Ronald Inglehart

Significant changes in sexual behavior after a diagnosis of human papillomavirus-positive and human papillomavirus-negative oral cancer

Sexual behavior and oral human papillomavirus (HPV) infection are risk factors for oral squamous cell carcinoma (OSCC). The effects of OSCC diagnosis and treatment on subsequent relationship stress and sexual behavior are unknown.

HPV knowledge gaps and information seeking by oral cancer patients

OBJECTIVESnThe incidence of human papillomavirus (HPV) positive oral squamous cell carcinoma (OSCC) continues to increase over time, challenging healthcare providers to address their patients HPV-related concerns.nnnMATERIALS AND METHODSnThis prospective study assessed health literacy, HPV knowledge, utilization and trust in information sources among patients with incident HPV-positive or HPV-negative OSCC diagnosed at the Ohio State University from 2011 to 2015. Health literacy was assessed with a standardized scale. Additional questions evaluated HPV knowledge (including transmission, prevalence, health consequences and treatment), the frequency and type of information sources sought, and trust in those sources.nnnRESULTSnSurveys were collected from 372 OSCC cases (HPV-positive, n=188; HPV-negative, n=184). Despite high mean health literacy scores, only 45.2% of HPV-related knowledge questions were answered correctly. HPV was known to be a sexually transmitted infection and a cause of cervical and anal cancer by 66.0%, 56.5% and 15.2%, respectively. In all domains, cases with HPV-positive OSCC were significantly more informed than HPV-negative cases (for all, p<0.01). Only 52.7% and 56.2% of patients with HPV-positive OSCC felt they knew enough to be comfortable discussing HPV with their doctor or sexual partner, respectively. The most frequently used information source was the internet (80.9%), which ranked 8th in trust of 15 possible sources. Although most (95.5%) patients trusted information from their doctors, only 37.9% used doctors as an information source.nnnCONCLUSIONSnDoctors are a highly trusted, but infrequent utilized, information source and should facilitate patient access to high-quality HPV information sources.

Modernization, Cultural Change, and Democracy: A Revised Theory of Modernization

The Controversy over Modernization Theory People in different societies see the world differently and have strikingly different values. In some countries, 95 percent of the people say that God is very important in their lives; in others, as few as 3 percent say so. In some societies, 90 percent of the people believe that if jobs are scarce, men have more right to a job than women; in others, only 8 percent think so. These cross-national differences are robust and enduring. But as this book demonstrates, these and many other important values are gradually changing in developed countries throughout the world. These changes are roughly predictable, for they are closely linked with socioeconomic development. They are occurring in virtually all modern societies, and they have important consequences. Changing values are reshaping religious beliefs, job motivations, fertility rates, gender roles, and sexual norms and are bringing growing mass demands for democratic institutions and more responsive elite behavior. As we will demonstrate, socioeconomic development brings roughly predictable cultural changes – and beyond a certain point, these changes make democracy increasingly likely to emerge where it does not yet exist, and to become stronger and more direct where it already exists. Modernization theory is based on the idea of human progress (Carneiro, 2003). Historically, this idea is relatively new. As long as humans did not exert significant control over their natural environment, and agrarian economies were trapped in a steady-state equilibrium where almost no perceptible change took place from one generation to the next, the idea of human progress seemed unrealistic (Jones, 1985; McNeill, 1990).

Modernization, Cultural Change, and Democracy: Components of a Prodemocratic Civic Culture

Rival Theories of Political Culture From the start, scholars of political culture have claimed that the functioning and survival of democratic institutions at the system level is closely linked with individual-level value orientations (Lerner, 1958; Almond and Verba, 1963; Eckstein, 1966). Thus, the notion of a population-system linkage that ties political institutions to mass tendencies in individual-level values is essential to the entire literature on political culture. From this perspective, the fate of a political system is largely determined by its peoples political attitudes and value orientations. Aristotle in the fourth century b. c. and Montesquieu (1989 [1748]) in the eighteenth century argued that different forms of government reflect the kinds of virtues that prevail among a people. Awareness of this insight reemerged in explanations of the Nazi takeover in Weimar Germany, with many observers concluding that this disaster could be traced to the fact that Weimar was a “democracy without democrats” (Bracher, 1971 [1955]). Starting from the premise that mass orientations were crucial to democracy, Almond and Verba (1963) launched the first comparative empirical survey of the mass attitudes linked with the stability and functioning of democracies. They concluded that a healthy mixture of “subject orientations” and “participant orientations” was conducive to a “civic culture” that helps democracies to flourish. Subsequent comparative empirical studies emphasized the importance of individual-level attitudes and values, in sustaining democratic institutions at the system level (among others, see Barnes, Kaase, et al., 1979; K. Baker et al., 1981; Putnam, 1993; Klingemann and Fuchs, 1995; Inglehart, 1997; Pharr and Putnam, 2000; Dalton, 2001; Norris, 2002).

Modernization, Cultural Change, and Democracy: Value Change and the Persistence of Cultural Traditions

Modernization theorists from Karl Marx to Daniel Bell have argued that socioeconomic development brings pervasive cultural changes. But cultural theorists from Max Weber to Samuel Huntington have claimed that cultural values have an enduring and autonomous influence on society. Paradoxically as it may seem, both schools are right. This chapter presents empirical evidence of massive cultural change and the persistence of distinctive cultural traditions. We analyze evidence of cultural change from the Values Surveys, the largest investigation ever made of attitudes, values, and beliefs around the world. These surveys have carried out four waves of representative national surveys, in 1981–3, 1989–91, 1995–97, and 1999–2001. They cover eighty-one societies on all six inhabited continents, containing more than 85 percent of the worlds population. Our thesis holds that socioeconomic development is linked with a broad syndrome of distinctive value orientations. Does such a syndrome exist? The Values Surveys contain hundreds of items, and not all of them tap important aspects of cross-cultural variation. In order to test the thesis that socioeconomic development brings systematic changes in basic values, we first need to identify a limited number of key dimensions that tap important values and then determine whether they are linked with socioeconomic development. Our theoretical framework implies that we should find two such dimensions, one linked with industrialization and the other with the rise of postindustrial society. In previous research, Inglehart (1997) analyzed aggregated national-level data from the forty-three societies included in the 1989–91 Values Survey, finding large and coherent cross-cultural differences.

Modernization, Cultural Change, and Democracy: The Causal Link between Democratic Values and Democratic Institutions: Empirical Analyses

Institutional versus Cultural Explanations The preceding chapter discussed the causal linkage between mass values and democratic institutions from the perspective of a theory of human development. This chapter tests these theoretical expectations empirically, using measures of democratic institutions and mass values from scores of societies. The strong link between mass values and democratic institutions has been explained both institutionally and culturally – and the two interpretations have radically different implications. The institutional explanation argues that living under democratic institutions causes prodemocratic values to emerge among the public. The cultural explanation reverses the causal arrow, arguing that prodemocratic mass values are conducive to the emergence and survival of democratic institutions. Conceivably, there could be reciprocal effects in the relationship between democratic institutions and democratic mass values, in which case the key question is whether the causal arrow is stronger in one direction than the other. The institutional explanation holds that a societys prior democratic experience has the stronger causal effect on its mass culture. The cultural explanation claims that a societys mass values have the stronger causal effect on its subsequent democratic performance. The previous chapter outlined some theoretical reasons why the cultural explanation of the relationship between mass values and democracy is more plausible than the institutional explanation. In this chapter we examine a broad base of evidence, using quantitative analyses to test whether the empirical evidence supports the cultural or the institutional explanation.