Articles>Scientific Communication>Biomedical

"Public" Perceptions of Gamete Donation: A Research Review

This paper reviews the literature on “public” perceptions of the practice of gamete (egg and sperm) donation in the treatment of infertility. Despite regular “consultation” exercises in the UK on the manner in which infertility treatments should be regulated, there is little sense of how a range of public groups respond to developments in this area. The key themes from thirty-three articles, chapters and reports are discussed. The review reveals the limited nature of our current knowledge of public understandings of and attitudes towards gamete donation as a form of infertility treatment which has been readily available and widely practiced for many years. The review is critical of the methodological and epistemological basis of much of the work in this area and argues that there is a strong case for social scientific research to attempt to capture the perceptions of a wider range of people who are rarely included in formal public consultations and often similarly excluded from research studies.

The Prostate Cancer Screening Debate: Public Reaction to Medical Controversy in the Media

This study explored older men's and their partners' reactions to a television news program on the medical debate surrounding the use of the prostate-specific antigen (PSA) test for prostate cancer screening. Six focus groups, split by gender and socio-economic status (SES), were conducted with men aged 50 years or older (n = 28) and female partners of such men (n = 13). A self-completion questionnaire was also used to yield quantitative indices. In general, viewers appeared to appreciate from the debate that there was controversy surrounding prostate cancer screening, and they recognized that PSA testing is more applicable to certain subgroups of men. Although there were differences by SES and gender, the results suggest that exposing health consumers to medical uncertainty and “expert” conflict can help raise awareness of the issue and complexities involved. However, there was evidence to suggest that health consumers may be better able to negotiate conflicting medical information if the different sides of the argument are plainly noted and a clear distinction is made between opinion and evidence. This study has broader relevance to the management of media coverage of medical controversies by public health organizations.

Consumer Attitudes and the Governance of Food Safety

This paper reports the analysis of a recent study of public perception of food safety governance in Spain, using genetically modified (GM) foods as an indicator. The data make clear that Spanish food consumers are aware of their rights and role in the marketplace. They are critical of current regulatory decision making, which they perceive to be unduly influenced by certain social actors, such as industry. In contrast, consumers demand decisions to be based primarily on scientific opinion, as well as consumer preferences. They want authorities to facilitate informed purchasing decisions, and favor labeling of GM foods mostly on the grounds of their right to know. However, consumers' actual level of knowledge with respect to food technology and food safety remains low. There are several ambivalences as to the real impact of these attitudes on actual consumer behavior (specifically when it comes to organizing themselves or searching out background information).

Just Around the Corner: Rhetorics of Progress and Promise in Genetic Research

The emerging “diabetes epidemic” threatens to affect 366 million people worldwide by 2030. In the UK, almost 2 million people (about 3.9 percent of the population) are currently diagnosed with diabetes and it is estimated that a further 1 million people have the disease but do not realize it. The prevalence of diabetes, its complications and their effects on the lives of those living with diabetes mean that diabetes research has the potential to bring significant benefits. In this paper, we are concerned with the research involving human embryonic stem (HES) cells that sees diabetes as a potential therapeutic location. Drawing on the idea of the “certainty trough” we examine how the hopes and uncertainties associated with this complex research agenda are understood. We show that those at the research front and those most opposed to the research agenda appear to be the most aware of the uncertainties that need to be resolved. In contrast, funders, typically one-step removed from the research work, see the promise of the research as more real and more likely to be achieved. Significantly, these optimistic funders are supported in their beliefs by the research scientists as constitutive claims are reproduced within the contingent forum. The effect is a collaborative project in which the promise of a technical solution “just around the corner” is sustained whilst concerns about the future difficulties are marginalized.

Consultations of Stakeholders on the Roles of Research in Relation to Genetically Modified Plants in France

This article reports the first consultations on the roles of research in relation to genetically modified plants in France. We present a new attempt at facilitating discussion towards acceptable decisions and their results. This method consists of three steps: individual in-depth interviews of 77 French stakeholders, analysis of the interviews to identify elements that could help a constructive debate among participants, and two round-table discussions to present this analysis to stakeholders and foster discussions among them. The interviews exhibit a diversity of perceptions that are vaster than the pro or against points of view within the media. The problems raised during interviews deal with how discussions on genetically modified organisms (GMOs) are being done, how risks are taken into account, how the information is diffused, and how there is a minimal level of attention paid to social needs in GMOs' production. A series of problems more specific to the subject of the study discuss the weaknesses of the public research system. On the basis of these problems, 21 elements were identified that the stakeholders would like to see improved. One request seemed to be important for all types of stakeholders: “Raising the objectivity of the debate on GMOs.” Our facilitation exercise led to a set of innovative concrete proposals for the design of an effective national debate.

Value-Sensitive Design and Health Care in Africa

In this paper, we describe our approach of using value-sensitive design to guide the design, development, and implementation of health information systems for use in rural areas of two developing countries in Africa. By using shared conceptual investigation, we are able to create a generalized list of stakeholders and values that span multiple projects without losing any of the power of the conceptual investigation. This process can be applied to other projects to develop a stronger set of stakeholders and values. We also present a technical investigation of a vaccine delivery project in Sub-Saharan Africa and plans for an upcoming empirical investigation for a mobile-phone-based support tool for community health workers in East Africa.

