“Me.No.Pause.”: Anxieties and fantasies of aging and femininity in contemporary menopause advertising

A cross-media content analysis of motivational themes in direct-to-consumer prescription drug advertising

Body Image and Televised Images of Thinness and Attractiveness: A Controlled Laboratory Investigation

e18179 Background: Drug advertisements marketed to consumers and healthcare providers have been the subject of recent debate, and the efficacy endpoints that underpin these advertisements may sway perceptions of drug efficacy. Methods: Using the AdPharm database we extracted data for oncology drug advertisements printed or aired between March 1, 2017 and September 1, 2018. Our primary objective was to evaluate endpoints from television and print advertisements and endpoints from the corresponding published papers. A secondary objective is to identify the frequency of drug advertisements that are aired or printed while overall survival data is immature. Results: We included 74 advertisements for 34 unique oncology drugs and 22 unique indications. Print ads were most common (n = 66) and most print ads were targeted to healthcare providers (n = 55, 83.3%). The 74 advertisements were underpinned by 48 published clinical trials. The primary endpoint of the 48 underpinning trials was most often PFS (n = 25), followed by OS (n = 11) and ORR (n = 7). Primary endpoints of underpinning trials were not reported in 8 (8/74, 10.8%) advertisements. Statistically significant endpoints were reported more often than nonsignificant endpoints (RR 1.42; 95% CI, 1.26 - 1.60). Thirty advertisements (42.3%) ran while OS data was immature. When OS and PFS were statistically significant, they were reported at a significantly higher rate than when not reported (each P < .001). ORR was not preferentially reported based on its statistical significance (RR 1.33; 95% CI, .94 - 1.87). Conclusions: Oncology drug advertisements appear to preferentially report statistically significant endpoints, which is highly suggestive of selective outcome reporting bias. By reporting only endpoints that achieve statistical significance, advertisers may encourage misconceived notions about a drug’s efficacy profile.

Background: Reflexive thematic analysis is widely used in qualitative research published in Palliative Medicine, and in the broader field of health research. However, this approach is often not used well. Common problems in published reflexive thematic analysis in general include assuming thematic analysis is a singular approach, rather than a family of methods, confusing themes and topics, and treating and reporting reflexive thematic analysis as if it is atheoretical. Purpose: We reviewed 20 papers published in Palliative Medicine between 2014 and 2022 that cited Braun and Clarke, identified using the search term ‘thematic analysis’ and the default ‘relevance’ setting on the journal webpage. The aim of the review was to identify common problems and instances of good practice. Problems centred around a lack of methodological coherence, and a lack of reflexive openness, clarity and detail in reporting. We considered contributors to these common problems, including the use of reporting checklists that are not coherent with the values of reflexive thematic analysis. To support qualitative researchers in producing coherent and reflexively open reports of reflexive thematic analysis we have developed the Reflexive Thematic Analysis Reporting Guidelines (the RTARG; in Supplemental Materials) informed by this review, other reviews we have done and our values and experience as qualitative researchers. The RTARG is also intended for use by peer reviewers to encourage methodologically coherent reviewing. Key learning points: Methodological incoherence and a lack of transparency are common problems in reflexive thematic analysis research published in Palliative Medicine. Coherence can be facilitated by researchers and reviewers striving to be knowing – thoughtful, deliberative, reflexive and theoretically aware – practitioners and appraisers of reflexive thematic analysis and developing an understanding of the diversity within the thematic analysis family of methods.

