Private Screening Research Articles

Breast-cancer mortality in screened versus unscreened women: Long-term results from a population-based study in Queensland, Australia

In the context of a mature mammographic screening programme, the aim of this population-based study was to estimate rates of breast-cancer mortality among participants versus non-participants in Queensland, Australia. The Queensland Electoral Roll was used to identify women aged 50-65 in the year 2000 (n = 269,198). Women with a prior history of invasive or in situ breast cancer were excluded (n = 6,848). The study population was then linked to mammography records from BreastScreen Queensland together with the Wesley Breast Screening Clinic (the largest provider of private screening in Queensland) to establish a screened cohort (n = 187,558) and an unscreened cohort (n = 74,792). Cohort members were matched and linked to cancer notifications and deaths through the state-based Queensland Oncology Repository. Differences in breast-cancer mortality between the two cohorts were measured using Cox proportional hazards regression. After 16 years of follow-up, women in the screened cohort showed a 39% reduction in breast-cancer mortality compared to the unscreened cohort (HR = 0.61, 95%CI = 0.55-0.68). Cumulative mortality over the same period was 0.47% and 0.77% in the screened and unscreened cohorts, respectively. This study found a significant reduction in breast-cancer mortality for women who participated in mammographic screening compared to unscreened women. Our findings of a breast-cancer mortality benefit for women who have mammographic screening are in line with other observational studies.

Engagement of private healthcare providers for case finding of tuberculosis and diabetes mellitus in Pakistan

BackgroundThe rising co-epidemic of tuberculosis (TB) and diabetes mellitus (DM) is a challenge for constrained health systems in low and middle-income countries. Diabetes is a known risk factor for tuberculosis and associated with poor tuberculosis treatment outcomes, while tuberculosis is associated with worsening glycemic control. We investigated the performance of bi-directional TB and DM case finding approaches through a private-sector engagement model in Karachi, Pakistan.MethodsBetween July 2016 and July 2018, private health care providers were engaged to generate referrals for bi-directional TB and DM screening at private diagnostic and treatment centers in Karachi, Pakistan. Individuals diagnosed with TB underwent glycated hemoglobin (HbA1c) testing at the time of anti-tuberculous treatment initiation and at three -month follow up stage. All individuals with a history of diabetes or random blood sugar of greater than 200 mg/dl were screened for TB using a chest X-ray and Xpert MTB/RIF.ResultsA total of 6312 persons with tuberculosis were tested on HbA1c at treatment initiation, of whom 1516 (24%) were newly diagnosed with DM. About one third of those with HbA1c in the diabetic range (≥ 6.5%) at baseline were found to have a normal HbA1c (< 5.7%) result at 3-month follow-up. A total of 3824 individuals with DM, of whom 2396 (63%) were known cases and 1428 (37%) were newly identified with random blood sugar > 200 mg/dl, underwent chest x-ray and Xpert MTB/RIF testing, with 321 (13.4%) known and 54 (3.8%) new diabetics respectively identified with tuberculosis.ConclusionThis study demonstrates a high yield of TB and DM through bidirectional screening and the feasibility of engagement of private sector in finding missing cases of tuberculosis and diabetes. Given the high prevalence of undiagnosed DM in individuals with TB tuberculosis patients, there is a need to scale-up DM screening within TB programmes. Increased awareness of the high risk of TB among individuals with DM is needed among private health providers and screening for TB among diabetics should be strongly considered.

Patient and prescriber perceptions of depression screening within a community pharmacy setting

ObjectivesTo determine patient and prescriber perceptions of depression screening within the community pharmacy setting and to assess the best strategies for patient engagement and care coordination. DesignQualitative semistructured key informant interviews using the Consolidated Framework for Implementation Research as a theoretical framework. Setting and participantsA community pharmacy in the metropolitan Piedmont region of North Carolina from February 2019 to May 2019. Prescriber and patient interviews were audio recorded, transcribed, and independently coded by 2 investigators. A qualitative analysis was completed, with a selection of supporting quotations for each theme. Outcome measuresQualitative analysis of prescriber and patient perceptions of depression screening provided in community pharmacies, strategies for patient engagement, and coordination of care for depression screenings. ResultsTwelve patients and 4 prescribers participated in the study. The patient perceptions were categorized into 3 key themes: (1) private and confidential screenings; (2) disparate views regarding the potential interventions that pharmacists could offer; and (3) mental health stigma concerns. The prescriber perceptions were categorized into 3 key themes: (1) support for expanded access to depression screenings provided in community pharmacies; (2) necessity of referral algorithms for transitions of care; and (3) communication of full screening results for positive and negative screens. A mutual theme was identified among patients and prescribers: the view that mental health care provided at a community pharmacy was influenced by an established relationship with a community pharmacist. ConclusionThis study describes patient and provider perceptions of depression screening within the community pharmacy setting. Prescribers were supportive of community pharmacists’ ability to close the gaps in access to care for patients with mental health conditions, whereas patients had mixed feelings that may have been influenced by concerns of privacy, confidentiality, and stigma. This deeper understanding of prescriber and patient perceptions of how community pharmacies could expand access to depression screening may provide a roadmap for offering these interventions in community pharmacies.

