Dressing up social psychology: Empirically investigating the psychological functions of clothing using the example of symbolic protection

Clothing behaviour remains an understudied research area within social psychology. Through the present research, we aim to anchor attire as an empirical research subject by investigating the psychological properties of one of its functionalities, namely, to provide protection. We argue that attire's undisputed role in shielding humans from environmental hazards may extend to the psychological level and protect them from the incorporeal consequences of existential threats symbolically. In this Registered Report, a mixed-methods approach links an ecologically valid field study of self-presentation in social media posts during Russia's war on Ukraine (Study 1; N = 248) with supraliminal priming of mortality salience in an online experiment (Study 2; N = 248). Across both studies, we expect that mortality concerns let people accentuate the physically protective attributes of clothing (e.g. more layers of clothing) and resort to more in-group prototypical dress styles (i.e. more gender-stereotypical). Findings show that people adjust their clothing preferences in response to existential threats, favouring in-group prototypical clothing (more gender-typical for both women and men in Study 1) and physically protective attire (higher in women and lower in men in Study 2) during high (vs. low) levels of existential threat. By positioning clothing as a research area within social psychology, our goal is to stimulate a wave of research on its profound role for humankind. Furthermore, we provide a dynamic and robust methodological approach to researching terror management theory.

Amplifying perceptual demands: How changes in the colour vests affect youth players performance during medium-sided games

This study explored how manipulating the colour of training vests affects footballers' individual and collective performance during a Gk+6vs6+Gk medium-sided game. A total of 21 under-17 years old players were involved in three experimental conditions in a random order for a total of four days: i) CONTROL, two teams using two different colour vests; ii) SAME, both teams wearing blue vests; iii) MIXED, all 6 players per team wore different colour vests. Players' positional data was used to compute time-motion and tactical-related variables, while video analysis was used to collect technical variables. Further, these variables were synchronized with spatiotemporal data allowing to capture ball-related actions in a horizontal 2D plan. All variables were analysed from the offensive and defensive perspective. From the offensive perspective, players performed more and further shots to goal during the CONTROL than in SAME and MIXED (small effects) conditions, with a decreased distance to the nearest defender (small effects). While defending, results revealed lower distance to the nearest teammate (small effects) in the CONTROL than in the SAME and MIXED conditions, and higher team longitudinal synchronization (small effects). In addition, the CONTROL showed in general lower values of team width while defending than in the other 2 conditions. Overall, coaches may use the CONTROL condition to emphasize offensive performance and defensive behaviour over the longitudinal direction with increased physical demands. In turn, coaches may use the manipulation of players vests to emphasize defensive performance, as players seem to behave more cohesively under such scenarios.

Public Perceptions of Physician Attire and Professionalism in the US

IMPORTANCE

In recent years, casual physician attire (fleece jackets and softshell jackets) has become increasingly popular, but to our knowledge, public perceptions of these garments have not been studied. Furthermore, gender biases may result in differing expectations and perceptions of female and male physicians and may be associated with patient rapport and trust building.

OBJECTIVE

To characterize public perceptions of casual physician attire and implicit gender biases in public assessment of physicians' professional attire.

DESIGN, SETTING, AND PARTICIPANTS

This survey study used a population-based survey administered via Amazon Mechanical Turk from May to June 2020 among individuals aged 18 years or older who were US residents and for whom English was the primary language.

INTERVENTION

Survey featuring photographs of a male or female model wearing various types of physician attire (white coat, business attire, and scrubs).

MAIN OUTCOMES AND MEASURES

Respondents' ratings of professionalism, experience, and friendliness of the male and female models in various attire and perceptions of the models' most likely health care profession. Preference scores for various outfits were calculated as the difference between the preference score for an outfit and the mean preference score for the outfit-role pairing.

RESULTS

Of 522 surveys completed, 487 were included for analysis; the mean (SD) age of respondents was 36.2 (12.4) years, 260 (53.4%) were female, and 372 (76.4%) were White individuals. Respondents perceived models of health care professionals wearing white coats vs those wearing fleece or softshell jackets as significantly more experienced (mean [SD] experience score: white coat, 4.9 [1.5]; fleece, 3.1 [1.5]; softshell, 3.1 [1.5]; P < .001) and professional (mean [SD] professionalism score: white coat, 4.9 [1.6]; fleece, 3.2 [1.5]; softshell, 3.3 [1.5]; P < .001). A white coat with scrubs attire was most preferred for surgeons (mean [SD] preference index: 1.3 [2.3]), whereas a white coat with business attire was preferred for family physicians and dermatologists (mean [SD] preference indexes, 1.6 [2.3] and 1.2 [2.3], respectively; P < .001). Regardless of outerwear, female models in business attire as inner wear were rated as less professional than male counterparts (mean [SD] professionalism score: male, 65.8 [25.4]; female, 56.2 [20.2]; P < .001). Both the male and the female model were identified by the greater number of respondents as a physician or surgeon; however, the female model vs the male model was mistaken by more respondents as a medical technician (39 [8.0] vs 16 [3.3%]; P < .005), physician assistant (56 [11.5%] vs 11 [2.3%]; P < .001), or nurse (161 [33.1%] vs 133 [27.3%]; P = .050).

CONCLUSIONS AND RELEVANCE

In this survey study, survey respondents rated physicians wearing casual attire as less professional and experienced than those wearing a white coat. Gender biases were found in impressions of professionalism, with female physicians' roles being more frequently misidentified. Understanding disparate public perceptions of physician apparel may inform interventions to address professional role confusion and cumulative career disadvantages for women in medicine.

