Incidence of Panic Disorder Diagnoses After Celebrity Disclosures of Panic Disorder in South Korea.

Importance: The persistent stigma associated with mental health conditions is a major challenge worldwide. Celebrities may improve this by openly discussing their own mental health issues, potentially influencing public attitudes and encouraging individuals to seek treatment for these conditions. Objective: To evaluate the impact of celebrity mental health disclosures on the incidence and prevalence of panic disorder diagnosis in South Korea. Design, Setting, and Participants: This cohort study included the entire South Korean population from January 2004 to December 2021, as reflected in the National Health Insurance Service data. Analysis was conducted from May 2022 through January 2024. Exposure: Time periods analyzed included the timeframe before (from January 2004 to December 2010) and after the public disclosures of panic disorder by 3 high-profile Korean celebrities between December 2010 and January 2012 (from January 2011 to December 2021). Main Outcomes and Measures: Monthly incidence and prevalence of panic disorder, defined by the presence of a clinical diagnosis of the condition. Trends were assessed using interrupted time series analysis with autoregressive integrated moving average models. To assess public interest in panic disorder, trends in search data were analyzed, examining the association between the timing of increased searches and changes in the incidence and prevalence of panic disorder. Data on obsessive-compulsive disorder (OCD) were included as a control. Results: The study covered the entire population of South Korea, including 48 559 946 individuals in January 2004 and 52 593 886 individuals in December 2021. Before 2011, the mean (SD) annual prevalence of panic disorder was stable at 560 (140) persons per 100 000 persons per year. The celebrity disclosure in December 2010 was associated with higher monthly incidence rates of panic disorder, as measured by insurance claims data, changes that were observed in both the level (5.8 persons; 95% CI, 2.2-9.5 persons) and slope (0.78 persons per month; 95% CI, 0.19-1.40 persons per month) per 100 000 persons. By 2021, the observed annual prevalence per 100 000 persons reached 7530 persons, an increase of 775.6% compared with the 860 persons (95% CI, 330-1400 persons) estimated if the disclosures had not occurred. Internet searches anticipated changes in monthly prevalence with a lag of 2 or 3 months (F = 4.26, P = .02 and F = 3.11, P = .03, respectively). The celebrity disclosures had no significant association with the incidence or prevalence of OCD. Conclusions and Relevance: In this observational cohort study, celebrity disclosure of mental health conditions was associated with a sustained reduction in stigma, as reflected in increased help-seeking behavior for the condition over more than a decade. This underscores the influential role celebrities can play in shaping public health perceptions and behaviors, offering valuable insights for the development of future mental health policies and public awareness campaigns.

Trends in hospital price transparency after implementation of the CMS Final Rule.

OBJECTIVE: To assess trends in hospital price disclosures after the Centers for Medicare & Medicaid Services (CMS) Final Rule went into effect. DATA SOURCES AND STUDY SETTING: The Turquoise Health Price Transparency Dataset was used to identify all US hospitals that publicly displayed pricing from 2021 to 2023. STUDY DESIGN: Price-disclosing versus nondisclosing hospitals were compared using Pearson's Chi-squared and Wilcoxon rank sum tests. Bayesian structural time-series modeling was used to determine if enforcement of increased penalties for nondisclosure was associated with a change in the trend of hospital disclosures. DATA COLLECTION/EXTRACTION METHODS: Not applicable. PRINCIPAL FINDINGS: As of January 2023, 5162 of 6692 (77.1%) US hospitals disclosed pricing of their services, with the majority (2794 of 5162 [54.1%]) reporting their pricing within the first 6 months of the final rule going into effect in January 2021. An increase in hospital disclosures was observed after penalties for nondisclosure were enforced in January 2022 (relative effect size 20%, p = 0.002). Compared with nondisclosing hospitals, disclosing hospitals had higher annual revenue, bed number, and were more likely to be have nonprofit ownership, academic affiliation, provide emergency services, and be in highly concentrated markets (p < 0.001). CONCLUSIONS: Hospital pricing disclosures are continuously in flux and influenced by regulatory and market factors.

