Chronic obstructive pulmonary disease (COPD) remains a major public health problem. It is the fourth leading cause of chronic morbidity and mortality in the United States, and is projected to rank fifth in 2020 in burden of disease worldwide, according to a study published by the World Bank/World Health Organization. Yet, COPD remains relatively unknown or ignored by the public as well as public health and government officials. In 1998, in an effort to bring more attention to COPD, its management, and its prevention, a committed group of scientists encouraged the U.S. National Heart, Lung, and Blood Institute and the World Health Organization to form the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Among the important objectives of GOLD are to increase awareness of COPD and to help the millions of people who suffer from this disease and die prematurely of it or its complications. The first step in the GOLD program was to prepare a consensus report, Global Strategy for the Diagnosis, Management, and Prevention of COPD, published in 2001. The present, newly revised document follows the same format as the original consensus report, but has been updated to reflect the many publications on COPD that have appeared. GOLD national leaders, a network of international experts, have initiated investigations of the causes and prevalence of COPD in their countries, and developed innovative approaches for the dissemination and implementation of COPD management guidelines. We appreciate the enormous amount of work the GOLD national leaders have done on behalf of their patients with COPD. Despite the achievements in the 5 years since the GOLD report was originally published, considerable additional work is ahead of us if we are to control this major public health problem. The GOLD initiative will continue to bring COPD to the attention of governments, public health officials, health care workers, and the general public, but a concerted effort by all involved in health care will be necessary.

https://www.who.int/respiratory/copd/GOLD_WR_06.pdf

Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.

How to Do Things With Words

http://science.sciencemag.org/content/sci/201/4359/899.2.full.pdf

Phenomenology of perception.

Medical practice is constantly changing. The rate of change is accelerating, and physicians can be forgiven if they often find it dizzying. How can physicians learn about new information and innovations, and decide how (if at all) they should modify their practice? Possible sources include summaries from the medical literature (review articles, practice guidelines, consensus statements, editorials, and summary articles in "throwaway" journals); consultation with colleagues who have special expertise; lectures; seminars; advertisements in medical journals; conversations with representatives from pharmaceutical companies; and original articles in journals and journal supplements. Each of these sources of information might be valuable, though each is subject to its own particular biases. 1,2 Problems arise when, as is often the case, these sources of information provide different suggestions about patient care. See also p 2093. Without a way of critically appraising the information they receive, clinicians are relatively helpless in deciding what new information

https://hopkinsmedicine.org/gim/_pdf/jama/17-screening.pdf

Users' Guides to the Medical Literature

Decades ago, discussion of an impending global pandemic of obesity was thought of as heresy. But in the 1970s, diets began to shift towards increased reliance upon processed foods, increased away-from-home food intake, and increased use of edible oils and sugar-sweetened beverages. Reductions in physical activity and increases in sedentary behavior began to be seen as well. The negative effects of these changes began to be recognized in the early 1990s, primarily in low- and middle-income populations, but they did not become clearly acknowledged until diabetes, hypertension, and obesity began to dominate the globe. Now, rapid increases in the rates of obesity and overweight are widely documented, from urban and rural areas in the poorest countries of sub-Saharan Africa and South Asia to populations in countries with higher income levels. Concurrent rapid shifts in diet and activity are well documented as well. An array of large-scale programmatic and policy measures are being explored in a few countries; however, few countries are engaged in serious efforts to prevent the serious dietary challenges being faced.

/pdf/global-nutrition-transition-and-the-pandemic-of-obesity-in-5cnfnv71ot.pdf

Global nutrition transition and the pandemic of obesity in developing countries

This paper focuses attention on alternative modes of expressing distress and the need to analyze particular manifestations of distress in relation to personal and cultural meaning complexes as well as the availability and social implications of coexisting idioms of expression. To illustrate this point the case of South Kanarese Havik Brahmin women is presented. These women are described as having a weak social support network and limited opportunities to ventilate feelings and seek counsel outside the household. Alternative means of expressing psychosocial distress resorted to by Havik women are discussed in relation to associated Brahminic values, norms and stereotypes. Somatization is focused upon as an important idiom through which distress is communicated. Idioms of distress more peripheral to the personal or cultural behavioral repertoire of Havik women are considered as adaptive responses in circumstances where other modes of expression fail to communicate distress adequately or provide appropriate coping strategies. The importance of an 'idioms of distress' approach to psychiatric evaluation is noted.

