Cognitive factors and willingness to participate in an HIV vaccine trial among HIV-positive injection drug users

There are gaps in our knowledge of the role cognitive factors play in determining people's willingness to participate (WTP) in therapeutic HIV vaccine trials. Using a cross-sectional study of HIV-positive injection drug users (IDU), we determined the role of three cognitive factors: HIV treatment optimism, self-efficacy beliefs, and knowledge of vaccine trial concepts in relation to WTP in a hypothetical phase 3 therapeutic HIV vaccine trial. WTP was 54%. Participants tended to be low in HIV treatment optimism (mean?=?3.9/10), high in self-efficacy (mean?=?79.8/100), and low in knowledge (mean?=?4.1/10). Items pertaining to HIV treatment optimism and knowledge of HIV vaccine trial concepts were generally unrelated to WTP. An increase in self-efficacy had a statistically significant positive association with WTP (OR?=?1.61, 95% CI?=?1.04-2.46, p?相似文献   

Those Who Have the Gold Make the Evidence: How the Pharmaceutical Industry Biases the Outcomes of Clinical Trials of Medications

Pharmaceutical companies fund the bulk of clinical research that is carried out on medications. Poor outcomes from these studies can have negative effects on sales of medicines. Previous research has shown that company funded research is much more likely to yield positive outcomes than research with any other sponsorship. The aim of this article is to investigate the possible ways in which bias can be introduced into research outcomes by drawing on concrete examples from the published literature. Poorer methodology in industry-funded research is not likely to account for the biases seen. Biases are introduced through a variety of measures including the choice of comparator agents, multiple publication of positive trials and non-publication of negative trials, reinterpreting data submitted to regulatory agencies, discordance between results and conclusions, conflict-of-interest leading to more positive conclusions, ghostwriting and the use of ??seeding?? trials. Thus far, efforts to contain bias have largely focused on more stringent rules regarding conflict-of-interest (COI) and clinical trial registries. There is no evidence that any measures that have been taken so far have stopped the biasing of clinical research and it??s not clear that they have even slowed down the process. Economic theory predicts that firms will try to bias the evidence base wherever its benefits exceed its costs. The examples given here confirm what theory predicts. What will be needed to curb and ultimately stop the bias that we have seen is a paradigm change in the way that we treat the relationship between pharmaceutical companies and the conduct and reporting of clinical trials.     

The impact of onlooking and including bystander behaviour on judgments and emotions regarding peer exclusion

We investigated judgments and emotions in contexts of social exclusion that varied as a function of bystander behaviour (N = 173, 12‐ and 16‐year‐olds). Adolescents responded to film vignettes depicting a target excluded by a group with no bystanders, onlooking bystanders, or bystanders who included the target. Adolescents were asked to judge the behaviour and attribute emotions to the excluding group, the excluded target, and the bystanders. Younger adolescents judged the behaviour of the excluding group as more wrong than older adolescents when there were no bystanders present, indicating that the presence of bystanders was viewed as lessening the negative outcome of exclusion by the younger group. Yet, bystanders play a positive role only when they are includers, not when they are silent observers. This distinction was revealed by the findings that adolescents rated the behaviour of onlooking bystanders as more wrong compared with the behaviour of including bystanders. Moreover, all adolescents justified the inclusive behaviour more frequently with empathy than the onlooking behaviour. Adolescents also anticipated more empathy to including bystanders than to onlooking bystanders, as well as anticipated more guilt to onlooking bystanders than including bystanders. The findings are discussed in light of the role of group norms and group processes regarding bystanders' roles in social exclusion peer encounters.     

Biased cognitive processing of cancer-related information among women with family histories of breast cancer: evidence from a cancer stroop task.

Stimuli associated with sources of stress have been shown to interfere with cognition. The authors hypothesized that women with the stress of having a family history of breast cancer (FH+) would exhibit greater interference on a task with cancer-related stimuli than women without cancer in the family (FH-). The authors developed a modified Stroop color-naming task to test this hypothesis in a sample of FH+ (n = 72) and FH- (n = 96) women. Consistent with the hypotheses, FH+ women had longer color-naming times and more errors (ps < .01) on a cancer word list relative to noncancer lists. This biased processing was not mediated by the significantly higher perceived risk, general distress, or cancer-specific distress in FH+ women. Maladaptive alterations in processing cancer stimuli may have important clinical implications, as these women must process complex cancer-related information critical to their health (e.g., options for chemoprevention, screening).     

Relations between emotion, illusory word perception, and orthographic repetition blindness: Tests of binding theory

This study reports effects of meaning and emotion (taboo vs. neutral words) on an illusory word (IW) phenomenon linked to orthographic repetition blindness (RB). Participants immediately recalled rapid serial visual presentation (RSVP) lists consisting of two critical words (C1 and C2) containing shared letters, followed by a word fragment: for example, lake (C1) brake (C2) ush (fragment). For neutral critical words, participants often recalled C1, but not C2 or the fragment, reporting instead a nonoccurring or illusory word: here, brush (a blend of C2 and the fragment). Forward RB (defined as reduced report of orthographically similar C2s) was more common for neutral than for taboo C2s, and taboo IWs were reported significantly more often than were neutral IWs. Moreover, when both C2 and the potential IW were taboo, a new phenomenon emerged: Participants reliably reported both the IW and the intact C2. These and other results supported a binding theory of the IW phenomenon and orthographic RB.     

Nonsuicidal Self‐Injury among Adolescents: A Training Priority for Primary Care Providers

Primary care providers were surveyed to determine how prepared they feel to address nonsuicidal self‐injury (NSSI) among adolescents, their interest in training on NSSI, and factors associated with routinely asking about NSSI when providing health supervision. Participants included family medicine physicians (n = 260), pediatricians (n = 127), family nurse practitioners (n = 96), and pediatric nurse practitioners (n = 54). Almost 50% felt unprepared to address NSSI, and over 70% wanted training in this area. Overall, relative to other areas of mental health care, clinicians felt least prepared to address and wanted more training on NSSI. Just 27% reported they routinely inquired about NSSI during health supervision. Factors associated with routinely asking about NSSI were identifying as female (OR = 2.37; 95% CI = 1.25–4.49), feeling better prepared to address NSSI (OR = 1.51; 95% CI = 1.04–2.20), and more frequently using a psychosocial interview to identify adolescents in distress (OR = 1.23; 95% CI = 1.02–1.48). Teaching clinicians to assess NSSI within a psychosocial interview may increase screening for and identification of the behavior among adolescents in primary care.