Front-of-pack nutrition labels: perceptions and preferences of Brazilian adult consumers

PurposeThis study aimed to examine the perceptions and preferences of Brazilian adult consumers about four different front-of-pack (FOP) food labeling systems proposed by the Brazilian National Health Regulatory Agency.Design/methodology/approachThis is a qualitative study conducted with 33 participants allocated in six focus groups. Four different types of FOP labels were displayed on processed and packaged bread: three interpretive warning labels (black triangle, black octagon and red ellipse) and a hybrid model (nutritional traffic light). Thematic analysis was used to identify the key topics addressed by participants.FindingsThree topics were identified: label design, clarity and precision of information. The results demonstrated an influence of labels on product development and consumers' food choices. Most participants expressed a preference for black warning labels and reported the importance of statements endorsed by the Ministry of Health, which provide credibility and could influence food choices. Furthermore, participants agreed that the traffic light system provides more information but is difficult to interpret when comparing products. Warning labels were reported to have the greatest influence on purchase decisions. However, participants were concerned about how to understand the lack of warning labels on some products.Practical implicationsThe results may help and support the Brazilian Health Regulatory Agency to identify and recommend the most effective FOP labeling system to be adopted in Brazil.Originality/valueFew studies investigating adult consumers' perceptions of different FOP label formats have been conducted in the Brazilian context. Our study contributes to the small pool of evidence on the topic by demonstrating that FOP labels can be helpful for consumers when they are presented in an intuitive, interpretative and trustworthy format.

Physicians’ perspectives on adverse drug reactions in pediatric routine care: a survey

Background Children and adolescents are at particular risk for adverse drug reactions (ADRs). We investigated physicians’ perceptions on ADRs in pediatric routine care. Methods In this exploratory study from April to November 2020, we invited physicians treating pediatric patients across Germany to complete an online questionnaire consisting mainly of closed questions. Results Completion rate was 98% (127/129). Of all participants, 23% (29/127) stated they were not able to estimate how many of their pediatric patients experienced ADRs during drug therapy. The remaining physicians estimated that 7.5% (median; Q25/Q75 3%/20%) of their pediatric patients were affected by ADRs. Regarding counseling on ADRs, 61% (77/127) stated they do not ask regularly the extent to which parents want to be informed. In total, 26% (33/127) stated they avoid counseling on ADRs concerning commonly used approved therapies, whereas only 4% (5/127) did so concerning off-label use (P < 0.001). Altogether, 16% (20/127) stated they rather prescribe new medicines as they hope for better effectiveness; 72% (91/127) said they are cautious about doing so owing to yet unknown ADRs. Of all respondents, 46% (58/127) stated they do not report ADRs to the authorities. Concerning the black triangle symbol, a European pharmacovigilance measure, 11% (14/127) stated they knew it and 6% (7/127) stated they reported any suspected ADR for drugs with that symbol. Conclusions Physicians’ perspectives on ADRs were ambivalent: ADRs influenced their parent counseling and drug prescribing; yet, they struggled to estimate the impact of ADRs on their patients and were not aware of specific pharmacovigilance measures.

Systematic Review and Meta-Analysis of the Use of Hyaluronic Acid Injections to Restore Interproximal Papillae

The absence of interdental papillae leads to the appearance of black triangle. For most patients, the appearance of these triangles is an important reason for concern and affects their social relationships. Multiple reconstruction techniques have been developed with different degrees of success and predictability. The main aim of this study was to evaluate the efficiency of hyaluronic acid (HA) injected into interproximal papillae six months after injection and to perform a systematic review and meta-analysis. After a systematic review, five articles were selected: a clinical randomised controlled trial and four clinical trials. In total, eighty-five patients with a deficiency in upper papillae in the front of the maxilla and jaw were included in the study. The height variable was evaluated (mm) six months after HA injection. In total, one hundred and four interproximal papillae were studied. Three articles showed an important difference in favour of intervention. The total result regarding in the injection of AH was favourable with an approximate average filling of 0.7 mm in the height of the interdental papilla. The injection of HA for the reconstruction of deficient papillae in the region of the upper and lower maxilla was a possible option treatment strategy.

