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28 pages, 2882 KB  
Article
Semantic Divergence in AI-Generated and Human Influencer Product Recommendations: A Computational Analysis of Dual-Agent Communication in Social Commerce
by Woo-Chul Lee, Jang-Suk Lee and Jungho Suh
Appl. Sci. 2026, 16(6), 2816; https://doi.org/10.3390/app16062816 - 15 Mar 2026
Viewed by 1026
Abstract
The proliferation of generative artificial intelligence (AI) as an autonomous recommendation agent fundamentally challenges traditional paradigms of marketing communication. As AI systems increasingly mediate consumer–brand relationships, understanding how artificial agents construct persuasive discourse—distinct from human communicators—becomes critical for developing effective dual-channel marketing strategies. [...] Read more.
The proliferation of generative artificial intelligence (AI) as an autonomous recommendation agent fundamentally challenges traditional paradigms of marketing communication. As AI systems increasingly mediate consumer–brand relationships, understanding how artificial agents construct persuasive discourse—distinct from human communicators—becomes critical for developing effective dual-channel marketing strategies. Grounded in Source Credibility Theory and the Computers Are Social Actors (CASA) paradigm, this study investigates the semantic and structural divergence between AI-generated product recommendations and human influencer marketing messages in social commerce contexts. Employing a mixed-methods computational approach integrating term frequency analysis, TF-IDF weighting, Latent Dirichlet Allocation (LDA) topic modeling, and BERT-based contextualized semantic embedding analysis (KR-SBERT), we examined 330 Instagram influencer posts and 541 AI-generated responses concerning inner beauty enzyme products—a hybrid category combining functional health claims with hedonic beauty appeals—in the Korean social commerce market. AI-generated responses were collected through a systematically designed query protocol with empirically grounded prompts derived from actual consumer search behaviors, and analytical robustness was verified through sensitivity analyses across multiple parameter thresholds. Our findings reveal a fundamental divergence in persuasive architecture: human influencers construct experiential narratives exhibiting message characteristics typically associated with peripheral-route cues (sensory descriptions, emotional testimonials, social context), while AI recommendations employ systematic, evidence-based discourse exhibiting message characteristics typically associated with central-route argumentation (functional mechanisms, ingredient specifications, objective criteria). Topic modeling identified four distinct thematic clusters for each source type: human discourse centers on embodied experience and relational consumption, whereas AI discourse organizes around informational utility and rational decision support. Jensen–Shannon Divergence analysis (JSD = 0.213 bits) confirmed moderate distributional divergence, while chi-square testing (χ2 = 847.23, p < 0.001) and Cramér’s V (0.312, indicating a medium-to-large effect) demonstrated statistically significant and substantively meaningful differences. These findings extend CASA theory by demonstrating that AI recommendation agents develop a characteristic “AI communication signature” distinguishable from human persuasion patterns. We propose an integrated Dual-Agent Persuasion Proposition—synthesizing CASA, ELM, and Source Credibility perspectives—suggesting that AI and human recommenders serve complementary functions across different stages of the consumer decision journey—a proposition whose predictions regarding sequential persuasive effectiveness and consumer processing routes await experimental validation. These findings carry implications for AI content strategy optimization, platform design, and emerging regulatory frameworks for AI-generated content labeling. Full article
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14 pages, 265 KB  
Article
Sports Nutrition Misinformation on Spanish-Language YouTube and Digital Health Literacy: Mapping a Young–Adult Relevant Information Environment
by Ainoa Sofía Pastor-González, Juan Pablo Hervás-Pérez, Eva María Rodríguez-González, María Del Carmen Lozano-Estevan, Carlos Ruíz-Núñez, Cibeles Serna-Menor and Ivan Herrera-Peco
Youth 2026, 6(1), 18; https://doi.org/10.3390/youth6010018 - 7 Feb 2026
Viewed by 1063
Abstract
YouTube is a de facto learning environment for athletes seeking fast, actionable nutritional guidance, yet platform dynamics may favor simplified or testimonial narratives over evidence-aligned messages. This study maps Spanish-language sports-nutrition videos to clarify who is most visible, how advice is framed, and [...] Read more.
