Press responses to the presence of free-living Wild Boar (Sus scrofa) in southern England

Wildlife management and conservation programmes are likely to attract media attention, especially when the programmes in question involve large mammals. The present study surveyed the response of the press (national and local newspapers, and magazines) to the existence of two populations of free‐living Wild Boar (Sus scrofa) that established in southern England in the early 1990s, following the escape of animals from captivity. One‐hundred and seven target articles from 46 different titles were searched for references to 18 separate issues related to topics such as agricultural damage, risk to humans and ecological impact. The presence of free‐living Wild Boar in the English countryside attracted predominantly negative press coverage: the issues most frequently raised by newspaper and magazine articles were that the animals constitute a danger to the public, damage agricultural crops, predate livestock and transmit disease. A minority of articles argued that the animals should be conserved, mainly on the grounds that they could be hunted for meat. There was relatively little coverage of environmental issues, and what there was tended to focus on detrimental effects of Wild Boar on native flora and fauna. We conclude that management and conservation programmes involving large, allegedly dangerous mammals are likely to encounter an adverse press reaction. This is something that the organizers of such programmes may need to take into account when predicting public attitudes.     

Professional and popular views of chronic fatigue syndrome.

OBJECTIVE--To study the coverage of the chronic fatigue syndrome in the popular and professional press. DESIGN--Search of all original research papers on the chronic fatigue syndrome published in British journals from 1980 onwards and of professional trade papers, national newspapers, and women''s magazines. Interviews with six medical journalists. SETTING--British scientific, medical, and popular press. RESULTS--37 (49%) articles in research journals did not favour organic causes and 23 (31%) favoured organic causes. By contrast 31 (55%) articles in the medical trade press and 118 (69%) in national newspapers and women''s magazines favoured organic causes. CONCLUSIONS--Press coverage of chronic fatigue syndrome has amplified and distorted divisions in the research community concerning the chronic fatigue syndrome. Articles in the press concentrate on a simple medical model of illness reinforcing the stigma of psychological illness and dissatisfaction with traditional medical authority.     

The early conception factor (ECF) lateral flow assay for non-pregnancy determination in the mare

The horse early conception factor (ECF) test is designed for qualitative determination of the ECF glycoprotein in the mare that has conceived. The objectives of this study were to determine the performance of the horse ECF test for the detection of the non-pregnant mare, and to determine the agreement among subjects or "readers" regarding the interpretation of the test. Blood samples from 60 mares were collected on Days 0, 5, 8, 11 and 18 following ovulation. Pregnancy status diagnosed with the ECF test was compared (2 x 2 table) to pregnancy status diagnosed by palpation per rectum and ultrasound examination on Day 18 following ovulation. Three readers interpreted the ECF test outcome independently. Two laboratories independently interpreted the ECF test outcome from the same serum samples. Agreement was tested by kappa coefficient. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy ranged from 0.74 to 0.84, 0.14 to 0.33, 0.62 to 0.66, 0.33 to 0.44 and 0.57 to 0.60, respectively. Agreement between readers was substantial (0.60相似文献   

Imaging Non-Specific Wrist Pain: Interobserver Agreement and Diagnostic Accuracy of SPECT/CT,MRI, CT,Bone Scan and Plain Radiographs

Purpose

Chronic hand and wrist pain is a common clinical issue for orthopaedic surgeons and rheumatologists. The purpose of this study was 1. To analyze the interobserver agreement of SPECT/CT, MRI, CT, bone scan and plain radiographs in patients with non-specific pain of the hand and wrist, and 2. to assess the diagnostic accuracy of these imaging methods in this selected patient population.

Materials and Methods

Thirty-two consecutive patients with non-specific pain of the hand or wrist were evaluated retrospectively. All patients had been imaged by plain radiographs, planar early-phase imaging (bone scan), late-phase imaging (SPECT/CT including bone scan and CT), and MRI. Two experienced and two inexperienced readers analyzed the images with a standardized read-out protocol. Reading criteria were lesion detection and localisation, type and etiology of the underlying pathology. Diagnostic accuracy and interobserver agreement were determined for all readers and imaging modalities.

Results

The most accurate modality for experienced readers was SPECT/CT (accuracy 77%), followed by MRI (56%). The best performing, though little accurate modality for inexperienced readers was also SPECT/CT (44%), followed by MRI and bone scan (38% each). The interobserver agreement of experienced readers was generally high in SPECT/CT concerning lesion detection (kappa 0.93, MRI 0.72), localisation (kappa 0.91, MRI 0.75) and etiology (kappa 0.85, MRI 0.74), while MRI yielded better results on typification of lesions (kappa 0.75, SPECT/CT 0.69). There was poor agreement between experienced and inexperienced readers in SPECT/CT and MRI.

