Following celebrities’ medical advice: meta-narrative analysis

Objective: To synthesise what is known about how celebrities influence people’s decisions on health. Design: Meta-narrative analysis of economics, marketing, psychology, and sociology literatures. Data sources Systematic searches of electronic databases: BusinessSource Complete (1886-), Communication & Mass Media Complete (1915-), Humanities Abstracts (1984-), ProQuest Political Science (1985-), PsycINFO (1806-), PubMed (1966-), and Sociology Abstracts (1952-). Inclusion criteria Studies discussing mechanisms of celebrities’ influence on people in any context. Results: Economics literature shows that celebrity endorsements act as signals of credibility that differentiate products or ideas from competitors and can catalyse herd behaviour. Marketing studies show that celebrities transfer their desirable attributes to products and use their success to boost their perceived credibility. Psychology shows that people are classically conditioned to react positively to the advice of celebrities, experience cognitive dissonance if they do not, and are influenced by congruencies with their self conceptions. Sociology helps explain the spread of celebrity medical advice as a contagion that diffuses through social networks and people’s desire to acquire celebrities’ social capital. Conclusions: The influence of celebrity status is a deeply rooted process that can be harnessed for good or abused for harm. A better understanding of celebrity can empower health professionals to take this phenomenon seriously and use patient encounters to educate the public about sources of health information and their trustworthiness. Public health authorities can use these insights to implement regulations and restrictions on celebrity endorsements and design counter marketing initiatives—perhaps even partnering with celebrities—to discredit bogus medical advice while promoting evidence based practices

Empirically Evaluating the Impact of Adjudicative Tribunals in the Health Sector: Context, Challenges and Opportunities

Adjudicative tribunals are an integral part of health system governance, yet their real-world impact remains largely unknown. Most assessments focus on internal accountability and use anecdotal methodologies; few, studies if any, empirically evaluate their external impact and use these data to test effectiveness, track performance, inform service improvements and ultimately strengthen health systems. Given that such assessments would yield important benefits and have been conducted successfully in similar settings (e.g. specialist courts), their absence is likely attributable to complexity in the health system, methodological difficulties and the legal environment within which tribunals operate. We suggest practical steps for potential evaluators to conduct empirical impact evaluations along with an evaluation matrix template featuring possible target outcomes and corresponding surrogate endpoints, performance indicators and empirical methodologies. Several system-level strategies for supporting such assessments have also been suggested for academics, health system institutions, health planners and research funders. Action is necessary to ensure that policymakers do not continue operating without evidence but can rather pursue data-driven strategies that are more likely to achieve their health system goals in a cost-effective way

Evaluating the Impact of Remedial Authority: Adjudicative Tribunals in the Health Sector

Adjudicative tribunals play an important role in the health sector yet their actual influence, as part of the health system, remains undetermined. Most of the studies that have evaluated their work have focused on measures of accountability and independence, rather than the indicators of societal impact. As efforts to reform health systems continue internationally, it is crucial that we understand the benefits and costs of adjudicative tribunals for providers and consumers of heath. In this regard, empirically evaluating the impact of adjudicative tribunals will help inform policymaking through the collection of objective data. A strong and accountable health care system depends on understanding the way these tribunals work and the effects of their decisions

The Elusive Search for Accountability: Evaluating Adjudicative Tribunals

Evaluating the success of adjudicative tribunals is an important but elusive undertaking. Adjudicative tribunals are created by governments and given statutory authority by legislatures for a host of reasons. These reasons may and often do include legal aspects, policy aspects and partisan aspects. While such tribunals are increasingly being asked by governments to be accountable, too often this devolves into publishing statistics on their caseload, dispositions, budgets and staffing. We are interested in a different and more basic question – are these tribunals successful? How do we know, for example, whether the remedies ordered by a tribunal actually do advance the purposes for which it was created? Can the success of an adjudicative tribunal be subject to meaningful empirical validation? While issues of evaluation and accountability cut across national and jurisdictional boundaries, the authors argue that this type of question can only be addressed empirically, by actually looking to the practice of a particular board or boards, in the context of a particular statute or statutes, and in particular jurisdictions at particular times. Such accounts can and should form the basis for comparative study. Only through comparative study can the value and limitations of particular methodologies become apparent. This study takes as its case study the role of adjudicative tribunals in the health system. The authors draw primarily from Canadian tribunal experience, though examples from other jurisdictions are used to demonstrate the potential of empirical evaluation. The authors discuss the relative dearth of empirical study in administrative law and argue that it ought to be the focus of the discussion on accountability in administrative justice

Sticky Metaphors and the Persistence of the Traditional Voluntary Manslaughter Doctrine

This Article begins with a curious puzzle: Why has the traditional voluntary manslaughter doctrine in criminal law-the so-called heat of passion defense to a charge of murder-proven so resistant to change, even in the face of more than a half-century of seemingly compelling empirical and normative arguments in favor of doctrinal reform? What could possibly account for the traditional doctrine\u27s surprising resilience? In this Article, we propose a solution to this puzzle. The Article introduces a new conceptual theory about metaphor-the sticky metaphor theory-that highlights an important aspect of metaphorical language and metaphorical thought that has been almost completely overlooked in the existing literature of law, psychology, and linguistics. We believe the sticky metaphor theory may turn out to be highly significant to both the voluntary manslaughter doctrine in particular and the law in general

Surface pinning of fluctuating charge order: an "extraordinary" surface phase transition

We study the mean-field theory of charge-density wave (CDW) order in a layered system, including the effect of the long-range Coulomb interaction and of screening by uncondensed electrons. We particularly focus on the conditions necessary for an ``extraordinary'' transition, in which the surface orders at a higher temperature, and is more likely to be commensurate, than the bulk. We interpret recent experiments on NaCCOC as indicating the presence of commensurate CDW at the surface that is not present in the bulk. More generally, we show that poor screening of the Coulomb interaction tends to stabilize incommensurate order, possibly explaining why the CDW order in LSCO and NbSe2 remains incommensurate to T -> 0, despite the small magnitude of the incommensurability.Comment: 9 pages, no figures, 31 references; 1 new figure and minor editing of the tex

Contact dermatitis: one for the books

Allergic contact dermatitis (ACD) is a frequent problem, often caused from repeated exposure to an object or substance related to the patient's routine activities. We present a case of a well-demarcated, erythematous, scaly plaque on a finger caused from reading with an e-book device. Although metal from mobile devices can cause ACD, mobile device cases may cause irritation or contain additives that can also cause contact dermatitis. Similar presentations of contact dermatitis may become more common as technology use increases

Assessing 15 Proposals for Promoting Innovation and Access to Medicines Globally

BackgroundThere is widespread recognition that the existing global systems for innovation and access to medicines need reform. Billions of people do not have access to the medicines they need, and market failures prevent new drugs from being developed for diseases that primarily affect the global poor. The World Health Organization's Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG) analyzed numerous proposals for reform. The aim of this article is to build on these previous inquiries.MethodsWe conducted a structured analysis that grouped proposals into five broad opportunities for global policy reform to help researchers and decision makers to meaningfully evaluate each proposal in comparison with similar proposals. Proposals were also analyzed along three important dimensions—potential health impact, financial implications, and political feasibility—further facilitating the comparison and application of this information.FindingsUpon analysis, no one solution was deemed a panacea, as many (often competing) considerations need to be taken into account. However, some proposals, particularly product development partnership and prizes, appeared more promising and feasible at this time and deserve further attention.ConclusionMore research is needed into the effectiveness of these mechanisms and their transferability across jurisdictions