YouTube is a de facto learning environment for athletes seeking fast, actionable nutritional guidance, yet platform dynamics may favor simplified or testimonial narratives over evidence-aligned messages. This study maps Spanish-language sports-nutrition videos to clarify who is most visible, how advice is framed, and what users encounter first. We conducted a cross-sectional, mixed-methods study of 558 YouTube videos on pre/post-exercise nutrition and supplementation. Data was coded for video types (divulgation/testimonial), claim presence, evidence links, and creator status (professional/non-professional). Exposure-adjusted metrics (View Ratio, Viewer Interaction) and nonparametric tests summarized distributions. An undirected network generated centrality rankings to select qualitative samples. Thematic analysis of titles and descriptions identified recurring rhetorical patterns and discourse modes. Divulgation videos predominated (97.3%). Evidence links were rare (0.2%). Exposure and interaction were right-skewed, indicating concentrated visibility. Non-professionals produced most videos, with older uploads and higher daily view accrual; however, interaction per view was similar across groups. Qualitative synthesis revealed two dominant discourse modes, scientific–cautious and experience–testimonial. Oversimplification and motivational cues clustered in testimonial/non-professional items; instructional language and scarce evidence links concentrated in professional/divulgation items. In Spanish sports-nutrition content, visibility is concentrated, and creator identity shapes advice framing. Evidence-aligned messages can compete when expressed with clear athletic framing, explicit caveats, and links to trustworthy sources. Full article
27 pages, 524 KB  
Article
The Message or the Messenger: The Impact of Explanation Satisfaction and Source Characteristics on Perceptions of Experts and Verdicts
by Kristen L. Gittings, Carly E. Giffin and Jessica M. Salerno
Behav. Sci. 2025, 15(12), 1670; https://doi.org/10.3390/bs15121670 - 3 Dec 2025
Viewed by 624
Abstract
Understanding how expert characteristics shape verdicts is critical. This study identified message (e.g., explanation satisfaction) and source characteristics (e.g., education) that predict perceived expertise and verdicts. We hypothesized an expert with more (versus less) satisfying explanations, education, and hands-on contact with the evidence [...] Read more.
Understanding how expert characteristics shape verdicts is critical. This study identified message (e.g., explanation satisfaction) and source characteristics (e.g., education) that predict perceived expertise and verdicts. We hypothesized an expert with more (versus less) satisfying explanations, education, and hands-on contact with the evidence would be perceived as higher in expertise, and that female experts would be perceived as lower in expertise than male experts. Further, higher expertise would predict more verdicts in line with the expert’s testimony. In three mock jury studies (N = 1853), we measured (Studies 1–3) and manipulated (Study 3) explanation satisfaction. We also manipulated source characteristics (i.e., education, Studies 1–3; evidence contact, Studies 1–2; expert gender, Studies 2–3). Mock jurors reported their verdicts and perceptions of the expert. Satisfaction with the expert’s explanation was the only consistent predictor of perceived expertise, and in turn, verdicts. This effect operated independently from source characteristics; expert gender, education, and more hands-on contact with the evidence did not have consistent influence on satisfaction. We found evidence that expertise cues (education, Studies 1–3; evidence contact, Studies 1–2) impacted explanation satisfaction but did not consistently influence verdicts. Our findings suggest that explanation satisfaction—not source characteristics—reliably predicted expertise and verdicts. Thus, attorneys should ensure the experts they retain can effectively communicate to jurors. Full article
(This article belongs to the Special Issue Social Cognitive Processes in Legal Decision Making)
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21 pages, 368 KB  
Article
Prophecy in Clay: The Construction of Prophetic Identities in the Royal Archives of Mari
by José Andrés Sánchez Abarrio
Religions 2025, 16(11), 1400; https://doi.org/10.3390/rel16111400 - 3 Nov 2025
Viewed by 2519
Abstract
The prophetic texts from Mari represent the earliest written testimony of the prophetic phenomenon in the Ancient Near East. Approximately sixty-five clay tablets—out of the more than eighteen thousand unearthed at Tell Hariri (Syria)—attest to the prophetic activity of various men and women [...] Read more.
