Objective: To examine the psychosocial experiences of hearing loss from the perspectives of both the person with hearing loss and their communication partner. Design: A meta-synthesis of the qualitative literature. Study Sample: From 880 records, 12 qualitative papers met the inclusion criteria, (i) adults with hearing loss, communication partners, or both, and (ii) explored psychosocial issues. Results: Four themes related to the psychosocial experience of hearing loss were found, (i) the effect of the hearing loss, (ii) the response to hearing aids, (iii) stigma and identity, and (iv) coping strategies. Hearing loss affected both people with hearing loss and communication partners. Hearing aids resulted in positive effects, however, these were often outnumbered by negative effects. Non-use of hearing aids was often influenced by stigma. Coping strategies used were related to how the person with hearing loss perceived their self and how the communication partner perceived the relationship. Aligned coping strategies appeared to have a positive effect. Conclusions: Hearing loss affects both people with hearing loss and their communication partners. Aligned coping strategies can facilitate adjustment to hearing loss.

Objectives Exposure to tobacco and alcohol content in audio-visual media is a risk factor for smoking and alcohol use in young people. Previous UK research has quantified tobacco and alcohol content in films and broadcast television but not that of video-on-demand (VOD) services such as Netflix and Amazon Prime. Furthermore, it is not clear whether regulation by Dutch (Netflix) or UK (Amazon Prime) authorities results in differences in content. We report an analysis of tobacco and alcohol content in a sample of episodes from the most popular programmes from these two VOD providers, and compare findings with earlier studies of UK prime-time television content. Setting UK. Participants None. Content analysis of a sample of 50 episodes from the five highest rated series released on Netflix and Amazon Prime in 2016, using 1 min interval coding of any tobacco or alcohol content, actual or implied use, paraphernalia and branding. Results Of 2704 intervals coded, any tobacco content appeared in 353 (13%) from 37 (74%) episodes. Any alcohol content appeared in 363 (13%) intervals in 47 (94%) episodes. There were no significant differences between the two services, however the proportion of episodes containing tobacco and alcohol was significantly higher in VOD original programmes than those recorded in an earlier study of prime-time UK television. Conclusions Audio-visual tobacco and alcohol content is common in VOD original programmes and represents a further source of exposure to imagery causing smoking uptake and alcohol use in young people. This appears to be equally true of services regulated in the UK and The Netherlands. Given that VOD services are consumed by a global audience, it appears likely that VOD content is an important global driver of tobacco and alcohol consumption.

Aims Exposure to audiovisual tobacco content in media is a risk factor for smoking in young people. While tobacco content in films has been extensively documented, content in mainstream television has received relatively little attention. We report an analysis of tobacco content in a sample of UK free-to-air prime-time television broadcasts in 2015, and compare this with a similar analysis from 2010. Design Content analysis of all programmes and advertisements or trailers broadcast on the five national UK free-to-air channels in the UK between 18:00 and 22:00 during three separate weeks in September, October and November 2015. Setting Great Britain. Participants None (media analysis only). Measurements Occurrence of any tobacco, tobacco use, implied use, other tobacco reference/related objects and branding in every 1 min coding interval. Findings Tobacco content occurred in 33% of all programmes and 8% of all adverts or programme trailer breaks. Actual tobacco use occurred in 12% of all programmes broadcast. Tobacco-related objects, primarily no smoking signs, occurred in 2% of broadcasts; implied tobacco use and tobacco branding were also rare. The majority of tobacco content occurred after the 21:00 watershed. Conclusions These findings are virtually unchanged from our earlier analysis of programme content from 2010. Audiovisual tobacco content remains common in UK television programmes.

