficacy) between-participants message experiment on a computer equipped with iMotions 6.4 that tracked real-time physiological responses (facial expression and skin conductance). Results demonstrated that PUV skin damage photos produced significantly greater self-reported fear and positive valence (detected by facial expression analysis) than NUV and SUV visuals. Mediation analysis demonstrated that fear had a significant indirect effect on the relationship between exposure to PUV skin damage visuals and behavior expectations.

Background: In this article, we attempt to demonstrate the superiority of the Bayesian approach over the frequentist approaches of the multiple linear regression model in identifying the influencing factors for the response variable., Methods and Material: A survey was conducted among the 310 respondents from the Kathirkamam area in Puducherry. We have considered the response variable, body mass index (BMI), and the predictors such as age, weight, gender, nature of the job, and marital status of individuals were collected with the personal interview method. Jeffreys's Amazing Statistics Program (JASP) software was used to analyze the dataset. In the conventional multiple linear regression model, the single value of regression coefficients is determined, while in the Bayesian linear regression model, the regression coefficient of each predictor follows a specific posterior distribution. Furthermore, it would be most useful to identify the best models from the list of possible models with posterior probability values. An inclusion probability for all the predictors will give a superior idea of whether the predictors are included in the model with probability., Results and Conclusions: The Bayesian framework offers a wide range of results for the regression coefficients instead of the single value of regression coefficients in the frequentist test. Such advantages of the Bayesian approach will catapult the quality of investigation outputs by giving more reliability to solutions of scientific problems., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Community Medicine.)

Public health interventions targeting coughing and spitting during the Tuberculosis and 1918 flu epidemics were largely successful. Specifically, public health officials' messaging framed the behavior of spitting as repulsive and endangering to others, prompting an elicitation of disgust. Anti-spitting campaigns - messaging that focuses on the threat of spit or sputum - have long been common during pandemics and manifested once again to combat the spread of COVID-19. Yet, few scholars have theorized if and how anti-spitting campaigns function to change behavior. One possibility is parasite stress theory, which posits that human behavior is driven by a desire to avoid pathogenic threats like spit. The application of these types of disgust appeals in public health messaging remains understudied and warrants exploration. To test the applicability of the parasite stress theory, our message experiment with US adults ( N  = 488) examined reactions to anti-spit messages that varied in visual disgust (low and high). For more highly educated respondents, the high disgust appeal directly decreased spitting intentions, and this relationship was stronger for individuals with higher levels of pathogen and moral disgust. Given the importance of public messaging during pandemics, future research should continue to examine the efficacy and theoretical underpinnings of specific disgust appeals.

Background: Ultraviolet (UV) photography and photoaging visuals make hidden sun damage visible to the naked eye, granting the potential to create messages that vary in temporal dimensionality. As UV photos depict immediate skin damage, the photo communicated that exposure in sun causes invisible damage to the young truck driver (near temporal frame) and visible damage (e.g., wrinkles) to the old truck driver (distant temporal frame)., Objective: The current study examines the moderating effects of loss/gain frames and temporality variables on the relationship between temporal framing and sun safe behavioral expectations., Method: U.S. adults (N = 897) were assigned to a 2 (near/distant temporal frame) × 2 (gain/loss frame) between-participants experiment., Results: The loss frame triggered greater fear compared to the gain frame, this fear forms an indirect path where loss frames increase fear and fear increases changes in sun safe behavioral expectations. Participants exposed to the distant frame had increased behavior expectations if either of the two temporality variables (CFC - future or current focus) were low. Participants with low temporality indicators (i.e., CFC - future, current focus, or future focus) exposed to the gain frame had increased behavior expectations., Conclusions: The findings demonstrate the potential utility of temporal frames as a tool for designing strategic health messages., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Despite decreased susceptibility, darker skin individuals who develop melanoma have worse survival. This disparity in melanoma mortality is the largest for any cancer, and partly driven by a lack of patient education materials targeted to darker skin populations in whom acral lentiginous melanoma (ALM) is the most common subtype. To address this communication disparity, the current study reports a multi-phase design process that leverages crowdsourcing and message testing to develop ALM-focused patient education materials for darker skin populations. Crowdsourced design was utilized to develop a pool of designs (phase 1), the pool was narrowed and thematically analyzed (phase 2), and select designs were evaluated via a message experiment (N = 1877). For darker skin populations, designs that depicted people enhanced knowledge of ALM through message memorability. The current study engages melanoma disparities by providing ALM patient education materials for darker skin populations vetted via a multi-phase process., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Sexual health risks are challenging to communicate given the potential negative reactions of target audiences to explicit language. Grounded in research on pathogen avoidance, the current study examined the impact of varying levels of explicit language on message perceptions and safe sex behavioral intentions. U.S. adults (N = 498) were randomly assigned to view messages detailing pandemic safe sexual behavior that contained either low or high levels of explicit language. High explicit language significantly increased perceived disgust which also indirectly linked high explicit language with increased intentions to engage in safe sex behavior. Individual difference variables moderated the impact of message explicitness; dispositional hygiene disgust moderated the impact of high explicit, hygiene-focused messages on safe sex intentions. Those with relatively low levels of dispositional disgust were more positively impacted by explicit language. The results suggest the value of increased message explicitness for sexual health communication and have implications for pathogen avoidance behaviors, the behavioral immune system, and dispositional and affective forms of disgust., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: Through the use of eye-tracking technology, this study explores the efficacy of current alcohol responsibility messages viewed by adolescents and proposes the development of new alcohol warning message design., Method: An adolescent sample ( N = 121; 72 males) was shown 14 advertisements (4 alcohol, 10 non-alcohol) in randomized order featuring messages modified by type size, type contrast, and message content (a 2 × 2 × 2 factorial design)., Results: Results suggested that modifying message content to include direct language and a consequence enhances recall and attention to alcohol responsibility messages among adolescents. No significant differences in attentional outcomes were observed for messages that included variances in type size or type contrast., Conclusions: Overall, to increase attention to and recall of alcohol responsibility messages, the greatest efficacy lies in varying the message itself, irrespective of size or contrast.

