The relationship between exposure to brand-specific alcohol advertising and brand-specific consumption among underage drinkers – United States, 2011–2012

ABSTRACT

Background: Marketing is increasingly recognized as a potentially important contributor to youth drinking, yet few studies have examined the relationship between advertising exposure and alcohol consumption among underage youth at the brand level. Objectives: To examine the relationship between brand-specific exposure to alcohol advertising among underage youth and the consumption prevalence of each brand in a national sample of underage drinkers. Methods: We analyzed the relationship between population-level exposure of underage youth ages 12–20 to brand-specific alcohol advertising in national magazines and television programs and the 30-day consumption prevalence – by brand – among a national sample of underage drinkers ages 13–20. Underage youth exposure to alcohol advertising by brand for each month in 2011, measured in gross rating points (GRPs, a standard measure of advertising exposure), was obtained from GfK MRI (a media consumer research company) and Nielsen for all measured national issues of magazines and all national television programs, respectively. The 30-day consumption prevalence for each brand was obtained from a national survey of 1031 underage drinkers conducted between December 2011 and May 2012. Results: Underage youth were more than five times more likely to consume brands that advertise on national television and 36% more likely to consume brands that advertise in national magazines. The consumption prevalence of a brand increased by 36% for each 1.5 standard deviation (50 GRPs) increase in television adstock among underage youth and by 23% for each 1.5 standard deviation (10 GRPs) increase in magazine adstock. Conclusion: These findings suggest that alcohol advertising influences an important aspect of drinking behavior – brand choice – among youth who consume alcohol.     

Age‐friendly buses? A comparison of reported barriers and facilitators to bus use for younger and older adults

Aim: To determine whether older people reported and prioritised different barriers and facilitators to bus use than younger people. Method: The Nominal Group Technique was used with 301 participants (231 older, 70 younger) to elicit reported barriers and facilitators to bus use. Categories were developed using qualitative content analysis and comparisons of categories and priorities were made. Results: Driver friendliness, ease of entry/exit and information useability were prioritised barriers and facilitators for older people. In contrast, younger participants prioritised bus punctuality, signage clarity, information provision at bus stops, bus service availability and parking facilities at the bus stop. Some similarities between older and younger adults were noted relating to convenience and bus scheduling. Conclusions: Older and younger adults have specific requirements for public transport systems which should be addressed in order to promote useable transport for all.     

How much alcohol do you buy? A comparison of self‐reported alcohol purchases with actual sales

Background Unrecorded alcohol has increased in the Nordic countries during recent years, above all in terms of cross‐border trade. This implies that trends and levels of per capita consumption would look different without estimates of this source of alcohol, estimates that in Sweden and other countries are made through surveys. Aim The overall aim is to analyse the validity of Swedish survey estimates of alcohol bought in the cross‐border trade and possibly to develop weights that can be applied to such estimates. Data and method The analysis consists of comparing self‐reported purchases of spirits, wine, cider/alcopops and beer at retail monopoly (Systembolaget) during 2008 (n = 18 000) with actual sales during the same period overall and monthly. Findings Of the recorded amount of purchases at Systembolaget, 87% was reported in the survey, compared with the 40–60% usually found for self‐reported consumption. Significant differences across beverages were revealed, showing a lower coverage rate for beer and spirits and a higher coverage rate for wine and cider. Changes in purchases of all beverages were captured fairly well, at least changes taking place from one month to another. Conclusions Self‐reported alcohol purchases achieve a higher coverage rate than found typically in studies based on self‐reported use of alcohol. If adjustments are to be made to correct for underreporting in self‐reported data on alcohol purchases, different weights should be applied to different beverages. Furthermore, at least major changes in how much alcohol is purchased in the population can be monitored using well‐designed population surveys.     

