Assessing the quality of newspaper medical advice columns for elderly readers.
(1/98)
BACKGROUND: Medical advice columns in newspapers can provide a valuable service by educating the general public about important health-related issues. However, these columns may be harmful if the advice or information given in them is incomplete, inappropriate or misleading. The objective of this study was to assess the safety and appropriateness of advice given to elderly readers of newspapers in medical advice columns. METHODS: Medical advice columns published in Canadian newspapers in 1995 were identified from a CD-ROM database. The articles that were selected were published in English and contained medical advice pertinent to elderly people about topics that could be found in a textbook of geriatric medicine. Fifty articles, randomly selected from the 109 articles that met these criteria, were independently assessed by 5 geriatricians. A scoring system was used to rate the ability to determine to which population the article applied, how well fact was distinguished from opinion, the degree to which critical issues were addressed, the safety and the appropriateness of the advice. When the kappa statistic for inter-rater agreement was 0.74 or less, a 2-stage Delphi process was used in an attempt to reach consensus. RESULTS: Agreement (kappa > 0.74) was eventually achieved for 232 (92.8%) of the 250 ratings. In 4 (8%) of the articles there was a high probability that the advice given could be applied to the wrong patient population; in 7 (14%) there was a high probability that opinion might be interpreted as fact; and in 11 (22%) the major critical issues were not identified. Of greatest concern, however, the advice in 25 (50%) of the articles was judged to be inappropriate, and in 14 (28%) advice may have been dangerous and potentially life-threatening. INTERPRETATION: Although medical advice columns have the potential to improve the health of elderly readers, a significant percentage of these articles contain inappropriate or even potentially dangerous advice. (+info)
Tobacco industry tactics for resisting public policy on health.
(2/98)
The tactics used by the tobacco industry to resist government regulation of its products include conducting public relations campaigns, buying scientific and other expertise to create controversy about established facts, funding political parties, hiring lobbyists to influence policy, using front groups and allied industries to oppose tobacco control measures, pre-empting strong legislation by pressing for the adoption of voluntary codes or weaker laws, and corrupting public officials. Formerly secret internal tobacco industry documents provide evidence of a 50-year conspiracy to "resist smoking restrictions, restore smoker confidence and preserve product liability defence". The documents reveal industry-wide collusion on legal, political and socially important issues to the tobacco industry and clearly demonstrate that the industry is not disposed to act ethically or responsibly. Societal action is therefore required to ensure that the public health takes precedence over corporate profits. Recommendations for reducing the political influence of the tobacco industry include the following. Every tobacco company in every market should publicly disclose what it knew about the addictiveness and harm caused by tobacco, when it obtained this information, and what it did about it. The industry should be required to guarantee internationally recognized basic consumer rights to its customers. Trade associations and other industry groupings established to deceive the public should be disbanded. These recommendations should be incorporated into WHO's Framework Convention on Tobacco Control. (+info)
Metaphors, models and organisational ethics in health care.
(3/98)
Crucial to discussions in organisational ethics is an evaluation of the metaphors and models we use to understand the organisations we are discussing. I briefly defend this contention and evaluate three possible models: the current corporate model, an orchestrator model which puts hospitals in the same class as malls and airports, and a community model. I argue that the corporate and orchestrator model push to the background some important organisational ethics issues and bias us inappropriately towards certain solutions. Furthermore, I argue that the community model allows these to be more easily brought up. I also respond to the likely challenge that hospitals really are corporations by arguing that this is not relevant to evaluations of the appropriateness of the corporate model. (+info)
Effects of patient demands on satisfaction with Japanese hospital care.
