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Are men more depressed than women in Norway? Validity of the Hospital Anxiety and Depression Scale.

OBJECTIVE AND METHODS: The aim was to evaluate the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) by comparing the gender-specific scores with another self-rated measure of mental health (MH), the SF-12 Health Survey, in a large general population (N=16,116). RESULTS: Using a score of 8 as a cut-off point for depression, the odds ratio for depression among men versus women was 1.29 [P<.0001; 95% confidence interval (CI): 1.16-1.43]. This contrasted with the results from the SF-12, in which the women had markedly and significantly poorer scores than men did. The women also reported a higher use of medicine for depression. Two of the seven HADS-D questions, related to interest in personal appearance and the ability to enjoy television, radio, and books, explained 70% of the higher depression scores among men. CONCLUSION: The results suggest that the validity related to gender differences in HADS-D is highly questionable.

Adult↗

AIDS knowledge and attitudes in Iran: results from a population-based survey in Tehran.

A population-based study was conducted to investigate about AIDS knowledge and attitudes among the general public in Tehran, Iran. Using a short questionnaire a random sample of 1172 individuals aged between 15 and 65 years were interviewed. The mean age of the respondents was 34.8 (S.D. = 12.9) years, 52% were male and mostly married (70%), and had received secondary education or above (84%). The findings indicated that the respondents had a fairly good to excellent knowledge about AIDS. The correct answers ranged from 53% to about 99%. Also the results showed that the majority of the respondents were strongly agree or agree with the statement that people with AIDS should have social right to study or work (84%) or with the statement that AIDS is a public health problem (98.7%). The majority of the respondents (87%) said that the mass media including radio, television and newspapers were the main source of their information about HIV/AIDS. The findings from this study indicate that although misconception exist among Iranian about AIDS, in general they have fairly good knowledge and have positive attitudes towards AIDS and people with AIDS. Such findings suggest that prevention programs should be encouraged and these might have the potential role to limit the emergence of Iran's HIV/AIDS epidemic.

Acquired Immunodeficiency Syndrome↗

HCV infection in Poland.

BACKGROUND: Hepatitis C virus (HCV) infection is one of the most prevalent infectious diseases in the world. In 1997, hepatitis C became a statutorily noticeable disease in Poland. Nevertheless, to date, only a few notable studies on the prevalence of HCV infection have been carried out in Poland. Therefore, a study to determine the prevalence of HCV infection markers in an unselected population of Polish subjects was performed. METHODS: After several advertisements (in the print media and on television, radio, and other public media) concerning free testing for all volunteers in a hospital laboratory, serum samples of 2,561 subjects (765 men and 1,796 women), with a mean age of 43 years (range 1-88 years), were collected and assessed. In the samples, we first tested for the presence of IgG anti-HCV antibodies using the third generation enzyme immunoassay Anti-HCV EIA Cobas(R) Core Test (Hoffmann La Roche, Basel, Switzerland). The determination of HCV-RNA was then performed on anti-HCV IgG-positive samples by qualitative reverse transcription-polymerase chain reaction (RT-PCR) by automatic Cobas Amplicor (Roche Molecular Systems Hepatitis C Virus Test 2.0, Roche Molecular Systems, Nutley, NJ, USA). RESULTS: The presence of anti-HCV IgG was detected in a total of 48 cases (1.9%). Prevalence was significantly higher in men (2.3%) than in women (1.7%) (p = 0.0057), but was not significantly related to the subject's age (p = 0.51) or domicile (p = 0.35). The presence of HCV-RNA was detected in 31 (65%) anti-HCV-positive cases tested, with no significant relationship to either the age (p = 0.15), domicile (p = 0.24), or gender (p = 0.79) of the subjects. CONCLUSIONS: To the best of our knowledge, this is the largest study on the prevalence of HCV infection in the general population in Poland. The study has several limitations, such as, the use of a nonrandomized population. Nevertheless, the results obtained may be more realistic and applicable to the general population in Poland than those obtained previously (i.e., in voluntary blood donors).

