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Sample records for cessation interventions targeting

  1. Using a realist approach to evaluate smoking cessation interventions targeting pregnant women and young people

    Directory of Open Access Journals (Sweden)

    van Teijlingen Edwin R

    2010-02-01

    Full Text Available Abstract Background This paper describes a study protocol designed to evaluate a programme of smoking cessation interventions targeting pregnant women and young people living in urban and rural locations in Northeast Scotland. The study design was developed on so-called 'realist' evaluation principles, which are concerned with the implementation of interventions as well as their outcomes. Methods/design A two-phased study was designed based on the Theory of Change (TOC using mixed methods to assess both process and outcome factors. The study was designed with input from the relevant stakeholders. The mixed-methods approach consists of semi-structured interviews with planners, service providers, service users and non-users. These qualitative interviews will be analysed using a thematic framework approach. The quantitative element of the study will include the analysis of routinely collected data and specific project monitoring data, such as data on service engagement, service use, quit rates and changes in smoking status. Discussion The process of involving key stakeholders was conducted using logic modelling and TOC tools. Engaging stakeholders, including those responsible for funding, developing and delivering, and those intended to benefit from interventions aimed at them, in their evaluation design, are considered by many to increase the validity and rigour of the subsequent evidence generated. This study is intended to determine not only the components and processes, but also the possible effectiveness of this set of health interventions, and contribute to the evidence base about smoking cessation interventions aimed at priority groups in Scotland. It is also anticipated that this study will contribute to the ongoing debate about the role and challenges of 'realist' evaluation approaches in general, and the utility of logic modelling and TOC approaches in particular, for evaluation of complex health interventions.

  2. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Møller, A; Villebro, N

    2005-01-01

    Smokers have a substantially increased risk of intra- and postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence. The preoperative period may be a well chosen time to offer smoking cessation interventions due to increased patient motivation....

  3. Smoking cessation intervention during pregnancy in a Polish urban community – what is the target population?

    Directory of Open Access Journals (Sweden)

    Polańska K

    2002-06-01

    Full Text Available Abstract The aim of this project was to evaluate the effect of intensive individual anti-smoking counselling among pregnant women from a Polish urban community with a large representation of socially underprivileged women. The study was conducted between 1 December 2000 and 31 December 2001. Out of 204 women who were asked to take part in a midwives-assisted program of educational counselling to stop smoking, 152 (74.5% agreed to participate. The intervention program included four visits of a midwife trained in smoking cessation techniques to the home of a smoking pregnant woman. The control group were 145 pregnant women who on the first visit to a maternity unit received only a standard written information on the health risk from maternal smoking to the foetus. The percentage of pregnant women who quitted smoking during the project was 46.1% in the intervention group and 23.4% among the controls (p

  4. Smoking cessation intervention during pregnancy in a Polish urban community – what is the target population?

    Directory of Open Access Journals (Sweden)

    Broszkiewicz M

    2003-01-01

    Full Text Available Abstract The aim of this project was to evaluate the effect of intensive individual anti-smoking counselling among pregnant women from a Polish urban community with a large representation of socially underprivileged women. The study was conducted between 1 December 2000 and 31 December 2001. Out of 204 women who were asked to take part in a midwives-assisted program of educational counselling to stop smoking, 152 (74.5% agreed to participate. The intervention program included four visits of a midwife trained in smoking cessation techniques to the home of a smoking pregnant woman. The control group were 145 pregnant women who on the first visit to a maternity unit received only a standard written information on the health risk from maternal smoking to the foetus. The percentage of pregnant women who quitted smoking during the project was 46.1% in the intervention group and 23.4% among the controls (p < 0.001. After combining the intervention group with the women who refused to participate in the project, the rate of quitting was 36.3%, still significantly higher than in controls (p = 0.01. The strongest influence of the intervention was found among women smoking more than 5 cigarettes/day. Women covered by the intervention programme, who reported smoking in previous pregnancies, were found to quit smoking to a much higher extent than the controls with a similar background. Such pattern was also observed for women whose husbands were smokers. The benefits of the intervention, especially for the socially underprivileged women, seem to result from an increased proportion of subjects who undertook a quitting attempt, rather than the effectiveness of these attempts. In the intervention group, among the subjects who did not manage to quit smoking during pregnancy, the number of women who at least slightly reduced their smoking rate was twice as high as in the controls.

  5. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, Nete; Møller, Ann Merete

    2014-01-01

    BACKGROUND: Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. OBJECTIVES: The objectives of this review...... are to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively, and on the incidence of postoperative complications. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group Specialized Register in January 2014. SELECTION CRITERIA......: Randomized controlled trials that recruited people who smoked prior to surgery, offered a smoking cessation intervention, and measured preoperative and long-term abstinence from smoking or the incidence of postoperative complications or both outcomes. DATA COLLECTION AND ANALYSIS: The review authors...

  6. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, N.; Møller, Ann Merete;

    2010-01-01

    Background Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. Objectives The objective of this review...... was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Search strategy The specialized register of the Cochrane Tobacco Addiction Group was searched using the free text......; pooled RR 10.76 (95% confidence interval (CI) 4.55 to 25.46, two trials) and RR 1.41 (95% CI 1.22 to 1.63, five trials) respectively. Four trials evaluating the effect on long-term smoking cessation found a significant effect; pooled RR 1.61 (95% CI 1.12 to 2.33). However, when pooling intensive...

  7. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, Nete; Møller, Ann Merete

    2010-01-01

    Background Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. Objectives The objective of this review...... was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Search strategy The specialized register of the Cochrane Tobacco Addiction Group was searched using the free text...... and keywords (surgery) or (operation) or (anaesthesia) or (anesthesia). MEDLINE, EMBASE and CINAHL were also searched, combining tobacco- and surgery-related terms. Most recent search April 2010. Selection criteria Randomized controlled trials that recruited people who smoked prior to surgery, offered...

  8. Multimodal intervention raises smoking cessation rate during pregnancy

    DEFF Research Database (Denmark)

    Hegaard, Hanne K; Kjaergaard, Hanne; Møller, Lars F;

    2003-01-01

    .003). The adjusted odds ratio (OR) for smoking cessation was 4.20 (95% CI 2.13-8.03). Logistic regression analysis showed a significant positive association of smoking cessation with low caffeine consumption in pregnancy, many years in school, no exposure to passive smoking outside the home, and previous attempts......BACKGROUND: The aim was to study the effect of a multimodal smoking cessation intervention regimen on a number of pregnant smokers. METHODS: A prospective intervention study was designed where participants were allocated to intervention or control based on their birth date. The study included 647...... pregnant smokers. The intervention group (n = 327) received initial individual smoking cessation counseling supplemented by an invitation to join, individually or in a group, a smoking cessation program with nicotine replacement therapy as a voluntary option. Intervention was designed as an integral part...

  9. Effect of preoperative smoking cessation interventions on postoperative complications and smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, T; Tønnesen, H; Møller, A M

    2009-01-01

    BACKGROUND: The aim of this study was to examine the effect of preoperative smoking cessation interventions on postoperative complications and smoking cessation itself. METHODS: Relevant databases were searched for randomized controlled trials (RCTs) of preoperative smoking cessation interventions....... Trial inclusion, risk of bias assessment and data extraction were performed by two authors. Risk ratios for the above outcomes were calculated and pooled effects estimated using the fixed-effect method. RESULTS: Eleven RCTs were included containing 1194 patients. Smoking interventions were intensive......, medium intensity and less intensive. Follow-up for postoperative complications was 30 days. For smoking cessation it was from the day of surgery to 12 months thereafter. Overall, the interventions significantly reduced the occurrence of complications (pooled risk ratio 0.56 (95 per cent confidence...

  10. Best Practices for Smoking Cessation Interventions in Primary Care

    Directory of Open Access Journals (Sweden)

    Andrew McIvor

    2009-01-01

    Full Text Available BACKGROUND: In Canada, smoking is the leading preventable cause of premature death. Family physicians and nurse practitioners are uniquely positioned to initiate smoking cessation. Because smoking is a chronic addiction, repeated, opportunity-based interventions are most effective in addressing physical dependence and modifying deeply ingrained patterns of beliefs and behaviour. However, only a small minority of family physicians provide thorough smoking cessation counselling and less than one-half offer adjunct support to patients.

  11. Use of Smoking Cessation Interventions by Physicians in Argentina

    Science.gov (United States)

    Schoj, Veronica; Mejia, Raul; Alderete, Mariela; Kaplan, Celia P.; Peña, Lorena; Gregorich, Steven E.; Alderete, Ethel; Pérez-Stable, Eliseo J.

    2015-01-01

    Background Physician-implemented interventions for smoking cessation are effective but infrequently used. We evaluated smoking cessation practices among physicians in Argentina. Methods A self-administered survey of physicians from six clinical systems asked about smoking cessation counselling practices, barriers to tobacco use counselling and perceived quality of training received in smoking cessation practices. Results Of 254 physicians, 52.3% were women, 11.8% were current smokers and 52% never smoked. Perceived quality of training in tobacco cessation counselling was rated as very good or good by 41.8% and as poor/very poor by 58.2%. Most physicians (90%) reported asking and recording smoking status, 89% advised patients to quit smoking but only 37% asked them to set a quit date and 44% prescribed medications. Multivariate analyses showed that Physicians’ perceived quality of their training in smoking cessation methods was associated with greater use of evidence-based cessation interventions. (OR = 6.5; 95% CI = 2.2–19.1); motivating patients to quit (OR: 7.9 CI 3.44–18.5), assisting patients to quit (OR = 9.9; 95% CI = 4.0–24.2) prescribing medications (OR = 9.6; 95% CI = 3.5–26.7), and setting up follow-up (OR = 13.0; 95% CI = 4.4–38.5). Conclusions Perceived quality of training in smoking cessation was associated with using evidence-based interventions and among physicians from Argentina. Medical training programs should enhance the quality of this curriculum. PMID:27594922

  12. Continuous-Time System Identification of a Smoking Cessation Intervention.

    Science.gov (United States)

    Timms, Kevin P; Rivera, Daniel E; Collins, Linda M; Piper, Megan E

    2014-01-01

    Cigarette smoking is a major global public health issue and the leading cause of preventable death in the United States. Toward a goal of designing better smoking cessation treatments, system identification techniques are applied to intervention data to describe smoking cessation as a process of behavior change. System identification problems that draw from two modeling paradigms in quantitative psychology (statistical mediation and self-regulation) are considered, consisting of a series of continuous-time estimation problems. A continuous-time dynamic modeling approach is employed to describe the response of craving and smoking rates during a quit attempt, as captured in data from a smoking cessation clinical trial. The use of continuous-time models provide benefits of parsimony, ease of interpretation, and the opportunity to work with uneven or missing data.

