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Diabetes portrayals in North American print media: a qualitative and quantitative analysis.

OBJECTIVES: This study investigated how media coverage has portrayed diabetes as newsworthy. METHODS: The quantitative component involved tabulating diabetes coverage in 2 major Canadian newspapers, 1988-2001 and 1991-2001. The qualitative component focused on high-profile coverage in 2 major US magazines and 2 major Canadian newspapers, 1998-2000. RESULTS: Although coverage did not consistently increase, the quantitative results suggest an emphasis on linking diabetes with heart disease and mortality to convey its seriousness. The qualitative component identified 3 main ways of portraying type 2 diabetes: as an insidious problem, as a problem associated with particular populations, and as a medical problem. CONCLUSIONS: Overall, the results suggest that when communicating with journalists, researchers and advocates have stressed that diabetes maims and kills. Yet even when media coverage acknowledged societal forces and circumstances as causes, the proposed remedies did not always include or stress modifications to social contexts. Neither the societal causes of public health problems nor possible societal remedies automatically received attention from researchers or from journalists. Skilled advocacy is needed to put societal causes and solutions on public agendas.

Attitude to Health↗

Tobacco advertisements in physicians' offices: a pilot study of physician attitudes.

A pilot study evaluated the feasibility of a campaign to eliminate magazines advertising cigarettes from doctors' office waiting rooms. Only six of 51 waiting rooms visited did not contain cigarette ads. Only 25 per cent of physicians interviewed would participate in a subscription-cancellation campaign; they expressed doubt that this would influence patients' smoking behavior. This suggests that such a campaign will fail unless it is possible to change physicians' beliefs in its effectiveness.

Advertising↗

The image and advocacy of public health in American caricature and cartoons from 1860 to 1900.

The decades just before and after the founding of the American Public Health Association in 1872 saw an efflorescence of political cartooning and caricature in national-circulation weeklies. Part of the political and social critique that cartoonists and their editors provided the public focused on needs or opportunities for preventing illness and accidents. This paper presents a small selection of editorial cartoons that agitated in support of public health activities over 4 decades. The goals are to illustrate several concerns that rose to national prominence in that era, to examine the kinds of imagery that newspapers and magazine editors offered their readers, and to observe how frequently the public was encouraged to see politicians and commercial interests as responsible for preventable health problems. This discussion focuses exclusively on propagandistic images, leaving aside the reportorial depictions of events in the news and the neutral illustrations of methods and machines in scientific and technical publications.

Caricatures as Topic↗

The cigar revival and the popular press: a content analysis, 1987-1997.

OBJECTIVES: The purpose of this study was to examine print media coverage of cigars during the period 1987 to 1997. METHODS: A content analysis of 790 cigar-focused newspaper and magazine articles was conducted. RESULTS: Cigar-focused articles increased substantially over the study period, paralleling increased cigar consumption. Articles focused on cigar business (39%) and events (19%). Only 4% of articles focused on health effects. Sixty-two percent portrayed cigars favorably. The tobacco industry was mentioned in 54% of articles and portrayed positively in 78%. Forty-two percent of the individuals quoted or described in articles were affiliated with the tobacco industry; only 5% were government/public health figures. CONCLUSIONS: Print coverage of cigars failed to communicate health risk messages and contributed to positive images of cigars.

Humans↗

Ranking of cities according to public health criteria: pitfalls and opportunities.

Popular magazines often rank cities in terms of various aspects of quality of life. Such ranking studies can motivate people to visit or relocate to a particular city or increase the frequency with which they engage in healthy behaviors. With careful consideration of study design and data limitations, these efforts also can assist policymakers in identifying local public health issues. We discuss considerations in interpreting ranking studies that use environmental measures of a city population's public health related to physical activity, nutrition, and obesity. Ranking studies such as those commonly publicized are constrained by statistical methodology issues and a lack of a scientific basis in regard to design.

Cities↗

An assessment of short-acting hypnotics.