Adolescent↗

[Symptoms experienced by people in vicinity of base stations: II/ Incidences of age, duration of exposure, location of subjects in relation to the antennas and other electromagnetic factors].

This is the 2nd part of a survey study conducted on 530 people (270 men, 260 women) living or not in vicinity of cellular phone base stations. Comparison of complaints frequencies for 16 Non Specific Health Symptoms was done with the CHI-Square test with Yates correction. Our results show significant increase (p < 0.05) in relation with age of subjects (elder subjects are more sensitive) and also, that the facing location is the worst position for some symptoms studied, especially for distances till 100 m from base stations. No significant difference is observed in the frequency of symptoms related to the duration of exposure (from < 1 year to > 5 years), excepted for irritability significantly increased after > 5 years. Other electromagnetic factors (electrical transformers, radio-television transmitters,...) have effects on the frequency of some symptoms reported by the subjects.

Adult↗

Contraceptive knowledge, attitude and practices of men in rural Maharashtra.

Since men are the dominant decision makers in India, it is prudent to discover the knowledge, perception, attitudes and contraceptive practices of men to improve their involvement in the reproductive health needs of families. Three thousand and seventy-two married men from a tribal Primary Health Centre (PHC) area in Thane district of Maharashtra State, India were surveyed with special emphasis on investigating the reasons for not accepting male methods. The majority of them not only had no concept of family spacing, but had not even taken any initiative to improve their knowledge or acceptance of condom/ vasectomy. Men who were aware of contraceptive methods had little knowledge of their correct use. Of the men, 53.7% had positive views about their role in family planning while 66.2% of men stressed the need to improve the acceptance of male methods by providing knowledge and information through sources such as radio, television, door-to-door campaigning and interpersonal communications. Thirty per cent emphasized the need to improve the availability and quality of services. This study indicates a pressing need for effective intervention strategies, both at the community and the clinic level, backed with efficient counselling, motivation and provision of services in rural and remote areas.

Adolescent↗

Foundation course for the Open University.

The Open University will take its first batch of students next January. In this article Dr Stannard discusses the thinking that has gone into the foundation course in science, and outlines some of the problems involved in adapting teaching techniques to make the best use of television, radio and correspondence courses.

Journal Article↗

Trust levels of physical activity information sources: a population study.

ISSUE ADDRESSED: To examine levels of trust for various sources of physical activity information. METHODS: Questions from a 2003 nationally representative survey (n=8,291), Obstacles to Action, relating to how much respondents would trust various sources of physical activity information, were examined. RESULTS: The most trusted source of physical activity information was the general practitioner (GP) and the least trusted source was the Internet. High levels of trust were also found for health organisations, dietitians and nurses, while low levels of trust were also found for television, radio, and print media. CONCLUSION: The primary care setting continues to be the most trusted source of physical activity information. Those more likely to trust their physician were older adults, those with chronic disease, and the insufficiently active.

Adult↗

Media interventions to promote responsible sexual behavior.

While the media have been used effectively to promote sexual responsibility in other countries for decades, few such opportunities have been seized in the United States. Mass media may be especially useful for teaching young people about reproductive health because elements of popular culture can be used to articulate messages in young people s terms, in language that won t embarrass them and may even make safe sex more attractive. Media can potentially change the way people think about sex, amidst cultural pressures to have sex at a young age, to have sex forcefully, or to have unsafe sex. Information can be communicated through a variety of channels--small media (e.g., pamphlets, brochures, and the Internet) and mass media--and in a variety of formats--campaigns, news coverage, and educational messages inserted into regular entertainment programming. Several international studies show that exposure to family planning messages through television, radio, and print media are strongly associated with contraceptive use. Domestically, safe sex media campaigns have been associated with increased teen condom use with casual partners, and reductions in the numbers of teenagers reporting sexual activity. Due to private ownership and First Amendment concerns, U.S. sexual health advocates have been working with the commercial media to incorporate subtle health messages into existing entertainment programming.