Introduction Migration is at the core of today’s professional sport. In football, since 2020, the rate of migrant players has increased by 20% (Poli et al., 2024). Transnational mobility has become a highly valuable commodity making transnational football career an inescapable pathway to either professional level or world-class level. Therefore, understanding cross-borders sports mobility processes is crucial for both players and stakeholders to effectively prepare and negotiate cultural transitions. Transnational career and pathway research in sport psychology is recent, limited, and suggests that maintaining a career as a migratory athlete remains challenging (Book et al., 2021; Ryba & et al., 2016; Storm et al., 2022). By identifying challenges faced, and psychological process involved, those researches highlight at what extent culture frames athletes’ sport and non-sport life experiences. However, no studies focused on neither the first cultural transition nor African athletes. From analysis of some previous studies, it seems that the experience of the first cultural transition shapes the willingness to initiate and the experience of the following migrations (Book et al., 2021; Ryba et al., 2016). On the other hand, African countries are deeply distinct from the most other countries worldwide regarding relevant features shaping people’s life experience: social security, gross domestic product, facilities, governance, and race. Furthermore, African countries are among those displaying the highest growth of expatriate footballers (Poli et al., 2024). Additionally, most of athletic migrations from Africa correspond to forced migration (United Nations Humans Rights Council, 2022), with the difference that it is triggered by a contract. Thus, what characterize the experience of the first cultural transition of African footballers? This study aimed to explore the athletic transnational career of Cameroonian footballers to characterize their experience of the first cultural transition. Methods This study is grounded within Critical Realism philosophy. It is useful to engage causal analysis and explanation of social problems and suggest practical recommendations for social change (Fletcher, 2017). Fourteen Cameroonian former footballers were purposively sampled following three criteria: having spent at least the formative years in Cameroon, did the first cultural transition for athletic career development, and having played professionally for a football club abroad at least one season. The participants’ position in the pitch included all the main positions acknowledged in football (goalkeeper, defender, midfielder, and striker), and the country of their first cultural transition included the four continents (Kingdom of Saudi Arabia, Germany, France, Indonesia, Greece, Côte d’Ivoire, Paraguay, Italy, Switzerland, and Turkey). The semi-structured interviews based on life story and timeline interviews approaches were conducted, focusing on the participants’ experience of athletic transnational mobilities. This included a series of two interview sessions which lasted between 25 and 121 minutes. A total of 26 interviews were audio recorded, transcribed, and reflexively thematically analyzed (Braun & Clarke, 2021). The study applied the four rigorous criteria to ensure qualitative study trustworthiness: credibility, dependability, confirmability, and transferability (Lincoln & Guba, 1985). Results Nine themes (with their sub-themes) and their relationship were identified: Mental Health Issues (MHI), Context of athletic migration and seven challenges related to: Club and Contract, Team, Pitch, Way of life, Geography, Home country, and High Level Athlete status. MHI emerged as output of the context and challenges. MHI were characterized by players’ psychological distress and inability to understand that condition, and inability of the club leading team to understand what they were going through. The context of athletic migration was characterized by unplanned transition, adolescence, club’s facilities, and perception of moving abroad as having succeed their football career and life (satisfaction of achieving the dream). Challenges characterized tough situations players went through like contract disruption (club and team), broken In-group (team), injury (pitch), new mentality (way of life), winter (geography), long-distance relationship (home country), and experience of professionalism (High Level Athlete status). Discussion/Conclusion This research is the first to study the first cultural transition of athletes and to use a sample of athletes from Africa. The results depict main features characterizing the experience of the first athletic migration of young talented Cameroonian footballers. Applying critical realism philosophy, MHI was identified as the effect of the migration context and challenges faced. Those findings are consistent with the holistic developmental and ecological perspectives to talent development (Wylleman & Rosier, 2016), Intersectionality (Book et al., 2021), cultural sport psychology (Schinke & Hanrahan, 2009), and challenges underscored in previous transnational athletic career studies (Book et al., 2021; Ryba et al., 2016; Storm et al., 2022). Most importantly, this study highlights new result patterns enriching literature and providing critical information for African athletes and sport stakeholders: MHI (explicitly underscored), context of athletic migration, challenges related to winter, new mentality, broken In-group, etc. As successful talented footballers, they anticipated migration with professional contract as the guarantee of happiness. Actually, those young talented footballers navigated through the satisfaction of achieving professional level and distress. They struggled with psychological distress by shouldering the acculturation load and some professional football’s drifts in an environment which was not supportive enough, because it does not understand them. They could not seek for help because the lack means to understand their condition. Thus, this study is directly related to two Sustainable Development Goals (the third and eighth) by addressing mental health and decent work (United Nations Humans Rights Council, 2022). The results suggest several practical implications: informed football stakeholders’ action, strengthen coaches’ training, adjust sport psychologists’ intervention, and build solid preparatory foundation for next transnational African footballers. References Book, R. T., Jr., Henriksen, K., & Stambulova, N. (2021). Oatmeal is better than no meal: The career pathways of African American male professional athletes from underserved communities in the United States. International Journal of Sport and Exercise Psychology, 19(4), 504–523. https://doi.org/10.1080/1612197X.2020.1735258 Braun, V., & Clarke, V. (2021). One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qualitative Research in Psychology, 18(3), 328–352. https://doi.org/10.1080/14780887.2020.1769238 Fletcher, A. J. (2017). Applying critical realism in qualitative research: Methodology meets method. International Journal of Social Research Methodology: Theory & Practice, 20(2), 181–194. https://doi.org/10.1080/13645579.2016.1144401 Lincoln, Y., & Guba, E. G. (1985). Naturalistic inquiry. Sage. Poli, R., Ravenel, L., & Besson, R. (2024, May). Origins and destinations of football expatriates (2020–2024). CIES Football Observatory [Monthly Report n°95]. https://football-observatory.com/MonthlyReport95 Ryba, T. V., Stambulova, N. B., & Ronkainen, N. J. (2016). The work of cultural transition: An emerging model. Frontiers in Psychology, 7, Article 427. https://doi.org/10.3389/fpsyg.2016.00427 Schinke, R. J., & Hanrahan, S. J. (Eds.). (2009). Cultural sport psychology. Human Kinetics. https://doi.org/10.5040/9781492595366 Storm, L. K., Book, R. T., Jr., Hoyer, S. S., Henriksen, K., Küttel, A., & Larsen, C. H. (2022). Every boy’s dream: A mixed method study of young professional Danish football players’ transnational migration. Psychology of Sport and Exercise, 59, 1–11. https://doi.org/10.1016/j.psychsport.2021.102125 United Nations Human Rights Council. (2022). Mid-year trends 2022. https://www.unhcr.org/mid-year-trends Wylleman, P., & Rosier, N. (2016). Holistic perspective on the development of elite athletes. In M. Raab, P. Wylleman, R. Seiler, A.-M. Elbe, & A. Hatzigeorgiadis (Eds.), Sport and exercise psychology research: From theory to practice (pp. 270–282). Elsevier Inc.

