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Biomedical subjects

D Finer

Publications and source records attributed to D Finer.

At least 19 recordsLinked to original sources
PubMed2000

Mass media interventions: effects on health services utilisation.

BACKGROUND: The mass media frequently cover health related topics, are the leading source of information about important health issues, and are targeted by those who aim to influence the behaviour of health professionals and patients. OBJECTIVES: To assess the effects of mass media on the utilisation of health services. SEARCH STRATEGY: We searched the Cochrane Effective Practice and Organisation of Care Group specialised register, MEDLINE, EMBASE, Eric, PsycLit, and reference lists of articles. We hand searched the journals Communication Research (February 1987 to August 1996), European Journal of Communication (1986 to 1994), Journal of Communication (winter 1986 to summer 1996), Communication Theory (February 1991 to August 1996), Critical Studies in Mass Communication (March 1984 to March 1995) and Journalism Quarterly (1986 to summer 1996). SELECTION CRITERIA: Randomised trials, controlled clinical trials, controlled before-and-after studies and interrupted time series analyses of mass media interventions. The participants were health care professionals, patients and the general public. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed study quality. MAIN RESULTS: Seventeen studies were included. All used interrupted time series designs. Fourteen evaluated the impact of formal mass media campaigns, and three of media coverage of health related issues. The overall methodological quality was variable. Six studies did not perform any statistical analysis, and seven used inappropriate statistical tests (ie not taking into account the effect of time trend). All of the studies apart from one concluded that mass media was effective. These positive findings were confirmed by our re-analysis in seven studies. The direction of effect was consistent across studies towards the expected change. The pooled effect sizes for studies assessing the impact of mass media on similar aspects of care revealed an effect upon the utilisation of health services that could not be explained by chance alone, ranging from -1.96 (95%CI -1. 19 to -2.73) for campaigns promoting immunisation programmes, to -1. 12 (95%CI -0.49 to -2.36) for those concerning cancer screening. REVIEWER'S CONCLUSIONS: Despite the limited information about key aspects of mass media interventions and the poor quality of the available primary research, there is evidence that these channels of communication may have an important role in influencing the use of health care interventions. Those engaged in promoting better uptake of research information in clinical practice should consider mass media as one of the tools that may encourage the use of effective services and discourage those of unproven effectiveness.

Health Education↗
PubMed2000

Workplace drug testing (WDT) likely to increase in Europe. Report from the First European Symposium on WDT including selected abstracts.

Will it take a series of drug-related accidents that have already occurred in the USA before workplace drug testing (WDT) becomes accepted in Europe as a preventive measure? Currently, the development of WDT in most European countries lags some 10-15 years behind that in the USA. Labour authorities in Europe now ought to take initiatives to demand a mandatory programme for accrediting drug analytical laboratories for WDT. Companies should realise that illicit drug use is no longer only a problem at street corners, and that having a testing system in place is important, not just for public health, but also for their reputations as responsible societal actors. Improved networking among police and regulatory authorities is required to keep pace with the rapid appearance and dissemination of new substances of abuse. European research collaboration, including the newly formed European Workplace Drug Testing Group, is needed to assess the impact of drug-testing policies on accidents and other outcome variables, and thereby to convince the general public and politicians that drug testing is beneficial and necessary. A 1993-1994 survey of quality analysis in some 200 European laboratories reported from Institut Municipal d'Investigació Medica (IMIM), Spain, showed good agreement between nominal and found concentrations but that only 10% of the laboratories could both screen, identify and quantify samples. Experiences from Italy show that proficiency testing schemes lead to improved accuracy of results. These were some major conclusions of the First European Symposium on Drug Testing held at Huddinge University Hospital in Stockholm, Sweden, 30 March to 1 April 1998, organised by Karolinska Institute, with participants from 22 countries.

Europe↗
PubMed1998

Tet offensive: winning hearts and minds for prevention. Discourse and ideology in Vietnam's "Health" Newspaper.

A quantitative content (CA) and qualitative discourse analysis (DA) was made of all 67 articles in the February 1995 ("Tet") issue of Suc Khoe ("Health"), a bi-weekly newspaper issued by Ministry of Health, Hanoi, Vietnam. The aim was to uncover discursive strategies used in the construction of health-related meaning during a period of rapid economic transition and latent ideological struggle in Vietnam. The DA was based on the work of i.a. Foucault, Fairclough, Thompson, and Fowler. The CA showed a strong domination of Western sources. There were four themes: prevention, cure, the Tet festival, and crime and punishment. In the two first, health-related groups, prevention (n = 31) dominated over cure (n = 22), modern (n = 19) over traditional (n = 13) medicine, and overall, the theme of continuity (prevention and crime/punishment) over change (cure and Tet), reflecting Vietnam's programmatic pluralism in the health field and its ideological struggle against outside influences. The DA revealed three mixed but unintegrated discourses in the material; "popular" (simplistic, authoritarian, and sentimentalizing), "expert" (technical, egalitarian, and uncritical), and "nationalist" (administrative, impersonal and propagandistic). Prevention was mainly expressed via the popular discourse, whereas cure was represented, prospectively, by the expert discourse, and retrospectively, by the nationalist discourse. This combined order of discourse functions, we suggest, as a disciplinary "Discourses of Order". A proposed integrative CA/DA model relates content themes and discursive foci to the classical rhetorical dichotomy hope/fear. We see "Health" as struggling to uphold traditional besieged values under the new economic policies by using preventive propaganda in both medical and political terms. These findings are compared with expressed editorial policy statements.

Health Education↗
PubMed1997

Ally, advocate, analyst, agenda-setter? Positions and perceptions of Swedish medical journalists.

Medical journalists in the mass media play a key role in health information dissemination and risk/benefit education. Public education on the rational use of various health technologies, e.g. pharmaceuticals, is increasingly important as part of ongoing global health sector reforms. In a survey of 110 Swedish medical journalists (55% response rate) about medicinal drugs, risk perceptions and professional concerns, fact-giving, stimulating, and critical functions were rated as the most important journalist role attributes, followed by advocacy of patient interests and of public health goals. Major perceived problems were self-imposed professional demands, job stress, knowledge and time constraints, and selection and contextualization of news material. In terms of medicinal drugs, attitudes were strongly in favor of a unique drug information role for the media and critical of physician prescribing and information-giving. Views on the appropriateness of specific ethical rules or guidelines for medical journalists were sharply divided. The results offer some promise for increased alliance-building between public health and the mass media.

Attitude to Health↗