South African consumers’ perceptions of front-of-package warning labels on unhealthy foods and drinks

Front-of-package labeling (FOPL) is a policy tool that helps consumers to make informed food choices. South Africa has not yet implemented this labeling system. The aim of this study was therefore to explore adult South African consumers’ perceptions of front-of-package warning labels on foods and non-alcoholic beverages (referred to as drinks in this paper) and their insights into features that could influence the effectiveness of the warning label. Using a qualitative approach, the study purposively selected consumers diversified by urbanization, gender, socioeconomic status, and literacy. We collected data from a total of 113 participants through 12 focus group discussions. Data were systematically coded and divided into five themes namely, positive attitudes toward warning labels, perceived benefits of warning labels, perceived behavior modification, perceived beneficiaries of warning labels, and effective attributes of warning labels. Almost all participants from all socio-economic backgrounds were positive about warning labels, reporting that warning labels concisely and understandably educated them about the nutritional composition of foods. Other perceived advantages were that warning labels warn of health implications, are easily understandable and could benefit child health. Some participants anticipated that warning labels would reduce their purchases of unhealthy foods, while others thought the labels would have no effect on their purchasing habits. Participants found the warning labels attention grabbing and stated that they preferred a black triangle placed on a white background (referred to as a holding strap henceforth), the words “high in” and “warning” in bold and uppercase text, an exclamation mark, and an icon depicting the excessive nutrient. In South Africa warning labels may improve consumer understanding of nutrition information and assist consumers in determining the nutritional quality of packaged foods and drinks.

Smile microesthetics as perceived by dental professionals and laypersons

ABSTRACT Objectives To evaluate and compare the perception of different dental professionals and laypersons toward altered gingival characteristics (microesthetics) and to identify those characteristics that are most negatively and positively rated. Materials and Methods A smiling photograph of a female dental student was selected and digitally manipulated to create changes in different microesthetic parameters. These altered images were rated by the following five groups: 120 orthodontists, 45 periodontists, 49 prosthodontists, 130 general dentists, and 172 laypersons. Smile esthetics scores were calculated, and comparisons between groups were performed using the univariate general linear model. Results The presence of black triangles between the upper incisors was the most negatively rated, and the ideal smile was the most positively rated. Significant differences were detected in the rating scores among the different study groups (P &lt; .05). Orthodontists, prosthodontists, and general dentists scored the presence of a black triangle in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons. Conclusions The ideal smile and that with black triangles between the upper incisors were rated as the most and the least attractive smiles, respectively. Orthodontists, prosthodontists, and general dentists scored the presence of black triangles in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive smiles, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons.

Gingival mask for conservative management of gingival recession: A case report

Smile is the jewel of the face, which not only enhances the beauty of the person but also influences self-confidence. Dental esthetic is composed of white and pink component. The long-term periodontal disease results in the destruction of the pink component leading to gingival recession in some cases, which results in elongated tooth with black triangle and unesthetic smile. When severe destruction is present in the maxillary anterior region surgical reconstruction is unpredictable. This destruction can be masked with a prosthesis like gingival mask after the control of periodontal disease. This case report describes the use of the gingival mask as a conservative treatment modality for recession, achieving optimum esthetics and patient satisfaction.

COMPARATIVE EVALUATION OF INJECTABLE-PLATELET RICH FIBRIN AND HYALURONIC ACID INJECTIONS IN THE TREATMENT OF GINGIVAL BLACK TRIANGLES.

Introduction : Gingival black triangles are cosmetic deformities which occur due to loss or absence of interdental papilla, so reconstruction of interdental papilla have always been a challenging task in esthetic dentistry. This study aims to compare injectable platelet rich brin and hyaluronic acid injections in the treatment of gingival black triangles. Material and Methods : 40 sites were divided into two groups ; Group A and Group B. In Group A, Injectable platelet rich brin was deposited whereas in Group B hyaluronic acid injections were deposited. All the sites were examined for gingival index, plaque index, Papillae presence index and Black triangle area at baseline, 1 month and 3 months follow up. Results : On statistical analysis of the recorded data, results revealed statistical signicant difference in both the groups in Papillae presence index and Black triangle area from baseline to 1 month and 3 months follow up. Conclusion : Injectable Platelet rich brin can be a viable alternative to hyaluronic acid injections in the treatment of gingival black triangles.

