Clinical Characteristics and Quality of Life in Adults Initiating Medical Marijuana Treatment

Introduction: Despite the rising availability and use of medical marijuana (MM) in the USA, little is known about the demographics, clinical characteristics, or quality of life of MM patients. This study describes the demographic characteristics and health-related quality of life (HRQoL) of MM patients who are initiating treatment in Pennsylvania. Methods: Two-hundred adults naive to MM and referred for any of the 23 state-approved qualifying conditions were recruited at three MM dispensaries in Pennsylvania between September 2020 and March 2021. All participants consented to the study; completed semi-structured interviews that included demographic questionnaires, the Short Form-36 (SF-36), and Generalized Anxiety Disorder-7 (GAD-7); provided height and weight measurements; and allowed access their dispensary medical records. Results: Participants had a mean age of 48.5 ± 15.6 years, predominantly identified as female (67.5%), and were most commonly referred for chronic pain (63.5%) and/or anxiety (58.5%). Additionally, 46.0% were living with obesity as determined by BMI. Relative to a normative sample, participants reported diminished HRQoL in several domains, most notably in role limitations due to physical health (M = 46.0 ± 42.0), role limitations due to emotional problems (M = 52.5 ± 42.3), energy and fatigue (M = 39.8 ± 20.2), and pain (M = 49.4 ± 26.0). Discussion/Conclusion: Patients initiating MM treatment experienced low HRQoL in multiple domains. Future studies could evaluate the relationship between HRQoL and patients’ decisions to pursue MM treatment, as well as changes in HRQoL with MM use over time

Belief in a Just World: Consumer Intentions and Behaviors Toward Ethical Products

Although consumers report positive attitudes toward ethical goods, their intentions and behaviors often do not follow suit. Just-world theory highlights the conditions under which consumers are most likely to prefer fair-trade products. This theory proposes that people are motivated to construe the world as a just place where people get what they deserve. In the current research, when people are confronted with high levels of injustice (communicated need is high) and avenues for justice restoration seem uncertain or unavailable, assisting others by supporting fair trade decreases. However, highlighting how injustice can be redressed through purchases enhances fair-trade support under conditions of high need. The effects are moderated by justice sensitivity factors, such as just-world beliefs and whether the product type (indulgence vs. necessity) makes the injustice of consumer privilege salient. The results suggest that communicating high need when requesting consumer prosocial actions can sometimes backfire. Marketers employing high need appeals should heighten perceptions of justice restoration potential and activate fairness-related thoughts through product positioning to encourage fair-trade purchases

Physicians and Drug Representatives: Exploring the Dynamics of the Relationship

BACKGROUND: Interactions between physicians and drug representatives are common, even though research shows that physicians understand the conflict of interest between marketing and patient care. Little is known about how physicians resolve this contradiction. OBJECTIVE: To determine physicians’ techniques for managing cognitive inconsistencies within their relationships with drug representatives. DESIGN, SETTING, AND PARTICIPANTS: Six focus groups were conducted with 32 academic and community physicians in San Diego, Atlanta, and Chicago. MEASUREMENTS: Qualitative analysis of focus group transcripts to determine physicians’ attitudes towards conflict of interest and detailing, their beliefs about the quality of information conveyed and the impact on prescribing, and their resolution of the conflict between detailers’ desire to sell product and patient care. RESULTS: Physicians understood the concept of conflict of interest and applied it to relationships with detailers. However, they maintained favorable views of physician–detailer exchanges. Holding these mutually contradictory attitudes, physicians were in a position of cognitive dissonance. To resolve the dissonance, they used a variety of denials and rationalizations: They avoided thinking about the conflict of interest, they disagreed that industry relationships affected physician behavior, they denied responsibility for the problem, they enumerated techniques for remaining impartial, and they reasoned that meetings with detailers were educational and benefited patients. CONCLUSIONS: Although physicians understood the concept of conflict of interest, relationships with detailers set up psychological dynamics that influenced their reasoning. Our findings suggest that voluntary guidelines, like those proposed by most major medical societies, are inadequate. It may be that only the prohibition of physician–detailer interactions will be effective

Nothing Is True? The Credibility of News and Conflicting Narratives during “Information War” in Ukraine

In international politics, the strategic narratives of different governments compete for public attention and support. The Russian government’s narrative has prompted western concern due to fears that it exerts a destabilizing effect on societies in Eastern Europe and elsewhere. However, the behavior and thought processes of news consumers targeted by contradictory strategic narratives are rarely subjected to analysis. This paper examines how Ukrainian news consumers decide where to get their news and what to believe in a media environment where “propaganda” and “disinformation” are regarded as major threats to national security. Evidence comes from thirty audio-diaries and in-depth interviews conducted in 2016 among adult residents of Odesa Region. Through qualitative analysis of the diary and interview transcripts, the paper reveals how participants judged the credibility of news and narratives based on their priorities (what they considered important), not just “facts” (what they believed had happened). The attribution of importance to different foreign policy issues was associated, in turn, with varying personal experiences, memories, and individual cross-border relationships