Behavioural mimicry as an indicator of affiliation

Previous research has shown that behavioural mimicry fosters affiliation, and can be used to infer whether people belong to the same social unit. However, we still know very little about the generalizability of these findings and the individual factors involved. The present study intends to disentangle two important variables and assess their importance for affiliation: the matching in time of the behaviours versus their matching in form. In order to address this issue, we presented participants with short videos in which two actors displayed a set of small movements (e.g. crossing their legs, folding their arms, tapping their fingers) arranged to be either contingent in time or in form. A dark filter was used to eliminate ostensive group marks, such us phenotype or clothing. Participants attributed the highest degree of affiliation to the actors when their subsequent movements matched in form, but were delayed by 4–5 seconds, and the lowest degree when the timing of their movements matched, but they differed in form. To assess the generalizability of our findings, we took our study outside the usual Western context and tested a matching sample of participants from a traditional small-scale society in Kenya. In all, our results suggest that movements are used to judge the degree of affiliation between two individuals in both large- and small-scale societies. While moving in different ways at the same time seems to increase the perceived distance between two individuals, movements which match in form seem to invoke closeness.

The role of clothing on participation of persons with a physical disability: A scoping review

Determining ways to facilitate participation of persons with a physical disability is crucial and clothing may play a central role. This review aims to synthesize and examine the role of clothing on participation of persons with a physical disability. Six research databases and grey literature were searched following Arksey & O'Malley's six steps, including multiple expert consultations. English and French articles contributing to how clothing affects participation were included and tabulated based on the International Classification of Functioning, Disability and Health. Fifty-seven articles and 88 websites were included. A variety of stakeholder perspectives, diagnoses, and types of clothing were represented. Clothing mostly influences mobility and self-care, as well as various personal factors. Forty-nine percent of articles reported essential clothing design features to consider. Clothing is an important and complex environmental factor that interacts with all health domains, including participation. Future research should consider intersectoral initiatives.

Survey of lipoedema symptoms and experience with compression garments

Lipoedema is an incurable chronic disease causing limb deformity, painful skin and excessive ecchymosis. Compression garments are frequently recommended to manage symptoms, but the existing products are not designed specifically for lipoedema, and are for other medical conditions. A structured questionnaire was prepared in Online Surveys in October 2018 to investigate lipoedema symptoms and the use of compression garments to manage them. Some 279 people with lipoedema completed the survey; 70% wore compression garments in all four compression classes, of which class 2 was most common (58% of wearers). The top three reasons for wearing compression garments were to feel supported (73%), reduce lipoedema pain (67%) and improve mobility (54%). Most people with lipoedema who wore compression garments found compression helpful in managing their symptoms, but overall satisfaction was low. Problems with existing compression garments were so severe in some cases that the garments were not worn at all or used less often. The information collected in this survey might be useful for the design and development of compression garments specifically for lipoedema.

Women's use of intimate apparel as subtle sexual signals in committed, heterosexual relationships

Current literature on women’s sexual signaling focuses on modes of attracting potential, new sexual partners, but says little about women’s subtle sexual signals in committed, romantic relationships. Subtle sexual signals are inherently private and are only visible to the intended audience; a woman might use these signals to elicit or accept a sexual response from her partner or to increase her overall attractiveness, or attractivity. In this study, we sought to identify women’s use of intimate apparel as a proceptive or receptive behavior as well as the effects of relative mate value, relationship commitment, relationship satisfaction, and sexual functioning. A total of N = 353 women in the United States aged 25–45 who were in committed, heterosexual relationships completed the survey; 88.7% of the sample indicated wearing or having worn sexy underwear. Results indicate that women report wearing sexier underwear the day taking the survey if they anticipate sexual activity that same day. However, during the most recent sexual activity, women did not report wearing sexier underwear if they initiated (proceptive) that activity. While relative mate value was not directly related to sexiness of intimate apparel, women who report higher mate value tend to wear sexier underwear. Women’s use of intimate apparel might be viewed as a method of increasing attractivity and underlying receptivity to aid relationship maintenance, though caveats regarding measures and alternative interpretations are also discussed. Findings suggest that these women use intimate apparel to feel sexy, desired, aroused, and to prepare for sex with their partners. This study is the first to examine intimate apparel in relationships and as a subtle sexual signal of proceptivity and receptivity.

Confrontation Process of Students with Hijab

Hijab as an Islamic value and divine duty is emphasized, and it is necessary in university settings. The misveiling is a social phenomenon, and its social, political and cultural aspects must be studied for understanding its factors and causes. The aim of this study was to understand how the process of confronting students with hijab. A grounded theory design was used. The data were collected by semi-structured interviews from sixteen students who left their veiling, eleven students with veiling, three advisors, two Vice in Student and Cultural Affairs and three family members of students who left their veiling. The participants were selected through conventional and theoretical sampling method, and the data were analyzed simultaneously by continuous comparisons based on Strauss and Corbin (Basics of qualitative research: procedures and techniques for developing grounded theory, Sage, Thousand Oaks, CA, 1998) method. Sociocultural paradox of hijab was appeared as the main (core) variable affecting the process of confronting students with hijab. The main variable in this study includes six axial codes: sociocultural paradox, transformation of values, values selection, adherence to spiritual, doubt in beliefs and normative conflict. The process of acceptance/rejection of the hijab occurs because of sociocultural paradox after the transformation of values. In the meantime, person thinks about strategy. The person's strategy to accept/leave the hijab is based on her beliefs. By adherence to spiritual, veiling can be strengthened and weakened by doubts in beliefs. In order to promote hijab, it is necessary to pay attention to its underlying conditions and causes. Individual beliefs and values must be strengthened for promoting hijab.

