Informa(c)tion: How to do things with medicine information leaflets

Abstract – This paper analyses how Patient Information Leaflets (PILs) of over-the-counter medical products convey information. More precisely, the article focuses on “instructions” on how to use medicines and related “instructional information” (Trimble 1985). The latter is used in PILs to explain why consumers should follow the instructions. The aim is to show, then, how and whether the PILs sampled help consumers to translate effectively the information contained into actions. The first part of the article examines the deontic devices employed in 8 English and Italian PILs of the most common over-the-counter medicines for human consumption used to relieve the same symptoms. The second part, instead, analyses whether and how the eight leaflets sampled followed the ‘instructions’ contained in one of the authoritative works by Sless and Shrensky in this field (2006). Both Australian authors, indeed, provide useful advice on how to write directives and related explanations in PILs.Riassunto – Questo lavoro si propone di analizzare come i foglietti illustrativi dei medicinali da banco veicolano le informazioni. Nel caso specifico, l’attenzione è rivolta alle “istruzioni” per l’uso (dei medicinali) e alle “informazioni sulle istruzioni” (Trimble 1985). Quest’ultime vengono utilizzate nei foglietti illustrativi per spiegare ai consumatori perché seguire specifiche istruzioni. L’intento è quello di mostrare, quindi, come e se i foglietti illustrativi dei medicinali presi a campione aiutino i consumatori a tradurre in modo efficace le informazioni in azioni. La prima parte dell’articolo è incentrata sulle strategie deontiche utilizzate in 8 foglietti illustrativi di medicinali da banco inglesi e italiani per uso umano, usati comunemente per curare la stessa tipologia di sintomi. La seconda parte, invece, analizza se e come gli otto foglietti illustrativi presi a campione hanno seguito, a loro volta, le ‘istruzioni’ contenute in uno degli lavori considerati più autorevoli nel campo dei foglietti illustrativi dei medicinali (Sless e Shrensky 2006). Entrambi gli autori australiani, infatti, offrono una serie di consigli utili su come scrivere le istruzioni e le relative spiegazioni

Vaghezza, indeterminatezza e incertezza nei foglietti illustrativi dei medicinali in inglese e in italiano

Abstract - This paper analyses vague words and expressions contained in 8 Patient Information Leaflets (PILs) of over-the-counter medical products (4 sold in the U.K. and 4 in Italy). More precisely, the article focuses on qualifying adjectives describing scale of “seriousness” together with the recommended “dosage”. It also looks at epistemic modal verbs (Halliday 2004; Palmer 1986), as well as adverbial adjuncts (Halliday 2004). “Vagueness is a form of unclarity – specifically, an unclarity about the boundaries of things” (Raffman 2014, p. 2). As a consequence, a concept or word is vague if it allows borderline cases (Smith 2008, p. 1; Van Deemter 2010, p. 8). PILs (and not only) are rich in vague expressions: sometimes they are “necessary” (Encott 200), but at other times they can be omitted so as to make a text more comprehensible for the addressee. For example, is it really necessary to use multiple adjectives such as “bad”, “severe”, “serious” within the same PIL or in several PILs, instead of using only one, perhaps the most common and understandable, for example the word “bad”?Abstract - Questo lavoro si propone di analizzare le parole ed espressioni vaghe contenute in 8 foglietti illustrativi (F.I.) di medicinali da banco (4 venduti in Inghilterra e 4 in Italia). L’analisi si sofferma in particolare sugli aggettivi qualificativi sulla scala della “gravità” e della “quantità”, e sulle forme verbali modali con funzione epistemica (Halliday 2004; Palmer, 1986) e sui connettivi di probabilità e di frequenza con funzione avverbiale e non di complemento (Halliday 2004). “La vaghezza è una forma di non chiarezza sui confini delle cose” (Raffman 2014, p. 2). Pertanto, una parola o un concetto sono vaghi se ammettono casi limite  (Smith 2008, p. 1; Van Deemter 2010, p. 8). La vaghezza è una caratteristica dei F.I. (e non solo), a volte “necessaria” (Encott 2000), ma che in altre circostanze si può evitare per rendere il testo più comprensibile al fruitore. Per esempio, è proprio necessario inserire in uno stesso F.I. o più F.I. gli aggettivi “severo”, “serio”, “grave” e non impiegare invece sempre e solo lo stesso aggettivo più comune e più conosciuto come “grave”

