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Explaining differential rates of mortality decline for Swedish men and women: a time-series analysis, 1945-1992.

The aim of this study is to identify social factors that could be related to differential rates of mortality decline for men and women in Sweden. The annual changes in fifteen indicators and their relationship with changes in absolute excess male mortality were analyzed by means of time series analysis for the period 1945-1992. Economic growth seems to have been more beneficial for women's survival than for that of men. A few labor market indicators (unemployment rate and the wage ratio men/women) may have had some influence on changes in excess male mortality as well. Consumption factors, such as alcohol consumption and cigarette consumption, have been important for changes in excess male mortality. Changes in excess male mortality have been particularly pronounced among 65-74 year olds, due to rapidly improved female survival in these age groups. I discuss the finding that there seem to be connections between, on the one hand, changes in general social factors such as economic growth and labor market factors, and perhaps urbanization and alcohol and cigarette consumption on the other. I therefore suggest that gender-specific consumer behavior, seen as an outcome of gender-specific norm systems, is one mechanism which links changes in general social factors to changes in excess male mortality.

Adolescent↗

Strategic marketing in the UK tobacco industry.

Tobacco-industry marketing has played a central part in the global spread of tobacco use and addiction. Although the absolute size of the tobacco market has dwindled, the industry is still immensely successful, largely due to sophisticated and manipulative marketing strategies. The UK tobacco industry identifies target groups and builds enduring relationships based on careful brand management. Potential customers are exposed to brands which are likely to appeal to them most. Tobacco companies tailor their products to target markets by altering the content of tar and nicotine, and by adding flavourings to produce a distinctive taste. Marketing strategies ensure that the products are promoted heavily at the point of sale, and directed advertising and sponsorship agreements are used to increase the visibility of the brand and strengthen its image. Tobacco companies also target non-consumer organisations such as retailers and policy makers with the aim of creating the best possible business environment for tobacco sales. We review published evidence, internal-advertising-agency documents, and observational data about tobacco promotion, and discuss the use of targeted marketing strategies in the UK.

Adolescent↗

Influence of storage on chemical, microbial and consumer acceptability of a milk-like product made from melon seeds.

The storage stability of melon milk at room (30 +/- 2 degrees C) and refrigeration (10 +/- 2 degrees C) temperatures was determined by analyzing changes in the chemical, microbial and sensory properties of the milk stored for 7 days. The results showed that at both storage temperatures, soluble solids and pH of the milk decreased while titratable acidity increased with storage. The standard plate counts increased appreciably while coliforms were absent in the milk with storage at both storage temperatures. The overall acceptability score of the melon milk dropped during storage, the drop being faster at 30 +/- 2 degrees C than at 10 +/- 2 degrees C. The milk samples stored at 30 +/- 2 degrees C and 10 +/- 2 degrees C were acceptable only within one and three days, respectively; thereafter, they were unacceptable.

Colony Count, Microbial↗

The effect of Medicare supplemental insurance on Medicare expenditures.

This study estimated the effect of Medicare supplemental insurance plans on Medicare expenditures, controlling for unobserved selection. For employer-sponsored policies, there was significant unobserved favorable selection into plans with and without prescription drug coverage. For individual plans, there was unobserved adverse selection into plans with drug benefits and unobserved favorable selection into plans without. Individual supplemental plans without prescription drugs increased Medicare expenditures by $914 annually, while those with drugs increased Medicare expenditures by $491. Employer policies also significantly increased Medicare expenditures ($207 without drug coverage and $447 with drug coverage), but the increase was less than that associated with individual policies.

Aged↗

[Shampoo].

The diversity of qualities demanded from a shampoo by today's consumer go beyond the sole function of cleansing the hair and scalp. A cosmetic benefit is expected, and the shampoo formulation has to be tailored to all the possible variations associated with hair quality (dry, greasy, permed, bleached, dyed), age (baby shampoo), care habit (frequency of shampooing) and specific problems relating to the superficial condition of the scalp (dandruff, seborrhea). The standard graduate medical training programs devote limited attention to the subject of shampoos, and much of the readily available information concerning shampoos is supplied by the industry. We should be increasingly aware that our patients look to us to supply information on what can be expected from a shampoo to enable them to make more informed choices at the consumer level. Moreover, selected ingredients of shampoos that have been popular with the consumer are currently under attack because of potential risks associated with their use, e.g. halogenated organic compounds, formaldehyde, nitromusc, and crude coal tar. Their critical appraisal also has to follow strict scientific criteria.