Conclusions

SPECT/CT proved to be the most helpful imaging modality in patients with non-specific wrist pain. The method was found reliable, providing high interobserver agreement, being outperformed by MRI only concerning the typification of lesions. We believe it is beneficial to integrate SPECT/CT into the diagnostic imaging algorithm of chronic wrist pain.     

A rural emergency department.

The appropriate use of emergency departments is of growing concern. By knowing which patients are more likely to make inappropriate visits to these departments, efforts can be directed to encourage more suitable care. Our study was done in a rural county hospital in eastern New Mexico. Data were collected from all emergency department visits over a 4-week period. Patient and physician questionnaires were administered to assess aspects of emergency department use, including appropriateness based on published criteria, physicians'' opinion of appropriateness, groups who made inappropriate visits, and the perception of the need for and the urgency of a visit. We found that 32% of visits were inappropriate based on published criteria and 24% were considered inappropriate by physician opinion. Two groups with a high rate of inappropriate visits were Hispanics and Medicaid recipients. Patients and physicians have differing opinions of the urgency of a visit and of how soon medical treatment is required. To decrease the frequency of inappropriate use of emergency departments, educational efforts should be focused on the subgroups with high rates of such use.     

《蛇志》文章2年回顾分析

本文对《蛇志》1989、1990两年8期所刊载的文章进行了统计分析.结果表明:两年来共开辟栏目24个、刊载文章344篇,其中专业性学术文章157篇(45.6%),其他文章187篇(54.4%)。157篇学术文章中来源于县级以下医疗单位41篇(26.1%)、省市级以上医疗单位60篇(38.2%)、部队及其他单位56篇(35.7%)。平均编辑过程119.2天。《蛇志》创刊两年来,坚持了正确的办刊宗旨、突出了“蛇”的特色、栏目众多、图文并茂,溶知识性、趣味性于一体。可读性强.真正填补了我国科技领域中关于蛇类知识的空白。同时笔者建议,今后要更进一步地面向基层、面向农村,多刊登专业性学术文章,使作为我国唯一介绍蛇类知识的综合性刊物——《蛇志》办得更好。     

Implantable Cardioverter Defibrillators in Octogenarians: Clinical Outcomes From a Single Center

AimsLimited data exist on outcomes in very elderly ICD recipients. We describe outcomes in new ICD and Cardiac Resynchronisation Therapy with Defibrillator (CRT-D) implants in octogenarians at our institution.MethodsPatients aged 80 years and above who underwent de novo ICD or CRT-D implantation from January 2006 to July 2012 were identified. Clinical data were collected from the procedural record, medical and ICD notes. Baseline characteristics were compared using independent sample t test for continuous variables and Fisher’s exact test for categorical variables. Kaplan-Meier curves were constructed.ResultsTen per cent of all new ICD/CRT-D implants were aged 80 years and over. Median age was 83.0 years. Median follow-up was 29 months. Death occurred in 17 (34%). Median time to death was 23 months. Three deaths (6%) occurred within 12 months of ICD implantation. Appropriate therapy (ATP or shock) occurred in 19 (38%). Inappropriate therapy occurred in 6 (12%).Rates of appropriate shocks and inappropriate therapy (shocks and ATP) and significant valvular incompetence were higher amongst deceased patients (P=0.03 OR 5.9 95% CI 1.3-27) and (P=0.02 OR 12 95% CI 1.3-112). Univariate analysis identified diuretic use (P=0.008 95% C.I. 0.05 to 0.63) and appropriate shock (P= 0.025 95% C.I. 1.25 to 26.3) as predictors of mortality.ConclusionOctogenarians make up a small but increasing number of ICD recipients. This study highlights high survival rates at one year with acceptable rates of appropriate and inappropriate device therapy. Ongoing debate regarding the appropriateness of ICD in very elderly patients is warranted.Key words: sudden cardiac death, implantable defibrillators, octogenarians     

Portrayal of the Human Resource Crisis and Accountability in Healthcare: A Qualitative Analysis of Ugandan Newspapers

Background

Uganda is one of the 57 countries with a critical shortage of health workers. The aim of this study was to determine how the human resources and health service crisis was covered in Ugandan newspapers and, in particular, how the newspapers attributed accountability for problems in the health services.

Methods

We collected all articles related to health workers and health services for the calendar year 2012 in the two largest national newspapers in Uganda (collection on daily basis) and in one local newspaper (collection on weekly basis). These articles were analysed qualitatively regarding the main themes covered and attribution of accountability.