Adolescent↗

Social and psychological factors associated with willingness to test for HIV infection among young people in Botswana.

In spite of extensive campaigns to promote voluntary counselling and testing through the radio, television, newspapers and mass rallies, testing for HIV remains a challenge in Botswana. Using a representative sample of 1,294 students from secondary schools and tertiary institutions, the study investigates the effects of socio-demographic background variables, family coherence, interpersonal relations, sexual experience and knowledge about sexual health, on willingness to test for HIV infection. The results show that willingness to test for HIV infection was negatively associated with being sexually active and having a number of partners. Indicators of family, coherence, psychological bonding and personal adjustment such as common residence among parents, emotional support from the family attachment to parents, happiness with life in general and satisfaction with life as a student were associated with willingness to test. The importance of sexual activity, number of partners, happiness with life in general, level of attachment to father and physical fights with other children were identified as the social and psychological predictors of willingness to test for HIV using multiple logistic regression. The study highlights the importance of continued education about voluntary counselling and testing among sexually active young people, especially those from poorer backgrounds in rural areas.

Adolescent↗

Communicating health information to an alarmed public facing a threat such as a bioterrorist attack.

Considerable literature exists on the communication of risk to the public through channels such as television, radio, and newspapers. However, little has been written on the communication of risk through less traditional communication forms, such as the Internet. The purpose of this study was to investigate the role of the Internet as an additional source of health information to that provided by the traditional news media in managing the public's response to an emerging health risk such as a bioterrorist attack. Despite some of the Internet's advantages over traditional media, including the depth and speed in which information can be conveyed to different audiences, the Internet was underutilized during fall 2001, when it became important to convey information on the risks of anthrax. A number of developments are required if the health care system is to capitalize on the Internet's potential as a risk communication device. These developments include research into public Internet searching behavior and further development in the role of search engines and government agencies in organizing quality health information.

Anthrax↗

Impacts from repeated mass media campaigns to promote sun protection in Australia.

Campaigns using television, radio and print media were conducted over three summers in New South Wales, Australia, aiming to increase the use of sun protection measures among children under 12 years. The evaluation entailed cross-sectional telephone surveys before and after each of the first two campaigns and following the third campaign. The study group were parents of children under 12 years. Random digit dialling yielded samples of approximately 800 for each survey. Measures addressed campaign recall and sun protection knowledge, attitudes and behaviours. The surveys revealed significant levels of campaign recall. Knowledge about the protective benefits of sunscreens, hats and protective clothing was high at baseline and showed little improvement over the campaigns. Knowledge levels about the benefits of shade cover and of the relative risks of skin cancer from childhood sun exposure were lower, and also did not show improvement. Just one of the four attitude factors showed significant improvement, and this concerned the importance that parents placed on the issue of child sun protection. After the final campaign there were increases compared with baseline in childrens' use of sunscreen, protective clothing and shade, but it was notable that between campaigns levels of these behaviours were similar to or below those at baseline. There was no evidence of a campaign-related increase in hat wearing by children. All sun protection measures were used less often by adults than children, but these showed similar trends. Mass media campaigns may contribute to short-term increases in some sun protection behaviours; however, as their impact is not sustained they should be repeated and supplemented by educational, policy and environmental strategies.

Adult↗

Evaluation of a national programme to reduce inappropriate use of antibiotics for upper respiratory tract infections: effects on consumer awareness, beliefs, attitudes and behaviour in Australia.

