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Comparison of methods for estimating drug coverage for filariasis elimination, Leogane Commune, Haiti.

In the global effort to eliminate lymphatic filariasis, annual mass treatments are conducted with diethylcarbamazine (DEC) or ivermectin, combined with albendazole. The success of this strategy depends on achieving high levels of drug coverage, which reduces the number of persons with circulating microfilariae so that transmission of the parasite is interrupted. Because resources are often limited, a simple, inexpensive, and reliable method to estimate drug coverage is needed. During the period December 2000 to February 2001, three methods were used to assess drug coverage in Leogane Commune, Haiti: a probability survey using a cluster sample design (n = 1421 persons); a distribution-point survey based on a convenience sample of houses near the distribution points (n = 4341 persons); and a survey based on a convenience sample of primary schools (n = 5036 children). The coverage estimations were 71.3% (95% CI 66.7-75.9), 73.6% (95% CI 70.1-77.0), and 77.8% (95% CI 73.5-82.1), respectively. Survey costs for the probability, distribution point, and school surveys were US$2217, US$979, and US$312, respectively. The 2 convenience sampling methods provided point estimates of drug coverage that were similar to those of the probability survey. These methods may have a role for monitoring drug treatment coverage between less frequent, but more costly, probability sample surveys.

Adult↗

Co-coverage of preventive interventions and implications for child-survival strategies: evidence from national surveys.

BACKGROUND: In most low-income countries, several child-survival interventions are being implemented. We assessed how these interventions are clustered at the level of the individual child. METHODS: We analysed data from Bangladesh, Benin, Brazil, Cambodia, Eritrea, Haiti, Malawi, Nepal, and Nicaragua. A co-coverage score was obtained by adding the number of interventions received by each child (including BCG, diphtheria-pertussis-tetanus, and measles vaccines), tetanus toxoid for the mother, vitamin A supplementation, antenatal care, skilled delivery, and safe water. Socioeconomic status was assessed through principal components analysis of household assets, and concentration indices were calculated. FINDINGS: The percentage of children who did not receive a single intervention ranged from 0.3% (14/5495) in Nicaragua to 18.8% (1154/6144) in Cambodia. The proportions receiving all available interventions varied from 0.8% (48/6144) in Cambodia to 13.3% (733/5495) in Nicaragua. There were substantial inequities within all countries. In the poorest wealth quintile, 31% of Cambodian children received no interventions and 17% only one intervention; in Haiti, these figures were 15% and 17%, respectively. Inequities were inversely related to coverage levels. Countries with higher coverage rates tended to show bottom inequity patterns, with the poorest lagging behind all other groups, whereas low-coverage countries showed top inequities with the rich substantially above the rest. INTERPRETATION: The inequitable clustering of interventions at the level of the child raises the possibility that the introduction of new technologies might primarily benefit children who are already covered by existing interventions. Packaging several interventions through a single delivery strategy, while making economic sense, could contribute to increased inequities unless population coverage is very high. Co-coverage analyses of child-health surveys provide a way to assess these issues.

Adult↗

What hysteria? A systematic study of newspaper coverage of accused child molesters.

OBJECTIVE: There were three aims: First, to determine the extent to which those charged with child molestation receive newspaper coverage; second, to analyze the nature of that coverage; and third, to compare the universe of coverage to the nature of child molestation charges in the criminal justice system as a whole. METHOD: Two databases were created. The first one identified all defendants charged with child molestation in Rhode Island in 1993. The database was updated after 5 years to include relevant information about case disposition. The second database was created by electronic searching the Providence Journal for every story that mentioned each defendant. RESULTS: Most defendants (56.1%) were not mentioned in the newspaper. Factors associated with a greater chance of coverage include: cases involving first-degree charges, cases with multiple counts, cases involving additional violence or multiple victims, and cases resulting in long prison sentences. The data indicate that the press exaggerates "stranger danger," while intra-familial cases are underreported. Newspaper accounts also minimize the extent to which guilty defendants avoid prison. CONCLUSIONS: Generalizing about the nature of child molestation cases in criminal court on the basis of newspaper coverage is inappropriate. The coverage is less extensive than often claimed, and it is skewed in ways that are typical of the mass media.

Bibliometrics↗

Attending coverage in academic emergency medicine: a national survey.