Collaborations are critical to address rural health challenges. We evaluated a new international collaboration between institutions in Georgia, the United States (US), and Scotland, United Kingdom (UK), to address rural health issues and to understand the barriers and facilitators to effective international collaboration efforts. A qualitative approach was used through in-depth interviews and focus groups with educators, researchers, and healthcare providers in the US and Scotland who were involved in the CONVERGE international rural health collaboration. Transcriptions were imported into the NVivo qualitative software program. A reflexive thematic analysis was employed to identify key themes from the collected data. Twelve interviews and two focus groups were conducted virtually with 17 participants. Two primary domains were identified from the thematic analysis: (1) motivators that increase engagement in international collaboration, and (2) mechanisms for, and barriers to, the continuity needed to create meaningful change. Six themes emerged related to commonality of issues, prospect of sharing knowledge, need of sustained funding and institutional support, and selection of human resources. Participants of CONVERGE were more likely to engage when they had a space to share ways to address challenging issues and integrate knowledge and practice. They were motivated by their desire for growth and the institutions they serve and emphasized that infrastructure support is vital for sustainable collaborations.

The Problem of Normal Birth

Selective outcome reporting bias in oncology drug advertisements may encourage misconceptions about a drug's efficacy profile. We sought to determine the rates of selective outcome reporting in published cancer clinical trials and in television and print advertisements for anticancer medications. We also quantified the number of advertisements that did not include or cite any studies with mature overall survival (OS) data (i.e., data with all required patient events for final analysis). We conducted a cross-sectional investigation of advertisements uploaded to the AdPharm Database (repository of pharmaceutical advertisements); the clinical trials supporting the ads; and the trial registrations associated with the trials. Data were extracted by two investigators who were blinded to each other's data. The first co-primary objective was to investigate selective outcome reporting between trial registrations and published trials. The second co-primary objective was to investigate selective outcome reporting between the same published trials and drug advertisements. We included 74 advertisements and 48 clinical trials. Print ads were the most common (n = 66), and most print advertisements were targeted to health care providers (n = 55, 83.3%). Overall, 41/48 (85.4%) trials were registered prior to study enrollment, and 41/48 (85.4%) did not deviate from the registered primary endpoints. Across all advertisements (n = 74), statistically significant endpoints were more often reported (unadjusted risk ratio [uRR] 1.26; 95% confidence interval [CI] (1.14-1.40)) and 22/55 (40.0%) advertisements cited trials with immature overall survival data (i.e., data without the required number of events for final analysis). In our sample, statistically significant endpoints were more commonly reported than nonsignificant endpoints. Immature endpoints (those analyzed before the required number of accrued patient events) were often reported. By reporting only significant endpoints and those that are immature, advertisers may encourage misconceptions about a drug's efficacy profile.

After the September 11, 2001, terrorist attacks on the World Trade Center, the New York State Office of Mental Health (NYOMH) initiated a three-phase multifaceted, multilingual media campaign that advertised the availability of counseling services. This study evaluated the association between patterns of spending within this campaign and the volume of calls received and referred to a counseling program. Spending on television, radio, print, and other advertising was examined, as was the corresponding volume of calls to the NetLife hotline seeking referrals to counseling services. From September 2001 to December 2002, $9.38 million was spent on Project Liberty media campaigns. Call volumes increased during months when total monthly expenditures peaked. Initially, flyers, billboards, and other material items accounted for most monthly expenses. Over time, spending for television and radio advertisements increased, whereas other advertising declined. Temporal patterns show that in periods after an increase in media spending, call volumes increased independently of other sentinel events such as the one-year anniversary of the attacks. Sustained advertising through multiple media outlets appeared to be effective in encouraging individuals to seek mental health services.

The preconception, pregnancy, and postpartum (PPP) periods represent a distinct life phase where women are particularly vulnerable to weight stigmatisation. While community members are often the primary source of weight stigma, little is known about their perspectives. This study aimed to explore community members' perceptions of women's body weight during the PPP periods, focussing on weight stigma and societal norms. We undertook 20 semi-structured interviews with community members residing in Australia. Interviews were transcribed verbatim and reflexive thematic analysis was conducted. Two main themes were identified: (1) societal value structures around PPP weight were evident with high value and continuous surveillance placed on women's weight; and (2) conflicting discourse relating to PPP women's body size was present with participants holding contradictory but simultaneous beliefs regarding women's weight. Our findings provide valuable insights into specific social norms and beliefs that perpetuate weight stigma towards PPP women.

Print and billboard advertising belong to the secondary media that require printing for production. In terms of visual form, they are characterised by fixed positioning of typeface and images on a flat advertising medium. While the visual appearances of print and billboard advertising have increasingly become similar in the course of history, the differences should not be neglected: The billboard is outdoor advertising, and it stands exposed in anonymous, public space on a physical surface where it is periodically exchanged. In contrast, print advertising is found in periodical newspapers or magazines, and is aimed at their target audience. Given the importance of image or typography, a rhetoric of print and billboard advertising should consider not only the linguistic modes, but also non-verbal modalities of the advertising message. In addition, the references of advertising criticism and art as advertising are discussed, which focused particularly on print and poster from the 19th century on.