Objective: In narratives, characters often face threats where they either live (survivor narratives) or die (death narratives). Both outcomes have the potential to persuade, and are frequently utilised in mass communication campaigns, yet more research is needed examining the relative effectiveness and underlying mechanisms of each strategy., Design: U.S. adults ( N  = 1010) were randomly assigned to a 2 (survivor, death) × 2 (non-foreshadowed, foreshadowed) × 2 (within-study replication: narrative 1, narrative 2) between-participants experiment with melanoma stories as stimuli., Main Outcome Measures: Intentions to engage in sun safe behaviour and skin self-examination behaviour were assessed in the pre- and posttest, and then transformed into change scores., Results: Death narratives increased sun safe behaviour intentions. Consistent with the entertainment overcoming resistance model, foreshadowed death narratives were found to increase sun safe behaviour intentions via increased transportation and decreased counterarguing., Conclusion: Compared to survivor narratives, death narratives increase intentions to engage in sun safe behaviour. The findings offer support for character death as a key feature of narrative persuasion, and narrative transportation and counterarguing as important mediational pathways.

For the past two decades, microbial monitoring of the International Space Station (ISS) has relied on culture-dependent methods that require return to Earth for analysis. This has a number of limitations, with the most significant being bias towards the detection of culturable organisms and the inherent delay between sample collection and ground-based analysis. In recent years, portable and easy-to-use molecular-based tools, such as Oxford Nanopore Technologies' MinION™ sequencer and miniPCR bio's miniPCR™ thermal cycler, have been validated onboard the ISS. Here, we report on the development, validation, and implementation of a swab-to-sequencer method that provides a culture-independent solution to real-time microbial profiling onboard the ISS. Method development focused on analysis of swabs collected in a low-biomass environment with limited facility resources and stringent controls on allowed processes and reagents. ISS-optimized procedures included enzymatic DNA extraction from a swab tip, bead-based purifications, altered buffers, and the use of miniPCR and the MinION. Validation was conducted through extensive ground-based assessments comparing current standard culture-dependent and newly developed culture-independent methods. Similar microbial distributions were observed between the two methods; however, as expected, the culture-independent data revealed microbial profiles with greater diversity. Protocol optimization and verification was established during NASA Extreme Environment Mission Operations (NEEMO) analog missions 21 and 22, respectively. Unique microbial profiles obtained from analog testing validated the swab-to-sequencer method in an extreme environment. Finally, four independent swab-to-sequencer experiments were conducted onboard the ISS by two crewmembers. Microorganisms identified from ISS swabs were consistent with historical culture-based data, and primarily consisted of commonly observed human-associated microbes. This simplified method has been streamlined for high ease-of-use for a non-trained crew to complete in an extreme environment, thereby enabling environmental and human health diagnostics in real-time as future missions take us beyond low-Earth orbit.

