Can mass media influence emergency department visits for stroke?

The relationship between trust in mass media and the healthcare system and individual health: evidence from the AsiaBarometer Survey

BACKGROUND

Vertical and horizontal trust, as dimensions of social capital, may be important determinants of health. As mass media campaigns have been used extensively to promote healthy lifestyles and convey health-related information, high levels of individual trust in the media may facilitate the success of such campaigns and, hence, have a positive influence on health. However, few studies have investigated the relationship between trust levels in mass media, an aspect of vertical trust, and health.

METHODS

Based on cross-sectional data of the general population from the AsiaBarometer Survey (2003-2006), we analyzed the relationship between self-rated health and trust in mass media, using a multilevel logistic model, adjusted for age, gender, marital status, income, education, occupation, horizontal trust, and trust in the healthcare system.

RESULTS

In a total of 39082 participants (mean age 38; 49% male), 26808 (69%) were classified as in good health. By the levels of trust in mass media, there were 6399 (16%) who reported that they trust a lot, 16327 (42%) reporting trust to a degree, 9838 (25%) who do not really trust, 3307 (9%) who do not trust at all, and 191 (0.5%) who have not thought about it. In the multilevel model, trust in mass media was associated with good health (do not trust at all as the base group): the odds ratios (OR) of 1.16 (95% confidence interval (CI) = 1.05-1.27) for do not really trust; OR of 1.35 (95% CI = 1.23-1.49) for trust to a degree, and 1.57 (95% CI = 1.36-1.81) for trust a lot. Horizontal trust and trust in the healthcare system were also associated with health.

CONCLUSION

Vertical trust in mass media is associated with better health in Asian people. Since mass media is likely an important arena for public health, media trust should be enhanced to make people healthier.

Ischemic middle cerebral artery stroke missing the tissue plasminogen activator time window: transcranial Doppler evaluation

We investigated the interconnection between natural history of middle cerebral artery (MCA) recanalization by transcranial Doppler (TCD) and stroke severity in patients not treated by fibrinolysis. A total of 54 patients with an acute MCA stroke were examined within the first 24 hours and again within 120 hours after stroke onset. The first TCD examination detected 16 patients (29.6%) with complete occlusion, 27 patients (50%) with partial occlusion, and 11 patients (20.4%) with patent MCA. There were no significant differences among groups according to mean National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale values. The second examination revealed 7 patients (13.2%) with complete occlusion, 31 patients (58.5%) with partial occlusion, and 15 patients (28.3%) with patent MCA. The mean NIHSS score in patients with total occlusion was significantly higher than in patients without occlusion or with partial occlusion. There was no significant difference in mean NIHSS value between patients with and without improvement on the second TCD examination. We conclude that MCA occlusion by TCD is associated with more severe stroke than that of patients without occlusion or with only a partial occlusion. A later MCA recanalization is not accompanied by significant improvement of neurologic or functional status.

The effect of personal relevance on learning stroke symptoms/response

The aim of this study was to test the effect of increasing the personal relevance of stroke symptom information on learning stroke symptoms/emergency response. A randomized pretest-posttest double-blind study design was used. A total of 173 community-dwelling adults participated. Treatment participants read the personally relevant statement, "Learn about stroke to save someone you love," completed the Stroke Action Test pretest, read the National Institute of Neurological Disorder and Stroke pamphlet titled Know Stroke. Know the Signs. Act in Time, and responded to the Stroke Action Test posttest. The control condition differed only in the omission of the personally relevant statement. The treatment group learned significantly more than the control group, F(1, 170) = 7.46, p < .007, eta2 = .02. The mean items learned by the treatment group was 8.3 (SD = 5.67) compared to the control group mean of 6.2 (SD = 5.76). Prefacing stroke prevention information with the statement, "Learn about stroke to save someone you love," could result in greater learning of stroke symptoms/response.

Guidelines for management of ischaemic stroke and transient ischaemic attack 2008

This article represents the update of the European Stroke Initiative Recommendations for Stroke Management. These guidelines cover both ischaemic stroke and transient ischaemic attacks, which are now considered to be a single entity. The article covers referral and emergency management, Stroke Unit service, diagnostics, primary and secondary prevention, general stroke treatment, specific treatment including acute management, management of complications, and rehabilitation.