The Effect of an Orthopedic Hand Surgeon's Attire on Patient Confidence and Trust

Background: Multiple studies have concluded that patients are more likely to understand and trust physicians who dress in more formal attire (shirt and tie) as opposed to casual attire (t-shirts and jeans). The white coat has repeatedly been reported as a major source of trust and confidence in a patient's eyes. Methods: This study explores the effect an orthopedic hand surgeon's attire has on a patient's perception of their surgeon's clinical values. All patients 18 years of age and older who visited our orthopedic hand surgeon's suburban outpatient practice were asked to participate in our survey-based study. Results: Ninety-seven surveys were completed and included. A majority of our responders are female (n = 59, 60.8%), Caucasian (n = 83, 85.6%) between the ages of 55 and 74 years (n = 40, 41.2%), currently employed (n = 59, 60.8%) with private health insurance (n = 69, 71.1%), and married (n = 64, 66.0%). Patients rated male and female hand surgeons wearing a white coat highest using the Likert scale and when asked about their perceived clinical qualities. Patients consistently poorly rated their surgeons wearing casual attire. Patients did note that the white coat, or any specific attire, was not necessary during the initial encounter to build a strong patient-surgeon relationship. Finally, goatees and beards do not positively or negatively impact a surgeon's patient-constructed image. Conclusions: Combining strong clinical skills with appropriate clinical attire highlighted by the physician wearing a white coat appears to be an effective way to enhance patient satisfaction while ultimately gaining the trust and respect needed to properly care for patients.

Understanding patient preference for physician attire in ambulatory clinics: a cross-sectional observational study

OBJECTIVES

We explored patient perceptions regarding physician attire in different clinical contexts and resultant effects on the physician-patient relationship.

SETTING

The 900-bed University Hospital Zurich, Switzerland.

PARTICIPANTS

A convenience sample of patients receiving care in dermatology, infectious diseases and neurology ambulatory clinics of the University Hospital Zurich participated in a paper-based survey.

PRIMARY AND SECONDARY OUTCOME MEASURES

The survey instrument was randomised and showed photographs of male or female physicians wearing various forms of attire. On the basis of the respondents' ratings of how the physician's attire affected perceptions across five domains (knowledgeable, trustworthy, caring, approachable and comfort with the physician), a composite preference score for attire was calculated as the primary outcome. Secondary outcomes included variation in preferences by respondent characteristics and context in which care was provided.

RESULTS

Of 834 patient respondents (140 in dermatology, 422 in infectious diseases and 272 in neurology), 298 (36%) agreed that physician attire was important. When compared with all available choices, the combination of white scrubs with white coat was rated highest while a business suit ranked lowest. Variation in preferences and opinions for attire were noted relative to respondent demographics and the clinical setting in which the survey was administered. For example, compared with younger patients, respondents ≥65 years of age more often reported that physician dress was both important to them and influenced how happy they were with their care (p=0.047 and p=0.001, respectively).

CONCLUSIONS

Outpatients at a large Swiss University hospital prefer their physicians to be dressed in white scrubs with white coat. Substantial variation among respondents based on demographics, type of physician and clinical setting were observed. Healthcare systems should consider context of care when defining policies related to dress code.

Camouflage pattern features interact with movement speed to determine human target detectability

Applied ergonomics research examines not only the fit, form and function of military uniforms, but also their ability to effectively camouflage personnel as they perform job-related tasks. Many of these job-related tasks involve moving through environments, but existing literature examining camouflage effectiveness often assumes that movement effectively "breaks" even the best camouflage patterns, rendering them of limited utility for reducing the visual signature of a moving target. However, recent research demonstrates that animals equipped with adaptive camouflage change their patterning in predictable ways during movement and this adaptation decreases detectability, suggesting that uniform patterning may still hold value for reducing conspicuity during movement. The present experiment examined whether three visual pattern characteristics, local contrast, orientation, and spatial frequency, would influence the detectability of a moving human target. Participants attempted to detect and localize a simulated human target moving across a background scene, and a factorial design varied target movement speed, and the local contrast, spatial frequency, and orientation of its camouflage patterning. Results showed that target detectability was strongly influenced by target movement rate, pattern local contrast, and pattern spatial frequency, and these effects persisted even under conditions of very fast movement. Importantly, we found that the effect of local contrast was most robust under conditions of movement, suggesting its importance for reducing detectability of moving personnel. We conclude that movement is not always sufficient to break the concealment offered by a pattern with low contrast and a spatial frequency match with its background. Results are discussed in the context of visual processing theories and the application of these findings to the design and development of static and adaptive camouflage patterns for military personnel.

The factors shaping car drivers' attitudes towards cyclist and their impact on behaviour

Cycling for transportation has multiple benefits to both individuals and societies. However, in many countries, cycling rates are very low. One major deterrent is hostile or aggressive behaviours directed towards cyclists. Past research has established that negative attitudes towards cyclist are a major driver of aggressive behaviour. However, the attitudinal roots that motivate these negative attitudes are currently not well understood. This study investigates to what extent negative attitudes towards cyclists are rooted in a sense of attachment to cars, and environmental attitudes. Furthermore, the study examines whether the distinctiveness of group-membership of cyclists, as signalled by cycling attire, influences the link between attitudes and aggressive behaviours directed at cyclists. An online survey of 308 car drivers measured automobility and environmental attitudes, attitudes towards cyclist, and aggressive behaviour addressed at two groups of cyclists (lycra-clad or casually dressed cyclists). Hierarchical regression analyses showed that automobility attitudes, but not environmental attitudes, were associated with negative car driver attitudes towards cyclists. A significant link between negative attitudes towards cyclists and aggressive behaviour addressed at cyclists was not moderated by the type of cyclist shown. These findings provide a more refined understanding of the basis in which negative attitudes towards cyclists are rooted and how they affect driver behaviour. This research may inform campaigns and initiatives aimed at changing attitudes towards cyclists.

Understanding patient preference for physician attire: a cross-sectional observational study of 10 academic medical centres in the USA

OBJECTIVE

Several large studies have shown that improving the patient experience is associated with higher reported patient satisfaction, increased adherence to treatment and clinical outcomes. Whether physician attire can affect the patient experience-and how this influences satisfaction-is unknown. Therefore, we performed a national, cross-sectional study to examine patient perceptions, expectations and preferences regarding physicians dress.

SETTING

10 academic hospitals in the USA.

PARTICIPANTS

Convenience sample of 4062 patients recruited from 1 June 2015 to 31 October 2016.

