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Coverage of medical research in the popular press amplifies the transmission of medical information from the scientific literature to the research community.

We examined the relation between 38 nationally televised news or feature stories about suicide from 1973 to 1979 and the fluctuation of the rate of suicide among American teenagers before and after these stories. The observed number of suicides by teenagers from zero to seven days after these broadcasts (1666) was significantly greater than the number expected (1555; P = 0.008). The more networks that carried a story about suicide, the greater was the increase in suicides thereafter (P = 0.0004). These findings persisted after correction for the effects of the day of the week, the month, holidays, and yearly trends. Teenage suicides increased more than adult suicides after stories about suicide (6.87 vs. 0.45 percent). Suicides increased as much after general-information or feature stories about suicide as after news stories about a particular suicide. Six alternative explanations of these findings were assessed, including the possibility that the results were due to misclassification or were statistical artifacts. We conclude that the best available explanation is that television stories about suicide trigger additional suicides, perhaps because of imitation.

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Background-Research published in Circulation has shown that cardiac mortality is highest during December and January. We investigated whether some of this spike could be ascribed to the Christmas/New Year's holidays rather than to climatic factors. Methods and Results-We fitted a locally weighted polynomial regression line to daily mortality to estimate the number of deaths expected during the holiday period, using the null hypothesis that natural-cause mortality is unaffected by the Christmas/New Year's holidays. We then compared the number of deaths expected during the holiday period, given the null hypothesis, with the number of deaths observed. For cardiac and noncardiac diseases, a spike in daily mortality occurs during the Christmas/New Year's holiday period. This spike persists after adjusting for trends and seasons and is particularly large for individuals who are dead on arrival at a hospital, die in the emergency department, or die as outpatients. For this group during the holiday period, 4.65% (Ϯ0.30%; 95% CI, 4.06% to 5.24%) more cardiac and 4.99% (Ϯ0.42%; 95% CI, 4.17% to 5.81%) more noncardiac deaths occur than would be expected if the holidays did not affect mortality. Cardiac mortality for individuals who are dead on arrival, die in the emergency department, or die as outpatients peaks at Christmas and again at New Year's. These twin holiday spikes also are conspicuous for noncardiac mortality. The excess in holiday mortality is growing proportionately larger over time, both for cardiac and noncardiac mortality. Conclusions-Our findings suggest that the Christmas/New Year's holidays are a risk factor for cardiac and noncardiac mortality. There are multiple explanations for this association, including the possibility that holiday-induced delays in seeking treatment play a role in producing the twin holiday spikes.

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BACKGROUNDEach July thousands begin medical residencies and acquire increased responsibility for patient care. Many have suggested that these new medical residents may produce errors and worsen patient outcomes—the so-called “July Effect;” however, we have found no U.S. evidence documenting this effect.OBJECTIVEDetermine whether fatal medication errors spike in July.DESIGNWe examined all U.S. death certificates, 1979–2006 (n = 62,338,584), focusing on medication errors (n = 244,388). We compared the observed number of deaths in July with the number expected, determined by least-squares regression techniques. We compared the July Effect inside versus outside medical institutions. We also compared the July Effect in counties with versus without teaching hospitals.OUTCOME MEASUREJR = Observed number of July deaths / Expected number of July deaths.RESULTSInside medical institutions, in counties containing teaching hospitals, fatal medication errors spiked by 10% in July and in no other month [JR = 1.10 (1.06–1.14)]. In contrast, there was no July spike in counties without teaching hospitals. The greater the concentration of teaching hospitals in a region, the greater the July spike (r = .80; P = .005). These findings held only for medication errors, not for other causes of death.CONCLUSIONSWe found a significant July spike in fatal medication errors inside medical institutions. After assessing competing explanations, we concluded that the July mortality spike results at least partly from changes associated with the arrival of new medical residents.

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