(4/98)
OBJECTIVE: The objective of this study was to detect whether there was any difference among the characteristics of patient satisfaction between two patient emphasis groups: patients demanding technical elements of hospital care and patients demanding interpersonal elements. DESIGN AND SETTING: The sample for this study was drawn from in-patients discharged from 77 voluntarily participating hospitals throughout Japan. The relationship between overall satisfaction with hospital care and patient satisfaction, and the evaluation of a hospital's reputation, was explored by stepwise multiple regression analysis of 33 variables relevant to aspects of hospital care for each patient group. RESULTS: In the interpersonal emphasis (IE) group, 'nurse's kindness and warmth' was associated significantly with overall satisfaction, while 'skill of nursing care' and 'nurse's explanation' were significant predictors of overall satisfaction in the technical emphasis (TE) group. On the other hand, 'doctor's clinical competence', 'recovery from distress and anxiety', and items pertaining to the hospital's reputation were significantly related to overall satisfaction in both emphasis groups. CONCLUSION: For overall patient satisfaction, it is essential to satisfy specific items related to the aspect of hospital care emphasized by the patient. Specific significant predictors of overall satisfaction (e.g. 'doctor's clinical competence') were indispensable measures of professional performance in hospital care, irrespective of the patients' emphasis. A positive perception of hospital reputation items might increase overall patient satisfaction with Japanese hospitals. (+info)
Community outreach at biomedical research facilities.
(5/98)
For biomedical researchers to fulfill their responsibility for protecting the environment, they must do more than meet the scientific challenge of reducing the number and volume of hazardous materials used in their laboratories and the engineering challenge of reducing pollution and shifting to cleaner energy sources. They must also meet the public relations challenge of informing and involving their neighbors in these efforts. The experience of the Office of Community Liaison of the National Institutes of Health (NIH) in meeting the latter challenge offers a model and several valuable lessons for other biomedical research facilities to follow. This paper is based on presentations by an expert panel during the Leadership Conference on Biomedical Research and the Environment held 1--2 November 1999 at NIH, Bethesda, Maryland. The risks perceived by community members are often quite different from those identified by officials at the biomedical research facility. The best antidote for misconceptions is more and better information. If community organizations are to be informed participants in the decision-making process, they need a simple but robust mechanism for identifying and evaluating the environmental hazards in their community. Local government can and should be an active and fully informed partner in planning and emergency preparedness. In some cases this can reduce the regulatory burden on the biomedical research facility. In other cases it might simplify and expedite the permitting process or help the facility disseminate reliable information to the community. When a particular risk, real or perceived, is of special concern to the community, community members should be involved in the design, implementation, and evaluation of targeted risk assessment activities. Only by doing so will the community have confidence in the results of those activities. NIH has involved community members in joint efforts to deal with topics as varied as recycling and soil testing. These ad hoc efforts are more likely to succeed if community members and groups have also been included in larger and longer term advisory committees. These committees institutionalize the outreach process. This can provide the facility with vocal and influential allies who create an independent line of communication with the larger community. (+info)
The new battleground: California's experience with smoke-free bars.
(6/98)
OBJECTIVES: This study examined the tobacco industry's tactics in the political, grassroots, and media arenas in attempting to subvert California's smoke-free bar law, and the efforts of health advocates to uphold and promote the law by using the same 3 channels. METHODS: Interviews with key informants involved in the development and implementation of the smoke-free bar law were conducted. Information was gathered from bill analyses, internal memoranda, tobacco industry documents, media articles, and press releases. RESULTS: The tobacco industry worked both inside the legislature and through a public relations campaign to attempt to delay implementation of the law and to encourage noncompliance once the law was in effect. Health groups were able to uphold the law by framing the law as a health and worker safety issue. The health groups were less successful in pressing the state to implement the law. CONCLUSIONS: It is possible to enact and defend smoke-free bar laws, but doing so requires a substantial and sustained commitment by health advocates. The tobacco industry will fight this latest generation of clean indoor air laws even more aggressively than general workplace laws. (+info)
User needs: the key to changing library services and policies.
(7/98)
A user survey and a series of faculty interviews are discussed as methods that can be used by a public relations librarian to change library policies and services in the direction of patrons' needs. (+info)
Communicating science: from the laboratory bench to the breakfast table.
(8/98)
If we are to maintain public appreciation and support for our scientific enterprise, we need to pay more attention to translating the benefits and grandeur of science into the language of broader society. Both educators and journalists have a role to play in communicating the achievements of science, but scientists must recognize that we have a responsibility to increase the availability and salience of science to the public. (+info)