Insomnia, the experience of poor quality or quantity of sleep, is a very common complaint. Approximately 65 million adults (36% of the American population) complain of poor sleep, and of this group, 25% have insomnia on a chronic basis. These chronic insomniacs not only report higher rates of difficulty with concentration, memory and the ability to cope with minor irritations but also have 2.5 times more fatigue-related automobile accidents than do good sleepers. Despite its ubiquity, insomnia is often either untreated or inadequately treated. Short-acting hypnotics are advocated for transient insomnia, which lasts less than 3 weeks, and in patients with chronic insomnia as an adjunctive treatment where nonpharmacological treatment is not sufficient to alleviate insomnia and the related daytime detrimental effects. The putative adverse effects of hypnotics must be weighted against the severe health effects caused by continued sleep impairment. If hypnotic agents are used, they should be taken nightly only for brief use, or intermittently in longer term use. Benzodiazepines, zolpidem and zopiclone (in countries where the latter is available) remain the recommended hypnotic agents, although in the past few years there has been much criticism in lay magazines and on television about the use of benzodiazepines. However, this review of the efficacy and tolerability data of the short-acting hypnotics suggests that triazolam is comparable with other short-acting hypnotics at equipotent doses while taking into consideration that for every hypnotic, different study populations display different degrees of efficacy. In addition, contrary to previous suggestions that such adverse effects are rebound insomnia and anterograde amnesia are unique to triazolam, hypnotically equivalent doses of tirazolam have not been shown to produce these effects more frequently than other short-acting hypnotics. The newer nonbenzodiazepine hypnotics seem to be equally efficacious as the short-acting benzodiazepines; whether they will truly have a better adverse effect profile will be determined as more clinical experience accumulates. Despite the availability, relative safety and efficacy of these newer hypnotic agents, they should not be perceived as the sole treatment for insomnia and should be used in conjunction with nonpharmacological techniques (such as adherence to good sleep hygiene, sleep restriction, stimulus control and biofeedback therapy).

Adult↗

Herbal supplement use by persons aged over 50 years in Britain: frequently used herbs, concomitant use of herbs, nutritional supplements and prescription drugs, rate of informing doctors and potential for negative interactions.

BACKGROUND: The use of herbal and nutritional supplements by older British people is increasing and despite the risks of adverse effects and negative herb-drug interactions, doctors are often not informed of their use. The number of herbal and nutritional supplements used most frequently by older people, and which particular herbal extracts are used, are unknown. This study aimed to identify how many herbal and nutritional supplements and which herbal extracts are most frequently used by British people >50 years of age, and to identify which herb-drug interactions represent the greatest risk to this age group. METHOD: A self-completed survey was promoted through websites and a popular magazine aimed at people >50 years of age. RESULTS: Respondents (n = 271) used a mean of 2.26 prescription drugs and 5.91 herbal and nutritional supplements, including 2.66 herbal extracts. The use of herbal medicines by older British people frequently involves the use of several herbs, often involves concomitant use with several nutritional supplements, is poorly reported to doctors and places older people at risk of negative herb-drug interactions. The most frequently used herbs and associated risks of negative interactions with prescription drugs are identified. CONCLUSIONS: Older people should be encouraged to report the use of herbs and nutritional supplements to their doctors, and doctors should be provided with comprehensive and up-to-date information about potential herb-drug interactions.

Aged↗

Direct-to-consumer promotion of prescription drugs. Economic implications for patients, payers and providers.

Spending on outpatient prescription drugs in the US is accelerating rapidly. Although numerous factors are driving this trend, attention has recently focused on the role played by the marketing, promotion and advertising of pharmaceuticals, in particular direct-to-consumer (DTC) advertising. In 1997, the US Food and Drug Administration (FDA) issued a 'guidance' on such mass media promotion. The guidance altered existing FDA rules and effectively permitted pharmaceutical companies to promote prescription drugs on television and radio without giving detailed or even summary information on indications, efficacy or potential adverse effects. Since then, television commercials, in particular, and print advertisements in consumer magazines and newspapers have proliferated rapidly. Pharmaceutical companies spent $US1.8 billion on DTC advertising in 1999, a 40% increase over 1998. This spending in 1999 was heavily concentrated on about 50 drugs. Evidence is growing that DTC promotion of prescription drugs is: (i) alerting consumers to the existence of new drugs and the conditions they treat; (ii) increasing consumer demand for many drugs; (iii) contributing increasingly to the recent sharp increase in the number of prescriptions being dispensed; (iv) raising sales revenues; and, thus, (v) contributing to the higher pharmaceutical costs of health insurers, government and consumers. The public policy issues surrounding DTC advertisements centre on the following questions: (i) are the advertisements leading to the inappropriate clinical use of some drugs? (ii) are the advertisements inducing both consumers and physicians to choose more costly new brand-name drugs over less expensive, but equally effective, older brand or generic drugs? (iii) do television advertisements for prescription drugs contain a balanced amount of information on benefits versus potential adverse effects? and (iv) will the revenue benefits generated by DTC advertising cause pharmaceutical companies to focus more on developing products to treat prevalent but not life-threatening conditions, such as baldness, sexual dysfunction or memory loss? These questions are just beginning to be probed despite prescription drug spending, insurance coverage and payment policies having become major political issues in the US.