We surveyed the 66 accredited emergency medicine residency programs in the United States during 1986 on the issue of attending coverage. Responses were received from 411 residents and 288 faculty; this accounted for 42% of the residents and 56% of the faculty from the 56 responding programs. Seventy-three percent of emergency medicine residency programs had 24-hour attending coverage. According to residents, faculty from programs with 24-hour coverage spent a greater percentage of their shift doing primary patient care than faculty from programs without 24-hour coverage (35% vs 17%, respectively, P less than .0001), and a smaller percentage of their shift educating residents (21% vs 30%, respectively, P less than .0001). Ninety-five percent of faculty and 71% of residents thought that the quality of patient care was better when faculty were present in the ED (P less than .0001). Sixty-one percent of residents and 60% of faculty did not think that 24-hour attending coverage in academic emergency medicine should be mandated. The impact of night-time attending coverage in emergency medicine residency programs on patient care, resident education, and faculty development is unclear and minimally studied.

Emergency Medicine↗

[Vaccine coverage study and intervention with health community agents in a marginal gypsy community of Alicante].

UNLABELLED: OBJEDTIVESñ To measure the vaccination coverage in a pediatric population living in Parque Ansaldo, Montoto, Casa Larga, Cabrera Vicario, San Antón and Travesía del Canal and evolution after an intervention health program performed by Gypsy educators specially trained for such intervention. DESIGN: Descriptive study, pretest-postest without control group. SETTING: Community. Primary health care. Participants. Four hundred and sixty three marginals Gypsies children younger than 15 years old. MEASUREMENTS AND MAIN RESULTS: The project includes an educational program and health care actions by means of home visits. Duration of the project was from 1-10-96 until 1-10-97 and from 1-10-98 until 1-10-99. Before intervention the vaccine coverage was for polio, diphtheria and tetanus 41%, pertussis 24% and measles, mumps and rubella 36%. After intervention the overall coverage increased 17%. The vaccine coverage was for polio, diphtheria and tetanus 53%, pertussis 45% y measles, mumps and rubella 54%. CONCLUSIONS: This study shows up the low vaccine coverage founded and the increase of overall coverage after the intervention in 17%. We also conclude of the intervention the necesity of collaboration between Gypsies associations, health primary care centers and public health centers to carry out efficacy interventions in marginal population.

Adolescent↗

The impact of the national polio immunization campaign on levels and equity in immunization coverage: evidence from rural North India.

Few studies have investigated the impact of immunization campaigns conducted under the global polio eradication program on sustainability of polio vaccination coverage, on coverage of non-polio vaccines (administered under Expanded Program on Immunization (EPI)), and on changes in social inequities in immunization coverage. This study proposes to fill the gaps in the evidence by investigating the impact of a polio immunization campaign launched in India in 1995. The study uses a before-and-after study design using representative samples from rural areas of four North Indian states. The National Family Health Survey I (NFHS I) and NFHS II, conducted in 1992-93 and 1998-99 respectively, were used as pre- and post-intervention data. Using pooled data from both the surveys, multivariate logistic regression models with interaction terms were used to investigate the changes in social inequities. During the study period, a greater increase was observed in the coverage of first dose of polio compared to three doses of polio. Moderate improvements in at least one dose of non-polio EPI vaccinations, and no improvements in complete immunization against non-polio EPI diseases were observed. The polio campaign was successful, to some extent, in reducing gender-, caste- and wealth-based inequities, but had no impact on religion- or residence-based inequities. Social inequities in non-polio EPI vaccinations did not reduce during the study period. Significant dropouts between first and third dose of polio raise concerns of sustainability of immunization coverage under a campaign approach. Similarly, little evidence to support synergy between polio campaign and non-polio EPI vaccinations raises questions about the effects of polio campaign on routine health system's functions. However, moderate success of the polio campaign in reducing social inequities in polio coverage may offer valuable insights into the routine health systems for addressing persistent social inequities in access to health care.

BCG Vaccine↗

Internal mammary node coverage: an investigation of presently accepted techniques.

