Faculty Bibliography

Compliance-gaining strategies refer to subtle differences in ways people use language when their goal is to influence someone else's behavior. This stands in contrast to other kinds of persuasion aimed only at influencing others beliefs and attitudes. We have developed a new method of coding what physicians say when they are trying to influence patients' behaviors. This method applies theory and methods from the fields of interpersonal influence, linguistics and social psychology. We tested the reliability of this new method by randomly selecting 37 audiotaped medical interviews collected for an unrelated study [J. Gen. Int. Med., 9 (1994) 402] and having three coders independently identify physician compliance-gaining utterances and then independently apply one of 57 codes to each utterance. These codes also were categorized on two underlying dimensions reflecting whether the physician (1) framed the compliance-gaining utterance in a direct or indirect way, and (2) did or did not give a justification for that direct or indirect request. Reliability among coders and coders agreement with the final utterance identification and coding decisions, measured as per cent agreement among coders and/or, where appropriate, by Cohen's kappa were good to excellent. Most physicians' strategies were indirect and incomplete. For female patients, physicians used significantly more strategies, including more indirect strategies, complete strategies, 'prescriptions' and 'demands'. For male patients, physicians used a greater percent of direct strategies, including 'procedural demands'. This method provides a reliable and promising new technique for observing naturally occurring physician compliance-gaining speech

Smokeless tobacco and areca nut usage are integral cultural traditions in South Asia. Paan and gutka are two commonly used products which contain these ingredients. They are immensely popular in South Asia and with South Asian immigrants. Regular paan and gutka use is associated with several deleterious health consequences, most significantly oral cancer. Of particular concern is the markedly increased risk of oral cancer in South Asian immigrants when compared with the natives in new areas of settlement. The South Asian community in the United States is large and rapidly growing. Paan and gutka are legal in the United States, and readily available in ethnic enclaves. Smokeless tobacco prevention and cessation research and interventions have not yet addressed the unique sociocultural circumstances of this growing, at-risk community. The medical, dental, and public health communities need to join forces to combat this emerging threat

Cigarette ads in popular magazines play a role in smoking and in brand preferences among women and men, but few studies have analyzed ads directed at women vs men, and no study has examined ads directed at women of different ethnic groups. Hence, we examined cigarette ads in popular magazines for White women, Latinas, and men 1998 through 2002 for the first time. Significant differences in the number of cigarette ads by magazine audience were found, along with significant differences in the type and brands of cigarettes advertised to each group. These preliminary findings suggest that the tobacco industry may target women in a manner that differs from its targeting of men, and may target Latinas in a manner that it does not target White women. Results are discussed in terms of the need for further research on tobacco ads directed at women

Most neurologists would contend that [Terri Schiavo] cannot feel anything, even pain or thirst. The problem with this assertion is that no one has come back from such a state of neurological impairment to verify or dispute this contention. She reportedly lacks upper brain function, meaning her thinking centers are still, but it cannot be proved that the lower brain would not allow her to feel discomfort. It is generally accepted that a physician's role in health care is to prolong life or relieve undue suffering. The only time a true medical debate emerges is when these two roles come into conflict. The Schiavo case is not such a time. It is difficult to argue for euthanasia because she does not appear to be suffering. Working to prolong her life simply means providing nutrition, which physicians usually do without endless debate. The most disturbing aspect of the Schiavo case is that the doctors are portrayed as those who will simply abide by the final decision and either put the tube back in or keep it out -- a job for a medical yo-yo rather than a professional. But doctors are not court-appointed mechanics. Our own code of ethics and standards must drive us. Removing feeding tubes is not part of my job description. It should not be part of a physician's job at a Florida hospice either

The death rate for bird flu is dwindling because it is easier to count people who die than those who become infected and have minor symptoms, or none at all. This phenomenon of subclinical disease essentially a mild case of bird flu seems to be occurring with more frequency than previously appreciated. On the grimmer side, other findings indicate that human bird flu infections may be more widespread than initially suspected and possibly may be transmitted by fecal contamination. The virus was found in a child with severe diarrhea and encephalitis, but no respiratory symptoms

The death rate for bird flu is dwindling because it is easier to count people who die than those who become infected and have minor symptoms, or none at all. This phenomenon of subclinical disease essentially a mild case of bird flu seems to be occurring with more frequency than previously appreciated. On the grimmer side, other findings indicate that human bird flu infections may be more widespread than initially suspected and possibly may be transmitted by fecal contamination. The virus was found in a child with severe diarrhea and encephalitis, but no respiratory symptoms, leading health officials to ask doctors to consider testing feces for the A(H5N1) virus more often. In Southeast Asia, some scientists can test for A(H5N1) virus only under trying conditions. He cited one laboratory where scientists can work on influenza samples for only two hours a day because they share the space and equipment with colleagues who study different infectious agents. Under such circumstances, contamination of tests can be a serious problem