An Information-Based Theory of Financial Intermediation

We advance a theory of intermediation that builds on private information and heterogeneous screening ability across market participants. We solve for the equilibrium market structure and show that investors with high screening ability are the largest intermediators: they are the most central in trade, they trade frequently, they trade with many different counterparties, and they extract high rents. We derive a set of testable predictions from the model and we test them using transaction-level micro data. Our empirical results provide evidence that our mechanism relying on private information and screening ability is a relevant feature of intermediation in over-the-counter markets.

The Salome Ensemble: Rose Pastor Stokes, Anzia Yezierska, Sonya Levien, and Jetta Goudal

The Salome Ensemble: Rose Pastor Stokes, Anzia Yezierska, Sonya Levien, and Jetta Goudal

Successful Suicide Screening in the Pediatric Emergency Department: Youth, Parent, Researcher, and Clinician Perspectives

The purpose of this study was to include youth, parents, researchers, and clinicians in the identification of feasible and acceptable strategies for teen suicide screening in the pediatric emergency department (ED). Concept mapping methodology was used to elicit stakeholder responses. Regarding the most important result of suicide screening for teens in the pediatric ED, suicide prevention and education for parents, friends, and community members was rated easiest to implement, while short- and long-term follow-up and treatment was rated most important. In terms of successful suicide screening for teens in the pediatric ED, provision of resources and information was rated most feasible, and a safe, friendly, private screening environment was rated most important. The concept maps can be used to align suicide risk screening with the priorities and recommendations of pediatric ED stakeholders.

Angular Optical Transparency Induced by Photonic Topological Transition in Hexagonal Boron Nitride

The transmission property of hexagonal boron nitride at its four photonic topological transitions has been studied. An interesting result is revealed that the angular optical transparency can be achieved at wavelength 12.0494 μm. The numerical results indicate that the transparency window has an angular full width at half maximum of 4° with an optical transmission higher than 0.9 at normal incidence. Besides, corresponding to an angular full width at half maximum narrower than 20°, the wavelength span is about 230 nm. These features may make the hexagonal boron nitride holds promise for applications in private screens and optical detectors.

1596P - Malignant lymphoma detected by screening program with esophagogastroduodenoscopy of one private screening center in Japan

1596P - Malignant lymphoma detected by screening program with esophagogastroduodenoscopy of one private screening center in Japan

Development of Assessment Tool for Psychological Effect of Thyroid Cancer Screening

Background: Nation cancer screening program is provided to all population who reached a certain age in Korea. Also individualized cancer screening also widely conducted in private screening units. The harms associated with cancer screening have rarely been reported. Moreover there have been few studies on the psychological effects associated with cancer screening. Aim: This study aimed to evaluate the psychological effects occurring in thyroid cancer screening which is frequently conducted in Korea. We evaluate the validity and reliability of developing measuring tools. Methods: The psychological effects on cancer screening were classified into 3 domains (quality of life, stress response and anxiety) through the review of previous studies and expert discussion. Four assessment tools were selected for measuring quality of life (WHOQOL-BREF), stress level (PSS, SRI), anxiety level (GAD-7). We conducted 2-step of survey. First step was conducted on the day of cancer screening. And second step survey was conducted after reporting cancer screening results. Inclusion criteria of participation is subjects who received thyroid cancer screening for the first time or who has not had thyroid cancer screening for the past 3 years. Based on the survey results, the final assessment tool for psychological effect of thyroid cancer screening was developed through the second expert meeting. The final assessment tool was verified the reliability and the validity through 2-step surveys before and after screening. Results: The new Assessment tool for Psychological Effect of Cancer Screening (APECS) was developed in 4 domains (quality of life, stress-anxiety level, stress responses, and thyroid cancer screening related psychological problems). A total of 143 patients were surveyed on the day of thyroid cancer screening using the developed assessment tool. Second survey was conducted for 99 patients who visited the hospital for counseling the screening results. Test-retest reliability showed high internal consistency with 0.859, P &lt; 0.001, and Cronbach's alpha showed high value with 0.918 in all domains. The reliability of the stress-reaction level domain was the highest in the all domains (0.878). Factor analysis identified 5 factors, including quality of life, stress-anxiety level/response, and thyroid cancer screening–related psychological problems domain were combined. Conclusion: Both of reliability and validity of the newly developed assessment tool for psychological effect of thyroid cancer screening were measured high in all domains. In the future, a strategy for minimizing psychological harms could be suggested from the results of a large scale survey with the new assessment tool on the psychological impact of thyroid cancer screening.