Interplay of Negative Emotion and Health Self-Efficacy on the Use of Health Information and Its Outcomes

During the course of illness, people diagnosed with cancer need information to cope with cancer. Despite the crucial role of information, little is known about why some people with cancer choose to seek further information about their illness and why others do not. This study investigates the interplay of two psychological factors, negative emotion and health self-efficacy, on patients' health information use. Using the data collected from 122 women diagnosed with breast cancer, the authors found that negative emotions and health self-efficacy jointly affect the use of health information. Among patients with high health self-efficacy, negative emotions were positively related to the amount of information sought, whereas among those with low health self-efficacy, negative emotions were negatively related to the amount of information sought. The results also show that there are significant increases in patients' health self-efficacy after the use of health information for 2 months.

The Role of Ambivalence in College Nonsmokers' Information Seeking and Information Processing

The abundant prosmoking influences in college can cultivate a sense of ambivalence about smoking among many nonsmoking students. In this study, the authors investigated the role of ambivalence in college nonsmokers' seeking and processing of smoking-related information. Three hundred ninety-six nonsmoking college students participated in an online study. Hypotheses were built into a predictive model and tested using structural equation modeling. Higher ambivalence was found to be associated with greater information seeking in the past 30 days. Past information seeking, in turn, was associated with deeper processing and greater acceptance of new antismoking information. Implications of the results for smoking prevention on college campuses are discussed.

Testimonials Versus Informational Persuasive Messages: The Moderating Effect of Delivery Mode and Personal Involvement

This study aims to test the relative effectiveness of testimonials compared to simple informational health messages, presented both through different modalities and to recipients with different levels of involvement. Results of the three independent experiments demonstrate that testimonials are more persuasive when presented through the audio mode rather than when presented through the written mode. Also, the informational messages are more persuasive when perceived by individuals characterized by high rather than low involvement and high rather than low need for cognition. The results are explained in terms of the Elaboration Likelihood Model. The interactive effect of transportation and involvement on persuasion is further examined. The findings help in the development of more efficient message targeting. The highest level of efficiency can be achieved if the appropriate media modality and message format are used for recipients with certain initial involvement or need for cognition.

Science TV News Exposure Predicts Science Beliefs: Real World Effects Among a National Sample

The authors attempt here to address a dilemma faced in recent investigation of science and health communication effects: the difficulty of assessing exposure impact in situations beyond the laboratory. Based on social representation theory, we posit that TV news exposure, especially for stories framed as relevant to the everyday lives of individual audience members, can affect people’s beliefs about science and that such exposure also should interact with interpersonal conversation to jointly predict beliefs. To assess these relationships in a real world setting, we integrated market-level and individual-level data from a science TV news project funded by the National Science Foundation and employed multilevel modeling to predict beliefs about science. This move allowed us to combine information about TV Designated Market Areas with responses from a national Internet-based survey and permitted a model that included both market-level and individual-level variables. Results indicate both main effects and interaction effects. Presence of relevant science stories in a TV market, for example, positively predicted subsequent beliefs about the general accessibility of science among audience members in that market even after controlling for individual-level variables.

Internet Health and the 21st-Century Patient: A Rhetorical View

Internet health—here, the public use of information Web sites to facilitate decision making on matters of health and illness—is a rhetorical practice, involving text and trajectories of influence. A fulsome account of it requires attention to all parts of the rhetorical triangle—the speaker, the subject matter, and the audience—yet most scholarship on Internet health focuses on the speaker only: it typically raises concerns primarily about the dangers of unreliable sources, suggesting that, where speakers are reliable and information is accurate, Internet health simply empowers patients. This essay turns attention to the other elements of the triangle. It argues that health information is a complex entity—not only transmitted but also transformed by the Web—and, further, that Internet-health users are a complex audience—not only informed but also transformed by the Web. Rhetorically-minded researchers are well positioned to study not simply the informed patient but rather, more comprehensively, the wired one.

"Proof" in Pictures: Visual Evidence and Meaning Making in the Ivory-Billed Woodpecker Controversy

This case study focuses on images in three Science articles on the ivory-billed woodpecker, whose rediscovery was recently heralded. Because the primary piece of evidence is a frustratingly fuzzy four-second video, two groups of authors ultimately disagree on its interpretation and the same still video images that are used to argue for the sighting are used to argue against it. Given that the authors are making taxonomic arguments, images that closely resemble reality are employed. These images, like all images, are coded, and this analysis seeks to unlock these visual codes to reveal how meaning is made at the site of production, the site of the image, and the site of the audience. It also exposes how meaning making at the site of the image fueled the controversy.

Resources of Ambiguity: Context, Narrative, and Metaphor in Richard Dawkins’s The Selfish Gene

Richard Dawkins’s The Selfish Gene illustrates the power of ambiguity in scientific discourse. The rhetorical and epistemic resources that ambiguity provide are most apparent at the level of metaphor but are also central to the exigency for Dawkins’s argument and to the narrative form that the argument takes. Using ratios derived from Burke’s dramatistic pentad, I analyze how ambiguous language helped Dawkins to link different theoretical conceptions of the gene and consequently posit connections between genes and organisms that had not yet been empirically established. I thus demonstrate at a conceptual and textual level how ambiguity contributes to the construction of novel scientific arguments. For Dawkins, ambiguity provided a discursive space in which he could speculate on connections and developments for which he did not yet have evidence, data, or terminology. Despite his insistence that his use of figurative motive language was simply a ‘‘convenient shorthand’’ for more technical language, The Selfish Gene demonstrates the powerful epistemological and rhetorical role that ambiguous metaphors play in biological discourse.

Localizing Medical Information for U.S. Spanish-Speakers

Examines focus group data about Spanish speakers' preferences for health communication. Contrasts known preferences of Mexican Spanish speakers with Spanish speakers in the U.S. Makes recommendations from the data for communicating health information to Spanish speakers within the U.S.

