Systematic evaluation of risk factors for diagnostic delay in inflammatory bowel disease.

The diagnosis of inflammatory bowel disease (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), continues to present difficulties due to unspecific symptoms and limited test accuracies. We aimed to determine the diagnostic delay (time from first symptoms to IBD diagnosis) and to identify associated risk factors. A total of 1591 IBD patients (932 CD, 625 UC, 34 indeterminate colitis) from the Swiss IBD cohort study (SIBDCS) were evaluated. The SIBDCS collects data on a large sample of IBD patients from hospitals and private practice across Switzerland through physician and patient questionnaires. The primary outcome measure was diagnostic delay. Diagnostic delay in CD patients was significantly longer compared to UC patients (median 9 versus 4 months, P < 0.001). Seventy-five percent of CD patients were diagnosed within 24 months compared to 12 months for UC and 6 months for IC patients. Multivariate logistic regression identified age <40 years at diagnosis (odds ratio [OR] 2.15, P = 0.010) and ileal disease (OR 1.69, P = 0.025) as independent risk factors for long diagnostic delay in CD (>24 months). In UC patients, nonsteroidal antiinflammatory drug (NSAID intake (OR 1.75, P = 0.093) and male gender (OR 0.59, P = 0.079) were associated with long diagnostic delay (>12 months). Whereas the median delay for diagnosing CD, UC, and IC seems to be acceptable, there exists a long delay in a considerable proportion of CD patients. More public awareness work needs to be done in order to reduce patient and doctor delays in this target population.

Associative Issue Ownership as a Determinant of Voters' Campaign Attention

Campaigns raise public interest in politics and allow parties to convey their messages to voters. However, voters' exposure and attention during campaigns are biased towards parties and candidates they like. This hinders parties' ability to reach new voters. This paper theorises and empirically tests a simple way in which parties can break partisan selective attention: owning an issue. When parties own issues that are important for a voter, that voter is more likely to notice them. Using survey data collected prior to the 2009 Belgian regional elections it is shown that this effect exists independent of partisan preferences and while controlling for the absolute visibility of a party in the media. This indicates that issue ownership has an independent impact on voters' attention to campaigns. This finding shows that owning salient issues yields (potential) advantages for parties, since getting noticed is a prerequisite for conveying electoral messages and increasing electoral success.