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Use of schizophrenia as a metaphor in US newspapers.

Research has identified misleading and stigmatizing popular beliefs about schizophrenia, but little is known about media images corresponding to these beliefs. Building on Susan Sontag's exploration of cancer in the 1978 book Illness as Metaphor, the authors hypothesize that "schizophrenia" is now more commonly misused. A total of 1740 newspaper articles from 1996 or 1997 that mentioned schizophrenia or cancer were randomly selected and then coded for contextual and metaphorical use. Only 1 percent of articles that mentioned cancer used that illness in a metaphorical way, compared with 28 percent of the articles that mentioned schizophrenia. Results differed by newspaper but not by region. The authors suggest that these inaccurate metaphors in the media contribute to the ongoing stigma and misunderstandings of psychotic illnesses.

Humans↗

The media vs managed health care: are we seeing a full court press?

BACKGROUND: Despite the fact that medical coverage for many Americans is shifting rapidly from traditional insurance to managed care, studies suggest that most citizens have limited knowledge or understanding of the implication of this change. OBJECTIVE: To evaluate the predominant message being portrayed by the lay press on managed care. METHODS: We conducted a review of newspaper articles dealing with managed care from several leading national newspapers. Surveys, editorials, letters to the editor, or nonclinical articles were excluded. The articles were examined to evaluate their likely effect on the reader's willingness to join a managed care organization, and were scored using a standardized survey instrument. The final analysis included data from 85 articles from an original pool of 277. RESULTS: In only 8% of cases, the articles were considered likely to have had a positive influence on the reader and, thus, encourage them to join or remain with a managed care organization. More important, in fully two thirds of cases, we believed the articles portrayed so unfavorable a message that the reader was less likely to join, or might even decide to leave, a managed care organization. The articles dealt most frequently (67%) with patient concerns with managed care, focused mainly on cost and quality issues, and managed care representatives were the people whose opinions were most commonly (53%) solicited. CONCLUSIONS: It seems highly likely that public perception of managed health care will be influenced by the strongly negative representation being portrayed by the newspapers. While debate over the good vs bad features of managed care continues, available evidence suggests this form of health care coverage continues to grow. The press is likely to remain an important source by which information about managed care is transmitted to the public and will certainly influence public decision making on the issue. If the current negative representation continues, we may soon begin to see a widespread backlash of public opinion opposing this form of health care.

Editorial Policies↗

Sex and the baths: a not-so-secret report.

During the 1984 debate about closing the baths in San Francisco the mayor directed the police to investigate sexual behavior in the bathhouses and write a report for her. The directive had been a secret, but when the community learned of the report, its response was quick and furious. The mayor squelched the report and no one but the report's authors, the mayor, and probably a handful of intermediaries ever saw the written report. In response to this investigation, two local journalists conducted a more open investigation that resulted in a newspaper article for Coming Up!, a lesbian and gay community newspaper published monthly in San Francisco (California). This article is reprinted here in large part because of its scientific rather than journalistic or historical value. These investigators approached their work systematically (certainly much more so than many other scientists, journalists or police professionals at the time), and as a result, their article provides a much more thorough description of what was happening in the baths at that point in the AIDS epidemic. Interestingly, many public policy options considered today were already part of the discussion then and, at times, already in place in the San Francisco bathhouses. Of note, at the time, orgy rooms were considered likely to be contributing to transmission, thus the authors gave particular attention to its presence/absence and use. The original paper was published in the July 1984 edition (pp. 17-22). As with all the reprinted papers in this volume, no editorial changes were made to the paper and only minor typographical errors were corrected. The editor of Coming Up! included a preface to the article in the original publication, and that preface is also reprinted here.

Acquired Immunodeficiency Syndrome↗

Criminal charges against marijuana compassion club members stayed.

As reported in a newspaper article, a British Columbia Provincial Court judge has stayed charges of possession of marijuana for the purpose of trafficking. Smith and Budda were charged after a January 2002 police raid on a business operating as a "compassion club."

