BackgroundConsumption of sugar-sweetened beverages (SSBs) is associated with increased risk of obesity, diabetes, heart disease and dental caries. Our aim was to assess the effects of plain packaging, warning labels, and a 20 % tax on predicted SSB preferences, beliefs and purchase probabilities amongst young people.MethodsA 2 × 3 × 2 between-group experimental study was conducted over a one-week period in August 2014. Intervention scenarios were delivered, and outcome data collected, via an anonymous online survey. Participants were 604 New Zealand young people aged 13–24 years who consumed soft drinks regularly. Participants were randomly allocated using a computer-generated algorithm to view one of 12 experimental conditions, specifically images of branded versus plain packaged SSBs, with either no warning, a text warning, or a graphic warning, and with or without a 20 % tax. Participant perceptions of the allocated SSB product and of those who might consume the product were measured using seven-point Likert scales. Purchase probabilities were measured using 11-point Juster scales.ResultsSix hundred and four young people completed the survey (51 % female, mean age 18 (SD 3.4) years). All three intervention scenarios had a significant negative effect on preferences for SSBs (plain packaging: F (6, 587) = 54.4, p <0.001; warning label: F (6, 588) = 19.8, p <0.001; 20 % tax: F (6, 587) = 11.3, p <0.001). Plain packaging and warning labels also had a significant negative impact on reported likelihood of purchasing SSB’s (p = <0.001). A 20 % tax reduced participants’ purchase probability but the difference was not statistically significant (p = 0.2).ConclusionsPlain packaging and warning labels significantly reduce young people’s predicted preferences for, and reported probability of purchasing, SSBs.

No abstract

Although social smokers regret smoking, their retrospective remorse was insufficient to promote behaviour change, and environmental modifications appear more likely to promote smoke-free behaviours among social smokers. Participants strongly supported extending the smoke-free areas outside bars, a measure that would help decouple their alcohol-fuelled behaviours from the identity to which they aspire.

No abstract

No abstract

Background There is a gap in knowledge about the kind and quality of care experienced by hospital patients at the end of their lives. Aims To document and compare the patterns in end‐of‐life care for patients dying across a range of different medical units in an acute care hospital. Methods A retrospective observational study of consecutive adult inpatient deaths between 1 July 2010 and 30 June 2014 in four different medical units of an Australian tertiary referral hospital was performed. Units were selected on the basis of highest inpatient death rates and included medical oncology, respiratory medicine, cardiology and gastroenterology/hepatology. Results Overall, 41% of patients died with active medical treatment plans, but significantly more respiratory and cardiology patients died with ongoing treatment (46 and 75% respectively) than medical oncology and gastroenterology patients (each 27%, P < 0.05). More medical oncology and gastroenterology patients were recognised as dying (92 and 88%) compared with 72% of respiratory and only 38% of cardiology patients (P < 0.001). Significantly, more medical oncology patients were referred to palliative care and received comfort care plans than all other patient groups. However, the rate of non‐palliative interventions given in the final 48 h was not significantly different between all four groups. Conclusions There were differences in managing the dying process between all disciplines. A possible solution to these discrepancies would be to create an integrated palliative care approach across the hospital. Improving and reducing interdisciplinary practice variations will allow more patients to have a high‐quality and safe death in acute hospitals.

Aim:  As well as providing mandatory nutrition information, some Australian and New Zealand food manufacturers insert additional nutrient details on the front of product packages. However, the format and content of this optional information has been questioned, as have its effects on consumers. This research explored parents' reactions to industry‐led labels and formats proposed by health advocates. Methods:  The qualitative study used semi‐structured depth interviews to examine 15 parents' views of four different front‐of‐pack nutrition labels (including ‘Percentage Daily Intake’ and ‘Traffic Light’ formats). An iterative thematic analysis was used to identify themes in the data. Results:  Key themes included the volume of information, the ease of interpreting this and the ability and time required to assimilate it into decisions. Strengths and weaknesses were identified for all labels; however, participants preferred information they could process easily and quickly. Simplified, graphic information formats appear more likely to inform consumers' food choices than labels dominated by numeric information. Conclusions:  Because parents are often distracted when purchasing food they may not read on‐pack nutrition information, especially if this is difficult to comprehend. Participants' responses suggest policy‐makers should explore several front‐of‐pack labels, particularly those that use visual heuristics such as Traffic Light labels.

PurposeTo explore how a “harm chain” analysis could identify and address stakeholders' concerns about direct‐to‐consumer advertising of prescription medicines (DTCA).Design/methodology/approachThe paper analyses the development of stakeholder theory before exploring and discussing the tension between normative and instrumental logic. The authors adopt a utilitarian perspective, which they use to identify the range of stakeholders involved with or affected by DTCA.FindingsA “harm chain” analysis identifies common concerns held by stakeholders; these include disquiet over the quality of information provided via DTCA and possible derogation of doctors' role as prescribers. The paper outlines prescriptive advertising guidelines that could address these issues, but notes that failure to achieve a satisfactory reduction in harm potential may result in a ban on DTCA.Research limitations/implicationsAlthough a utilitarian norm will not satisfy all stakeholders' interests, the authors believe that it will produce the greatest reduction in harm, as well as maximising the benefits that can result from DTCA. The conclusions imply the need for independent monitoring of DTCA's effects on stakeholder groups to ensure that regulations governing this advertising are broadly based.Practical implicationsThe authors suggest changes to DTCA regulation, specifically the introduction of a “fair balance” criterion and a statement explicitly recognising doctors' role in determining appropriate treatments.Originality/valueAlthough the debate over DTCA has been well documented, this paper represents the first attempt to use stakeholder theory to explore the ethical issues associated with this advertising. The analysis produces a decision‐making model that the authors recommend should guide future policy decisions.