  13. Brief smoking cessation intervention in relation to breast cancer surgery: a randomized controlled trial

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Tønnesen, Hanne; Okholm, Mette;

    2010-01-01

    Smokers are more prone to develop postoperative complications. Smoking cessation intervention beginning 4-8 weeks prior to surgery improves the postoperative outcome. Cancer patients, however, often undergo surgery less than 4 weeks after diagnosis. The primary objective of this study was therefore...... to examine if a brief smoking cessation intervention shortly before breast cancer surgery would influence postoperative complications and smoking cessation....

  14. Brief smoking cessation intervention in relation to breast cancer surgery: a randomized controlled trial

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Tønnesen, Hanne; Okholm, Mette;

    2010-01-01

    Smokers are more prone to develop postoperative complications. Smoking cessation intervention beginning 4-8 weeks prior to surgery improves the postoperative outcome. Cancer patients, however, often undergo surgery less than 4 weeks after diagnosis. The primary objective of this study was therefo...... to examine if a brief smoking cessation intervention shortly before breast cancer surgery would influence postoperative complications and smoking cessation....

  15. Smoking Cessation Intervention After Ischemic Stroke or Transient Ischemic Attack. A Randomized Controlled Pilot Trial

    DEFF Research Database (Denmark)

    Brunner Frandsen, Nicole; Sørensen, Margit; Hyldahl, Tanja Kirstine;

    2012-01-01

    BACKGROUND: Smoking cessation is widely recommended for secondary stroke prevention. However, little is known about the efficacy of smoking cessation intervention after stroke or transient ischemic attack (TIA). METHODS: Ninety-four smokers under age 76, admitted with ischemic stroke or TIA were......-report and verified by measurement of exhaled carbon monoxide (CO). Fewer patients than expected were recruited, which renders this report a pilot study. RESULTS: The 6-month self-reported smoking cessation rate was 37.8% in the minimal intervention group and 42.9% in the intensive intervention group. Smoking...... randomized to minimal smoking cessation intervention or intensive smoking cessation intervention. All patients attended a 30-min individual counseling by the study nurse. Patients randomized to intensive smoking cessation intervention also participated in a 5-session outpatient smoking cessation program...

  16. Efficacy and use of an internet-delivered computer-tailored lifestyle intervention, targeting saturated fat intake, physical activity and smoking cessation : A randomized controlled trial

    NARCIS (Netherlands)

    Oenema, Anke; Brug, Johannes; Dijkstra, Arie; de Weerdt, Inge; de Vries, Hein

    2008-01-01

    Background Although experts claim that computer-tailored interventions provided over the Internet have great potential to promote health behavior change, few studies have tested the efficacy of computer-tailored lifestyle interventions online-delivered over the Internet. Purpose To evaluate the shor

  17. A pilot study of a smoking cessation intervention for women living with HIV: study protocol

    Directory of Open Access Journals (Sweden)

    Kim SS

    2017-02-01

    Full Text Available Sun S Kim, Sabreen Darwish, Sang A Lee, Rosanna F DeMarco Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA Background: Prevalence of cigarette smoking is substantially higher among people living with human immunodeficiency virus (HIV than the general population in the USA. Women living with HIV (WLHIV who smoke are at higher risk of developing acquired immunodeficiency syndrome and have a higher mortality rate than nonsmoking WLHIV. Compared to men, women generally require more intensive counseling for smoking cessation. The primary aim of this study is to examine the acceptability and feasibility of a videoconferencing smoking cessation intervention that is tailored to the specific needs of WLHIV. Methods: A total of 50 WLHIV will be randomized at a ratio of 1:1 to either a videoconferencing or a telephone counseling arm. Both arms have the same cessation intervention, that is, eight weekly individualized counseling sessions of 30-minute cognitive behavioral therapy plus active nicotine patches for 8 weeks. The only difference between the two arms is the delivery mode of the counseling, that is, telephone video call vs. telephone voice call. Data collection is scheduled at baseline and three follow-up points: 1, 3, and 6 months from the target quit day. Data will be analyzed using STATA 14. The primary outcome is a 6-month prolonged abstinence. Home-based salivary cotinine test will be conducted to verify self-reported smoking abstinence using a NicAlert® test strip, while a research coordinator monitors the whole process by a telephone video call. Conclusion: The study is a two-arm parallel-group pilot clinical trial of a smoking cessation intervention. It attempts to examine whether videoconferencing smoking cessation intervention will be acceptable and feasible for WLHIV and will yield a better cessation outcome than telephone counseling intervention. Findings may have the

  18. Principles of Community Organization and Partnership for Smoking Cessation in the Community Intervention Trial for Smoking Cessation (COMMIT).

    Science.gov (United States)

    Thompson, B; Wallack, L; Lichtenstein, E; Pechacek, T

    1990-01-01

    The Community Intervention Trial for Smoking Cessation (COMMIT) has adopted a community approach to smoking cessation. State-of-the-art interventions that have proven efficacious for smoking cessation are delivered to smokers through community-based organizations. An innovative adaptation of community organization methods accommodated the need for a standardized protocol with the flexibility required for diverse and unique communities. The unique characteristics of the eleven intervention communities are examined with a focus on differences in size, location, availability and importance of the intervention channels, and other factors that were important for community mobilization. Initial results of the mobilization process are summarized. Although there were some differences in the structures formed and the time required to complete the initial project activities, all eleven intervention sites were mobilized around the COMMIT goals and activities.

  19. Tobacco Cessation Intervention for People with Disabilities: Survey of Center for Independent Living Directors

    Science.gov (United States)

    Moorhouse, Michael D.; Pomeranz, Jamie L.; Barnett, Tracey E.; Yu, Nami S.; Curbow, Barbara A.

    2011-01-01

    People with disabilities (PWD) are 50% more likely to smoke compared with the general population, yet interventions tailored to the needs of PWD remain limited. The authors surveyed directors from a leading disability service organization to assess their delivery of tobacco cessation interventions. Although tobacco cessation was identified as a…

  20. Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial

    DEFF Research Database (Denmark)

    Lindström, David; Sadr Azodi, Omid; Wladis, Andreas;

    2008-01-01

    To determine whether an intervention with smoking cessation starting 4 weeks before general and orthopedic surgery would reduce the frequency of postoperative complications.......To determine whether an intervention with smoking cessation starting 4 weeks before general and orthopedic surgery would reduce the frequency of postoperative complications....

  1. RCT of a client-centred, caseworker-delivered smoking cessation intervention for a socially disadvantaged population

    Directory of Open Access Journals (Sweden)

    Girgis Afaf

    2011-01-01

    Full Text Available Abstract Background Disadvantaged groups are an important target for smoking cessation intervention. Smoking rates are markedly higher among severely socially disadvantaged groups such as indigenous people, the homeless, people with a mental illness or drug and alcohol addiction, and the unemployed than in the general population. This proposal aims to evaluate the efficacy of a client-centred, caseworker delivered cessation support intervention at increasing validated self reported smoking cessation rates in a socially disadvantaged population. Methods/Design A block randomised controlled trial will be conducted. The setting will be a non-government organisation, Community Care Centre located in New South Wales, Australia which provides emergency relief and counselling services to predominantly government income assistance recipients. Eligible clients identified as smokers during a baseline touch screen computer survey will be recruited and randomised by a trained research assistant located in the waiting area. Allocation to intervention or control groups will be determined by time periods with clients randomised in one-week blocks. Intervention group clients will receive an intensive client-centred smoking cessation intervention offered by the caseworker over two face-to-face and two telephone contacts. There will be two primary outcome measures obtained at one, six, and 12 month follow-up: 1 24-hour expired air CO validated self-reported smoking cessation and 2 7-day self-reported smoking cessation. Continuous abstinence will also be measured at six and 12 months follow up. Discussion This study will generate new knowledge in an area where the current information regarding the most effective smoking cessation approaches with disadvantaged groups is limited. Trial registration number ISRCTN: ISRCTN85202510

  2. Pregnant women's responses to a tailored smoking cessation intervention: turning hopelessness into competence

    Directory of Open Access Journals (Sweden)

    Zaino Petersen

    2010-12-01

    Full Text Available Background: Cognitive behavioral interventions consisting of brief counseling and the provision of self-help material designed for pregnancy have been documented as effective smoking cessation interventions for pregnant women. However, there is a need to understand how such interventions are perceived by the targeted group. Aim: To understand the cognitive, emotional, and behavioral responses of pregnant women to a clinic-based smoking cessation intervention. Methods: In-depth interviews with women attending four antenatal clinics in Cape Town, South Africa, who were exposed to a smoking intervention delivered by midwives and peer counselors. Women were purposively selected to represent a variation in smoking behavior. Thirteen women were interviewed at their first antenatal visit and 10 were followed up and reinterviewed later in their pregnancies. A content analysis approach was used, which resulted in categories and themes describing women's experiences, thoughts, and feelings about the intervention. Results: Five women quit, five had cut down, and three could not be traced for follow-up. All informants perceived the intervention positively. Four main themes captured the intervention's role in influencing women's smoking behavior. The process started with ‘understanding their reality,’ which led to ‘embracing change’ and ‘deciding to hold nothing back,’ which created a basis for ‘turning hopelessness into a feeling of competence.’Conclusion: The intervention succeeded in shifting women from feeling pessimistic about ever quitting to feeling encouraged to try and quit. Informants rated the social support they received very highly and expressed the need for the intervention to become a routine component of clinic services.

