The effects of forcing on a single stream shear layer and its parent boundary layer

Forcing and its effect on fluid flows has become an accepted tool in the study and control of flow systems. It has been used both as a diagnostic tool, to explore the development and interaction of coherent structures, and as a method of controlling the behavior of the flow. A number of forcing methods have been used in order to provide a perturbation to the flow; among these are the use of an oscillating trailing edge, acoustically driven slots, external acoustic forcing, and mechanical piston methods. The effect of a planar mechanical piston forcing on a single stream shear layer is presented; it can be noted that this is one of the lesser studied free shear layers. The single stream shear layer can be characterized by its primary flow velocity scale and the thickness of the separating boundary layer. The velocity scale is constant over the length of the flow field; theta (x) can be used as a width scale to characterize the unforced shear layer. In the case of the forced shear layer the velocity field is a function of phase time and definition of a width measure becomes somewhat problematic

Tobacco companies' use of retailer incentives after a ban on point-of-sale tobacco displays in Scotland

Introduction  Incentives have been used by tobacco companies for many years to encourage retailers to sell and promote their products. However, few studies have examined the use of retailer incentives in countries with a ban on the open display of tobacco products in stores. Methods  As part of the DISPLAY(Determining the Impact of Smoking Point of Sale Legislation Among Youth) study, annual qualitative interviews were conducted with 24 small retailers in four Scottish communities. This article focuses on data collected in June to July 2015 and June to July 2016 after a ban on the open display of tobacco was fully implemented in Scotland. Results  Retailers described being offered and benefiting from a range of financial and other incentives, typically offered via tobacco company representatives ('reps'). Most of the retailers received tobacco manufacturer support for converting their storage unit to be compliant with the new regulations, and several participated in manufacturer 'loyalty' or 'reward' schemes. Incentives were additionally offered for maintaining stock levels and availability, positioning brands in specified spaces in the public-facing storage units (even though products were covered up), increasing sales, trialling new products and participating in specific promotions, such as verbally recommending specific brands to customers. Conclusions  Even in a market where the open display of tobacco is prohibited, tobacco companies continue to incentivise retailers to sell and promote their brands and have developed new promotional strategies. For countries that have implemented tobacco display bans, or are considering doing so, one option to combat these practices would be to ban promotional communications between manufacturers and retailers

Scottish adolescents' sun-related behaviours, tanning attitudes and associations with skin cancer awareness:a cross-sectional study

Objectives: To describe Scottish adolescents’ sun-related behaviours and tanning attitudes and assess associations with skin cancer awareness.Design: Cross-sectional study.Setting: 20 state secondary schools in one Scottish local authority (Glasgow City).Participants: 2173 adolescents (females: 50.7%,n=1102) with a mean age of 12.4 (SD=0.55).Outcome measures: Sun-related behaviour (suntan, sunbathing, sunburn, sunscreen use, sunbed use),tanning attitudes, skin cancer-related symptom and risk factor awareness.Results: Adolescents reported poor sun-related practice: 51% of adolescents reported sunburn the previous summer of whom 38% indicated sunburn on more than one occasion. Skin cancer awareness was low: 45% recognised ‘change in the appearance of amole’ as a cancer symptom, and 39% agreed that‘ getting sunburnt more than once as a child’ increased cancer risk. 42% and 26% of adolescents, respectively, reported that friends and family held protanning attitudes. Compared with males, females were statistically significantly more likely to: report sunbathing ( p<0.001), use of lotions or oil to aid tanning ( p=0.009) and sunburn ( p<0.001); know that changes in the appearance of a mole was a skin cancer symptom ( p=0.036) and sunburn more than once as a child was a skin cancer risk factor( p=0.005); perceive their friends to hold protanning attitudes ( p<0.001) and indicate that a tan made them feel better about themselves ( p<0.001), more attractive to others ( p=0.011) and healthier( p<0.001).Conclusions: Scottish adolescents had poor sun protection practice and low skin cancer awareness. Girls adopted riskier sun-related behaviour despite greater awareness of skin cancer-related risk. Urgent action is required to promote positive sun-related behaviour and increase skin cancer awareness among Scottish adolescents. However, further research is needed to inform the development of effective sun safe interventions

Adolescent Cancer Education (ACE) to increase adolescent and parent cancer awareness and communication:Study protocol for a cluster randomised controlled trial