PRIMARY AND SECONDARY OUTCOMES MEASURES

We conducted a questionnaire-based study of patients across 10 academic hospitals in the USA. The questionnaire included photographs of a male and female physician dressed in seven different forms of attire. Patients were asked to rate the provider pictured in various clinical settings. Preference for attire was calculated as the composite of responses across five domains (knowledgeable, trustworthy, caring, approachable and comfortable) via a standardised instrument. Secondary outcome measures included variation in preferences by respondent characteristics (eg, gender), context of care (eg, inpatient vs outpatient) and geographical region.

RESULTS

Of 4062 patient responses, 53% indicated that physician attire was important to them during care. Over one-third agreed that it influenced their satisfaction with care. Compared with all other forms of attire, formal attire with a white coat was most highly rated (p=0.001 vs scrubs with white coat; p<0.001 all other comparisons). Important differences in preferences for attire by clinical context and respondent characteristics were noted. For example, respondents≥65 years preferred formal attire with white coats (p<0.001) while scrubs were most preferred for surgeons.

CONCLUSIONS

Patients have important expectations and perceptions for physician dress that vary by context and region. Nuanced policies addressing physician dress code to improve patient satisfaction appear important.

Displaying Red and Black on a First Date: A Field Study Using the "First Dates" Television Series

Previous research has shown that displaying the color red can increase attractiveness. As a result, women display red more often when expecting to meet more attractive men in a laboratory context. Here, we carried out a field study by analyzing 546 daters from the "First Dates" television series. Each participant was filmed in a pre-date interview and during a real first date, allowing direct comparison of the clothing worn by each person in these two contexts. Analysis of ratings of the amount of red displayed showed that both men and women wore more red clothing during their dates. This pattern was even stronger for black clothing, while the amount of blue clothing did not differ across the two contexts. Our results provide the first real-world demonstration that people display more red and black clothing when meeting a possible mate for the first time, perhaps seeking to increase their attractiveness and/or reveal their intentions to potential partners.

Disguise and Deception of Action Outcomes Through Sports Garment Design Impair Anticipation Judgments

The ability to disguise and deceive action outcomes was examined by manipulating sports garments. In Experiment 1, those with higher and lower skill levels in anticipation predicted the throw direction of an opponent who wore a garment designed to disguise kinetic-chain information. Higher skill anticipators were more adversely affected by the disguise garment than the lower skill anticipators, demonstrating that disguise removed the anticipation advantage. In Experiment 2, using the same occlusion methodology, the effect of deception was examined using 2 garments designed to create visual illusions of motion across the proximal-to-distal sequence of the thrower's action and compared with a white-garment control. Performances for the deceptive garments were reduced relative to the control garment at the earliest occlusion points for the rightmost targets, but this effect was reversed for the leftmost targets at the earliest occlusion point, suggesting that the visual illusion garments were deceiving participants about motion information from the proximal-to-distal sequence of the action.

Dressing disrupted: negotiating care through the materiality of dress in the context of dementia

This paper explores how the materiality of dress mediates and shapes practices of care in the context of dementia. Earlier research called for an approach to conceptualising care that recognised the role played by everyday artefacts. We extend this to a consideration of dress and dressing the body in relation to people with dementia that involves the direct manipulation of material objects, as well as the materiality of bodies. The paper draws on an ESRC funded study Dementia and Dress, which examined experiences of dress for people with dementia, families and care-workers using ethnographic and qualitative methods. Our analysis explores the process of dressing the body, the physicality of guiding and manipulating bodies into clothing, dealing with fabrics and bodies which 'act back' and are resistant to the process of dressing. We consider how the materiality of clothing can constrain or enable practices of care, exploring tensions between garments that support ease of dressing and those that sustain identity. Examining negotiations around dress also reveals tensions between competing 'logics' of care (Mol ).

Spatial language, question type, and young children's ability to describe clothing: Legal and developmental implications

Children's descriptions of clothing placement and touching with respect to clothing are central to assessing child sexual abuse allegations. This study examined children's ability to answer the types of questions attorneys and interviewers typically ask about clothing, using the most common spatial terms (on/off, outside/inside, over/under). Ninety-seven 3- to 6-year-olds were asked yes/no (e.g., "Is the shirt on?"), forced-choice (e.g., "Is the shirt on or off?"), open-choice (e.g., "Is the shirt on or off or something else?"), or where questions (e.g., "Where is the shirt?") about clothing using a human figurine, clothing, and stickers. Across question types, children generally did well with simple clothing or sticker placement (e.g., pants completely on), except for yes/no questions about "over," suggesting children had an underinclusive understanding of the word. When clothing or sticker placement was intermediate (e.g., pants around ankles, and therefore neither completely on nor off), children performed poorly except when asked where questions. A similar task using only stickers and boxes, analogous to forensic interviewers' assessments of children's understanding, was only weakly predictive of children's ability to describe clothing. The results suggest that common methods of questioning young children about clothing may lead to substantial misinterpretation. (PsycINFO Database Record

Hijab and Depression: Does the Islamic Practice of Veiling Predict Higher Levels of Depressive Symptoms?

Hijab or veiling is commonly practiced by Muslim women but remains controversial in the broader secular society. Some Western feminists argue that veiling is an oppressive behavior that negatively affects women by, for example, engendering depression. This article tests this hypothesis with a national sample of American Muslim women (N = 194). The results of the regression analysis did not support the hypothesis. Indeed, women who veiled more frequently reported lower, rather than higher, levels of depressive symptoms. In other words, wearing the hijab appears to be a protective factor in the area of depression. Given the prevalence of depression among women, the results have important implications for practice with Muslim women at both the micro and the macro levels.

