Editorial: When news in the Journal is news.
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One hundred patients on four general surgical wards in a large teaching hospital were interviewed about the information they had received about their illness and what they had been told about the investigations they had undergone. Fifty-five of them expressed some dissatisfaction and 14 were strongly dissatisfied. The way in which ward rounds were conducted was heavily criticised, but most patients did not object to the teaching of medical students at the bedside. Twenty-four patients would have liked more explanation about why investigations were performed, and 38 though that they had not been told enough about the results of their investigations. This lack of information led to anxiety and fear. The findings suggest that more effort is needed to improve communication between doctors and patients.
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OBJECTIVE: Media portrayals of people with mental illness have the power to mitigate or perpetuate stigma related to mental health. This study aimed to investigate reported real-world exposure to news media portrayals about people with mental health problems in the past 12 months and the impact of these. METHODS: Data were from a nationally representative survey of 6032 Australians exploring attitudes towards people with mental health problems. Participants were asked about their exposure to positive news stories about a person with a mental health problem, as well as negative portrayals, in which someone was harmed by a person with a mental health problem. Further questions covered the sources (traditional or social media) and impact of these exposures. RESULTS: Regression models were used to explore sociodemographic predictors of impact. Most participants reported exposure to negative news portrayals (68.4%, 95% confidence interval = [66.9, 69.8]), while fewer reported exposure to positive news stories (33.7%, 95% confidence interval = [32.3, 35.2]). Most people exposed to the negative news stories reported a negative impact (69.0%, 95% confidence interval = [67.2, 70.7]), and most exposed to positive news stories reported a positive impact (80.2%, 95% confidence interval = [77.6, 82.5]). Age and gender were associated with reported impact but not lived experience of mental illness. CONCLUSIONS: Exposure to negative news stories about mental health problems was prevalent. Given their impact on news audiences broadly, negative news stories need to be accurate and responsible to mitigate negative impacts. A renewed focus on generating and promoting positive and stigma-challenging news stories is needed to increase subsequent positive impacts.
OBJECTIVES: This systematic review aimed to both determine whether educational interventions improve medical students' ability and/or confidence in Bad News Communication (BNC), as well as assess the relative efficacy of instructional formats. METHODS: Performed according to the PRISMA guidelines, four databases were searched for articles describing education-based interventions to improve medical student's BNC ability and/or confidence, published in English between 2001 and 2024. Data on students' self-reported or observer-assessed level of competence/ability in BNC (primary outcome), and students' self-assessed confidence in BNC skills (secondary outcomes), were analysed. Meta regression explained the influence of several categorical moderators on heterogeneity in relation to intervention effects on competence/ability. RESULTS: 27 studies met the criteria for inclusion in the systematic review and 17 studies for the meta-analysis. Interventions described in controlled studies were associated with a moderate and significant increase in BNC ability (13 data sets; standardized mean difference [SMD] = 1.09, 95% CI = 0.52 - 1.66). Interventions detailed in pre-post design studies were associated with a significant increase in BNC ability (20 data sets; SMD = 0.92, 95% CI = 0.52 - 1.32), and student confidence/comfort in their BNC skills (12 data sets; SMD = 1.16, 95% CI = 0.57 - 1.75). Subgroup analysis demonstrated better skills/competence outcomes in studies that included simulation-based training (SBT). CONCLUSIONS: Educational interventions improve the BNC ability and confidence of medical students. Interventions should include an SBT element as this leads to greater improvements in BNC ability. Further research is needed to determine to what extent these interventions translate to positive patient outcomes. PRACTICE IMPLICATIONS: Diverse educational programme, especially those including simulation-based training, are effective in improving BNC skills, although the longetivity of these improvements is at present unclear. Therefore, we recommend that refresher courses or practice opportunities should be scheduled throughout students' medical education to ensure retention of BNC skills.
In the configuration used, the Hydron sponge did not enhance the ingrowth of bone into the Dacron for prosthesis anchorage. In fact, the presence of the Hydron seemed to retard such ingrowth, even though there was bony incorporation of portions of the Hydron polymer. Fixation was more rigid when Dacron was implanted bare. Hydron sponge does not appear to remain intact within a joint. It would not seem suitable for intra-articular protection of a prosthesis or local delivery of antibiotics here. We did not search further for the polymer in the regional lymph nodes. Hydron sponge is capable of eleciting an unusual phenomenon of woven bone formation. This is "good news" for its potential, but realization of such potential will certainly require additional study. Double and triple interval fluorochrome labelling would be especially helpful in further studying the localization and rate of this bone formation.
A medical center is using a monthly videotaped television news program to effectively inform its departments and personnel about one another, to provide them with special recognition, and to help nurture their esprit de corps. For these reasons, staff participation, especially by nonsupervisory personnel, both in producing and in appearing on the program is emphasized.
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Two recent reports have rendered psychiatric research a great service in acknowledging the serious problem under which this research has been laboring and by making recommendations for improved functioning. The President's Biomedical Research Panel is the first high-level government body to take note of what it has felicitously called the "precipitous decline" in research support of the National Institute of Mental Health. Its recommendations of a greatly strengthened research advisory capability of the Alcohol, Drug Abuse, and Mental Health Administration Institutes effectively complements its recommendations for increased funding of these institutes. The Committee on Biomedical Research in the Veterans Administration, noting the "severely limited" support of research on the VA's massive problem of mental illness, proposed a series of specific recommendations for an improved and expanded research effort.
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