Portrayals of canine obesity in English-language newspapers and in leading veterinary journals, 2000-2009: implications for animal welfare organizations and veterinarians as public educators

Transvaginal mesh in Australia: An analysis of news media reporting from 1996 to 2021

INTRODUCTION

Transvaginal mesh (mesh) surgeries have been used to treat stress urinary incontinence (incontinence) and/or pelvic organ prolapse (prolapse). In Australia, as in many other countries, the harms caused by mesh eventually prompted individual and collective attempts to achieve redress. The rise of mesh surgery as a procedure, the experience of mesh-affected women and the formal inquiries and legal actions that followed all occurred in social, cultural and discursive contexts. One strategy to understand these contexts is to track how the mesh and key actors in the mesh stories have been portrayed in mass media sources. We conducted a media analysis of the most highly read Australian newspapers and online news media platforms, focusing on how mesh and the interaction of stakeholders in mesh stories were presented to the Australian public.

METHOD

We searched systematically in the top 10 most-read print and online media outlets in Australia. We included all articles that mentioned mesh, from the date of first use of mesh in Australia to the date of our final search (1996-2021).

RESULT

After early scant media reporting focusing on the benefits of mesh procedures, major Australian medicolegal processes created a hook to shift reporting about mesh. The news media then played a significant role in redressing women's experienced epistemic injustice, including by amplifying previously ignored evidence of harm. This created an opportunity for previously unreported suffering to be revealed to powerful actors, in settings beyond the immediate control and epistemic authority of healthcare stakeholders, validating women's testimony and creating new hermeneutic resources for understanding mesh. Over time, media reports show healthcare stakeholders responding sympathetically to these new understandings in public discourse, contrasting with their statements in earlier media coverage.

CONCLUSION

We argue that mass media reporting, in synergy with medicolegal actions and the Australian Senate Inquiry, appears to have provided women with greater epistemic justice, giving their testimony privileged epistemic status such that it was considered by powerful actors. Although medical reporting is not recognised in the hierarchy of evidence embedded in the medical knowledge system, in this case, media reporting appears to have contributed to shaping medical knowledge in significant ways.

PATIENT OR PUBLIC CONTRIBUTION

We used publicly available data, print and online media outlets, for our analysis. Therefore, this manuscript does not contain the direct contribution of patients, service users, caregivers, people with lived experience or members of the public.

Development, factor structure and application of the Dog Obesity Risk and Appetite (DORA) questionnaire

Background. Dogs are compelling models in which to study obesity since the condition shares many characteristics between humans and dogs. Differences in eating behaviour are recognised to contribute to obesity susceptibility in other species but this has not been systematically studied in dogs.

Aim. To develop and validate an owner-reported measure of canine eating behaviour and owner or dog related factors which can alter the development of obesity. Further, to then test variation in food-motivation in dogs and its association with obesity and owner management.

Methods. Owner interviews, a literature review and existing human appetite scales were used to identify relevant topics and generate items for the questionnaire. Following a pilot phase, a 75 item online questionnaire was distributed via social media. Responses from 302 dog/owner dyads were analysed and factor structure and descriptive statistics calculated. Results were compared with descriptions of dog behaviour and management from a subset of respondents during semi-structured interviews. The optimum questions were disseminated as a 34 item final questionnaire completed by 213 owners, with a subset of respondents repeating the questionnaire 3 weeks later to assess test–retest reliability.

Results. Analysis of responses to the final questionnaire relating to 213 dog/owner dyads showed a coherent factor structure and good test–retest reliability. There were three dog factors (food responsiveness and satiety, lack of selectivity, Interest in food), four owner factors (owner motivation to control dog weight, owner intervention to control dog weight, restriction of human food, exercise taken) and two dog health factors (signs of gastrointestinal disease, current poor health). Eating behaviour differed between individuals and between breed groups. High scores on dog factors (high food-motivation) and low scores on owner factors (less rigorous control of diet/exercise) were associated with obesity. Owners of more highly food-motivated dogs exerted more control over their dogs’ food intake than those of less food-motivated dogs.

Conclusions. The DORA questionnaire is a reliable and informative owner-reported measure of canine eating behaviour and health and management factors which can be associated with obesity development. The tool will be applicable to study of the canine obesity model and to clinical veterinarians. Results revealed eating behaviour to be similarly associated with obesity as exercise and owners giving titbits.

How often do primary care veterinarians record the overweight status of dogs?

Obesity is a prevalent medical condition in dogs caused by the excess accumulation of fat, with negative effects on quality of life, longevity and the risk of developing associated pathologies. However, it is unclear how frequently first-opinion veterinarians record dogs as overweight (OW) or obese in medical records, and what factors determine when they do. Data sourced through the Small Animal Surveillance Network were used to determine the relative frequency of recording OW status (obesity or OW) in dogs presented to the UK first-opinion practices. Cases were identified using a search of clinical record-free text for relevant keywords. A case–control study was then conducted, comparing dogs where the OW status was recorded with a control group of obese dogs with no diagnosis recorded. Of 49 488 consultations, the OW status was recorded in 671 dogs (relative frequency 1·4 %). Using multiple logistic regression, the OW status of a dog was more likely to be recorded when the consultation was for osteoarthritis (OR 5·42; 95 % CI 2·09, 14·07; P < 0·001) or lameness (OR 2·02; 95 % CI 1·20, 3·42; P = 0·006). Furthermore, the OW status was more commonly recorded in dogs that were members of a practice health scheme (OR 5·35; 95 % CI 1·57, 18·17; P = 0·04) and less commonly recorded in microchipped dogs (OR 0·43; 95 % CI 0·41, 0·91; P = 0·02). These results suggest that OW and obesity are underdiagnosed in the first-opinion practice. However, a presentation for orthopaedic disease appears a key prompt for recording the OW status. Further studies are now warranted to determine the reasons for such marked underdiagnosis.