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PubMed2005

[Validation of a questionnaire to assess the quality of health information in Argentinian newspapers].

INTRODUCTION: The daily press is an important source of health information and may influence health care utilization. However, medical reports published in newspapers from developed countries have shown a poor quality. OBJECTIVES: The reliability of the questionnaire Index of Scientific Quality was evaluated by using it to measure the scientific quality of health information published by Argentinian newspapers between 2000 and 2002. It assessed the readability of the texts in grade levels and explored the relationship between quality and other factors. MATERIALS AND METHODS: The Spanish adaptation of the instrument consisted in translation, back-traslation and pilot study. The reliability was assessed by applying the instrument to newspaper articles with more than 300 words that discussed therapy, diagnosis, prevention, lifestyle effects, and hazardous exposure. Two physicians independently graded 129 articles. Inter-observer and intra-observer concordance was quantified for each item with the intra-class correlation coefficient (CI95%). To measure scientific quality, a randomized sample of 210 articles was assessed. Each received a mark that ranged from 0 to 100. Readability was determined by the FRY graph method. The relationship between quality and other variables was explored with multiple linear regression analysis. RESULTS: The inter-rater concordance varied between 0.48 (0.34-0.61) and 0.67 (0.56-0.75). Intra-rater concordance varied from 0.51 (0.37-0.63) to 0.95 (0.93-0.96). The internal consistency (Cronbach's alpha) was 0.88. The quality-of-health-information was rated at 25 points (16.7, 33.3) [median (intercuartil range)]. The reading level was assessed to be at the 10.4 grade (10.2-10.6) [mean (CI 95%)]. CONCLUSIONS: Quality of the health information was greatly deficient; however, no specific factors were related with quality. Readability was probably a key barrier for access to the health information.

Argentina↗
PubMedDate not supplied

Communicating clinical nursing issues through the newspaper.

The information quality of nursing news is a critical factor in gaining public support for the acquisition of scarce resources necessary to undergird clinical nursing practice. A content analysis of 3,098 newspaper articles about nursing in 1978 was employed to examine the treatment of clinical nursing news. Among the variables studied were practice settings, educational levels, role clarity, professional activities, nurse-physician relationships, and degree of favorable image. Results revealed that the quality of news about clinical nursing varied by specialties, with maternity nursing and pediatric nursing news shown to be more progressive and community health nursing and medical-surgical nursing revealed as quite traditional. Psychiatric nursing received an inordinately low level of news coverage. Recommendations are offered to assist improvement in the amount and quality of news treatment of clinical nursing.

Communication↗
PubMed2006

All in the family: media presentations of family assisted suicide in Britain.

This paper presents a preliminary investigation of the press coverage of family assisted suicide in Britain during the mid to late 1990s. The newspaper articles we examine focus on court cases in which a family member had been charged with assisting a terminally ill relative to put an end to their lives. The paper aims to typify basic characteristics of the coverage and to explore their potential political implications. The observations reveal a consistently supportive stance towards family assisted suicide that is produced by depictions of dying persons and perpetrators as autonomous and conscientious individuals; by idyllic portrayals of family relations; and by praising judges for their lenient verdicts. Presentations of the law as a dated State system, as well as the marginalization of opposing voices, further enhanced the supportive message. We suggest that the commending of actors' self-reliance and the call for decreased State interference in personal affairs aligns with the neo-liberal spirit that has come into prominence in Britain since the 1980s. Within this context, we raise some questions regarding the broader political significance of such media representations.

Attitude to Death↗
PubMedDate not supplied

A community-based program to facilitate dental care for senior citizens.

This article presents findings of a one-year trial which examined a community-based program in Clinton County, Indiana, to help facilitate entry of senior citizens into the oral health care delivery system. A multifaceted approach addressed the senior citizens' limited knowledge of oral health care, personal barriers to obtaining dental services, and the community's concern for the health of older citizens. Program components included oral health education (newspaper articles, presentations, pamphlet distribution), personalized patient motivation ("Bring-a-Friend" campaign), and oral health screenings (public screenings and "Senior Day at the Dentist"). During the study year, 345 patients visited the dentist, compared to 179 in the baseline year. Ninety-three participated in the two "Senior Day" screenings, and 53 percent of the total 134 screening patients returned for follow-up care. Given its experimental nature, the program was a success.

Aged↗
PubMed2005

Emotional and deliberative reactions to a public crisis: Mad Cow disease in France.