Individuals residing in U.S. frontier counties have limited access to dermatology care and higher melanoma mortality rates. Given these limitations, frontier residents rely disproportionately on skin self-examinations (SSE) for early detection of melanoma, though little is known about their SSE behaviors and barriers to conducting SSEs. The goal of the present study was to identify obstacles to SSE performance via a survey of adults ( N = 107) living in a U.S. frontier county. Approximately 43% of participants were classified as inclined abstainers - individuals who intended to perform SSE, but failed to follow through. Compared to those who did follow through, inclined abstainers were more likely to be hindered by twelve barriers, including forgetting, letting other tasks get in the way of SSE, and struggling to identify a good time or routine for SSE performance. The barriers to action for these inclined abstainers are modifiable - for example, not remembering to do it - and well positioned for a behavioral intervention.

Objective: Past research suggests a large number of adults feel overwhelmed by the amount of cancer information - a phenomenon labeled cancer information overload (CIO). The current study examines whether CIO is discriminant from other negative message perceptions (reactance, information avoidance) and related to sun safe behaviors., Methods: U.S. adults (N = 2,219) completed survey questions assessing CIO, dispositional reactance, defensive/information avoidance, sun safe behavior, and knowledge., Results: The results demonstrated that CIO was discriminant from dispositional reactance, information avoidance, and defensive avoidance, and individuals with higher overload were more likely to tan, less likely to have an annual checkup with a healthcare provider, and less knowledgeable about sun safe protection. Unexpectedly, individuals with higher CIO were more likely to wear wide-brimmed hats., Conclusion: CIO is distinct from reactance and avoidance, and related to performance/knowledge of sun safe behaviors, and receiving annual healthcare checkups., Practice Implications: The correlation between CIO and sun safe behavior differs by behavior; a pattern which suggests practitioners might benefit from adapting their communication strategy based on the target population and behavior., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The MinION sequencer has made in situ sequencing feasible in remote locations. Following our initial demonstration of its high performance off planet with Earth-prepared samples, we developed and tested an end-to-end, sample-to-sequencer process that could be conducted entirely aboard the International Space Station (ISS). Initial experiments demonstrated the process with a microbial mock community standard. The DNA was successfully amplified, primers were degraded, and libraries prepared and sequenced. The median percent identities for both datasets were 84%, as assessed from alignment of the mock community. The ability to correctly identify the organisms in the mock community standard was comparable for the sequencing data obtained in flight and on the ground. To validate the process on microbes collected from and cultured aboard the ISS, bacterial cells were selected from a NASA Environmental Health Systems Surface Sample Kit contact slide. The locations of bacterial colonies chosen for identification were labeled, and a small number of cells were directly added as input into the sequencing workflow. Prepared DNA was sequenced, and the data were downlinked to Earth. Return of the contact slide to the ground allowed for standard laboratory processing for bacterial identification. The identifications obtained aboard the ISS, Staphylococcus hominis and Staphylococcus capitis , matched those determined on the ground down to the species level. This marks the first ever identification of microbes entirely off Earth, and this validated process could be used for in-flight microbial identification, diagnosis of infectious disease in a crewmember, and as a research platform for investigators around the world.

Ultraviolet (UV) photos reveal the world in a different light spectrum, including damage that is caused by UV light. In the context of skin cancer control, UV photos have the potential to communicate fear because they reveal underlying skin damage. U.S. adults (N = 2219) were assigned to a 5 (visual: UV skin damage, sun exposure, sunburn, photoaging, and mole removal) × 3 (replication: three examples of each visual condition) × 4 (efficacy: no efficacy, text only, visual, visual + text) randomized controlled trial. Compared to all other visual conditions combined, UV skin damage visuals generated greater fear which triggered increased sun safe behavior expectations. Compared with other visual conditions separately, only mole removal visuals produced equivalent fear as UV skin damage visuals. Visual efficacy conditions appeared to nullify rather than magnify the indirect path through fear. The results suggest one way UV images impact sun safe behavioral expectations is via fear and that researchers should continue to examine the position of fear in fear appeal theories.