Helicobacterpylori infection and gastropathy： A comparison between Indonesian and Japanese patients

AIM: To compare the effects of Helicobacter pylori ( H pylori) infection on gastropathy between Indonesian and Japanese patients.METHODS: Biopsy specimens were obtained during upper gastrointestinal endoscopy from 167 subjects (125 Indonesians and 42 Japanese) with uninvestigated symptoms of dyspepsia. The specimens were analyzed for the presence of H pylori using urease analysis, histopathology, and cell culture. The grade and activity of gastritis was assessed using the updated Sydney system.RESULTS: The percentages of Indonesian and Japanese patients who were H pylori-positive at the antrum or body of the stomach were similar (68% and 59.5%, respectively; P = 0.316). Of those who were H pylori-positive, more Japanese patients than Indonesian patients had high levels of polymorphonuclear cells ( P = 0.001), mononuclear cells ( P = 0.013), glandular atrophy ( P = 0.000), and intestinal metaplasia ( P = 0.011) in both the antrum and body of the stomach.CONCLUSION: The grade of gastritis and prevalence of mucosal atrophy and intestinal metaplasia were higher in Japanese patients. The difference between Indonesian and Japanese patients was significant.     

A comparison of abdominal surgical outcomes between African–American and Caucasian Crohn’s patients

Background and objective

Whether race affects the natural history of Crohn’s disease is a matter of debate. The aim of the current study was to evaluate the differences in surgical outcomes between African–American (AA) and Caucasian (C) Crohn’s patients undergoing surgery at a tertiary care referral center.

Methods

With Institutional Review Board approval, the medical records of our institution were queried to identify consecutive AA and C patients who underwent surgery for Crohn’s disease from December 1, 2009 to December 15, 2011. A retrospective chart review was performed using electronic medical records.

Results

A total of 77 patients were included in this study, including 32 AA (41 %) and 45 C (59 %). No significant differences were seen with respect to age, gender, type of insurance, preoperative exposure to immunosuppressives, body mass index, or smoking history between the two populations (p?>?0.05). There was a trend toward lower albumin in AAs (p?=?0.09). AA and C patients who underwent their first Crohn’s disease (CD)-related surgery had similar lag periods between diagnosis and surgery. No significant differences were seen in location of disease, indication for operation, and need for open laparotomy over laparoscopy. No significant differences were seen in need for a repeat operation within 90 days of the original surgery or major postoperative complications. There was a trend toward higher rate of minor complications in the AA group (p?=?0.07).

Conclusion

No significant differences were noted in the current study in several preoperative variables and surgical outcomes between AA and C.     

Surgical treatment for Zenker’s diverticulum: comparison between diverticulectomy and diverticulopexy

Background

The ideal surgical technique for symptomatic Zenker’s diverticulum has not been identified yet. Endoscopic treatment, although frequently performed, has not replaced the open cricopharyngeal myotomy, which is still deemed the standard therapy by many dedicated physicians. The management of the diverticular sac after myotomy is still a matter of debate. The aim of this study is to compare the results of diverticulectomy and diverticulopexy after cricopharyngeal myotomy, in homogeneous groups of patients.

Methods

Thirty-seven patients were treated for Zenker’s diverticulum at the same university medical school, but in two different units, with open cricopharyngeal myotomy, associated with diverticulectomy in 17 patients and with diverticulopexy in the remaining. No clinical criteria influenced the different choice of treatment of the diverticular pouch, but only the surgeon’s preference. Clinical data, diverticulum size, postoperative course, and complications were analyzed. Patients were followed up for median duration of 37 months (range 12–113 months) through contrast swallow study and clinical evaluation, aided by a specifically conceived questionnaire. Records were analyzed by Mann–Whitney–Wilcoxon test and Fisher’s exact test.

Results

Homogeneous comparative values for sex, age, diverticulum size, and symptoms were found in the two groups. Statistical analysis indicated that diverticulopexy, as compared with diverticulectomy, allowed reduced postoperative complications and slightly improved long-term swallowing.

Conclusions

Diverticulopexy is feasible also in large Zenker’s diverticula and can achieve equivalent or even better results than diverticulectomy with a smoother postoperative course.

     

Family history and disease outcomes in patients with Crohn’s disease:A comparison between China and the United States

AIM To investigate the differences in family history of inflammatory bowel disease(IBD) and clinical outcomes among individuals with Crohn’s disease(CD) residing in China and the United States.METHODS We performed a survey-based cross-sectional study of participants with CD recruited from China and the United States.We compared the prevalence of IBD family history and history of ileal involvement,CD-related surgeries and IBD medications in China and the United States,adjusting for potential confounders.RESULTS We recruited 49 participants from China and 145 from the United States.The prevalence of family history of IBD was significantly lower in China compared with the United States(China:4.1%,United States:39.3%).The three most commonly affected types of relatives were cousin,sibling,and parent in the United States compared with child and sibling in China.Ileal involvement(China:63.3%,United States:63.5%) and surgery for CD(China:51.0%,United States:49.7%) were nearly equivalent in the two countries.CONCLUSION The lower prevalence of familial clustering of IBD in China may suggest that the etiology of CD is less attributed to genetic background or a family-shared environment compared with the United States.Despite the potential difference in etiology,surgery and ileal involvement were similar in the two countries.Examining the changes in family history during the continuing rise in IBD may provide further insight into the etiology of CD.     

