Paul McDonald

Comparison of patient questionnaire, medical record, and audio tape in assessment of health promotion in general practice consultations

Abstract Objective: To determine what proportion of health promotion activities reported by the patient is recorded in the general practice notes and to compare these methods of assessing health promotion with audio tape analysis. Design: Secondary analysis of data obtained in a controlled trial of differing appointment lengths. After each consultation the medical record was examined and the patient invited to completed a questionnaire. A subsample of consultations was audio taped. Setting: Nottinghamshire. Subjects—16 general practitioners from 10 practices. This report includes 3324 consultations with patients aged >/=17, with data on measurement of blood pressure and advice about smoking and alcohol. Results: Data from questionnaire and medical notes were available for 2281 consultations. Advice on smoking was recorded in the notes in 30.9% of cases in which a patient reported it (for alcohol and measurement of blood pressure, 44.4% and 82.7% of cases respectively). In 516 cases analysis of audio tape and review of records was performed. Advice on smoking was recorded in the patients notes in 28.6% of cases in which it was detected on audio tape (for alcohol, 31.1% of cases). In 335 consultations data from audio tape and questionnaire were available. Advice on smoking was reported by patients in 73.9% of cases in which it was detected on audio tape (for alcohol, 75.0% of cases). Conclusions: Review of the medical record is a reasonably accurate method of assessing measureent of blood pressure in the consultation but would lead to significant underestimation of advice about smoking and alcohol.

Universal ideals in local realities Online viewing in South Korea, Brazil and India

The potential of the Internet to act as a global distribution outlet for screen content has long come into conflict with the nationally focused strategies of producers, broadcasters, governments and Internet service providers. Online viewing therefore acts as a useful case study for interrogating how tensions between ‘global’ and ‘local’ manifest within an increasingly digitized media landscape. This article examines the online viewing markets in three countries at different stages of digital maturity (South Korea, Brazil and India) to consider how online viewing has evolved in each. It then examines audience questionnaire and interview data generated in each country to explore how viewers are making sense of and valuing online viewing services. By interrogating all three samples before focusing specifically on India in more detail, it examines two tensions within the global expansion of online film and television distribution: between global trends and local infrastructures and between the ideals of online viewing services and the grounded realities of their daily use.

Hollywood and the Law

Since the earliest days of cinema the law has influenced the conditions in which Hollywood films are made, sold, circulated or presented – from the talent contracts that enable a film to go into production, to the copyright laws that govern its distribution and the censorship laws that may block exhibition. Equally, Hollywood has left its own impression on the American legal system by lobbying to expand the duration of copyright, providing a highly visible stage for contract disputes and representing the legal system on screen.

Channel 4 and British film culture

Among the many broadcasting achievements recognised at the 25th anniversary of UK television’s Channel 4 in 2007, relatively little attention was paid to its contribution to British film culture. This neglect was surprising for a number of reasons. Chief among these was that Channel 4 was the first British broadcaster to establish a commissioning structure underpinned by financial subsidy, which provided a significant lifeline to an indigenous film industry in the doldrums in the early 1980s. This cultural-subsidy model has since been replicated, with differences, by the BBC, and together with grant-in-aid from the UK’s National Lottery, these public service broadcasters (PSBs) have become the mainstay of a resurgent British film culture.Among the many broadcasting achievements recognised at the 25th anniversary of UK television’s Channel 4 in 2007, relatively little attention was paid to its contribution to British film culture. This neglect was surprising for a number of reasons. Chief among these was that Channel 4 was the first British broadcaster to establish a commissioning structure underpinned by financial subsidy, which provided a significant lifeline to an indigenous film industry in the doldrums in the early 1980s. This cultural-subsidy model has since been replicated, with differences, by the BBC, and together with grant-in-aid from the UK’s National Lottery, these public service broadcasters (PSBs) have become the mainstay of a resurgent British film culture. But sustaining and influencing the character of a national film culture is about more than providing production finance, and Channel 4’s contribution has been more far-reaching and more diverse. An Arts and Humanities Research Council (AHRC) funded project based at the University of Portsmouth in partnership with the British Universities Film and Video Council (BUFVC, www.bufvc.ac.uk), aims to assess the range and significance of that contribution through a programme of extensive archival and interview-based research, involving Channel 4, the BUFVC and a six-member team. The project also seeks to stimulate further work in the field. This special issue of the Historical Journal combines witness testimony and reflection from some key contributors to the story of film at Channel 4, with the ongoing work of current researchers. Together they reassess a vital period in British broadcasting, which forged a new and lasting synergy between the UK’s film and television cultures. The UK’s fourth television channel was launched in November 1982. In its organisational structure and policy remit Channel 4 marked a distinctive departure from the existing duopoly of the BBC and independent television (ITV) networks. BBC television, funded entirely from an annual licence fee, began broadcasting in 1946. ITV was launched in 1955 and was sustained by the revenue from its own advertising, monitored by its regulator, the Independent Broadcasting Authority (IBA). As part of the recommendations of the Pilkington report (1960), a second Historical Journal of Film, Radio and Television, 2013 Vol. 33, No. 3, 355–364, http://dx.doi.org/10.1080/01439685.2013.823023