The prophetic texts from Mari represent the earliest written testimony of the prophetic phenomenon in the Ancient Near East. Approximately sixty-five clay tablets—out of the more than eighteen thousand unearthed at Tell Hariri (Syria)—attest to the prophetic activity of various men and women who received divine revelations primarily intended for the king. However, a detailed reading of the texts reveals that there is no single term used to identify prophetic agents, inviting reflection on the diversity of roles and functions within this phenomenon. Why, then, do scholars refer to them collectively as “prophetic agents” (a term that, moreover, carries a strong biblical resonance)? Can we discern in their actions the counterpart or the very essence of the prophets of Israel? This article explores, based on the original Akkadian texts, the multiple identities of the prophets of Mari through an analysis of the terms employed, their etymology, and their occurrence in Old Babylonian sources. Furthermore, since these individuals are recipients of divine revelation, the study also includes those men and women who bear witness to revelatory dreams. Finally, it raises the question of whether these prophets and their practices can be regarded as precursors to the biblical prophets, given the striking similarities in their behavior and message. This study thus provides grounds to speak of a continuum of prophetic phenomena throughout the biblical Near East. Full article
21 pages, 617 KB  
Article
“Pay Attention! Pay Attention! Pay Attention!!!”: The Pivotal Role of Educators and the Educational System as Experienced by Survivors of Child Sexual Abuse
by Laura I. Sigad, Dafna Tener, Efrat Lusky-Weisrose, Jordan Shaibe and Carmit Katz
Behav. Sci. 2024, 14(5), 419; https://doi.org/10.3390/bs14050419 - 16 May 2024
Cited by 6 | Viewed by 3709
Abstract
Educational institutions and educators are significant in children’s lives, and they have a crucial role in implementing policies, practices, and sexual education to enhance children’s safety. Such policies and practices should be based on the voices of CSA survivors. This study explored child [...] Read more.
Educational institutions and educators are significant in children’s lives, and they have a crucial role in implementing policies, practices, and sexual education to enhance children’s safety. Such policies and practices should be based on the voices of CSA survivors. This study explored child sexual abuse (CSA) survivors’ viewpoints on their past experiences with educators and the educational system. A qualitative thematic approach was used to analyze 61 written testimonies collected in 2020–2021 by the Israeli Independent Public Inquiry on CSA. Two interrelated themes arose: (1) CSA survivors’ retrospective perspectives of educators and the educational system’s responses to signs of their CSA, described as ranging from abusive to life-saving. Specifically, they shared three types of responses: (a) harmful and hurtful; (b) dismissive and ignoring; and (c) accepting and attending. (2) The second theme described the survivors’ messages to educators to promote constructive change. The survivors conveyed expectations that educators should play a central role in CSA prevention, detection, and intervention and, specifically, the need for educators to receive professional training, provide beneficial sexual education, and identify and respond to CSA. The findings promoted moving beyond individual-level interventions to focus on improving educational institutional and organizational cultures related to CSA in both national and international contexts. Full article
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22 pages, 2447 KB  
Article
“It Happened to Me and It’s Serious”: Conditional Indirect Effects of Infection Severity Narrated in Testimonial Tweets on COVID-19 Prevention
by Juan-José Igartua, Laura Rodríguez-Contreras, Íñigo Guerrero-Martín and Andrea Honorato-Vicente
Int. J. Environ. Res. Public Health 2023, 20(13), 6254; https://doi.org/10.3390/ijerph20136254 - 29 Jun 2023
Cited by 5 | Viewed by 2651
Abstract
The health crisis caused by COVID-19 resulted in societal breakdowns around the world. Our research is based on determining which features of testimonial messages are most relevant in increasing persuasive impact. An online experiment with a 2 (severity infection narrative: low vs. high) [...] Read more.
