Humorous health messages : "a fresh approach" for road safety advertising campaigns?

Theoretical Background and research questions/hypothesis: Recently, throughout Australasia, humorous appeals have become implemented increasingly in health advertising despite limited evidence regarding the persuasiveness of different types of humour. Of those studies available which have examined the persuasiveness of humorous messages, the type of humour is often not defined so it is unclear what type of humour is being examined. Speck’s (1991) typology includes five types of humour; comic wit, sentimental humour, satire, sentimental comedy, and full comedy. Each type of humour is based on one or more humour generation processes; namely, incongruity-resolution, disparagement humour, and arousal-safety. It has been acknowledged that more research is needed to determine the relative persuasiveness of these different types of humour and to identify those types which may be most effective for health advertising. The current research explored individuals’ thoughts about, and their responses to some different types of, humorous messages addressing the serious health topic of road safety. Methods: A preliminary qualitative, study was conducted involving discussions with licensed drivers (N = 18) regarding their thoughts and feelings about humorous road safety messages in general as well as in response to some (5 in total) pre-existing advertisements. Men (n = 10) and women of younger and older age groups (17-24 or 25+ years) participated in one of six discussions. Participants were recruited from an existing community-based database held by the authors’ Research Centre or were approached directly on the university campus. Ethical approval was gained for the study. Each participant was offered $AUD40. A semi-structured interview schedule guided the discussion (e.g., was it humorous?, would this ad influence you?). Audio-recordings of the discussions were professionally transcribed and the transcripts were analysed using thematic analysis. Results: The findings revealed that, irrespective of age and gender, humour that was clever, incorporated something unexpected and contrasting with the everyday, was a preferred and relevant approach, thus aligning with incongruity-based theories of humour generation and humour types, such as comic wit and satire. As a persuasive function, humorous messages were considered likely to be talked about (and relatively more so than traditional fear-based approaches). Participants also felt that humorous messages would need to be used cautiously as humour that was considered inappropriate and/or associated with serious occurrences, such as a crash, would be unlikely to persuade. Conclusions: The findings highlight some of the potential benefits of using humour, such as increasing the extent to which an advertisement is talked about as well as the types of humour which may be effective in this context. Implications for research and/or practice: While this research has provided important insight, future research which quantitatively assesses the persuasive effects of different types of humorous road safety messages within a larger, representative sample is needed. This current study has highlighted some humorous approaches which may hold persuasive promise in encouraging individuals to adopt safer attitudes and behaviours not only on the road, but in relation to serious health issues more broadly.

The effect of poser race on the happy categorization advantage depends on stimulus type, set size, and presentation duration

The question as to whether poser race affects the happy categorization advantage, the faster categorization of happy than of negative emotional expressions, has been answered inconsistently. Hugenberg (2005) found the happy categorization advantage only for own race faces whereas faster categorization of angry expressions was evident for other race faces. Kubota and Ito (2007) found a happy categorization advantage for both own race and other race faces. These results have vastly different implications for understanding the influence of race cues on the processing of emotional expressions. The current study replicates the results of both prior studies and indicates that face type (computer-generated vs. photographic), presentation duration, and especially stimulus set size influence the happy categorization advantage as well as the moderating effect of poser race.

Experiential learning as a constraint-led process: an ecological dynamics perspective

In this paper we present key ideas for an ecological dynamics approach to learning that reveal the importance of learner–environment interactions to frame outdoor experiential learning.We propose that ecological dynamics provides a useful framework for understanding the interacting constraints of the learning process and for designing learning opportunities in outdoor experiential learning.

Exploring expedition research methodology : a personal reflection

Research into the human dynamics of expeditions is a potentially rewarding and fruitful area of study. However, the complex nature of expedition work presents the researcher with numerous challenges. This paper presents a personal reflection on the challenges linked to determining appropriate methodological processes for a study into expedition teamwork. Previous expedition research is outlined and reviewed for appropriateness. Some alternative methodological theories are described and limitations highlighted. Lastly the actual data gathering and analysis processes are detailed. The aim being to show that what happened in the field inevitably dictated how methodological processes were adapted. Essentially the paper describes a personal journey into research. A journey that sparked numerous personal insights in the science of human dynamics and expeditions and one that I hope will add to the development of expedition research in general.

