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New frontier, new power: the retail environment in Australia's dark market.

OBJECTIVE: To investigate the role of the retail environment in cigarette marketing in Australia, one of the "darkest" markets in the world. DESIGN: Analysis of 172 tobacco industry documents; and articles and advertisements found by hand searching Australia's three leading retail trade journals. RESULTS: As Australian cigarette marketing was increasingly restricted, the retail environment became the primary communication vehicle for building cigarette brands. When retail marketing was restricted, the industry conceded only incrementally and under duress, and at times continues to break the law. The tobacco industry targets retailers via trade promotional expenditure, financial and practical assistance with point of sale marketing, alliance building, brand advertising, and distribution. Cigarette brand advertising in retail magazines are designed to build brand identities. Philip Morris and British American Tobacco are now competing to control distribution of all products to retailers, placing themselves at the heart of retail business. CONCLUSIONS: Cigarette companies prize retail marketing in Australia's dark market. Stringent point of sale marketing restrictions should be included in any comprehensive tobacco control measures. Relationships between retailers and the industry will be more difficult to regulate. Retail press advertising and trade promotional expenditure could be banned. In-store marketing assistance, retail-tobacco industry alliance building, and new electronic retail distribution systems may be less amenable to regulation. Alliances between the health and retail sectors and financial support for a move away from retail dependence on tobacco may be necessary to effect cultural change.

Advertising↗

Are marketing campaigns in Taiwan by foreign tobacco companies targeting young smokers?

OBJECTIVE: To assess the impact of promotions on cigarette sales in Taiwan after the cigarette market opened to foreign companies, and to assess whether young smokers were targeted by these companies. METHODS: Trends in cigarette sales, advertising expenditure, brand preference, and cigarette consumption were examined for the period following the 1987 opening of the cigarette market. Tobacco industry internal documents from Legacy Tobacco Documents Library of the University of California, San Francisco, were searched for corporate strategies on promoting youth consumption in Taiwan. RESULTS: Between 1995 and 2000, the inflation adjusted advertising expenditures by all foreign firms increased fourfold. Much of the expenditure was spent on brand stretching the Mild Seven (Japan) and Davidoff (Germany) brands in television advertising. By 2000, the market share of foreign cigarettes exceeded domestics by three to one among young smokers and the leading brand preferred by this segment shifted from the most popular domestic brand (Long Life) to a foreign brand (Mild Seven). Furthermore, there was a sudden increase of 16.4% in smoking rates among young adults (from 36.1% to 42.0%) during the first five years after the market opened. This was also accompanied by increased per capita cigarette consumption and decreased age of smoking initiation. Industry documents confirmed the use of strategies targeted at the young. In particular, establishing new point of sale (POS) retail stores or promotional activities at POS were found to be more effective than advertising in magazines. CONCLUSIONS: This study provides evidence that advertising increased with increased competition following the market opening, which, in turn, spurred cigarette sales and consumption. Foreign tobacco companies have deliberately targeted youth in Taiwan and succeeded in gaining three quarters of their cigarette purchases within a decade. Expanding youth consumption will incur excessive future health care costs borne by society. Foreign tobacco companies should be obligated to reimburse these expenses through higher tariffs on cigarettes.

Adolescent↗

Tobacco industry successfully prevented tobacco control legislation in Argentina.

OBJECTIVE: To evaluate how transnational tobacco companies, working through their local affiliates, influenced tobacco control policymaking in Argentina between 1966 and 2005. METHODS: Analysis of internal tobacco industry documents, local newspapers and magazines, internet resources, bills from the Argentinean National Congress Library, and interviews with key individuals in Argentina. RESULTS: Transnational tobacco companies (Philip Morris International, British American Tobacco, Lorillard, and RJ Reynolds International) have been actively influencing public health policymaking in Argentina since the early 1970s. As in other countries, in 1977 the tobacco industry created a weak voluntary self regulating code to avoid strong legislated restrictions on advertising. In addition to direct lobbying by the tobacco companies, these efforts involved use of third party allies, public relations campaigns, and scientific and medical consultants. During the 1980s and 1990s efforts to pass comprehensive tobacco control legislation intensified, but the organised tobacco industry prevented its enactment. There has been no national activity to decrease exposure to secondhand smoke. CONCLUSIONS: The tobacco industry, working through its local subsidiaries, has subverted meaningful tobacco control legislation in Argentina using the same strategies as in the USA and other countries. As a result, tobacco control in Argentina remains governed by a national law that is weak and restricted in its scope.

