Always stay cheerful - health information in the 1920s. / Vær alltid i godt humør ­ helseopplysning i 1920-årene.

BACKGROUND: The interwar period was a time of comprehensive preventive health programmes in Norway. Physical exercise, nutritious diets, strict sleep regimens and better hygiene were at the centre of these efforts. A massive mobilisation of volunteers and professionals took place. The publication of House Maxims for Mothers and Children was part of this large-scale mobilisation, and consisted of ten posters with pithy health advice for hanging on the wall. Mothers were an important target group for health promotion. MATERIAL AND METHOD: The posters have previously received little attention in medical literature, but they can elucidate some features of life and the health propaganda of their time. We have used databases that provide access to newspapers, books and medical literature: Retriever, bokhylla.no, Oria, PubMed and Web of Science. RESULTS: It is hard to quantify the effect of this popular movement when compared to political measures to improve living conditions. In any case, mortality rates fell, life expectancy increased and the dreaded communicable diseases were largely defeated. Special efforts were targeted at children, also with good results. Infant mortality fell and schoolchildren became healthier, stronger, taller and cleaner. INTERPRETATION: The line between social hygiene and general disciplining is blurred, for example the boundary between a healthy diet and bourgeois norms. The education of mothers and children also included a normative aspect that concerned good manners and control.

Consumer Health Informatics: Past, Present, and Future of a Rapidly Evolving Domain.

OBJECTIVES: Consumer Health Informatics (CHI) is a rapidly growing domain within the field of biomedical and health informatics. The objective of this paper is to reflect on the past twenty five years and showcase informatics concepts and applications that led to new models of care and patient empowerment, and to predict future trends and challenges for the next 25 years. METHODS: We discuss concepts and systems based on a review and analysis of published literature in the consumer health informatics domain in the last 25 years. RESULTS: The field was introduced with the vision that one day patients will be in charge of their own health care using informatics tools and systems. Scientific literature in the field originally focused on ways to assess the quality and validity of available printed health information, only to grow significantly to cover diverse areas such as online communities, social media, and shared decision-making. Concepts such as home telehealth, mHealth, and the quantified-self movement, tools to address transparency of health care organizations, and personal health records and portals provided significant milestones in the field. CONCLUSION: Consumers are able to actively participate in the decision-making process and to engage in health care processes and decisions. However, challenges such as health literacy and the digital divide have hindered us from maximizing the potential of CHI tools with a significant portion of underserved populations unable to access and utilize them. At the same time, at a global scale consumer tools can increase access to care for underserved populations in developing countries. The field continues to grow and emerging movements such as precision medicine and the sharing economy will introduce new opportunities and challenges.

Fifty years of immunisation in Australia (1964-2014): the increasing opportunity to prevent diseases.

Medicine has seen dramatic changes in the last 50 years, and vaccinology is no different. Australia has made a significant contribution to world knowledge on vaccine-preventable diseases. Certain deadly diseases have disappeared or become rare in Australia following successful introduction of vaccines. As diseases become rarer, public knowledge about the diseases and their serious consequences has decreased, and concerns about potential vaccine side effects have increased. To maintain confidence in immunisations, sharing of detailed information about the vaccines and the diseases we are trying to prevent is integral to the continued success of our public health programme. Modern quality immunisation programmes need to communicate complex information to immunisation providers and also to the general community. Improving immunisation coverage rates and eliminating the gap in coverage and timeliness between Aboriginal and Torres Strait Islander peoples and non-Indigenous people has become a high priority.

Information prescriptions, 1930-2013: an international history and comprehensive review.

