Medicalization, markets and consumers.

This paper examines the impact of changes in the medical marketplace on medicalization in U.S. society. Using four cases (Viagra, Paxil, human growth hormone and in vitro fertilization), we focus on two aspects of the changing medical marketplace: the role of direct-to-consumer advertising of prescription drugs and the emergence of private medical markets. We demonstrate how consumers and pharmaceutical corporations contribute to medicalization, with physicians, insurance coverage, and changes in regulatory practices playing facilitating roles. In some cases, insurers attempt to counteract medicalization by restricting access. We distinguish mediated and private medical markets, each characterized by differing relationships with corporations, insurers, consumers, and physicians. In the changing medical environment, with medical markets as intervening factors, corporations and insurers are becoming more significant determinants in the medicalization process.

Waiting time for cataract surgery and its influence on patient attitudes.

PURPOSE:

To characterize willingness to pay for private operations and preferred waiting time among patients awaiting cataract surgery in Hong Kong.

METHODS:

This was a cross-sectional survey. Subjects randomly selected from cataract surgical waiting lists in Hong Kong (n = 467) underwent a telephone interview based on a structured, validated questionnaire. Data were collected on private insurance coverage, preferred waiting time, amount willing to pay for surgery, and self-reported visual function and health status.

RESULTS:

Among 300 subjects completing the interview, 144 (48.2%) were 76 years of age or older, 177 (59%) were women, and mean time waiting for surgery was 17 +/- 15 months. Among 220 subjects (73.3%) willing to pay anything for surgery, the mean amount was US$552 +/- 443. With adjustment for age, education, and monthly household income, subjects willing to pay anything were less willing to wait 12 months for surgery (OR = 4.34; P = 0.002), more likely to know someone having had cataract surgery (OR = 2.20; P = 0.03), and more likely to use their own savings to pay for the surgery (OR = 2.21; P = 0.04). Subjects considering private cataract surgery, knowing people who have had cataract surgery, using nongovernment sources to pay for surgery, and having lower visual function were willing to pay more.

CONCLUSIONS:

Many patients wait significant periods for cataract surgery in Hong Kong, and are willing to pay substantial amounts for private operations. These results may have implications for other countries with cataract waiting lists.

How Does the Unemployment Insurance System Shape the Time Profile of Jobless Duration?

This paper updates a sparse literature on the effects of unemployment benefits (UB) on the time profile of escape rates from unemployment. These effects, as well as those of other regressors, are found to vary profoundly over the course of unemployment.

Media coverage of sustainable development issues – attention cycles or punctuated equilibrium?

Over the last two decades there has been a marked change in the way that the public perceives environmental issues and the concepts associated with sustainable development. Few would argue that this has moved into the mainstream of public consciousness. Coverage of sustainability related concepts within the media, as illustrated by a sample of 112 worldwide newspapers, shows a clear upward trajectory. Taking the example of climate change and sustainable development this paper explores this increasing coverage, and arguably awareness of, sustainability concepts and considers parallels with the concepts of punctuated equilibrium and issue-attention cycles.

‘A planet of confusion and debate’: children's and young people's response to the news coverage of Pluto's loss of planetary status

Despite calls that the school science curriculum should develop among students an ability to understand and respond critically to science-related media reports, very little research has been directed toward an important matter relevant to that aim, namely, how children and young people, untutored, react to science in the news. This study sought, in the context of media coverage of the debate surrounding the planetary status of Pluto, to explore this issue. A questionnaire, completed by 350 students aged between eight and 18, showed just over half of the children and young people were able to write relevantly about the subject though it was the gist not the detail of the story they recounted. There was evidence, nonetheless, that this media-acquired information functioned as active rather than passive knowledge. Students demonstrated relatively few misconceptions and those presented were predominately pre-existing rather than media-derived. As with the wider public, many of the children and young people held strong opinions on Pluto's loss of planethood. Such responses diminished with age, however, with older students expressing a degree of indifference. The paper concludes with a discussion of some implications of the research findings for science instruction.

Optical and near-infrared coverage of SN 2004et: physical parameters and comparison with other Type IIP supernovae

We present new optical and near-infrared (NIR) photometry and spectroscopy of the Type IIP supernova (SN), SN 2004et. In combination with already published data, this provides one of the most complete studies of optical and NIR data for any Type IIP SN from just after explosion to +500 d. The contribution of the NIR flux to the bolometric light curve is estimated to increase from 15 per cent at explosion to around 50 per cent at the end of the plateau and then declines to 40 per cent at 300 d. SN 2004et is one of the most luminous IIP SNe which has been well studied and characterized, and with a luminosity of log L = 42.3 erg s-1 and a 56Ni mass of 0.06 +/- 0.04 M-circle dot, it is two times brighter than SN 1999em. We provide parametrized bolometric corrections as a function of time since explosion for SN 2004et and three other IIP SNe that have extensive optical and NIR data. These can be used as templates for future events in optical and NIR surveys without full wavelength coverage. We compare the physical parameters of SN 2004et with those of other well-studied IIP SNe and find that the kinetic energies span a range of 1050-1051 erg. We compare the ejected masses calculated from hydrodynamic models with the progenitor masses and limits derived from pre-discovery images. Some of the ejected mass estimates are significantly higher than the progenitor mass estimates, with SN 2004et showing perhaps the most serious mass discrepancy. With the current models, it appears difficult to reconcile 100 d plateau lengths and high expansion velocities with the low ejected masses of 5-6 M-circle dot implied from 7-8 M-circle dot progenitors. The nebular phase is studied using very late-time Hubble Space Telescope photometry, along with optical and NIR spectroscopy. The light curve shows a clear flattening at 600 d in the optical and the NIR, which is likely due to the ejecta impacting on circumstellar material. We further show that the [O i] 6300, 6364 A line strengths in the nebular spectra of four Type IIP SNe imply ejected oxygen masses of 0.5-1.5 M-circle dot.