Are we selling children & adolescents a lifetime of ill-health? Join CAP-2030 for the debate

In February 2020, the WHO-UNICEF-Lancet Commission ‘A Future for the World’s Children?’ launched its landmark report calling for urgent action for children’s health and well-being, to put them at the centre of the UN Sustainable Development Goals (SDGs) and at the centre of all policies across sectors. The report finds that children across the world face an uncertain future due to a rapidly changing climate, mass commercial marketing of harmful products like sugar, fast food, tobacco and alcohol, polluted environments, poverty, pervasive inequalities, migration and conflict, and from the failure of all sectors to integrate children’s needs and rights into their policies. Following our global launch on climate change, we'll be taking a deeper look at the mass commercial marketing of harmful products to children & adolescents at this event.

Representación de la imagen del menor en la publicidad difundida a través de Internet / Representation of the image of the minor in the publicity circulated via the Internet

INTRODUCCIÓN: La representación del menor en los anuncios de publicidad es un tema poco investigado y reflejado en la bibliografía, tanto de la pediatría social como de la comunicación audiovisual. El objetivo del presente estudio es describir cómo se representa al menor en la publicidad que se vehiculiza a través de Internet, y si esa representación es adecuada o no. MATERIAL Y MÉTODOS: Se analizaron todos los anuncios en los que aparecían menores a lo largo de 2 meses, visualizando, 3 días por semana, las páginas web más visitadas en España. La valoración de cómo se representaba al menor se realizó con una herramienta de evaluación, elaborada por los autores, basada en la legislación europea y española, que mostró una alta concordancia interevaluador. Se realizó un análisis descriptivo de las variables categóricas y se estableció la relación de interdependencia entre las mismas a través de la prueba Chi-cuadrado. RESULTADOS: Se identificaron 173 anuncios donde apareció al menos un menor, que es generalmente representado solo (63,5%), en un entorno natural (36,9%) y con edad escolar (44,5%). Las páginas web de «prensa general» son las que más frecuentemente muestran anuncios donde se representan menores, a través del uso de banners (82%). En la mayor parte de los casos el uso inadecuado de la figura del menor tiene lugar mediante la representación táctica del mismo, y no meramente estratégica. CONCLUSIONES: El uso de la imagen del menor en la publicidad que se vehiculiza a través de las páginas web más visitadas en España es inadecuada en 2 de cada 3 anuncios. Dicho mal uso del menor suele objetivarse en la representación del mismo de forma estratégicamente no justificable, y favoreciendo valores no positivos o que favorecen situaciones de desigualdad

INTRODUCTION: The representation of the minor in advertisements is a topic that is scarcely studied and reflected in the bibliography, in social paediatrics as well as audio-visual communication. The aim of the present study is to describe how the minor is represented in the publicity that is conveyed through the internet, and whether or not that representation is adequate. MATERIAL AND METHODS: An analysis was made of all the advertisements in which minors appeared during a period of two months, on three days a week, on the most visited web pages in Spain. The evaluation on how the minor was represented was carried out with an evaluation tool, constructed by the authors, based on European and Spanish legislation, which showed a high concordance between evaluators. A descriptive analysis was performed on the categorical variables, and the inter-dependent relationship was established between them using the chi-squared test. RESULTS: A total of 173 advertisements were identified in which at least one minor appeared, which was generally represented solo (63.5%), in a natural environment (36.9%) and of school age (44.5%). The web pages of the "general press" are those that most frequently show advertisement in which minors are represented, through the use of banners (82%). In the majority of cases the inadequate use of the figure of the minor takes place using tactical representation, and not just strategic. CONCLUSIONS: The image of the minor in the publicity that is conveyed via the most visited web pages in Spain is inadequate in 3 of every 3 advertisements. This misuse of the minor is usually seen in as unjustifiably strategic, and favouring non-positive values or that they favour situations of inequality

What popular bars post on social media platforms: a case for improved alcohol advertising regulation. / Publications non conformes des bars populaires sur les plateformes de médias sociaux : une invitation à améliorer la réglementation de la publicité sur l'alcool.