OBJECTIVES: Recently, government agencies in several countries have promoted information prescription programs to increase patients' understanding of their conditions. The practice has a long history and many publications, but no comprehensive literature reviews such as this. METHODS: Using a variety of high-precision and high-recall strategies, the researcher searched two dozen online bibliographic databases, citation databases, and repositories, as well as many print sources, to identify and retrieve documents for review. Of these documents, ninety relevant English-language case reports, research reports, and reviews published from 1930-2013 met the study criteria. RESULTS: Early to mid-twentieth century reports covered long-standing practices and used no rigorous research methods. The literature since the mid-1990s reports on short-term trial projects, especially of government-sponsored programs in the United States and United Kingdom. Although the concept of information prescription has been in the literature and practiced for decades, no long-term research studies were found. CONCLUSIONS: Most of the literature is anecdotal concerning small pilot projects. The reports investigate physician, patient, and librarian satisfaction but not changes in patient knowledge or behavior. Many twenty-first century projects emphasize materials and projects from specific government agencies and commercial enterprises. IMPLICATIONS: While the practice is commonly believed to be a good idea and there are many publications on the subject, few studies provide any evidence of the efficacy of information prescriptions for increased patient knowledge. Well-designed and executed large or long-term studies might produce needed evidence for professional practice.

Market empowerment of the patient: the French experience.

Through analysis of the French experience, this article explores the way economic policy has sought to encourage active, well-informed patients by giving them market power. The new status of the patient as consumer is based on two foundations: the endeavour to build a healthcare market and the activation of demand-based policies. The keystone of this new system is a conception of the market as a process constructed by economic policy. Recent measures such as the standardization of care and the introduction of incentives to respect a treatment pathway then constitute effective levers to establish a free-market rationale.

History and overview of DSHEA.

The Dietary Supplement Health and Education Act (DSHEA), enacted in 1994, had two primary goals: to ensure continued consumer access to a wide variety of dietary supplements, and to provide consumers with more information about the intended use of dietary supplements. It accomplished these goals, and more, without changing the fundamental regulatory status of dietary supplements as a category of foods. This article explores the history and reasoning behind the major provisions of the Act and reflects on the impact of each during 15 years of experience under DSHEA.

HIV/AIDS information by African companies: an empirical analysis.

This article investigates the extent of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Disclosures (HIV/AIDSD) in online annual reports by 200 listed companies from 10 African countries for the year ending 2006. Descriptive statistics reveal a very low level of overall HIV/AIDSD practices with a mean of 6 per cent disclosure, with half (100 out of 200) of the African companies making no disclosures at all. Logistic regression analysis reveals that company size and country are highly significant predictors of any disclosure of HIV/AIDS in annual reports. Profitability is also statistically significantly associated with the extent of disclosure.

A curious jumble: the Canadian approach to online consumer health information.

As part of a larger e-health strategy, Canadian governments have invested millions in online health information services for the lay public. These services are intended to reduce demands on the primary health care system by encouraging greater individual responsibility for health and are often promoted using the language of personal empowerment. In this paper, we describe how lay searchers generally look for online health information and discuss the disempowering challenges they are likely to face in (a) locating Canadian government-sponsored health information sites and (b) finding useful information on these sites to address everyday health concerns. We conclude with several recommendations for policy changes.

Where has the doctor gone? The mediazation of medicine on Dutch television, 1961-2000.

Health issues and medical science receive a lot of attention on television. Of all the sciences, the European public is most interested in medicine, and the public uses television as their main source of information on science. There has been hardly any empirical research, however, into the historical development of the representation of medical science on television. The development of medical television was explored by carrying out a content analysis of Dutch non-fiction medical television programs spanning a period of 40 years. The speaking time allotted to experts has decreased over the years, while that allotted to laypeople has increased. We are seeing fewer references to sources and science and more expression of emotion and tension. The results suggest three periods of medical television: a scientific, a journalistic and a lay period. Medical television in 2000 shows a personified picture of patients against an instrumentalized and symbolized medical backdrop.

Methods to meet the informational demands of patients and health professionals. Findings from the Section on Education and Consumer Informatics.

OBJECTIVES: To summarize current excellent research in the field of education and consumer informatics. METHOD: Synopsis of the articles selected for the IMIA Yearbook 2006. RESULTS: In the consumer informatics field current research focuses on meeting the informational needs of laypersons as well as health professionals with their specific demands and abilities. The selected papers' topics are genetic diseases and conditions, decision support for women considering genetic testing for the risk of breast cancer, history taking and advice for parents with children suffering from asthma, timed messages to motivate and support quit smoking efforts and the integration of health economics in medical education. CONCLUSIONS: The selected articles demonstrate examples of excellent research in consumer health informatics and medical education. The methods presented can contribute to the development of systems for the education of both laypersons and health professionals.