Advertising↗

Are direct to consumer advertisments of prescription drugs educational?: comparing 1992 to 2002.

We investigate the educational value of direct-to-consumer (DTC) prescription drug advertisements from 58 popular magazines published in 1992 and 2002. We find that the number of DTC prescription drug ads increased nine-fold from 1992 to 2002, while the advertisements for other health care products increased only slightly. We examine changes in 1992-2002 DTC prescription drug ads both quantitatively and qualitatively. We find that the educational value as it relates to serious medical conditions decreases over time based on the media logic that the primary purpose of advertisements is to promote consumption, rather than education. We enumerate and describe the media logic tactics employed, and find a statistically significant increase in the number of such tactics per ad in 2002.

Advertising↗

Sources of drug information among adolescent students.

A sample of 1023 eighth and tenth grade students in small to medium-sized central Texas school districts was assessed to determine the amount of information they receive from ten sources about six categories of drugs. The amount of information males reported receiving about each drug category was significantly greater than what females reported, and the amount of information that eighth graders reported receiving about each drug category was significantly greater than what tenth graders reported. Television was the primary source of drug information for all categories of drugs except inhalants, for which friends and television were equally important sources. Parents and printed media (magazines or newspapers) were of secondary importance, followed by friends and teachers. Adolescents were less likely to receive drug-related information from experience, siblings, church, doctors, and police. The reliance on the mass media for drug information in smaller school districts is a pattern which has been previously observed in larger urban districts. This consistency suggests that mass media approaches to drug education are likely to be as effective in rural areas and smaller towns as they are among urban adolescents. Implications for television programming are discussed.

Adolescent↗

Use of the Internet by patients before and after cardiac surgery: telephone survey.

BACKGROUND: Little is known about to what extent patients who underwent medical treatment access the Internet and whether they benefit from consulting the Internet. OBJECTIVE: To understand if cardiopathic patients use the Internet for health-related information and whether they find retrieved information understandable and useful. METHODS: Telephone interviews, using a semi-structured questionnaire, were conducted with 82 patients who had undergone off-pump coronary-artery bypass grafting at the Center for Less Invasive and Robotic Heart Surgery in Buffalo, New York, USA. Study design was multidisciplinary, combining expertise of medical and communication science. Sources of medical information were identified (doctor, Internet, magazines, newspapers, television, radio, family members). Accessibility, quality, and readability of Internet medical information from the patients point of view were investigated. RESULTS: Out of 82 patients, 35 (35/82, 42.7%) were Internet users. Internet users had a significantly higher education level than Internet non-users (college education: 42.9% of users, 10.6% of non-users; P <.001). Among the Internet users, 18 (18/35, 51.4%) had used the Internet for retrieving medical information; 17 (17/35, 48.6%) had not. No statistically significant differences in demographic data were found when comparing these 2 sub-groups of patients. Family-members involvement was high (15/18, 83.3%). Internet medical information was rated helpful in most cases; readability was acceptable for only 3 patients (3/18, 16.7%). To improve on-line medical information, all patients interviewed suggested sites designed by their physicians. CONCLUSIONS: Although 1 in 5 patients in our sample has used the Internet to retrieve medical information, the majority of them experiences difficulties comprehending the information retrieved. Health-care providers should provide Internet medical information that is adequate for the non-medical public's needs.

Cardiac Care Facilities↗

Safety recommendations for laser pointers.

The use of laser diode pointers that operate in the visible radiation region (400-760 nm) is becoming widespread. These pointers are intended for use by educators while presenting talks in the classroom or at conventions and meetings. They are also useful in any situation where one needs to point out special items during any instructive situation. The pointers can be purchased in novelty stores, mail-order magazines, office supply stores, common electronic stores, and over the internet. The power omitted by these laser pointers ranges from 1 to 5 mW. The potential for hazard with laser pointers is generally considered to be limited to the unprotected eyes of individuals who might be exposed by a direct beam (intrabeam viewing). No skin hazard usually exists. There are, however, even more powerful laser pointers now appearing. The units are imported into the U.S. often without proper manufacturer certification or labeling. The potential for hazards with these devices is not well understood by the general public and workers, and numerous exposure incidents have been recorded by the authors. Users of these products need to be alerted to the potential hazards and be encouraged to follow appropriate safety recommendations. These factors are discussed and safety recommendations for laser pointers are presented.

