Tobacco, e-cigarette and alcohol content in popular UK soap operas: a content analysis to explore changes in social norms and scene location over time

Background Exposure to tobacco and alcohol on-screen promotes use and despite regulations and policies to limit impact, these behaviours remain common. We report a longitudinal analysis of tobacco, e-cigarette and alcohol content in three popular UK television soap operas, to examine changing social norms between 2002-2022. Methods We used one-minute interval coding to measure content in programmes in two one-week periods in three years (2002, 2012 and 2022). Change in probability of actual and implied use of tobacco, e-cigarette and alcohol over time was examined using logistic regression. Results We coded 2505 intervals from 78 episodes. Tobacco content occurred in 22% of episodes and significantly decreased from 2002 to 2022 (OR 0.15 95% CI 0.06-0.40). Tobacco use changed over time with decreasing use indoors and increasing use outdoors. No e-cigarette use was identified. Alcohol content was found in 88% of episodes and while it also significantly decreased over time (OR 0.78 95% CI 0.61 – 0.99) it featured in 20% of broadcast minutes in 2022. Alcohol use in homes increased over time. Conclusion While tobacco imagery is increasingly rare on television, alcohol content has remained common. Current regulations are not sufficient to reduce exposure. Soap opera producers should consider the impact of on-screen tobacco and alcohol use and opportunities to change social norms and help protect future generations

The Frequency and Content of Discussions About Alcohol Use in Primary Care and Application of the Chief Medical Officer’s Low-Risk Drinking Guidelines: A Cross-Sectional Survey of General Practitioners and Practice Nurses in the UK

ABSTRACT Aims: To examine how often General Practitioners (GPs) and Practice Nurses (PNs) working in primary care discuss alcohol with patients, what factors prompt discussions, how they approach patient discussions, and whether the Chief Medical Officer’s (CMO’s) revised low-risk drinking guidelines are appropriately advised. Methods: Cross-sectional survey with GPs and PNs working in primary care in the UK, conducted January-March 2017 (n=2,020). A vignette exercise examined what factors would prompt a discussion about alcohol, whether they would discuss before or after a patient reported exceeded the revised CMO guidelines (14 units per week), and whether the CMO’s drinking guidelines were appropriately advised. For all patients, participants were asked how often they discussed alcohol and how they approached the discussion (e.g. used screening tool). Results: The most common prompts to discuss alcohol in the vignette exercise were physical cues (44.7% of participants) or alcohol-related symptoms (23.8%). Most practitioners (70.1%) said they would wait until a patient was exceeding CMO guidelines before instigating discussion. Two-fifths (38.1%) appropriately advised the CMO guidelines in the vignette exercise, with PNs less likely to do so than GPs (OR=0.77, p=0.03). Less than half (44.7%) reportedly asked about alcohol always/often with all patients, with PNs more likely to ask always/often than GPs (OR=2.22, p<0.001). Almost three-quarters said they would enquire by asking about units (70.3%), compared to using screening tools. Conclusion: Further research is required to identify mechanisms to increase the frequency of discussions about alcohol and appropriate recommendation of the CMO drinking guidelines to patients.This research was supported by funding from Cancer Research UK. JMB is supported by the Medical Research Council (MRC) (Grant MC_UU_12015/4)

‘Draw, write and tell’. A literature review and methodological development on the ‘draw and write’ research method.

The creative research method ‘draw and write’ has been used in health, social care and education research for several decades. A literature search of studies utilising this method was conducted during the planning stages of a study exploring primary school children’s perceptions of infant feeding. A review of this literature noted a range of benefits of ‘draw and write’ in enabling child participation. However, it also identified that the method has been used inconsistently and found that there are issues for researchers in relation to interpretation of creative work and analysis of data. As a result of this, an improvement on this method, entitled ‘draw, write and tell’, was developed in an attempt to provide a more child-orientated and consistent approach to data collection, interpretation and analysis. This article identifies the issues relating to ‘draw and write’ and describes the development and application of ‘draw, write and tell’ as a case study, noting its limitations and benefit

Alcohol Marketing during the UEFA EURO 2016 Football Tournament: A Frequency Analysis

This study examined the frequency and nature of alcohol marketing references in broadcasts of the 2016 UEFA (Union of European Football Associations) European Championships football tournament in the United Kingdom (UK). Eighteen matches from across the tournament were recorded in full as broadcast in the UK, including all four matches featuring the English national team and all seven featuring the French national team. All visual and verbal references to alcohol marketing were recorded using a tool with high inter-rater reliability. A total of 2213 alcohol marketing references were recorded, an average of 122.94 per broadcast and 0.65 per broadcast minute (0.52 per minute in-play and 0.80 per minute out-of-play). Almost all references were visual (97.5%), with 77.9% occurring around the pitch border. Almost all (90.6%) were indirect references to alcohol brands (e.g., references to well-known slogans), compared to only 9.4% direct references to brands (e.g., brand names). The frequency of references to alcohol marketing was high. Although the overall proportion of direct brand references was low, the high proportion of indirect references demonstrates that alcohol producers were able to circumvent the French national law governing alcohol marketing (the Loi Évin) using indirect “alibi marketing”. To ensure the spirit of the Loi Évin regulations are achieved, stricter enforcement may be required to limit exposure to alcohol marketing, particularly for young peopleThis research was funded by the Institute of Alcohol Studies, Scottish Health Actions on Alcohol Problems and Alcohol Action Ireland