No compelling positive association between ovarian hormones and wearing red clothing when using multinomial analyses

Several studies report that wearing red clothing enhances women's attractiveness and signals sexual proceptivity to men. The associated hypothesis that women will choose to wear red clothing when fertility is highest, however, has received mixed support from empirical studies. One possible cause of these mixed findings may be methodological. The current study aimed to replicate recent findings suggesting a positive association between hormonal profiles associated with high fertility (high estradiol to progesterone ratios) and the likelihood of wearing red. We compared the effect of the estradiol to progesterone ratio on the probability of wearing: red versus non-red (binary logistic regression); red versus neutral, black, blue, green, orange, multi-color, and gray (multinomial logistic regression); and each of these same colors in separate binary models (e.g., green versus non-green). Red versus non-red analyses showed a positive trend between a high estradiol to progesterone ratio and wearing red, but the effect only arose for younger women and was not robust across samples. We found no compelling evidence for ovarian hormones increasing the probability of wearing red in the other analyses. However, we did find that the probability of wearing neutral was positively associated with the estradiol to progesterone ratio, though the effect did not reach conventional levels of statistical significance. Findings suggest that although ovarian hormones may affect younger women's preference for red clothing under some conditions, the effect is not robust when differentiating amongst other colors of clothing. In addition, the effect of ovarian hormones on clothing color preference may not be specific to the color red.

She Wears the Pants: The Reform Dress as Technology in Nineteenth-Century America

This article examines the American dress-reform movement, detailing the ways in which reformers conceptualized clothing as a social and bodily technology. In the mid-nineteenth century, women began making and wearing the "reform dress"-a costume consisting of pants and shortened, lightweight skirts-as an alternative to burdensome feminine fashions. When ridiculed in public for wearing overtly masculine garments, dress reformers insisted their clothing was healthful, functional, and natural. This article discusses women's use of medical science and technical knowledge in their rejection of fashion, promotion of sexual equality, and efforts to change mainstream clothing practices. When approached from a technological perspective, the reform dress reveals broader tensions in an industrializing American society, such as changing gender relations and new understandings of the relationship between humans and technology.

What you wear does not affect the credibility of your treatment: A blinded randomized controlled study

OBJECTIVE

Professional appearance is easily modifiable, and might alter the effects of a clinical encounter. We aimed to determine whether professional attire influences a patient's perception of treatment credibility.

METHODS

We performed a single-blind randomized controlled study on 128 patients with acute non-specific low back pain who were about to receive treatment in primary care. The treating clinician was randomly allocated to wear formal attire (experimental condition) or casual attire (control condition) to the consultation. Clinicians provided a standardized briefing on the rationale behind the patient's forthcoming treatment. Treatment credibility (Credibility and Expectancy Questionnaire) was assessed immediately after this briefing.

RESULTS

All patients received the experimental or control condition as allocated and provided complete primary outcome data. Formal attire had no effect on perceived treatment credibility (Mean difference between groups 1.2 [95%CI-1.1 to 3.5]). Age was the only significant predictor of treatment credibility; older patients rated treatment credibility higher (Beta=0.16 [95%CI 0.08 to 0.24]).

CONCLUSION

In a trial setting, whether or not a clinician is formally dressed has no effect on perceptions of treatment credibility in patients with acute low back pain.

PRACTICE IMPLICATION

Clinicians should dress comfortably without fear of losing credibility.

Women's Advantage at Remembering Others' Appearance: A Systematic Look at the Why and When of a Gender Difference

Women recall the appearance of others better than men. The goal of the present research was to shed light on the explanations and boundary conditions of this gender difference. In three studies (592 participants), the authors tested potential mediators and moderators of the gender difference. Results corroborated the robustness of the gender difference. General task motivation, general memory ability, importance of appearance, appearance knowledge, attention paid to target, gazing at target, and communal or agentic orientation could not explain why women were better at recalling others' appearance than men were. Except for importance of appearance and appearance knowledge, which both decreased the magnitude of the gender difference, general task motivation, attention paid to target, length of exposure to target, delay in responding, cognitive load, and response format (verbal vs. nonverbal) had no effect on the gender difference. Results are discussed in relation to gender differences found in the nonverbal sensitivity literature.

"It Has No Color, It Has No Gender, It's Gender Bending": Gender and Sexuality Fluidity and Subversiveness in Drag Performance

Gender identity is a key question for drag performers. Previous research has shown a lack of consensus about the subversiveness and gender fluidity of drag performers. This article examines the question: How does the relationship between performers and their audience affect the subversive nature and gender representation of drag performers in this study? Furthermore, is this relationship complicated by sexuality? This study uses ethnographic and interview methods, examining experiences of 10 drag performers. Findings indicate mutuality in the relationship between performers and audience. The recursiveness of this relationship provides a constant feedback to the performers in their effort to displace the audience's previously held notions. The performers have fluid understandings of gender and sexuality, often presenting multiple genders in and out of drag. Interactions between performers and their audience indicate their belief in gender fluidity; moreover, the drag performers themselves desire to be subversive and gender and sexually fluid.

Seeing Inscriptions on the Shroud of Turin: The Role of Psychological Influences in the Perception of Writing