The over-use of antibiotics, in particular, inappropriate use to treat upper respiratory tract infections (URTIs), is a global public health concern. In an attempt to reduce inappropriate use of antibiotics for URTIs, and, in particular, to modify patient misconceptions about the effectiveness of antibiotics for URTIs, Australia's National Prescribing Service Ltd (NPS) has undertaken a comprehensive, multistrategic programme for health professionals and the community. Targeted strategies for the community, via the NPS common colds community campaign, commenced in 2000 and have been repeated annually during the winter months. Community strategies were closely integrated, using the same tagline, key messages and visual images, and were delivered in numerous settings including general practice, community pharmacy, child-care centres and community groups. Strategies included written information via newsletters and brochures, mass media activity using billboards, television, radio and magazines and small grants to promote local community education. The evaluation used multiple methods and data sources to measure process, impact and outcomes. Consistent with intervention messages, the integrated nationwide prescriber and consumer programme is associated with modest but consistent positive changes in consumer awareness, beliefs, attitudes and behaviour to the appropriate use of antibiotics for URTIs. These positive changes among the community are corroborated by a national decline in total antibiotic prescriptions dispensed in the community (from 23.08 million prescriptions in 1998-99 to 21.44 million in 2001-02) and, specifically, by a decline among the nine antibiotics commonly used for URTI such that by 2003 nationally 216,000 fewer prescriptions for URTI are written each year by general practitioners.

Anti-Bacterial Agents↗

How do people with intellectual disabilities think about empowerment and information and communication technology (ICT)?

Several studies from the 1990s show that information and communication technology (ICT) can be important for people with intellectual disabilities, although later results have queried what importance technology can have in increasing the influence and participation of this group. This article presents the results from a study of people with moderate and mild intellectual disabilities and their view of issues related to empowerment and ICT. Data were collected through a study of original sources, participation observation, a group interview and four in-depth interviews with people with mild intellectual disabilities. Results show that respondents feel that it is important to be able have an influence on issues concerning work, housing, leisure time and social relationships. The way one views one's own ability to influence and control situations depends on individual self-esteem, social networks, previous experience and knowledge; the participants' coping skills also depend on these factors to a great extent. The ten participants who were interviewed had experience with ICT and felt that it was useful and enjoyable in a variety of ways concerning their studies, work and, for some, even their leisure time. Computers were used to gather information, to communicate with the surrounding world, to shop, for creative activities and for games. The respondents used media, such as television, radio, music systems and daily papers, for recreation and to gain information and knowledge.

Adult↗

Effects of a traditional lifestyle on the cardiovascular risk profile: the Amondava population of the Brazilian Amazon. Comparison with matched African, Italian and Polish populations.

OBJECTIVE: To determine the relationships between lifestyle and cardiovascular risk factors among the Brazilian Amondava, one of the world's most isolated populations. DESIGN: Cross-sectional, population-based study. Four age- and sex-matched samples from Brazil Africa, Italy and Poland, representing different levels of modernization, were compared. Body weight, height, blood pressure, serum cholesterol and glycaemia were measured, and a standard questionnaire administered. Data concerning dietary habits and physical activity were collected. A personal socio-economic score was calculated, on the basis of type of economy, level of formal education, type of occupation, type of habitat, availability of piped water and electricity, main source of income, housing conditions, availability of radio, television or personal computer, knowledge of a second language, and organized health facilities. SETTING: Primary epidemiological screening, at an institution. RESULTS: Among the Amondava blood pressure was always <140/90 mm Hg, it did not increase with age and was not correlated with any other variable; 46.6% of subjects had systolic blood pressure <100 mm Hg. Blood pressure among the Amondava (109.6+/-11.1/69.5+/-6.4 mm Hg) was on average lower (P<0.0001) than in all other samples. Among the Amondava, the concentration of total cholesterol was always <200 mg/dl, i.e. similar to that of Africans whose diet included large amounts of vegetable foodstuffs; 90% had glycaemia (<80 mg/dl), and their mean value was the lowest (55.1+/-14.9 mg/dl) of all the groups. CONCLUSIONS: In addition to a possible genetic predisposition not analysed in this study, a traditional lifestyle (no contact with civilization, diet based on complex carbohydrates and vegetables, high energy expenditure) may protect against the development of hypertension, hypercholesterolaemia, and diabetes.

