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Professional responsibilities of biomedical scientists in public discourse.

This article describes how a small but vocal group of biomedical scientists propagates the views that either HIV is not the cause of AIDS, or that it does not exist at all. When these views were rejected by mainstream science, this group took its views and arguments into the public domain, actively campaigning via newspapers, radio, and television to make its views known to the lay public. I describe some of the harmful consequences of the group's activities, and ask two distinct ethical questions: what moral obligations do scientists who hold such minority views have with regard to a scientifically untrained lay audience, and what moral obligations do mainstream newspapers and government politicians have when it comes to such views. The latter question will be asked because the "dissidents" succeeded for a number of years in convincing the South African government of the soundness of their views. The consequences of their stance affected millions of HIV infected South Africans severely.

Acquired Immunodeficiency Syndrome↗

The internet and social life.

The Internet is the latest in a series of technological breakthroughs in interpersonal communication, following the telegraph, telephone, radio, and television. It combines innovative features of its predecessors, such as bridging great distances and reaching a mass audience. However, the Internet has novel features as well, most critically the relative anonymity afforded to users and the provision of group venues in which to meet others with similar interests and values. We place the Internet in its historical context, and then examine the effects of Internet use on the user's psychological well-being, the formation and maintenance of personal relationships, group memberships and social identity, the workplace, and community involvement. The evidence suggests that while these effects are largely dependent on the particular goals that users bring to the interaction-such as self-expression, affiliation, or competition-they also interact in important ways with the unique qualities of the Internet communication situation.

Communication↗

RDA for science.

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Audiovisual Aids↗

Effects of public and professional education on reducing the delay in presentation and referral of stroke patients.

BACKGROUND AND PURPOSE: Several emerging stroke therapies require patients to be treated within several hours of symptom onset. Past studies have documented a significant delay between symptom onset and hospital presentation. As part of an experimental treatment study using tissue-type plasminogen activator, we began a multifaceted program of public and professional education to reduce the delay in presentation and referral of acute stroke patients. METHODS: The educational efforts focused on improving the recognition of stroke symptoms, the study enrollment criteria, and the need for rapid treatment of stroke patients. This program included 1) interviews on television and radio, 2) newspaper articles, 3) lectures to local and regional primary care and emergency department physicians, 4) mailings to several thousand local physicians, 5) having neurologists on-call for referrals 24 hrs/day, and 6) use of the Duke Life-Flight helicopter. RESULTS: Since starting our program, 139 of 159 (86%) patients with cerebral infarction presented primarily to our were referred to our facility within 24 hours of symptom onset, compared with 70 of 187 (37%) before our educational efforts (p less than 0.00001). No significant change was seen in patients with intracerebral hemorrhage (23 of 30 +AD77%+BD within 24 hours after program, compared with 25 of 40 +AD63%+BD before educational efforts; p = 0.30). CONCLUSIONS: These findings suggest that educational efforts aimed at the public and health professionals may increase recognition of stroke symptoms and reduce the delay in presentation and referral of stroke patients.

Cerebral Hemorrhage↗

Language acculturation and screening practices of elderly Hispanic women. The role of exposure to health-related information from the media.

The present study examined the hypothesis that language acculturation of Hispanics in the United States increases their exposure to media-based health information which, in turn, increases medical screening practices and knowledge of cancer symptoms. We interviewed 598 elderly Hispanic women (55-92 years of age) residing in Los Angeles. Language acculturation was measured with items on understanding of English and language preference for interpersonal communication, reading materials, television, and radio. Recency of screening (physician breast exam, Pap smear, routine physical exam, mammogram) and exposure to media-based health information were assessed with Likert-type scales; knowledge of symptoms of breast, cervical, colorectal, and oral cancers was assessed through open-ended questions. The results of multiple regression analyses provide support for the hypothesis. First, language acculturation predicted media exposure after controlling for demographic variables. Second, media exposure predicted screening and symptom knowledge after controlling for language acculturation and the demographic factors. The findings suggest that cancer prevention programs should use Spanish-language media to reach a wider Hispanic audience, especially those who are monolingual.