Metastability and emergent performance of dynamic interceptive actions

Objectives: Adaptive patterning of human movement is context specific and dependent on interacting constraints of the performer–environment relationship. Flexibility of skilled behaviour is predicated on the capacity of performers to move between different states of movement organisation to satisfy dynamic task constraints, previously demonstrated in studies of visual perception, bimanual coordination, and an interceptive combat task. Metastability is a movement system property that helps performers to remain in a state of relative coordination with their performance environments, poised between multiple co-existing states (stable and distinct movement patterns or responses). The aim of this study was to examine whether metastability could be exploited in externally paced interceptive actions in fast ball sports, such as cricket. Design: Here we report data on metastability in performance of multi-articular hitting actions by skilled junior cricket batters (n = 5). Methods: Participants’ batting actions (key movement timings and performance outcomes) were analysed in four distinct performance regions varied by ball pitching (bounce) location. Results: Results demonstrated that, at a pre-determined distance to the ball, participants were forced into a meta-stable region of performance where rich and varied patterns of functional movement behaviours emerged. Participants adapted the organisation of responses, resulting in higher levels of variability in movement timing in this performance region, without detrimental effects on the quality of interceptive performance outcomes. Conclusions: Findings provide evidence for the emergence of metastability in a dynamic interceptive action in cricket batting. Flexibility and diversity of movement responses were optimised using experiential knowledge and careful manipulation of key task constraints of the specific sport context.

A pre-post evaluation of an ambulatory nutrition support service for malnourished patients post hospital discharge: a pilot study

Introduction Malnutrition is common among hospitalised patients, with poor follow-up of nutrition support post-discharge. Published studies on the efficacy of ambulatory nutrition support (ANS) for malnourished patients post-discharge are scarce. The aims of this study were to evaluate the rate of dietetics follow-up of malnourished patients post-discharge, before (2008) and after (2010) implementation of a new ANS service, and to evaluate nutritional outcomes post-implementation. Materials and Methods Consecutive samples of 261 (2008) and 163 (2010) adult inpatients referred to dietetics and assessed as malnourished using Subjective Global Assessment (SGA) were enrolled. All subjects received inpatient nutrition intervention and dietetic outpatient clinic follow-up appointments. For the 2010 cohort, ANS was initiated to provide telephone follow-up and home visits for patients who failed to attend the outpatient clinic. Subjective Global Assessment, body weight, quality of life (EQ-5D VAS) and handgrip strength were measured at baseline and five months post-discharge. Paired t-test was used to compare pre- and post-intervention results. Results In 2008, only 15% of patients returned for follow-up with a dietitian within four months post-discharge. After implementation of ANS in 2010, the follow-up rate was 100%. Mean weight improved from 44.0 ± 8.5kg to 46.3 ± 9.6kg, EQ-5D VAS from 61.2 ± 19.8 to 71.6 ± 17.4 and handgrip strength from 15.1 ± 7.1 kg force to 17.5 ± 8.5 kg force; p<0.001 for all. Seventy-four percent of patients improved in SGA score. Conclusion Ambulatory nutrition support resulted in significant improvements in follow-up rate, nutritional status and quality of life of malnourished patients post-discharge.

Validity and reliability of 3-minute nutrition screening (3-MinNS)performed by nurses on oncology and surgical patients

Background Nutrition screening is usually administered by nurses. However, most studies on nutrition screening tools have not used nurses to validate the tools. The 3-Minute Nutrition Screening (3-MinNS) assesses weight loss, dietary intake and muscle wastage, with the composite score of each used to determine risk of malnutrition. The aim of the study was to determine the validity and reliability of 3-MinNS administered by nurses, who are the intended assessors. Methods In this cross sectional study, three ward-based nurses screened 121 patients aged 21 years and over using 3-MinNS in three wards within 24 hours of admission. A dietitian then assessed the patients’ nutritional status using Subjective Global Assessment within 48 hours of admission, whilst blinded to the results of the screening. To assess the reliability of 3-MinNS, 37 patients screened by the first nurse were re-screened by a second nurse within 24 hours, who was blinded to the results of the first nurse. The sensitivity, specificity and best cutoff score for 3-MinNS were determined using the Receiver Operator Characteristics Curve. Results The best cutoff score to identify all patients at risk of malnutrition using 3-MinNS was three, with sensitivity of 89% and specificity of 88%. This cutoff point also identified all (100%) severely malnourished patients. There was strong correlation between 3-MinNS and SGA (r=0.78, p<0.001). The agreement between two nurses conducting the 3-MinNS tool was 78.3%. Conclusion 3-Minute Nutrition Screening is a valid and reliable tool for nurses to identify patients at risk of malnutrition.