INTRODUCTION: The aim of this study was to document the scope of violations of the Canadian Radio-television and Telecommunications Commission (CRTC) "Code for Broadcast Advertising of Alcoholic Beverages" (CRTC Code) by drinking venues posting alcohol-related content on social media platforms, and to assess whether CRTC Code violations by drinking venues relate to their popularity among university students and to students' drinking behaviours. METHODS: In phase 1 of the study, a probability sample of 477 students from four Canadian university responded to a questionnaire about their drinking and preferred drinking venues. In phase 2, a probability sample of 78 students assessed the compliance of drinking venues' social media posts with the 17 CRTC Code guidelines. We pooled both datasets and linked them by drinking venues. RESULTS: Popular drinking venues were overwhelming posting alcohol-related content that contravenes the CRTC Code. Adjusted effect estimates show that a decrease in the mean level of compliance with the CRTC Code was significantly associated with a 1% increase in popularity score of drinking venues (t-test, p < .001). With regard to drinking behaviours, a 1% increase in the overall mean level of compliance with the CRTC Code was associated with 0.458 fewer drinking days per week during a semester (t-test, p = .01), 0.294 fewer drinks per occasion (t-test, p = .048) and a lesser likelihood of consuming alcohol when attending a drinking venue (t-test, p = .001). CONCLUSION: The results of this study serve as a reminder to territorial and provincial regulatory agencies to review their practices to ensure that alcohol advertising guidelines are applied and enforced consistently. More importantly, these results call for the adoption of federal legislation with a public health mandate that would apply to all media, including print, television and radio, digital and social.

Assessing the Impact of a Social Marketing Campaign on Program Outcomes for Users of an Internet-Based Testing Service for Sexually Transmitted and Blood-Borne Infections: Observational Study.

BACKGROUND: While social marketing (SM) campaigns can be effective in increasing testing for sexually transmitted and blood-borne infections (STBBIs), they are seldom rigorously evaluated and often rely on process measures (eg, Web-based ad click-throughs). With Web-based campaigns for internet-based health services, there is a potential to connect campaign process measures to program outcomes, permitting the assessment of venue-specific yield based on health outcomes (eg, click-throughs per test). OBJECTIVE: This study aims to evaluate the impact of an SM campaign by the promotional venue on use and diagnostic test results of the internet-based STBBI testing service GetCheckedOnline.com (GCO). METHODS: Through GCO, clients create an account using an access code, complete a risk assessment, print a lab form, submit specimens at a lab, and get results online or by phone. From April to August 2015, a campaign promoted GCO to gay, bisexual, and other men who have sex with men in Vancouver, Canada. The campaign highlighted GCO's convenience in 3 types of promotional venues-location advertisements in print or video displayed in gay venues or events, ads on a queer news website, and ads on geosocial websites and apps. Where feasible, individuals were tracked from campaign exposures to account creation and testing using venue-specific GCO access codes. In addition, Web-based ads were linked to alternate versions of the campaign website, which used URLs with embedded access codes to connect ad exposure to account creation. Furthermore, we examined the number of individuals creating GCO accounts, number tested, and cost per account created and test for each venue type. RESULTS: Over 6 months, 177 people created a GCO account because of the campaign, where 22.0% (39/177) of these completed testing; the overall cost was Can $118 per account created and Can $533 per test. Ads on geosocial websites and apps accounted for 46.9% (83/177) of all accounts; ads on the news website had the lowest testing rate and highest cost per test. We observed variation between different geosocial websites and apps with some ads having high click-through rates yet low GCO account creation rates, and vice versa. CONCLUSIONS: Developing mechanisms to track individuals from Web-based exposure to SM campaigns to outcomes of internet-based health services permits greater evaluation of the yield and cost-effectiveness of different promotional efforts. Web-based ads with high click-through rates may not have a high conversion to service use, the ultimate outcome of SM campaigns.

Marketing social y su influencia en la solución de problemas de salud / Social marketing and its influence in the solution of health problems

Introducción: El marketing social es una disciplina de la mercadotecnia dirigida a influir en el comportamiento de las personas a fin de que mejoren su bienestar y el de la sociedad. Por sus características tiene potencialidades de influir en la solución de problemas de salud a nivel individual, grupal y social, en especial desde el punto de vista de las acciones de comunicación a aplicarse, como las actividades sociales, campañas sociales, charlas, relaciones públicas, ruedas de prensa, entre otras. Objetivo: El objetivo del artículo es valorar a partir del criterio de expertos, la influencia que puede ejercer el marketing social en la solución de problemas de salud en Ecuador. Métodos: Se aplicó un cuestionario para conocer el criterio de 10 especialistas de las ciencias médicas y administrativas de Ecuador, en función de la influencia que pueden ejercer los instrumentos y estrategias de comunicación de marketing social en la solución de problemas de salud. El procesamiento de los datos se realizó con Microsoft Excel, para determinar el comportamiento descriptivo de los mismos y de forma inferencial a través del Coeficiente R de Pearson. Resultados: A partir del criterio de los expertos se determinó la importancia de las actividades sociales para la solución de problemas de salud en Ecuador, en especial las campañas sociales explicativas y de desmotivación de vicios, así como los mensajes de motivación. Destacan como principales objetos de las campañas las enfermedades epidémicas y del desarrollo, y el gobierno nacional como principal agente de marketing social. Mientras que la comunidad tiene una baja participación y negativas relaciones con otras variables estudiadas. El control del proceso de comunicación limita la efectividad de las acciones de marketing social. Conclusiones: El análisis empírico desarrollado a partir del criterio de expertos permitió diagnosticar la influencia que ejerce el marketing social en la solución de problemas de salud, así como los principales instrumentos de comunicación que se emplean, los agentes más activos y algunas insuficiencias en el proceso(AU)

