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Biomedical subjects

M Brodie

Publications and source records attributed to M Brodie.

At least 19 recordsLinked to original sources
PubMed2001

Americans' views on the use and regulation of dietary supplements.

This article presents the views of Americans on what the government's future role should be in regulating or overseeing the growing sales of dietary supplements for health purposes. Based on results of multiple national opinion surveys, including the views of both users and nonusers of supplements, we found that a substantial percentage of Americans surveyed reported that they regularly take dietary supplements as a part of their routine health regimen. However, they reported that they do not discuss the use of dietary supplements with their physicians because they believe that the physicians know little or nothing about these products and may be biased against them. Many users felt so strongly about the potential health benefits of some of these products that they reported that they would continue to take them even if they were shown to be ineffective in scientifically conducted clinical studies. However, there also was broad public support for increased government regulation of these products. We found that a majority of Americans surveyed supported the following: to require that the Food and Drug Administration review the safety of new dietary supplements prior to their sale; to provide increased authority to remove from sale those products shown to be unsafe; and to increase government regulation to ensure that advertising claims about the health benefits of dietary supplements are true.

Adolescent↗
PubMed2000

Tiagabine in the treatment of epilepsy--a clinical review with a guide for the prescribing physician.

Tiagabine is currently recommended mainly as add-on therapy in adults and children above 12 years with partial epilepsy not satisfactorily controlled with other antiepileptic drugs. Based on available evidence and our clinical experience, tiagabine should be used preferably in patients sharing one or more of the following additional features, (i) a history of drug-induced cutaneous adverse events; (ii) mild to moderate epilepsy allowing for a slow titration and gradual onset of anticonvulsant action over a few weeks; (iii) patients for whom it is particularly important to avoid a deterioration in cognitive performance; and, (iv) patients who failed to respond to previous treatment with sodium channel blocker agents as they may particularly benefit from the introduction of tiagabine, due to its GABAergic mechanism of action. Tiagabine can also be used successfully in other patients with refractory partial epilepsy. Tiagabine is not indicated for patients with generalized or unclassified epilepsies and for patients with severely impaired liver function.

Adult↗
PubMed2000

Race, ethnicity, and the health care system: public perceptions and experiences.

To assess the public's perceptions and attitudes about racial and ethnic differences in health care, the Kaiser Family Foundation surveyed a nationally representative sample of 3,884 whites, African Americans, and Latinos in 1999. The survey found that the majority of Americans are uninformed about health care disparities--many were unaware that blacks fare worse than whites on measures such as infant mortality and life expectancy, and that Latinos are less likely than whites to have health insurance. Views on whether the health system treats people equally were strikingly different by race. For example, most minority Americans perceive that they get lower quality care than whites, but most whites think otherwise. Nonetheless, more minority Americans were concerned about the cost of care than racial barriers. Efforts to eliminate disparities will need to improve public awareness of the problems as well as address racial and financial barriers to care.

Black or African American↗
PubMed1997

Understanding the quality challenge for health consumers: the Kaiser/AHCPR Survey.

BACKGROUND AND PURPOSE: "Americans as Health Care Consumers: The Role of Quality Information," a nationally representative telephone survey of 2,006 adults, designed by the Henry J. Kaiser Family Foundation (Kaiser) and the Agency for Health Care Policy and Research (AHCPR) of the U.S. Department of Health and Human Services, was presented at the Kaiser/AHCPR conference "Value and Choice: Providing Consumers with Information on the Quality of Care" in Arlington, Virginia, October 29-30, 1996. The survey was conducted by Princeton Survey Research Associates between July 16 and September 5, 1996, and has a margin of error of plus or minus 3 percentage points. RESULTS: The survey found that Americans value quality but that the use of quality indicators is likely to be only one factor in their decision making, given their reliance on and preference for quality information from their physicians, friends, and family. A plurality (42%) chose having high quality of care as their most important concern, but only 39% reported seeing information comparing health plans, and only about one-third of that group said they used this information themselves to make decisions. The following are possible explanations for why consumers don't use information on quality in making health care decisions: They trust friends, families, and physicians about all other sources for advice; They do not (at the time of the survey) have many health plan choices to make; or They lack familiarity with comparative health care quality information.