Certification↗

Changes in body size of elite high school football players: 1963-1989.

An examination of the heights and weights of members of the Parade Magazine's High School All-American Football Teams from 1963-1971 indicates no significant changes in the Body Mass Index of these elite athletes whereas an increased pattern in Body Mass Index was noted within this group from 1972-1989. The large increases in Body Mass Index after 1971 among the All-American high school football players raise interesting research questions; in particular, what portion of these gains can be attributed to improved nutrition and training techniques and what portion is the result of use of performance enhancing drugs such as anabolic steroids?

Adolescent↗

Parents' beliefs about cholesterol and its effects on their children.

A random sample of parents of primary grade children (N = 500) was obtained from two higher socioeconomic-status suburban elementary schools. The respondents (n = 277) were well educated (92% attended or graduated from college), white (92%), primarily higher in socioeconomic status (79% earned more than $50,000/year), and female (70%). Two-thirds of the parents believed that all elementary school children should have their cholesterol levels checked, 70% believed high cholesterol in children was serious, yet only 21% believed their child would develop a high cholesterol level. To control their children's cholesterol level, the majority of parents (73%) made lifestyle changes for their children since the majority believed high cholesterol levels would clog arteries (95%) and cause heart disease (90%). Parents most often received their information on cholesterol from magazines (73%), newspapers (62%), and physicians (52%).

Adult↗

Media messages and alcohol education: a school-based study.

The immediate effects of a media intervention on attitudes toward alcohol were investigated with 134 secondary school pupils (aged 13 to 17 years) who completed a drinking and smoking questionnaire and expressed strength of agreement or disagreement with 13 statements about alcohol, drinking and health. Pupils then read news cuttings from popular magazines. One group read a negative message about alcohol, another group a positive message. Other groups read both positive and negative messages, and a control group had no media intervention. Immediately afterwards, all pupils responded to the same 13 statements again. Those pupils who received only a negative message became significantly more negative in their attitudes towards alcohol. Those receiving only a positive message were significantly more positive afterwards. The control group and those receiving both positive and negative messages showed little change. These findings are discussed in terms of their implications for alcohol education programs at school.

Adolescent↗

A psychometric analysis of the three gunas.

The Vedic Personality Inventory was devised to assess the validity of the Vedic concept of the three gunas or modes of nature as a psychological categorization system. The sample of 619 subjects included persons of varying ages and occupations from a middle-size city in southeastern United States, and also of subscribers to a magazine focusing on Eastern-style spirituality. The original 90-item inventory was shortened to 56 items on the basis of reliability and validity analyses. Cronbach alpha for the three subscales ranged from .93 to .94, and the corrected item-total correlation of every item score with its subscale score was greater than .50. Three measures of convergent validity and four measures of discriminant validity provide evidence for construct validity. The loading of every item on the scale is stronger for the intended subscale than for any other subscale. Although each subscale contains congeneric items, the factors are not independent. The nonorthogonality is consistent with Vedic theory. This inventory requires psychometric development and testing cross-culturally as well as to be experimentally implemented in group research and individual assessment.

Adolescent↗

Poetry writing and secretory immunoglobulin A.

17 healthy students provided saliva samples for Immunoglobulin A (s-IgA) assay before and after sessions of either writing poetry or reading magazines (control). Levels of s-IgA increased after the poetry-writing sessions but not after reading.

Adult↗

Clark and Hatfield's evidence of women's low receptivity to male strangers' sexual offers revisited.

Although frequently cited, there has been no published scientific replication of Clark and Hatfield's (1989) and Clark's (1990) findings concerning women's low receptivity to male strangers' offers of casual sex. Consistently across three identically designed naturalistic experiments (aggregated N = 144), these authors reported a 0% acceptance rate by women. The present research analyzed an informal "real-life" journalistic project (N= 100) initiated by an Austrian magazine, in which results indicated a 6.1% acceptance rate (95% CI: 2.8-12.6%) for a complete stranger offering women immediate sexual involvement. Various contextual differences, such as setting, subjects' age and attractiveness, and age differences between requestor and receiver, probably contributed to the observed difference in outcome between the journalistic project and the original experiments. The present findings point to the importance of contextual effects in naturalistic investigations of women's receptivity to sexual offers.

Adult↗