Consumer Behavior↗

Biotechnology: a solution for improving nutrient bioavailability.

Biotechnology strategies are now available to improve the amount and availability of nutrients in plant crops. Those strategies include simple plant selection for varieties with high nutrient density in the seeds, cross-breeding for incorporating a desired trait within a plant, and genetic engineering to manipulate the nutrient content of the plant. In plant cross-breeding, all genes of the parent plants are combined and the progeny have both desirable and undesirable traits. To eliminate undesirable traits, plant breeders "back-cross" the new plant varieties with other plants over several generations. This technique, called hybridization, has been used to create varieties of low-phytate corn, barley, and rice. Using the techniques of genetic engineering, the gene(s) encoding for a desired trait(s) in a plant are introduced in a precise and controlled manner within a relatively short period of time. Golden rice, containing carotenoids, and rice with higher amounts of iron, are two examples of genetically engineered plants for improved nutrition. Genetic engineering has tremendous potential for revolutionizing nutrition. However, public concerns regarding safety, appearance, and ethics must be overcome before these products can be effectively introduced into the food supply.

Biological Availability↗

Understanding knowledge effects on attitude-behavior consistency: the role of relevance, complexity, and amount of knowledge.

The role of properties of attitude-relevant knowledge in attitude- behavior consistency was explored in 3 experiments. In Experiment 1, attitudes based on behaviorally relevant knowledge predicted behavior better than attitudes based on low-relevance knowledge, especially when people had time to deliberate. Relevance, complexity, and amount of knowledge were investigated in Experiment 2. It was found that complexity increased attitude- behavior consistency when knowledge was of low-behavioral relevance. Under high-behavioral relevance, attitudes predicted behavior well regardless of complexity. Amount of knowledge had no effect on attitude- behavior consistency. In Experiment 3, the findings of Experiment 2 were replicated, and the complexity effect was extended to behaviors of ambiguous relevance. Together, these experiments support an attitude inference perspective, which holds that under high deliberation conditions, people consider the behavioral relevance and dimensional complexity of knowledge underlying their attitudes before deciding to act on them.

Analysis of Variance↗

Reinforcing, subjective, and psychomotor effects of sevoflurane and nitrous oxide in moderate-drinking healthy volunteers.

AIMS: To characterize the reinforcing, subjective and psychomotor effects of sevoflurane, a volatile anesthetic, across a range of subanesthetic concentrations in non-drug-abusing humans. In addition, a concentration of nitrous oxide was included in the design in order to compare and contrast behavioral effects of a gaseous to a volatile anesthesic. DESIGN: Repeated measures, double-blind, placebo control experiment. SETTING: Human psychopharmacology laboratory. PARTICIPANTS: Fourteen moderate-drinking healthy volunteers. INTERVENTION: In each of four sessions, subjects first sampled placebo-oxygen and an active drug (end-tidal concentrations of 0.2, 0.4, 0.6% sevoflurane and 30% nitrous oxide in oxygen) and then chose between the two MEASUREMENTS: Mood and psychomotor performance during the sampling trials, and choice of drug or placebo-oxygen during choice trial. FINDINGS: Nitrous oxide was chosen by 71% of the subjects, and 0.2, 0.4 and 0.6% sevoflurane were chosen by 50%, 57% and 50% of the subjects, respectively. Neither drug was chosen at levels that exceeded that of chance. Sevoflurane and nitrous oxide both impaired psychomotor performance and produced changes in mood. There were several differences in subjective effects between sevoflurane and nitrous oxide at concentrations which were considered to be equivalent in anesthetic effect. Finally, although sevoflurane did not function as a reinforcer in the majority of individuals tested, there was evidence that sevoflurane functioned as a reinforcer in some volunteers: subjects who chose to inhale sevoflurane over placebo-oxygen tended to report a positive spectrum of subjective effects during the sevoflurane sampling trial, relative to those subjects who chose placebo-oxygen over sevoflurane. CONCLUSIONS: Although sevoflurane did not function as a reinforcer in the majority of subjects tested, the correspondence between positive subjective effects of sevoflurane and subsequent sevoflurane choice suggests that the volatile anesthetic drug can function as a reinforcer in some moderate drinkers.