Idioms of distress: alternatives in the expression of psychosocial distress: a case study from South India.

The paper examines body image ideals and dieting behaviors among African American and White adolescent females. Data are drawn from focus groups, individual interviews, and surveys. African American females were found to be more flexible than their White counterparts in their concepts of beauty and spoke about "making what you've got work for you." In contrast, many White adolescent females expressed dissatisfaction with their body shape and were found to be rigid in their concepts of beauty. Cultural factors which impact on weight perception. body image, and style are explored. Limitations of survey methodology for understanding cultural differences are discussed.

Body image and weight concerns among African American and White adolescent females: Differences that make a difference.

Pharmacies, self-medication and pharmaceutical marketing in Bombay, India.

This paper summarizes results of empirical studies on cigarette advertising and promotions, antismoking advertising, product placement in movies, on television and in music media and news coverage about smoking. In addition, we provide an overview of some of the theoretical literature relevant to the study of media uses and effects. Finally, we discuss empirical findings in the context of these theories to draw some conclusions about media influences on smoking and identify issues for further research. We conclude that (a) the media both shape and reflect social values about smoking; (b) the media provide new information about smoking directly to audiences; (c) the media act as a source of observational learning by providing models which teenagers may seek to emulate; (d) exposure to media messages about smoking also provides direct reinforcement for smoking or not smoking; (e) the media promote interpersonal discussion about smoking; (f) the media can influence ‘intervening’ behaviors that may make teenage smoking less likely; and (g) antismoking media messages can also set the agenda for other change at the community, state or national level. We outline priorities for further research which emphasize the need for longitudinal studies, multi-level studies, an awareness of the probably dynamic relationship between tobacco advertising and antismoking advertising, the importance of determining appraisal of tobacco industry youth smoking prevention efforts and the dearth of research on news coverage about smoking.

Role of the media in influencing trajectories of youth smoking

I am pleased to have this opportunity to offer some reflections on what I have foreseen as an idioms-of-distress research agendum, and some thoughts on what an idioms-of-distress assessment adds to anthropological research on human suffering and culturally informed therapy facilitation in clinical settings. The term idioms of distress has now been in circulation for 30 years and has clearly taken on a life of its own. It was used in DSM IV and is likely to be considered for use in DSM V. A point of discussion in psychiatry at the moment is whether idioms of distress and ‘‘culture syndromes’’ are redundant terms or whether they refer to different phenomena. I weigh in on this issue as well as address two critiques of the way the term idioms of distress has been conceptualized by some scholars. I suggest that a distinction among idioms of distress, cultural idioms of distress and cultural syndromes is warranted. And I suggest that the two critiques of idioms of distress reviewed are necessary correctives, returning us to the original intent of an idiomsof-distress agenda. Finally, I highlight a few of the unique contributions made by papers in this issue that push an idioms-of-distress assessment in new and productive directions. In 1977, I wrote a pair of papers laying out an idioms-of-distress research agenda and calling attention to the role practitioners (from diagnosticians to diviners) play in framing experiences and expressions of distress in ways that Obeyesekere (1985, 1990) later came to refer to as the work of culture. My papers were published a few

Mark Nichter

Papers

Idioms of distress: alternatives in the expression of psychosocial distress: a case study from South India.

Body image and weight concerns among African American and White adolescent females: Differences that make a difference.

Pharmacies, self-medication and pharmaceutical marketing in Bombay, India.

Role of the media in influencing trajectories of youth smoking

Idioms of distress revisited.