Adult↗
PubMed1996

Americans' political participation in the 1993-94 national health care reform debate.

The health politics and policy communities are still struggling with the question of "what went wrong" in the 1993-94 health care reform effort. Here I identify which Americans were politically active and inactive during the health care reform debate to explore the role political participation may have had in determining the outcome of the debate. Using data from a national and California random-sample telephone surveys, and controlling for other demographic attributes, I found that those who engaged in political activity specifically related to health care reform were disproportionately more likely to be self-identified conservatives, less likely to favor an employer mandate plan, more likely to be fifty to sixty-four years old, more likely to be men, and more likely to have greater interest in and knowledge of the health care issue. Even in California, where a single-payer proposal was on the November ballot, self-identified liberals were no more likely to engage in political activity on health care reform than were moderates or conservatives. I consider implications for the reform outcome given that liberals, the elderly, and those favoring the employer mandate proposal were all disproportionately "silent" during this debate, and finally I discuss the potential for mobilization during future debates.

Adult↗
PubMed1995

The public and the welfare reform debate.

OBJECTIVES: To identify the core beliefs and policy preferences of the American public toward changing the welfare system and providing support for low-income families. DESIGN: Results are presented from 19 telephone and in-person surveys of adults nationwide between 1937 and February 1995. SETTING: At-home interviews with adults. PARTICIPANTS: Seventeen surveys; each survey involved 1000 to 2000 adults nationwide. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The results showed that the public supports strong welfare reform measures (eg, time limits and work requirements), but it is reluctant simply to cut off welfare benefits to people and leave them without some means of basic support. The surveys identified five underlying beliefs that shape the public's policy preferences: (1) welfare causes more harm than good because it discourages work and causes families to break up; (2) welfare should be a temporary transition to work, not a long-term subsidy for low-income families; (3) the country spends too much on welfare programs; (4) lack of economic opportunity as well as personal responsibility is the reason people need welfare; and (5) both government and people themselves have a shared responsibility for ensuring that people have a minimum standard of living. CONCLUSIONS: The outcome of the welfare reform debate will have a substantial impact on the 21% of the nation's children who now live in poverty. The jury is still out on what the public will support in the welfare reform debate. The Medicaid program is caught in the middle of the welfare reform debate, and its ultimate fate may rely on state rather than federal decision making.

Adult↗
PubMed1995

What happened to Americans' support for the Clinton health plan?

Within a twelve-month period public support for the Clinton plan fell from 71 percent to 43 percent. The administration lost substantial support among two politically important groups--the elderly and Democrats. This outcome was brought on by a series of key strategic and substantive misjudgments by the administration in the choices that it made in the development of its plan. These particular decisions inadvertently reinforced the public's deeply held cynicism that although health care reform was needed, the government in Washington would not do it right and would ultimately leave the middle class worse off than it was before.

Health Care Reform↗
PubMed1993

Economic incentives in the choice between vaginal delivery and cesarean section.

The dramatic rise in cesarean-section (C-section) rates, and their high costs and wide variation, has raised interest in understanding the factors affecting decisions to use this procedure. The economic incentives of physicians, hospitals, payers, and mothers are examined. In the economic framework, physicians must balance their short-term interests against their reputation, which is derived from efficiently providing what mothers want. Providers who encounter higher opportunity costs while attending to mothers in prolonged labor can reduce these costs by operating or by restructuring their practices. The mainly indirect evidence on financial incentives indicates that insured mothers have low marginal financial costs when they undergo C-section. Mothers with private, fee-for-service insurance have higher C-section rates than mothers who are covered by staff-model HMOs, who are uninsured, or who are publicly insured. In conclusion, research and payment reforms to reduce distortions to good practice are proposed.

Cesarean Section↗