Although most theories of choice are cognitive, recent research has emphasized the role of emotions. We used a novel context--the Mad Cow crisis in France--to investigate how emotions alter choice even when consequences are held constant. A field study showed that individuals reduced beef consumption in months after many newspaper articles featured the emotional label "Mad Cow," but beef consumption was unaffected after articles featured scientific labels for the same disease. The reverse pattern held for the disease-related actions of a government bureaucracy. A lab study showed that the Mad Cow label induces people to make choices based solely on emotional reactions, whereas scientific labels induce people to consider their own probability judgments. Although the Mad Cow label produces less rational behavior than scientific labels, it is two to four times more common in the environment.

Animals↗
PubMed2001

From source material to news story in New Zealand print media: a prospective study of the stigmatizing processes in depicting mental illness.

OBJECTIVE: The aim of this study was to analyse how newspaper articles that depict mental illnesses are generated from source materials. METHOD: From a prospectively collected national sample of print materials involving mental illness, 50 published items that related to the Privacy Commissioner's opinion about disclosure of a psychiatric patient's health information were identified. A copy of the Privacy Commissioner's original Case Note and three news stories about the Case Note distributed by the New Zealand Press Association constituted the database. These materials were subjected to discourse analysis. We identified themes and their transformation from the Case Note through the news stories and examined the impact of these transformations on the stigmatization of mental illness. RESULTS: Four themes were identified: human rights, vulnerability, risk of dangerousness and threat, and mental illness/psychiatric patient. The only potentially positive theme, human rights, was limited both by being fragmented in the source material, and by being utilized, in the published news stories to undermine the legitimacy of the patient's right to privacy. Use of the other themes was consistent with stereotypes about mental illness. CONCLUSIONS: Although there were no inaccuracies in the content of the news stories they were substantially more negative than the source material in their depiction of the identified patient. A potentially positive discourse (human rights) was not by itself sufficient to ensure a positive portrayal of mental illness. An understanding of the transformations is important for efforts to effectively combat the stigmatization of those with mental illness.

Bibliometrics↗
PubMed1998

Language, ideology, and nursing practice.

This article explores the ways in which nursing practice is shaped by language and ideology. It is based on an ethnographic study conducted at two general surgical units in one of the main acute care hospitals in Iceland. The data used were qualitative: transcribed semistructured interviews with registered nurses on two acute care units, field notes from a participant observation on the two units and contextual information from written documents, such as yearly reports from the hospital and newspaper articles. The main findings revealed a stark contrast between the two discourses noticed. The public discourse, observed at team meetings in giving reports and in the written documentation, was characterized by objectivity and distancing from patients' personal understandings. The style of presentation was distant and mechanical. The private discourse, which emerged in private discussions between staff on the units and in interviews with the researcher, reflected the nurses' attempts to understand each patient's situation and outlook on life. This discourse was much more engaged, reflecting the nurses' energy and interest in being of assistance. By highlighting the difference between private and public discourses, this study provides important insight into the complex ways in which language and power interact to create different conditions for nursing practice. Based on these findings inferences are made as to how nursing practice is shaped by ideology.

Anthropology, Cultural↗
PubMedDate not supplied

A primer of drug safety surveillance: an industry perspective. Part II: Product labeling and product knowledge.

OBJECTIVE: To place the fundamentals of clinical drug safety surveillance in a conceptual framework that will facilitate understanding and application of adverse drug event data to protect the health of the public and support a market for pharmaceutical manufacturers' products. Part II of this series discusses specific issues regarding product labeling, such as developing the labeling, changing the labeling, and the legal as well as commercial ramifications of the contents of the labeling. An adverse event report scenario is further analyzed and suggestions are offered for maintaining the product labeling as an accurate reflection of the drug safety surveillance data. This article also emphasizes the necessity of product knowledge in adverse event database management. Both scientific and proprietary knowledge are required. Acquiring product knowledge is a part of the day-to-day activities of drug safety surveillance. A knowledge of the history of the product may forestall adverse publicity, as shown in the illustration. DATA SOURCES: This review uses primary sources from the federal laws (regulations), commentaries, and summaries. Very complex topics are briefly summarized in the text. Secondary sources, ranging from newspaper articles to judicial summaries, illustrate the interpretation of adverse drug events and opportunities for drug safety surveillance intervention. STUDY SELECTION: The reference materials used were articles theoretically or practically applicable in the day-to-day practice of drug safety surveillance. DATA SYNTHESIS: The role of clinical drug safety surveillance in product monitoring and drug development is described. The process of drug safety surveillance is defined by the Food and Drug Administration regulations, product labeling, product knowledge, and database management. Database management is subdivided into the functions of receipt, retention, retrieval, and review of adverse event reports. Emphasis is placed on the dynamic interaction of the components of the process. Suggestions are offered to facilitate communication of a review of adverse event data for various audiences. CONCLUSIONS: Careful drug safety surveillance is beneficial to the health of the public and the commercial well-being of the manufacturer. Attention to the basic principles is essential and, as illustrated, may be sufficient to resolve some problems.