Findings from years of research on fear appeals suggest that individuals with low efficacy utilize avoidance strategies when they perceive a significant threat-a process called fear control. Some research suggests that joking could be an avoidance strategy. The current study identifies conditions in which people are more likely to joke about colorectal cancer and explores how this behavior may be associated with screening avoidance. Older adults (N = 209) recruited from eight different worksites completed a survey measuring fear appeal constructs and enactment of colorectal cancer-related joking. Results of a moderated mediation analysis suggest that men were more likely to joke about colorectal cancer than women, particularly if they perceived significant threat but had limited self-efficacy, signifying fear control. Results support prior fear appeal research, suggesting that an increase in joking behavior concerning colorectal cancer may be indicative of screening avoidance, and describe belief-based mechanisms that explain differences between biological sex and joking., (Published by Oxford University Press 2017. This work is written by US Government employees and is in the public domain in the US.)

Eye-tracking technology has been used within a multitude of disciplines to provide data linking eye movements to visual processing of various stimuli (i.e., x-rays, situational positioning, printed information, and warnings). Despite the benefits provided by eye-tracking in allowing for the identification and quantification of visual attention, the discipline of dermatology has yet to see broad application of the technology. Notwithstanding dermatologists' heavy reliance upon visual patterns and cues to discriminate between benign and atypical nevi, literature that applies eye-tracking to the study of dermatology is sparse; and literature specific to patient-initiated behaviors, such as skin self-examination (SSE), is largely non-existent. The current article provides a review of eye-tracking research in various medical fields, culminating in a discussion of current applications and advantages of eye-tracking for dermatology research., (Copyright © 2018 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.)

Objective: Little is known about positive emotion communication (PEC) in end-of-life care. This study aims to identify types and patterns of PEC among hospice nurses, caregivers, and patients., Methods: A coding system based on positive psychology theory was applied as a secondary analysis to audio recordings of hospice nurse home visits with cancer patients and family caregivers, collected as part of a prospective longitudinal study. Eighty recordings (4 visits from 20 triads) were coded for humor, connection, praise, positive focus, gratitude, taking joy/savoring, and perfunctory statements., Results: Descriptive statistics revealed the greatest proportion of PEC was made by nurses. Humor was most frequently used across all speakers. Cluster analysis revealed four PEC visit types: Savor/Take Joy; Humor; Perfunctory; and Other-focused Expressions of Positive Emotions. Linear mixed effect regression was used to estimate the trajectory of PEC over time, but no significant change was found., Conclusion: We found that positive emotions are common in nurse, caregiver and patient communication at end-of-life and do not decline closer to death., Practice Implication: This study is among the first to explore PEC at end-of-life, and offers a way to bring strengths-based approaches into end of life communication research., (Copyright © 2017 Elsevier B.V. All rights reserved.)

We evaluated the performance of the MinION DNA sequencer in-flight on the International Space Station (ISS), and benchmarked its performance off-Earth against the MinION, Illumina MiSeq, and PacBio RS II sequencing platforms in terrestrial laboratories. Samples contained equimolar mixtures of genomic DNA from lambda bacteriophage, Escherichia coli (strain K12, MG1655) and Mus musculus (female BALB/c mouse). Nine sequencing runs were performed aboard the ISS over a 6-month period, yielding a total of 276,882 reads with no apparent decrease in performance over time. From sequence data collected aboard the ISS, we constructed directed assemblies of the ~4.6 Mb E. coli genome, ~48.5 kb lambda genome, and a representative M. musculus sequence (the ~16.3 kb mitochondrial genome), at 100%, 100%, and 96.7% consensus pairwise identity, respectively; de novo assembly of the E. coli genome from raw reads yielded a single contig comprising 99.9% of the genome at 98.6% consensus pairwise identity. Simulated real-time analyses of in-flight sequence data using an automated bioinformatic pipeline and laptop-based genomic assembly demonstrated the feasibility of sequencing analysis and microbial identification aboard the ISS. These findings illustrate the potential for sequencing applications including disease diagnosis, environmental monitoring, and elucidating the molecular basis for how organisms respond to spaceflight.

