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(2) CHRONIC
DISEASES LINKED TO FALLS IN
ELDERLY WOMEN
(3) HOW
CAN DOCTORS BEST COMMUNICATE
HEALTH RISKS?
(1) HAVE PARENTS
BEHAVED IRRATIONALLY
TOWARDS MMR?
(Communication and miscommunication
of risk:
understanding UK parents' attitudes
to combined MMR
vaccination)
http://bmj.com/cgi/content/full/327/7417/725
Parents seem to neglect a real risk to
their children
(injuries from road crashes) but amplify
an insignificant
risk (autism caused by MMR vaccine), argues
a senior
researcher in this week's BMJ. But does
this suggest that
parents are irrational?
Paul Bellaby of Salford University considers
the public
perception of three risks to children:
an insignificant risk
(autism from vaccination), a real but
probably small risk
(vCJD from BSE), and a real and demonstrably
larger
risk (injuries from road crashes).
Although injuries from road crashes carry
by far the
largest risk of the three, they have raised
little
controversy, says the author. In contrast,
the alleged link
between MMR vaccination and autism, and
the small
risk of vCJD both met with widespread
concern from
parents.
He suggests that parents seem to neglect
the easily
perceptible risk, to reject the expert
assessment, and to
amplify the virtual risk.
However, in spite of appearances to the
contrary, one
can argue that parents have behaved rationally,
says the
author. They act in what they perceive
to be the interests
of their children. Thus they avoid beef
products and
question the safety of MMR. Even though
taking children
to school and elsewhere by car is a risk,
it is seen as a
way of protecting them from greater dangers
on the
streets, such as abduction by strangers.
Communicating risk effectively is about
much more than
providing even the best of information:
it is a matter of
two-way communication and obtaining agreement,
he
concludes.
Contact:
Paul Bellaby, Director, Institute for Public
Health
Research and Policy, University of Salford,
Greater
Manchester, UK
Email: p.bellaby@salford.ac.uk
(2) CHRONIC DISEASES
LINKED TO FALLS IN
ELDERLY WOMEN
(Association between falls in elderly
women and chronic
diseases and drug use: cross sectional
study)
http://bmj.com/cgi/content/full/327/7417/712
Elderly women with chronic diseases, such
as arthritis
and depression, are at higher risk of
falling, finds a study
in this week's BMJ.
In fact, chronic diseases may account for
30% of falls in
this group.
Researchers at the University of Bristol
surveyed 4,050
women aged 60-79 years about whether they
had had a
fall in the previous 12 months, how many
times they had
fallen, and whether they had received
medical attention
for any falls.
Nearly three quarters (2,961) of the women
had at least
one chronic disease. The risk of falling
associated with
having any chronic disease was 32%. Circulatory
disease, chronic obstructive pulmonary
disease,
depression, and arthritis were each associated
with
higher odds of falling, even after adjusting
for other
factors.
However, no such relation with falling
was found for the
number of drugs used. After adjusting
for chronic
diseases, only sedatives and anti-depressants
were
associated with an increased risk of falling
of between
2% and 5%.
These findings suggest that, in public
health terms,
targeting prevention and control of chronic
diseases
rather than the number of drugs taken
may be a more
useful strategy for preventing falls in
elderly people,
conclude the authors.
Contact:
Debbie Lawlor, Senior Lecturer in Epidemiology,
Department of Social Medicine, University
of Bristol,
UK
Email: d.a.lawlor@bristol.ac.uk
(3) HOW CAN DOCTORS
BEST COMMUNICATE
HEALTH RISKS?
(Education and Debate:)
http://bmj.com/cgi/content/full/327/7417/728
Doctors can improve the ways in which they
communicate risk information, according
to several
articles in this week's Education and
Debate section of
the BMJ.
Most approaches to communication of risk
are based on
the assumption that patients rationally
review evidence,
but for various reasons, we do not think
rationally about
risk, write Andy Alaszewski and Tom Horlick-Jones.
Instead, individuals evaluate the trustworthiness
of
sources and the relevance of information
for their
everyday lives.
They suggest that if doctors want to communicate
risk
effectively to their patients and the
public, they need to
be aware that they are just one source
of information and
may no longer be the most trusted.
In another article, researchers from Canada
describe
how decision aids may help by structuring
the way risk
information is presented, displaying options,
and helping
patients to clarify their values in healthcare
decisions.
Bad presentation of medical statistics
can lead to patients
being misled or making uninformed decisions
about
treatment, warn Gerd Gigerenzer and Adrian
Edwards in
a third article. They demonstrate that
simple mind tools
can reduce confusion and suggest that
efficient
communication of statistical information
should be part of
medical curriculums.
Finally, John Paling, a consultant in risk
communication,
offers some simple rules that can help
doctors
communicate risks clearly.
Contacts:
Andy Alaszewski, Professor of Health Studies,
Centre
for Health Studies, University of Kent,
Canterbury,
Kent, UK
Email: a.m.alaszewski@kent.ac.uk
Annette O'Connor, Professor, Ottawa Health
Research
Institute, Ottawa Hospital, Ottawa, Canada
Email: aoconnor@ohri.ca
Gerd Gigerenzer, Director, Centre for Adaptive
Behaviour and Cognition, Max Planck Institute
for
Human Development, Berlin, Germany
Email: gigerenzer@mpib-berlin.mpg.de
John Paling, Research Director, Risk Communication
Institute, Florida, USA
Email: drp@trci.info
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