A national cross-sectional study of adherence to timely mammography use in Malta

BackgroundRoutine mammography improves survival. To achieve health benefits, women must attend breast screening regularly at recommended time intervals. Maltese women are routinely invited to undergo mammography at three-year intervals at an organized breast screening programme (MBSP) or can opt to attend a private clinic. Previous research shows that health beliefs, particularly perceived barriers, were the most significant predictors of uptake to the first MBSP invitation. Whether these beliefs and other factors are predictive of adherence with recommended time intervals for mammography at organized or private screening in Malta is unknown. For the first time, this paper explores the predictors for Maltese women screened within or exceeding the recommended three-year frequency in organized or private screening in Malta.MethodsInformation was obtained from a cross-sectional survey of 404 women, aged 50 to 60 years at the time of their first MBSP invitation, where women’s characteristics, knowledge, health beliefs and illness perceptions were compared. The main variable of interest was women’s mammography attendance within a three-year interval (ADHERENT) or exceeding three years (NON-ADHERENT). Data were analysed using descriptive statistics, chi-square test, Mann Whitney test, Independent Samples t-test and Shapiro Wilk test.ResultsAt the time of the survey, 80.2% (n = 324) had been screened within three years (ADHERENT), 5.9% (n = 24) had exceeded the three-year frequency (NON-ADHERENT) while 13.9% (n = 56) never had a mammogram. No significant associations were found between ADHERENT or NON-ADHERENT women in relation to sociodemographic or health status variables (p > 0.05). Knowledge of screening frequency was significantly associated with women’s mammography adherence (χ2 = 5.5, p = 0.020). Health beliefs were the strongest significant predictors to describe the variance between ADHERENT and NON-ADHERENT screeners. When Mann Whitney test and Independent Samples t-test were applied on mammography adherence, perceived barriers and cues to action were found to be the most important predictors (p = 0.000, p = 0.039 respectively).ConclusionsTo increase routine and timely mammography practices, women who are non-adherent to recommended time frequency guidelines should be targeted, together with their health beliefs, predominantly perceived barriers and cues to action.

A Study on Longitudinal Associations between Health Screening and Health Behaviors among Older Adults

Objectives Despite the increasing importance of older adults’ own health behaviors in achieving healthy aging, there has been lack of research on associations between health screening and other health behaviors of older adults. The present study aims to examine longitudinal associations between health screening and smoking, drinking, and practice of regular exercise among older adults. Methods Analyse were based on 2,458 individuals aged 65 and over who participated in the 1-4 waves of the Korean Longitudinal Study of Ageing (KLoSA). Generalized Estimating Equations were performed to investigate associations between health screening and health behaviors when effects of demographic characteristics and health-related variables were controlled. Results Findings suggested that older adults who participated in private health screening showed a lower odds of drinking over the 6-year-period. Both public screening and private screening were associated with greater odds practice of regular exercise. Conclusions Results from the present analyses emphasized health screening, as a preventive health behavior, could promote healthier lifestyle of older adults and suggest potential needs for follow-up after health screening. Key words: Health screening, Health behaviors, Older adults, Generalized estimating equations

Regicide on Repeat: The Pensive Spectator of Rebecca West's &lt;em&gt;Black Lamb and Grey Falcon&lt;/em&gt;