Evaluation of an ambulatory nutrition support service for malnourished patients post hospital discharge

Introduction Malnutrition is common among hospitalised patients, with poor follow-up of nutrition support post-discharge. Published studies on the efficacy of ambulatory nutrition support (ANS) for malnourished patients post-discharge are scarce. The aims of this study were to evaluate the rate of dietetics follow-up of malnourished patients post-discharge, before (2008) and after (2010) implementation of a new ANS service, and to evaluate nutritional outcomes post-implementation. Materials and Methods Consecutive samples of 261 (2008) and 163 (2010) adult inpatients referred to dietetics and assessed as malnourished using Subjective Global Assessment (SGA) were enrolled. All subjects received inpatient nutrition intervention and dietetic outpatient clinic follow-up appointments. For the 2010 cohort, ANS was initiated to provide telephone follow-up and home visits for patients who failed to attend the outpatient clinic. Subjective Global Assessment, body weight, quality of life (EQ-5D VAS) and handgrip strength were measured at baseline and five months post-discharge. Paired t-test was used to compare pre- and post-intervention results. Results In 2008, only 15% of patients returned for follow-up with a dietitian within four months post-discharge. After implementation of ANS in 2010, the follow-up rate was 100%. Mean weight improved from 44.0 ± 8.5kg to 46.3 ± 9.6kg, EQ-5D VAS from 61.2 ± 19.8 to 71.6 ± 17.4 and handgrip strength from 15.1 ± 7.1 kg force to 17.5 ± 8.5 kg force; p<0.001 for all. Seventy-four percent of patients improved in SGA score. Conclusion Ambulatory nutrition support resulted in significant improvements in follow-up rate, nutritional status and quality of life of malnourished patients post-discharge.

Hepatitis C, mental health and equity of access to antiviral therapy : a systematic narrative review

Introduction Access to hepatitis C (hereafter HCV) antiviral therapy has commonly excluded populations with mental health and substance use disorders because they were considered as having contraindications to treatment, particularly due to the neuropsychiatric effects of interferon that can occur in some patients. In this review we examined access to HCV interferon antiviral therapy by populations with mental health and substance use problems to identify the evidence and reasons for exclusion. Methods We searched the following major electronic databases for relevant articles: PsycINFO, Medline, CINAHL, Scopus, Google Scholar. The inclusion criteria comprised studies of adults aged 18 years and older, peer-reviewed articles, date range of (2002--2012) to include articles since the introduction of pegylated interferon with ribarvirin, and English language. The exclusion criteria included articles about HCV populations with medical co-morbidities, such as hepatitis B (hereafter HBV) and human immunodeficiency virus (hereafter HIV), because the clinical treatment, pathways and psychosocial morbidity differ from populations with only HCV. We identified 182 articles, and of these 13 met the eligibility criteria. Using an approach of systematic narrative review we identified major themes in the literature. Results Three main themes were identified including: (1) pre-treatment and preparation for antiviral therapy, (2) adherence and treatment completion, and (3) clinical outcomes. Each of these themes was critically discussed in terms of access by patients with mental health and substance use co-morbidities demonstrating that current research evidence clearly demonstrates that people with HCV, mental health and substance use co-morbidities have similar clinical outcomes to those without these co-morbidities. Conclusions While research evidence is largely supportive of increased access to interferon by people with HCV, mental health and substance use co-morbidities, there is substantial further work required to translate evidence into clinical practice. Further to this, we conclude that a reconsideration of the appropriateness of the tertiary health service model of care for interferon management is required and exploration of the potential for increased HCV care in primary health care settings.

Clinical skin examination outcomes after a video-based behavioral intervention analysis from a randomized clinical trial