  3. Integrated smoking cessation and binge drinking intervention for young adults: a pilot efficacy trial.

    Science.gov (United States)

    Ames, Steven C; Pokorny, Steven B; Schroeder, Darrell R; Tan, Winston; Werch, Chudley E

    2014-05-01

    Alcohol consumption is strongly associated with cigarette smoking in young adults. The primary aim of this investigation was to complete a pilot evaluation of the efficacy of an integrated intervention that targets both cigarette smoking and binge drinking on the cigarette smoking and binge behavior of young adults at 6-month follow-up. Participants were 95 young adult (M=24.3; SD=3.5 years) smokers (≥1 cigarettes per day) who binge drink (≥1 time per month) and who were randomly assigned to standard treatment (n=47) involving six individual treatment visits plus eight weeks of nicotine patch therapy or the identical smoking cessation treatment integrated with a binge drinking intervention (integrated intervention; n=48). Using an intent-to-treat analysis for tobacco abstinence, at both 3 month end of treatment and 6 month follow-up, more participants who received integrated intervention were biochemically confirmed abstinent from tobacco than those who received standard treatment at 3 months (19% vs. 9%, p=0.06) and 6 months (21% vs. 9%, p=0.05). At 6 months, participants who completed the study and who received integrated intervention consumed fewer drinks per month (psmoking cessation and reduces binge drinking compared to standard treatment.

  4. Multimodal intervention raises smoking cessation rate during pregnancy

    DEFF Research Database (Denmark)

    Hegaard, Hanne K; Kjaergaard, Hanne; Møller, Lars F

    2003-01-01

    of the midwives' prenatal care. All pregnant smokers in the usual care group (n = 320) received standard counseling from a midwife. Outcome was self-reported smoking cessation in the 37th week of pregnancy and the reported cessation was validated by cotinine saliva concentration. RESULTS: Self-reported cessation.......003). The adjusted odds ratio (OR) for smoking cessation was 4.20 (95% CI 2.13-8.03). Logistic regression analysis showed a significant positive association of smoking cessation with low caffeine consumption in pregnancy, many years in school, no exposure to passive smoking outside the home, and previous attempts...

  5. The Systematic Development of an Internet-Based Smoking Cessation Intervention for Adults

    DEFF Research Database (Denmark)

    Dalum, Peter; Brandt, Caroline Lyng; Skov-Ettrup, Lise

    2016-01-01

    cognitive theory," the "transtheoretical model/stages of change," "self-regulation theory," and "appreciative inquiry" were relevant theories for smoking cessation interventions. From these theories, we selected modeling/behavioral journalism, feedback, planning coping responses/if-then statements, gain...... a needs assessment, we identified important changeable determinants of cessation behavior, specified objectives for the intervention, selected theoretical methods for meeting our objectives, and operationalized change methods into practical intervention strategies. ITALIC! Results We found that "social...

  6. Multimodal intervention raises smoking cessation rate during pregnancy

    DEFF Research Database (Denmark)

    Hegaard, Hanne K; Kjaergaard, Hanne; Møller, Lars F

    2003-01-01

    .003). The adjusted odds ratio (OR) for smoking cessation was 4.20 (95% CI 2.13-8.03). Logistic regression analysis showed a significant positive association of smoking cessation with low caffeine consumption in pregnancy, many years in school, no exposure to passive smoking outside the home, and previous attempts...

  7. Reach and uptake of Internet- and phone-based smoking cessation interventions

    DEFF Research Database (Denmark)

    Skov-Ettrup, L S; Dalum, P; Ekholm, O;

    2014-01-01

    To study whether demographic and smoking-related characteristics are associated with participation (reach) in a smoking cessation trial and subsequent use (uptake) of two specific smoking interventions (Internet-based program and proactive telephone counseling)....

  8. The Systematic Development of an Internet-Based Smoking Cessation Intervention for Adults

    NARCIS (Netherlands)

    Dalum, Peter; Brandt, Caroline Lyng; Skov-Ettrup, Lise; Tolstrup, Janne; Kok, Gerjo

    2016-01-01

    ITALIC! Objectives The objective of this project was to determine whether intervention mapping is a suitable strategy for developing an Internet- and text message-based smoking cessation intervention. ITALIC! Method We used the Intervention Mapping framework for planning health promotion programs. A

  9. How do perceptions about cessation outcomes moderate the effectiveness of a gain-framed smoking cessation telephone counseling intervention?

    Science.gov (United States)

    Latimer-Cheung, Amy E; Fucito, Lisa M; Carlin-Menter, Shannon; Rodriguez, Jocelyn; Raymond, Lindsey; Salovey, Peter; Makuch, Robert; Cummings, K Michael; Toll, Benjamin A

    2012-01-01

    The distinction between prevention and detection behaviors provides a useful guideline for appropriately framing health messages in terms of gains or losses. However, this guideline assumes that everyone perceives the outcomes associated with a behavior in a consistent manner, as prevention or detection. Individuals' perceptions of a behavior vary, and so the effects of framed messages may be optimized by considering individuals' perceptions rather than the prevention or detection function of the behavior. The authors tested this message-framing paradigm in a secondary analysis of data from a trial evaluating gain-framed smoking cessation counseling delivered through a state quitline (Toll et al., 2010 ). Smokers (N = 2,032) who called a state quitline received either gain-framed or standard care messages. Smokers' beliefs about the positive consequences of stopping smoking (outcome expectancies) were evaluated at baseline. Smoking status and self-efficacy were assessed at 3 months. Outcome expectancies moderated the framing effects among men but not among women. Men in the gain-framed counseling condition who had positive outcome expectancies were more likely to quit and had more confidence in their ability to quit or to remain abstinent than men who were uncertain of the positive outcome of smoking cessation. Among men, self-efficacy mediated the moderated framing effects of the intervention on quit status. These findings suggest that it may be useful to consider sex and individual differences in outcome expectancies when delivering gain-framed smoking cessation messages in the context of a state quitline.

  10. Posting behaviour patterns in an online smoking cessation social network: implications for intervention design and development.

    Directory of Open Access Journals (Sweden)

    Benjamin Healey

    Full Text Available Online Cessation Support Networks (OCSNs are associated with increased quit success rates, but few studies have examined their use over time. We identified usage patterns in New Zealand's largest OCSN over two years and explored implications for OCSN intervention design and evaluation.We analysed metadata relating to 133,096 OCSN interactions during 2011 and 2012. Metrics covered aggregate network activity, user posting activity and longevity, and between-user commenting. Binary logistic regression models were estimated to investigate the feasibility of predicting low user engagement using early interaction data.Repeating periodic peaks and troughs in aggregate activity related not only to seasonality (e.g., New Year, but also to day of the week. Out of 2,062 unique users, 69 Highly Engaged Users (180+ interactions each contributed 69% of all OCSN interactions in 2012 compared to 1.3% contributed by 864 Minimally Engaged Users (< = 2 items each. The proportion of Highly Engaged Users increased with network growth between 2011 and 2012 (with marginal significance, but the proportion of Minimally Engaged Users did not decline substantively. First week interaction data enabled identification of Minimally Engaged Users with high specificity and sensitivity (AUROC= 0.94.Results suggest future research should develop and test interventions that promote activity, and hence cessation support, amongst specific user groups or at key time points. For example, early usage information could help identify Minimally Engaged Users for tests of targeted messaging designed to improve their integration into, or re-engagement with, the OCSN. Furthermore, although we observed strong growth over time on varied metrics including posts and comments, this change did not coincide with large gains in first-time user persistence. Researchers assessing intervention effects should therefore examine multiple measures when evaluating changes in network dynamics over time.

  11. Abstinence and Use of Community-Based Cessation Treatment After a Motivational Intervention Among smokers with Severe Mental Illness.

    Science.gov (United States)

    Ferron, Joelle C; Devitt, Timothy; McHugo, Gregory J; A Jonikas, Jessica; Cook, Judith A; Brunette, Mary F

    2016-05-01

    Motivational interventions help people with mental illness try to quit smoking, but few studies have evaluated factors associated with this groups' cessation with community treatment. We examined predictors of abstinence after a brief motivational intervention among smokers with severe mental illness. Education, stage of change post intervention, and use of cessation treatment predicted any 1-week period of self-reported abstinence over 6 months (29%). Cessation treatment mediated the relationship between stage of change and abstinence. Because treatment was the key modifiable predictor of abstinence, future research should establish strategies that improve motivation for, access to, and retention in cessation treatment. Clinical Trials Identifier NCT01412866.

  12. Learning About Intervention Target Zones

    OpenAIRE

    Klein, Michael W; Karen K. Lewis

    1991-01-01

    This paper provides a framework for evaluating how market participants' beliefs about foreign exchange target zones change as they learn about central bank intervention policy. In order to examine this behavior, we first generalize the standard target zone model to allow for intra-marginal intervention. Intra-marginal intervention implies that the position of market participants' beliefs about the target zone can be determined from their beliefs about the likelihood of intervention. As an app...

  13. Smoking cessation in pregnancy: psychosocial interventions and patient-focused perspectives

    Directory of Open Access Journals (Sweden)

    Miyazaki Y

    2015-04-01

    Full Text Available Yukiko Miyazaki,1 Kunihiko Hayashi,2 Setsuko Imazeki1 1Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, 2School of Health Sciences, Faculty of Medicine, Gunma University, Maebashi, Japan Background: Smoking during pregnancy causes obstetric and fetal complications, and smoking cessation may have great benefits for the mother and the child. However, some pregnant women continue smoking even in pregnancy.Objective: To review the literature addressing the prevalence of smoking during pregnancy, explore psychosocial factors associated with smoking, and review the evidence of psychosocial interventions for smoking cessation during pregnancy in recent years.Literature review: Computerized Internet search results in PubMed for the years spanning from 2004 to 2014, as well as references cited in articles, were reviewed. A search for the keywords “smoking cessation pregnancy” and “intervention” and “clinical trials” yielded 52 citations. Thirty-five citations were identified as useful to this review for the evidence of psychosocial interventions for smoking cessation during pregnancy.Results: The prevalence of smoking during pregnancy differs by country, reflecting the countries’ social, cultural, and ethnic backgrounds. Women who had socioeconomic disadvantages, problems in their interpersonal relationships, higher stress, depression, less social support, and who engaged in health-risk behaviors were more prone to smoking during pregnancy. Psychosocial interventions, such as counseling, are effective methods for increasing smoking cessation.Conclusion: Smokers may have various psychosocial problems in addition to health problems. It is important to understand each individual’s social situation or psychosocial characteristics, and a psychosocial intervention focused on the characteristics of the individual is required. Keywords: women’s health, smoking cessation, pregnancy, psychosocial intervention  

  14. Cost-effectiveness analysis of face-to-face smoking cessation interventions by professionals

    NARCIS (Netherlands)

    T.L. Feenstra (Talitha); H.H. Hamberg-van Reenen; R.T. Hoogenveen (Rudolf); M.P.M.H. Rutten-van Mölken (Maureen)

    2003-01-01

    textabstractObjectives: To estimate the cost-effectiveness of five face-to-face smoking cessation interventions: 1) Telephone Counseling (TC), 2) Minimal counseling by a general practitioner (H-MIS), 3) Minimal counseling by a general practitioner combined with Nicotine Replacement Therapy (H-MIS+NR

  15. Cost-effectiveness of face-to-face smoking cessation interventions: A dynamic modeling study

    NARCIS (Netherlands)

    T.L. Feenstra (Talitha); H.H. Hamberg-Van Reenen (Heleen); R.T. Hoogenveen (Rudolf); M.P.M.H. Rutten-van Mölken (Maureen)

    2005-01-01

    textabstractObjectives: To estimate the cost-effectiveness of five face-to-face smoking cessation interventions (i.e., minimal counseling by a general practitioner (GP) with, or without nicotine replacement therapy (NRT), intensive counseling with NRT, or bupropion, and telephone counseling) in term

  16. Cost-effectiveness of an Intensive Smoking Cessation Intervention for COPD Outpatients

    NARCIS (Netherlands)

    Christenhusz, L.C.A.; Prenger, H.C.; Pieterse, M.E.; Seydel, E.R.; Palen, van der J.