La campagna elettorale inglese e italiana in prima pagina

Abstract – This paper examines the front pages of four printed newspapers (The Guardian, The Times, Corriere della Sera and la Repubblica) on the first day of the general election campaign in 2005 in the UK (4th April) and the Italian campaign in 2006 (11th February). The aim is to show first of all how the positioning of elements (i.e. pictures, cartoons, headlines, articles and even advertisements), on the left and on the right of the page, or in the upper or lower sections is not at random and in fact conveys specific information. Secondly, it will also illustrate how words, images and colours on the same page bond with each other by means of a common theme or “topic of the day” suggested by the newspaper itself. The second part of this work, instead, focuses on the language of the headlines (and their articles) adopted on the front pages of the four dailies during both the 2005 and 2006 election campaigns in the UK and in Italy respectively and how they are designed to affect and influence their readers, who are, after all, prospective voters.Keywords: newspapers, front page, headlines, topic, election campaign

Preliminary analysis of site effects in the Ischia island: new insights from md 4.0 earthquake of 21 august 2017 and seismic noise data

On August 21, 2017, at 18:57 UTC, an earthquake of MD 4.0 occurred in Casamicciola, district of Ischia island. The damage caused by the earthquake was massive, with two victims and several buildings collapsed, and circumscribed to the areas of uptown Casamicciola, particularly in the Piazza Maio-La Rita area, and in a small area, called Fango, in Lacco Ameno. Medium and minor damages occurred in Piazza Bagni, in the area around the town hall of Casamicciola and in the Sentinella area. Even assuming the poor quality constructions and/or not in compliance with the anti-seismic regulations, such a level of damage has induced the scientific community to analyse the effects of local site amplifications, that usually are not negligible in volcanic areas. As a matter of fact the seismic station IOCA, located very close to the high damage areas, recorded a peak ground acceleration (PGA) of 2.6 m/s2. This paper is aimed to study the possible site amplification in the areas heavily affected by the August 21 earthquake in order to better understand the causes of these macroseismic effects and high damage levels already observed in the past.PublishedCentro Congressi della Stazione Marittima, Trieste, Italy6V. Pericolosità vulcanica e contributi alla stima del rischi

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Il potere delle parole: verbi modali e avverbi di frequenza sui foglietti illustrativi dei medicinali in inglese e in italiano

Il presente lavoro mira a verificare se ci siano stati cambiamenti, dal 2006 al 2020, nell’uso dei modali in funzione epistemica (Palmer 1986) e degli avverbi di frequenza su 16 foglietti illustrativi (FI) di medicinali da banco (venduti nel Regno Unito e in Italia), in particolar modo in merito all’incidenza degli effetti indesiderati. Studi dimostrano che gli avverbi di frequenza, oltre che gli indicatori numerici, sono ancora difficili da interpretare non solo dai consumatori (Al Juffali et al., 2014; Dyda 2017; Raynor et al. 2018) ma anche dagli stessi specialisti del settore: sia da parte dei medici che li adoperano (Edwards et al. 1998; O’Brien 1989; Stheeman et al. 1993) sia quando dottori e farmacisti sono essi stessi i destinatari (Ziegler et al 2013). La difficoltà nell’interpretare gli avverbi di frequenza e i modali sui FI è causa, altresì, dell’aumento dell’effetto nocebo (Webster et al. 2017) nei pazienti. In altre parole, “molte reazioni avverse avvengono non soltanto a causa del medicinale ma per il fatto che i pazienti si aspettano effetti molto più negativi rispetto a quelli riportati con i descrittori”. Di conseguenza, per paura, i pazienti sono più propensi a non seguire alla lettera le indicazioni riportate sui FI per cercare di ridurre l’incidenza degli effetti indesiderati, cioè per tentare di soffrirne il meno possibile o di evitarli in assoluto. Il presente lavoro, dunque, si sofferma sull'importanza delle parole in ambito medico perché hanno un potere immenso sui pazienti e per questo vanno scelte con cura