Effectiveness of a Patient Safety Incident Disclosure Education Program: A Quasi-Experimental Study.

BACKGROUND: The accurate disclosure of patient safety incidents is necessary to minimize patient safety incidents and medical disputes. As prospective healthcare providers, nursing students need to possess the ability to disclose patient safety incidents. PURPOSE: This study was designed to investigate the effect of a patient safety incident disclosure education program for undergraduate nursing students on participants' knowledge and perception of disclosure of these incidents, attitudes toward patient safety, and self-efficacy regarding disclosure of these incidents. METHODS: A quasi-experimental study with a nonequivalent pretest-posttest design was conducted on fourth-year undergraduate nursing students recruited between September 6 and October 22, 2021, through convenience sampling from two universities in South Korea. The experimental group (n = 25) received the education program. The control group (n = 25) received educational materials on the disclosure of patient safety incidents only. Knowledge and perceptions of patient safety incident disclosure, attitudes toward patient safety, and self-efficacy regarding incident disclosure were measured. Data were analyzed using descriptive analysis, t test, χ2 test, Fisher's exact test, Mann-Whitney U test, Wilcoxon signed-rank test, and ranked analysis of covariance. RESULTS: Posttest results revealed knowledge (p < .001), perceptions (p = .031), and self-efficacy (p < .001) with regard to the disclosure of patient safety incidents were all significantly higher in the experimental group than in the control group. Posttest attitudes toward patient safety were not significantly different between the two groups (p = .908). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The patient safety incident disclosure education program effectively enhances the knowledge, perception, and self-efficacy of nursing students with regard to safety incidents. The findings may be used to improve training and educational programs in nursing colleges and hospitals to improve the knowledge, perception, and self-efficacy of nursing students with regard to disclosing patient safety incidents in clinical settings.

Preference and Disclosure of Fetal Gender to Pregnant Women during Prenatal Ultrasonography in South South Nigeria.

BACKGROUND: Ultrasound scan (USS) in pregnancy has become a common diagnostic tool used in the assessment of pregnancy in recent time. In the course of routine pregnancy assessment using USS, some pregnant women will request to know the sex of their unborn babies. Their reasons for wanting to know the gender of their baby could be either for social reason like planning for an unborn child or their desire for a preferred gender. AIM: The aim of the study was to evaluate gender preferences and disclosure of foetal sex at prenatal USS. METHODS: This was a cross-sectional study conducted at the antenatal clinic of Central Hospital Agbor, Delta State, Nigeria. A total of 235 consecutive consenting women who came for antenatal care (ANC) registration were recruited for the study after obtaining their informed written consent. Questionnaire was used to seek for their sociodemographic characteristics, preference and desires for foetal gender disclosure, reasons for gender disclosure, and awareness of USS accuracy for gender determination. RESULTS: The desire to know the sex of baby was high (99.6%). The major reason for wanting to know the sex of baby was to plan for the unborn child (47.7%) and maternal curiosity (37.0%). Majority of the women (57.4%) had no gender preference. Sixty percent (60%) were not aware that USS sex diagnosis could be wrong. CONCLUSION: There is a strong desire by pregnant women to know the sex of their babies at routine USS. Considering the fact that many of the women were not aware that there could be wrong diagnosis at prenatal ultrasound, it is suggested that adequate counselling be given before fetal sex disclosure.

Preferências de pessoas idosas pela informação prognóstica numa situação de doença grave, com menos de um ano de vida / Older people's preferences for prognostic information in a situation of serious illness with less than a year to live

