Consumer's Guide Research Articles

AWHONN Launching Women’s Health Guide for Consumers: Distribution Sites Being Recruited for ‘Essential Guide for Healthy Living’

AWHONN Launching Women’s Health Guide for Consumers: Distribution Sites Being Recruited for ‘Essential Guide for Healthy Living’

The Consumer's Guide to Effective Environmental Choices: Practical Advice from the Union of Concerned Scientist

The Consumer's Guide to Effective Environmental Choices: Practical Advice from the Union of Concerned Scientist

Lead us into temptation: the triumph of American materialism

Introduction1. Attention Kmart Shoppers: A Brief Consumer Guide to Consumption, Commercialism, and the Meaning of Stuff2. The Language of Things: Advertising and the Rhetoric of Salvation3. But First, a Lot of Words from Our Sponsor: How We Hear What Things Have to Say4. Boxed In: The Power of Packaging5. The Branding of Experience: Or Why the Label Has Moved from Inside the Collar to Outside on the Shirt6. The Function of Fashion in an Age of Individualism7. Enough Talk: Let's Shop!8. The Liberating Role of Consumption

Worst Pills, Best Pills: A Consumer's Guide to Avoiding Drug-Induced Death or Illness

Worst Pills, Best Pills: A Consumer's Guide to Avoiding Drug-Induced Death or Illness

MISCELLANY: What "Fair Housing" Means for People With Disabilities: A Guide for Consumers, Advocates, and Landlords Miscellany

MISCELLANY: What "Fair Housing" Means for People With Disabilities: A Guide for Consumers, Advocates, and Landlords Miscellany

Put to the Test: An Educator's and Consumer's Guide to Standardized Testing

Put to the Test: An Educator's and Consumer's Guide to Standardized Testing

Reproducing the value of professional expertise in post‐traditional culture: Financial advice and the creation of the client

The UK's personal financial services sector has been the site of controversy over alleged professional malpractice. Financial advisers’ status as professionals is in question, and their claim to knowledge and expertise is apparently challenged by an extensive consumer literature on personal finance. This article analyses a corpus of seventeen consumer guides to personal finance and money management published in the UK, together with a range of financial material available on the internet. These guides urge readers to give high priority to their finances, given the irreversible global retreat of the state from welfare provision. They argue that expert professional advice is indispensable. They prepare readers to play their part as clients in mutually profitable collaboration with professional advisers. They offer reassurance about the effectiveness of industry regulation and consumer protection. The guides are reflexively implicated in the promotional culture of personal financial services. They support financial advisers’ claim to professional standing, and contribute to the cultural work of creating a clientele for them.

Public Disclosure of Performance Information in Pennsylvania: Impact on Hospital Charges and the Views of Hospital Executives

Forty states have now passed legislation establishing governmental agencies charged with the task of gathering hospital-level data. Since 1988 all acute care hospitals in Pennsylvania have been submitting data to the Pennsylvania Health Care Cost Containment Council (PHC4). Pennsylvania's policy was designed to make patients and purchasers more informed and selective buyers of medical services, to increase the public accountability of providers of these services, and to encourage hospitals and physicians to compete more on clinical outcomes and charges. The impact of Pennsylvania's policy of public disclosure of performance information on hospital charges over time has not previously been evaluated. Nor has the importance that hospital executives assign to the publication of comparative charges and clinical outcomes information been assessed. From 1990 through 1994 the PHC4 published a number of hospital-level performance reports (including the regional Hospital Effectiveness Reports and A Consumer's Guide to Coronary Artery Bypass Graft Surgery) containing hospital average charges, average lengths of stay, a rating of severity of illness, and two outcome measurements--morbidity and in-hospital mortality--on a total of 59 diagnosis-related groups. An 18-item survey designed to assess hospital executives' opinions of the usefulness and importance of the PCH4 information was sent to the chief executive officers at the study hospitals. There were no significant trends toward a reduction in the dispersion of charges in either category of hospitals during the study period. Most hospital executives assigned low ratings of importance to published comparative charges information; however, executives of high-competition hospitals assigned significantly higher importance ratings to the information as a whole in enouraging hospital competition based on quality.