This essay examines Rebecca West's treatment of the 1934 newsreel footage of the assassination of King Alexander of Yugoslavia in her classic book on the Balkans, Black Lamb and Grey Falcon (1941). Giving an account of watching the newsreel again and again in a specially arranged, post-theatrical private screening—an account that gestures at and rhetorically emulates a host of image-manipulating playback techniques (rewinding, slowing, freezing, zooming)—West offers a striking anticipation of the ground covered by Laura Mulvey in Death 24x a Second: Stillness and the Moving Image (2006), where Mulvey mobilizes Raymond Bellour's concept of "the pensive spectator" to theorize the newly widespread affordances of digital home-viewing technology. Relating ideas of unhurried seeing in Bellour and Mulvey to West's famously long, time-taking book, the essay identifies in West's evocation of cinematic spectatorship a pattern of endlessly refracting self-projection that speaks to the complexities of her devotion not to "los[e] sight of the importance of process." Enlarging and pushing backwards in time the genealogy of the pensive spectator, West offers to film studies a rich nodal point in the ongoing project of writing the prehistory of the digital.

Geographical differences in risk of advanced breast cancer: Limited evidence for reductions over time, Queensland, Australia 1997–2014

BackgroundReducing geographical inequalities in breast cancer stage remains a key focus of public health policy. We explored whether patterns of advanced breast cancer by residential accessibility and disadvantage in Queensland, Australia, have changed over time. MethodsPopulation-based cancer registry study of 38,706 women aged at least 30 years diagnosed with a first primary invasive breast cancer of known stage between 1997 and 2014. Multilevel logistic regression was used to examine temporal changes in associations of area-level factors with odds of advanced disease after adjustment for individual-level factors. ResultsOverall 19,401 (50%) women had advanced breast cancer. Women from the most disadvantaged areas had higher adjusted odds (OR = 1.23 [95%CI 1.13, 1.32]) of advanced disease than those from least disadvantaged areas, with no evidence this association had changed over time (interaction p = 0.197). Living in less accessible areas independently increased the adjusted odds (OR = 1.18 [1.09, 1.28]) of advanced disease, with some evidence that the geographical inequality had reduced over time (p = 0.045). Sensitivity analyses for un-staged cases showed that the original associations remained, regardless of assumptions made about the true stage distribution. ConclusionsBoth geographical and residential socioeconomic inequalities in advanced stage diagnoses persist, potentially reflecting barriers in accessing diagnostic services. Given the role of screening mammography in early detection of breast cancer, the lack of population-based data on private screening limits our ability to determine overall participation rates by residential characteristics. Without such data, the efficacy of strategies to reduce inequalities in breast cancer stage will remain compromised.

P3-252 - Current Status and Perspective of Call Request in Lung Cancer Screening

Chest X ray has been the most common screen procedure for detection of lung cancer. It plays a significant role in both private and public health screening program. However, if patients have old inflammatory shadows such as tuberculosis, it would become increasingly difficult to detect the lung cancer. Methods: Our clinic “MedCity21 “was established as an outpatient clinic to undergo a complete medical checkup aimed at pre-emptive preventive medicine. The participants with abnormalities detected in chest X ray, were announced by our calling system and invited to our clinic for further examinations. Here, we report the chest X ray results of the complete medical checkup. Between January 1st and December 31st 2015, the 5603 participants were enrolled in this study, who received private health screening programs including chest X ray in our clinic. Abnormalities were detected in 230 (4.1%) participants of chest X ray and 174 (76%) were received chest CT scan in our clinic. Abnormal shadows were detected in 156 (89.7%), including 106 of nodule, and 17 of ground glass opacity. Six participants were diagnosed as lung cancer within 12 months of medical checkup. The lung cancer detection rate was 0.11%. The division between “lung cancer detection number” to “the expectation value of lung cancer existence” was 1.52. The chest CT scan clarified the detail of lung abnormal shadows in 174 participants. This experience may result in an early prevention and treatment of lung cancer.

1413P - Gastric cancer detected after Helicobacter pylori eradication at one private screening center in Japan

1413P - Gastric cancer detected after Helicobacter pylori eradication at one private screening center in Japan

Association between Socioeconomic Status and Cancer Screening in Koreans over 40 Years in Age Based on the 2010-2012 Korean National Health and Nutrition Examination Survey.