Examining the frequency and nature of gambling marketing in televised broadcasts of professional sporting events in the United Kingdom

Objective: Gambling operators in the United Kingdom have introduced a voluntary ban on adverts broadcast during televised sport before 21:00 (the 'whistle-to-whistle' ban). To inform debates around the potential effectiveness of this ban, we examine the frequency and nature of gambling marketing in televised broadcasts across professional sporting events. Study Design: Frequency analysis of verbal and visual gambling marketing references during television broadcasts of football (n=5), tennis, Formula 1, boxing and rugby union (each n=1) from 2018. Methods: For each gambling reference, we coded: whether it appeared in-play or out-of-play; location (e.g. pitch-side advertising); format (e.g. branded merchandise); duration (seconds); number of identical references visible simultaneously; brand; and presence of age restriction or harm reduction messages. Results: Boxing contained the most gambling references, on average, per broadcast minute (4.70 references), followed by football (2.75), rugby union (0.55), and tennis (0.11). Formula 1 contained no gambling references. In boxing, references most frequently appeared within the area-of-play. For football and rugby union, references most frequently appeared around the pitch border or within the area-of-play (e.g. branded shirts). Only a small minority of references were for adverts during commercial breaks that would be subject to the whistle-to-whistle ban(e.g. 2% of references in football). Less than 1% of references in boxing, and only 3% of references in football, contained age restriction or harm-reduction messages. Conclusions: As gambling sponsorship extends much beyond adverts in commercial breaks, the 'whistle-to-whistle' ban will have limited effect on gambling exposure. Gambling sponsorship activities rarely contain harm reduction messages

How did smokers respond to standardised cigarette packaging with new, larger health warnings in the United Kingdom during the transition period? A cross-sectional online survey

Introduction: In the United Kingdom, standardised packaging for cigarettes was phased in between May 2016 and May 2017. We assessed whether there was an association between using standardised packs and warning salience, thoughts about the risks of smoking, thoughts about quitting, and awareness and use of stop-smoking websites. Methods: We conducted a cross-sectional online survey with current smokers aged 16 and over (N = 1865) recruited in two regions of England between February-April 2017, when both standardised and fully-branded packs were on the market. Participants were asked about use of standardised packs, warning salience (noticing, reading closely), and whether the packs they were using increased thoughts of the risks of smoking and quitting. They were also asked about awareness of stop-smoking websites, source of awareness (including warnings on packs), and whether they had visited a stop-smoking website. Results: Most participants reported currently using standardised packs (76.4%), 9.3% were not currently using them but had previously used them, and 14.3% had never used them. Compared with never users, current users were more likely to have noticed the warnings on packs often/very often (AOR (95%CI) = 2.76 (2.10, 3.63)), read them closely often/very often (AOR(95%CI) = 2.16 (1.51, 3.10)), thought somewhat/a lot about the health risks of smoking (AOR(95%CI) = 1.92 (1.38, 2.68)), and thought somewhat/a lot about quitting (AOR(95%CI) = 1.90 (1.30, 2.77)). They were also more likely to have noticed a stop-smoking website on packs. Conclusions: Consistent with the broad objectives of standardised packaging, we found that it was associated with increased warning salience and thoughts about risks and quittingOutput Status: Forthcoming/Available Onlin

Information Extraction from Unstructured Text for the Biodefense Knowledge Center

The Bio-Encyclopedia at the Biodefense Knowledge Center (BKC) is being constructed to allow an early detection of emerging biological threats to homeland security. It requires highly structured information extracted from variety of data sources. However, the quantity of new and vital information available from every day sources cannot be assimilated by hand, and therefore reliable high-throughput information extraction techniques are much anticipated. In support of the BKC, Lawrence Livermore National Laboratory and Oak Ridge National Laboratory, together with the University of Utah, are developing an information extraction system built around the bioterrorism domain. This paper reports two important pieces of our effort integrated in the system: key phrase extraction and semantic tagging. Whereas two key phrase extraction technologies developed during the course of project help identify relevant texts, our state-of-the-art semantic tagging system can pinpoint phrases related to emerging biological threats. Also we are enhancing and tailoring the Bio-Encyclopedia by augmenting semantic dictionaries and extracting details of important events, such as suspected disease outbreaks. Some of these technologies have already been applied to large corpora of free text sources vital to the BKC mission, including ProMED-mail, PubMed abstracts, and the DHS's Information Analysis and Infrastructure Protection (IAIP) news clippings. In order to address the challenges involved in incorporating such large amounts of unstructured text, the overall system is focused on precise extraction of the most relevant information for inclusion in the BKC

Visibility of age restriction warnings, harm reduction messages, and terms and conditions::A content analysis of paid-for gambling advertising in the United Kingdom.