Hollywood, the MPAA, and the formation of anti-piracy policy

Combating piracy is fundamental to the policy ‘priorities’ of the Motion Picture Association of America, the trade association representing the major Hollywood entertainment corporations. As the MPAA implements a multitude of actions to fight piracy, it is impossible to locate the formation of the Association’s anti-piracy policy in any single source. Instead, this article sees MPAA anti-piracy policy as formed across three fronts: the legal, through anti-piracy litigation; the political, by the MPAA joining with other trade groups from across the copyright industries to lobby for stronger domestic copyright laws and influence US trade policy; and the discursive, seen in the production of statistics to evidence the value of copyright to the US economy and consequent harms caused by piracy. Examining these actions confirms the cultural and economic influence of MPAA policy but the article is also concerned with how Hollywood’s anti-piracy efforts are challenged and contested from various directions.

RAPID RESPONSES FROM BMJ.COM: Best practice is best in general practice

research and development results. London: Management School, Imperial College of Science Technology and Medicine, 1994. (Report to North Thames Regional Health Authority.) 4. Sweeney KG. Evidence an uncertainty. In: Marinker M, ed. Sense and sensibility in health care. London: BMJ Publishing, 1996:59-87. 5. Veldhuis M, Wigersma L, Okkes I. Deliberate departures from good general practice: a study of motives among Dutch general practitioners. Br J Gen Pract 1998;48:1833-1836. 6. Howitt A, Armstrong D. Implementing evidence based medicine in general practice: audit and qualitative study of antithrombotic treatment for atrial fibrillation. BMJ 1999;318:1324-1327. 7. McColl A, Smith H, White P, Field J. General practitioner’s perceptions of the route to evidence based medicine: a questionnaire survey. BMJ 1998;316:361-365. 8. Balint M. The doctor, his patient and the illness. London: Pitman, 1957. 9. Salinsky J. Psychoanalysis and general practice: what did the Romans do for us? Br J Gen Pract 2001;51:506. 10. Glaser B, Strauss A. The discovery of grounded theory. Chicago: Aldine, 1957. 11. Tomlin Z, Humphrey C, Rogers S. General practitioners’ perceptions of effective health care. BMJ 1999;318:1532-1535. 12.Mayer J, Piterman L. The attitudes of Australian GPs to evidence-based medicine: a focus group study. Fam Pract 1999;16: 627-632. 13. Kernick DP. Muddling through in a parallel track universe [letter]. Br J Gen Pract 2000;50:325. 14. Sweeney KG, MacAuley D, Gray DP. Personal significance: the third dimension. Lancet 1998;351:134-136. Papers

Reviews : Daya Kishan Thussu, International Communication: Continuity and Change (London: Arnold, 2000), 342pp. ISBN 0 340 74131 7 (pbk

Understanding and conceptualising the role of communications in the making of international connections has produced a rich vein of scholarly research. This field of work is covered in Thussu’s wellstructured book. Individual chapters address the history and theorisation of international communications, before looking at the formation of the international communication infrastructure, the global market for communications, the cultural aspects of globalisation, and patterns of contra-flow in transnational media. A final chapter brings these perspectives together in thinking about the ways in which the internet is

The Entertainment Computer Trade Show, Olympia, London, UK, 7-9 September 1997

Lara Croft will appear. She is here at the Entertainment Computer Trade Show (ECTS) as part of the publicity for the new Tomb Raider I!, developed by Core Design and published by Eidos Entertainment. Anticipation mounts as the publicised time draws near. The Eidos exhibition stand is large but was certainly not built to take the number of people who flock to it. All are here on the promise that they will get to meet and greet Lara, adventure hero of the top-selling video game title of recent years. Lara has run, jumped, rolled and shot her way through underground caverns in search of an ancient trinket called the Scion. Indiana Jones cannot compete with her kick ass feats of derringdo. Today her challenge is to battle through the hordes and take the stage as queen of the cyberbabes. Rumour has it, and there have been