ObjectivesTo quantify tobacco advertising, promotion and sponsorship (TAPS), self-reported exposure from online and offline platforms among adolescents in Indonesia.MethodsA cross-sectional school-based survey was conducted in 2017. In total, 2820 students...

Women's History, Women's Health Audra Jennings (bio) Deirdre Cooper Owens. Medical Bondage: Race, Gender, and the Origins of American Gynecology. Athens: University of Georgia Press, 2017. xiv + 165 pp.; ISBN 978-0-8203-5135-3 (cl); 978-0-8203-5475-0 (pb). Tanya Hart. Health in the City: Race, Poverty, and the Negotiation of Women's Health in New York City, 1915–1930. New York: New York University Press, 2015. xi + 329 pp.; ISBN 978-1-4798-6799-8 (cl). Jennifer Nelson. More Than Medicine: A History of the Feminist Women's Health Movement. New York: New York University Press, 2015. xi + 265 pp.; ISBN 978-0-8147-6277-6 (cl); 978-0-8147-7066-5 (pb). In response to the untimely death of Representative Elijah Cummings (D-MD), the historian Ibram X. Kendi wrote, "There may be no more consequential white privilege than life itself. The privilege of being on the living end of racism." Kendi noted that black men have the lowest life expectancy in the United States. Black women also die years sooner than white women and are far more likely than white women to die during pregnancy.1 Bodies, particularly the bodies of people of color and women, stand at the center of politics in the age of Trump. Death, fear, and the loss of freedom, agency, and bodily autonomy shape the political present as people of color continue to die at the hands of police at disproportionate rates; a staggering number of Americans—including children—die in mass shootings; allegations of sexual assault create no barrier to public office; a growing number of states pass restrictions on abortion, which in some states have narrowed access to legal abortion to have effectively banned safe, legal access to the procedure; and mass incarceration and detention at the border disproportionately ensnare people of color living in poverty in a system where private corporations profit from their suffering. The scholars Deirdre Cooper Owens, Tanya Hart, and Jennifer Nelson bring a painful past into focus. They show that racism, nativism, and misogyny have shaped the development of American medicine, access to care, or lack thereof, and the quality of care as well as the context and tone of its delivery—a system that linked white privilege to "life itself." [End Page 164] In Medical Bondage, Cooper Owens situates the growth of modern American gynecology in the context of chattel slavery and mass immigration, two systems that provided physicians access to women who endured the experimental surgeries that gave rise to modern gynecology. She aims to move beyond the illnesses that initially drew physicians' attention and the pain and exploitation of enduring (often repeated) experimental procedures while, in the case of slave women, also being forced to work as surgical assistants in addition to other forms of labor. Cooper Owens instead elucidates the skilled nursing labor that these women provided, centers the importance of this labor and these women's lives and bodies in the development of gynecology, and works to give nuance to the lives and experiences of women who appear in the historical record often only as subjects of the men who experimented on them and exploited their labor. Cooper Owens examines the contradictions inherent in slavery and the science of race and the ways these contradictions shaped the development of American gynecology. She notes that "slavery created an environment in which black women performed more rigorous labor than white women and some white men" (3). This brutal reality influenced physicians' perceptions of enslaved patients. White physicians operated on black women's bodies to maintain or restore their reproductive capacity and find cures for white women's gynecological ailments. That physicians sought these cures by experimenting on black women's bodies underscores their understanding that there were no differences in how white and black women's bodies functioned. Yet physicians went about their work believing in and furthering prevailing ideas about race that "erased gender distinction" when considering black women's health and physical strength, perceiving them to be "stronger medical 'specimens'" (3). Cooper Owens demonstrates that through the system of slavery, southern physicians gained power, influence, and subjects from whom they painfully extracted new knowledge. She...