    2012-01-01

    Introduction: To determine the cost-effectiveness of a high-intensity smoking cessation program (SmokeStop Therapy; SST) versus a medium-intensity treatment (Minimal Intervention Strategy for Lung patients [LMIS]) for chronic obstructive pulmonary disease outpatients. Methods: The cost-effectiven

  17. Effect of smoking cessation intervention on results of acute fracture surgery: a randomized controlled trial

    DEFF Research Database (Denmark)

    Nåsell, Hans; Adami, Johanna; Samnegård, Eva;

    2010-01-01

    Tobacco smoking is a major health and economic concern and is also known to have a significant negative effect on surgical outcomes. The benefits of a smoking cessation intervention prior to elective orthopaedic surgery have been evaluated previously. Our aim was to assess whether a smoking cessa...

  18. Cost-effectiveness of face-to-face smoking cessation interventions : a dynamic modeling study

    NARCIS (Netherlands)

    Feenstra, Talitha L; Hamberg-van Reenen, Heleen H; Hoogenveen, Rudolf T; Rutten-van Mölken, Maureen P M H

    2005-01-01

    OBJECTIVES: To estimate the cost-effectiveness of five face-to-face smoking cessation interventions (i.e., minimal counseling by a general practitioner (GP) with, or without nicotine replacement therapy (NRT), intensive counseling with NRT, or bupropion, and telephone counseling) in terms of costs p

  19. Lay Health Influencers: How They Tailor Brief Tobacco Cessation Interventions

    Science.gov (United States)

    Yuan, Nicole P.; Castaneda, Heide; Nichter, Mark; Nichter, Mimi; Wind, Steven; Carruth, Lauren; Muramoto, Myra

    2012-01-01

    Interventions tailored to individual smoker characteristics have increasingly received attention in the tobacco control literature. The majority of tailored interventions are generated by computers and administered with printed materials or web-based programs. The purpose of this study was to examine the tailoring activities of community lay…

  20. Smoking-cessation interventions in people living with HIV infection: a systematic review.

    Science.gov (United States)

    Moscou-Jackson, Gyasi; Commodore-Mensah, Yvonne; Farley, Jason; DiGiacomo, Michelle

    2014-01-01

    Tobacco smoking remains a prevalent behavior in people living with HIV infection (PLWHs) and is associated with impaired immune functioning, increased cardiovascular risk, and decreased response to antiretroviral therapy. This review presents a critique and synthesis of evidence on effective smoking-cessation interventions for PLWHs. A comprehensive search identified nine peer-reviewed intervention studies published between 1989 and 2012. The highest likelihood of smoking cessation (range of odds ratios 4.33-5.6) were in two randomized controlled trial interventions using cell phone technology. Clinically significant reductions in systolic blood pressure, weight gain, and increased CD(4+) T-cell count were reported in participants who ceased smoking in three of the nine studies. Overall, multistrategy smoking-cessation interventions, delivered over multiple sessions, were effective. However, the most effective interventions were tailored to the unique individual needs of PLWHs, including assessment of and intervention for polysubstance abuse and mental health issues, as well as the inclusion of access-promoting elements.

  1. Evaluation of QuitNow Men: An Online, Men-Centered Smoking Cessation Intervention

    Science.gov (United States)

    Sharp, Paul; Mackay, Martha H; Stolp, Sean

    2016-01-01

    Background Men continue to smoke cigarettes in greater numbers than women. There is growing evidence for the value of developing targeted, men-centered health promotion programs. However, few smoking cessation interventions have been designed for men. A gender-specific website, QuitNow Men, was developed based on focus group interview findings, stakeholder feedback, and evidence-based cessation strategies. The website was designed to incorporate a masculine look and feel through the use of images, direct language, and interactive content. Usability experts and end-users provided feedback on navigation and functionality of the website prior to pilot testing. Objectives The objectives of the pilot study were to describe (1) men’s use and evaluations of the interactive resources and information on the QuitNow Men website, and (2) the potential of QuitNow Men to engage men in reducing and quitting smoking. Methods A one-group, pretest-posttest study design was used. Men who were interested in quitting were recruited and invited to use the website over a 6-month period. Data were collected via online questionnaires at baseline, 3-month, and 6-month follow-up. A total of 117 men completed the baseline survey. Over half of those (67/117, 57.3%) completed both follow-up surveys. Results At baseline, participants (N=117) had been smoking for an average of 24 years (SD 12.1) and smoked on average 15 cigarettes a day (SD 7.4). The majority had not previously used a quit smoking website (103/117, 88.0%) or websites focused on men’s health (105/117, 89.7%). At the 6-month follow-up, the majority of men used the QuitNow Men website at least once (64/67, 96%). Among the 64 users, 29 (43%) reported using the website more than 6 times. The men using QuitNow Men agreed or strongly agreed that the website was easy to use (51/64, 80%), the design and images were appealing (42/64, 66%), they intended to continue to use the website (42/64, 66%), and that they would recommend Quit

  2. Results of a Feasibility and Acceptability Trial of an Online Smoking Cessation Program Targeting Young Adult Nondaily Smokers

    Directory of Open Access Journals (Sweden)

    Carla J. Berg

    2012-01-01

    Full Text Available Despite increases in nondaily smoking among young adults, no prior research has aimed to develop and test an intervention targeting this group. Thus, we aimed to develop and test the feasibility, acceptability, and potential effectiveness of an online intervention targeting college student nondaily smokers. We conducted a one-arm feasibility and acceptability trial of a four-week online intervention with weekly contacts among 31 college student nondaily smokers. We conducted assessments at baseline (B, end of treatment (EOT, and six-week followup (FU. We maintained a 100% retention rate over the 10-week period. Google Analytics data indicated positive utilization results, and 71.0% were satisfied with the program. There were increases (P<.001 in the number of people refraining from smoking for the past 30 days and reducing their smoking from B to EOT and to FU, with additional individuals reporting being quit despite recent smoking. Participants also increased in their perceptions of how bothersome secondhand smoke is to others (P<.05; however, no other attitudinal variables were altered. Thus, this intervention demonstrated feasibility, acceptability, and potential effectiveness among college-aged nondaily smokers. Additional research is needed to understand how nondaily smokers define cessation, improve measures for cessation, and examine theoretical constructs related to smoking among this population.

  3. A randomised controlled trial of a smoking cessation intervention delivered by dental hygienists: a feasibility study

    Directory of Open Access Journals (Sweden)

    Jenkins William

    2007-05-01

    Full Text Available Abstract Background Tobacco use continues to be a global public health problem. Helping patients to quit is part of the preventive role of all health professionals. There is now increasing interest in the role that the dental team can play in helping their patients to quit smoking. The aim of this study was to determine the feasibility of undertaking a randomised controlled smoking cessation intervention, utilising dental hygienists to deliver tobacco cessation advice to a cohort of periodontal patients. Methods One hundred and eighteen patients who attended consultant clinics in an outpatient dental hospital department (Periodontology were recruited into a trial. Data were available for 116 participants, 59 intervention and 57 control, and were analysed on an intention-to-treat basis. The intervention group received smoking cessation advice based on the 5As (ask, advise, assess, assist, arrange follow-up and were offered nicotine replacement therapy (NRT, whereas the control group received 'usual care'. Outcome measures included self-reported smoking cessation, verified by salivary cotinine measurement and CO measurements. Self-reported measures in those trial participants who did not quit included number and length of quit attempts and reduction in smoking. Results At 3 months, 9/59 (15% of the intervention group had quit compared to 5/57 (9% of the controls. At 6 months, 6/59 (10% of the intervention group quit compared to 3/57 (5% of the controls. At one year, there were 4/59 (7% intervention quitters, compared to 2/59 (4% control quitters. In participants who described themselves as smokers, at 3 and 6 months, a statistically higher percentage of intervention participants reported that they had had a quit attempt of at least one week in the preceding 3 months (37% and 47%, for the intervention group respectively, compared with 18% and 16% for the control group. Conclusion This study has shown the potential that trained dental hygienists

  4. Effective smoking cessation interventions for COPD patients: a review of the evidence

    OpenAIRE

    Coronini-Cronberg, Sophie; Heffernan, Catherine; Robinson, Michael

    2011-01-01

    Objectives To review the effectiveness of smoking cessation interventions offered to chronic obstructive pulmonary disease (COPD) patients, and identify barriers to quitting experienced by them, so that a more effective service can be developed for this group. Design A rapid systematic literature review comprising computerized searches of electronic databases, hand searches and snowballing were used to identify both published and grey literature. Setting A review of studies undertaken in nort...

  5. Informing Tobacco Cessation Benefit Use Interventions for Unionized Blue-Collar Workers: A Mixed-Methods Reasoned Action Approach.