Resumo O objetivo deste estudo foi determinar as preferências de pessoas idosas, residentes na comunidade, pela divulgação de informações relativas ao tempo de vida limitado, sintomas e problemas, e opções disponíveis para cuidados numa situação de doença grave, com menos de um ano de vida; e identificar os fatores associados com a preferência pela informação sobre prognóstico de vida limitado. Foi aplicado a versão brasileira do questionário sobre Preferências e Prioridades para os Cuidados de Fim de Vida (PRISMA), por meio de entrevista face-a-face, a 400 pessoas idosas, residentes na cidade de Belo Horizonte, Minas Gerais, Brasil. Os principais resultados indicam que: 74.0% preferem ser informados sobre o tempo de vida limitado, 89.3% sobre os sintomas e problemas e 96.3% acerca das opções de cuidados. Os fatores associados à preferência pela informação sobre prognóstico de vida limitado foram: gênero (mulheres: OR=0.446, 95% IC:0.269-0.738) e local menos preferido de morte (casa de um familiar ou amigo: OR=2.423, 95% IC:1.130-5.198). Esses resultados mostram que a maioria das pessoas idosas deseja ser informada numa situação de doença avançada, com menos de um ano de vida. Os profissionais de saúde precisam estar preparados para antecipar notícias sobre o prognóstico de vida limitado e a doença.

Abstract This study aimed to determine the preferences of community-dwelling older people about information disclosure regarding poor prognosis, the likely symptoms and problems, and the care options available in a situation of serious illness with less than a year to live; and to identify factors associated with a preference for information disclosure regarding poor prognosis. The Brazilian version of the Preferences and Priorities for End of Life Care (PRISMA) questionnaire was administered face-to-face to 400 older people, living in the city of Belo Horizonte, Minas Gerais, Brazil. The main results indicated that 74.0% preferred to be informed that they had limited time left, 89.3% wished to be informed about symptoms and problems, and 96.3% about available care options. The factors associated with preferences for information about poor prognosis were: gender (women: OR = 0.446, 95% CI: 0.269-0.738) and choosing the least preferred place to die (home of a relative or friend: OR = 2.423, 95% CI: 1.130-5.198. These results show that most older people want to be informed in an advanced illness situation with less than a year to live. Health care professionals need to be prepared to anticipate news about poor prognosis and the disease.

To tell or not: parental thoughts on disclosure of urologic surgery to their child

Literature pertaining to surgical disclosure to the pediatric patient is lacking. We hypothesized parents would find it difficult to disclose urologic surgery to a child.

O fator de impacto influencia na ética das instruções aos autores de uma revista? / Does impact factor influence the ethics of the instructions provided to journal authors?

OBJETIVO: Verificar se o fator de impacto de um periódico é um mecanismo modificador dos quesitos éticos descritos nas instruções aos autores de revistas médicas nacionais. MÉTODOS: Foram selecionadas 48 revistas divididas em dois grupos: grupo com fator de impacto (n = 24), e grupo sem fator de impacto (n = 24). Foi comparada a quantidade de quesitos éticos entre os dois grupos baseados num protocolo de pesquisa próprio, variando de zero a seis pontos, analisando a presença de aprovação por Comitê de Ética em Pesquisa; citação de que a pesquisa segue os preceitos da Declaração de Helsinque e as normas da resolução 196/96; uso de Termo de Consentimento Livre e Esclarecido; informação sobre os conflitos de interesse dos Pesquisadores; e solicitação para que os estudos clínicos sejam cadastrados no Registro Brasileiro de Estudos Clínicos. RESULTADOS: A média da pontuação do grupo com fator de impacto foi significativamente maior que o grupo sem fator de impacto (3,12 ±1,03 vs. 2,08 ±1,64, p = 0,0121). Quando cada quesito ético foi comparado entre os grupos, houve diferença significativa apenas entre a solicitação do TCLE e o conflito de interesses (p < 0,05). CONCLUSÃO: O fator de impacto é um fator determinante na ética contida nas instruções aos autores das revistas científicas, mostrando que as revistas de maior qualidade buscam artigos com melhores desenhos e que sejam criteriosos quando do início da pesquisa.

OBJECTIVE: Verify whether a journal's impact factor is a mechanism that modifies the ethi cal requirements described in the instructions provided to authors of articles published in Brazilian medical journals. METHODS: 48 selected journals were divided into two groups: impact-factor (n = 24), and no impact-factor (n = 24). The number of ethical requirements was compared between both groups based on a specific research protocol, ranging from zero to six points, analyzing the presence of an approval by a research ethics committee; reference to the fact that the research follows the precepts of the Declaration of Helsinki and the rules of Resolution 196/96; use of an informed consent; information about the authors' conflicts of interest; and a request for registration of clinical trials in the Brazilian Clinical Trials Registry. RESULTS: The average score of the impact-factor group was significantly higher than that of the no-impact-factor group (3.12 ± 1.03 vs. 2.08 ± 1.64, p = 0.0121). When each ethical requirement was compared between the groups, there was significant difference only between the requirement of an informed consent and the disclosure of conflicts of interest (p < 0.05). CONCLUSION: The impact factor is a determinant factor on the ethics included in the instructions to authors of articles in scientific journals, showing that higher-quality journals seek better-designed articles that are conscientious at the beginning of the research.