PURPOSE: Recent publications have generated a renewed interest in regional nodal treatment to include the ipsilateral supraclavicular and internal mammary nodes (IMN). The purpose of this study is to evaluate three presently accepted treatment techniques for coverage of the intact breast and ipsilateral lymph node regions and to construct recommendations regarding the utilization of these techniques. METHODS AND MATERIALS: Anatomic data were obtained from five randomly selected patients with computerized tomography (CT) in treatment position. Three patients presented with cancer of the left breast and two with cancer of the right. Using the Pinnacle 3-D planning system, normal tissue volumes of breast, ipsilateral lung, heart, sternum, and the IMN target were delineated for each patient. Three accepted techniques used to treat ipsilateral breast, internal mammary and supraclavicular nodes (extended tangents, 5-field, partly wide tangents) were configured and compared to a supraclavicular field matched to standard tangential fields. A dosage of 50 Gy in 25 fractions was prescribed to the target volume. Dose-volume histograms (DVH) were generated and analyzed with regard to target volume coverage and lung/heart volumes treated. RESULTS: All of the treatment techniques covering IMN include at least 10% more lung and heart volume than that covered by standard tangential fields. The relative lung and heart volumes treated with each technique were consistent from patient to patient. The 5-field technique clearly treats the largest volume of normal tissue; however, most of this volume receives less than 50% of the dose prescribed. The percent of heart and ipsilateral lung treated to 20 Gy, 30 Gy, and 40 Gy have been calculated and compared. Due to the increase in chest wall thickness and depth of IMN superiorly, complete coverage was not achieved with any technique if the IMN target extended superiorly into the medial supraclavicular field where dose fall-off resulted in a significant underdosing at depth. For the same anatomic reasons, the 5-field technique underdosed 10-15% of the IMN target volume in 4 of the 5 cases. This technique also yielded a greater dose heterogeneity, which was not seen with the other techniques evaluated and correlated with the change of anterior chest wall thickness. CONCLUSIONS: Anatomic variation in chest wall thickness and IMN depth strongly suggests the routine use of multislice CT planning to ensure complete coverage of the target volume and optimal sparing of normal tissue. All of the techniques can be constructed to look acceptable at central axis. To cover the superior most aspect of the IMN chain either high tangential fields, a supraclavicular field photon beam of energy >6 MV, or an AP/PA supraclavicular setup should be considered. The 5-field technique has the most difficulty in compensating for the increased depth of the IMN in the superior aspect of the tangent fields with up to +/-40% variation of the dose noted in isolated areas within the target volume. Based on our evaluation, the partly wide tangent technique offers many advantages. It provides optimal coverage of the target volume, reduces coverage of normal tissue volumes to an acceptable level, and is easily reproducible with a high degree of dose homogeneity throughout the target.

Breast Neoplasms↗

Optimizing target coverage by dosimetric feedback during prostate brachytherapy.

PURPOSE: Postimplant dosimetry of permanent prostate implants shows a loss of coverage compared to the preplan. One contributing factor is needle misplacement. The significance of needle misplacement and the clinical utility of dosimetric feedback were analyzed in the setting of interventional magnetic resonance (IMR) guided prostate brachytherapy. METHODS AND MATERIALS: Information provided by an intraoperative planning system was analyzed for 10 patients. Needle misplacement was measured and the dosimetric consequences calculated. Additional catheters and sources were placed following the insertion of all planned catheters to compensate for nonideal needle placement. RESULTS: Source misplacement ranged from 0.0 to 1.0 cm (median, 0.3 cm). The resulting loss of coverage ranged from 1% to 13%, and the intraoperative dosimetric feedback allowed a recovery of from 0% to 12% coverage. Between 0 and 3 (median, 2) additional needles and from 0 to 10 (median, 8) additional sources were required to restore coverage of the target. Final planned coverage exceeded 94% for all patients. CONCLUSION: The discrepancy between planned and achieved needle placement leads to a loss of dosimetric coverage of the target volume. Dosimetric feedback allows compensation for needle divergence. The technique of real-time dosimetric feedback does not require an IMR system, and could be generalized to ultrasound-guided implants.

Brachytherapy↗

[Influenza vaccination: coverage of Portuguese population from 1998/1999 a 2002/2003].

Between 1999 and 2003 the Portuguese National Health Observatory, has conducted four telephone surveys (1998/99, 1999/00, 2001/02 and 2002/03) using the ECOS - Em Casa Observamos Saúde - panel of Portuguese families, with telephone aiming at studying the influenza vaccination coverage of the mainland Portuguese population. From the results it can be highlighted: The percentage of individuals that declared to have taken the influenza vaccine, showed a consistent increase between 1998/99 (14.2%) and 2001/02 (17.0%), and a decrease in 2002/03 (15.0%), without statistical significance. In 2002/03, the age group 65 years and older had the highest coverage of influenza vaccination (36.9%). The lowest percentage occurred in the 15 - 44 age group (7.0%). The individuals that declared to suffer from chronic diseases (asthma, rheumatic disease, hypertension and diabetes), showed higher coverage when compared with the general population. The highest values were verified in individuals that declared to suffer from diabetes (34.5%) and asthma (34.3%). Based on these results, it figures out important to promote a larger coverage of the influenza vaccination in the individuals with 65 years or more, once this coverage is not sufficiently high, if compared with the estimates from other European countries. Although there are no European estimates to compare with, it seems equally necessary to take measures to improve the coverage, in the risk groups studied, as well as in others risk groups that were not included the present study.

