Increasing Intention to Comply with Pharmaceutical Product Instructions: An Exploratory Study Investigating the Rolesof Frame and Plain Language

ABSTRACT

Purpose: The purpose of this study was to describe the coverage and portrayal of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) risk factors as framed in newspapers targeting Aboriginal (First Nations, Métis, and Inuit) peoples in Canada.

Methods: From a sample of 31 Aboriginal newspapers published in English from 1996 to 2000, 14 newspapers were randomly selected. Of the 167 articles published on HIV/AIDS during this time period, all anecdotal (n = 34) and an approximate 25% random sample of scientific (n = 32) articles were analyzed using both quantitative (coding reliability and frequencies) and qualitative (in-depth content analysis) analyses.

Results: Individual risk factors for HIV/AIDS were described in 74% (49/66) of the articles and included unprotected sexual intercourse (20/49 or 41%), sharing of needles for injection drug use (IDU; 16/49 or 33%), infected blood transfusions (3/49 or 6%), and vertical transmission from mother to baby (10/49 or 20%). Additional risk factors of alcohol use and poverty were mentioned in 29% and 25% of the articles. In addition to the well-recognized HIV/AIDS risk groups of prostitutes and homosexual men, sexual abuse victims, prisoners, and women were identified in Aboriginal newspapers as being at risk. Although Aboriginal women were identified as being at high risk, the newspaper coverage also emphasized their lack of knowledge regarding HIV/AIDS. Heterosexual men were not mentioned as being at risk for HIV/AIDS in the newspaper articles.

Background: The prevalence of HIV/AIDS is higher among Canadian Aboriginals than in the general population. Local and community newspapers are an important channel for the dissemination of health information for isolated, rural, and Aboriginal communities.

Interpretation: The findings show that Aboriginal media identify high-risk groups and individualistic risk factors for HIV/AIDS, within a public health perspective. The articles also emphasize, however, Aboriginal people's lack of knowledge about disease transmission and the full spectrum of who is at risk.     

CD44 IS AN INDEPENDENT PROGNOSTIC FACTOR IN CONVENTIONAL RENAL CELL CARCINOMAS

PURPOSE: CD44 is a transmembrane glycoprotein involved in cell-cell and cell-matrix interactions. De novo expression of CD44 and its variant isoforms has been associated with aggressive behavior in various tumors. Since few data are available concerning the role of CD44 in the biological behavior of locally confined renal tumors, we analyzed the expression of CD44 in a large set of conventional renal cell carcinomas to determine its prognostic value in association with other clinicopathologic variables. MATERIALS AND METHODS: Ninety-one patients with locally confined conventional renal cell carcinomas were studied. CD44 standard form (CD44H) and v6 isoform expressions were semiquantitatively evaluated on paraffin-embedded tumor tissue by immunohistochemistry. The prognostic value of the usual clinicopathological variables and CD44 expression was tested using Kaplan-Meier plots by the log rank test and Cox multiple hazard regression analysis. RESULTS: No immunostaining was observed in normal renal tissue. Thirty-two of the 66 conventional renal cell carcinomas (48%) showed CD44H membranous staining of the tumor cells. Only 2 cancers displayed CD44v6 immunostaining. Among the different clinicopathological variables analyzed, tumor stage (p = 0.001), nuclear grade (p = 0.01), size (p = 0.02), vascular (p = 0.05) and perirenal adipose tissue invasion (p = 0.005), and CD44H expression (p = 0.01) were found to be significant prognostic parameters for survival using univariate analysis. Moreover, multivariate analysis indicated stage, nuclear grade and CD44 expression as independent prognostic factors both for overall and disease-free survival. CONCLUSION: CD44 can be considered as a useful prognostic parameter in conventional renal cell carcinoma and may be used in evaluation of the outcome of these tumors.     