Advertising↗

The temporal relationship between advertising and sales of low-tar cigarettes.

OBJECTIVE AND HYPOTHESIS: To determine whether a temporal relationship exists between the advertising and sales of low-tar cigarettes. It was hypothesised that increases in the advertising of low-tar cigarettes would precede increases in sales for these cigarettes. METHODS: The themes of cigarette advertisements were reviewed and coded for 20 low-tar cigarette brands advertised in 13 widely read magazines in the US between 1960 and 1996. These 20 brands represented most of the low-tar cigarette advertisements and cigarette sales from 1967 to 1996. Cigarette sales data were obtained from the 1994 Maxwell report that summarises all cigarette sales from 1925 to 1990. If the advertisement referred to the low-tar attributes of the cigarette advertised, the advertisement was coded as having a low-tar theme and was included in the analysis. RESULTS: Five different graphical presentations of the relationship between the advertising and sales of the 20 low-tar cigarette brands showed a temporal relationship between low-tar advertising and sales for these brands. This relationship was observed for brands that introduced a low-tar alternative into an existing brand family (eg, Marlboro Light) and for new exclusively low-tar brands (eg, Carlton). Despite large increases in the advertising for the exclusively low-tar brands, sales of these brands remained low relative to sales of the low-tar alternative brands. CONCLUSIONS: Increases in print advertising of 20 of the most popular low-tar cigarette brands were followed by increases in sales for these cigarettes. Despite increases in the advertising of exclusively low-tar brands in the mid-1970s and early 1980s, the sales of these brands never matched the sales of the low-tar alternative brands. This suggests that it may have been easier to get smokers to switch to low-tar brands within a brand family compared with entirely new low-tar brands. Over the past 30 years, the marketing of low-tar cigarettes as a healthier alternative to higher-tar cigarettes has resulted in these brands dominating the market, and may have kept concerned smokers from quitting.

Advertising↗

An evaluation of an automated radiographic table.

Results of an official field trial of an automated radiographic film-handling system for horizontal Bucky radiography without cassettes, complete with vacuum exposure magazine are reported. An integral tube stand may limit usefulness of the equipment; a fast film/screen combination and delayed film transport protects the x-ray tube. No film transport problems were found.

Automation↗

An inexpensive photographic strip-chart recorder for use with a commercially available ultrasonic scanner.

A simple arrangement for producing strip-chart records using moving 70mm film and a commercially available motor-driven film magazine is described. The quality of the records is excellent and the cost is about $500. It is necessary to modify the ultrasonic B-mode scanner slightly by connecting the verticle deflection plates of the oscilloscope to one another through an on-off switch.

Humans↗

The computer in the radiologist's office.

Today, the radiologist is able to equip his or her office with a powerful personal computer system equivalent to the large mainframe computers of just a few years ago. If funds permit, purchase of a 486 equivalent system with 200-300 Mbytes of hard-disk storage, 16 Mbytes of random access memory (RAM), a high-resolution color video card and monitor, and a laser printer is recommended. The practical uses for such a system are almost limitless and include word processing, spreadsheet and data-base management, telecommunications, multimedia presentations, business applications, teleradiology, resident and medical student education, and research applications. No matter how much one becomes involved in computer applications, it is essential to establish good habits for backing up critical data files and programs. Becoming familiar with computer technology is not easy at first. Finding a good computer buddy, taking simple night school courses, and reading computer articles and magazines are good ways to get started. Computers are wonderful devices. The day is fast approaching when they will become a necessary tool for every radiologist.