Adolescent↗

Impact of different coverage techniques on incidence of postpneumonectomy stump fistula.

OBJECTIVE: Postpneumonectomy bronchial stump fistula (PBSF) is a serious complication with a reported incidence between 0 and 12%. The aim of this retrospective study was to investigate the effectiveness of different coverage techniques of the bronchial stump applied in a consecutive series of pneumonectomies in avoiding this particular problem. METHODS: Between 1/87 and 10/97, 129 patients (90 male, 39 female, mean age 57.8 years, range: 15-78 years) underwent pneumonectomy by one surgeon (W.K.). In 14 patients, additional resection procedures were performed (aorta n = 6, vena cava n = 5, thoracic wall n = 3). In all patients with malignancies (n = 123), mediastinal lymphadenectomy was routinely added to the procedure. Bronchial stump closure was performed by means of stapling devices in all patients. Coverage of the bronchial stump was performed with a generous pedicled pericardial flap and concomitant reconstruction of the pericardium with Vicryl mesh (n = 50), with a portion of the posterior pericardium (n = 16), with the azygos vein (n = 12), with surrounding mediastinal tissue (n = 25), with pleura (n = 16), or with intercostal muscle flap (n = 3); no coverage at all was performed in seven patients. In all patients with high risk for development of PBSF, i.e. patients who received any form of neoadjuvant therapy or had extended resections, the pericardial flap technique was used. RESULTS: Perioperative mortality was 5.4% (n = 7) and five patients (3.9%) experienced significant perioperative complications, with one of them directly related to the method of bronchial stump coverage (cardiac tamponade due to the use of a too small Vicryl mesh for reconstruction of the pericardium). Follow-up was 96.1% complete (five patients were lost to follow-up). Fourty-seven patients (36.4%) died late after operation (mean 19+/-13 months, median 17 months), mainly due to recurrence of their underlying malignant disease. PBSF occurred in one patient only (0.8%), 2 weeks after operation (coverage with pleura). No PBSF was seen in the long term follow-up period. CONCLUSION: Coverage of the bronchial stump contributes to a low incidence of PBSF. In view of the fact, that this serious complication was completely avoided in the pericardial flap group (used in patients with expected higher risk for PBSF), this particular technique seems to offer the best results.

Adolescent↗

Injury surveillance during medical coverage of sporting events--development and testing of a standardised data collection form.

Medical coverage services have the potential to play a key role in sports injury surveillance activities. Provided that injury surveillance activities are fully coordinated and a standardised data collection procedure is implemented, valuable sports injury information can be obtained by medical coverage personnel. This paper describes the development of a standardised injury data collection form for use by medical coverage personnel during large sporting events. The form was trialed during two large sporting events in Melbourne, Australia in 1995. A range of sports medicine and sports first aid personnel was involved in the trial and injury details were collected on all persons receiving treatment from the coverage team, irrespective of injury severity. The final sports injury data collection form is easy to use, can be used by all types of medical coverage personnel and can provide valuable data in a timely manner. The form has since been adopted as the injury data collection standard at a number of major Australian sporting events. Recommendations for incorporating injury surveillance activities when organising sporting events and planning medical coverage services are given. Suggestions for maximising compliance with data collection procedures are also discussed.

Algorithms↗

Electrooxidation of carbon monoxide on gold nanoparticle ensemble electrodes: effects of particle coverage.

Gold nanoparticles were attached to amine-functionalized indium tin oxide substrate to form particle ensemble electrodes with controlled particle coverage. Electrooxidation of carbon monoxide (CO) on these particle ensemble electrodes was studied in CO-saturated alkaline solutions by means of cyclic voltammetry, with an emphasis on the effects of particle coverage. CO oxidation half-wave potential was found to decrease with increasing particle density. However, the current density was significantly larger at lower particle coverage electrodes. On the basis of a model for electron transfer on a partially covered electrode, the observations were explained in terms of the change in reactant mass transport pattern with varying particle coverages: CO diffusion is predominantly mixed spherical and linear at low particle coverages and changes to mostly linear at high particle coverages. The possibility of contributions from particle agglomeration is also briefly discussed.