Background: Raising cancer awareness among adolescents has potential to increase their knowledge and confidence in identifying cancer symptoms and seeking timely medical help in adolescence and adulthood. Detecting cancer at an early stage is important because it reduces the risk of dying of some cancers and thereby contributes to improved cancer survival. Adolescents may also play an important role in increasing cancer communication within families. However, there are no randomised controlled trials (RCT) of the effectiveness of school-based educational interventions to increase adolescents' cancer awareness, and little is known about the role of adolescents in the upward diffusion of cancer knowledge to parents/carers. The aim of this study is to determine the effectiveness of a school-based educational intervention to raise adolescent and parent cancer awareness and adolescent-parent cancer communication.Methods: The Adolescent Cancer Education (ACE) study is a school-based, cluster RCT. Twenty secondary schools in the area covered by Glasgow City Council will be recruited. Special schools for adolescents whose additional needs cannot be met in mainstream education are excluded. Schools are randomised to receive a presentation delivered by a Teenage Cancer Trust educator in Autumn 2013 (intervention group) or Spring 2014 following completion of six-month follow-up measures (control group). Participants will be students recruited at the end of their first year of secondary education (S1) (age 12 to 13 years) and one parent/carer for each student, of the student's choice. The primary outcome is recognition of cancer symptoms two weeks post-intervention. Secondary outcomes are parents' cancer awareness and adolescent-parent cancer communication. Outcomes will be assessed at baseline (when adolescents are in the final term of S1), two-week, and six-month follow-up (when adolescents are in S2, age 13 to 14 years). Differences in outcomes between trial arms will be tested using multiple regression methods, adjusted for clustering by school. An audit of cancer-related and health-promotion activity within the school curriculum and environment during the RCT will be conducted at six-month follow-up to contextualise the intervention effect.Discussion: Results from the ACE study will provide evidence about the public health effectiveness of a school-based intervention designed to increase adolescent and parent cancer awareness and adolescent-parent cancer communication

Cancer symptom awareness and barriers to medical help seeking in Scottish adolescents:a cross-sectional study

Background: Initiatives to promote early diagnosis include raising public awareness of signs and symptoms ofcancer and addressing barriers to seeking medical help about cancer. Awareness of signs and symptoms of cancerand emotional barriers, such as, fear, worry, and embarrassment strongly influence help seeking behaviour. Whetheranxiety influences seeking medical help about cancer is not known. The purpose of this study about adolescentswas to examine: 1) the relationship between contextual factors and awareness of signs and symptoms of cancerand barriers (including emotional barriers) to seeking medical help, and 2) associations between anxiety andendorsed barriers to seeking medical help. Interpretation of data is informed by the common sense model of theself-regulation of health and illness.Methods: A cross-sectional study of 2,173 Scottish adolescents (age 12/13 years) using the Cancer AwarenessMeasure. Socio-demographic questions were also included. Descriptive statistics were calculated and two Poissonregression models were built to determine independent predictors of: 1) the number of cancer warning signsrecognized, and; 2) number of barriers to help seeking endorsed.Results: Analysis identified that knowing someone with cancer was a significant independent predictor ofrecognising more cancer warning signs whereas Black and Minority Ethnic status was a significant independentpredictor of recognising fewer cancer warning signs. Emotional barriers were the most commonly endorsed,followed by family, service and practical barriers. Over two thirds of adolescents were ‘worried about what thedoctor would find’ and over half were ‘scared’. Higher anxiety scores, knowing more cancer warning signs andfemale gender were significant independent predictors of barriers to help seeking.Conclusion: Improving cancer awareness and help seeking behaviour during adolescence may contribute to earlypresentation. Contextual factors (for example, ethnicity, gender, knowing someone with cancer), and emotionaldimensions (for example, anxiety, fear, worry) are critical components in help seeking behaviours. The role ofemotional factors indicates that public health campaigns focused on awareness and help seeking may benefit fromhaving a more emotional focus, for example, including references to feelings, such as, fears and worries

Cancer symptom awareness and barriers to medical help seeking in Scottish adolescents: a cross-sectional study.