Acculturation↗

The asthma year in Swedish pharmacies: a nationwide information and pharmaceutical care program for patients with asthma.

OBJECTIVE: To increase the understanding of asthma among patients and the general public in Sweden and to increase the collaboration among healthcare personnel for the benefit of asthma patients. DESIGN: Based on the results from problem detection studies, Apoteksbolaget, the national organization for pharmacies in Sweden, designed a program to educate healthcare professionals and the public about asthma. Entitled the "Asthma Year," all pharmacy staffs were offered education on asthma, patients were provided written information and audiovisual materials, and the general public was made more aware of asthma through local media. SETTING: Pharmacies, healthcare centers, hospital outpatient areas, libraries, places of work, and domestic airports. PARTICIPANTS: All pharmacy staffs (12,000 persons) were offered an education on asthma. Patients with asthma were offered brochures and leaflets in pharmacies and information in the pharmacy magazine Apoteket. The general public received information about asthma through posters, radio, and television. MAIN OUTCOME MEASURES: The evaluations of the Asthma Year indicate that the activities had an impact on the public, on patients with asthma, and on the pharmacy staffs. RESULTS: About 4.5 million people in Sweden (42% of the population) observed the Asthma Year or received information about asthma, and 49% of the patients learned something new about their disease. Twice as many patients used steroid therapy regularly after the campaign than before. Of the pharmacy staffs, 96% were favorable to the idea of working with campaign years and 85% believed that they were personally involved with the activities. CONCLUSIONS: Patient outcomes in terms of reduced morbidity have not been possible to document, but the number of deaths from asthma in Sweden decreased from 438 during the previous year to 398 during the Asthma Year.

Adolescent↗

Assessing cancer beliefs in a Chinese immigrant community.

Although many studies have focused on cancer screening utilization and attitudes, no study has yet been conducted that examines community beliefs toward a cancer diagnosis and some of the beliefs about cancer and cancer patients. While certain types of cancer have been decreasing in the White population, minority populations are more likely to be diagnosed in a later stage and die of cancer. Stigmas caused by a cancer diagnosis and the disease itself may be a contributing factor in late detection and increased mortality. A telephone survey of 798 Chinese immigrants living in San Francisco was conducted. Subjects were asked several questions with established responses regarding their beliefs about cancer. One quarter of the 798 participants still believe cancer is contagious. Many also believe cancer is caused by environmental as well as personal action such as immoral behavior. A logistic regression model indicated that women who are at a low income level and have resided in the United States for an extended period of time are more likely to believe cancer is contagious. Community stigmas toward cancer and cancer survivors will prevent some Chinese immigrants from seeking early diagnosis. Multimedia education efforts that utilize print, television, and radio may provide a point of entry to reach otherwise unreachable individuals. This concerted education effort may help to dispel some of the myths regarding cancer, its treatment, and prognosis. It is hoped this would encourage a healthy dialogue about cancer, thus increasing screening and early detection among Chinese immigrants.

Acculturation↗

Getting messages on the air: findings from the 1982 Alcohol Abuse Prevention Campaign.

A necessary step in an effective public education campaign is obtaining sufficient broadcast time to reach substantial numbers of a target audience. By this criterion, the 1982 Alcohol Abuse Prevention Campaign was very successful. Between February and December 1982, 17,409 alcohol-related public service announcements (PSAs) were broadcast in 75 major media markets around the country. Campaign messages reached target audiences with sufficient frequency to have had likely effects on attitudes and behavior. Key elements in the success of the effort were producing high quality broadcast materials, providing technical assistance to aid state and local groups in the message dissemination process, and providing for state and local control over the timing and release of materials.

Adolescent↗

Knowledge, attitude and practice towards SARS.