Consumer Guide to Fast Foods Based On Caloric and Fat Gram Limitations

The purpose of this project was to develop an educational tool for consumers frequenting fast food restaurants. The Fast Food Freeway Guide TM was developed to help people select SizeWise TM meals that would keep them below a certain level of calories and grams of fat. Surveys show that dietary fat is the number one consumer nutrition concern. It consistently ranks higher than concern for salt, cholesterol, sugar, and caloric intake. According to the Prevention Index, the majority of adults are trying to avoid too much fat. However, according to The Third Report on Nutrition Monitoring, there does not appear to be sufficient public knowledge on how to reduce dietary fat from various sources. Consumers also complain of hearing about “what not to eat” rather than “what they should eat,” and state by a 62 percent margin that they would prefer to learn how to choose foods rather than about individual nutrients. The Fast Food Freeway Guide TM addresses these issues by providing consumers with SizeWise TM meals they can consume while on the road that are below 400 calories/15 grams of fat for women and 600 calories/25 grams of fat for men.

Thematic Apperception Tests for Child and Adolescent Assessment: A Practitioner's Consumer Guide

This article reviews the thematic apperception tests that are currently available to the practitioner for child and adolescent assessment. Besides the well-established CAT and TAT, various new tests have been developed to address contemporary issues relevant to young children and adolescents. The discussion of the comparative strengths and weaknesses of these instruments' is related to issues of test validity and reliability

Use of public performance reports: a survey of patients undergoing cardiac surgery.

Publicly released performance reports ("report cards") are expected to foster competition on the basis of quality. Proponents frequently cite the need to inform patient choice of physicians and hospitals as a central element of this strategy. To examine the awareness and use of a statewide consumer guide that provides risk-adjusted, in-hospital mortality ratings of hospitals that provide cardiac surgery. Telephone survey conducted in 1996. Pennsylvania, where since 1992, the Pennsylvania Consumer Guide to Coronary Artery Bypass Graft [CABG] Surgery has provided risk-adjusted mortality ratings of all cardiac surgeons and hospitals in the state. A total of 474 (70%) of 673 eligible patients who had undergone CABG surgery during the previous year at 1 of 4 hospitals listed in the Consumer Guide as having average mortality rates between 1% and 5% were successfully contacted. Patients' awareness of the Consumer Guide, their knowledge of its ratings, their degree of interest in the report, and barriers to its use. Ninety-three patients (20%) were aware of the Consumer Guide, but only 56 (12%) knew about it before surgery. Among these 56 patients, 18 reported knowing the hospital rating and 7 reported knowing the surgeon rating, 11 said hospital and/or surgeon ratings had a moderate or major impact on their decision making, but only 4 were able to specify either or both correctly. When the Consumer Guide was described to all patients, 264 (56%) were "very" or "somewhat" interested in seeing a copy, and 273 (58%) reported that they probably or definitely would change surgeons if they learned that their surgeon had a higher than expected mortality rate in the previous year. A short time window for decision making and a limited awareness of alternative hospitals within a reasonable distance of home were identified as important barriers to use. Only 12% of patients surveyed reported awareness of a prominent report on cardiac surgery mortality before undergoing cardiac surgery. Fewer than 1% knew the correct rating of their surgeon or hospital and reported that it had a moderate or major impact on their selection of provider. Efforts to aid patient decision making with performance reports are unlikely to succeed without a tailored and intensive program for dissemination and patient education.

How Pennsylvania Hospitals Have Responded to Publicly Released Reports on Coronary Artery Bypass Graft Surgery

A Consumer Guide to Coronary Artery Bypass Graft Surgery, published annually since 1992 by the Pennsylvania Health Care Cost Containment Council, compares the outcomes and charges for the state's hospitals and surgeons providing this surgery. To determine whether performance data caused hospitals to change their policies and practices, hospitals were surveyed in Pennsylvania, where the state releases annual coronary artery bypass graft (CABG) outcomes data and, as a control, in New Jersey, where the state does not release these data. Key informants representing hospitals, health insurance payers, health maintenance organizations, and purchasers were asked to list specific changes made because of comparative performance data released in public reports. Focus groups were conducted and surveys were then developed and administered to samples of hospitals, payers, and purchasers in both states. The results suggested, for example, that access to performance information encouraged hospitals to implement new approaches to marketing their CABG services. Thirty-eight percent of Pennsylvania CABG hospitals reported using performance information to recruit staff thoracic surgeons and residents, compared with none in New Jersey. For the most frequently initiated changes in patient care, the Pennsylvania hospitals depended on performance information released by a "government agency" to a much greater degree than did the hospitals in New Jersey. The results suggest that public release of performance information has encouraged hospitals in Pennsylvania to make changes in the areas of marketing, governance, and clinical care and that the impact of the release of public data on performance was greater in Pennsylvania hospitals than New Jersey hospitals.

Does It Run in the Family? A Consumer's Guide to DNA Testing for Genetic Disorders. By Doris Teichler Zallen. New Brunswick, NJ, London: Rutgers University Press, 1997. Pp. 201.