Health at High Speed: Broadband Internet Access, Health Communication, and the Digital Divide

The study reported here explored the broadband digital divide in the context of Internet- based health communication. Inequities in the adoption of broadband technology were examined and the comprehensive model of health information seeking (CMIS) was used to make predictions about the implications of broadband Internet for personal health. Data from a population-based survey conducted by the National Cancer Institute in 2005 (N = 5,586) were analyzed. Results showed that those who were younger, more educated, and lived in an urban area were more likely to have a broad- band Internet connection in their home. Furthermore, consistent with the CMIS, those with a broadband connection were more likely to use the Internet for health-related information seeking and communication than those with a dial-up connection.

Playing Doctor? Trends in Health Information Seeking on the Web

Evolving and improving technology can improve health and healthcare in a myriad of ways. Equipment that is designed with the user, task, and environment in mind will reduce errors and improve outcomes. New designs make it possible for patients to do things for themselves that previously only doctors could.

Can Two Established Information Models Explain the Information Behaviour of Visually Impaired People Seeking Health and Social Care Information?

This study provides a new and valuable insight into the information behaviour of visually impaired people, as well as testing the applicability of a specific and generic information model to the information behaviour of visually impaired people seeking health and social care information.

A Grounded Theory Model of On-Duty Critical Care Nurses' Information Behavior: The Patient-Chart Cycle of Informative Interactions

Critical care nurses' work is rich in informative interactions. Although there have been post-hoc self report studies of nurses' information seeking, there have been no observational studies of the patterns of their on-duty information behavior. This paper seeks to address this issue.

Use and Outcome of Online Health Information Services: A Study Among Scottish Population

The purpose of this paper is to report on a research designed to find out how people in Scotland access and use online health information.

A Grounded Investigation of Genred Guidelines in Cancer Care Deliberations

Genred documents facilitate collaboration and workplace practices in many ways—particularly in the medical workplace. This article represents a portion of a larger grounded investigation of how medical professionals invoke a wide range of rhetorical strategies when deliberating about complex patient cases during weekly, multidisciplinary deliberations called Tumor Board meetings. Specifically, the author explores the role of one key document in oncological practice, the Standard of Care document. Each Standard of Care document (one for every known cancer) presents a set of national guidelines intended to standardize the treatment of cancer. Tumor Board participants invoke these guidelines as evidence for or against particular future action. In order to better understand how genred, generalizable guidelines like Standard of Care documents afford decision making amid uncertainty, the author conducts a temporal and contextual analysis of the document's use during deliberations as well as a modified Toulminian analysis of a representative sample. Results suggest that, while on its own the document achieves an authoritative, charter-like purpose, it fails to make explicit a link between individual patients' experiences and the profession's expectations for how to act. Implications for how genred, generalizable guidelines—given the way they encourage certain ways of seeing over others—organize and authorize work are discussed, and a modified Toulminian approach to understanding the relationship between claim and evidence in multimodal texts is modeled.

Ethical or Unethical Persuasion? The Rhetoric of Offers to Participate in Clinical Trials

Based on a sample of 22 oncology encounters, this article presents a discourse analysis of positive, neutral, or negative valence in the presentation of three elements of informed consent—purpose, benefits, and risks—in offers to participate in clinical trials. It is found that physicians regularly present these key elements of consent with a positive valence, perhaps blurring the distinction between clinical care and clinical research in trial offers. The authors argue that the rhetoric of trial offers constructs and reflects the complex relationships of two competing ethical frameworks—contemporary bioethics and professional medical ethics—both aimed at governing the discourse of trial offers. The authors consider the status of ethical or unethical persuasion within each framework, proposing what is called the best-option principle as the ethical principle governing trial offers within professional medical ethics.

Gestural Enthymemes: Delivering Movement in 18th- and 19th-Century Medical Images

This article contributes to recent efforts to add life and movement to rhetorical studies by focusing on the representation of movement in medical texts. More specifically, this study examines medical texts, illustrations, and photographs involving movement by Johann Casper Lavater, G. B. Duchenne de Bologne, Charles Darwin, and Étienne-Jules Marey. By identifying how figures of speech epitomize arguments, this examination follows a shift in the way arguments about movement are represented, a shift from static, visual arguments to gestural enthymemes, as they are named, arguments that are made in movements; these shifts are linked to developments in medical technologies involving photography. These arguments about and using movement attempt to “capture” or express the moments within which life, through the embodied gesture, resides. This extended understanding of the enthymeme broadens current understanding of argument to include delivery, links medical and rhetorical discursive practices, and informs how we make sense of and study the relationships between technology and rhetoric both in the past and present.

How Do People at FDA Read Documents On-Screen?

With the substantial move to submitting electronic documents versus paper documents to FDA, it is useful to pause and consider how a regulatory reviewer actually reads a large complex technical document on screen.

Why the Focus on Review Practices?

improving document review practices is of great concern to many in the biopharmaceutical industry. The reason for this interest can be explained by the following observations which provide some insight as to why review is, or needs to be, a central focus for improving knowledge propagation and dissemination.

XML Initiatives in Pharma

The pharmaceutical industry has been slow to adopt XML until recently. Initiatives in the US and EU, as well as other jurisdictions, have begun that use XML to define important documentation formats as part of the drug product life cycle. In the US the FDA is mandating that drug product descriptions called "labels" be submitted in an XML format called the Standard Product Label (SPL) language by the end of 2005 and similar mandates are being made in the EU and other regions. Since most pharmaceutical companies are international, companies are scrambling to figure out the best method for managing their data in order to meet all of meeting these specific requirements. Also, drug label information will become an important component in the broader set of medical records and prescription standards that are being developed concurrently. This session will describe the roles and status of these standards, initiatives for adoption in the US and the EU, and provide some ideas on strategies for managing data within this complex set of requirements.