BackgroundWe investigated the association between socioeconomic status (SES) and cancer screening in a Korean population aged 40 years or older.MethodsThis cross-sectional study included 12,303 participants (5,284 men and 7,019 women) who participated in the 2010–2012 Korean National Health and Nutrition Examination Survey. Self-reported questionnaires were used to assess participant's SES (household income, occupational, and educational status) and cancer screening behavior.ResultsCompared to the lowest household income group, the odds ratios (ORs) (95% confidence intervals [CIs]) for overall cancer screening of the highest income group were 2.113 (1.606–2.781) in men and 1.476 (1.157–1.883) in women; those for private cancer screening of the highest income group were 2.446 (1.800–3.324) in men and 2.630 (2.050–3.373) in women, while those for National Cancer Screening Programs (NCSP) in the highest income group were 1.076 (0.805–1.439) in men and 0.492 (0.388–0.623) in women. Compared to manual workers, ORs (95% CIs) for private cancer screening of office workers were 1.300 (1.018–1.660) in men and 0.822 (0.616–1.098) in women. In comparison to the least educated men, OR (95% CI) for private cancer screening of the most educated men was statistically significant (1.530 [1.117–2.095]).ConclusionHigher economic status was associated with higher rates of overall and private cancer screening in both sexes and a lower rate of NCSP in women. Male office workers and more educated individuals underwent private cancer screening at a higher rate than manual workers and less educated individuals, respectively.

1115 Gastric cancer of helicobacter pylori negative stomach detected at one private screening center in Japan

1115 Gastric cancer of helicobacter pylori negative stomach detected at one private screening center in Japan

Abstract A34: Church-based recruitment and retention of Appalachian adults in an eHealth program to reduce obesity

Abstract Purpose: Appalachia is a socioeconomically-disadvantaged region with limited preventive health services. The ACCN is a NCI-funded research initiative that collaborates with community-based cancer coalitions to increase awareness, provide education, and promote cancer prevention. Using CBPR principles, ACCN researchers are testing in a group randomized trial a faith-based program focused on obesity, a modifiable risk factor for cancer. The primary outcome is change in body mass index from baseline to twelve months. Secondary outcomes are changes in physical activity, diet and blood pressure, and the maintenance of the intervention effect during a sustainability period. This paper focuses on participant recruitment to this faith-based program and retention of enrolled participants throughout the 12-month intervention phase. Methods: The project employed CBPR strategies to recruit participants following principles put forth in the Accrual to Clinical Trials (ACT) Framework. The program is based on Social Cognitive Theory and the Transtheoretical Model. The research team includes ACCN, Viocare, Inc., community coalitions, community members, and churches. Community coalitions assisted in identifying churches and designing educational sessions. Participants were recruited through bulletins and announcements from the pulpit. Individuals attended an information/screening session conducted by regional and local staff, or completed a private screening with local staff. In order to keep participants engaged in the program throughout the 12-month intervention phase, education sessions were held monthly and included activities, games, trivia, healthy snacks, and prizes. Gift cards were given to all participants who completed 12-month outcome screenings. Results: As of 8/31/2013, 22 churches have enrolled into the study. 715 church members were screened. Of those, 606 (84.8%) were determined to be eligible, and 566 (93.4%) of those eligible enrolled as participants. Main reasons for ineligibility included BMI &amp;lt; 25 (53.2%), not completing all baseline screenings (25.7%), and existing dietary restrictions (7.3%). To date, 47 participants have withdrawn from the study (8.3%), with the most cited reason having to do with time constraints. Conclusion: Congregation size most significantly limited recruitment in that it was more difficult to recruit at smaller churches. This may be avoided by discussing congregation size and interest with church leaders before selecting churches. Geographical barriers in rural Appalachia impacted participant recruitment and retention in some churches, but assistance from church navigators and field staff helped to abate this. Distrust of outsiders, a common characteristic in Appalachia, slowed recruitment, but regional staff presence at church and community events supported successful recruitment. Recruitment strategies will continue to be modified as accrual is completed in Fall 2013. Although the intervention phase is ongoing in the majority of the churches, it has been observed that motivated and engaged church navigators and leaders positively impact participant involvement. Citation Format: Ryan Baltic, Electra D. Paskett, Stephenie Kennedy, Gene Lengerich, Karen Roberto, Nancy Schoenberg, Samuel Lesko, Mark Dignan. Church-based recruitment and retention of Appalachian adults in an eHealth program to reduce obesity. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A34. doi:10.1158/1538-7755.DISP13-A34

Do breast cancer risk factors differ among those who do and do not undertake mammography screening?