Carbon Monoxide↗

DFT investigation of CO adsorption on Pt(211) and Pt(311) surfaces from low to high coverage.

Adsorption of CO on Pt(211) and Pt(311) surfaces has been investigated by the density functional theory (DFT) method (periodic DMol3) with full geometry optimization. Adsorption energies, structures, and C-O stretching vibrational frequencies are studied by considering multiple possible adsorption sites and comparing them with the experimental data. The calculated C-O stretching frequencies agree well with the experimental ones, and precise determination of adsorption sites can be carried out. For Pt(211), CO adsorbs at the atop site on the step edge at low coverage, but CO adsorbs at the atop and bridge sites simultaneously on both the step edge and the terrace with further increasing CO coverage. The present results interpret the reflection adsorption infrared (RAIR) spectra of Brown and co-workers very well from low to high coverage. For Pt(311), CO adsorbs also at the atop site on the step edge at low coverage. The lifting of reconstruction by CO adsorption occurs also for Pt(311), whereas the energy gain for lifting the reconstruction of the Pt(311) surface is smaller than that for Pt(110). The largest difference between the stepped Pt(211)/Pt(311) and Pt(110) surfaces is the occupation on the edge sites at higher coverage. For the stepped surfaces, the bridge site begins to be occupied at higher coverage, whereas the atop site is always occupied for the Pt(110) surface.

Journal Article↗

Coverage and precision of confidence intervals for area under the curve using parametric and non-parametric methods in a toxicokinetic experimental design.

PURPOSE: The coverage and precision of parametric Bailer-type confidence intervals (CIs) for area under the curve (AUC) was compared to nonparametric bootstrap confidence intervals. METHODS: Concentration-time data was simulated using Monte Carlo simulation under a toxicokinetic paradigm with sparse (SSC) and dense sampling (DSC) conditions. AUC was calculated using the trapezoidal rule and 95% CIs were computed using various parametric and nonparametric methods. RESULTS: Under SSC, the various parametric CIs contained the true population AUC with coverage probabilities ranging from 0.77 to 0.95 with low inter-subject variation (coefficient of variation (CV) = 15%) and from 0.82 to 0.95 with high inter-subject variation (CV = 50%). The nominal value should be close to 0.95. DSC tended to increase coverage by about 0.05. Bailer's method always produced the lowest coverage of all parametric CIs examined. Under SSC, bootstrap CIs had coverage probabilities ranging from 0.62 (CV = 15%) to 0.68 (CV = 50%). DSC increased coverage to 0.77. Parametric CIs were wider than their nonparametric counterparts, often giving lower CI estimates less than zero. Bailer's method and Bailer's method using the jackknife estimate of the standard error were the worst in this respect. Bootstrap CIs never had lower CI estimates less than zero. However, SSC tends to produce bootstrap distributions that are not continuous which, if used, may produce biased CI estimates. CONCLUSIONS: Bootstrap CI estimates were judged to be the "best". However, the limitations of the bootstrap should be clearly recognized and it should not be used indiscriminately. Examination of the bootstrap distribution for its degree of discreteness must be part of the statistical process.

Area Under Curve↗

Surface visualization at 3D endoluminal CT colonography: degree of coverage and implications for polyp detection.

BACKGROUND & AIMS: Effective colonoscopic screening for polyps, whether by optical or virtual means, requires adequate visualization of the entire colonic surface. The purpose of this study was to assess prospectively the degree of surface coverage at 3-dimensional (3D) endoluminal computed tomography colonography (CTC) after retrograde fly-through, combined retrograde-antegrade fly-through, and review of remaining missed regions. METHODS: The study group consisted of 223 asymptomatic adults (mean age, 57.8 +/- 7.2 y; 111 men, 112 women) undergoing primary CTC screening. CTC studies were interpreted by experienced readers using a primary 3D approach. The CTC software system that was used continually tracks the percentage of endoluminal surface visualized. The degree of coverage was assessed prospectively after retrograde and combined retrograde-antegrade navigation. The added effect of reviewing missed regions was also assessed prospectively. RESULTS: The mean surface coverage after only retrograde 3D endoluminal fly-through from rectum to cecum was 76.6% +/- 4.8% (range, 63%-92%); coverage was 80% or less in 181 (81.2%) patients. Antegrade navigation back to the rectum increased the overall coverage to 94.1% +/- 2.3% (range, 84%-99%; P < .0001). A review of missed regions 300 mm(2) or larger increased coverage to 97.9% +/- 1.1% (range, 93%-99%; P < .0001) and added 21.4 +/- 11.4 seconds to the interpretation time (range, 3-67 s). CONCLUSIONS: Combined bidirectional retrograde and antegrade 3D navigation, supplemented by rapid review of missed regions, effectively covers the entire evaluable surface at CTC. Unidirectional retrograde 3D fly-through typically excludes 20% or more of the endoluminal surface, which may provide insight into potential limitations at optical colonoscopy.