Technical Communicators Put the "Public" in Public Health

How does Web 2.0 fit into the world of public health? STC Fellow, Dr. Thomas Barker discusses the values of social networking in regards to largescale public disasters, such as Hurricane Katrina and the SARS outbreak.

Health Informatics: Current Issues and Challenges

Health informatics concerns the use of information and information and communication technologies within healthcare. Health informatics and information science need to take account of the unique aspects of health and medicine. The development of information systems and electronic records within health needs to consider the information needs and behaviour of all users. The sensitivity of personal health data raises ethical concerns for developing electronic records. E-health initiatives must actively involve users in the design, development, implementation and evaluation, and information science can contribute to understanding the needs and behaviour of user groups. Health informatics could make an important contribution to the ageing society and to reducing the digital divide and health divides within society. There is a need for an appropriate evidence base within health informatics to support future developments, and to ensure health informatics reaches its potential to improve the health and well-being of patients and the public.

Better Reporting of Randomized Trials in Biomedical Journal and Conference Abstracts

Well reported research published in conference and journal abstracts is important as individuals reading these reports often base their initial assessment of a study based on information reported in the abstract. However, there is growing concern about the reliability and quality of information published in these reports. This article provides an overview of research evidence underpinning the need for better reporting of abstracts reported in conference proceedings and abstracts of journal articles; with a particular focus in the area of health care. Where available we highlight evidence which refers specifically to abstracts reporting randomized trials. We seek to identify current initiatives aimed at improving the reporting of these reports and recommend that an extension of the CONSORT Statement (Consolidated Standards of Reporting Trials), CONSORT for Abstracts, be developed. This checklist would include a list of essential items to be reported in any conference or journal abstract reporting the results of a randomized trial.

The Use of Electronic Mail in Biomedical Communication

Publication in general medical journals stimulates more conventional than electronic mail. However, the content of e-mail may be of greater scientific relevance. Electronic mail can be encouraged without fear of diminishing the quality of the communications received.

Health Care Institutions, Communication, and Physicians' Experience of Managed Care

This study uses the institutional theory of organizational communication (ITOC) to explain physicians' reactions to managed care. ITOC posits that enduring beliefs and practices both transcend and shape particular organizations and organizing. The authors find that physicians' institutional beliefs moderated the negative relationship between managed care medical practice and satisfaction. ITOC also posits that the negotiation of institutional, environmental, organizational, and individual factors occurs through communication. Controlling for these factors, communication with managed care representatives remains significantly and positively related to satisfaction. The results provide support for ITOC and macro approaches to organizational communication research and offer insights for the management of professionals in general and physicians in particular.

Teaching Students to Design Information About Difficult Subjects: Public Information About Pediatric AIDS

Advanced technical communication students analyzed information about pediatric AIDS that was designed for dtrerent segments of the public. They then produced individual projects for local segments of the university and surrounding community. Through this assignment, students learned the importance of community standards in designing accurate and locally 'acceptable' communication about a difficult subject.

Writing Across the Chemistry Curriculum

While chemistry faculty agree that writing is an important professional skill, few know how to teach it. They lack a strategy for incorporating writing into their courses, skill in designing eflective writing assignments, and knowledge of evaluation methods. Our practical manual, funded by the Camille and Henry Dreyfus Foundation and the College of Arts and Sciences of the University of Tennessee Knoxville, will provide chemistry and other science faculty with these skills along with a set of ready-to-use assignments for their courses. The manual will allow chemistry faculty to teach writing purposefully and effectively, focusing on the scientific content while systematically developing this all-important skill.

Graphic Barriers: Enhanced Comprehension of Patient Education Material

In this paper, I will demonstrate that when choosing graphics for patient education material, document designers should consider empirical research on memory of pictures and mental processing of graphs. It has been shown that comprehension of patient education materials is often impeded by text written at reading levels too high for the patient population. Graphics have been used to aid in overcoming the deficits of complex text. However, graphics too can be too advanced for the client to understand if designers do not consider audience and cognitive processing of images.

Adapting Technical Communication Core Skills to Navigate the Health Care System

Technical communicators gather data from subject-matter experts and then transform it into information that helps users accomplish tasks. In this workshop, we demonstrate how to adapt our expertise to effectively interact with health care professionals--to improve our understanding of the health care industry. By relying on our professional skills, we can successfully navigate the health care maze and effectively operate in the "foreign" environment of the doctor's office, hospital, and care facilities. And, in doing so, we will improve the quality of care we receive.

Assessing Information Needs of Diverse Users to Guide Web Design and Content Development

This paper presents a qualitative study of Centers for Disease Control and Prevention's diverse users and their mental models regarding injury-related content. The study employed an innovative modified contextual inquiry method utilizing tailored, in-depth interviews with five distinct user groups. Included in this paper is a detailed description of the background, framework, and method used for this study. Analysis of the full results was still in process at the due date of this paper. The results will be in the presentation's slide set and available from the STC website www.stc.org.

Congratulations, You Have ADD!

The author describes his history after being diagnosed with Attention Deficit Disorder (ADD), including a brief discussion of what the disorder is, how he came to be diagnosed as having it, and how he has come to live in harmony with, and even embrace, ADD. Murray concludes by offering helpful hints for accommodating the disorder that have helped him lead a fulfilling and successful career in technical communications.