Importance Older men are at risk of dying of melanoma. Objective To assess attendance at and clinical outcomes of clinical skin examinations (CSEs) in older men exposed to a video-based behavioral intervention. Design, Setting, and Participants This was a behavioral randomized clinical trial of a video-based intervention in men aged at least 50 years. Between June 1 and August 31, 2008, men were recruited, completed baseline telephone interviews, and were than randomized to receive either a video-based intervention (n = 469) or brochures only (n = 461; overall response rate, 37.1%) and were again interviewed 7 months later (n = 870; 93.5% retention). Interventions Video on skin self-examination and skin awareness and written informational materials. The control group received written materials only. Main Outcomes and Measures Participants who reported a CSE were asked for the type of CSE (skin spot, partial body, or whole body), who initiated it, whether the physician noted any suspicious lesions, and, if so, how lesions were managed. Physicians completed a case report form that included the type of CSE, who initiated it, the number of suspicious lesions detected, how lesions were managed (excision, nonsurgical treatment, monitoring, or referral), and pathology reports after lesion excision or biopsy. Results Overall, 540 of 870 men (62.1%) self-reported a CSE since receiving intervention materials, and 321 of 540 (59.4%) consented for their physician to provide medical information (received for 266 of 321 [82.9%]). Attendance of any CSE was similar between groups (intervention group, 246 of 436 [56.4%]; control group, 229 of 434 [52.8%]), but men in the intervention group were more likely to self-report a whole-body CSE (154 of 436 [35.3%] vs 118 of 434 [27.2%] for control group; P = .01). Two melanomas, 29 squamous cell carcinomas, and 38 basal cell carcinomas were diagnosed, with a higher proportion of malignant lesions in the intervention group (60.0% vs 40.0% for controls; P = .03). Baseline attitudes, behaviors, and skin cancer history were associated with higher odds of CSE and skin cancer diagnosis. Conclusions and Relevance A video-based intervention may increase whole-body CSE and skin cancer diagnosis in older men. Trial Registration: anzctr.org.au Identifier: ACTRN12608000384358

Adding SUGAR : service user and carer collaboration in mental health nursing research

‘SUGAR: Service users and carers group advising on research’ is an exciting initiative established to develop collaborative working in mental health nursing research between mental health service users, carers, researchers and practitioners at City University London, UK. This paper will describe the background to SUGAR and how and why it was established; how the group operates; some of the achievements to date including researcher reflections; and case studies of how this collaboration influences our research. Written reflective narratives of service user and carer experiences of SUGAR were analysed using constant comparative methods by the members. Common themes are presented with illustrative quotes. The article highlights the benefits and possible limitations identified so far by members of SUGAR; outlines future plans and considers the findings in relation to literature on involvement and empowerment. This paper has been written by staff and members of SUGAR and is the first venture into collaborative writing of the group and reflects the shared ethos of collaborative working.

Monitoring the health-related labelling of foods and non-alcoholic beverages in retail settings

Food labelling on food packaging has the potential to have both positive and negative effects on diets. Monitoring different aspects of food labelling would help to identify priority policy options to help people make healthier food choices. A taxonomy of the elements of health-related food labelling is proposed. A systematic review of studies that assessed the nature and extent of health-related food labelling has been conducted to identify approaches to monitoring food labelling. A step-wise approach has been developed for independently assessing the nature and extent of health-related food labelling in different countries and over time. Procedures for sampling the food supply, and collecting and analysing data are proposed, as well as quantifiable measurement indicators and benchmarks for health-related food labelling.

Better prepared next time : considering nutrition in an emergency response

To the Editor: Cyclones, floods and bushfires are experienced in Australia every year, and Australia’s management of natural disasters centres on prevention, preparedness, response and recovery.1 Although access to safe food is a basic human need, during the 2010–2011 Queensland floods there was minimal information available to guide household food preparedness and food supply to communities...

Implementation of a better choice healthy food and drink supply strategy for staff and visitors in government owned health facilities in Queensland, Australia

Objective The present paper reports on a quality improvement activity examining implementation of A Better Choice Healthy Food and Drink Supply Strategy for Queensland Health Facilities (A Better Choice). A Better Choice is a policy to increase supply and promotion of healthy foods and drinks and decrease supply and promotion of energy-dense, nutrient-poor choices in all food supply areas including food outlets, staff dining rooms, vending machines, tea trolleys, coffee carts, leased premises, catering, fundraising, promotion and advertising. Design An online survey targeted 278 facility managers to collect self-reported quantitative and qualitative data. Telephone interviews were sought concurrently with the twenty-five A Better Choice district contact officers to gather qualitative information. Setting Public sector-owned and -operated health facilities in Queensland, Australia. Subjects One hundred and thirty-four facility managers and twenty-four district contact officers participated with response rates of 48·2 % and 96·0 %, respectively. Results Of facility managers, 78·4 % reported implementation of more than half of the A Better Choice requirements including 24·6 % who reported full strategy implementation. Reported implementation was highest in food outlets, staff dining rooms, tea trolleys, coffee carts, internal catering and drink vending machines. Reported implementation was more problematic in snack vending machines, external catering, leased premises and fundraising. Conclusions Despite methodological challenges, the study suggests that policy approaches to improve the food and drink supply can be implemented successfully in public-sector health facilities, although results can be limited in some areas. A Better Choice may provide a model for improving food supply in other health and workplace settings.