Aged↗

Variation in approval by insurance companies of coverage for autologous bone marrow transplantation for breast cancer.

BACKGROUND: The proper evaluation of new forms of technology depends on the results of clinical trials. However, the treatment of patients in grant-sponsored clinical trials of cancer therapy usually requires that the proposed treatment be approved in advance by an insurance carrier in a process called predetermination. METHODS: We examined the consistency of predetermination decisions by insurance companies for 533 patients enrolled in grant-supported clinical trials of high-dose chemotherapy and autologous bone marrow transplantation (ABMT) for breast cancer from 1989 through 1992. These decisions about coverage were compared with peer-reviewed decision making according to the study protocol and with clinical outcomes. RESULTS: Requests for insurance coverage for ABMT were approved in 77 percent of the cases. Of these patients, 23 percent did not undergo bone marrow transplantation for protocol-based or medical reasons. Insurance coverage for ABMT was denied in response to the other requests, primarily because the therapy was considered experimental; of these patients, 51 percent eventually underwent bone marrow transplantation despite the denial of insurance. In some instances, the patient had to hire an attorney to gain coverage. The frequency of approval was not influenced by the pretreatment clinical characteristics of the patients, the design or phase of the study, the year in which the predetermination request was made, or the response to induction therapy. There was substantial inconsistency in the frequency of approval of coverage both among insurers and between decisions made by some individual insurers, even for patients in the same study protocol. CONCLUSIONS: The predetermination process as applied to patients receiving care in clinical research trials of cancer therapy was arbitrary and capricious. Although most of the patients eventually received financial coverage for entry into clinical trials, the process of predetermination by insurers did not correlate with protocol-based medical decision making, and it was a barrier to obtaining treatment.

Antineoplastic Agents↗

n-alkanes on MgO(100). I. Coverage-dependent desorption kinetics of n-butane.

High-quality temperature-programmed desorption (TPD) measurements of n-butane from MgO(100) have been made for a large number of initial butane coverages (0-3.70 ML, ML-monolayers) and a wide range of heating ramp rates (0.3-10 K/s). We present a TPD analysis technique which allows the coverage-dependent desorption energy to be accurately determined by mathematical inversion of a TPD spectrum, assuming only that the preexponential factor (prefactor) is coverage independent. A variational method is used to determine the prefactor that minimizes the difference between a set of simulated TPD spectra and corresponding experimental data. The best fit for butane desorption from MgO is obtained with a prefactor of 10(15.7+/-1.6) s(-1). The desorption energy is 34.9+/-3.4 kJ/mol at 0.5-ML coverage, and varies with coverage approximately as Ed(theta)=34.5+0.566theta+8.37 exp(-theta/0.101). Simulations based on these results can accurately reproduce TPD experiments for submonolayer initial coverages over a wide range of heating ramp rates (0.3-10 K/s). Advantages and limitations of this method are discussed.

Journal Article↗

Media advocacy and newspaper coverage of tobacco issues: a comparative analysis of 1 year's print news in the United States and Australia.

Tobacco control advocates now recognize the value of influencing news coverage of tobacco; news coverage influences attitudes and behavior as well as policy progression. It is, however, difficult to assess the progress of such efforts within a single national and temporal context. Our data represent the first systematic international comparison of press coverage of tobacco issues. Tobacco articles from major daily newspapers in Australia (12 newspapers; 1,188 articles) and the United States (30 newspapers; 1,317 articles) were collected over 1 year (2001). The analysis shows that coverage in the two countries was similarly apportioned between hard news (>70%) and opinion pieces. Similarly, stories in both countries were most likely to recount positive events. The substantive focus of coverage, however, differed, as did the expression of hostile opinion toward tobacco control efforts (United States, 4%; Australia, 7.1%). Although secondhand smoke and education, cessation, and prevention efforts were covered widely in both settings, these topics dominated coverage in Australia (29.2%) more than in the United States (17.6%), where a more diffuse set of tobacco topics gained relative prominence. The difference in policy conditions seems to offer contrasting opportunities for advocates in the two countries to use newspapers to promote helpful tobacco control messages for both behavior and policy change.

Australia↗