The Shroud of Turin (hereafter the Shroud) is one of the most widely known and widely studied artifacts in existence, with enormous historical and religious significance. For years, the Shroud has inspired worldwide interest in images on its fabric which appear to be of the body and face of a man executed in a manner consistent with crucifixion, and many believe that these images were formed in the Shroud's fibers during the Resurrection of Jesus of Nazareth. But, more recently, other reports have suggested that the Shroud also contains evidence of inscriptions, and these reports have been used to add crucial support to the view that the Shroud is the burial cloth of Jesus. Unfortunately, these reports of inscriptions are based on marks that are barely visible on the Shroud, even when images are enhanced, and the actual existence of writing on the Shroud is still a matter of considerable debate. Here we discuss previous evidence concerning the psychological processes involved generally in the perception of writing, and especially when letters and words are indistinct. We then report two experiments in which the influence of religious context on perception of inscriptions was addressed specifically, using an image of woven fabric (modern linen) containing no writing and with no religious provenance. This image was viewed in two different contexts: in the Religious Context, participants were informed that the image was of a linen artifact that was important to the Christian faith whereas, in the non-religious Neutral Context, participants were informed that the image was of a simple piece of linen. Both groups were told that the image may contain faint words and were asked to report any words they could see. All participants detected words on the image, and indicated that these words were visible and were able to trace on the image the words they detected. In each experiment, more religious words were detected in the Religious Context condition than in the Neutral Context condition whereas the two contexts showed no effect on the number of non-religious words detected, indicating that religious context had a specific effect on the perception of illusory writing. Indeed, in the Neutral Context condition, no religious words at all were reported in either experiment. These findings suggest that images of woven material, like linen, inspire illusory perceptions of writing and that the nature of these perceptions is influenced considerably by the religious expectations of observers. As a consequence, the normal psychological processes underlying perception of writing, and the tendency of these processes to produce illusory perceptions, should be an essential consideration when addressing the existence of religious inscriptions on religious artifacts such as the Shroud of Turin.

Preferences of Dentist's Attire by Anxious and Nonanxious Indian Children

PURPOSE

The purpose of this study was to evaluate preferences of dentist's attire and gender by anxious and nonanxious children in India.

METHODS

This cross-sectional study included 1,008 nine- to 14-year-old children. Anxiety levels were measured using the Children's Fear Survey Schedule-Dental Subscale. Children were provided with a series of photographs of dentists in different attires and were asked to choose in which attire they would prefer their dentists to perform treatment. The data obtained was analysed using Pearson's test and chi-square analysis.

RESULTS

There were 603 boys (60 percent) and 405 girls, among whom 56 percent were anxious. Anxious children preferred female dentists in formal attire (19 percent). Nonanxious children equally preferred female dentists in formal attire and white coat with glasses (15 percent).

CONCLUSION

Irrespective of the anxiety levels, the female dentist was the preferred choice among most of the children. However formal attire might be more appropriate for anxious children.

The effect of uniform color on judging athletes' aggressiveness, fairness, and chance of winning

In the current study we questioned the impact of uniform color in boxing, taekwondo and wrestling. On 18 photos showing two athletes competing, the hue of each uniform was modified to blue, green or red. For each photo, six color conditions were generated (blue-red, blue-green, green-red and vice versa). In three experiments these 108 photos were randomly presented. Participants (N = 210) had to select the athlete that seemed to be more aggressive, fairer or more likely to win the fight. Results revealed that athletes wearing red in boxing and wrestling were judged more aggressive and more likely to win than athletes wearing blue or green uniforms. In addition, athletes wearing green were judged fairer in boxing and wrestling than athletes wearing red. In taekwondo we did not find any significant impact of uniform color. Results suggest that uniform color in combat sports carries specific meanings that affect others' judgments.

Shorts that ensure a patient's dignity

Dignity shorts that are worn under hospital gowns have been introduced at Norfolk and Norwich University Hospital.

Understanding the role of physician attire on patient perceptions: a systematic review of the literature--targeting attire to improve likelihood of rapport (TAILOR) investigators

OBJECTIVES

Despite a growing body of literature, uncertainty regarding the influence of physician dress on patients' perceptions exists. Therefore, we performed a systematic review to examine the influence of physician attire on patient perceptions including trust, satisfaction and confidence.

SETTING, PARTICIPANTS, INTERVENTIONS AND OUTCOMES

We searched MEDLINE, Embase, Biosis Previews and Conference Papers Index. Studies that: (1) involved participants ≥18 years of age; (2) evaluated physician attire; and (3) reported patient perceptions related to attire were included. Two authors determined study eligibility. Studies were categorised by country of origin, clinical discipline (eg, internal medicine, surgery), context (inpatient vs outpatient) and occurrence of a clinical encounter when soliciting opinions regarding attire. Studies were assessed using the Downs and Black Scale risk of bias scale. Owing to clinical and methodological heterogeneity, meta-analyses were not attempted.

RESULTS

Of 1040 citations, 30 studies involving 11 533 patients met eligibility criteria. Included studies featured patients from 14 countries. General medicine, procedural (eg, general surgery and obstetrics), clinic, emergency departments and hospital settings were represented. Preferences or positive influence of physician attire on patient perceptions were reported in 21 of the 30 studies (70%). Formal attire and white coats with other attire not specified was preferred in 18 of 30 studies (60%). Preference for formal attire and white coats was more prevalent among older patients and studies conducted in Europe and Asia. Four of seven studies involving procedural specialties reported either no preference for attire or a preference for scrubs; four of five studies in intensive care and emergency settings also found no attire preference. Only 3 of 12 studies that surveyed patients after a clinical encounter concluded that attire influenced patient perceptions.

CONCLUSIONS

Although patients often prefer formal physician attire, perceptions of attire are influenced by age, locale, setting and context of care. Policy-based interventions that target such factors appear necessary.

The effect of hip belt use and load placement in a backpack on postural stability and perceived exertion: a within-subjects trial

The purpose of this study was to assess the effects of hip belt use and load placement in a backpack on perceived exertion and postural stability. Thirty participants were instructed to stand on a force plate and walk along a designated route under five conditions: unloaded, high-load placement, low-load placement, hip belt on and hip belt off. The average velocity and sway area from the force plate were measured. Participants also rated their perceived stability and exertion. Compared to the unloaded condition, all loaded conditions significantly increased average velocity, sway area, perceived stability and exertion. Hip belt use did not affect average velocity and sway area; however, participants reported higher levels of stability and lower levels of exertion with hip belt use. Load placement did not affect average velocity, sway area, perceived stability or exertion. This study showed that wearing a backpack loaded to 20% of body weight reduced postural stability, while manipulation of load placement in a backpack did not affect subjective and objective measures of postural stability. Also, hip belt use only improved subjective measures of postural stability.