    Science.gov (United States)

    Yzer, Marco; Weisman, Susan; Mejia, Nicole; Hennrikus, Deborah; Choi, Kelvin; DeSimone, Susan

    2015-08-01

    Blue-collar workers typically have high rates of tobacco use but low rates of using tobacco cessation resources available through their health benefits. Interventions to motivate blue-collar tobacco users to use effective cessation support are needed. Reasoned action theory is useful in this regard as it can identify the beliefs that shape tobacco cessation benefit use intentions. However, conventional reasoned action research cannot speak to how those beliefs can best be translated into intervention messages. In the present work, we expand the reasoned action approach by adding additional qualitative inquiry to better understand blue-collar smokers' beliefs about cessation benefit use. Across three samples of unionized blue-collar tobacco users, we identified (1) the 35 attitudinal, normative, and control beliefs that represented tobacco users' belief structure about cessation benefit use; (2) instrumental attitude as most important in explaining cessation intention; (3) attitudinal beliefs about treatment options' efficacy, health effects, and monetary implications of using benefits as candidates for message design; (4) multiple interpretations of cessation beliefs (e.g., short and long-term health effects); and (5) clear implications of these interpretations for creative message design. Taken together, the findings demonstrate how a mixed-method reasoned action approach can inform interventions that promote the use of tobacco cessation health benefits.

  6. Self-reported smoking cessation interventions among dental practitioners: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Raghad Hashim

    2016-01-01

    Full Text Available Objective: The aim of this study is to determine the attitudes and practices of dentists toward smoking cessation intervention (SCI; to identify the barriers that prevent them from advising their patients to quit smoking and to determine the level of interest in future training in smoking cessation. Methods: Self-administered questionnaires were distributed to all (122 dentists practicing in private sectors in the Emirate of Ajman, United Arab Emirates. The questionnaire was personally administered, and the dental practitioners were given explanations regarding how to complete it. Only descriptive statistics was calculated. Results: More than half of the respondents (55% inquired about their patients smoking status, whereas 40% of the dentists documented it. The most common barrier cited by the respondents was the lack of training and preparation in the smoking cessation techniques, followed by lack of availability of educational material. Almost three-quarters of the respondent were interested in further training in SCI; being provided to them through full-day training course. Conclusions: Dentists require more access to appropriate forms of training in the SCI and more support needed to enable the dentist to help their patient to quit the habit. Providing training program to the dental practitioners in the United Arab Emirates to equip them with the required skill to deliver SCI would be highly beneficial.

  7. The Role of Facebook in Crush the Crave, a Mobile- and Social Media-Based Smoking Cessation Intervention: Qualitative Framework Analysis of Posts

    OpenAIRE

    Struik, Laura Louise; Baskerville, Neill

    2014-01-01

    Background Social networking sites, particularly Facebook, are increasingly included in contemporary smoking cessation interventions directed toward young adults. Little is known about the role of Facebook in smoking cessation interventions directed toward this age demographic. Objective The aim of this study was to characterize the content of posts on the Facebook page of Crush the Crave, an evidence-informed smoking cessation intervention directed toward young adults aged 19 to 29 years. Me...

  8. Systematic review and meta-analysis of Internet interventions for smoking cessation among adults

    Directory of Open Access Journals (Sweden)

    Graham AL

    2016-05-01

    Full Text Available Amanda L Graham,1,2 Kelly M Carpenter,3 Sarah Cha,1 Sam Cole,3 Megan A Jacobs,1 Margaret Raskob,3 Heather Cole-Lewis,4,51Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, DC, 2Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, 3Alere Wellbeing, Seattle, WA, 4Johnson & Johnson Health and Wellness Solutions, Inc., New Brunswick, NJ, 5ICF International, Rockville, MD, USA Background: The aim of this systematic review was to determine the effectiveness of Internet interventions in promoting smoking cessation among adult tobacco users relative to other forms of intervention recommended in treatment guidelines. Methods: This review followed Cochrane Collaboration guidelines for systematic reviews. Combinations of “Internet,” “web-based,”and “smoking cessation intervention” and related keywords were used in both automated and manual searches. We included randomized trials published from January 1990 through to April 2015. A modified version of the Cochrane risk of bias assessment tool was used. We calculated risk ratios (RRs for each study. Meta-analysis was conducted using random-effects method to pool RRs. Presentation of results follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Forty randomized trials involving 98,530 participants were included. Most trials had a low risk of bias in most domains. Pooled results comparing Internet interventions to assessment-only/waitlist control were significant (RR 1.60, 95% confidence interval [CI] 1.15–2.21, I2=51.7%; four studies. Pooled results of largely static Internet interventions compared to print materials were not significant (RR 0.83, 95% CI 0.63–1.10, I2=0%; two studies, whereas comparisons of interactive Internet interventions to print materials were significant (RR 2.10, 95% CI 1.25–3

  9. Speed of engagement with support generated by a smoking cessation smartphone Just In Time Adaptive Intervention (JITAI

    Directory of Open Access Journals (Sweden)

    Felix Naughton

    2015-10-01

    Full Text Available Background: An advantage of the high portability and sensing capabilities of smartphones is the potential for health apps to deliver advice and support to individuals close in time to when it is deemed of greatest relevance and impact, often referred to as Just In Time Adaptive Interventions (JITAI. However, little research has been undertaken to explore the viability of JITAI in terms of how long it takes users to engage with support triggered by real time data input, compared to scheduled support, and whether context affects response. This paper is focused on Q Sense, a smoking cessation app developed to deliver both Just in Time and scheduled support messages (every morning during a smoker’s quit attempt. The Just in Time cessation support generated by Q Sense is triggered by and tailored to real time context using location sensing. Objectives: To assess: 1 the time to engage with the app after a Just in Time support notification is delivered and whether this is influenced by the context in which the notification was initially delivered, 2 whether the time to engage with the app differs between Just in Time support notifications and scheduled support message notifications and 3 whether findings from objectives 1 and 2 differ between smokers receiving or not receiving NHS smoking cessation support. Methods: Data are from two studies evaluating the use of Q Sense: a feasibility study using an opportunity sample of smokers initiating a quit attempt with Q Sense without NHS cessation support (N=15 and an ongoing acceptability study of smokers receiving NHS smoking cessation support alongside app use (target N=40, recruitment due to be completed end of November 2015. Time elapse between notification generation and the user opening the app will be calculated and compared between message types (Just in Time vs. scheduled messages, contexts (home, work, socialising, other and samples (receiving or not receiving NHS cessation support using t

  10. Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women.

    Science.gov (United States)

    Lee, Minsun; Miller, Suzanne M; Wen, Kuang-Yi; Hui, Sui-kuen Azor; Roussi, Pagona; Hernandez, Enrique

    2015-12-01

    This study evaluated a theory-guided cognitive-behavioral counseling (CBC) intervention for smoking cessation during pregnancy and postpartum. It also explored the mediating role of cognitive-affective variables on the impact of CBC. Underserved inner city pregnant women (N = 277) were randomized to the CBC or a best practice (BP) condition, each of which consisted of two prenatal and two postpartum sessions. Assessments were obtained at baseline, late pregnancy, and 1- and 5-months postpartum. An intent-to-treat analysis found no differences between the two groups in 7-day point-prevalence abstinence. However, a respondents-only analysis revealed a significantly higher cessation rate in the CBC (37.3 %) versus the BP (19.0 %) condition at 5-months postpartum follow-up. This effect was mediated by higher quitting self-efficacy and lower cons of quitting. CBC, based on the Cognitive-Social Health Information Processing model, has the potential to increase postpartum smoking abstinence by assessing and addressing cognitive-affective barriers among women who adhere to the intervention.

  11. Assessing the Impact of Nationwide Smoking Cessation Interventions among Employed, Middle-Aged Japanese Men, 2005-2010.

    Directory of Open Access Journals (Sweden)

    Koji Wada

    Full Text Available A variety of tobacco control interventions have become available in Japan over the past decade, however, the magnitude to which they have impacted on smoking rates may have varied by socioeconomic status such as job content, particularly for middle-aged men who were formerly long-term smokers. We conducted a longitudinal study to investigate the differences between smoking cessation strategies among a national sample of middle-aged Japanese employed men between 2005 and 2010.Data was extracted from a previous longitudinal survey of middle-aged and elderly people that had been conducted by the Ministry of Health, Labour and Welfare. In 2005, 16,738 Japanese men aged 50-59 years were recruited and sent a questionnaire in each year of the study. We analyzed data for individuals who reported being current smokers at baseline. Cox's discrete time proportional hazard regression analysis was used to examine potential associations between smoking cessation and socioeconomic factors.Of the 6187 employed, male smokers who participated in 2005, 31% subsequently quit smoking during the 5-year follow-up period. Those working in manufacturing, transportation, or security were less likely to have quit smoking than those working in management. Having no marital partner, never having been married, or those experiencing psychological distress were significantly less likely to have quit smoking during this time.Although almost one-third of middle-aged, male smokers quit their habit between 2005 and 2010; the uptake of this national strategy appears to have been far from uniform across Japanese society. Socioeconomic factors such as occupation, marital status and psychological distress were negatively correlated with quitting, suggesting that these groups should be more aggressively targeted in further interventions.

  12. Enabling and sustaining the activities of lay health influencers: lessons from a community-based tobacco cessation intervention study.

    Science.gov (United States)

    Castañeda, Heide; Nichter, Mark; Nichter, Mimi; Muramoto, Myra

    2010-07-01

    The authors present findings from a community-based tobacco cessation project that trained lay health influencers to conduct brief interventions. They outline four major lessons regarding sustainability. First, participants were concerned about the impact that promoting cessation might have on social relationships. "Social risk" must be addressed during training to ensure long-term sustainability. Second, formal training provided participants with an increased sense of self-efficacy, allowed them to embrace a health influencer identity, and aided in further reducing social risk. Third, material resources functioned to mediate social tensions during health intervention conversations. A variety of resources should be made available to health influencers to accommodate type of relationship, timing, and location of the interaction. Finally, project design must be attentive to the creation of a "community of practice" among health influencers as an integral part of project sustainability. These lessons have broad implications for successful health promotion beyond tobacco cessation.

  13. Effectiveness of a Smoking Cessation Intervention for Methadone-Maintained Women: A Comparison of Pregnant and Parenting Women

    Directory of Open Access Journals (Sweden)

    Amber M. Holbrook

    2011-01-01

    Full Text Available Women in substance abuse programs have high rates of smoking. Pregnancy represents a unique opportunity for intervention, but few data exist to guide tailoring of effective interventions. In this study, 44 pregnant and 47 nonpregnant opioid-dependent women enrolled in comprehensive substance abuse treatment received a 6-week smoking cessation intervention based on the 5A's counseling model. The number of daily cigarettes decreased by 49% for pregnant patients and 32% for nonpregnant patients at the 3-month followup. Length of time in substance abuse treatment did not correlate with smoking cessation or reduction for either group. Factors predicting reduction of cigarette smoking differed for pregnant versus nonpregnant patients. For pregnant patients, lower levels of nicotine use prior to intervention and self-reported cigarette cravings predicted successful reduction in smoking. For nonpregnant patients, lower affiliative attachment to cigarettes, reliance on cigarettes for cognitive enhancement, and greater sense of control predicted more successful outcomes.