The health crisis caused by COVID-19 resulted in societal breakdowns around the world. Our research is based on determining which features of testimonial messages are most relevant in increasing persuasive impact. An online experiment with a 2 (severity infection narrative: low vs. high) × 2 (infection target: narrative’s protagonist vs. protagonist’s father) between-subject factorial design was carried out. Young people between 18 and 28 years (N = 278) were randomly assigned to one of the four experimental conditions, where they were asked to read a narrative message in the form of a Twitter thread describing a COVID-19 infection (with mild or severe symptoms) that affected either the protagonist of the message (a 23-year-old young person) or their father. After reading the narrative message, the mediating and dependent variables were evaluated. A message describing a severe COVID-19 infection affecting their protagonist to increase the perception of personal risk increased the persuasive impact through an increase in cognitive elaboration and a reduction in reactance. Our study highlights that creating persuasive messages based on social media targeted at young people that describe a careless behavior resulting in a severe COVID-19 infection can be an appropriate strategy for designing prevention campaigns. Full article
(This article belongs to the Special Issue Media Psychology and Health Communication)
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17 pages, 2089 KB  
Article
Qualitative Evaluation of YouTube Videos on Dental Fear, Anxiety and Phobia
by Natalie Sui Miu Wong, Andy Wai Kan Yeung, Colman Patrick McGrath and Yiu Yan Leung
Int. J. Environ. Res. Public Health 2023, 20(1), 750; https://doi.org/10.3390/ijerph20010750 - 31 Dec 2022
Cited by 19 | Viewed by 4799
Abstract
The aim of this study was to review the health information of dental fear-, dental anxiety-, and dental phobia-related videos on YouTube. The 100 most widely viewed videos for the keywords “dental fear”, “dental anxiety”, and “dental phobia” were chosen for evaluation. Out [...] Read more.
The aim of this study was to review the health information of dental fear-, dental anxiety-, and dental phobia-related videos on YouTube. The 100 most widely viewed videos for the keywords “dental fear”, “dental anxiety”, and “dental phobia” were chosen for evaluation. Out of the 300 videos, 145 videos met the inclusion criteria and were analyzed. It was found that most of them were produced by the professions, with a dentist delivering the key messages or with patients giving testimonials. Many etiological factors and symptoms were described. Many pharmacological and non-pharmacological interventions were recommended to the audience, such as sedation and distraction, respectively. However, there was a lack of information on the definition or diagnostic criteria of dental fear, dental anxiety, and dental phobia. Videos with high views had a higher ratio of misleading information. Videos with a dentist being the informant had a similar ratio of misleading information compared to other videos. Without adequate information on how to diagnose, it would be very difficult for the audience to determine if the video content was relevant or useful. The dental profession can work together with psychologists or psychiatrists to produce authoritative videos with accurate content. Full article
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11 pages, 2441 KB  
Article
Contemporary Murals in the Street and Urban Art Field: Critical Reflections between Preventive Conservation and Restoration of Public Art
by Paola Mezzadri
Heritage 2021, 4(3), 2515-2525; https://doi.org/10.3390/heritage4030142 - 18 Sep 2021
Cited by 25 | Viewed by 17159
Abstract
This paper focuses on the presentation of some of the main critical reflections concerning the current debate about conservation and restoration of contemporary murals in the Street and Urban Art field. More and more, the operations thought of for this kind of wall [...] Read more.