Health and the Rhetoric of Medicine

Health and the Rhetoric of Medicine is a fine introduction to the burgeoning field of medical rhetoric and an excellent addition to the annals of rhetorical criticism in general. Written by Judy Z. Segal from the University of British Columbia, the work is solidly grounded in the mainstay rhetorical traditions of Burke, Perelman and Olbrects-Tyteca, Booth, and Aristotle. But Health and the Rhetoric of Medicine is hardly conservative in its mission or methodology, and the result is a work that captures the essence of discursive encounters in medicine, especially those between doctors and patients and their families, and yet unabashedly attempts to reform these encounters for the betterment of all parties involved.

A Visual and Social Analysis of Optometric Record-Keeping Practices

This article investigates the contribution visual rhetoric and rhetorical genre studies (RGS) can make to health care education and communication genres. Through a visual rhetorical analysis of a patient record used in an optometry teaching clinic, this article illustrates that a genre's visual representations provide significant insights into the social action of that genre. These insights are deepened by an insider analysis of the patient record that highlights how content analyses of visual designs need to be elaborated by contextual considerations. A combined visual rhetoric and RGS analysis shows that clinical novices learn to interpret the record's visual cues to safely traverse the complex requirements of this apprenticeship genre. The article demonstrates that visual rhetoric research can meaningfully contribute to the understanding of genres by presenting an enriched contextual analysis achieved by consulting with context insiders.

Implementation of Medical Research Findings Through Insulin Protocols: Initial Findings from an Ongoing Study of Document Design and Visual Display

Medical personnel in hospital intensive care units routinely rely on protocols to deliver some types of patient care. These protocol documents are developed by hospital physicians and staff to ensure that standards of care are followed. Thus, the protocol document becomes a _de facto_ standing order, standing in for the physician's judgment in routine situations. This article reports findings from Phase I of an ongoing study exploring how insulin protocols are designed and used in intensive care units to transfer medical research findings into patient care 'best practices.' We developed a taxonomy of document design elements and analyzed 29 insulin protocols to determine their use of these elements. We found that 93% of the protocols used tables to communicate procedures for measuring glucose levels and administering insulin. We further found that the protocols did not adhere well to principles for designing instructions and hypothesized that this finding reflected different purposes for instructions (training) and protocols (standardizing practice).

Multimodal Analysis: An Integrative Approach for Scientific Visualizing on the Web

The Multimodal approach offers technical communicators and science writers an analytical tool to synthesize the meaning made in the connections across communicative modes. This multimodal synthesis can help technical communicators better exploit the meaning-making potential of multimodal combinations and understand the needs of future generations shaped by their increasingly developed multimodal literacy.

Seeing Cells: Teaching the Visual/Verbal Rhetoric of Biology

This pilot study obtained baseline information on verbal and visual rhetorics to teach microscopy techniques to college biology majors. We presented cell images to students in cell biology and biology writing classes and then asked them to identify textual, verbal, and visual cues that support microscopy learning. Survey responses suggest that these students recognized some of the rhetorical strategies used and conflated others, revealing intriguing questions for further research in undergraduate microscopy education.

The Median Isn't the Message

Many people make an unfortunate and invalid separation between heart and mind, or feeling and intellect. In some contemporary traditions, abetted by attitudes stereotypically centered on Southern California, feelings are exalted as more "real" and the only proper basis for action -- if it feels good, do it -- while intellect gets short shrift as a hang-up of outmoded elitism.

Florence Nightingale's Visual Rhetoric in the Rose Diagrams

Florence Nightingale is usually pictured as an angelic nurse tending to British soldiers in military hospitals during the Crimean War. Although Nightingale was indeed a tender of soldiers, she was also an administrator, advocate for the common soldier, and proponent of the use of statistics and information design. This article examines Nightingale's rose diagrams, which she designed following her service as the director of nurses at a field hospital in the Crimean War. When the war ended, Nightingale was asked by the queen to write a report on the poor sanitary conditions and make recommendations for reform. When, after six months, the government did not act on the reforms, Nightingale decided to write an annex to the report, in which she would include her invention, the rose diagrams. Nightingale's ultimate success in persuading the government to institute reforms is an illustration of the power of visual rhetoric, as well as an example of Nightingale's own passionate resolve to right what she saw as a grievous wrong.

Technical Communication and the Role of the Public Intellectual: A Community HIV-Prevention Case Study

This article argues that technical communicators are uniquely poised to function as public intellectuals. To demonstrate this point, the author offers the example of her work on a major AIDS prevention program report. Situating this work within the history of technical communication, the current discussion of rhetorics of risk, and the writing classroom, the author argues that technical writers don't have simply the opportunity to engage in textual activism; in many cases they have no alternative.

Context-Driven: How is Traditional Chinese Medicine Labeling Developed?

To promote intercultural understanding in medical communication, this article studies a regulation issued by the Chinese government to standardize traditional Chinese medicine labeling. Then the author claims that the traditional Chinese medicine labeling is medicine-focused. This feature has its roots in traditional Chinese philosophy of stressing the context while de-emphasizing individuals. The author examines a particular medicine label to support his claim that the medicine-focused feature draws patients' attention to the situations that cause disorders.

