A massive hit that targets kids quite a bit: Where and how Australian school children see energy drinks.

ISSUES ADDRESSED: Energy drinks (EDs) are not recommended for children due to their high caffeine content and adverse health risks. Their popularity among children may be due to children's exposure to ED marketing. This study aimed to identify where children have seen ED marketing and whether they believe ED marketing targets them. METHODS: Participant data were drawn from 'AMPED UP: An Energy Drink Study', where 3688 students in grades 7-12 (age 12-17 years) from 25 randomly selected secondary schools in Western Australia were asked if they had ever seen ED advertising on television, posters/signs in shops, online/internet, movies, cars/vehicles, social media, magazines/newspapers, music videos, video games, merchandise and free samples. Participants were also shown three ED advertisements and asked, 'Which age group/s do you think this ad targets?' (12 years or less, 13-17 years, 18-23 years, 24 years or older) and could select multiple age groups for each advertisement. RESULTS: On average, participants saw ED advertising on 6.5 (SD = 2.5) of 11 possible marketing channels, including television (seen by 91% of participants), posters/signs in shops (88%), online/internet (82%) and movies (71%). Participants also perceived ED advertisements targeted children (< 18 years). CONCLUSIONS: ED marketing has a high reach among Western Australian children. The voluntary ED advertising pledge to not market EDs to children in Australia does not prevent children from seeing or being targeted by ED marketing. SO WHAT?: Stronger regulatory control of ED marketing is needed to better protect children from the appeal and adverse health risks of ED use.

Regulating Obesity in Australia: Current Frameworks, Reflections upon the Impact of COVID-19 and Future Reform.

This article considers the legal and policy regulatory frameworks in Australia relevant to two of the key areas identified as central to managing and preventing obesity, namely, food labelling and junk food advertising. It does so against the backdrop of a global pandemic which resulted in a perfect storm: a global virus colliding with an obesity epidemic. The aetiology of the COVID-19 virus, and the isolation and shut down restrictions associated with combatting it, mean that introducing reforms in these key areas is, more than ever, a public health priority. This article provides important practical recommendations to modify legal and regulatory policy frameworks in the two key areas to address the obesity epidemic in Australia.

Comment on: Conservative management of an infected laparoscopic hernia mesh: A case study.

INTRODUCTION: We recently published an article in this journal describing the successful conservative treatment of a patient with an infected laparoscopically inserted hernia mesh using gentamycin flushes via a pig-tail drain and long term oral antibiotics. This prevented the need for major reconstructive surgery. However, 3 months after we published our report, the patient re-presented with symptoms of a recurrence of infection. PRESENTATION OF CASE: Seven months after stopping oral antibiotics, our patient represented with fever and swelling and redness over his left sided inguinal hernia mesh. This mesh had to be surgically removed. The procedure was laparoscopic and showed infection confined to the central 5cm of the mesh. Microbiology culture results were the same as on initial presentation. DISCUSSION: The microbiology results suggest that it is likely that the infection was never fully eradicated and that our intervention merely kept the infection at bay. Once long term antibiotics were stopped it is likely that the infection was able to eventually recur. CONCLUSION: Consequently, we have been unable to show that our method of conservative management of infected hernia meshes is effective to prevent long term recurrence of infection.

Conservative management of an infected laparoscopic hernia mesh: A case study.

INTRODUCTION: A dreaded complication of laparoscopic hernia repair is infection of the mesh. Traditionally mesh infection is managed by surgical removal of the mesh, an extensive procedure resulting in high re-herniation rates. A technique to treat such infections whilst salvaging the mesh is sorely needed. We describe a case in which a laparoscopic mesh infection was treated solely with drainage, parenteral antibiotics and antibiotic irrigation of the mesh. PRESENTATION OF CASE: A 65 year old gentleman presented 11 months post laparoscopic repair of an inguinal hernia with malaise and an uncomfortable groin swelling. Computed tomography scanning revealed a collection surrounding the mesh which was drained and cultured to show heavy growth of Staphylococcus aureus. A pigtail drain on continuous drainage was inserted and kept in situ for 7 weeks. The patient received one week of intravenous flucloxacillin and two gentamycin irrigations through the drain as an inpatient. He then received 6 weeks of oral flucloxacillin and bi-weekly saline flushes through the drain in the community. By 12 weeks an ultrasound scan showed resolution of the collection. At 7 months he remains clinically free from recurrence. DISCUSSION: Here we report a novel conservative method used to treat a hernia mesh infection, preserve the mesh and avoid major surgery. Other reports exist suggesting variations in conservative methods to treat mesh infections, however ours is by far the most conservative. CONCLUSION: Clearly, further research is required to identify which method is most effective and in which patients it is likely to be successful.