Microcomputers↗

Knowledge of stroke in Hong Kong Chinese.

A random telephone survey on knowledge of stroke was conducted in 1, 238 Hong Kong Chinese. Most respondents realized that effective treatment was available, that stroke was preventable and that it could be fatal or disabling. Sudden unilateral limb weakness, sudden speech and language disturbances, and sudden vertigo and clumsiness were better recognized than other warning symptoms of stroke. A slightly better recognition of symptoms of stroke was seen in those with a belief of knowing about stroke, providing a correct description of stroke, those with a positive household history of stroke and those with a better knowledge of potential risk factors. Most respondents would choose desirable actions if stroke was suspected in their family members or themselves. Friends and relatives, newspapers and magazines, and mass media provided the major sources of their knowledge.

Adolescent↗

Why do patients with atopic dermatitis refuse to apply topical corticosteroids?

BACKGROUND: The number of patients with atopic dermatitis who refuse to use topical corticosteroids because of personal fears seems to be increasing. However, studies on this subject are scarce. Consequently, we have investigated this issue further. METHODS: A cross-sectional study based on a questionnaire. Between September 1998 and January 1999, a questionnaire was distributed to patients who responded to an announcement and to those attending 18 hospitals or clinics and 11 self-help groups throughout Japan to identify what makes patients resistant to applying topical corticosteroids. RESULTS: Patients who are reluctant to use topical corticosteroids often experienced: ineffective or short-lasting results, adverse side effects and feelings of distrust towards their physician. These feelings of distrust were found to be significantly stronger among patients who were reluctant to apply topical corticosteroids than among patients who accepted the treatment with little or no feelings of resistance. External influences such as those from family members, acquaintances, mass media (television, newspapers and magazines), alternative 'nondoctor' therapists and self-help groups were not found to be a significant factor between both groups. However, the influence of the physician was found to be significant and directly related to the patients' lack of trust. CONCLUSIONS: Patients with atopic dermatitis who refuse to use topical corticosteroids attribute their feelings of resistance to personal experiences rather than to information from external sources. Information or warnings about associated side effects from physicians may help to reduce these fears and ultimately benefit the physician-patient relationship.

Administration, Topical↗

[From Swiss herbs to the global plant system and individual use--a biographic approach to Alfred Vogel].

BACKGROUND: Even 100 years after the birth of Alfred Vogel there is a lack of reliable data about his life as a non-doctoral therapist in the fields of naturopathy and phytotherapy. OBJECTIVE: Which documents about A. Vogel do exist, which facts do they prove about his career and which interpretations of his point of view of phytotherapy do they allow. MATERIALS AND METHODS: With the methods in medical history (heuristic, critic, interpretation) video, audio and written documents from the A. Vogel Museum and A. Vogel publisher in Teufen, the A. Vogel collection in the Museum in Aesch and the Bioforce AG in Roggwil have been examined. RESULTS: From 1923 to 1932 A. Vogel runs a grocer's shop or a herb and health-food store in Basel and later Bern, Zürich and Solothurn. The economic success of his health-food stores and his interest in the field of naturopathy enable him to take part in a training to become a 'natural doctor' and in 1933 he is registered by the 'Natural Doctors Association of Switzerland'. From 1935 on he is working as a nutritionalist in his own spa pension in Trogen and produces plant extracts in his 'Laboratory Bioforce'. From 1937 to 1957 he has a spa hotel in Teufen and is producer of extracts from fresh plants. He is able to travel all continents of the world from 1958 on, in order to observe customs and medical habits of different tribes. He writes about his findings in his own magazine and books. His knowledge about the usage of herbs in different cultures inspires his production of herbal extracts in his company. In 1963, to meet the increasing sales of his products, he founds the < > where he, until the early 1990s, takes part in the adjustment of the recipes to the new pharmaceutic-medical standards. CONCLUSION: Because of his work as a 'natural doctor' A. Vogel becomes one of Switzerland's best known non-doctoral therapists in the 20th century. The publication of his collected wisdom in a lay-like language is a contribution to the tradition and popularity in this field through which, as well as through the development of extracts from fresh plants, he becomes a promoter of phytotherapy.