Effects of religious veiling on Muslim men's attractiveness ratings of Muslim women

Hijab and other Islamic veiling clothing are important social and political symbols for Muslim women's identity. Although recently there has been a large body of literature on the social and political aspects of hijab in Western countries, there has been no investigation of the origin and function of veiling itself. This article hypothesized that religious veiling, which eliminates the estrogen-induced body curves of reproductive age women, decreases men's perceptions of women's physical attractiveness, thereby serving mate guarding functions against rival men. To test this hypothesis. Measures of the motivational appeal and self-reported perceived attractiveness of women exhibiting different degrees of veiling were obtained from 80 Muslim male participants. The results showed that men were more motivated to view women exhibiting the less veiling and rated them more attractive than those women whose bodily curves were less apparent. These results support veiling serving a mate guarding function and reinforcing the marital bond.

The science of style: in fashion, colors should match only moderately

Fashion is an essential part of human experience and an industry worth over $1.7 trillion. Important choices such as hiring or dating someone are often based on the clothing people wear, and yet we understand almost nothing about the objective features that make an outfit fashionable. In this study, we provide an empirical approach to this key aesthetic domain, examining the link between color coordination and fashionableness. Studies reveal a robust quadratic effect, such that that maximum fashionableness is attained when outfits are neither too coordinated nor too different. In other words, fashionable outfits are those that are moderately matched, not those that are ultra-matched ("matchy-matchy") or zero-matched ("clashing"). This balance of extremes supports a broader hypothesis regarding aesthetic preferences-the Goldilocks principle--that seeks to balance simplicity and complexity.

Moving beyond survival as a measure of success: understanding the patient experience of necrotizing soft-tissue infections

BACKGROUND

Necrotizing soft tissue infections (NSTIs) represent a devastating spectrum of disease with high case mortality and resource intensive care. Treatment consists of wide surgical debridement and often prolonged periods of intensive care unit care. Major complications are common. The severity of the disease and the aggressive treatment requirements put survivors at risk for significant long-term sequelae related to the trauma of both disease and treatment. Information about the postdischarge impact of NSTIs on survivors is extremely limited. Qualitative approaches are typically used to explore new phenomena and to capture individuals' thoughts, feelings, or interpretations of meaning and process. Therefore, qualitative methods are ideally suited for hypothesis generation to guide future quantitative study and ensure measured outcomes are patient-centered.

MATERIALS AND METHODS

Semistructured interviews were conducted with survivors of NSTIs from a single regional referral center. Stratified purposive sampling was used to select interview candidates based on severity of illness. Descriptive thematic analysis was performed to identify major themes described by the patients.

RESULTS

Interviews with 18 survivors identified three primary domains of experience: (1) individual factors, (2) relational factors, and (3) societal factors. These domains were split into the following two categories: factors effecting the disease process and recovery, and factors that were outcomes of the disease process. Each category yielded between one and seven themes. Themes identified included physical, psychological, relationship, and employment aspects.

CONCLUSIONS

Patient's reported quality of life was significantly affected by their disease and recovery. The results demonstrate that many outcomes of importance for patients are not easily assessed by traditional measures of outcomes. This work illustrates the multidimensional nature of recovery from critical illness, and shows that it represents a massive transition period in the lives of survivors that affects the patient, their family, and the patient's ability to interact with society. Interviews with survivors ensure that the patient voice is heard before developing tools to assess long-term outcomes.

Russia's social upper class: from ostentation to culturedness

This article discusses examples of strategies employed by representatives of Russia's new social upper class to acquire social distinction. By the late 2000s many of the upper-class Russians included in this study distanced themselves from the conspicuous ostentation ascribed to the brutish 1990s. Instead, they strove to gain legitimacy for their social position by no longer aggressively displaying their wealth, but instead elaborating more refined and individualized tastes and manners and reviving a more cultured image and self-image. These changes found their expression in various modes of social distinction ranging from external signs, such as fashion and cars, to ostentation vicariously exercised through the people these upper-class Russians surrounded themselves with. The article will trace these interviewees' strategies for distinction in the late 2000s by discussing tastes in lifestyle and consumption as well as adornment through sartorial signs and through vicarious ostentation, as exemplified by their choice of female company. Changing attitudes towards vehicles and modes of transport, with special regards to the Moscow Metro, will serve as a further illustration of modes of distinction. Crucial for this discussion is the role of the Russian/Soviet intelligentsia, both for vicarious status assertion and elite distinction anchored in the interviewees' social backgrounds.

The influence of a bicycle commuter's appearance on drivers' overtaking proximities: an on-road test of bicyclist stereotypes, high-visibility clothing and safety aids in the United Kingdom

This study looked at whether drivers overtaking a bicyclist changed the proximities of their passes in response to the level of experience and skill signalled by the bicyclist's appearance. Seven outfits were tested, ranging from a stereotypical sport rider's outfit, portraying high experience and skill, to a vest with 'novice cyclist' printed on the back, portraying low experience. A high-visibility bicycling jacket was also used, as were two commercially available safety vests, one featuring a prominent mention of the word 'police' and a warning that the rider was video-recording their journey, and one modelled after a police officer's jacket but with a letter changed so it read 'POLITE'. An ultrasonic distance sensor recorded the space left by vehicles passing the bicyclist on a regular commuting route. 5690 data points fulfilled the criteria for the study and were included in the analyses. The only outfit associated with a significant change in mean passing proximities was the police/video-recording jacket. Contrary to predictions, drivers treated the sports outfit and the 'novice cyclist' outfit equivalently, suggesting they do not adjust overtaking proximity as a function of a rider's perceived experience. Notably, whilst some outfits seemed to discourage motorists from passing within 1m of the rider, approximately 1-2% of overtakes came within 50 cm no matter what outfit was worn. This suggests there is little riders can do, by altering their appearance, to prevent the very closest overtakes; it is suggested that infrastructural, educational or legal measures are more promising for preventing drivers from passing extremely close to bicyclists.