There is considerable interest in whether mammography screening leads to over-diagnosis of breast cancer. However self-selection into screening programmes may lead to risk differences that affect estimates of over-diagnosis. This study compares the breast cancer risk profiles of participants and non-participants of population-based mammography screening. Risk profiles are also compared between those who have and have not used private screening services. This study involved 1162 women aged 40-84 who participated in the 2012 Health Omnibus, an annual face-to-face interview-based survey of a representative sample of the population in the state of South Australia. Data were collected on participation in mammography screening, demographic characteristics and breast cancer risk factors (including reproductive, familial and lifestyle factors). Missing data were multiply imputed. Factors independently associated with ever having been screened were identified using multivariable logistic regression, for population-based and ad hoc, private mammography screening separately. Compared with non-participants, participants of population-based screening were more likely to have used hormone replacement therapy (odds ratio [OR] = 3.72), experienced breast biopsy or surgery (OR = 2.22), and be overweight or obese (OR = 1.57). They were less likely to be sufficiently active (OR = 0.57) or be born in a non-English speaking country (OR = 0.50) or aged under 50 (OR = 0.09). Women who were screened privately were more likely to have a family history of breast cancer (OR = 1.66) and have experienced breast biopsy or surgery (OR = 3.17) than those who had not. South Australian women who participated in the population-based mammography screening have a slightly higher prevalence of breast cancer risk factors. This also applies to those who undertook private screening.

Book Review: Equal Time: Television and the Civil Rights Movement, by Aniko Bodroghkozy

Equal Time: Television and the Rights Movement. Aniko Bodroghkozy. Urbana: University of Illinois Press, 2012. 280 pp. $50 hbk.Part of The History of Communication series, Equal Time: Television and the Rights Movement combines analysis of news coverage with a study of three prime-time programs to address representations of African Americans on network television during a critical era in American history. In the introduction, Aniko Bodroghkozy underscores the importance of her study by citing the Rev. Martin Luther King Jr.: We are here to say to the white men that we no longer will let them use clubs on us in the dark corners. We're going to make them do in the glaring light of television.Edited by Robert W. McChesney and John C. Nerone, the series includes books written or compiled by well-known communication and media scholars, including Gerald J. Baldasty, Bonnie Brennen, John M. Coward, Clifford G. Christians, Theodore L. Glasser, Hanno Hardt, Denis McQuail, Peter Simonson, Linda Steiner, Inger Stole, and Doug Underwood. Although Equal Time occasionally drifts into com- mentary, effectively a compelling era and complements other studies pub- lished in the landmark University of Illinois Press series.Divided into two sections, Network News in the Rights Era and Civil Rights in Prime-Time Entertainment, Equal Time is the result of encyclopedia entries and essays Bodroghkozy published in collections such as African American Popular Culture and Private Screenings: Television and the Female Consumer, and in journals such as Screen and Television and New Media. As she notes in the acknowledgments, the book had a rather long gestation, beginning during her graduate work at the University of Wisconsin-Madison in the 1990s and culminating in 2012.An associate professor of media studies at the University of Virginia, Bodroghkozy focuses on two topics: First, Equal Time explores the crucial role American network television played during the civil rights revolution in reconfiguring a new 'common sense' about race relations and complicate[s] the picture of the relationship among the civil rights movement, television, audiences, and partisans on either side of the black empowerment struggle. Second, she discusses three prime-time television pro- grams that allow black actors to take center stage. Until the mid-1960s, Bodroghkozy writes, it was rare for viewers to see blacks in entertainment programming. This set up a bizarre disjunction between news which focused increasing atten- tion on the Southern black struggle, and fictional shows that presented mostly all- white worlds.Reasons for selecting East Side/West Side, Julia, and Good Times instead of other texts are not clear, especially since other prime-time programming might be more celebrated by the public and/or more critically acclaimed. One explanation might be the availability of viewer responses in the archives and libraries where Bodroghkozy conducted her research. Most television viewers did not record their responses to what they were viewing and thus leave a documentary record for historians. But some did, Bodroghkozy writes. And some of those responses, typically letters written to program producers or networks, have ended up in the collected papers of those pro- ducers . . . [or] published in newspapers.Bodroghkozy is especially effective when she discusses specific topics, including the Little Rock Nine, the contributions of the newsmagazine See It Now, heroic challenges to Mississippi voting practices, James Meredith and Ole Miss, and I Have a Dream. She is persuasive when she holds television networks accountable for their pursuit of the least objectionable programming, explaining how ideologically dan- gerous is for broadcasters to try to offend as few viewers as possible in order to maximize audience share. Additionally, she demonstrates formidable critical sensi- bility when she explains, for example, how photojournalism is often more effective than television images that can be chaotic, rapid paced, often difficult to see-and how the opposite can also be true. …