The objective of the study was to explore the knowledge, attitude and practice of the population of Qatar towards severe acute respiratory syndrome (SARS). The study took the form of a cross-sectional community-based survey in Doha International Airport and primary health care centres situated in urban and semi-urban areas of Qatar. The survey was conducted among travellers arriving at Doha International Airport and community residents visiting health centres from April to September 2003. A total of 1,800 subjects were approached for the study of which 1,386 (77.0%) responded to the questionnaire. The study showed that although 79.4% of the total subjects claimed to know about SARS, only 8.0% had accurate knowledge about all of the symptoms of SARS. The respondents' satisfaction with the preventive measures taken by the health authorities was only 66.6%. Overall, 73.0% of the total subjects knew that SARS was highly infectious; 69.9% knew that it could spread through close contact; 67.4% were aware that high fever was the early symptom; and 60.8% thought SARS could be cured. Half of the subjects said they had gained most of their knowledge on SARS through television and radio programmes (52.2%). Three-fifths (60.1%) were afraid to travel for fear of being affected by SARS. The level of awareness of SARS among Qataris was poor (31.7%) compared to that among non-Qataris (68.3%). The level of knowledge about SARS was better among educated subjects. The survey found a high level of stress and fear among the respondents. Health authorities should be on the alert and re-examine their capacity to manage an outbreak like SARS in the event that such a mishap should recur in the future.

Adult↗

Journalists and gender-based violence in Ibadan, Nigeria.

Violence against women (VAW) continues to occur in many countries of the world despite various measures taken to stop it. The media can shape the attitudes and perceptions of people and can be an advocate for social change. Thus an assessment of the knowledge, attitude and coverage of prevention of VAW by 230 media practitioners in Nigeria was conducted using semi-structured self-administered questionnaires. Results of the survey revealed that 86 of the 230 (37%) stated that both sexes have equal privileges and rights, while 78 (34%) felt that violence could help to keep women 'in check' or in control. Mean knowledge score out of 10 was 7.5 +/- 2.1, while attitude scores out of 11 were 6.4 +/- 1.2. Two main groups of journalist were identified: prejudiced, (105, 46%), and non-prejudiced (125, 54%). The non-prejudiced group consisted mostly of females (p<0.05), over the age of 36 (p<0.05), and held senior positions within their profession (p>0.05). Female media practitioners had significantly higher knowledge and attitude scores than their male counterparts (7.47 +/- 2.0 versus 6.39 +/- 2.3) and (6.27 +/- 2.0 versus 5.11 +/- 6.1). Ninety respondents (39%) had worked on prevention of VAW in the last two years. Most of these (60, 67%) had worked on one-off programmes. Regular programmes usually consisted of 30-minutes or one-hour weekly programmes on radio and television as well as articles in the newspapers. Enlightening the public (41%) and 'portraying women in a successful light' (12%) were some of the activities the practitioners were ready to embark upon. Media practitioners need first of all comprehensive training on VAW, which should be followed by increased coverage of prevention of VAW in the media. Finally, more interactive media engagement with the public should be employed. Media organisations for women may be useful in initiating some of these changes.

Adult↗

Nurses' evaluations of sources of information about HIV and AIDS.

Reviews of the literature indicate that nurses feel ill-informed about HIV/AIDS and that poor knowledge is associated with anxiety and negative attitudes towards infected patients and their care. Although some studies have sought to identify the sources of HIV/AIDS information available to nurses, few have attempted to understand how nurses evaluate such sources. In this study in 1992, 15 sources of HIV/AIDS information were identified during group discussions with nursing staff and nurse tutors. 277 nursing staff evaluated each of the sources in terms of perceived frequency (how often the source is used) and six items chosen to assess the usability and usefulness of each source (e.g. how informative the source is, how easy it is to understand). The results indicate that in-service training, basic training and professional colleagues are the sources evaluated most highly while posters and advertisements, television and radio and popular newspapers are the most frequently used sources of information. Trades unions' journals and pamphlets are the least frequently used sources of information and receive only modest evaluations. 20% of respondents report never having received any training regarding HIV and AIDS. Implications for the future provision of HIV/AIDS information and directions for further research are discussed.

Acquired Immunodeficiency Syndrome↗

Factors influencing participation in national immunization days in Kumasi, Ghana.