Adult↗

Modeling choice behavior for new pharmaceutical products.

This paper presents a dynamic generalization of a model often used to aid marketing decisions relating to conventional products. The model uses stated-preference data in a random-utility framework to predict adoption rates for new pharmaceutical products. In addition, this paper employs a Markov model of patient learning in drug selection. While the simple learning rule presented here is only a rough approximation to reality, this model nevertheless systematically incorporates important features including learning and the influence of shifting preferences on market share. Despite its simplifications, the integrated framework of random-utility and product attribute updating presented here is capable of accommodating a variety of pharmaceutical marketing and development problems. This research demonstrates both the strengths of stated-preference market research and some of its shortcomings for pharmaceutical applications.

Analgesics↗

Consumer perception of risk associated with eating genetically engineered soybeans is less in the presence of a perceived consumer benefit.

OBJECTIVE: To determine whether perceived benefit alters personal risk perception associated with eating genetically engineered soybeans, consumer desire for labeling, preferred phrase on a label symbol, and desired information in an educational brochure. DESIGN: Comparison of responses of two consumer groups who completed one of two survey versions. SUBJECTS/SETTINGS: One hundred fifty supermarket shoppers, age 21 years and older, for each survey or n=300 total. Focus groups and a pilot test were used to develop the final survey in which consumers read a description of a genetically engineered soybean with either no obvious consumer benefit or an obvious consumer benefit and then completed a set of attitude questions and evaluated a voluntary label design and educational brochure content. Main outcome measures were mean opinion scores of personal risk and desire for labeling and ranking of desired label phrase and brochure topics. STATISTICAL ANALYSIS: Chi;(2) and t Tests were used. RESULTS: Consumers reading about the soybean with obvious consumer benefit were significantly more comfortable eating these than those reading about the soybean with no obvious consumer benefit (2.9+/-1.1 vs 3.4+/-1.0, respectively; P</=.001). However, the groups did not differ in desire for labeling of foods made with these soybeans or preferred brochure content. They did differ significantly in preferred phrase on the symbol (P</=.05). APPLICATIONS/CONCLUSIONS: Dietitians can use descriptions of genetic engineering applications such as those in this study to help consumers assess these applications. Dietitians can play a critical role in explaining labeling terms and designing educational materials when the FDA finalizes voluntary labeling regulations for genetically engineered foods.

Adult↗

Approaches to controlling the costs of medical care: short-range and long-range alternatives.

Cost containment requires changes either in patterns of consumption or in the way services are provided. Although the former includes prevention, changing social expectations and finding suitable substitutes for some types of care, the latter involves mix of personnel technologic inputs, auspices of care and the content of encounters. Ultimately, the future of medical care and cost containment depends on advances in biomedical and health-services research. In the short run, costs will be contained increasingly by rationing mechanisms. Whereas cost sharing is intended to affect consumer behavior, implicit rationing, as through capitation and prospective budgeting, is intended to encourage physicians to make tougher allocation decisions. Explicit rationing, in contrast, depends more on administrative decisions that limit physician discretion. A better understanding of the effects of different rationing technics on patient and physician behavior and the quality of care, as well as on cost, is required.

Attitude↗

The price of choice: private health insurance in Australia.

Private Health Insurance (PHI) is an integral part of the financing of the Australian health care system. PHI is popular and has strong political support because it is perceived to give choice of access and responsiveness. However, in the past increasing premiums have led to a progressive decline in membership. A package of reforms by the Commonwealth Government in support of the private health insurance has reinvigorated the industry over the last three years. Some strategies for achieving a sustainable PHI industry are described. The key challenge is to control claims cost to maintain affordable premiums. Many techniques to do this compromise choice and challenge the very rationale for purchasing the product. Funds and providers will have to establish a new level of relationship to meet this challenge.

Australia↗

The effect of the 30% private health insurance rebate on the purchasing behaviour and intentions of the Australian population.