British Columbia↗

Changes in newspaper coverage about hormone therapy with the release of new medical evidence.

BACKGROUND: Results of 2 trials of postmenopausal hormone therapy (HT) challenged established practice patterns; 1 was not associated with changes in HT use, whereas the other was associated with substantial decline. Differential coverage by lay newspapers may have contributed to the differential impact. OBJECTIVE: To examine newspaper coverage of HT before and after the publication of the Heart and Estrogen Replacement Study (HERS) in August 1998, and the main findings of the estrogen plus progestin therapy arm of the Women's Health Initiative (EPT-WHI) in July 2002. DESIGN: Longitudinal review of newspaper articles, 1998 to 2003 (n=663). SETTING: Twenty local and 6 regional/national newspapers. MEASUREMENTS: Number and content of articles about HT. RESULTS: The average number of articles about HT published during the month of the publication of the EPT-WHI was at least 8-fold greater than the number of articles published on the topic during any prior period. While the majority of articles in all periods presented information about the potential benefits of HT, information about harms became more common than information about benefits during the 2 months before the publication of the EPT-WHI, when the trial participants were notified of the early termination of the study. The presentation of specific health harms was more common after the publication of the EPT-WHI than after the publication of HERS. Few articles in any period used visual aids. CONCLUSIONS: The publication of the EPT-WHI was associated with a change in both the volume and content of newspaper coverage about HT.

Estrogen Replacement Therapy↗

School nursing in the news.

This study investigated the image of school nursing in the American press during 1978 and 1980. Content analysis of newspaper articles yielded specific measurements of the extent to which school nursing is visible via the press, the content of messages disseminated to the public about school nursing issues and two year changes in newspaper treatment of this topic. The mean number of articles published per state was 1.43 in 1978 and 6.30 in 1980. The typical school nurse article appeared in a daily newspaper circulated to less than 10,000 readers. Articles published in 1978 were significantly larger than those published in 1980 and were more likely to focus primarily on the school nursing program rather than on teachers, school boards, funding concerns or other issues. The majority of the articles (77%) devoted some space to describing the services provided by school nurses. Nearly 30% of the articles reported problems with funding for school nursing programs and 21% reported threatened or actual loss of funding for services. Although reports of protests against budget cuts by school nurses, teachers, administrators and parents were found, parents were depicted as the only interest group to succeed in efforts to avert the loss of services. Criticism of school nursing services was found in only 2% of the articles. More than 80% of the articles praised school nursing as a vital force for improving the health of American school children. It was concluded that school nursing has not yet attained a position on the public agenda as an important community issue despite the fact that the quality and level of school health services are increasingly threatened in the current budget-cutting climate.

Child↗

"No pictures from summer vacation": portrayals of pathologists in the printed media.

Public perceptions of pathologists can be shaped by individuals' direct contacts with these medical specialists, as well as by portrayals of them in the media. Few lay people, whether healthy or ill, have direct professional interaction with pathologists. Accordingly, media portrayals can assume great importance in shaping public views of pathologists and their profession. This report discusses how pathologists and the specialty of pathology are depicted in newspaper articles.

Forensic Medicine↗

The news on smoking: newspaper coverage of smoking and health in Australia, 1987-88.

All newspaper articles (n = 1601) mentioning tobacco or smoking drawn from a 12-month census of 30 Australian capital city newspapers in 1987-88 were coded for content, "slant," and apparent origin. Overall, 62 percent of articles were positive in their orientation toward smoking control objectives, 17 percent were negative, and 21 percent were neutral. Newspapers owned by Rupert Murdoch published 55.7 percent positive and 23.7 percent negative articles compared to 68.0 percent positive and 13.7 percent negative articles in the other large chain of Australian newspapers.

Attitude↗

Mental illness and the media: Part II. Content analysis of press coverage of mental health topics.