A study of the factors influencing participation in national immunization days (NID) in Kumasi, Ghana was carried out between the April and June of 1999. Polio-immunization coverage during NID was assessed among children aged < 5 years; > 90% of these children had received polio vaccinations on both of the two previous NID. The mothers who participated most in the NID tended to be those who were better educated and Ghanaian. Mothers who were salaried workers participated fully in NID. Radio and television played a major role in public education about NID, whereas the attitude of health workers was a strong factor that prevented many mothers/caregivers from bringing their children to be immunized. The coverage of the Expanded Programme on Immunization (EPI) was assessed in children aged 12-23 months; nearly 70% of these children were fully immunized. BCG had the highest coverage (97.0%) and measles the lowest (79%). Again, full coverage of the children of mothers who had been educated beyond primary level was higher than that of the other children (75.9% v. 65.2%), and coverage of the children of Ghanaian women was higher than that of the others (70.8%. v. 50.0%). Although the mothers/caregivers raised concerns about the costs of the routine immunizations, these charges apparently did not prevent them from taking their children to be immunized. NID complement the routine EPI-associated work in Ghana, increasing overall polio-immunization coverage. The results of this study will be used to improve the overall performance of immunization programmes, especially in the Kumasi metropolis. Hopefully, sustained, increased polio-immunization coverage will contribute positively towards polio eradication in Ghana.

Adolescent↗

No difference in stroke knowledge between Korean adherents to traditional and western medicine - the AGE study: an epidemiological study.

BACKGROUND: Effective stroke intervention and risk reduction depend on the general public's awareness and knowledge of stroke. In Korea, where both traditional Oriental medicine and Western medicine are practiced, estimates of the general public's awareness and knowledge of stroke are poor. The present study sought to describe the inception cohort of the Ansan Geriatric Study (AGE study) and to determine baseline stroke awareness and preferred medical treatment for stroke in this Korean sample. METHODS: A total of 2,767 subjects selected randomly from the Ansan Geriatric Study in South Korea were questioned about stroke. Their answers were compared with their sociodemographic data and other variables. RESULTS: Only 44.8% of participants correctly identified stroke as a vascular disease in the human brain. Sudden numbness or weakness was the most frequently identified stroke warning sign (60.2%). Hypertension (66.7%) and mental stress (62.2%) were most frequently identified as stroke risk factors. The contributions of diabetes mellitus and cardiovascular disease to stroke were underestimated; they were identified as risk factors by 28.3% and 18.6% of participants, respectively. The predictors for poor knowledge of stroke warning signs and risk factors were similar irrespective of preference for Western or Oriental medical treatment, and included those with lower levels of education and inaccurate definition of stroke. Television and radio (40.3%) were the most frequent sources of stroke information for both groups. CONCLUSION: This study shows that knowledge of stroke is similar among Koreans with preferences for either Western or Oriental medical treatment and that misunderstandings about stroke are common among the Korean elderly. In order to prevent and manage stroke effectively, public health education regarding basic concepts of stroke is necessary. This should target those with a lower level of education and a misunderstanding of the definition of stroke.

Aged↗

Internet-based monitoring of influenza-like illness (ILI) in the general population of the Netherlands during the 2003-2004 influenza season.

BACKGROUND: An internet-based survey of influenza-like illness (ILI)--the Great Influenza Survey or GIS--was launched in the Netherlands in the 2003-2004 influenza season. The aim of the present study was to validate the representativeness of the GIS population and to compare the GIS data with the official ILI data obtained by Dutch GPs participating in the Dutch Sentinel Practice Network. METHOD: Direct mailings to schools and universities, and repeated interviews on television and radio, and in newspapers were used to kindle the enthusiasm of a broad section of the public for GIS. Strict symptomatic criteria for ILI were formulated with the assistance of expert institutes and only participants who responded at least five times to weekly e-mails asking them about possible ILI symptoms were included in the survey. Validation of GIS was done at different levels: 1) some key demographic (age distribution) and public health statistics (prevalence of asthma and diabetes, and influenza vaccination rates) for the Dutch population were compared with corresponding figures calculated from GIS; 2) the ILI rates in GIS were compared with the ILI consultation rates reported by GPs participating in the Dutch Sentinel Practice Network. RESULTS: 13,300 persons (53% of total responders), replied at least five times to weekly e-mails and were included in the survey. As expected, there was a marked under-representation of the age groups 0-10 years and 81->90 years in the GIS population, although the similarities were remarkable for most other age groups, albeit that the age groups between 21 and 70 years were slightly overrepresented. There were striking similarities between GIS and the Dutch population with regard to the prevalence of asthma (6.4% vs. 6.9%) and the influenza vaccination rates, and to a lesser degree for diabetes (2.4% vs. 3.5%). The vaccination rates in patients with asthma or diabetes, and persons older than 65 years were 68%, 85%, and 85% respectively in GIS, while the corresponding percentages in the Dutch population were 73%, 85% and 87%. There was also a marked similarity between the seasonal course of ILI measured by GIS and the GPs. Although the ILI rate in GIS was about 10 times higher, the curves followed an almost similar pattern, with peak incidences occurring in the same week. CONCLUSION: The current study demonstrates that recruitment of a high number of persons willing to participate in on-line health surveillance is feasible. The information gathered proved to be reliable, as it paralleled the information obtained via an undisputed route. We believe that the interactive nature of GIS and the appealing subject were keys to its success.