This article examines the likely effect of the 30% private health insurance rebate on private health insurance coverage. It is based on a survey of the Australia population conducted in April-May 1999 which collected information on health insurance purchasing behaviour and intentions. These data are used to predict the subsidy's likely effect on hospital insurance coverage, with estimates ranging from 30.5% to 34.3% by May 2000. Ancillary insurance membership is forecast to increase to between 32.7% and 37.2% of the population over the same period. The 30% insurance rebate will probably produce, at best, a small increase in hospital insurance membership. The cost of the rebate is estimated at $1.4 billion in 1999-2000. Given the small increases in projected membership, the cost of the initiative is very high.

Age Factors↗

Mad cows, mad corn and mad communities: the role of socio-cultural factors in the perceived risk of genetically-modified food.

The rapid globalization of the world economy has increased the need for a knowledge base of reliable socio-cultural differences in perceptions, values and ways of thinking about new food technologies. Awareness of socio-cultural differences is important because collaborative efforts to deal with food hazards presuppose some understanding of where, how and why the viewpoints of various stakeholders may differ. In the present paper factors that influence public perceptions of genetically-modified (GM) food are discussed, with a special focus on the unique circumstances of populations in the USA, Europe and developing countries. It is argued that effective communication and decision making about the risk of GM food depends critically on understanding how socio-cultural groups differ in their values and in the way they deal with the risks and benefits of new technologies. The implications of psychological aspects of perceived risk (including the roles of qualitative dimensions of risk, world views and trust) for public acceptance of new food technologies are highlighted.

Animals↗

Genetically modified foods, science, consumers and the media.

In contrast to the situation in the USA, where a wide range of genetically modified (GM) foods is available, in Europe very few GM products have been approved for marketing as foods, and there is widespread public concern about their safety and environmental impact. The marketing of a GM crop for food use in Europe falls under the EC novel foods regulations, and applications require the submission of an extensive dossier of information. The safety evaluation of GM foods presents considerable problems both in the conduct and interpretation of experimental studies, because conventional toxicity tests used in the evaluation of simple chemicals may not be appropriate for whole foods. To rationalise the safety evaluation process and to circumvent the difficulties in toxicological assessment of food materials, the concept of substantial equivalence has been developed. The concept is that if it can be demonstrated that the novel food is essentially similar to its conventional counterpart in terms of critical nutritional or anutritional components, then it is likely to be no more or less toxic than the latter. The possible introduction of unintended effects by the genetic modification process is particularly problematic for the safety evaluation process. The new genomic and post-genomic techniques are potentially valuable in the safety evaluation of GM foods, although they are as yet in their infancy.

Animals↗

Explaining gender segregation.

Occupational gender segregation--the tendency for women and men to work in different occupations--is an important feature of all societies, and particularly the wealthy industrialized ones. To understand this segregation, and to explain its significance, we need to distinguish between vertical segregation entailing inequality and horizontal segregation representing difference without inequality, with overall segregation being the resultant of these components. Three major theoretical approaches to understanding occupational gender segregation are examined: human capital/rational choice, patriarchy, and preference theories. All are found to be inadequate; they tend to confuse overall segregation with its vertical component, and each entails a number of other faults. It is generally assumed or implied that greater empowerment of women would reduce gender segregation. This is the reverse of what actually happens; in countries where the degree of women's empowerment is greater, the level of gender segregation is also greater. An alternative theoretical approach based on processes of social reproduction is shown to be more useful.

Adult↗

Obesity and perceptual reactance.

Similarities in anomalous perception of internal gastric states and sensitivity to distraction among the obese to variations in perceptual reactance suggest that the obese tend to augment the intensity of visceral cues associated with hunger. It was hypothesized that the obese would be overrepresented at the augmenter end of the perceptual reactance continuum. Thirteen obese (six male, seven female) and 14 nonobese (eight male, six female) college students participated in a study in which perceptual reactance was assessed by degree of Kinesthetic Figural Aftereffect (KFA). A highly significant relationship in the predicted direction was observed for perceptual reactance category and mean percent weight deviation. Additionally, there was a highly significant interaction of sex by category, with the hypothesized relationship intensified for the female Ss. Results supported interpretation of obesity as a consequence of animalous perception of cues associated with consuming behavior.

Attention↗