Food, Organic↗

5-Year trends in use of hallucinogens and other adjunct drugs among UK dance drug users.

AIMS: To describe and assess trends in the use of hallucinogens and other adjunct drugs over a 5-year period. DESIGN: Repeated-measures cross-sectional survey. SETTING AND PARTICIPANTS: Annual magazine-based survey targeting people who use drugs in dance contexts. MEASUREMENTS: Lifetime use prevalence (ever used); age of first use; current use prevalence (any use within the last month), and extent of use within the last month (number of days used) for LSD, psilocybin, ketamine, GHB and nitrates. FINDINGS: Prevalence increases for psilocybin, ketamine, GHB and nitrates use have been detected, with a sharp recent rise in current psilocybin use in 2002-2003 contrasting with more gradual and comprehensive evidence of increased ketamine use throughout the period 1999-2003. The declining prevalence of LSD use in general population surveys is replicated in this sentinel population study. CONCLUSIONS: The rise in prevalence of hallucinogen and other adjunct drugs identified among dance drug users may be mirrored by wider prevalence increases among young people with a consequent need to study these trends carefully and to develop effective interventions, where required.

Adult↗

The technique of transperitoneal laparoscopic nephrectomy, adrenalectomy and nephroureterectomy.

In the traditional kidney position three trocars are inserted after creation of a pneumoperitoneum: 10 mm periumbilical (port I), 10/12 mm subcostal (port II) and 12/10 mm above the iliac spine (port III) in the mamillary line. After laterocolic incision the colon is dissected away from the lateral wall. Thereafter two 5-mm trocars (ports IV, V) are inserted into the lateral abdominal wall parallel to parts II and III. Following clipping and dissection of the ovarian (spermatic) vein, the ureter is isolated and incised. Then the cranial part of the ureter is used as a retractor exposing the renal hilum for dissection of the renal vessels. The main renal artery and vein are dissected separately by use of an endoscopic stapling device (Endo-GIA, white magazine). Finally, the kidney including Gerota's fascia is isolated from the adrenal and the upper peritoneum. Entrapment of the organ is performed with a specially designed bag (Lap-sac). The neck of the bag is brought out onto the surface of the abdomen (via port II/III) allowing digital morcellation with index finger inside the bag and removal of the organ in several pieces. We have applied this technique for 17 procedures in the upper retroperitoneum: 9 transperitoneal laparoscopic nephrectomies (TLN) for benign disease (5 hydronephrosis, 3 renovascular disease, 1 chronic pyelonephritis), 3 radical TLN including adrenalectomy for renal cell carcinoma (T2G2), 1 adrenalectomy for a cortical adrenaloma, 1 nephroureterectomy, 1 diagnostic ureterolysis and 2 modified retroperitoneal lymphadenectomies for stage I testicular cancer. The mean operation time was 4 h (2-5), the mean postoperative hospital stay 6 days (4-12).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenalectomy↗

Body image, media, and eating disorders.

OBJECTIVE: Eating disorders, including obesity, are a major public health problem today. Throughout history, body image has been determined by various factors, including politics and media. Exposure to mass media (television, movies, magazines, Internet) is correlated with obesity and negative body image, which may lead to disordered eating. The authors attempt to explain the historical context of the problem and explore potential avenues for change. METHOD: The authors review changes in ideal female body type throughout history, comment on current attitudes toward shape and weight in both men and women, and outline interventions aimed at increasing healthy habits and fostering self-esteem in youth. RESULTS: Throughout history, the ideal of beauty has been difficult to achieve and has been shaped by social context. Current mass media is ubiquitous and powerful, leading to increased body dissatisfaction among both men and women. CONCLUSION: Parents need to limit children's exposure to media, promote healthy eating and moderate physical activity, and encourage participation in activities that increase mastery and self-esteem. Funding for high-quality, visible advertising campaigns promoting healthy life styles may increase awareness.