Imprecise Frequency Descriptors and the Miscomprehension of Prescription Drug Advertising: Public Policy and Regulatory Implications

Two separate studies, conducted among a total sample of 147 adults, explored the communicative effectiveness of imprecise frequency descriptors within the context of direct to consumer prescription drug advertising. Study One used imprecise frequency descriptors to describe level of side effect occurrence and then asked consumers to numerically estimate the frequency of side effect occurrence. A comparison of consumers estimated to actual level of incidence indicated that they are unable to accurately estimate level of side effect occurrence when those levels are described by an imprecise frequency descriptor. Study Two presented consumers with a list of side effects preceded by an imprecise frequency descriptor. Consumers were then asked to estimate the relative likelihood of side effect occurrence. The results indicated that consumers are unable to accurately estimate the relative likelihood of side effect occurrence when a list of side effects are preceded by an imprecise frequency descriptor. The pattern of consumer response across both studies indicates that when imprecise frequency descriptors are used to describe the incidence of side effects within the context of direct to consumer prescription drug advertising, consumers estimate likelihood of side effect occurrence on the basis of an intuitive judgment of the side effect s commonness/severity within the general population.

Learning-to-Communicate and Communicating-to-Learn in Veterinary Medicine: A Survey of Writing, Speaking, and Reading in Veterinary Medical Curricula

This article reports the results of a survey of thirty-one colleges of veterinary medicine in the United States and Canada to identify common writing, speaking, and reading tasks performed by veterinary medical students and practicing veterinarians. From the twenty-seven colleges that responded (87% response rate), we learned that writing, speaking, and reading tasks are assigned in almost every veterinary medical course and that the communication tasks assigned in veterinary medical courses accord well with the communication tasks expected to be performed by practicing veterinarians. Along with these learning-to-communicate tasks, veterinary medical students are also assigned communicating-to-learn tasks. Unlike many of the writing-to-learn tasks associated with writing-across-the-curriculum programs, communicating-to- learn tasks in veterinary medical courses seem concerned with teaching students to think like veterinary medical practitioners. The emphasis on communication in veterinary medical curricula is probably due to some extent to the emphasis on problem-based learning, a curricular innovation popular in veterinary medical education. Problem-based learning requires that instruction be designed around cases or problems to be solved rather than topics or information to be covered. This merging of research and practice in the education of veterinary medical students may offer lessons for the education of professional practitioners in technical communication.

The Missing Metaphor

To determine the metaphor that represents cloning, a contemporary scientific revolution, this study examines articles published in Nature, Nature Biotechnology, Science, and Time that describe the cloning of the sheep Dolly. A plethora of figurative language may be garnered from these articles, and this study describes a number of them: metaphor (dead, natural, and technical), simile, hyperbole, personification, irony, cliché, paronomasia, antithesis, metonymy, anthimera, oxymoron, the rhetorical question, and analogy. The significance and relationship to cloning are explicated. The article concludes that the figures do not support a central metaphor. Further research is suggested to determine if the lack of a metaphor is a fluke or a trend in the development of scientific research and what the difference may be between scientific and technical metaphor.

The Non-Fiction Novel as Psychiatric Casebook: Truman Capote's In Cold Blood

As proposed in the classic work by Hervey Cleckley, M.D.--The Mask of Sanity--a psychopath typically meets sixteen diagnostic criteria. Every one of them applies to Richard Hickock as he is revealed by Truman Capote's <em>In Cold Blood</em>, a nonfiction novel about the murder of Kansas farmer Herbert W. Clutter and his family forty years ago. It transcends the boundaries of traditional journalism by closely examining the entire constellation of antisocial personality traits that Hickock exhibits. Drawn in large part from jailhouse interviews, Capote's portrait of Hickock breathes life into the psychiatric literature, thus rendering intelligible the mental evaluation provided by the physician who examined the accused in preparation for his upcoming trial. In so doing, Capote s best-selling masterpiece serves as a case study of a psychopath, one that conforms to established medical authority while maintaining its popular appeal.

The Rhetoric Of Promoting Health

This article uses Chaim Perelman's theories of argumentation to examine a recent Institute of Medicine (IOM) report, Promoting Health: Intervention Strategies from Social and Behavioral Research (2000). The IOM's text explores social and behavioral research to devise multipronged intervention strategies; it focuses on social, economic, behavioral, and political health as a means of assuring population health--and thereby expands the conventional boundaries of public health. Since Chaim Perelman's rhetoric is seldom applied in the field of health communication, employing his ideas to consider the role of style, arrangement, and argument in such a cutting-edge document can illuminate public health writing, as well as shed new light on Perelmanian rhetoric.

Technical Communication and Clinical Health Care: Improving Rural Emergency Trauma Care Through Synchronous Videoconferencing

While debates continue over the effectiveness of innovative communication technologies to bring information and services to populations that have been underserved by such new technologies, a federally-funded program at the University of Vermont and Fletcher Allen Health Care (FAHC), Burlington, Vermont, has enabled trauma specialists to link with rural emergency room health care providers through a synchronous videoconferencing (telemedicine) network. Analysis of patient histories and surveys completed by the participating physicians after each use of the computer conferencing system as well as interviews and observations indicate that the FAHC consulting trauma specialists and the remotely located physicians felt the linkups do not interfere with standard ER procedures, that communication was at least adequate for all consultations, and that the consults improved the quality of care, for over half of the cases. Furthermore, interviews with rural ER physicians indicated that they saw the program operating as the first stage of FAHC's management of a patient to be transferred to that facility.

Issues in Medical Writing

Look Who's Talking: Teaching and Learning Using the Genre of Medical Case Presentations

In a pediatric teaching hospital, the authors examined 16 novice medical case presentations that were classified as instances of a hybrid apprenticeship genre. In contrast to strict school and workplace genres, an apprenticeship genre results from the sometimes competing activity systems of student education and patient care. The authors examined these novice case presentations for the amount and patterns of time devoted to student learning and expert teaching, the difficulties created for participants, the sometimes misunderstood implicit messages delivered by experts, and the opportunities to address educational objectives. This study offers professional communication researchers a model that combines quantitative and qualitative methodologies to assess the effects of competing activity systems in the development of communication expertise.