The impact of weather on women's tendency to wear red or pink when at high risk for conception

Women are particularly motivated to enhance their sexual attractiveness during their most fertile period, and men perceive shades of red, when associated with women, as sexually attractive. Building on this research, we recently found that women are more likely to wear reddish clothing when at peak fertility (Beall & Tracy, 2013), presumably as a way of increasing their attractiveness. Here, we first report results from a methodological replication, conducted during warmer weather, which produced a null effect. Investigating this discrepancy, we considered the impact of a potentially relevant contextual difference between previous research and the replication: current weather. If the red-dress effect is driven by a desire to increase one’s sexual appeal, then it should emerge most reliably when peak-fertility women have few alternative options for accomplishing this goal (e.g., wearing minimal clothing). Results from re-analyses of our previously collected data and a new experiment support this account, by demonstrating that the link between fertility and red/pink dress emerges robustly in cold, but not warm, weather. Together, these findings suggest that the previously documented red-dress effect is moderated by current climate concerns, and provide further evidence that under certain circumstances red/pink dress is reliably associated with female fertility.

Physician use of white coats in pediatric ophthalmology

PURPOSE

Recent literature reports that patients and parents of pediatric patients prefer their physician to wear a white coat and to address them informally. This study aims to characterize current practice patterns of pediatric ophthalmologists regarding their use of white coats and salutations during outpatient pediatric encounters.

METHODS

An eight-question survey was e-mailed to members of the American Academy of Pediatric Ophthalmology and Strabismus in 2012. The questions focused on clinical setting, use of white coats in out-patient encounters, and preferred language used to address the patient's parents. Surveys not completed in full were excluded from data analysis.

RESULTS

Of approximately 1,266 members who received the survey, 606 completed the survey. Five hundred ninety-nine surveys were included in the data analysis. Sixty-three percent of attending physicians and 80% of fellows reported they did not routinely wear white coats while examining outpatient children. Forty-six percent of attending physicians and 48% of fellows addressed the patient's parents as "mom" or "dad". There was no significant association between wearing a white coat and type of practice setting, practice characteristics, or location in a children's hospital for attending physicians or fellows.

CONCLUSIONS

Contrary to preferences expressed by patients and their parents, a majority of pediatric ophthalmologists do not routinely wear white coats during pediatric outpatient examinations. Practice patterns appear to be in line with previously reported parental greeting preferences.

Influence of red jersey color on physical parameters in combat sports

Hill and Barton (2005) showed that fighters in tae kwon do, boxing, and wrestling who wore red jerseys during the 2004 Olympic Games won more often than those wearing blue jerseys. Regarding these results, this study investigated the effects of jersey color during a combat situation on fighters' physical parameters of strength and heart rate. An artificial, experimental combat situation was created in which the color of sport attire was assigned randomly. Fourteen pairs of male athletes matched for weight, height, and age had to fight each other: once in a red jersey and once in a blue. Heart rate (before, during, and after the fight) and strength (before the fight) were tested wearing the blue and the red jerseys. Participants wearing red jerseys had significantly higher heart rates and significantly higher pre-contest values on the strength test. Results showed that participants' body functions are influenced by wearing red equipment.

Cloak of compassion, or evidence of elitism? An empirical analysis of white coat ceremonies

CONTEXT

White coat ceremonies (WCCs) are widely prevalent as a celebration of matriculation in medical schools. Critics have questioned whether these ceremonies can successfully combine the themes of professionalism and humanism, as well as whether the white coat is an appropriate symbol.

OBJECTIVES

This study aimed to add a process of empirical assessment to the discussion of these criticisms by analysing the content and messages communicated during these ceremonies.

METHODS

Multiple qualitative methods were used to discern the core meanings expressed in a sample of 18 ceremonies through the analysis of artefacts, words, phrases, statements and narratives. Out of a stratified random sample of 25 US schools of medicine conducting WCCs in 2009, 18 schools submitted video, audio and written materials.

RESULTS

All ceremonies followed the same general format, but varied in their content, messages and context. Ceremonies included five principal descriptions of what is symbolised by the white coat, including: commitment to humanistic professional care; a reminder of obligations and privileges; power; the student's need to 'grow', and the white coat as a mantle. Statements about obligations were made three times more frequently than statements about privileges. Key words or phrases in WCCs mapped to four domains: professionalism; morality; humanism, and spirituality. Spoken narratives focused on humility and generosity.

CONCLUSIONS

The WCCs studied did not celebrate the status of an elite class, but marked the beginning of educational, personal and professional formation processes and urged matriculants to develop into doctors 'worthy of trust'. The ceremonies centred on the persons entering the vocation, who were invited to affirm its calling and obligations by donning a symbolic garb, and to join an ancient and modern tradition of healing and immersion in their community. The schools' articulated construct of the white coat situated it as a symbol of humanism. This study's findings may clarify and guide schools' choices in designing their own WCCs.

How to dress as a paediatrician?

AIM

Do different clothing styles have an influence on the doctor-patient-parent relationship and which kind of outfit is preferred by children and parents.

METHODS

One hundred and seven children and 72 parents were visited by a paediatrician randomly wearing one of the three different outfits (casual, semiformal, formal) during a hospital stay. Parents and children between 6 and 18 years were then interviewed about their opinion by use of a semi-structured questionnaire, while children between 0 and 6 years were observed concerning their behaviour during the examination.

RESULTS

Using a 'likert scale', the casual outfit received the best mark by 95.5% of parents (58.3% in the semiformal, 30.8% in the formal group). The degree of the parents' trust in the paediatrician was comparable in all three groups. In children between 6 and 18 years, the casual dress was rated highest in 100%. In children between 0 and 6 years, the outfit had no significant influence on the patients' behaviour.

CONCLUSION

Apparently, parents do not only tolerate a casual outfit, but even prefer it without any loss of trust. The same holds true for children between 6 and 18 years. For younger children, the paediatricians' outfit seems to play no major role.