Databases, Factual↗
PubMed2002

Halitosis prevention campaign: a report of oral health promotion activities in Japan.

A local dental association, Hakodate Dental Association, has been conducting an oral health promotion campaign, 'Good-bye Bad Breath', in a local community since April 1998. The purpose of this campaign was not only to prevent oral malodour but also to raise people's awareness about oral health. Oral health education has been provided at schools and through television commercials, radio programmes and newspaper articles. Campaign posters and leaflets on bad breath have also been distributed to drug stores, medical clinics and schools, as well as dental clinics. It has been emphasised that oral malodour is a preventable condition and that the dentist can provide adequate advice and suitable treatment. Medical and pharmaceutical associations have cooperated with the Dental Association in running the campaign. Dental care was provided free of charge to the local residents. The free services provided included the assessment of oral malodour using a portable sulphide detector, instructional programmes, and consultations with dentists. This campaign offered a good opportunity to encourage people to visit the dentist for regular check-ups. The number of regular check-ups and halitosis patients has increased in 70% of the clinics belonging to the Dental Association.

Counseling↗
PubMed1999

Reading with a head-mounted video magnifier.

PURPOSE: This study compared the effectiveness of a head-mounted video magnifier, low-vision enhancement system (LVES), with closed-circuit TV (CCTV) and large print as a device or means of improving reading performance in people with low vision. METHODS: The reading performance of ten low-vision participants was assessed in two ways: (1) By measuring reading speed as a function of print size with LVES and without LVES, and (2) by comparing reading speed and comprehension of news articles using the LVES vs. a popular non-head-mounted video magnifier, the CCTV. RESULTS: Maximum reading speeds with LVES matched the maximum reading speeds with unaided vision attained by enlarging print. The critical print size (the smallest print size that could be read at maximum reading speed) improved significantly for all participants using LVES compared with unaided vision. When comparing reading performance using LVES and CCTV, we found that reading speed and comprehension for the two conditions were equivalent. The two low-vision participants with lowest acuities (20/640 and 20/960) could not read the 10-point newspaper articles with LVES, even with an 8 D auxiliary reading lens that permitted a very close reading distance. CONCLUSIONS: Head-mounted video magnifiers, such as LVES, can support good low-vision reading performance, but the restricted range of magnification may limit the usefulness of the device as a reading magnifier for people with very low acuity.

Adult↗
PubMed2000

The need for continuing education of the prescriber.

The Millennium will be seen as an important time of change in the doctor-patient relationship. Until very recently, many patients, male and female, expected not only advice from their doctor, but also to be told which treatment would be best for them. This paternalistic approach, however, is rapidly disappearing. Nowadays, early post-menopausal women expect to make decisions about their treatment, after being fully informed of all the possible benefits and risks. Provision for this requires the doctor to keep abreast of the literature. Occasionally, new data are released that challenge established beliefs. It was thought, for example, that hormone replacement therapy (HRT) would reduce the risk of coronary heart disease. This still applies to apparently fit and healthy women but data from the Heart and Estrogen/progestin Replacement Study (HERS) have shown that the use of HRT in women with established risk factors for coronary heart disease increases mortality in the short term. A protective effect of HRT on the risk of coronary heart disease was not observed until after 2-3 years of treatment. Patient access to medical information has been revolutionized during the last decade. The availability of books, magazines and newspaper articles, which have always been an important source of patient information, has greatly increased. In addition, the Internet has transformed patient knowledge. According to surveys, these forms of communication provide the major source of information for 50% of women seeking advice about HRT. Indeed, the patient is often aware of the latest medical information before her doctor, possibly because she has more time. With such a large readership, these forms of communication have to report accurately. Unfortunately, they frequently do not and errors in reporting change the emphasis of a piece of medical research. The result is women are frightened and continuance suffers. It is worth remembering that 'bad news', suitably publicized, sells more newspapers and magazines than 'good news'. Competition is growing for 'alternative' products. 'Natural' treatments are 'in'. These treatments are widely claimed to reduce menopausal complaints in older patients and patients are keen to take them. But where is the evidence of efficacy and safety from robust and rigorous studies? All too often it is lacking. The doctor therefore has to advise the patient accurately about products for their treatment, and may also have to provide an opinion on 'alternative' remedies. Knowledge of alternative medical literature is therefore becoming essential. If doctors wish to continue to be respected by patients, they must remain knowledgeable and communicate their knowledge in an unbiased manner. They must emphasize the benefits and risks of different treatments according to the concerns of the patient. Failure of the doctor to provide this service will result not only in loss of respect, but alas, too often, in medico-legal consequences.