  14. Diagnóstico y tratamiento psicosocial del tabaquismo Smoking cessation: Diagnosis and psychosocial intervention

    Directory of Open Access Journals (Sweden)

    SERGIO BELLO S

    2009-01-01

    . The current treatment of smoking has two pillars: psycho-social intervention and pharmacological therapy. The current interventions are based on two theoretical models that try to understand changes of smoking behavior: The Stages of Change and PRIME Theory. Brief intervention is a strategy internationally approved because of its population impact on smoking cessation. The methodology used is named "5A's": Ask, Advise, Asses, Assist and Arrange follow-up. For not motivated patients at the intervention time it can be used the "5R 's" methodology: Relevance, Risks, Rewards, Roadblocks and Repetition. The actual approach used in smokers management, is Motivational Interview, which tries to produce the behavioral change from inside and not imposing it. Its four tools are: express empathy, develop discrepancy, roll with resistance and support self efficacy. The useful psychosocial strategies, in which exists consensus, are: 1 Give practical counseling of problem solving and skills training to face risky situations; 2 Intra-treatment support, encouraging attempts of smoking cessation and communicate caring and concern.

  15. An internet-based abstinence reinforcement smoking cessation intervention in rural smokers.

    Science.gov (United States)

    Stoops, William W; Dallery, Jesse; Fields, Nell M; Nuzzo, Paul A; Schoenberg, Nancy E; Martin, Catherine A; Casey, Baretta; Wong, Conrad J

    2009-11-01

    The implementation of cigarette smoking abstinence reinforcement programs may be hindered by the time intensive burden placed on patients and treatment providers. The use of remote monitoring and reinforcement of smoking abstinence may enhance the accessibility and acceptability of this intervention, particularly in rural areas where transportation can be unreliable and treatment providers distant. This study determined the effectiveness of an Internet-based abstinence reinforcement intervention in initiating and maintaining smoking abstinence in rural smokers. Sixty-eight smokers were enrolled to evaluate the efficacy of an Internet-based smoking cessation program. During the 6-week intervention period, all participants were asked to record 2 videos of breath carbon monoxide (CO) samples daily. Participants also typed the value of their CO readings into web-based software that provided feedback and reinforcement based on their smoking status. Participants (n=35) in the Abstinence Contingent (AC) group received monetary incentives contingent on recent smoking abstinence (i.e., CO of 4 parts per million or below). Participants (n=33) in the Yoked Control (YC) group received monetary incentives independent of smoking status. Participants in the AC group were significantly more likely than the YC group to post negative CO samples on the study website (OR=4.56; 95% CI=2.18-9.52). Participants assigned to AC were also significantly more likely to achieve some level of continuous abstinence over the 6-week intervention compared to those assigned to YC. These results demonstrate the feasibility and short-term efficacy of delivering reinforcement for smoking abstinence over the Internet to rural populations.

  16. Effectiveness of dentist’s intervention in smoking cessation: A review

    OpenAIRE

    Omaña Cepeda, Carlos; Jane Salas, Enric; Estrugo Devesa, Albert; Chimenos Küstner, Eduardo; López López, José

    2016-01-01

    Introduction Smoking is one of the main public health problems in developed countries. Despite extensive evidence on the effects of smoking on both oral and general health, the rate of smoking cessation is not promising. Material and Methods To review the evidence on knowledge and programs for smoking cessation developed by dentists, a literature review was carried out on programs for smoking cessation from the dentist’s perspective, as well as a review of behavioral guidelines that have been...

  17. Targeting Body Image Schema for Smoking Cessation among College Females: Rationale, Program Description, and Pilot Study Results

    Science.gov (United States)

    Napolitano, Melissa A.; Lloyd-Richardson, Elizabeth E.; Fava, Joseph L.; Marcus, Bess H.

    2011-01-01

    Smoking among young adults is a significant public health problem. Despite the negative health effects, many young women smoke for weight and body image reasons. Understanding the factors that prompt young women to initiate and continue smoking is important for designing smoking cessation interventions. The aim of the current article is to outline…

  18. Influence of dental education in motivational interviewing on the efficacy of interventions for smoking cessation

    NARCIS (Netherlands)

    M. Schoonheim-Klein; C. Gresnigt; U. van der Velden

    2013-01-01

    Aim To test whether education of dental students in motivational interviewing (MI) for smoking cessation counselling will increase the number of patients and students who quit smoking and will improve knowledge and attitudes of dental students towards tobacco cessation counselling. Methods Over 2 ye

  19. A Randomized Evaluation of Smoking Cessation Interventions for Pregnant Women at a WIC Clinic.

    Science.gov (United States)

    Mayer, Jeffrey P.; And Others

    1990-01-01

    Investigates a randomized trial of a self-help smoking cessation program for pregnant smokers at the Kent County Health Department in Grand Rapids, (Michigan). Results indicate larger quit rates amongst program participants than those in the usual care group. Suggests that smoking cessation programs for low-income pregnant WIC clients are…

  20. The SCIDOTS Project: Evidence of benefits of an integrated tobacco cessation intervention in tuberculosis care on treatment outcomes

    Directory of Open Access Journals (Sweden)

    Syed Sulaiman Syed Azhar

    2011-09-01

    Full Text Available Abstract Background There is substantial evidence to support the association between tuberculosis (TB and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation. Therefore, connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes. However, no study has extensively documented the evidence of benefits of such integration. SCIDOTS Project is a study from the context of a developing nation aimed to determine this. Methods An integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course (DOTS providers at five chest clinics in Malaysia. The study was a prospective non-randomized controlled intervention using quasi-experimental design. Using Transtheoretical Model approach, 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups: conventional TB DOTS plus smoking cessation intervention (integrated intervention or SCIDOTS group or conventional TB DOTS alone (comparison or DOTS group. At baseline, newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group, while those who were contemplating quitting were assigned to the comparison group. Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group. The impacts of the novel approach on biochemically validated smoking cessation and TB treatment outcomes were measured periodically as appropriate. Results A linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group. At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting smoking when

  1. Participant-level meta-analysis of mobile phone-based interventions for smoking cessation across different countries.

    Science.gov (United States)

    Ybarra, Michele L; Jiang, Yannan; Free, Caroline; Abroms, Lorien C; Whittaker, Robyn

    2016-08-01

    With meta-analysis, participant-level data from five text messaging-based smoking cessation intervention studies were pooled to investigate cessation patterns across studies and participants. Individual participant data (N=8315) collected in New Zealand (2001-2003; n=1705), U.K. (2008-2009; n=5792), U.S. (2012; n=503; n=164) and Turkey (2012; n=151) were collectively analyzed in 2014. The primary outcome was self-reported 7-day continuous abstinence at 4weeks post-quit day. Secondary outcomes were: (1) self-reported 7-day continuous abstinence at 3months and (2) self-reported continuous abstinence at 6months post-quit day. Generalized linear mixed models were fit to estimate the overall treatment effect, while accounting for clustering within individual studies. Estimates were adjusted for age, sex, socioeconomic status, previous quit attempts, and baseline Fagerstrom score. Analyses were intention to treat. Participants lost to follow-up were treated as smokers. Twenty-nine percent of intervention participants and 12% of control participants quit smoking at 4weeks (adjusted odds ratio [aOR]=2.89, 95% CI [2.57, 3.26], p<.0001). An attenuated but significant effect for cessation for those in the intervention versus control groups was observed at 3months (aOR=1.88, 95% CI [1.53, 2.31]) and 6months (aOR=2.24, 95% CI [1.90, 2.64]). Subgroup analyses were conducted but few significant findings were noted. Text messaging-based smoking cessation programs increase self-reported quitting rates across a diversity of countries and cultures. Efforts to expand these low-cost and scalable programs, along with ongoing evaluation, appear warranted.

  2. Computer-tailored smoking cessation intervention in a general population setting in Germany: outcome of a randomized controlled trial.

    Science.gov (United States)

    Schumann, Anja; John, Ulrich; Baumeister, Sebastian E; Ulbricht, Sabina; Rumpf, Hans-Jürgen; Meyer, Christian

    2008-02-01

    This study reports the outcome of a randomized controlled trial testing a computer-tailored smoking cessation intervention based on the transtheoretical model in a general population setting in Germany. Participants of the smoking intervention study were recruited from an existing general population health examination survey in a university hospital. The sample consisted of 611 current and former smokers at baseline, and of 485 participants in the core group of baseline daily cigarette smokers. Follow-ups were conducted 6, 12, 18, and 24 months after baseline. The intervention was designed for both current and former smokers, involved up to three individualized feedback letters, and was created using expert-system technology. Based on 7-day point-prevalence abstinence and 6-month prolonged abstinence as the outcome measures, the study identified no significant differences between the intervention and control groups. Modeling the full longitudinal data in generalized estimation equation analyses, using different nonresponse procedures, and adjusting for covariates did not alter the results. We conclude that the computer-tailored transtheoretical model-based smoking cessation intervention, as delivered in this study and in this special setting, was ineffective.