Adolescent↗

Psychotherapy as adjunct in treatment of vomiting during pregnancy.

Adjunctive psychotherapeutic measures were used to treat ten consecutive pregnant women referred to a psychiatric consultation service because of severe intractable vomiting. In addition to customary medical measures, they received three types of psychotherapy: (1) supportive psychotherapy (establishment of positive relationship, frequent reassuring conversations, and encouragement of expression of thoughts and feelings); (2) hypnotherapy (trance induction and suggestions of comfort in the gastrointestinal tract, desirability of feeling of substance in stomach, and ability to retain and digest food eaten); and (3) behavior modification (positive reinforcement for retaining food and gaining weight, through granting desirable considerations such as visitors, radio, television, and being up in or outside the room). Results were encouraging. Nine patients recovered and completed normal pregnancies, while one improved but later aborted due to other complications. When compared with a control group of routinely treated patients, recovery was more rapid.

Adolescent↗

Comparison of media for dissemination of information about cancer in rural communities.

A study was done in Orangeburg County, South Carolina, to compare the effectiveness of the various mass media--television, radio, and newspaper--for the dissemination of educational material about cancer. Effectiveness of these media in reaching certain subpopulations defined by race, sex, income, and population density was also examined. The newspaper was found to be generally more effective than other media. This superiority held for almost all subpopulations. Furthermore, it was found that certain subpopulations differed from others in the extent to which they were reached by a particular medium.

Adult↗

Expectations and needs of persons with family members in an intensive care unit as opposed to a general ward.

The positive effect of family support on the outcome from serious illness that requires intensive care has been recognized by clinicians for decades. We have all seen that family visitation and an intensive care environment more similar to that of a general ward (sunlight, radio, television) can benefit patients with psychosis related to intensive care. The severity of illness of the individual patient exerts a powerful stress on the family unit, but it has been difficult to measure this effect. We used a 40-question family needs survey with a degree of importance scale to compare the intensive care unit (ICU) with the general ward in terms of impact on the family. Five needs were found to discriminate these two environments. The family members of patients in an ICU considered it very important (1) for staff to give directions on what to do at the bedside, (2) to receive more support from their own family unit, (3) to have a place to be alone as a family unit in the hospital, (4) to be informed in advance of any transfer plan, and (5) to have flexibility in the time allowed for visitation. Family members are willing to accept decreased visitation time if the physicians and nurses can equate this decrease with the complexity of care in the ICU. The results of this survey have helped us modify and individualize our approach based on family expectations especially when patients are transferred from the general ward to the ICU or from the ICU to the ward.

Adult↗

Deaf community analysis for health education priorities.

Deaf persons' access to health-related information is limited by barriers to spoken or written language: they cannot overhear information; they have limited access to television, radio, and other channels for public information; and the average reading level of Deaf adults is at a 3rd to 4th grade level. However, literature searches revealed no published reports of community analysis focusing specifically on health education priorities for Deaf communities. A seven-step community analysis was conducted to learn the health education priorities in Arizona Deaf communities and to inform development of culturally relevant health education interventions in Deaf communities. The word "Deaf" is capitalized to reflect the cultural perspective of the Deaf community. A 14-member Deaf Health Committee collected data using multimethods that included review of state census data, review of national health priorities, key informant interviews, discussions with key community groups, a mail survey (n = 20), and semistructured interviews conducted in sign language with 111 Deaf adults. The community diagnosis with highest priority for health education was vulnerability to cardiovascular disease (CVD). Following completion of the community analysis, a heart-health education intervention (The Deaf Heart Health Intervention) was developed using a train-the-trainer, community health worker model. If this model proves to be effective in addressing vulnerability to CVD, then a similar protocol could be employed to address other health concerns identified in the Deaf community analysis.

Adolescent↗