Skin self-examination (SSE) consists of routinely checking the body for atypical moles that might be cancerous. Identifying atypical moles is a visual task; thus, SSE training materials utilize pattern-focused visuals to cultivate this skill. Despite widespread use, researchers have yet to explicate how pattern-focused visuals cultivate visual skill. Using eye tracking to capture the visual scanpaths of a sample of laypersons (N = 92), the current study employed a 2 (pattern: ABCDE vs. ugly duckling sign [UDS]) × 2 (presentation: photorealistic images vs. illustrations) factorial design to assess whether and how pattern-focused visuals can increase layperson accuracy in identifying atypical moles. Overall, illustrations resulted in greater sensitivity, while photos resulted in greater specificity. The UDS × photorealistic condition showed greatest specificity. For those in the photo condition with high self-efficacy, UDS increased specificity directly. For those in the photo condition with self-efficacy levels at the mean or lower, there was a conditional indirect effect such that these individuals spent a larger amount of their viewing time observing the atypical moles, and time on target was positively related to specificity. Illustrations provided significant gains in specificity for those with low-to-moderate self-efficacy by increasing total fixation time on the atypical moles. Findings suggest that maximizing visual processing efficiency could enhance existing SSE training techniques.

Past research has found that older US adults (aged 50-75 years) exhibit high levels of cancer information overload and cancer worry; however, no study to date has examined whether these perceptions are related to information seeking/scanning. To explore this relationship, older adults ( N = 209, M age  = 55.56, SD = 4.24) were recruited to complete a survey measuring seeking, scanning, cancer information overload, and cancer worry. Most participants were high-scan/seekers (40.2%) followed by low-scan/seekers (21.1%), high-scan/no seekers (19.6%), and low-scan/no seekers (19.1%). Low-scan/no seekers had significantly higher cancer information overload compared to all other groups, consistent with the postulate that overload and seeking/scanning are negatively related. Low-scan/no seekers and high-scan/seekers both exhibited higher cancer worry severity, consistent with past research suggesting that cancer worry explains high levels of activity/inactivity.

Narratives are common in health campaigns and interventions, with many depicting individuals battling a particular illness or disease. Past research has focused primarily on the form and effects of survivor stories, but considerably less attention has been devoted to stories in which 1 or more of the central characters passes away. The goal of the current study was to compare the relative persuasive impact of survivor and death narratives in influencing skin prevention behaviors and to test narrative mediators that might explicate underlying mechanisms of effect. To that end, adults (N = 635, M age = 32.43 [SD = 11.23]) were randomly assigned to 1 of 6 narrative intervention conditions in an online message experiment. Participants read 1 of 2 stories about a person with melanoma (Rusty or Diane) that was manipulated as a narrative depicting the survival, death, or foreshadowed death of the main character. Foreshadowed death narratives increased intentions to perform a skin self-exam (SSE), a relationship that was mediated by narrative transportation and perceived SSE benefits. The results support the central postulate of narrative transportation theory and the utility of using foreshadowed death narratives in communication-based interventions designed to increase SSE frequency.

Objectives: Research indicates that mood-based motivations may be an important predictor of indoor tanning bed use and may be related to indoor tanning dependence. Problematically, little research has been conducted to develop a psychometric measure of mood-based tanning motivations. The current study seeks to develop and validate the moodbased indoor tanning scale (MITS)., Methods: Two studies were conducted to identify and verify the MITS factor structure as well as assess construct validity. Study 1 was conducted at 5 geographically diverse universities in the United States. Study 2 was conducted by using a national online sample in the United States., Results: Results from study 1 specified the factor structure of the MITS. Results from study 2 suggest that a one-point increase in the MITS measure corresponds with using indoor tanning beds 11 more times in the past year., Conclusions: These findings demonstrate that moodbased tanning motivations are a strong predictor of indoor tanning intentions and behavior. Further, they suggest that health behavior researchers and healthcare practitioners can use the MITS to assess the extent to which mood-based motivations impact indoor tanning bed use.

Rapid DNA sequencing and analysis has been a long-sought goal in remote research and point-of-care medicine. In microgravity, DNA sequencing can facilitate novel astrobiological research and close monitoring of crew health, but spaceflight places stringent restrictions on the mass and volume of instruments, crew operation time, and instrument functionality. The recent emergence of portable, nanopore-based tools with streamlined sample preparation protocols finally enables DNA sequencing on missions in microgravity. As a first step toward sequencing in space and aboard the International Space Station (ISS), we tested the Oxford Nanopore Technologies MinION during a parabolic flight to understand the effects of variable gravity on the instrument and data. In a successful proof-of-principle experiment, we found that the instrument generated DNA reads over the course of the flight, including the first ever sequenced in microgravity, and additional reads measured after the flight concluded its parabolas. Here we detail modifications to the sample-loading procedures to facilitate nanopore sequencing aboard the ISS and in other microgravity environments. We also evaluate existing analysis methods and outline two new approaches, the first based on a wave-fingerprint method and the second on entropy signal mapping. Computationally light analysis methods offer the potential for in situ species identification, but are limited by the error profiles (stays, skips, and mismatches) of older nanopore data. Higher accuracies attainable with modified sample processing methods and the latest version of flow cells will further enable the use of nanopore sequencers for diagnostics and research in space., Competing Interests: The authors declare no conflict of interest.