This paper focuses on the presentation of some of the main critical reflections concerning the current debate about conservation and restoration of contemporary murals in the Street and Urban Art field. More and more, the operations thought of for this kind of wall paintings are connected to the concept of preventive conservation or some actions with the aim of reducing the future deterioration linked to the outdoor context. The idea of protecting urban and street murals arises from two principal issues: on one hand, the (not yet) official, but social, recognition of them as works of art and beloved icons in the communities—or better “testimonies which spread the values of civilization” (definition of Cultural Heritage) from the last decades of the XX century to nowadays—and, on the other hand, the necessity of finding a way to preserve their artistic messages in the ephemeral urban context. In fact, developing a correct plan for the conservation and restoration of these works of art located in the outdoor context needs to consider—more than ever—the strict relationship between their materials, their environment, and even their viewer. This fragile axiom is strictly linked to the law of the street, where all the decay processes are, often, unpredictable. At the moment, the ICR’s (The Istituto Centrale per il Restauro) research in this field is focused on a work in progress project to develop some trials and tests with innovative materials for their preservation and a common glossary to outline particular forms of damaging in murals often based on “plastic on a wall”. The final aim could be to define institutional guidelines for the preservation of urban and street contemporary mural paintings in a perspective of a “share for care” conservative program. Full article
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15 pages, 305 KB  
Article
When “I” Becomes “We”: Religious Mobilization, Pilgrimage and Political Protests
by Adrian Schiffbeck
Religions 2021, 12(9), 735; https://doi.org/10.3390/rel12090735 - 8 Sep 2021
Cited by 3 | Viewed by 3919
Abstract
Scholars have extensively studied social and psychological components of pilgrimage in the past decades. Its political ingredients have less been taken into account. Moreover, there is marginal scientific evidence on connections between pilgrimage and political protests: A response to injustice within a specific [...] Read more.
Scholars have extensively studied social and psychological components of pilgrimage in the past decades. Its political ingredients have less been taken into account. Moreover, there is marginal scientific evidence on connections between pilgrimage and political protests: A response to injustice within a specific agenda and certain goals, remembrance, testimony, imagination, as well as transformation, along with communion and solidarity—are some common features of pilgrims and protesters. There is also the resource mobilization factor—to be analyzed here with a view upon the Romanian 1989 anti-communist revolution in Timișoara. We look at religion as a provider of social ties, in terms of messages with political connotations coming from clergy, and of chain reactions inside religious groups. The qualitative research relies on content analysis of documents, and of 30 semi-structured interviews with former participants to the demonstrations. Results point towards a subtle and circumstantial collective religious mobilization before and during the Romanian revolution. Similarities with pilgrimage are related to the presence of a resourceful actor, converting individual into common needs and generating a collective identity. Differences refer to the spiritual vs. political movement, and to the socio-religious experience vs. the secular search for freedom and justice. Full article
(This article belongs to the Special Issue Pilgrimage and Religious Mobilization in Europe)
13 pages, 296 KB  
Article
Ayatollah Yusuf Sanei’s Contribution to the Discourse of Women’s Rights
by Ali Akbar
Religions 2021, 12(7), 535; https://doi.org/10.3390/rel12070535 - 15 Jul 2021
Cited by 12 | Viewed by 6892
Abstract
Ayatollah Yusef Sanei was a prominent contemporary Shia scholar whose particular methodological approach led him to issue some of the most progressive Shia fatwas on the subject of women’s rights. However, the ideas he expressed in the last decades of his life have [...] Read more.