Attitude to Health↗
PubMed2004

The failed conversion of CareFirst BlueCross Blueshield to for-profit status: part 1, the whole story.

This article presents in detail the relevant facts surrounding CareFirst's failed attempt to convert to for-profit status and be acquired by the for-profit company, Wellpoint Health Networks, Inc. It chronicles events and describes the political environment leading up to the Maryland insurance commissioner's review of the application, the review process and roles played by various stakeholders and the media, the commissioner's decision and rationale, and the aftermath of actions and reactions by various parties, including state legislation to reform CareFirst. This case study was based on interviews with several key players, as well as a review of numerous newspaper articles and the wealth of documents prepared for, and emanating from the review process. Providing an in-depth look at the missteps by CareFirst's board and executives, this article sets the stage for a second one translating these details into lessons for other states and for all types of nonprofit health care organizations involved in any kind of strategic decision making that affects the public interest.

Blue Cross Blue Shield Insurance Plans↗
PubMed1999

[Reports in the Dutch newspapers prompted by articles from medical scientific journals].

OBJECTIVE: To gain an impression of the frequency and nature of reports in Dutch newspapers about publications in medical-scientific journals. DESIGN: Retrospective, descriptive. METHODS: Press reports appearing during February to July 1995 in the internal and external collections of newspaper cuttings of the Ministry of Public Health, Welfare and Sports, both composed of reports from, among other things, nine popular evening and morning newspapers, were examined for articles that had been prompted directly by medical publications; this study was carried out in the editorial offices of the Dutch Journal of Medicine (NTvG). The title of the publication and the report, the name of the newspaper and the name of the journal were recorded. RESULTS: In all, 34 reports prompted by 27 different articles were found, most of them (21%) written in reference to publications in The New England Journal of Medicine, followed by the NTvG (15%). The list was headed by socially relevant subjects such as cancer and aids (29% and 12%, respectively, of the reports). The Telegraaf and the Volkskrant contained the largest numbers of reports (both 18%) and nearly all newspapers used journals published in either English or Dutch. CONCLUSION: Dutch newspapers regularly use articles from various medical-scientific journals published in English and in Dutch as a direct source for reporting. Most attention was given to socially relevant subjects such as cancer and aids.

Bibliometrics↗
PubMed2000

Coverage by the news media of the benefits and risks of medications.

BACKGROUND: The news media are an important source of information about new medical treatments, but there is concern that some coverage may be inaccurate and overly enthusiastic. METHODS: We studied coverage by U.S. news media of the benefits and risks of three medications that are used to prevent major diseases. The medications were pravastatin, a cholesterol-lowering drug for the prevention of cardiovascular disease; alendronate, a bisphosphonate for the treatment and prevention of osteoporosis; and aspirin, which is used for the prevention of cardiovascular disease. We analyzed a systematic probability sample of 180 newspaper articles (60 for each drug) and 27 television reports that appeared between 1994 and 1998. RESULTS: Of the 207 stories, 83 (40 percent) did not report benefits quantitatively. Of the 124 that did, 103 (83 percent) reported relative benefits only, 3 (2 percent) absolute benefits only, and 18 (15 percent) both absolute and relative benefits. Of the 207 stories, 98 (47 percent) mentioned potential harm to patients, and only 63 (30 percent) mentioned costs. Of the 170 stories citing an expert or a scientific study, 85 (50 percent) cited at least one expert or study with a financial tie to a manufacturer of the drug that had been disclosed in the scientific literature. These ties were disclosed in only 33 (39 percent) of the 85 stories. CONCLUSIONS: News-media stories about medications may include inadequate or incomplete information about the benefits, risks, and costs of the drugs as well as the financial ties between study groups or experts and pharmaceutical manufacturers.

Alendronate↗
PubMed2005

Influence of various recruitment strategies on the study population and outcome of a randomized controlled trial involving patients with osteoarthritis of the hip or knee.