The public image of psychiatry has been tarnished in recent years. In order to determine the extent to which press coverage has contributed to negative attitudes towards psychiatry, we conducted a content analysis of a random selection of newspaper articles which appeared over a twenty-year period in two different newspapers. We found that although there had been some minor, cosmetic changes over the years, such as more appropriate headlines and more direct quotes from psychiatric experts, on the whole, content and attitudes had changed very little. An accuracy check of media reporting of forensic cases over a 20-year period revealed that when reporters have access to written material, the accuracy levels are greatly improved.

Attitude to Health↗

Obtaining outpatient referrals for clinical research.

Two methods of recruiting patients with generalised anxiety disorder (GAD) were compared. One hundred general practitioners in the immediate neighbourhood of a major urban hospital were approached for referrals, and an article on generalised anxiety asking for volunteers was placed in the evening newspaper. The former resulted in ten doctor-initiated referrals, two of whom fulfilled DSM-III criteria for GAD. The latter resulted in over 500 volunteers. In a random selection of 136 volunteers who secured their doctors' approval, 56 fulfilled GAD criteria. The majority of the remainder had a depressive illness. The newspaper article was more economical of researchers' time and more successful in finding suitable subjects than directly approaching general practitioners.

Adult↗

Scientific drug information in newspapers: sensationalism and low quality. The example of therapeutic use of cannabinoids.

OBJECTIVE: We aimed to analyse the quality of newspaper articles (NAs) concerning the therapeutic use of cannabis published in Spanish newspapers. METHODS: A preliminary questionnaire of the Index of Scientific Quality was used [scores ranged from 0 (no misleading) to 14 (misinformation in each item)]. RESULTS: Of the 29 NAs analysed, 16 (55.2%) were scored as 4 or lower, and 6 (20.7%) scored 7 or higher. Up to 23 NAs (79.3%) did not manage the knowledge related to cannabinoids; 20 (69%) gave a sensationalist message; 11 (37.9%) were able to wrongly influence clinical decision taking; and 8 (27.6%) misled medical concepts. CONCLUSION: The leading medical journals could play an especially relevant role while preparing their press releases if they specify study limitations and context.

Biomedical Research↗

The managed care contract: implementation in radiation oncology.

PURPOSE/OBJECTIVES: To explore the risks and benefits, for patients and the department, of managed care capitation in radiation oncology and to discuss nurses' roles in participating in a managed care contract. DATA SOURCES: Published articles, American Nurse Association and American College of Radiology publications, newspaper articles, newsletters, and oral presentations. DATA SYNTHESIS: As of June 1, 1992, Fox Chase Cancer Center entered into an agreement for radiation oncology service with U.S. Healthcare. This attempt to capitate oncology services was one of the first made by a managed care network. Consumers and care providers may experience advantages and disadvantages as a result of capitation. Nurses can maximize the advantages for patients and institutions by becoming familiar with managed care. CONCLUSION: Nurses no longer can care for patients without recognizing the political and market forces that influence their ability to deliver care. Familiarity with managed care is a mandatory requirement for all nurses at the staff and management levels. IMPLICATIONS FOR NURSING PRACTICE: Nurses' role in the contractual arrangement of managed care include educator, coordinator, negotiator, and patient advocate. Nurses need to be acutely aware of today's managed care climate and its effect on the amount, cost, quality, and location of patient services provided.

Contract Services↗

Do newspapers lead with lead? A content analysis of how lead health risks to children are covered.

Lead poses a serious environmental health risk to young children, causing such irreversible health effects as mental retardation, stunted growth, and hearing and visual impairment. Studies suggest that various sectors of the public, including children's caregivers, are not sufficiently concerned about this risk or knowledgeable about ways of minimizing it. Because newspapers are one of the primary ways members of the public learn about risks, the authors examined the characteristics and content of 152 newspaper articles on lead to determine when coverage occurred and what information was provided. Results revealed that newspapers most often covered lead as a local news story. Few articles identified children under six years of age as the most vulnerable group or provided important information on health effects, sources of exposure, or abatement methods. The authors' recommendations focus on helping environmental health professionals work with newspaper journalists to improve the information available to the public.