AMWA Position Statement on the Contributions of Medical Writers to Scientific Publications

AMWA formed a new task force in 2001 to develop a statement regarding AMWA’s position on the contributions of biomedical communicators to scientific publications.

Patients, Medicines, and Information

Van der Waarde summarizes the reasons why medicinal information provided to patients is often confusing and describes a method for evaluating its effectiveness.

Visual Information about Medicines for Patients

In Europe, when someone gets ill, it is common to visit a doctor. Most consultations end when a doctor prescribes a medicine that can be obtained from a pharmacy. After collecting the medicine a patient has to decide if the use of this medicine is more beneficial than not taking it. In order to make this decision, and in order to take medicines effectively, information is essential. Not only the instructions about how much to take and at what times, but also the potential risks caused by interactions with other medicines and common behaviour (eating, smoking, drinking, sleeping, exercising). It also becomes necessary to know how to recognize that a medicine does what it supposes to do. Historical developments have led to a tightly regulated situation in which the patient gets a clear message that health care providers (pharmaceutical industry, pharmacists, prescribers, etc) do not care very much about informed patients.

The Key to Mayo's Successful Publications? Dave Swanson

Mayo wants to give people actionable, not merely interesting, information.

Teaching Technical Writing to University Students Using the Medical Report

Technical and medical writing share many similar properties. Using a medical report assignment, in which students research and write about a physical or mental disease, is an effective tool that introduces the principles of technical writing. The assignment for lower division students is to write in the IMRAD format, while upper division students compose a report integrating multiple sources cited in CBE documentation style. In each case, adhering to fact-based, clear, audience-appropriate language in a technical format provides the student with valuable practice writing in this important genre.

Challenges for Technical Communicators in Bioinformatics

Bioinformatics, a specialized field in the area of biotechnology, has been a major growth market for the last decade. Generally, bioinformatics companies serve pharmaceutical and other life science research institutes by providing powerful computational solutions for the analysis, storage, and integration of molecular data. The project-oriented organizational structures, international environment, and interdisciplinary approaches that characterize bioinformatics companies provide a wealth of challenges and opportunities. Technical communicators who want to work in this field must be willing to apply strategies and techniques that enable them to streamline communication channels and write effective documentation.

Drug Information Association: XML Resources for Life Sciences Pro

The Drug Information Association (DIA) has compiled a series of useful articles designed to help you understand XML and related technologies. Don't worry! You don't have to be an IT guru to understand XML. The resources provided are written in laymen's terms and geared towards life sciences professionals, but may prove beneficial to professionals in other industries and vertical markets.

Kairos in the Rhetoric of Science

If there is a canonical text in this still-early period of the rhetorical criticism of science, it is the 1953 Nature paper in which James D. Watson and Francis H.C. Crick proposed the double helix structure for DNA.

Use of Race and Ethnicity in Biomedical Publication

Researchers, clinicians, and policy makers face 3 challenges in writing about race and ethnicity: accounting for the limitations of race/ethnicity data; distinguishing between race/ethnicity as a risk factor or as a risk marker; and finding a way to write about race/ethnicity that does not stigmatize and does not imply a we/they dichotomy between health professionals and populations of color. Josurnals play an important role in setting standards for research and policy literature. The authors outline guidelines that might be used when race and ethnicity are addressed in biomedical publications.

Empirical Studies Assessing the Quality of Health Information for Consumers on the World Wide Web: A Systematic Review

The quality of consumer health information on the World Wide Web is an important issue for medicine, but to date no systematic and comprehensive synthesis of the methods and evidence has been performed.

AMWA Journal

The AMWA Journal is the official publication of the American Medical Writers Association. Delivered quarterly to AMWA members and Journal subscribers, the AMWA Journal aims to be an authoritative, comprehensive source of information about the knowledge, skills, and opportunities in the field of biomedical communication worldwide.

Distinguishing Characteristics of Medical Writing

Medical writers and editors need to understand medicine as a discipline, its nature as a science, its humanitarian rather than commercial goal of alleviating pain and suffering, the sensitive nature of some subjects, and the reduced or distorted cognitive abilities of some patients. They need to understand medical terminology, the nature of truth, the scientific method, the primary research paper, numbers, probability, risk, statistical significance, and some specific language issues.

Medical Technical Writing

In a multibillion-dollar-per-yearcindustry, medical technical writers are well situated between companies that manufacture drugs and medical equipment and the federal government, which regulates the manufacture of drugs and medical equipment. The government requires that these companies produce specific types of documents, which must be of a very high standard. This situation creates lucrative opportunities for technical writers.

Making the Rules: A Day in the Life of a Regulatory Drafter

David Spicer, Senior Regulatory Drafting Officer with the CFIA, discusses the regulatory drafting process, writing complex texts in the context of federal plain language principles, and what it’s like to write the words that define and protect Canadians.

Issues in Medical Writing

In this country several factors influence the medical writing of medical professionals, professionals in a field that prides itself on combining art with science. The fairly exclusive culture of the medical professional, the power and highly competitive nature of publishing within that discourse community, and the need for accurate, reliable information for immediate use in solving problems, and a strong inclination to put medical 'facts' first and communication of those facts second create interesting dynamics and rhetorical complexities in medical writing. For over a century the quality of medical writing has been a great concern to both medical professionals and lay readers. According to Dr. Lester King, physician and retired, long-time editor of the Journal of the American Medical Association (JAMA) 'more than a century ago critics deplored the repulsive quality of medical prose' to such an extent that the AMA set up committees to evaluate the problem of medical literature as early as 1851.