Low-Energy Impedance-Compensating Biphasic Waveforms Terminate Ventricular Fibrillation at High Rates in Victims of Out-of-Hospital Cardiac Arrest

Biphasic Waveform Defibrillation. Introduction : New automatic external defibrillators (AEDs), which are smaller, lighter, easier to use, and less costly make the goal of widespread AED deployment and early defibrillation for out-of-hospital cardiac arrest feasible. The objective of this study was to observe the performance of a low-energy impedance-compensating biphasic waveform in the out-of-hospital setting on 100 consecutive victims of sudden cardiac arrest.
Methods and Results : AEDs incorporating a 150-J impedance-compensating biphasic waveform were used by 12 EMS systems. Data were obtained from the AED PC card reporting system. Defibrillation was defined as conversion to an organized rhythm or to asystole. Endpoints included: defibrillation efficacy for ventricular fibrillation (VE); restoration of an organized rhythm at the time of patient transfer to an advanced life support (ALS) team or to the emergency department (ED); and time from AED power-on to first defibrillation. The AED correctly identified 44 of 100 patients presenting in VE as requiring a shock (100% sensitivity) and 56 of 100 patients not in VF as not requiring a shock (100% specificity). The time from 911 call to first shock delivery averaged 8.1 ± 3.0 minutes. A single 150-J biphasic shock defibrillated the initial VE episode in 39 of 44 (89%) patients. The average time from power-on to first defibrillation was 25 ± 17 seconds. At patient transfer to ALS or ED care, an organized rhythm was present in 34 of 44 (77%) patients presenting with VF. Asystole was present in 7 (16%) and VE in 3 (7%).
Conclusions : Low-energy impedance-compensating biphasic waveforms terminate long-duration VE at high rates in out-of-hospital cardiac arrest. Use of this waveform allows AED device characteristics consistent with widespread AED deployment and early defibrillation.     

Histological demonstration and frequency of intrahepatocytic copper in patients suffering from alcoholic liver disease

This study was carried out to determine whether stainable copper accumulates in the hepatocytes of patients with alcoholic liver disease. Liver sections from 44 cases of alcoholic cirrhosis and 32 cases of non-cirrhotic alcoholic liver disease were stained by the rubeanic acid, rhodanine and orcein methods. Intrahepatocytic copper granules were found in 13 cases of cirrhosis (30%), but in none of the non-cirrhotic livers. The abundance of granules did not appear to be related either to the activity of the cirrhotic process or to the presence of cholestasis. It may well be that alcoholic cirrhosis is the most common disease associated with excess of intrahepatocytic copper.     

A collaborative study on RAST inhibition using a common method

A collaborative study was carried out to determine the reproducibility of the inhibition form of the radioallergosorbent test (RAST). Seven laboratories were provided with three coded extracts of cocksfoot (Dactylis glomerata) pollen. All laboratories used a common method of RAST inhibition and were supplied with all reagents required to carry out the assays. In addition, four laboratories used local methods of RAST inhibition. Potency estimates were in reasonable agreement between laboratories when the study method was used but insufficient data were available to assess reproducibility when local methods were used. Two extracts prepared from the same source material were found to have parallel log dose-response lines but the line for the unrelated extract was steeper in all but one of the assays. This finding was an indication that the third extract differed qualitatively from the other extracts. It was concluded that the use of a study method of RAST inhibition resulted in good agreement between potency estimates obtained by different laboratories.     

A randomized study comparing timolol and methyldopa in hospital treatment of puerperal hypertension

Summary. Treatment of puerperal hypertension (diastolic blood pressure 95–105 mm Hg) with methyldopa 750–3000 mg/day was compared with treatment with timolol 15–60 mg/day in a random trial of 80 patients. Within these dose ranges and over the period studied (9 days) both drugs appeared equally effective. Therefore, in the treatment of puerperal hypertension, timolol could be considered as a suitable alternative to methyldopa.     

Seasonal changes in human hair growth

Various parameters of hair growth were determined every 28 days for 18 months in 14 healthy Caucasian men aged 18-39 with indoor occupations in Sheffield, U.K. (latitude 53.4 degrees N). In the scalp the proportion of follicles in anagen reached a single peak of over 90% in March, and fell steadily to a trough in September. The number of shed hairs reached a peak around August/September, when least follicles were in anagen. At this time the average loss of hairs was about 60 per day, more than double that during the preceding winter. The rate of growth of the beard was lowest in January and February and increased steadily from March to July to reach a peak about 60% above the winter level. The rate of growth of thigh hair showed a similar pattern though with less pronounced differences. No seasonal fluctuations in finger- or toenail growth were detected.     

Basal cell carcinomatous changes on the lower leg: a possible association with chronic venous stasis

Twenty-one patients are reported who developed basal cell carcinomas on the lower leg. The commonest presentation was of a chronic 'stasis' ulcer which usually occurred at atypical sites. It is suggested that the development of basal cell carcinoma changes on the lower leg is a not infrequent complication of chronic venous stasis.