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      Giving Legs to Restless Legs: A Case Study of How the Media Helps Make People Sick

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      PLoS Medicine
      Public Library of Science

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          Abstract

          To get a sense of how the media works in the context of a major disease promotion effort, the authors examined news coverage of restless leg syndrome.

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          Most cited references20

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          Epidemiology of restless legs symptoms in adults.

          Restless legs syndrome (RLS) is a disorder characterized by sleep-disrupting unpleasant leg sensations, often accompanied by daytime behavioral problems. Treatment for this condition is available, but it is suspected that most instances of RLS remain undiagnosed. The goal of this investigation was to assess the prevalence and health status correlates of restless legs symptoms (hereinafter referred to as restless legs) in the general population. A question reflecting the clinical features of RLS was added to the 1996 Kentucky Behavioral Risk Factor Surveillance Survey. Data on the frequency of experiencing restless legs, self-rated general and mental health status, demographics, and behavioral risk factors were collected by telephone interview from 1803 men and women, 18 years and older. Experiencing restless legs 5 or more nights per month was reported by 3% of participants aged 18 to 29 years, 10% of those aged 30 to 79 years, and 19% of those 80 years and older. The age-adjusted prevalence for Kentucky adults is 10.0%; prevalence did not vary significantly by sex. The adjusted odds ratios (95% confidence intervals) for restless legs and diminished general health and poor mental health status were 2.4 (1.4-4.0) and 3.1 (2.0-4.6), respectively. Restless legs were significantly associated with increased age and body mass index, lower income, smoking, lack of exercise, low alcohol consumption, and diabetes. The prevalence of restless legs in the general adult population is high. Restless legs may be associated with decreased well-being, emphasizing the need for further research and greater medical recognition of this condition.
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            Increased absenteeism from work after detection and labeling of hypertensive patients.

            A study of hypertension in an industrial setting allowed us to confirm and explore an earlier retrospective finding that the labeling of patients as hypertensive resulted in increased absenteeism from work. After screening and referral, we found that absenteeism rose (mean +/- 1 S.E.) 5.2 +/- 2.3 days per year (P less than 0.025); this 80 per cent increase greatly exceeded the 9 per cent rise in absenteeism in the general employee population during this period. The main factors associated with increased absenteeism were becoming aware of the condition (P less than 0.01) and low compliance with treatment (P less than 0.001). Subsequent absenteeism among patients unaware of their hypertension before screening was not related to the degree of hypertension, whether the worker was started on therapy, the degree of blood-pressure control achieved or exposure to attempts to promote compliance. These results have major implications for hypertension screening programs, especially since absenteeism rose among those previously unaware of their condition, regardless of whether antihypertensive therapy was begun.
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              An algorithm for the management of restless legs syndrome.

              Restless legs syndrome (RLS) is a common disorder with a prevalence of 5% to 15%. Primary care physicians must become familiar with management of this disorder. This algorithm for the management of RLS was written by members of the Medical Advisory Board of the Restless Legs Syndrome Foundation and is based on scientific evidence and expert opinion. Restless legs syndrome is divided into intermittent, daily, and refractory types. Nonpharmacological approaches, including mental alerting activities, avoiding substances or medications that may exacerbate RLS, and addressing the possibility of iron deficiency, are discussed. The role of carbidopa/levodopa, dopamine agonists, opioids, benzodiazepines, and anticonvulsants for the different types of the disorder is delineated.
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                Author and article information

                Journal
                PLoS Med
                pmed
                PLoS Medicine
                Public Library of Science (San Francisco, USA )
                1549-1277
                1549-1676
                April 2006
                11 April 2006
                : 3
                : 4
                : e170
                Author notes

                Competing Interests: The funders played no role in the submission or preparation of this paper. The authors have declared that no competing interests exist.

                Steven Woloshin and Lisa M. Schwartz are at the Veterans Affairs Outcomes Group, White River Junction, Vermont, United States of America, and the Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, New Hampshire, United States of America.

                * To whom correspondence should be addressed. E-mail: steven.woloshin@ 123456dartmouth.edu .
                Article
                10.1371/journal.pmed.0030170
                1434499
                16597175
                704d0eaf-9631-419f-b478-f84b5154c5ee
                This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.
                History
                Categories
                Policy Forum
                Other
                Epidemiology/Public Health
                Health Policy
                Neurology/Neurosurgery
                Neurology
                Drugs and Adverse Drug Reactions
                Communication in Health Care
                Public Health

                Medicine
                Medicine

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