Adult↗

Are pediatric practice settings adolescent friendly? An exploration of attitudes and preferences.

This study describes adolescent preferences about offices and waiting. Fifty-four adolescents participated in 12 discussion groups, which were audiotaped and transcribed. The transcripts were analyzed qualitatively. Two themes emerged about the health care environment: (1) making the interior design less childish, more teen-oriented, and more home-like; and (2) decreasing waiting time and enhancing waiting experience by providing teen diversions (e.g., magazines, tv, games). Teens preferred that artwork portray realistic images, that medical paraphernalia be hidden, and that colors be neutral. Modifying interior décor, constructing smaller subwaiting areas, and incorporating diversions that are teen-oriented may help promote positive health care experiences and utilization by adolescents.

Adolescent↗

Fostering critical thinking skills in students with learning disabilities: an instructional program.

An instructional unit was developed to enhance the critical thinking skills of middle school and high school students with learning disabilities by teaching them the principles of scientific reasoning. Student-teacher dialogues were used to engage the students in an active process of critical inquiry. Students analyzed everyday information presented in brief magazine articles and advertisements by applying the principles of the scientific method. The students made statistically significant improvements in their ability to (a) identify the principal claim made in an article or advertisement, (b) graph the relevant data, and (c) evaluate the claims made in the article and explain their support or rejection of the claims based on data. After the instructional unit, the overall performance of the special education students exceeded that of a control group composed of regular education students who had not received instruction in critical thinking.

Adolescent↗

Are patients shocked by ECT?

Seventy-two consecutive patients treated with electroconvulsive therapy (ECT) for severe mental illness were asked their opinions about ECT: 83% considered they had improved as a result of the treatment and 81% would have it again. Most found the experience neutral or pleasant and 54% thought the dentist more distressing. Claims in newspapers, magazines, television and elsewhere that ECT is cruel and frightening receive little support from the results of this study.

Adult↗

Appearance-related social comparisons: the role of contingent self-esteem and self-perceptions of attractiveness.

Two studies examined contingent self-esteem (CSE) and responses to appearance-related social comparisons. Study 1 was an experimental study in which women rated a series of advertisements from popular women's magazines. Study 2 employed an event-contingent diary recording procedure. In Study 1, women who were higher in CSE and lower in self-perceptions of attractiveness (SPA) experienced greater decreases in positive affect and greater increases in negative affect following the ad-rating task. Study 2 results supported a mediation model in which women who were higher in CSE felt worse after social comparisons because they made primarily upward comparisons. Overall, results suggest that appearance-related comparisons are more distressing for those who base their self-worth on contingencies and have lower self-perceived attractiveness.

Adolescent↗

Mother's milk: an existential perspective on negative reactions to breast-feeding.

Drawing from an existential perspective rooted in terror management theory, four studies examined the hypothesis that breast-feeding women serve as reminders of the physical, animal nature of humanity and that such recognition is threatening in the face of one's unalterable mortality. Study 1 demonstrated that mortality salience (MS) led to more negative reactions toward a scenario depicting a woman breast-feeding her infant in public, and in Study 2, MS decreased liking and increased physical avoidance of a potential task partner described as breast-feeding in another room. Further supporting the hypothesis that such reactions are rooted in threats associated with human creatureliness, MS in conjunction with a breast-feeding prime led to an increase in the accessibility of creaturely related cognitions (Study 3) and priming human/animal similarities (i.e., creatureliness) led to increased negativity toward a magazine cover depicting a woman breast-feeding her child (Study 4). Implications of this research are discussed.

Adolescent↗