Ayatollah Yusef Sanei was a prominent contemporary Shia scholar whose particular methodological approach led him to issue some of the most progressive Shia fatwas on the subject of women’s rights. However, the ideas he expressed in the last decades of his life have scarcely been addressed in the English language scholarship. This article explores Sanei’s broader jurisprudential approach and how he applied it to analyzing and often challenging traditional Shia rulings related to gender issues. The article first differentiates Sanei’s approach towards jurisprudence from established methodologies, particularly in relation to his consideration of the Sunna as secondary to the Qurʾān, his rejection of the practice of using consensus as an independent basis of legal rulings, his idea that Sharia rulings may change over time, and his strong emphasis on the Qurʾān’s messages of justice and human dignity. The article illuminates how this combination led Sanei to challenge traditional ideas about men’s authority over women, a fixed socio-political role for women, and men’s superiority in the areas of divorce rights, testimony and worth in blood money (dīya), while concurring with earlier scholars on the unequal division of inheritance. Notwithstanding this latter exception, the article demonstrates that Sanei drew upon jurisprudential approaches in arguing in favor of equality between men and women in many areas. Full article
(This article belongs to the Special Issue New Approaches to Qur'anic Hermeneutics in the Muslim World)
15 pages, 2315 KB  
Article
Narrative Voice Matters! Improving Smoking Prevention with Testimonial Messages through Identification and Cognitive Processes
by Juan-José Igartua and Laura Rodríguez-Contreras
Int. J. Environ. Res. Public Health 2020, 17(19), 7281; https://doi.org/10.3390/ijerph17197281 - 5 Oct 2020
Cited by 30 | Viewed by 4959
Abstract
Narrative messages are increasingly being used in the field of tobacco prevention. Our study is based on narrative persuasion and aims to analyze the psychological mechanisms that explain why the narrative voice is relevant to promote persuasive impact. An online experiment with a [...] Read more.
Narrative messages are increasingly being used in the field of tobacco prevention. Our study is based on narrative persuasion and aims to analyze the psychological mechanisms that explain why the narrative voice is relevant to promote persuasive impact. An online experiment with a 2 (narrative voice) × 2 (message) factorial design was carried out. Participants (525 adult smokers) were randomly assigned to two experimental conditions (first-person versus third-person narrative message). To increase the external validity of the study, two different messages were used within each condition. After reading the narrative message the mediating and dependent variables were evaluated. Participants who read the narrative in the first person experienced greater identification. Moreover, mediational analysis showed that both counterarguing and cognitive elaboration played a significant role in the relationship between narrative voice, identification, and persuasive impact. This study confirm that narrative voice is not only an anecdotal formal choice but that it indirectly affects variables related to tobacco prevention, due to the fact that first-person messages activate a mechanism of affective connection with the message (increasing the identification with the protagonist) that decreases resistance to prevention (the counterarguing process) while simultaneously stimulating reflection or cognitive elaboration. Full article
(This article belongs to the Section Health Communication and Informatics)
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22 pages, 12318 KB  
Article
Evaluating a Website to Teach Children Safety with Dogs: A Randomized Controlled Trial
by David C. Schwebel, Peng Li, Leslie A. McClure and Joan Severson
Int. J. Environ. Res. Public Health 2016, 13(12), 1198; https://doi.org/10.3390/ijerph13121198 - 2 Dec 2016
Cited by 21 | Viewed by 6513
Abstract
Dog bites represent a significant threat to child health. Theory-driven interventions scalable for broad dissemination are sparse. A website was developed to teach children dog safety via increased knowledge, improved cognitive skills in relevant domains, and increased perception of vulnerability to bites. A [...] Read more.
Dog bites represent a significant threat to child health. Theory-driven interventions scalable for broad dissemination are sparse. A website was developed to teach children dog safety via increased knowledge, improved cognitive skills in relevant domains, and increased perception of vulnerability to bites. A randomized controlled trial was conducted with 69 children aged 4–5 randomly assigned to use the dog safety website or a control transportation safety website for ~3 weeks. Assessment of dog safety knowledge and behavior plus skill in three relevant cognitive constructs (impulse control, noticing details, and perspective-taking) was conducted both at baseline and following website use. The dog safety website incorporated interactive games, instructional videos including testimonials, a motivational rewards system, and messaging to parents concerning child lessons. Our results showed that about two-thirds of the intervention sample was not adherent to website use at home, so both intent-to-treat and per-protocol analyses were conducted. Intent-to-treat analyses yielded mostly null results. Per-protocol analyses suggested children compliant to the intervention protocol scored higher on knowledge and recognition of safe behavior with dogs following the intervention compared to the control group. Adherent children also had improved scores post-intervention on the cognitive skill of noticing details compared to the control group. We concluded that young children’s immature cognition can lead to dog bites. Interactive eHealth training on websites shows potential to teach children relevant cognitive and safety skills to reduce risk. Compliance to website use is a challenge, and some relevant cognitive skills (e.g., noticing details) may be more amenable to computer-based training than others (e.g., impulse control). Full article
(This article belongs to the Section Global Health)
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15 pages, 1828 KB  
Article
Gathering the Voices: Disseminating the Message of the Holocaust for the Digital Generation by Applying an Interdisciplinary Approach
by Angela Shapiro, Brian McDonald and Aidan Johnston
Soc. Sci. 2014, 3(3), 499-513; https://doi.org/10.3390/socsci3030499 - 27 Aug 2014
Cited by 5 | Viewed by 6976
Abstract
The aim of the Gathering the Voices project is to gather testimonies from Holocaust survivors who have made their home in Scotland and to make these testimonies available on the World Wide Web. The project commenced in 2012, and a key outcome of [...] Read more.