Multifactorial Contributions to Central Incisor Tooth Morphology and the Presence of Black Triangles: A Case Study

Dentists are often faced with patient concerns of smile esthetics in addition to oral health and should be equipped to help patients manage both. Black triangle disease, or a lack of interdental papilla, is esthetically displeasing particularly in the central incisor region and has a hoard of etiologies ranging from gum disease to inherited tooth morphologic features. Addressing patients’ esthetic concerns must first be met with understanding the causation of the black triangles before treatment can be rendered. Genetic contributions are multifactorial, and this case report provides evidence for a case of a central incisor black triangles without other affected family members.Background: Black triangles are a prominent feature for those experiencing a lack of interdental papilla between central incisors and may dramatically affect the presentation of a person’s smile. The aim of this case report is to convey the importance of managing patients’ esthetic chief complaints while addressing the etiology of the esthetic concern.Case Description: A 24-year-old man presented to his dental colleague with concern of his black triangle spaces. The patient does not have gingival recession in the area of interest, and his biological mother and brother do not have black triangle spaces. Pathology is not an issue, but instead inadequate length of the central incisor mesial contact area prevents the interdental papilla from reaching the contact. Esthetics are a concern, but the patient is not interested in irreversible treatment for his healthy tissue.Practical Implications: Dentists should be aware of the multifactorial contributions to patients’ esthetic concerns. Dentists should also be aware that meeting a patient’s expectations may require a more complex treatment plan than the patient expected.

Use of Hexyon/Hexacima/Hexaxim in preterm infants in Europe

Background Worldwide 13 million babies born prematurely every year have increased susceptibility to infection and require adequate immunization. Hexavalent vaccines against diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B and Haemophilus influenzae type b are standard of care in pediatric vaccination and are particularly important for preterm infants. Hexyon® is registered in Europe since April 2013. Methods Considering birth data from official national databases and only countries with periods of exclusive use of Hexyon from 2013-19, we estimated the total number of preterm infants (&lt;37weeks GA) vaccinated with Hexyon. Results Since registration, Hexyon has been used in 23 European countries and exclusively used in the following: Austria, Feb-2017 to present; Belgium, Jul-2014 (Flanders)/Sep-2015 (Overall) to present; Bulgaria, Nov-2014 to Dec-2016; Croatia, Jan-2016 to present; Denmark, Feb-2016 to Apr-2017; Italy, Apr-2016 to present, exclusivity based on Regions; Macedonia, Oct-2015 to present; Norway, Feb-2017 to present; Romania, Apr-2015 to Dec-2017. The estimated total number of preterm infants during these periods of exclusive use is 183 000. Assuming 90% vaccination coverage, ∼164 700 preterm infants received at least 1 dose of this vaccine. From the analysis of the post-marketing safety data available to date, no new risk has been identified in preterm infants. Conclusions Hexyon has become a standard for hexavalent immunization in infants, regardless of the gestational age at birth. More than 90 million doses have been administered worldwide, including the estimated 164 000 preterm infants in the 9 European countries considered here. The EU Marketing Authorization granted in 2013 with no contraindication for use in preterm infants, was renewed in 2018 and the black triangle was removed confirming that the safety of Hexyon is well established. The marketing authorization holder continues to support evidence generation for use in preterm infants. Key messages Hexyon/Hexacima/Hexaxim has become a standard for hexavalent immunization in infants including for preterm infants (&lt;37weeks GA); around 164 000 preterm infants in 9 European countries received it. The safety of Hexyon/Hexacima/Hexaxim is well established, no new risk has been identified in preterm infants from the analysis of the post-marketing safety data available to date.