OBJECTIVE: To examine the effect of 2 different recruitment methods on the characteristics of participants with osteoarthritis (OA) of the hip or knee and on the efficacy of an exercise program. METHODS: In a clinical trial on the effectiveness of exercise therapy in OA of the hip or knee, 2 groups of patients were recruited: one group through referrals by physiotherapists (PT group, n = 110) and one group invited by newspaper articles (NP group, n = 90). At baseline, demographic, clinical, and psychosocial data were collected and compared between the 2 groups using chi-square and Student's t-tests. After 13 weeks of exercise therapy and followup assessments at weeks 39 and 65, the main outcome measures (pain, physical function, and global perceived effect) were assessed and compared by multiple regression analysis. RESULTS: The NP group reported less pain and tiredness at baseline, although more joints were affected with osteoarthritis. The PT group scored higher on the scale 'powerful-others' of locus of control. After adjusting for baseline differences, the effect of treatment after 13, 39, and 65 weeks was comparable for both groups for all outcome measures. CONCLUSION: Recruitment method affects clinical characteristics and physical functioning of patients recruited for the study. A mix of recruitment strategies does not seem to affect treatment outcome, on the condition that adjustments are made for baseline differences.

Exercise Therapy↗
PubMed2003

Influence of the news media on diagnostic testing in the emergency department.

OBJECTIVE: To examine the association between mass media attention regarding invasive group A streptococcal (GAS) disease and testing for GAS in a pediatric emergency department (ED). DESIGN, SETTING, AND PARTICIPANTS: An observational analysis was performed of patients who had GAS tests done in a pediatric ED between December 1, 1999, and November 30, 2001. Data were analyzed by dividing each of the 2 years into 4 consecutive 90-day intervals. Data including age, date of the visit, presenting complaint, primary discharge diagnosis, whether a GAS test was obtained, and the results were collected from an electronic data repository. The date of the news stories, the station, and the duration of the broadcast were collected from electronic archives of the local newspaper and a broadcast monitoring service. MAIN OUTCOME MEASURE: The rate of GAS tests done per 1000 ED visits and the rate of positive tests per 1000 ED visits. RESULTS: An average of 103 GAS tests were performed per 1000 ED visits in the December through February period in year 2 compared with 55 GAS tests per 1000 ED visits in a similar period in year 1. This difference was statistically significant (difference, 48 tests; 95% confidence interval, 24-72 tests; P<.001). There were no significant differences in the proportion of positive tests (32% in year 1 vs 20% in year 2; mean difference, -11%; 95% confidence interval, -23% to 1%; P =.07). There were a total of 16 newspaper articles and 34 television stories on GAS during the 2-year study period. The peak in GAS tests and the peak in media events were concomitant. CONCLUSION: A surge in news stories regarding GAS disease was associated with an increase in testing for GAS in a pediatric ED.

Child↗
PubMed2003

Psychopathic traits predict attitudes toward a juvenile capital murderer.

The current study manipulated the presence/:absence of psychopathic traits and the ethnicity (Black/:White) of a juvenile capital murderer to examine their impact on layperson attitudes regarding what types of legal sanction were appropriate. Participants (N=360) reviewed a newspaper article concerning a death row inmate who was appealing his sentence primarily based on the fact that he committed the crime when he was 16 years of age. Compared to those in the control condition, those who read a scenario in which the defendant had been described at trial as exhibiting psychopathic traits (e.g. remorselessness, pathological lying) were significantly more likely to support a death sentence and less likely to believe he should receive any treatment in prison. Moreover, participant ratings of the extent to which they believed the defendant exhibited prototypically psychopathic traits (regardless of whether they were in the psychopathy or control condition) also significantly predicted these criterion measures. Ethnic status was relatively less influential, although participants were somewhat more punitive towards a Black defendant than a White defendant when considering the relevance of possible mitigating factors (e.g. history of sexual abuse).

Adolescent↗
PubMed2002

Functional networks in emotional moral and nonmoral social judgments.

Reading daily newspaper articles often evokes opinions and social judgments about the characters and stories. Social and moral judgments rely on the proper functioning of neural circuits concerned with complex cognitive and emotional processes. To examine whether dissociable neural systems mediate emotionally charged moral and nonmoral social judgments, we used a visual sentence verification task in conjunction with functional magnetic resonance imaging (fMRI). We found that a network comprising the medial orbitofrontal cortex, the temporal pole and the superior temporal sulcus of the left hemisphere was specifically activated by moral judgments. In contrast, judgment of emotionally evocative, but non-moral statements activated the left amygdala, lingual gyri, and the lateral orbital gyrus. These findings provide new evidence that the orbitofrontal cortex has dedicated subregions specialized in processing specific forms of social behavior.

Adult↗