Latino Culture and Health Communication

Many Latinos face barriers to receiving health care in the U.S. These barriers can include lack of English and literacy skills, as well as cultural differences in the communication styles used by Latino patients and non-Latino health care providers and communicators. Simply translating health materials into Spanish may not be enough to overcome these communication barriers. However, research has shown that oral forms of communication such as Spanish-language radio broadcasts, lectures in English-as-a-second-language classes, or small-group discussions led by Spanishspeaking leaders can be very effective in disseminating health information to Latino audiences.

Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust

The effective practice of medicine requires narrative competence, that is, the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. Medicine practiced with narrative competence, called narrative medicine, is proposed as a model for humane and effective medical practice. Adopting methods such as close reading of literature and reflective writing allows narrative medicine to examine and illuminate 4 of medicine's central narrative situations: physician and patient, physician and self, physician and colleagues, and physicians and society. With narrative competence, physicians can reach and join their patients in illness, recognize their own personal journeys through medicine, acknowledge kinship with and duties toward other health care professionals, and inaugurate consequential discourse with the public about health care. By bridging the divides that separate physicians from patients, themselves, colleagues, and society, narrative medicine offers fresh opportunities for respectful, empathic, and nourishing medical care.

Medical Communications

In order to promote the results of their medical research to other healthcare professionals, researchers must publish their work. This is usually done by publishing manuscripts in medical journals and by presenting papers and posters at conferences. Medical writers may write these documents on behalf of the researchers that carried out the studies. This is termed ghostwriting. This is most common when studies are sponsored by pharmaceutical companies, but academic researchers sometimes also use the services of medical writers. The medical writer and researchers collaborate to determine what should be written and the researchers gain from the expert writing skills of the medical writer.

Debate-Creating vs. Accounting References in French Medical Journals

This article investigates the quantitative and qualitative evolution of debate-creating (DEB) vs. accounting (ACC) references in 90 French medical articles published between 1810 and 1995. My findings suggest that nineteenth-century French academic writing tends to be more polemical oroppositional than cooperative by contrast to its twentieth-century counterpart. These results suggest that the debate-creating vs. accounting opposition could be a rhetorical universal of referential behavior in medical literature.

Interdisciplinary Communication in a Literature and Medicine Course: Personalizing the Discourse of Medicine

To provide modest insight into whether or not reading literature helps medical students communicate more effectively in the physician-patient encounter, I conducted an ethnographic study of medical students taking a required three-hour literature and medicine course. This article will demonstrate that although these medical students were embedded in the discourse of medicine, reflective writing enabled them to conceive medicine as an interpretive, personal, and idiosyncratic activity rather than as a stagnant diagnosis-based process.

Making Disability Visible: How Disability Studies Might Transform the Medical and Science Writing Classroom

This article describes how disability studies can be used in a medical and science writing class to critically examine the assumptions of scientific discourse. An emerging, interdisciplinary field, disability studies draws on feminist, postmodern, and post-colonial theory and extends their critiques to the medicalization of disability. Deconstructing the medical model of disability helps students understand how science is socially constructed. After conceptualizing disability studies, this essay discusses sample disability-related classroom activities, readings, and writing assignments.

Rational Management: Medical Authority and Ideological Conflict in Ruth Lawrence's Breastfeeding: A Guide for the Medical Profession

This article presents a close reading of one chapter of the only guidebook written for physicians about the clinical management of breastfeeding. The medical discussion of the psychological aspects of breastfeeding articulates conflicting ideological views of women and their place in society, demonstrating how medicine reflects and contributes to a cultural context that is ambivalent about women's changing roles and the transformation of their practices as mothers. At stake is medicine's role in regulating maternal behavior.

"Aristotle's Pharmacy": The Medical Rhetoric of a Clinical Protocol in the Drug Development Process

This article analyzes the clinical protocol within the rhetorical framework of the drug development and approval process, identifying the constraints under which the protocol is written and the rhetorical form, argumentative strategies, and style needed to improve and teach the writing of this document.

Writing Technical Documents for the Global Pharmaceutical Industry

Technical writers in the global pharmaceutical industry write for two major audiences: regulatory agencies and healthcare practitioners. These audiences differ in their information needs and expectations. Therefore, information products that address these audiences must balance the competing forces of business interests, market penetration, and the cultural variables of products so tied to people's beliefs. Pharmaceutical writers may carry an extra burden because the topics of their documents have such a potential for social benefit or serious harm. Electronic technology can greatly enhancing writers' abilities to meet these document needs, but system incompatibilities must first be overcome. Audience analysis still remains the key to crafting effective pharmaceutical documents.

Knowledge Management and Pharmaceutical Development Teams: Using Writing to Guide Science

This article introduces a way of working with drug development teams that relies on writing as a key development activity. The work of cross-functional teams in pharmaceutical research and development can be guided by the use of tools normally thought of as 'writing' tools. Writing can be used intentionally to help teams develop their thinking, identify and respond to troublesome issues, and develop project documentation efficiently. The article introduces the use of a 'seed document' (one step in a systematic, wholly collaborative, document development process) to establish a conceptual knowledge bank for a development team, and demonstrates how complex documentation can flow naturally out of the evolving seed document. The authors argue that structured writing can help team members, who have varying perspectives and expertise, engage in substantive conflict and reach consensus on team responses to difficult issues.