Objective: The inclusion and design of age restriction warnings, harm reduction messages, and terms and conditions (T&Cs) in gambling advertising is self-regulated in the United Kingdom. Our study examines the visibility and nature of this information in a sample of paid-for gambling adverts. Study design: Content analysis of a stratified random sample of gambling adverts (n=300) in the United Kingdom from eight paid-for advertising channels (March 2018). Methods: For each advert, we assessed whether any age restriction warnings, harm reduction messages, and T&Cs were present. If so, visibility was scored on a five-point scale ranging from Very poor (25% of advert), which had high inter-rater reliability. Descriptive information on position, design, and tone of language was recorded. Results: One-in-seven adverts (14%) did not feature an age restriction warning or harm reduction message. In adverts that did, 84% of age restriction warnings and 54% of harm reduction messages had very poor visibility. At least one-in-ten adverts did not contain T&Cs. In adverts that did, 73% had very poor visibility. For age restriction warnings, harm reduction messages, and T&Cs, most appeared in small fonts and outside the main advert frame. Most harm reduction messages did not actually reference gambling-related harms. Conclusion: Age restriction warnings, harm reduction messages, and T&Cs do not always appear in paid-for gambling advertising. When they do, visibility is often very poor and the messaging not clear. The findings do not support a self-regulatory approach to managing this information in gambling adverts

Dysconnection in schizophrenia: from abnormal synaptic plasticity to failures of self-monitoring

Over the last 2 decades, a large number of neurophysiological and neuroimaging studies of patients with schizophrenia have furnished in vivo evidence for dysconnectivity, ie, abnormal functional integration of brain processes. While the evidence for dysconnectivity in schizophrenia is strong, its etiology, pathophysiological mechanisms, and significance for clinical symptoms are unclear. First, dysconnectivity could result from aberrant wiring of connections during development, from aberrant synaptic plasticity, or from both. Second, it is not clear how schizophrenic symptoms can be understood mechanistically as a consequence of dysconnectivity. Third, if dysconnectivity is the primary pathophysiology, and not just an epiphenomenon, then it should provide a mechanistic explanation for known empirical facts about schizophrenia. This article addresses these 3 issues in the framework of the dysconnection hypothesis. This theory postulates that the core pathology in schizophrenia resides in aberrant N-methyl-D-aspartate receptor (NMDAR)–mediated synaptic plasticity due to abnormal regulation of NMDARs by neuromodulatory transmitters like dopamine, serotonin, or acetylcholine. We argue that this neurobiological mechanism can explain failures of self-monitoring, leading to a mechanistic explanation for first-rank symptoms as pathognomonic features of schizophrenia, and may provide a basis for future diagnostic classifications with physiologically defined patient subgroups. Finally, we test the explanatory power of our theory against a list of empirical facts about schizophrenia

Neuroticism-related personality traits are related to symptom severity in patients with premenstrual dysphoric disorder and to the serotonin transporter gene-linked polymorphism 5-HTTPLPR

Neuroticism has been linked to a functional polymorphism in the serotonin transporter gene (5-HTTLPR), with short-allele carriers being overrepresented among high-scorers on neuroticism. Studies evaluating neuroticism-related personality traits in relation to the 5-HTTLPR polymorphism among patients with premenstrual dysphoric disorder (PMDD) and are lacking. The primary aim of this study was to evaluate the relationship between PMDD and neuroticism-related personality traits, and secondly, to relate the personality trait scores of PMDD patients to experienced symptom severity and to the 5-HTTLPR short allele. Thirty PMDD patients and 55 asymptomatic healthy controls were included in the study. The Swedish Universities Scale of Personality was used to evaluate personality traits. Genotype analyses were available in 27 PMDD patients and 18 healthy controls. Women with PMDD displayed higher levels of neuroticism-related personality traits (psychic trait anxiety, somatic trait anxiety, embitterment, stress susceptibility and mistrust) than healthy controls, and these effects were most prominent in women with more severe luteal phase symptoms. Furthermore, PMDD patients with at least one copy of the short allele of the 5-HTTLPR polymorphism scored higher on psychic trait anxiety and lack of assertiveness than PMDD patients who were homozygous for the long allele. PMDD patients who suffer from more severe luteal phase symptoms also display increased scores of neuroticism-related personality traits in comparison with healthy controls. Within the group of PMDD patients, differences in certain personality trait scores are associated with the short allele of the 5-HTTLPR polymorphism