  3. Behavioral intervention to promote smoking cessation and prevent weight gain: A systematic review and meta-analysis

    Science.gov (United States)

    Spring, Bonnie; Howe, Dorothea; Berendsen, Mark; McFadden, H. Gene; Hitchcock, Kristin; Rademaker, Alfred W.; Hitsman, Brian

    2009-01-01

    Aims The prospect of weight gain discourages many cigarette smokers from quitting. Practice guidelines offer varied advice about managing weight gain after quitting smoking, but no systematic review and meta-analysis have been available. We reviewed evidence to determine whether behavioral weight control intervention compromises smoking cessation attempts, and if it offers an effective way to reduce post-cessation weight gain. Methods We identified randomized controlled trials that compared combined smoking treatment and behavioral weight control to smoking treatment alone for adult smokers. English-language studies were identified through searches of PubMed, Ovid MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials. Of 779 articles identified and 35 potentially relevant RCTs screened, 10 met criteria and were included in the meta-analysis. Results Patients who received both smoking treatment and weight treatment showed increased abstinence (OR=1.29, 95% CI=1.01,1.64) and reduced weight gain (g = -0.30, 95% CI=-0.63, -0.04) in the short term (6 months). Conclusions Findings provide no evidence that combining smoking treatment and behavioral weight control produces any harm and significant evidence of short-term benefit for both abstinence and weight control. However, the absence of long-term enhancement of either smoking cessation or weight control by the time-limited interventions studied to date provides insufficient basis to recommend societal expenditures on weight gain prevention treatment for patients who are quitting smoking. PMID:19549058

  4. Effectiveness of a stepped primary care smoking cessation intervention (ISTAPS study: design of a cluster randomised trial

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    Zarza Elvira

    2009-02-01

    Full Text Available Abstract Background There is a considerable body of evidence on the effectiveness of specific interventions in individuals who wish to quit smoking. However, there are no large-scale studies testing the whole range of interventions currently recommended for helping people to give up smoking; specifically those interventions that include motivational interviews for individuals who are not interested in quitting smoking in the immediate to short term. Furthermore, many of the published studies were undertaken in specialized units or by a small group of motivated primary care centres. The objective of the study is to evaluate the effectiveness of a stepped smoking cessation intervention based on a trans-theoretical model of change, applied to an extensive group of Primary Care Centres (PCC. Methods/Design Cluster randomised clinical trial. Unit of randomization: basic unit of care consisting of a family physician and a nurse, both of whom care for the same population (aprox. 2000 people. Intention to treat analysis. Study population: Smokers (n = 3024 aged 14 to 75 years consulting for any reason to PCC and who provided written informed consent to participate in the trial. Intervention: 6-month implementation of recommendations of a Clinical Practice Guideline which includes brief motivational interviews for smokers at the precontemplation – contemplation stage, brief intervention for smokers in preparation-action who do not want help, intensive intervention with pharmacotherapy for smokers in preparation-action who want help, and reinforcing intervention in the maintenance stage. Control group: usual care. Outcome measures: Self-reported abstinence confirmed by exhaled air carbon monoxide concentration of ≤ 10 parts per million. Points of assessment: end of intervention period and 1 and 2 years post-intervention; continuous abstinence rate for 1 year; change in smoking cessation stage; health status measured by SF-36. Discussion The

  5. [Smoking cessation therapies in Germany].

    Science.gov (United States)

    Kröger, C; Gradl, S

    2010-02-01

    Reducing the consumption of tobacco products in Germany is a health objective that is achievable with smoking cessation treatments for smokers. This objective turns out to be more successful when using different interventions for smoking cessation than with self-initiated smoking cessation methods. This survey describes the range of smoking cessation treatments in Germany and evaluates them on the basis of international guidelines.

  6. Web-based smoking cessation intervention that transitions from inpatient to outpatient: study protocol for a randomized controlled trial

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    Harrington Kathleen F

    2012-08-01

    Full Text Available Abstract Background E-health tools are a new mechanism to expand patient care, allowing supplemental resources to usual care, including enhanced patient-provider communication. These applications to smoking cessation have yet to be tested in a hospitalized patient sample. This project aims to evaluate the effectiveness and cost-effectiveness of a tailored web-based and e-message smoking cessation program for current smokers that, upon hospital discharge, transitions the patient to continue a quit attempt when home (Decide2Quit. Design A randomized two-arm follow-up design will test the effectiveness of an evidence- and theoretically-based smoking cessation program designed for post-hospitalization. Methods A total of 1,488 patients aged 19 or older, who smoked cigarettes in the previous 30 days, are being recruited from 27 patient care areas of a large urban university hospital. Study-eligible hospitalized patients receiving usual tobacco cessation usual care are offered study referral. Trained hospital staff assist the 744 patients who are being randomized to the intervention arm with registration and orientation to the intervention website. This e-mail and web-based program offers tailored messages as well as education, self-assessment and planning aids, and social support to promote tobacco use cessation. Condition-blind study staff assess participants for tobacco use history and behaviors, tobacco use cost-related information, co-morbidities and psychosocial factors at 0, 3, 6, and 12 months. The primary outcome is self-reported 30-day tobacco abstinence at 6 months follow-up. Secondary outcomes include 7-day point prevalence quit rates at 3-, 6-, and 12-month follow-up, 30-day point prevalence quit rates at 3 and 12 months, biologically confirmed tobacco abstinence at 6-month follow-up, and multiple point-prevalence quit rates based on self-reported tobacco abstinence rates at each follow-up time period. Healthcare utilization and quality

  7. Intervention to assess and improve the knowledge and attitudes of health professionals in brief counseling for smoking cessation: The B.O.A.T program (Brief Opportunistic Advice Training Program for smoking cessation

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    Konstantina Kikkini-Paschou

    2014-01-01

    Full Text Available Smoking is the leading preventable cause of morbidity and mortality worldwide. Health care professionals can contribute to controlling the epidemic of smoking by applying brief counseling for smoking cessation in clinical practice. Purpose: The program B.O.A.T was implemented to increase knowledge and enhance health professionals’ attitudes on the brief counseling for smoking cessation. The purpose of the intervention was to enforce participants' intention to implement counseling. Material and Method: The research project was a pretest-posttest equivalent groups design. The sample consisted of 33 health professionals of various specialties. The intervention consisted of a two-hour training course and distribution of printed material. Attitudes, subjective norm, perceived control and intention of health professionals were measured, regarding the counseling in smoking cessation. Results: Statistical analysis showed an increase of perceived control in the experimental group (p = 0.031 and increase of its intention to implement smoking cessation counseling compared to the comparison group (p = 0.003. There was no difference between and within groups before and after the intervention for the variables of attitudes and subjective norm. The evaluation also showed an increase of knowledge in the experimental group. Conclusion: This study reinforces the current literature which supports that training health professionals on smoking cessation counseling can be effective. The theoretical background turns out to be important. In the future more time and resources should be invested to increase effectiveness and efficiency of such programs.

  8. Brief intervention to promote smoking cessation and improve glycemic control in smokers with type 2 diabetes: a randomized controlled trial

    Science.gov (United States)

    Li, William H. C.; Wang, M. P.; LAM, T. H.; Cheung, Yannes T. Y.; Cheung, Derek Y. T.; Suen, Y. N.; Ho, K. Y.; Tan, Kathryn C. B.; CHAN, Sophia S. C.

    2017-01-01

    The aim of the study was to examine the effects of a brief stage-matched smoking cessation intervention group compared with a control group (with usual care) in type 2 diabetes mellitus patients who smoked by randomized controlled trial. There were 557 patients, randomized either into the intervention group (n = 283) who received brief (20- minute) individualized face-to-face counseling by trained nurses and a diabetes mellitus-specific leaflet, or a control group (n = 274) who received standard care. Patient follow-ups were at 1 week, 1 month, 3 months, 6 months, and 12 months via telephone, and assessment of smoking status from 2012 to 2014. Patients smoked an average of 14 cigarettes per day for more than 37 years, and more than 70% were in the precontemplation stage of quitting. The primary outcome showed that both the intervention and control groups had similar 7-day point-prevalence smoking abstinence (9.2% vs. 13.9%; p = 0.08). The secondary outcome showed that HbA1c levels with 7.95% [63 mmol/mol] vs. 8.05% [64 mmol/mol], p = 0.49 at 12 months, respectively. There was no evidence for effectiveness in promoting the brief stage-matched smoking cessation or improving glycemic control in smokers with type 2 diabetes mellitus, particularly those in the pre-contemplation stage. PMID:28378764

  9. A teachable moment communication process for smoking cessation talk: description of a group randomized clinician-focused intervention

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    Flocke Susan A

    2012-05-01

    Full Text Available Abstract Background Effective clinician-patient communication about health behavior change is one of the most important and most overlooked strategies to promote health and prevent disease. Existing guidelines for specific health behavior counseling have been created and promulgated, but not successfully adopted in primary care practice. Building on work focused on creating effective clinician strategies for prompting health behavior change in the primary care setting, we developed an intervention intended to enhance clinician communication skills to create and act on teachable moments for smoking cessation. In this manuscript, we describe the development and implementation of the Teachable Moment Communication Process (TMCP intervention and the baseline characteristics of a group randomized trial designed to evaluate its effectiveness. Methods/Design This group randomized trial includes thirty-one community-based primary care clinicians practicing in Northeast Ohio and 840 of their adult patients. Clinicians were randomly assigned to receive either the Teachable Moments Communication Process (TMCP intervention for smoking cessation, or the delayed intervention. The TMCP intervention consisted of two, 3-hour educational training sessions including didactic presentation, skill demonstration through video examples, skills practices with standardized patients, and feedback from peers and the trainers. For each clinician enrolled, 12 patients were recruited for two time points. Pre- and post-intervention data from the clinicians, patients and audio-recorded clinician‒patient interactions were collected. At baseline, the two groups of clinicians and their patients were similar with regard to all demographic and practice characteristics examined. Both physician and patient recruitment goals were met, and retention was 96% and 94% respectively. Discussion Findings support the feasibility of training clinicians to use the Teachable Moments

  10. Design and Testing of an Interactive Smoking Cessation Intervention for Inner-City Women

    Science.gov (United States)

    McDaniel, Anna M.; Casper, Gail R.; Hutchison, Sondra K.; Stratton, Renee M.

    2005-01-01

    The purpose of this study was to design and test the usability of a computer-mediated smoking cessation program for inner-city women. Design and content were developed consistent with principles of user-centered design. Formative and summative evaluation strategies were utilized in its testing. The summative evaluation was designed to test…

  11. Project EX-India: A classroom-based tobacco use prevention and cessation intervention program.

    Science.gov (United States)

    Sidhu, Anupreet Kaur; Sussman, Steve; Tewari, Abha; Bassi, Shalini; Arora, Monika

    2016-02-01

    Tobacco use experimentation is most frequent between the ages of 15–24 in India. Therefore, programming to counteract tobacco use among adolescents is needed. There is a lack of evidence-based teen tobacco use prevention and cessation programs. The current study provides an outcome evaluation of the Project EX tobacco use prevention and cessation program among Indian adolescents (16–18 years). An eight-session classroom-based curriculum was adapted to the Indian context and translated from English to Hindi (local language). Next, it was tested using a quasi-experimental design with 624 Indian students at baseline, involving two program and two control schools, with a three-month post-program follow-up. Project EX involves motivation enhancement (e.g., talk shows and games) and coping skills (e.g., complementary and alternative medicine) components. Program participants rated complementary and alternative medicine (CAM) activities like meditation, yoga and healthy breathing higher than talk shows and games. Compared to the standard care control condition, the program condition revealed a prevention effect, but not a cessation effect. Implications for prevention/cessation programming among Indian teens are discussed. This study was approved by the Independent Ethics Committee, Mumbai.

