Antismoking Ads at the Point of Sale: The Influence of Ad Type and Context on Ad Reactions

Efforts are underway to educate consumers about the dangers of smoking at the point of sale (POS). Research is limited about the efficacy of POS antismoking ads to guide campaign development. This study experimentally tests whether the type of antismoking ad and the context in which ads are viewed influence people’s reactions to the ads. A national convenience sample of 7,812 adult current smokers and recent quitters was randomized to 1 of 39 conditions. Participants viewed one of the four types of antismoking ads (negative health consequences—graphic, negative social consequences—intended emotive, benefits of quitting—informational, benefits of quitting—graphic) in one of the three contexts (alone, next to a cigarette ad, POS tobacco display). We assessed participants’ reactions to the ads, including perceived effectiveness, negative emotion, affective dissonance, and motivational reaction. Graphic ads elicited more negative emotion and affective dissonance than benefits of quitting ads. Graphic ads elicited higher perceived effectiveness and more affective dissonance than intended emotive ads. Antismoking ads fared best when viewed alone, and graphic ads were least influenced by the context in which they were viewed. These results suggest that in developing POS campaigns, it is important to consider the competitive pro-tobacco context in which antismoking ads will be viewed.     

Acquired prolactin deficiency indicates severe hypopituitarism in patients with disease of the hypothalamic-pituitary axis

OBJECTIVE: Prolactin deficiency has been the subject of many scientific studies, but there is a paucity of information regarding prolactin deficiency in humans. In this report, adults with disease of the hypothalamic-pituitary axis (HPA) were studied to determine the prevalence of severe acquired prolactin deficiency (APD) and the pathophysiological characteristics associated with it. PATIENTS AND METHODS: APD was defined as a serum prolactin level persistently below the detection limit of the assay, i.e. less than 50 mU/l (normal range: male 85-444, female 85-530). Patients with a diagnosis of acromegaly, prolactinoma or with congenital or drug induced prolactin deficiency were excluded. Three hundred and sixty-nine patients (190 women, age range 17-79 years) with disease of the HPA, meeting the specified criteria were identified. RESULTS: Twenty-two (13 women, age range 29-76 years), showed evidence of APD. Thirteen of the 22 patients with APD had been treated for Cushing's disease. In all, 62 patients treated for Cushing's disease were identified, resulting in a prevalence of APD in treated Cushing's disease of 20.97%. Excluding treated Cushing's disease, the prevalence of APD in the remainder of the cohort was 2.93%. Nineteen patients with APD (86.4%) and 183 without APD (52.7%) underwent surgery in the region of the HPA (P = 0.0042). In contrast, nine patients with APD (40.9%) and 283 without APD (80.4%) had received radiotherapy, with fields which included the HPA (P < 0.001). No patient with isolated APD was identified. All patients with APD had evidence of severe GH deficiency (GHD) with a peak GH response to provocative stimuli of < 1.6 mU/l and a median IGF-I standard deviation score (SDS) of -4.85 (quartiles -9.56 to -2.80). Of the 13 patients with APD and Cushing's disease, all were gonadotrophin and TSH-deficient, six were adrenocorticotropic hormone (ACTH)-deficient and six (46.1%) had cranial diabetes insipidus (CDI). Of the remaining nine patients with APD, total anterior pituitary hormone failure was present in all and CDI was present in two (22.2%). CONCLUSIONS: The presence of APD indicates severe hypopituitarism in adults with HPA disease. It is universally associated with severe GHD. It is more common after surgery to the HP region. It has a low overall prevalence except in patients surgically treated for Cushing's disease.     

Nahrungsmittelallergie und atopische Dermatitis

Food allergy can be observed in a subgroup of atopic patients, such as patients suffering from atopic dermatitis (AD). Approximately 30?% of children with moderate or more severe forms of AD and sensitization to food allergens show associated clinical symptoms of hypersensitivity. Many patients with AD or parents of affected children suspect food as being relevant trigger factors for AD. Patients who actually benefit from elimination diets must be identified by means of validated diagnostic procedures. In turn malnutrition and associated limitations of quality of life should be avoided in those patients for whom food allergy could be excluded. As determination of specific IgE, results of skin prick tests and the patient history often do not correlate with eczematous reactions to food allergens, oral food challenges supervised by allergologists still represent the diagnostic gold standard for elucidating the clinical relevance of sensitization. As eczematous lesions often deteriorate after a period of 6–48 h after food challenge, examination of the skin should also be performed on the following day. Moreover, in patients with AD, the challenge with a food allergen should be performed in a repeated test over 2 days.     

Anti‐inflammatory therapies in atopic dermatitis

The pathogenesis of atopic dermatitis (AD) is multifactorial and complex. Consequently, clinical signs and symptoms vary strongly depending on individually relevant trigger factors and the stage of the disease. So far, treatment of AD was commonly limited to topical treatment or, in more severe cases, to systemic drugs mostly approved for other indications than AD. However, emerging data on new anti‐inflammatory agents have been published in the recent years. As these new substances specifically focus on immune responses in AD, these are partially considered as possible ‘breakthrough’ in the treatment of AD. Therapeutic strategies of the future appear to be ‘customized’ for inflammation in AD as they target pro‐inflammatory, highly relevant cytokines and cytokine receptors, such as IL‐4Rα, IL‐13, IL‐31, and IL‐17. Further innovative therapeutic approaches aim to block the function of relevant molecules such as thymic stromal lymphopoietin, chemoattractant‐receptor homologous molecule expressed on Th2 lymphocytes (CRTh2), and phosphodiesterase (PDE)‐4 inhibitors. Recently, anti‐inflammatory effects in AD by antagonizing the histamine (H)‐4 receptor have also been detected. Finally, specific immunotherapy is under further investigation as treatment option for AD patients with clinically relevant sensitization.     

Symptomatische Therapie der atopischen Dermatitis

The optimal treatment of atopic dermatitis requires regular medical supervision. The course of this chronic skin disease is influenced by multiple triggers which are relevant for the treatment. The mainstays of topical therapy include regular use of emollients coupled with antimicrobial substances, corticosteroids and immune modulators as required. Ultraviolet radiation and immunosuppressive regimens represent further options for the treatment of severe exacerbations and may lead to long term improvement. Data from experimental studies provide insight into possible future treatment methods.