Adolescent↗

Changes in public attitudes to depression during the Defeat Depression Campaign.

BACKGROUND: Aims of the Defeat Depression Campaign between 1991 and 1996 included the reduction of stigma associated with depression, education of the public about the disorder and its treatment and encouragement of earlier treatment-seeking. Newspaper and magazine articles, radio and television programmes and other media activities were employed. METHOD: Surveys of public attitudes were conducted by MORI in late 1991, early 1995 and mid-1997. Each covered approximately 2000 subjects, sampled to be representative of the population of Great Britain. Structured interviews covered views on depression, treatment and general practitioners (GPs). RESULTS: There were significant positive changes regarding attitudes to depression, reported experience of it, attitudes to antidepressants, and less consistently, to treatment from GPs. Changes were of the order of 5-10%. Throughout, attitudes to depression and to treatment by counselling were very favourable, whereas antidepressants were regarded as addictive and less effective. CONCLUSIONS: Positive attitude change was achieved during the Campaign, although there is still room for improvement in some aspects.

Adult↗

Primary sources of health information: comparisons in the domain of health attitudes, health cognitions, and health behaviors.

The recent growth in consumer autonomy in health care accompanied by the surge in the use of new media for health information gathering has led to an increasing scholarly interest in understanding the consumer health information search construct. This article explores consumer health information seeking in the realm of the primary sources of health information used by consumers. Based on an analysis of the 1999 HealthStyles data, the paper demonstrates that active communication channels such as interpersonal communication, print readership, and Internet communication serve as primary health information sources for health-conscious, health-information oriented individuals with strong health beliefs, and commitment to healthy activities. On the other hand, passive consumption channels such as television and radio serve as primary health information resources for individuals who are not health-oriented. Media planning implications are drawn from the results, suggesting that broadcast outlets with an entertainment orientation are better suited for prevention campaigns. Such channels provide suitable sites for entertainment-education. On the other hand, print media, interpersonal networks, and the Internet are better suited for communicating about health issues to the health-active consumer segment.

Adult↗

Day to day use and service-related issues with the bone-anchored hearing aid: the Entific Medical Systems questionnaire.

Over a 12-year period, the Birmingham implantation otology unit has implanted more than 300 patients with bone-anchored hearing aids (BAHA). The Entific Medical Systems questionnaire was administered to these patients to evaluate the day to day use of the BAHA, professional needs, after-care, wear and tear concerns and service related issues. Data analysis revealed that most patients used their BAHA for more than eight hours a day (90 per cent of BAHA users) and every day of the week (93 per cent of BAHA users). A high degree of satisfaction was expressed as regards sound amplification, listening to radio or television news, listening to music, speech perception in quiet conditions, during conversation with one person in noisy surroundings and conversation with family at home. Some degree of difficulty was expressed with the use of the BAHA during conversation with two or more people in noisy surroundings. A slow process of perceptual acclimatization was noticed with the majority of the patients. The majority of patients were pleased with the service as regards care of the wound, BAHA nursing clinics, device repairs and other service-related issues.

Adolescent↗