Navigating health sources on the Internet: A mixed-methods examination of online consumer reviews and expert text on psychotropic drugs

Purpose. The Internet has provided an unprecedented opportunity for psychotropic medication consumers, a traditionally silenced group in clinical trial research, to have voice by contributing to the construction of drug knowledge in an immediate, direct manner. Currently, there are no systematic appraisals of the potential of online consumer drug reviews to contribute to drug knowledge. The purpose of this research was to explore the content of drug information on various websites representing themselves as consumer- and expert-constructed, and as a practical consideration, to examine how each source may help and hinder treatment decision-making.^ Methodology. A mixed-methods research strategy utilizing a grounded theory approach was used to analyze drug information on 5 exemplar websites (3 consumer- and 2 expertconstructed) for 2 popularly prescribed psychotropic drugs (escitalopram and quetiapine). A stratified simple random sample was used to select 1,080 consumer reviews from the websites (N=7,114) through February 2009. Text was coded using QDA Miner 3.2 software by Provalis Research. A combination of frequency tables, descriptive excerpts from text, and chi-square tests for association were used throughout analyses.^ Findings. The most frequently mentioned effects by consumers taking either drug were related to psychological/behavioral symptoms and sleep. Consumers reported many of the same effects as found on expert health sites, but provided more descriptive language and situational examples. Expert labels of less serious on certain effects were not congruent with the sometimes tremendous burden described by consumers. Consumers mentioned more than double the themes mentioned in expert text, and demonstrated a diversity and range of discourses around those themes.^ Conclusions. Drug effects from each source were complete relative to the information provided in the other, but each also offered distinct advantages. Expert health sites provided concise summaries of medications’ effects, while consumer reviews had the added advantage of concrete descriptions and greater context. In short, consumer reviews better prepared potential consumers for what it’s like to take psychotropic drugs. Both sources of information benefit clinicians and consumers in making informed treatment-related decisions. Social work practitioners are encouraged to thoughtfully utilize online consumer drug reviews as a legitimate additional source for assisting clients in learning about treatment options.^

The moderate voice of John Sherman and the Republican agenda 1855-1898

Republican John Sherman, United States Congressman, Senator, Treasury Secretary, and Secretary of State had a political career of major importance from 1855 to 1898, yet there have been only casual references by historians and only two biographies of him, with the most recent published in 1902. From a strong Whig Party background, he was first elected to the United States House of Representatives in 1854; switching to the Republicans that same year. Then elevated to the Senate in 1861, he served in that body throughout the Civil War and Reconstruction when he was the most important voice of party unity and moderation. In 1877, the new President Rutherford Hayes appointed Sherman Secretary of the Treasury. He returned to the Senate after the Hayes administration where he sat for the following 15 years. In this particularly notable period, he not only led the upper house, but he engineered more bills in Congress which bore his name than any other member of either house. These included the critically important Sherman Silver Purchase Act, the Sherman Anti-Trust Act and Sherman Inter-State Commerce Act. In 1897 he left the Senate finally when William McKinley appointed him Secretary of State. ^ Through this long, distinguished career, Sherman was involved in all the important legislation that brought the country through the Civil War and Reconstruction and into the post-war world of the Gilded Age of rapid industrialization, and urban growth, Politically, he never strayed far from the nationalistic and economic principles of the Whig Party, and brought both these values to bear in the Republican Party that dominated American political life from 1860 to 1900. Similarly, party loyalty and loyalty to the President always characterized his service. He was indeed, an exemplar of political and statesmanship. ^ While research for this dissertation included review of both journal and monographic literature, its basis lies more critically in primary research in unpublished archival material in repositories from Maine to Ohio, in particular the Library of Congress. ^

The effects of semantic and syntactic instruction on user performance and satisfaction in search user interface design

The design of interfaces to facilitate user search has become critical for search engines, ecommercesites, and intranets. This study investigated the use of targeted instructional hints to improve search by measuring the quantitative effects of users' performance and satisfaction. The effects of syntactic, semantic and exemplar search hints on user behavior were evaluated in an empirical investigation using naturalistic scenarios. Combining the three search hint components, each with two levels of intensity, in a factorial design generated eight search engine interfaces. Eighty participants participated in the study and each completed six realistic search tasks. Results revealed that the inclusion of search hints improved user effectiveness, efficiency and confidence when using the search interfaces, but with complex interactions that require specific guidelines for search interface designers. These design guidelines will allow search designers to create more effective interfaces for a variety of searchapplications.