Background: Initiatives to promote early diagnosis include raising public awareness of signs and symptoms ofcancer and addressing barriers to seeking medical help about cancer. Awareness of signs and symptoms of cancerand emotional barriers, such as, fear, worry, and embarrassment strongly influence help seeking behaviour. Whetheranxiety influences seeking medical help about cancer is not known. The purpose of this study about adolescentswas to examine: 1) the relationship between contextual factors and awareness of signs and symptoms of cancerand barriers (including emotional barriers) to seeking medical help, and 2) associations between anxiety andendorsed barriers to seeking medical help. Interpretation of data is informed by the common sense model of theself-regulation of health and illness.Methods: A cross-sectional study of 2,173 Scottish adolescents (age 12/13 years) using the Cancer AwarenessMeasure. Socio-demographic questions were also included. Descriptive statistics were calculated and two Poissonregression models were built to determine independent predictors of: 1) the number of cancer warning signsrecognized, and; 2) number of barriers to help seeking endorsed.Results: Analysis identified that knowing someone with cancer was a significant independent predictor ofrecognising more cancer warning signs whereas Black and Minority Ethnic status was a significant independentpredictor of recognising fewer cancer warning signs. Emotional barriers were the most commonly endorsed,followed by family, service and practical barriers. Over two thirds of adolescents were ‘worried about what thedoctor would find’ and over half were ‘scared’. Higher anxiety scores, knowing more cancer warning signs andfemale gender were significant independent predictors of barriers to help seeking.Conclusion: Improving cancer awareness and help seeking behaviour during adolescence may contribute to earlypresentation. Contextual factors (for example, ethnicity, gender, knowing someone with cancer), and emotionaldimensions (for example, anxiety, fear, worry) are critical components in help seeking behaviours. The role ofemotional factors indicates that public health campaigns focused on awareness and help seeking may benefit fromhaving a more emotional focus, for example, including references to feelings, such as, fears and worries

Scottish adolescents' sun-related behaviours, tanning attitudes and associations with skin cancer awareness: a cross-sectional study

Objectives To describe Scottish adolescents’ sun-related behaviours and tanning attitudes and assess associations with skin cancer awareness. Design Cross-sectional study. Setting 20 state secondary schools in one Scottish local authority (Glasgow City). Participants 2173 adolescents (females: 50.7%, n=1102) with a mean age of 12.4 (SD=0.55). Outcome measures Sun-related behaviour (suntan, sunbathing, sunburn, sunscreen use, sunbed use), tanning attitudes, skin cancer-related symptom and risk factor awareness. Results Adolescents reported poor sun-related practice: 51% of adolescents reported sunburn the previous summer of whom 38% indicated sunburn on more than one occasion. Skin cancer awareness was low: 45% recognised ‘change in the appearance of a mole’ as a cancer symptom, and 39% agreed that ‘getting sunburnt more than once as a child’ increased cancer risk. 42% and 26% of adolescents, respectively, reported that friends and family held protanning attitudes. Compared with males, females were statistically significantly more likely to: report sunbathing (p<0.001), use of lotions or oil to aid tanning (p=0.009) and sunburn (p<0.001); know that changes in the appearance of a mole was a skin cancer symptom (p=0.036) and sunburn more than once as a child was a skin cancer risk factor(p=0.005); perceive their friends to hold protanning attitudes (p<0.001) and indicate that a tan made them feel better about themselves (p<0.001), mor eattractive to others (p=0.011) and healthier (p<0.001).ConclusionsScottish adolescents had poor sun protection practice and low skin cancer awareness. Girls adopted riskier sun-related behaviour despite greater awareness of skin cancer-related risk. Urgent action is required to promote positive sun-related behaviour and increase skin cancer awareness among Scottish adolescents. However, further research is needed to inform the development of effective sun-safe interventions

Assessing Change in Tobacco Visibility at Point-of-sale Following a Display Ban

Objectives:  In this paper, we describe a point-of-sale (POS) tobacco visibility tool and examine its utility for assessing changes in visibility following legislation banning tobacco displays.  Methods:  An observational tool was developed as part of DISPLAY, a multimodal, longitudinal study evaluating the impact of the tobacco POS display ban in Scotland. Measures were taken of product and storage unit visibility, over 5 years, pre- and post-implementation in all retail outlets selling tobacco in 4 contrasting study areas (N = 103).  Results:  Data generated by the visibility tool illustrated that whereas the display ban had reduced product visibility, it had little impact on reducing visibility of tobacco storage units. However, it did narrow the inequality gap in storage visibility. It also found some shop types reduced product visibility before legally required to do so.  Conclusions:  The DISPLAY visibility tool provides a reliable method for measuring visibility of tobacco displays before and after implementation of POS legislation. Tobacco product visibility reduced as expected following implementation of the legislation, but storage unit visibility persisted, providing residual cues of tobacco availability which may confound the effects of the legislation. The DISPLAY tool has the potential to be utilized in countries planning POS display bans

School-based brief psycho-educational intervention to raise adolescent cancer awareness and address barriers to medical help-seeking about cancer: a cluster randomised controlled trial: School-based psycho-educational intervention to raise cancer awareness