Results

The two more urban national newspapers published 229 articles on human resources and health services in Uganda (on average over two articles per week), whereas the local more rural newspaper published only a single article on this issue in the 12 month period. The majority of articles described problems in the health service without discussing accountability. The question of accountability is raised in only 46% of articles (106 articles). The responsibility of the government was discussed in 50 articles (21%), and negligence, corruption and misbehaviour by individual health workers was reported in 56 articles (25%). In the articles about corruption (n=35), 60% (21 articles) mention corruption by health workers and 40% (14 articles) mention corruption by government officials. Six articles defended the situation of health workers in Uganda.

Conclusions

The coverage of accountability in the Ugandan newspapers surveyed is insufficient to generate informed debate on what political actions need to be taken to improve the crisis in health care and services. There exists not only an “inverse care law” but also an “inverse information law”: those sections of society with the greatest health needs and problems in accessing quality health care receive the least information about health services.     

Critical review of articles regarding pregnancy exposures in popular magazines

To determine the scope of teratogen information available to the public through the media, a survey of 15 popular magazines was conducted. All 1985 issues of the selected magazines were reviewed for articles addressing pregnancy exposure concerns, yielding 56 articles from 10 magazines. The remaining 5 publications provided no pertinent articles. Two health professionals, both experienced teratology counselors, independently rated each article for accuracy of content and quality of presentation based on standardized evaluation criteria. The findings were compared and agreement for all criteria in each article was reached by the 2 reviewers. Regarding the quality of the information in the 56 articles, 31 (55.4%) were scored as misleading or inaccurate. On examination of overall presentation, 26 (46.4%) were rated as alarming and 8 (14.3%) presented a false sense of security; 22 (39.3%) provided a balanced presentation. A review of the types of articles rated revealed 19 (33.9%) general overviews of pregnancy issues, 18 (32.1%) news stories, 17 (30.4%) question-and-answer columns, and 2 (3.6%) feature stories. Of the reviewed papers, 7 (12.5%) included a citation from which the primary data could be obtained and only 14 of the articles (25%) suggested that the reader contact her/his healthcare provider regarding the issues. We conclude that the information available in popular magazines regarding exposures in pregnancy is frequently misleading, alarming, and unsupported by the scientific literature.     

The Evidence Based Medicine approach to diagnostic testing: practicalities and limitations

Evidence-Based Medicine (EBM) has become a popular approach to medical decision making and is increasingly part of undergraduate and postgraduate medical education. EBM follows four steps: 1. formulate a clear clinical question from a patient's problem; 2. search the literature for relevant clinical articles; 3. evaluate (critically appraise) the evidence for its validity and usefulness; 4. implement useful findings into clinical practice. This review describes the concepts, terminology and skills taught to attendees at EBM courses, focusing specifically on the approach taken to diagnostic questions. It covers how to ask an answerable clinical question, search for evidence, construct diagnostic critically appraised topics (CATs), and use sensitivity, specificity, likelihood ratios, kappa and phi statistics. It familiarises readers with the lexicon and techniques of EBM and allows better understanding of the needs of EBM practitioners.     

Media Coverage of Medical Journals: Do the Best Articles Make the News?

Background

News coverage of medical research is followed closely by many Americans and affects the practice of medicine and influence of scientific research. Prior work has examined the quality of media coverage, but no investigation has characterized the choice of stories covered in a controlled manner. We examined whether the media systematically covers stories of weaker study design.

Methods

We compared study characteristics of 75 clinically-oriented journal articles that received coverage in the top five newspapers by circulation against 75 clinically-oriented journal articles that appeared in the top five medical journals by impact factor over a similar timespan. Subgroup analysis was performed to determine whether differences between investigations from both sources varied by study type (randomized controlled trial [RCT] or observational study).

Results

Investigations receiving coverage from newspapers were less likely to be RCTs (17% vs. 35%, p = 0.016) and more likely to be observational studies (75% vs. 47%, p<0.001). No difference was observed in number of people studied (median: 1034 vs. 1901, p = 0.14) or length of follow-up (median: 1.80 vs. 1.00 years, p = 0.22). In subgroup analysis, observational studies from the media used smaller sample sizes (median: 1984 vs. 21136, p = 0.029) and were more likely to be cross-sectional (71% vs. 31%, p<0.001), while no differences were observed for RCTs.

Conclusions

Newspapers were more likely to cover observational studies and less likely to cover RCTs than high impact journals. Additionally, when the media does cover observational studies, they select articles of inferior quality. Newspapers preferentially cover medical research with weaker methodology.