The aim of the Gathering the Voices project is to gather testimonies from Holocaust survivors who have made their home in Scotland and to make these testimonies available on the World Wide Web. The project commenced in 2012, and a key outcome of the project is to educate current and future generations about the resilience of these survivors. Volunteers from the Jewish community are collaborating with staff and undergraduate students in Glasgow Caledonian University in developing innovative approaches to engage with school children. These multimedia approaches are essential, as future generations will be unable to interact in person with Holocaust survivors. By students being active participants in the project, they will learn more about the Holocaust and recognize the relevance of these testimonies in today’s society. Although some of the survivors have been interviewed about their journeys in fleeing from the Nazi atrocities, for all of the interviewees, this is the first time that they have been asked about their lives once they arrived in the United Kingdom. The interviews have also focused on citizenship and integration into society. The project is not yet completed, and an evaluation will be taking place to measure the effectiveness of the project in communicating its message to the public. Full article
(This article belongs to the Special Issue New Media and Social Learning)
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11 pages, 439 KB  
Article
Health Care Strategies to Promote Earlier Presentation of Symptomatic Breast Cancer: Perspectives of Women and Family Physicians
by R. Heisey, M. Clemons, L. Granek, K. Fergus, S. Hum, B. Lord, D.R. McCready and B. Fitzgerald
Curr. Oncol. 2011, 18(5), 227-237; https://doi.org/10.3747/co.v18i5.869 - 1 Oct 2011
Cited by 22 | Viewed by 1356
Abstract
Background: Many women with symptoms suggestive of a breast cancer diagnosis delay presentation to their family physician. Although factors associated with delay have been well described, there is a paucity of data on strategies to mitigate delay. Objectives: We conducted a qualitative research [...] Read more.
Background: Many women with symptoms suggestive of a breast cancer diagnosis delay presentation to their family physician. Although factors associated with delay have been well described, there is a paucity of data on strategies to mitigate delay. Objectives: We conducted a qualitative research project to examine factors related to delay and to identify health care system changes that might encourage earlier presentation. Methods: Individual semi-structured interviews were conducted with women who sought care 12 weeks or more after self-detection of breast cancer symptoms and with family physicians whose practices included patients meeting that criterion. Results: The women and physicians both suggested a need for clearer screening mammography guidelines for women 40–49 years of age and for better messaging concerning breast awareness. The use of additional hopeful testimonials from breast cancer survivors were suggested to help dispel the notion of cancer as a “death sentence.” Educational initiatives were proposed, aimed at both increasing awareness of “non-lump” breast cancer symptoms and advising women that a previous benign diagnosis does not ensure that future symptoms are not cancer. Women wanted empathic nonjudgmental access to care. Improved methods to track compliance with screening mammography and with periodic health exams and access to a rapid diagnostic process were suggested. Conclusions: A list of “at-risk situations for delay” in diagnosis of breast cancer was developed for physicians to assist in identifying women who might delay. Health care system changes actionable both at the health policy level and in the family physician’s office were identified to encourage earlier presentation of women with symptomatic breast cancer. Full article
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