Shades of Grey: Ethical Dilemmas

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From protest to agenda building: Description bias in media coverage of protest events in Washington, D.C

Social movements often seek to draw attention to issues they deem important by organizing public demonstrations with the aim of attracting mass media coverage. But only a small proportion of all public demonstrations receives any media attention. This article asks whether even the minimal coverage that demonstrations receive reveal any influence of social movements in shaping how issues are framed by the mass media. Analyzing newspaper and television news stories on Washington, D.C. protests held during 1982 and 1991, we ask whether news reports on protests are framed in ways consistent with the aims of protesters. Do demonstrators receive media coverage that highlights the issues about which they are concerned, or does coverage focus on the protest event itself, to the exclusion of the social issues that movements target? Our results support much of the surmising among media scholars, that even when movements succeed at obtaining the attention of mass media outlets, media reports portray protests in ways that may undermine social movement agendas. Despite this obstacle to communicating protest messages through demonstrations, movements engage in other forms of communication that can affect public interpretations of mass media frames

Role of Waiting in Health Care Service Quality

The study was a randomized field experiment which examined the effects of uncertain waits versus certain waits in preprocess delays on the perceived service quality of emergency room patients. Adult patients with minor conditions were chosen to participate. Patients were in one of two groups: those who were given no information about the expected wait before examination by a doctor or those who were told the wait would be about 35 minutes, the median wait for the categories selected. 399 surveys were mailed; 171 were returned. The study's hypothesis that "consumers will perceive higher quality of service when their expectations about a delay are established accurately at the outset" was not confirmed. Results did indicate, however, that subjects who thought they had been given a time, were more satisfied, regardless of whether or not they were actually given an expected time.Business Administratio

The Role of Interest in Fostering Sixth Grade Students' Identities As Competent Learners

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72489/1/0362-6784.00153.pd

Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis

This is the final published version. Available from Elsevier via the DOI in this record.Introduction Most symptomatic women with breast cancer have relatively short diagnostic intervals but a substantial minority experience prolonged journeys to diagnosis. Atypical presentations (with symptoms other than breast lump) may be responsible. Methods We examined the presenting symptoms of breast cancer in women using data from a national audit initiative (n = 2316). Symptoms were categorised topographically. We investigated variation in the length of the patient interval (time from symptom onset to presentation) and the primary care interval (time from presentation to specialist referral) across symptom groups using descriptive analyses and quantile regression. Results A total of 56 presenting symptoms were described: breast lump was the most frequent (83%) followed by non-lump breast symptoms, (e.g. nipple abnormalities (7%) and breast pain (6%)); and non-breast symptoms (e.g. back pain (1%) and weight loss (0.3%)). Greater proportions of women with ‘non-lump only’ and ‘both lump and non-lump’ symptoms waited 90 days or longer before seeking help compared to those with ‘breast lump only’ (15% and 20% vs. 7% respectively). Quantile regression indicated that the differences in the patient interval persisted after adjusting for age and ethnicity, but there was little variation in primary care interval for the majority of women. Conclusions About 1 in 6 women with breast cancer present with a large spectrum of symptoms other than breast lump. Women who present with non-lump breast symptoms tend to delay seeking help. Further emphasis of breast symptoms other than breast lump in symptom awareness campaigns is warranted.UK Department of HealthCancer Research U

Morbidity and measures of the diagnostic process in primary care for patients subsequently diagnosed with cancer

Background: There is uncertainty regarding how pre-existing conditions (morbidities) may influence the primary care investigation and management of individuals subsequently diagnosed with cancer. / Methods: We identified morbidities using information from both primary and secondary care records among 11,716 patients included in the English National Cancer Diagnosis Audit (NCDA) 2014. We examined variation in 5 measures of the diagnostic process (the primary care interval, diagnostic interval, number of pre-referral consultations, use of primary care-led investigations, and referral type) by both primary care- and hospital records-derived measures of morbidity. / Results: Morbidity prevalence recorded before cancer diagnosis was almost threefold greater using the primary care (75%) vs secondary care-derived measure (28%). After adjustment, there was limited variation in the primary care interval and the number of pre-referral consultations by either definition of morbidity. Patients with more severe morbidities were less likely to have had a primary care-led investigation before cancer diagnosis compared with those without any morbidity (adjusted odds ratio, OR [95% confidence interval]: 0.72 [0.60–0.86] for Charlson score 3+ vs 0; joint P 1.00–1.41], respectively), and more likely to receive an emergency referral (aOR: 1.60 [1.26–2.02] and 1.61 [1.26–2.06], respectively). / Conclusion: Among cancer cases with up to 2 morbidities, there was no evidence of differences in diagnostic processes and intervals in primary care but higher morbidity burden was associated with longer time to diagnosis and higher likelihood of emergency referral

Associations between diagnostic pathways and care experience in colorectal cancer: Evidence from patient-reported data

This is the final version. Available from the publisher via the DOI in this recordObjective: To examine how different pathways to diagnosis of colorectal cancer may be associated with the experience of subsequent care. Design: Patient survey linked to information on diagnostic route. English patients with colorectal cancer (analysis sample n=6837) who responded to a patient survey soon after their hospital treatment. Main outcome measures: Odds Ratios and adjusted proportions of negative evaluation of key aspects of care for colorectal cancer, including the experience of shared decision-making about treatment, specialist nursing and care coordination, by diagnostic route (ie, screening detection, emergency presentation, urgent and elective general practitioner referral). Results: For 14 of 18 questions, there was evidence (p≤0.02) for variation in patient experience by diagnostic route, with 6-31 percentage point differences between routes in adjusted proportions of negative experience. Emergency presenters were more likely to report a negative experience for most questions, including those about adequacy of information about their diagnosis and sufficient explanation before operations. Screen-detected patients were least likely to report negative experiences except for support from primary care. Patients diagnosed through elective primary care referrals were most likely to report worse experience for questions for which overall variation by route was generally small. Conclusions: Screening-detected patients tend to report the best and emergency presenters the worst experience of subsequent care. Improvement efforts can target care integration for screening-detected patients and provision of information about the diagnosis and treatment of emergency presenters.Cancer Research U