Do we undertreat hypertensive smokers? A comparison between smoking and non-smoking hypertensives

The acute effect of smoking is a rise in blood pressure and heart rate. Nevertheless, in several epidemiologic studies, smokers tend to have a slightly lower office blood pressure than non-smokers. We studied the 24 h ambulatory blood pressure consecutively in hypertensive smokers (> or = 10 cigarettes per day, n = 26) and hypertensive non-smokers (n = 26) to test the hypothesis that smoking is associated with a rise in ambulatory blood pressure. There was no difference between smokers and non-smokers in office blood pressure (153.8 +/- 22.2/98.5 +/- 10.6 vs 149.0 +/- 16.1/96.9 +/- 11.6 mmHg). However, we found a statistically significant higher daytime systolic and diastolic blood pressure in smokers (153.7 +/- 16.2/96.1 +/- 9.5 vs 145.0 +/- 12.1/90.1 +/- 10.0 mmHg) than in non-smokers. Differences were also found for office-daytime differences and when studying patients on pharmacological antihypertensive treatment separately. Daytime heart rate was also significantly higher in smokers (86.6 +/- 9.4 vs 76.0 +/- 10.9). We conclude that smokers tend to be undertreated in that they have a higher daytime blood pressure than do non-smokers, a difference that is not recognized by measuring office blood pressure alone. We therefore recommend 24h ambulatory blood pressure measurement in smokers with essential hypertension.     

A survey of internists’ recommendations for aspirin in older adults and barriers to evidence-based use

Journal of Thrombosis and Thrombolysis - Recent trials suggest that aspirin for primary prevention may do more harm than good for some, including adults over 70 years of age. We sought to...     

Is it meaningful to use biochemical parameters to discriminate between transudative and exudative pleural effusions?

OBJECTIVES: The usefulness of biochemical criteria to separate pleural transudates from exudates is controversial, and the limitations of Light's criteria in patients receiving diuretic therapy is of general concern. We evaluated the added value of biochemical criteria to clinical judgment for separating transudates from exudates. SETTING: A community teaching hospital. DESIGN: A prospective, observational study for the evaluation of diagnostic tests. Patients and measurements: In 249 consecutive patients referred for diagnostic thoracentesis, two physicians classified the pleural effusion as transudate or exudate based on all available information just before performing the thoracentesis. The sensitivity, specificity, and accuracy of the clinical presumption were compared with those of Light's criteria, and serum-pleural fluid albumin and protein gradients. The combined accuracy of biochemical and clinical criteria was also assessed. RESULTS: The accuracy of Light's criteria (93%) was significantly higher than that showed by the initial clinical presumption (84%; p < 0.01) and that of the alternative biochemical criteria: serum-pleural fluid albumin gradient (87%; p < 0.03) and serum-pleural fluid protein gradient (86%; p < 0.01). In patients receiving diuretic therapy, the accuracy of Light's criteria was 83% (60 of 72 cases), neither different to that of the albumin gradient (88%; 63 of 72 cases) nor to that of the protein gradient (86%; 62 of 72 cases). When these alternative biochemical criteria were applied exclusively to patients receiving diuretics who were thought to have a transudative effusion by clinical criteria, but having fluid identified as exudative by Light's criteria, the results did not improve significantly. Using a multiparametric model for the population receiving diuretics, the accuracy was greater (93%; 67 of 72 cases) than that of Light's criteria but without reaching statistical significance (p = 0.12). CONCLUSIONS: Light's criteria are significantly superior to the clinical presumption to separate pleural transudates from exudates. In patients receiving diuretics, Light's criteria lose accuracy, which is similar to that showed by the use of alternative biochemical criteria alone or combined with clinical judgment.