Subliminal Messaging in Multimodal Newspaper Editing. The Case of the 2008 US Presidential Election on the Front Pages of the "New York Times" and the "Washington Post"

Subliminal Messaging in Multimodal Newspaper Editing The Case of the 2008 US Presidential Election on the Front Pages of the New York Times and the Washington Post Anna Bianco Abstract The front page of a newspaper generally contains what its editor considers to be the most important “news of the day”. The front page is known to be a multimodal setting for a whole series of headings, subtitles, articles, reports, news flashes, photographs and other images that are placed together in apparently random fashion. The readership knows little about this layout structure that goes much beyond a general awareness that the most important news is “carried” in a top/central position on the page with large-print headlines, whereas the less important topics are below to one side (and sometimes centrally) in a smaller type size. Specialists in news reading and writing, for their part, know that there is much more to a page and that the multimodal choice of similar topics and related structures also constitute what is known as “newsworthiness”. A few other studies have also looked at the “less important” items reported on the front page and have shown that even unrelated items are actually carriers of the same message or theme as the main items, though without the readers being consciously aware of what is going on. These “unrelated” news items or “implicit topics” are in fact non-casual subliminal messages chosen and designed by the editorial staff as an intrinsic part of the theme of the page as a whole. This paper therefore intends to explore how subliminal messaging was actually used by the New York Times and the Washington Post during last year’s US Presidential election campaign. The conclusions to be drawn about this sort of editorial manipulation and subjective reporting, especially during key ideological moments like political elections, will hopefully provide enhance our critical awareness and further debate

Istruzioni e informazioni sui foglietti illustrativi dei medicinali in inglese e in italiano 10 anni dopo: è cambiato qualcosa?

Il lavoro mette a confronto i foglietti illustrativi (FI) di medicinali da banco in inglese e in italiano revisionati tra il 2006 e il 2020 ed evidenzia se e come sono cambiate, da un punto di vista linguistico, le istruzioni e le informazioni ivi contenute nell'arco di 10 anni. Si riscontra, per esempio, un aumento delle istruzioni "dirette", cioè più esplicite, con l'uso dell'imperativo sia sui FI in italiano che in inglese, e delle glosse esplicative o spiegazioni dei termini specialistici delle malattie o "effetti indesiderati". Ancora problematica e di difficile comprensione sono gli avverbi di frequenza degli effetti indesiderati, incomprensione che, sommata alla paura, determina il cosiddetto "effetto placebo" sui pazienti. Emergono, infine, ancora incongruenze sulle informazioni sui foglietti degli stessi medicinali venduti nei due Paesi (Regno Unito e Italia

VAGHEZZA, INDETERMINATEZZA E INCERTEZZA NEI FOGLIETTI ILLUSTRATIVI DEI MEDICINALI IN INGLESE E IN ITALIANO

– This paper analyses vague words and expressions contained in 8 Patient Information Leaflets (PILs) of over-the-counter medical products (4 sold in the U.K. and 4 in Italy). More precisely, the article focuses on qualifying adjectives describing scale of “seriousness” together with the recommended “dosage”. It also looks at epistemic modal verbs (Halliday 2004; Palmer 1986), as well as adverbial adjuncts (Halliday 2004). “Vagueness is a form of unclarity – specifically, an unclarity about the boundaries of things” (Raffman 2014, p. 2). As a consequence, a concept or word is vague if it allows borderline cases (Smith 2008, p. 1; Van Deemter 2010, p. 8). PILs (and not only) are rich in vague expressions: sometimes they are “necessary” (Encott 200), but at other times they can be omitted so as to make a text more comprehensible for the addressee. For example, is it really necessary to use multiple adjectives such as “bad”, “severe”, “serious” within the same PIL or in several PILs, instead of using only one, perhaps the most common and understandable, for example the word “bad”