Exercising 'soft closure' on lay health knowledge? Harnessing the declining power of the medical profession to improve online health information

This study aims to address the increasingly complex medical predicament of low quality online health information contributing to lay health knowledge and consequently to clinical outcomes. We situate the predicament within a social change paradigm of individualism, choice, diminishing medical power, and emergence of the legitimacy of lay health knowledge. We contend that the prominence of lay health knowledge has been facilitated by the internet, and is due to a surge in broadcasting of experiential knowledge coupled with increased access to and enactment of medical and non-medically sanctioned online information on health and illness. We draw on and further test the application of social closure theory to help conceive a potential solution to this enduring problem. We conduct a quality assessment of an indicative case study, Apicectomies, and test the application of our notion of soft closure on its findings, resulting in targeted, feasible and potentially beneficial solutions to increasing the medical quality of online health information. We further present the extant application of soft closure by Healthtalkonline.org, which collates a medically reliable set of experiential knowledge on a range of health issues. As such, we propose a constructive re-enactment of the traditional closure of the medical profession on medical knowledge

Effect of a psycho-educational intervention for family members on caregiver burdens and psychiatric symptoms in patients with schizophrenia in Shiraz, Iran

<p>Abstract</p> <p>Background</p> <p>This study explored the effectiveness of family psycho-education in reducing patients’ symptoms and on family caregiver burden.</p> <p>Methods</p> <p>Seventy Iranian outpatients with a diagnosis of schizophrenia disorder and their caregivers were randomly allocated to the experimental (n = 35) or control groups (n = 35). Patients in the experimental group received antipsychotic drug treatment and a psycho-educational program was arranged for their caregivers. The psycho-educational program consisted of ten 90-min sessions held during five weeks (two session in each week). Each caregiver attended 10 sessions (in five weeks) At baseline, immediately after intervention, and one month later. Validated tools were used to assess patients’ clinical status and caregiver burden.</p> <p>Results</p> <p>Compared with the control group, the case group showed significantly reduced symptom severity and caregiver burden both immediately after intervention and one month later.</p> <p>Conclusions</p> <p>These results suggest that even need based short-term psycho-educational intervention for family members of Iranian patients with schizophrenic disorder may improve the outcomes of patients and their families.</p> <p>Trial registration</p> <p>IRCT Number:138809122812 N1`</p

A Re-assessment of Narragansett Bay Benthic Habitat Quality Between 1988 and 2008

The first bay-wide synoptic survey of benthic habitat quality in Narragansett Bay, Rhode Island, USA, was conducted in August of 1988. Twenty years later, we revisited the same sampling locations as the original survey using similar sediment profile imagery technology and analysis tools. Like estuaries throughout the US, increased temperatures and reductions to anthropogenic nutrient inputs have cumulatively affected Narragansett Bay in the intervening 20 years. To understand how these changes may have influenced benthic organic enrichment and habitat quality, we compared the prevalence and spatial arrangement of benthic biotopes (i.e., biotic and abiotic benthic descriptions) between 1988 and 2008 surveys. Biotopes dominated by Ampelisca spp. tubiculous amphipods increased \u3efivefold between 1988 and 2008, and expanded into the more urban, anthropogenically stressed Providence River estuary. Ampelisca beds occurred at critical boundaries in organic enrichment and habitat quality in both years and indicated the quantity of organic matter reaching the benthos. In general, benthic biotopes reflect the degree of benthic-pelagic coupling and are an important link between estuarine water quality and other marine life. As estuaries globally cope with the effects of increased warming and legislated anthropogenic nutrient reductions, rapid assessments of benthic biotopes will be critical for understanding changes to whole-estuary condition as a result of these cumulative stressors