Back to table of contents Previous article Next article International NewsFull AccessRapid Rise in Psychotropic Use Becomes Global PhenomenonJoan Arehart-TreichelJoan Arehart-TreichelSearch for more papers by this authorPublished Online:17 Dec 2004https://doi.org/10.1176/pn.39.24.00390001bPsychotropic drug prescribing for American youth has soared over the past several decades (Psychiatric News, February 7, 2003), and now it looks as though the same trend may be occurring in other countries, a new study indicates.The study was headed by Ian Wong, Ph.D., director of the Center for Pediatric Pharmacy Research at the University of London. Results appeared in the December Archives of Disease in Childhood.Wong and his coworkers obtained data about psychotropic prescribing for youth under 18 years of age in nine countries between 2000 and 2002. The countries included France, Germany, Spain, and the United Kingdom—the four European countries with the largest markets for these medications; Argentina, Brazil, and Mexico—the three Latin-American countries with the largest markets for these medications; and Canada and the United States.Results indicated that the number of psychotropics prescribed for youth in all nine countries rose between the years 2000 and 2002, and seven of the nine countries showed a significant increase. The United Kingdom had the largest percentage increase at 68 percent, while Germany had the smallest, 13 percent.Wong told Psychiatric News that the results did not surprise him.“ American data showed a similar trend a few years ago.”He also indicated that he was not surprised to find that the United Kingdom is outpacing the United States in psychotropic prescribing for youth.“The U.S. already had a high baseline, so it can't really grow as fast as the United Kingdom. There is no doubt, however, that we are catching up.”Psychiatric News likewise asked Wong whether there was more of an increase in one category of psychotropic prescribing for youth in the countries of interest than in another category—say, more SSRI antidepressant prescribing than antipsychotic prescribing. Wong said that he and his coworkers have already learned that both SSRI and stimulant prescribing for youth increased significantly in the United Kingdom from 2000 to 2002, and that his team will now analyze more data from the United Kingdom and the other countries to further answer this question.Why psychotropic prescribing is surging not just in the United States, but also in numerous other countries is not known. Wong and his colleagues, however, offer several possible explanations in their study report: “The increase probably represents the improved recognition of pediatric psychopathology; there is also a concern that drugs are being used to replace nondrug treatments.”In any event, they pointed out, “The observed increase in so many countries should raise concern, as little research has been conducted in children to study the effects of most psychotropic medications” and because of the brouhaha about antidepressants' possibly increasing suicide risk in children (Psychiatric News, November 5).“The use of psychotropic medications in children is a global public health issue,” Wong and his colleagues concluded, “which should be studied in partnership with pharmaceutical companies, governments, and researchers to grow and expand the evidence base for their use in children.”“The problem with this type of psychotropic medication market research is that it contains no information about quality of the clinical treatment that is associated with the use of these medications,” Darrel Regier, M.D., executive director of the American Psychiatric Institute for Research and Education and director of APA's Division of Research, told Psychiatric News. “In the absence of associated data on the prevalence of treated and untreated mental disorders, and the degree to which use of these medications follow established treatment guidelines, the author is free to speculate about the implications of the increase in medication use in children.“If one starts from a public health perspective that there is well-documented evidence of undertreatment of child and adolescent mental disorders in all countries and that there is an attendant high level of disability and waste of human potential because of the absence of treatment, then the evidence of increased use of psychotropic medications could be seen in very positive terms.“If, on the other hand, one starts from a perspective that mental disorders don't exist and that medications are a means whereby poor parenting is being supported by inappropriate use of psychotropic medications, then there is a very negative spin for this information.“My concern is that the author adds a negative spin with an incomplete reporting on the effectiveness data for psychotropic medications in children and adolescents.”The study was funded by the Department of Health in England.An abstract of the study, “Increased Prescribing Trends of Pediatric Psychotropic Medications,” is posted online at<http://adc.bmjjournals.com/cgi/content/abstract/89/12/1131?>.▪ Arch Dis Child 2004 89 1131 ISSUES NewArchived

The Missing Women of Sande: A Necessary Exercise in Museum Decolonization