Attitude to Health↗

Constructing deservingness: federal welfare reform, supplemental security income, and elderly immigrants.

On August 22, 1996, President Clinton signed the welfare reform law that ended eligibility for all immigrants to federal means tested entitlements. Poor elderly immigrants on Supplemental Security Income were specifically targeted. This article documents how the print media responded to these policy changes. The following are the major research questions: (1) How were older immigrants on Supplemental Security Income portrayed in the print media before and after federal welfare reform? (2) Who was involved in the print media coverage of older immigrants on Supplemental Security Income before and after federal welfare reform? (3) What types of statements were made by those involved in the print media coverage of older immigrants on Supplemental Security Income, before and after federal welfare reform? The approach used was an in-depth content analysis of newspaper articles from major U.S. newspapers. The findings demonstrate that older immigrants were constructed as "undeserving" in news articles prior to the passage of the federal welfare reform bill. However, after the passage of the federal welfare reform bill the coverage of older immigrants on Supplemental Security Income started to change, and older immigrants were portrayed as "deserving." In advancing aging policy for poor, vulnerable elderly, such as elderly immigrants, advocates, health and social service providers can play an influential role in bringing their voices to the print media.

Aged↗

Advanced practice nursing: reflections on the past, issues for the future.

PURPOSE/OBJECTIVES: To provide a comprehensive historical review of advanced practice nursing, describe the development of the professional role of oncology advanced practice nurses (APNs), and document the current status of major issues. DATA SOURCES: Published articles, research findings, position papers and statements, conference proceedings, books, newsletters, newspaper articles, executive summaries, standards and guidelines, and personal communications. DATA SYNTHESIS: The oncology APN role has evolved over the past 100 years in response to the healthcare needs of society and available educational opportunities. Trends in health care and education continue to influence the expansion of the professional APN role. CONCLUSIONS: Oncology APNs are prepared to practice in a variety of roles, providing expert clinical, educational, emotional, and supportive care to patients with cancer. Several major professional issues have been identified and addressed. Oncology APNs must document the influence of expert nursing care on patient outcomes and organizational efficiency.

Education, Nursing, Graduate↗

Journalists and their sources of ideas and information on medicines.

In this article we describe from which sources science writers who write about medicines in daily newspapers get their ideas and information. This study was undertaken because mass media, and therefore newspapers, can play an important role in the diffusion of information about medicines. Two approaches, interviews and a content analysis, were used to answer the research questions. Both methods show the importance of professional medical journals and information from universities and their hospitals as sources of ideas and information. Although the pharmaceutical industry did not seem to play a role as source of ideas and information according to the journalists, it is the third most frequently cited source of information in the newspaper articles. To gain a better insight in the role of the pharmaceutical industry as source of ideas and information for newspaper journalists further research is necessary.

Drug Industry↗

Mental illness: media perpetuation of stigma.

Content analysis of 83 newspaper articles from February 1991 to January 1993 was the chosen method to determine the role of newspapers in the portrayal of the mentally ill. Two emergent themes arose: the closure of a mental health hospital was viewed negatively; and the stereotypical perception of the mentally ill as violent and unpredictable was reinforced. Over the two year period of the study the shift in focus from the ideology of de-institutionalisation, funding issues, crisis and chaos in the mental health hospital eventuated in an emphasis on the negativity associated with mental illness.

Attitude to Health↗

Spatial analysis of news sources.

People in different places talk about different things. This interest distribution is reflected by the newspaper articles circulated in a particular area. We use data from our large-scale newspaper analysis system (Lydia) to make entity datamaps, a spatial visualization of the interest in a given named entity. Our goal is to identify entities which display regional biases. We develop a model of estimating the frequency of reference of an entity in any given city from the reference frequency centered in surrounding cities, and techniques for evaluating the spatial significance of this distribution.

Journal Article↗