Introduction: Social marketing is a discipline of marketing aimed at influencing people's behavior in order to improve their well-being and that of society. Because of its characteristics, it has the potential to influence the solution of health problems at the individual, group and social level, especially from the point of view of communication actions to be applied, such as social activities, social campaigns, talks, public relations, press conferences, among others. Objective: The objective of the article is to evaluate, based on the criterion of experts, the influence that social marketing can exert on solving health problems in Ecuador. Methods: A questionnaire was applied to know the criteria of 10 specialists from the medical and administrative sciences of Ecuador, depending on the influence that can be exerted on the instruments and strategies of communication of social marketing in the solution of health problems. The data processing was done with Microsoft Excel, to determine the descriptive behavior of the same and inferential form through Pearson R Coefficient. Results: Based on the criteria of the experts, the importance of social activities for the solution of health problems in Ecuador was determined, especially the explanatory social campaigns and demotivation of vices, as well as motivational messages. The epidemic and developmental diseases are highlighted as the main objects of the campaigns, and the national government is the main agent of social marketing. While the community has low participation and negative relationships with other variables studied. Controlling the communication process limits the effectiveness of social marketing actions. Conclusions: The empirical analysis developed from the expert criterion allowed to diagnose the influence of social marketing in the solution of health problems, as well as the main communication tools used, the most active agents and some shortcomings in the process(AU)

Hypoactive sexual desire disorder: inventing a disease to sell low libido.

Condition branding is a marketing technique in which companies develop conditions concurrently with developing drugs; examples include gastro-oesophageal reflux disease, premenstrual dysphoric disorder, social anxiety disorder, erectile dysfunction and hypoactive sexual desire disorder. Although it is illegal for pharmaceutical companies to market drugs prior to regulatory approval, there are no restrictions on marketing diseases, and industry seeks to establish a disease state in the minds of clinicians years before an expected drug launch. Continuing medical education (CME) courses are an important part of promotion prior to drug approval and have become a key marketing tool for increasing clinician receptivity to new products. We systematically identified 14 free, internet-based, industry-funded, accredited CME modules on hypoactive sexual desire disorder in women which came out before a new drug, flibanserin, was being considered for regulatory approval in the USA. Common themes in these modules included the following: (1) Hypoactive sexual desire disorder is common, underdiagnosed and can have a profound effect on quality of life. (2) Women may not be aware that they are sick or distressed. (3) Simple questionnaires can assist clinicians in diagnosing the disorder. (4) It is problematic that there are medicines available to treat sexual problems for men but not women. In fact, there is no scientifically established norm for sexual activity, feelings or desire, and there is no evidence that hypoactive sexual desire disorder is a medical condition. Hypoactive sexual desire disorder is a typical example of a condition that was sponsored by industry to prepare the market for a specific treatment.

[Non-medical applications for brain MRI: Ethical considerations]. / Applications non médicales de l'IRM cérébrale : considérations éthiques.

INTRODUCTION: The recent neuroimaging techniques offer the possibility to better understand complex cognitive processes that are involved in mental disorders and thus have become cornerstone tools for research in psychiatry. The performances of functional magnetic resonance imaging are not limited to medical research and are used in non-medical fields. These recent applications represent new challenges for bioethics. OBJECTIVE: In this article we aim at discussing the new ethical issues raised by the applications of the latest neuroimaging technologies to non-medical fields. METHODS: We included a selection of peer-reviewed English medical articles after a search on NCBI Pubmed database and Google scholar from 2000 to 2013. We screened bibliographical tables for supplementary references. Websites of governmental French institutions implicated in ethical questions were also screened for governmental reports. RESULTS: Findings of brain areas supporting emotional responses and regulation have been used for marketing research, also called neuromarketing. The discovery of different brain activation patterns in antisocial disorder has led to changes in forensic psychiatry with the use of imaging techniques with unproven validity. Automated classification algorithms and multivariate statistical analyses of brain images have been applied to brain-reading techniques, aiming at predicting unconscious neural processes in humans. We finally report the current position of the French legislation recently revised and discuss the technical limits of such techniques. DISCUSSION: In the near future, brain imaging could find clinical applications in psychiatry as diagnostic or predictive tools. However, the latest advances in brain imaging are also used in non-scientific fields raising key ethical questions. Involvement of neuroscientists, psychiatrists, physicians but also of citizens in neuroethics discussions is crucial to challenge the risk of unregulated uses of brain imaging.

