Up to a quarter of the Australian population may have suboptimal health literacy depending upon the measurement tool : results from a population-based survey

The objective of this paper is to measure health literacy in a representative sample of the Australian general population using three health literacy tools; to consider the congruency of results; and to determine whether these assessments were associated with socio-demographic characteristics. Face-to-face interviews were conducted in a stratified random sample of the adult Victorian population identified from the 2004 Australian Government Electoral Roll. Participants were invited to participate by mail and follow-up telephone call. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM), Test of Functional Health Literacy in Adults (TOFHLA) and Newest Vital Sign (NVS). Of 1680 people invited to participate, 89 (5.3%) were ineligible, 750 (44.6%) were not contactable by phone, 531 (32%) refused and 310 (response rate 310/1591, 19.5%) agreed to participate. Compared with the general population, participants were slightly older, better educated and had a higher annual income. The proportion of participants with less than adequate health literacy levels varied: 26.0% (80/308) for the NVS, 10.6% (51 33/310) for the REALM and 6.8% (21/309) for the TOFHLA. A varying but significant proportion of the general population was found to have limited health literacy. The health literacy measures we used, while moderately correlated, appear to measure different but related constructs and use different cut offs to indicate poor health literacy.

Western propaganda models reconsidered : the "Catherine Whell" of censorship circumvention in developing world internal conflicts

This study is a deep-text analysis of military censorship applied to the national press in the Sri Lankan conflict. We examine press coverage of two Sri Lankan military operations, namely Operation Jayasikurui (1997) and the Capture of Elephant Pass (2000), to identify patterns of signification that help us construct a novel theory of conflict reporting under censorship within the context of ethnic, intrastate conflict. Our study shows that Sri Lankan newspapers, while abiding by censorship regulations, contradictorily also manoeuvred around these regulations as if censorship did not exist. Noteworthy were the censorship circumvention techniques that were used. For example, journalists taught readers how to ‘read’ blank space. They used commentary to educate readers how to read the straight news. They used conflict frames to overcome bias towards official viewpoints. They used multi-source confirmation to avoid pre-dominance of official views. They used respectful words rather than demonised opponents. Great attention
was paid to victims of the conflict, destruction of life and property, and civil society. Our findings do not accord well with previous theoretical models of the media role in society and of press censorship under conflict. The Sri Lankan press is highly intertwined within its cultural context and follows its own value system. We propose the ‘Catherine Wheel Model of Censorship Circumvention’ about press behaviour in times of internal conflict. Our model attempts to explain internal conflict within the developing world context in which the press system is based deeply in culture and is more accustomed to circumventing censorship than obeying it.

Review : Ethics for health care (2nd edition) by Catherine Berglund

Ethics is a broad discipline and in health the debate between bioethics and behavioural ethics is one that goes to the centre of public health debates.

Australian doctors’ non-clinical activities: results from the MABEL survey of doctors

Objective. The aim of the present study was to investigate non-clinical work conducted by Australian doctors.
Methods. This study was an exploratory descriptive study using data from Wave 5 of the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal survey, collected in 2012 from Australian medical practitioners (2200 general practitioners (GPs), 3455 specialists, 1270 specialists in training and 1656 hospital non-specialists). The main outcome measure was the number of hours worked per week in non-clinical work. Regression analysis was used to determine associations between non-clinical activities (i.e. education-related, management and administration and other) and personal and professional characteristics, including age, gender, job and life satisfaction, total clinical working hours, sector of practice
(public or private) and doctor type.
Results. Australian doctors spend an average of just under 7 h per week, or 16% of their working time, on non-clinical activities. Doctors who worked more hours on non-clinical activities overall, and in education-related and management and
administration specifically, were male, younger, had lower life satisfaction and generally spent fewer hours on clinical work. Lower job satisfaction was associated with longer management and administration hours, but not with time spent in
education-related activities. Specialists were more likely to work long non-clinical hours, whereas GPs were more likely to report none. Hospital non-specialists reported relatively high management and administration hours.
Conclusions. Further work is required to better understand the full range of non-clinical activities doctors are involved in and how this may impact future workforce projections.