Background: Exposure to alcohol, tobacco and high fat, sugar and salt (HFSS) food imagery is a significant risk factor for the uptake and regular use of these products in young people, and imagery are more frequently portrayed in video-on-demand (VOD) than in terrestrial television programmes. This study compared alcohol, tobacco and HFSS imagery in original films on Amazon Prime Instant Video and Netflix. Methods: Content analysis of 11 original films released by Amazon Prime and Netflix in 2017 using 5-minute interval coding of alcohol, tobacco and HFSS content. Proportions of intervals containing alcohol, tobacco and HFSS imagery were compared between services using the chi-square test. Results: Alcohol content appeared in 200 (41.7%) out of the total of 479 intervals coded, whereas tobacco and HFSS appeared in 129 (26.9%) and 169 (35.24%), respectively. Proportions were similar between Amazon Prime Instant Video and Netflix original films and were unrelated to film age classification. Conclusions: Alcohol, tobacco and HFSS content likely to promote consumption among young people occurs frequently in original films shown by VOD services in the UK. Further studies are needed to investigate effective regulatory frameworks for VOD services to protect viewers from harmful or unwanted contents.

Prevention of smoking uptake in young people is an essential public health target. We have previously reported a systematic review and meta-analysis of the effect of exposure to smoking imagery in films on the risk of smoking uptake in young people. This study updates that review, and includes studies of the effects of exposure to media vaping imagery on vaping uptake. Four electronic databases (MEDLINE, EMBASE, PsycINFO, and IBSS) were searched to August 2020 for studies reporting the association between exposure to smoking/vaping in films and smoking/vaping uptake in adolescents. Two authors independently screened papers, extracted data, and assessed quality. This review included 26 studies. Exposure to high levels of smoking imagery in films was associated with an increased likelihood of having ever smoked in nine cross-sectional studies and of smoking uptake in 11 longitudinal studies. Vaping imagery in films was associated with increased likelihood of ever vaping in two cross-sectional studies and vaping uptake in five longitudinal studies. This review concluded that exposure to smoking imagery in films increases the risk of smoking among young people. It is likely that a similar association exists between exposure to vaping imagery and vaping uptake. Therefore, this review recommends introduction of new policies to minimize the impact of this in films which contain smoking or vaping and are likely to be viewed by children and adolescents.

CME/CNE Information: Activity Available Online: To access the article, post-test, and evaluation online, go to http://www.cmscscholar.org. Target Audience: The target audience for this activity is physicians, physician assistants, nursing professionals, and other health care providers involved in the management of patients with multiple sclerosis (MS). Learning Objectives: Accreditation Statement: In support of improving patient care, this activity has been planned and implemented by the Consortium of Multiple Sclerosis Centers (CMSC) and Delaware Media Group. The CMSC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Physician Credit The CMSC designates this journal-based activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nurse Credit The CMSC designates this enduring material for 1.0 contact hour (none in the area of pharmacology). Disclosures: Editor in Chief of the International Journal of MS Care (IJMSC), has served as physician planner for this activity. He has disclosed relationships with Springer Publishing (royalty); Qr8 (receipt of intellectual property rights/patent holder); Abide Therapeutics, GW Pharma (consulting fee); Biogen (speakers' bureau); and Adamas Pharmaceuticals (contracted research).Francois Bethoux, MD, has served as reviewer for this activity. She has disclosed no relevant financial relationships.Laurie Scudder, DNP, NP, has disclosed no relevant financial relationships.Alexander B. Barker, PhD, has disclosed no relevant financial relationships.Kathryn Smale, PhD, has disclosed no relevant financial relationships.Nigel Hunt, PhD, has disclosed no relevant financial relationships.Nadina B. Lincoln, PhD, has disclosed a relationship with Biogen and Novartis (speakers' bureau).Roshan das Nair, PhD, The peer reviewers for IJMSC have disclosed no relevant financial relationships. The staff at IJMSC, CMSC, and Delaware Media Group who are in a position to influence content have disclosed no relevant financial relationships. Note: Financial relationships for some authors may have changed in the interval between listing these disclosures and publication of the article. Method of Participation: Release Date: October 1, 2019 Valid for Credit Through: October 1, 2020 In order to receive CME/CNE credit, participants must: Statements of Credit are awarded upon successful completion of the post-test with a passing score of >70% and the evaluation. There is no fee to participate in this activity. Disclosure of Unlabeled Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the FDA. CMSC and Delaware Media Group do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of CMSC or Delaware Media Group. Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any medications, diagnostic procedures, or treatments discussed in this publication should not be used by clinicians or other health-care professionals without first evaluating their patients' conditions, considering possible contraindications or risks, reviewing any applicable manufacturer's product information, and comparing any therapeutic approach with the recommendations of other authorities.