The neglected repercussions of a physician advertising ban.

Although the adverse implications of physician advertising are the subject of a fierce and sustained debate, there is almost no scholarly discussion on the ethical repercussions of physician advertising bans. The present paper draws attention to these repercussions as they exist today in most of the world, with particular focus on three serious implications for the public: (a) uncertainty about the physician's interests, namely, that patients must trust the physician to put patient wellbeing ahead of possible gains when taking medical decisions; (b) uncertainty about alternative treatments, namely, that patients must trust in the physician's treatment decisions; and (c) uncertainty about the exclusive patient-physician relationship, namely, that patients must develop and maintain a good relationship with one physician. Physician advertising bans continue to tell the public in most of the modern world that these are irrelevant or inappropriate issues, meaning that they are effectively left to the public to resolve.

Medical students' attitudes to and contact with the pharmaceutical industry: a survey at eight German university hospitals.

BACKGROUND: Drug companies maintain close contact with physicians. We studied the extent to which medical students are already in contact with drug companies, and their attitudes toward them. METHODS: An anonymous questionnaire containing 74 questions was distributed to 1151 medical students at eight German universities. 1038 (90.3%) of the questionnaires were filled out, returned, and evaluated. RESULTS: 12.1% of the students had never received any kind of gift from a drug company or participated in any drug company-sponsored event. 13.0% had received at least one sponsored lunch, and 24.6% had attended at least one sponsored lecture or CME event. 65.6% had received at least one non-informational gift, 50.8% an informational gift, 39.3% a reprint, and 8.6% a drug sample. 39.8% considered sponsored lectures informative and helpful, but simultaneously judged the presentation of content as biased. 45.6% and 49.7% of students, respectively, considered it all right to accept gifts because their influence was minimal in any case or because they considered themselves in a bad financial situation. 24.6% of the students thought gifts would influence their future prescribing behavior, while 45.1% thought gifts would influence their classmates' future prescribing behavior (p<0.001 for this difference). CONCLUSION: Medical students have extensive contact with the pharmaceutical industry even before they are out of medical school. Therefore, the medical school curriculum should include information about the strategies drug companies use to influence physicians' prescribing behavior, so that medical students can develop an appropriately critical attitude.

The ethics of social media in dental practice: ethical tools and professional responses.

This article considers several important trends in dental practice that result from innovations in digital and social media. It provides ethical tools for analysis, Illuminates areas of ethical concern in the current practice environment and offers recommendations for future practice. A summary in the form of a checklist is posted at the end of this essay for dentists considering the use of social media in their practice.

Tobacco control in the Russian Federation--a policy analysis.

BACKGROUND: The Russian Federation (Russia) has one of the highest smoking rates in the world. The purpose of this study is to analyze past and current trends of the tobacco epidemic in the Russian Federation, review current tobacco control policy responses, and identify areas of opportunity for policy priorities. METHODS: We used a policy triangle as analytical framework to examine content, context, and processes of Russian tobacco control policy. The analysis was based on secondary data on supply and demand sides of the Russian tobacco epidemic, tobacco-related economic and health effects during Russia's economic transition, and compliance of Russian tobacco policy with international standards and regulations. RESULTS: Tobacco-promoting strategies have specifically targeted women and youth. Russia's approval of a "National Tobacco Control Concept" and draft for a comprehensive tobacco control bill increasingly align national legislature with the WHO Framework Convention on Tobacco Control (FCTC). However, several structural and cultural factors represent substantial barriers to the policy process. The influence of transnational tobacco companies on policy processes in Russia has so far impeded a full implementation of the FCTC mandates. CONCLUSIONS: Several strategies have been identified as having the potential to reduce the prevalence of tobacco use in Russia and decrease tobacco-related national health and economic burden: adjusting national tobacco policy by raising tobacco tax from the current lowest level in Europe to at least 70%; consequent enforcement of a complete smoking ban in public places; marketing restrictions; and smoking cessation interventions integrated into primary care. Russia's tobacco control efforts need to target women and youths specifically to efficiently counter industry efforts.