ObjectivesRaising cancer awareness and addressing barriers to help-seeking may improve early diagnosis. The aim was to assess whether a psycho-educational intervention increased adolescents' cancer awareness and addressed help-seeking barriers.MethodsThis was a cluster randomised controlled trial involving 2173 adolescents in 20 schools. The intervention was a 50-min presentation delivered by a member of Teenage Cancer Trust's (UK charity) education team. Schools were stratified by deprivation and roll size and randomly allocated to intervention/control conditions within these strata. Outcome measures were the number of cancer warning signs and cancer risk factors recognised, help-seeking barriers endorsed and cancer communication. Communication self-efficacy and intervention fidelity were also assessed.ResultsRegression models showed significant differences in the number of cancer warning signs and risk factors recognised between intervention and control groups. In intervention schools, the greatest increases in recognition of cancer warning signs at 6-month follow-up were for unexplained weight loss (from 44.2% to 62.0%) and change in the appearance of a mole (from 46.3% to 70.7%), up by 17.8% and 24.4%, respectively. Greatest increases in recognition of cancer risk factors were for getting sunburnt more than once as a child (from 41.0% to 57.6%) and being overweight (from 42.7% to 55.5%), up by 16.6% and 12.8%, respectively. Regression models showed that adolescents in intervention schools were 2.7 times more likely to discuss cancer at 2-week follow-up compared with the control group. No differences in endorsement of barriers to help-seeking were observed.ConclusionsSchool-based brief psycho-educational interventions are easy to deliver, require little resource and improve cancer awareness

The impact of the point-of-sale tobacco display ban on young people in Scotland: before-and-after study

Funding: This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme.Background Tobacco displays at point of sale have been shown to increase young people’s pro-smoking attitudes, susceptibility to smoking and smoking initiation. In Scotland, legislation that prohibited tobacco point-of-sale displays was implemented in large stores (i.e. those > 280 m2) in April 2013 and in small retailers in April 2015. Objective To assess the impact of the point-of-sale tobacco display ban on young people’s exposure to tobacco advertising, their attitudes to smoking and smoking susceptibility, and their risk of smoking initiation. Design Multimodal before-and-after study design using mixed methods to collect data at baseline (2013) and then longitudinally for 4 years. Setting Four main study communities in the central belt of mainland Scotland, UK, purposively selected to reflect two levels of urbanity (urban vs. small town) and two levels of deprivation (high vs. medium/low). Four matched communities. Participants In the main study communities, 94 tobacco retail outlets. All Secondary 2 (aged 13 years) and Secondary 4 (aged 15 years) pupils in 2013 and 2014 together with all Secondary 1 to Secondary 6 (aged 12–17 years) pupils in 2015–17. This included 6612 pupils who completed 14,344 questionnaires over 5 years. Three hundred and eighty-two participants in 80 focus groups who were recruited from Secondary 2 and Secondary 4 in 2013–17. In matched communities, 24 retail panel members in 2013–17. Main outcome measures Tobacco product and tobacco storage visibility, density of retail outlets (the number of retailers in a pre-defined area such as a residential neighbourhood), tobacco product exposure, brand awareness, perceived accessibility of tobacco, pro-smoking attitudes, pro-smoking norms, smoking susceptibility and smoking initiation. Data platform and methods The study had four components – a mapping and spatial analysis of retail outlets; a tobacco marketing audit, including retail panel interviews in matched communities; school surveys; and focus group discussions with secondary school pupils. Limitations The study was based on a small number of communities and did not include communities in remote areas. Results Compliance with the point-of-sale legislation in Scotland was high. This led to a large reduction in the visibility of tobacco products in retail outlets. However, when the results were stratified by socioeconomic status, declines in retailer density, weighted by total product visibility, were restricted to the least disadvantaged tertile of participants. Nevertheless, the implementation of the legislation was associated with a reduction in risk of both smoking susceptibility and smoking initiation in young people, as well as a reduction in the perceived accessibility of tobacco and in pro-smoking attitudes after both the partial and the comprehensive bans were introduced. Conclusions The Scottish point-of-sale legislation has been successful in reducing the overall visibility of tobacco products and is associated with improvements in attitudinal and behavioural outcomes in young people. However, cues that tobacco is for sale are still highly visible, particularly in retail outlets in areas of deprivation. In addition, the increase in retailer density that was observed after 2015 increased inequalities in product visibility. There was also evidence that the emergence of e-cigarettes may have disrupted the full impact of the legislation. Future work Our research indicates that further research is needed to examine the longitudinal relationships between tobacco outlet availability and product visibility inequalities; and the impact of e-cigarettes and standardised packaging on smoking initiation and prevalence.Publisher PDFPeer reviewe