<i>Does It Run in the Family? A Consumer's Guide to DNA Testing for Genetic Disorders</i>. By Doris Teichler Zallen. New Brunswick, NJ, London: Rutgers University Press, 1997. Pp. 201.

Does It Run in the Family? A Consumer's Guide to DNA Testing for Genetic Disorders. By Doris Teichler Zallen. New Brunswick, NJ, London: Rutgers University Press, 1997. Pp. 201.

Does It Run in the Family? A Consumer's Guide to DNA Testing for Genetic Disorders. By Doris Teichler Zallen. New Brunswick, NJ, London: Rutgers University Press, 1997. Pp. 201.

Reviews

Winning Ways Through Corporate Governance NEVILLE BAIN and DAVID BANDThe Art of Judgment: A Study of Policy Making SIR GEOFFREY VICKERSAustralian Political Institutions GWYNNETH SINGLETON, DON AITKIN, BRIAN JINKS and JOHN WARHURSTLeadership of Public Bureaucracies: The Administrator as Conservator LARRY D TERRYResponsibility as Paradox: A Critique of Rational Discourse on Government MICHAEL M HARMONThe Wik Case: Issues and Implications GRAHAM HILEYWorking the System: A Guide for Citizens, Consumers and Communities PUBLIC INTEREST ADVOCACY CENTRE

Review &amp; Booknote: Working the System: A Guide for Citizens, Consumers and Communities

Review &amp; Booknote: Working the System: A Guide for Citizens, Consumers and Communities

Infomedicine: A Consumer's Guide to the Latest Medical Research: Fred B. Baldwin and Suzanne McInerney

Infomedicine: A Consumer's Guide to the Latest Medical Research: Fred B. Baldwin and Suzanne McInerney

Influence of cardiac-surgery performance reports on referral practices and access to care. A survey of cardiovascular specialists.

Reports on the comparative performance of physicians are becoming increasingly common. Little is known, however, about the credibility of these reports with target audiences or their influence on the delivery of medical services. Since 1992, Pennsylvania has published the Consumer Guide to Coronary Artery Bypass Graft Surgery, which lists annual risk-adjusted mortality rates for all hospitals and surgeons providing such surgery in the state. In 1995, we surveyed a randomly selected sample of 50 percent of Pennsylvania cardiologists and cardiac surgeons to find out whether they were aware of the guide and, if so, to determine their views on its usefulness, limitations, and influence on providers. Eighty-two percent of the cardiologists and all the cardiac surgeons were aware of the guide. Only 10 percent of these respondents reported that its mortality rates were "very important" in assessing the performance of a cardiothoracic surgeon. Less than 10 percent reported discussing the guide with more than 10 percent of their patients who were candidates for a coronary-artery bypass graft (CABG). Eighty-seven percent of the cardiologists reported that the guide had a minimal influence or none on their referral recommendations. For both groups, the most important limitations of the guide were the absence of indicators of quality other than mortality (cited by 78 percent), inadequate risk adjustment (79 percent), and the unreliability of data provided by hospitals and surgeons (53 percent). Fifty-nine percent of the cardiologists reported increased difficulty in finding surgeons willing to perform CABG surgery in severely ill patients who required it, and 63 percent of the cardiac surgeons reported that they were less willing to operate on such patients. The Consumer Guide to Coronary Artery Bypass Graft Surgery has limited credibility among cardiovascular specialists. It has little influence on referral recommendations and may introduce a barrier to care for severely ill patients. If publicly released performance reports are intended to guide the choice of providers without impeding access to medical care, a collaborative process involving physicians may enhance the credibility and usefulness of the reports.

Consumer's Guide to Nursing Research: Exercises, Learning Activities, Tools and Resources

Consumer's Guide to Nursing Research: Exercises, Learning Activities, Tools and Resources

A Consumer's Guide to Evenness Indices

Many indices have been proposed for measuring species evenness in ecological communities, but there is no consensus on which are best. We assemble criteria for an appropriate index for the evenness of a biological sample. The most important criterion is that evenness should be independent of species richness. Twelve previously proposed indices and variants are considered, and two apparently new indices. Four indices are recommended as joint best buys: A) If symmetry between minor and abundant species is not important, or if it is required that the index be less affected by minor species: 1) If it is essential that the index be able to reach a minimum of zero with any particular number of species, or if the shape of the index response to an evenness gradient is important: E 1/D (based on a common form of Simpson's index). 2) If good mid-range behaviour is desired: E' (proposed by Camargo). B) If equal sensitivity to minor and abundant species is required: I) If the shape of the index response to an evenness gradient is not important, the clear winner is: E Q (a new index). 2) If the shape is important: E var (another new index). The overall recommendation for general use is E war .