Disclosure of the diagnosis of Alzheimer's disease: caregivers' opinions in a Brazilian sample / A revelação do diagnóstico de doença de Alzheimer: opiniões de cuidadores em uma amostra brasileira

BACKGROUND: Disclosure of the diagnosis of Alzheimer's disease (AD) remains a contentious issue, and has been little studied in developing countries. OBJECTIVE: To investigate the influence of socio-demographic factors and the experience of being a caregiver on opinion about disclosing AD diagnosis to the patient in a Brazilian sample. METHOD: Caregivers of 50 AD patients together with 50 control participants that did not have the experience of being a caregiver of AD patient were interviewed using a structured questionnaire. RESULTS: Most of the participants (73.0 percent) endorsed disclosure of the diagnosis, while caregivers were less prone to disclose (58.0 percent) than controls (88.0 percent; p=0.0007). Logistic regression confirmed that only the experience of being a caregiver was associated with a lesser tendency for disclosure endorsement. CONCLUSION: The majority of participants was in favor of disclosing the diagnosis, but caregivers were less willing to disclose the diagnosis to the AD patient.

FUNDAMENTO: A revelação do diagnóstico de doença de Alzheimer (DA) tem sido tema polêmico e pouco estudado em países em desenvolvimento. OBJETIVO: Investigar a influência de fatores sócio-demográficos e a experiência de ter sido cuidador na opinião sobre a revelação do diagnóstico em uma amostra brasileira. MÉTODO: Cuidadores de 50 pacientes com DA e 50 indívíduos controle que não tinham tido experiência como cuidadores de pacientes com DA foram entrevistados com o uso de um questionário estruturado. RESULTADOS: A maioria dos participantes (73,0 por cento) manifestou-se a favor da revelação diagnóstico aos pacientes, mas cuidadores foram menos favoráveis (58,0 por cento) que controles (88,0 por cento; p=0,0007). Regressão logística demonstrou que apenas a experiência como cuidador foi associada com menor tendência a apoiar a revelação do diagnóstico. CONCLUSÃO: A maioria dos participantes foi a favor da revelação do diagnóstico ao paciente, mas aqueles com experiência como cuidadores de pacientes com DA foram menos favoráveis.

¿Explicitan los autores de la Revista Médica de Chile sus fuentes de financiamiento? / Disclosure of financial sources and conflicts of interest among research articles published in Revista Médica de Chile

Background: Financial relationships between the industry and researchers have raised concerns about the existence of conflicts of interest that could influence the scientific validity of the studies. Aim: To determine the financial sources of research articles published in the Revista Médica de Chile during a five-year period. Material and Methods: Retrospective analysis of all articles classified as ôresearch articlesõ, published in this journal between years 2001-2005, identifying the funding source and the existence of a declaration of conflicts of interest by the authors. Results: Two hundred seventeen out of 519 research articles published in the period (42 percent) had an explicit financial source disclosed. Of these, 28 percent were funded by internal sources, 36 percent by Fondo Nacional de Desarrollo Científico y Tecnológico and 36 percent by other sources. Twenty-six studies (5 percent) received funding from the industry. In only five of these, the authors explicity declared the absence of conflict of interest. Among the studies that did not disclose any financial source, one third required some funding to be carried out. Conclusions: Forty two percent of research articles published in the last five years did not specify the financial source. Those that did specify a funding source were mainly supported by non-profit agencies including university centers and governmental funds. This is in contrast with international reports that evidence an important financial support from the industry. Only a minority of the authors sponsored by the industry declared absence of conflict of interest.