Personalization Paradox in Behavior Change Apps:Lessons from a Social Comparison-Based Personalized App for Physical Activity

Social comparison-based features are widely used in social computing apps. However, most existing apps are not grounded in social comparison theories and do not consider individual differences in social comparison preferences and reactions. This paper is among the first to automatically personalize social comparison targets. In the context of an m-health app for physical activity, we use artificial intelligence (AI) techniques of multi-armed bandits. Results from our user study (n=53) indicate that there is some evidence that motivation can be increased using the AI-based personalization of social comparison. The detected effects achieved small-to-moderate effect sizes, illustrating the real-world implications of the intervention for enhancing motivation and physical activity. In addition to design implications for social comparison features in social apps, this paper identified the personalization paradox, the conflict between user modeling and adaptation, as a key design challenge of personalized applications for behavior change. Additionally, we propose research directions to mitigate this Personalization Paradox

When Flexibility Is Stable: Implicit Long-Term Shaping of Olfactory Preferences

Preferences are traditionally assumed to be stable. However, empirical evidence such as preference modulation following choices calls this assumption into question. The evolution of such postchoice preference over long time spans, even when choices have been explicitly forgotten, has so far not been studied. In two experiments, we investigated this question by using a variant of the free choice paradigm: In a first session, participants evaluated the pleasantness of a number of odors. We then formed pairs of similarly rated odors, and asked participants to choose their favorite, for each pair. Participants were then presented with all odors again, and asked for another pleasantness rating. In a second session 1 week later, a third pleasantness rating was obtained, and participants were again asked to choose between the same options. Results suggested postchoice preference modulation immediately and 1 week after choice for both chosen and rejected options, even when choices were not explicitly remembered. A third experiment, using another paradigm, confirmed that choice can have a modulatory impact on preferences, and that this modulation can be long-lasting. Taken together, these findings suggest that although preferences appear to be flexible because they are modulated by choices, this modulation also appears to be stable over time and even without explicit recollection of the choice. These results bring a new argument to the idea that postchoice preference modulation could rely on implicit mechanisms, and are consistent with the recent proposal that cognitive dissonance reduction could to some extent be implicit

Drug education in victorian schools (DEVS): the study protocol for a harm reduction focused school drug education trial

<p>Abstract</p> <p>Background</p> <p>This study seeks to extend earlier Australian school drug education research by developing and measuring the effectiveness of a comprehensive, evidence-based, harm reduction focused school drug education program for junior secondary students aged 13 to 15 years. The intervention draws on the recent literature as to the common elements in effective school curriculum. It seeks to incorporate the social influence of parents through home activities. It also emphasises the use of appropriate pedagogy in the delivery of classroom lessons.</p> <p>Methods/Design</p> <p>A cluster randomised school drug education trial will be conducted with 1746 junior high school students in 21 Victorian secondary schools over a period of three years. Both the schools and students have actively consented to participate in the study. The education program comprises ten lessons in year eight (13-14 year olds) and eight in year nine (14-15 year olds) that address issues around the use of alcohol, tobacco, cannabis and other illicit drugs. Control students will receive the drug education normally provided in their schools. Students will be tested at baseline, at the end of each intervention year and also at the end of year ten. A self completion questionnaire will be used to collect information on knowledge, patterns and context of use, attitudes and harms experienced in relation to alcohol, tobacco, cannabis and other illicit drug use. Multi-level modelling will be the method of analysis because it can best accommodate hierarchically structured data. All analyses will be conducted on an Intent-to-Treat basis. In addition, focus groups will be conducted with teachers and students in five of the 14 intervention schools, subsequent to delivery of the year eight and nine programs. This will provide qualitative data about the effectiveness of the lessons and the relevance of the materials.</p> <p>Discussion</p> <p>The benefits of this drug education study derive both from the knowledge gained by trialling an optimum combination of innovative, harm reduction approaches with a large, student sample, and the resultant product. The research will provide better understanding of what benefits can be achieved by harm reduction education. It will also produce an intervention, dealing with both licit and illicit drug use that has been thoroughly evaluated in terms of its efficacy, and informed by teacher and student feedback. This makes available to schools a comprehensive drug education package with prevention characteristics and useability that are well understood.</p> <p>Trial registration</p> <p>Australia and New Zealand Clinical Trials Register (ANZCTR): <a href="http://www.anzctr.org.au/ACTRN12612000079842.aspx">ACTRN12612000079842</a></p