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The researchers found similar results in open trials conducted at 10 sites and involving 186 patients. They reported that in patients who had mild to moderate bone loss-those who had lost less than 35 percent of their spinal bone mass-only 4.5 percent developed new spinal fractures after treatment with the sodium fluoride and calcium citrate supplements. UTSMC researchers reported these results at the 17th annual meeting of the American Society of Bone and Mineral Research held in Baltimore last September. They also noted that bone fluoride levels in the test group were well below the toxic level and that the architecture and strength of spongy bone improved in patients who took the sodium fluoride supplements. NIH PANEL GIVES NOD TO BEHAVIORAL THERAPIES
An independent panel convened by the National Institutes of Health encouraged wider acceptance of behavioral therapies and relaxation techniques for treating chronic pain and insomnia. Included in the chronic pain category were inflammatory conditions of the mouth and temporomandibular disorders. "Integrating behavioral and relaxation therapies with conventional medical treatment is imperative for successfully managing these conditions," said panel chair Julius Richmond, M.D., professor emeritus at Harvard Medical School. At a conference held last October in Washington, D.C., the panel reviewed presentations by clinicians who used behaviorial therapies with conventional treatments in addressing chronic pain and insomnia. The panel concluded that research 1604 JADA, Vol. 126, December 1995
supports use of approaches like biofeedback, relaxation techniques and cognitive/behavioral techniques to enhance traditional treatments in some cases. They also noted that hypnosis has been effective in relieving some chronic pain symptoms such as those caused by TMD and inflammatory conditions of the mouth. The panel acknowledged that before these approaches can be fully implemented, some barriers must be overcome, including reluctance among patients to try these techniques and among insurance companies to reimburse for these therapies. CIGARETTE PACKAGING APPEALS TO TEENS
American tobacco companies could help discourage teen smoking by making a few changes to the packaging, say researchers at the University of Illinois at Chicago and the University of Toronto. Public health researchers at the universities teamed up on a two-year project to study the effectiveness of the warning labels on cigarette packs and the appeal of the packs themselves. Researchers surveyed 2,400 teenagers in Ontario and Chicago. The study showed that most teens in Canada recall the warning labels when asked about cigarette packs marketed in that country, while few American teens even mention the warning labels. American adolescents were more likely to recall the packaging. In both cities, researchers asked the teens to write down everything they remembered about a cigarette pack that had been removed from their sight. Of the Canadian teens, 83 percent listed the warning label, compared with only 3 percent of
the American teens. Dee Burton, Ph.D., associate professor, UIC, attributes the difference to the size, wording and placement of the warnings. A warning label on a Canadian pack of cigarettes may say "Smoking is addictive" in large type on the front of the pack. Warning labels on cigarettes manufactured in the United States, by contrast, appear in small print on the side of the package. "When looking at plain packages (beige with black lettering and no logo)," Dr. Burton continues, "the adolescents said that they thought the warning labels were more serious." The study also affirmed that current package designs appeal to American 12- to 13-year-olds and 16- to 17-year-olds. The researchers presented teens in these age groups with nine cigarette packs: three brand-name, three novelty-design packs and three plain packs (beige with black lettering). More than twothirds of the teens in each age group preferred the brand-name packaged cigarettes over the other two types of packaging. Dr. Burton notes that for many teens, what they smoke is a symbol of who they are. "We know, for instance," she explains, "that kids who want to be seen as tough smoke Marlboro, whereas other kids identify being suave and cool with smoking Camels. This is what they tell us." Dr. Burton and colleagues have forwarded the results of their study to lobbyists and activists seeking measures to help curb teen smoking. ADA SEEKS ROSS AWARD NOMINEES
The Association is calling for