In this article, we present strategies for collecting and coding a large longitudinal communication data set collected across multiple sites, consisting of more than 2000 hours of digital audio recordings from approximately 300 families. We describe our methods within the context of implementing a large-scale study of communication during cancer home hospice nurse visits, but this procedure could be adapted to communication data sets across a wide variety of settings. This research is the first study designed to capture home hospice nurse-caregiver communication, a highly understudied location and type of communication event. We present a detailed example protocol encompassing data collection in the home environment, large-scale, multisite secure data management, the development of theoretically-based communication coding, and strategies for preventing coder drift and ensuring reliability of analyses. Although each of these challenges has the potential to undermine the utility of the data, reliability between coders is often the only issue consistently reported and addressed in the literature. Overall, our approach demonstrates rigor and provides a "how-to" example for managing large, digitally recorded data sets from collection through analysis. These strategies can inform other large-scale health communication research.

Based on a public health model of obesity, this study set out to examine whether a news article reporting the obesity issue in a societal versus individual frame would increase perceptions of societal responsibilities for the obesity problem and motivate responsibility-taking behaviors. Responsibility-taking behaviors were examined at 3 levels: personal, interpersonal, and societal. Data from a Web-based experiment revealed significant framing effects on behaviors via causal and treatment responsibility attributions. The societal frame increased societal causal and treatment attribution, which led to greater likelihoods of interpersonal and social responsibility-taking behaviors as well as personal behaviors. Our findings suggest that news framing can be an effective venue for raising awareness of obesity as a societal issue and mobilizing collective efforts.

Background: In 2009, the U.S. Preventive Services Task Force released new mammography screening guidelines that sparked a torrent of criticism. The subsequent conflict was significant and pitted the Task Force against other health organizations, advocacy groups, the media, and the public at large. We argue that this controversy was driven by the systematic removal of uncertainty from science communication. To increase comprehension and adherence, health information communicators remove caveats, limitations, and hedging so science appears simple and more certain. This streamlining process is, in many instances, initiated by researchers as they engage in dissemination of their findings, and it is facilitated by public relations professionals, journalists, public health practitioners, and others whose tasks involve using the results from research for specific purposes., Analysis: Uncertainty is removed from public communication because many communicators believe that it is difficult for people to process and/or that it is something the audience wants to avoid. Uncertainty management theory posits that people can find meaning and value in uncertainty. We define key terms relevant to uncertainty management, describe research on the processing of uncertainty, identify directions for future research, and offer recommendations for scientists, practitioners, and media professionals confronted with uncertain findings., Conclusions: Science is routinely simplified as it is prepared for public consumption. In line with the model of information overload, this practice may increase short-term adherence to recommendations at the expense of long-term message consistency and trust in science.

Background: A wide range of childhood illnesses are accompanied by fever,, including malaria. Child mortality due to malaria has been attributed to poor health service delivery system and ignorance. An assessment of a mother's ability to recognize malaria in children under-five was carried out among the Bwatiye, a poorly-served minority ethnic group in north-eastern Nigeria., Methods: A three-stage research design involving interviews, participatory observation and laboratory tests was used to seek information from 186 Bwatiye mothers about their illness-related experiences with childhood fevers., Results: Mothers classified malaria into male (fever that persists for longer than three days) and female (fever that goes away within three days) and had a system of determining when febrile illness would not be regarded as malaria. Most often, malaria would be ignored in the first 2 days before seeking active treatment. Self-medication was the preferred option. Treatment practices and sources of help were influenced by local beliefs, the parity of the mother and previous experience with child mortality., Conclusion: The need to educate mothers to suspect malaria in every case of febrile illness and take appropriate action in order to expose the underlying "evil" will be more acceptable than an insistence on replacing local knowledge with biological epidemiology of malaria. The challenge facing health workers is to identify and exploit local beliefs about aetiology in effecting management procedures among culturally different peoples, who may not accept the concept of biological epidemiology.