  12. A cost-utility analysis of lung cancer screening and the additional benefits of incorporating smoking cessation interventions.

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    Andrea C Villanti

    Full Text Available BACKGROUND: A 2011 report from the National Lung Screening Trial indicates that three annual low-dose computed tomography (LDCT screenings for lung cancer reduced lung cancer mortality by 20% compared to chest X-ray among older individuals at high risk for lung cancer. Discussion has shifted from clinical proof to financial feasibility. The goal of this study was to determine whether LDCT screening for lung cancer in a commercially-insured population (aged 50-64 at high risk for lung cancer is cost-effective and to quantify the additional benefits of incorporating smoking cessation interventions in a lung cancer screening program. METHODS AND FINDINGS: The current study builds upon a previous simulation model to estimate the cost-utility of annual, repeated LDCT screenings over 15 years in a high risk hypothetical cohort of 18 million adults between age 50 and 64 with 30+ pack-years of smoking history. In the base case, the lung cancer screening intervention cost $27.8 billion over 15 years and yielded 985,284 quality-adjusted life years (QALYs gained for a cost-utility ratio of $28,240 per QALY gained. Adding smoking cessation to these annual screenings resulted in increases in both the costs and QALYs saved, reflected in cost-utility ratios ranging from $16,198 per QALY gained to $23,185 per QALY gained. Annual LDCT lung cancer screening in this high risk population remained cost-effective across all sensitivity analyses. CONCLUSIONS: The findings of this study indicate that repeat annual lung cancer screening in a high risk cohort of adults aged 50-64 is highly cost-effective. Offering smoking cessation interventions with the annual screening program improved the cost-effectiveness of lung cancer screening between 20% and 45%. The cost-utility ratios estimated in this study were in line with other accepted cancer screening interventions and support inclusion of annual LDCT screening for lung cancer in a high risk population in clinical

  13. Nurse-initiated intervention programs: future directions for cessation and prevention of adolescent smoking.

    Science.gov (United States)

    Hebb, Andrea L O

    2014-01-01

    Tobacco use in adolescence remains at unacceptable levels. Increasing teen knowledge about the dangers of smoking appears to be insufficient in changing adolescent attitudes regarding the use of tobacco. To incite change and increase their effectiveness, adult smoking cessation programs need to be tailored to adolescents. Ultimately, intrapersonal, interpersonal, and environmental factors that underlie tobacco use and smoking behaviors in adolescents must be identified. The nurse's role is both in identification of the adolescent smoker and assessment of the smoking behavior. Future directions in nursing practice, nursing education, and research surrounding tobacco use in youth are discussed.

  14. Changes in risk perception following a smoking cessation intervention: the role of acculturation in a sample of Latino caregivers.

    Science.gov (United States)

    Wagener, Theodore L; Busch, Andrew M; Dunsiger, Shira I; Chiang, Karl S; Borrelli, Belinda

    2014-10-01

    The present exploratory study examined the role of acculturation in the perception of the risks of smoking following a smoking cessation induction intervention among Latino caregivers of children with asthma. The sample consisted of 131 Latino smokers (72.9% female; 18.3% born in the U.S.) who were caregivers of a child with asthma. Caregivers were randomized to one of two smoking cessation interventions that were part of a home-based asthma program. Self-report measures of risk-perception were assessed at baseline, end of treatment (2 months after baseline), and 2- and 3-months post-treatment. At baseline, caregivers, regardless of level of acculturation, reported moderate to high levels of concern about the effects of secondhand smoke on their child's health as well as perceived risk regarding the effect of smoking on their own health. However, caregivers who were low in acculturation had a greater increase in concern about the effects of smoking on their child from pre-to post treatment compared to those who were high in acculturation (p = .001). Lastly, level of acculturation moderated the association between caregivers' concern about smoking on their child's health and their motivation to quit smoking (p .05). Specifically, motivation to quit at 3 months was greater for those with low acculturation. Though exploratory, these findings suggest that risk perception may be more easily influenced in low versus high acculturated populations and this should be considered in the design of clinical interventions and potentially mass media campaigns seeking to influence risk of caregiver behavior on child health with ethnic and racial minorities.

  15. Prevention of cardiovascular diseases: Role of exercise, dietary interventions, obesity and smoking cessation.

    Science.gov (United States)

    Buttar, Harpal S; Li, Timao; Ravi, Nivedita

    2005-01-01

    Hypertension, myocardial infarction, atherosclerosis, arrhythmias and valvular heart disease, coagulopathies and stroke, collectively known as cardiovascular diseases (CVDs), contribute greatly to the mortality, morbidity and economic burden of illness in Canada and in other countries. It has been estimated that over four million Canadians have high blood pressure, a comorbid condition that doubles or triples the risk of CVD. According to the Heart and Stroke Foundation of Canada, CVDs caused 36% of deaths in 2001 and were responsible for 18% of the total hospital costs in Canada. The majority of Canadians exhibit at least one CVD-related risk factor, such as tobacco smoking, physical inactivity, diabetes, obesity, hypertension, a lack of daily fruit and vegetable consumption, and psychosocial factors, making these people more prone to developing a serious CVD-related illness in the future. It is therefore important that CVD-related causes and concerns be addressed. Given the scope and prevalence of CVDs, it is obvious that a population health approach - 'prevention is better than cure' - would be the most appropriate model to adopt to deal with this ubiquitous health problem and to reduce the costs of hospitalization, long-term medication and rehabilitation. The focus of the present review is to evaluate and compare the results of epidemiological, experimental and clinical studies, reporting on the influence of physical activity, dietary intervention, obesity and cigarette smoking on cardiovascular health and the prevention of CVDs. The prophylactic measures must be dealt with collectively because there is overwhelming evidence that the occurrence of CVDs can be reduced by approximately 80% by making lifestyle modifications. The preventive strategies against CVDs must be targeted at a primary health promotion level before some of the important underlying causes of CVD seriously afflict a person or a population at large. Such preventive approaches would help in

  16. The QUIT-PRIMO provider-patient Internet-delivered smoking cessation referral intervention: a cluster-randomized comparative effectiveness trial: study protocol

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    Ford Daniel E

    2010-11-01

    Full Text Available Abstract Background Although screening for tobacco use is increasing with electronic health records and standard protocols, other tobacco-control activities, such as referral of patients to cessation resources, is quite low. In the QUIT-PRIMO study, an online referral portal will allow providers to enter smokers' email addresses into the system. Upon returning home, the smokers will receive automated emails providing education about tobacco cessation and encouragement to use the patient smoking cessation website (with interactive tools, educational resources, motivational email messages, secure messaging with a tobacco treatment specialist, and online support group. Methods The informatics system will be evaluated in a comparative effectiveness trial of 160 community-based primary care practices, cluster-randomized at the practice level. In the QUIT-PRIMO intervention, patients will be provided a paper information-prescription referral and then "e-referred" to the system. In the comparison group, patients will receive only the paper-based information-prescription referral with the website address. Once patients go to the website, they are subsequently randomized within practices to either a standard patient smoking cessation website or an augmented version with access to a tobacco treatment specialist online, motivational emails, and an online support group. We will compare intervention and control practice participation (referral rates and patient participation (proportion referred who go to the website. We will then compare the effectiveness of the standard and augmented patient websites. Discussion Our goal is to evaluate an integrated informatics solution to increase access to web-delivered smoking cessation support. We will analyze the impact of this integrated system in terms of process (provider e-referral and patient login and patient outcomes (six-month smoking cessation. Trial Registration Web-delivered Provider Intervention for

  17. Cognitive changes in cardiovascular patients following a tailored behavioral smoking cessation intervention

    NARCIS (Netherlands)

    Oort, FJ; Dijkstra, A; de Haes, JCJM; Legemate, DA; Smets, EMA

    2005-01-01

    Background. Action aimed at changing smoking behavior to prevent cardiovascular patients from further impairing their health is advisable. Cognitive behavioral interventions can be effective in this regard since they attempt to influence cognitive determinants that presumably lead to smoking cessati

  18. Randomized Controlled Trial of Behavioral Activation Smoking Cessation Treatment for Smokers with Elevated Depressive Symptoms

    Science.gov (United States)

    MacPherson, Laura; Tull, Matthew T.; Matusiewicz, Alexis K.; Rodman, Samantha; Strong, David R.; Kahler, Christopher W.; Hopko, Derek R.; Zvolensky, Michael J.; Brown, Richard A.; Lejuez, C. W.

    2010-01-01

    Objective: Depressive symptoms are associated with poor smoking cessation outcomes, and there remains continued interest in behavioral interventions that simultaneously target smoking and depressive symptomatology. In this pilot study, we examined whether a behavioral activation treatment for smoking (BATS) can enhance cessation outcomes. Method:…

  19. Efficacy of a Brief Intervention to Improve Emergency Physicians' Smoking Cessation Counseling Skills, Knowledge, and Attitudes

    Science.gov (United States)

    Bernstein, Steven L.; Boudreaux, Edwin D.; Cabral, Lisa; Cydulka, Rita K.; Schwegman, David; Larkin, Gregory L.; Adams, Annette L.; McCullough, Lynne B.; Rhodes, Karin V.

    2009-01-01

    The objective of this study was to test whether a brief educational/administrative intervention could increase tobacco counseling by emergency physicians (EPs). Pre-/post-study at eight emergency departments (EDs) with residency programs were carried out. EPs received a 1-hour lecture on the health effects of smoking and strategies to counsel…

  20. Patient education for alcohol cessation intervention at the time of acute fracture surgery

    DEFF Research Database (Denmark)

    Tønnesen, Hanne; Egholm, Julie Weber; Oppedal, Kristian

    2015-01-01

    BACKGROUND: Patients with hazardous alcohol intake are overrepresented in emergency departments and surgical wards. These patients have an increased risk of postoperative complications with prolonged hospital stays and admissions to intensive care unit after surgery. In elective surgery...... at university hospitals in Denmark, Sweden and Norway. Included patients will be randomly allocated to either standard care or the gold standard programme aimed at complete alcohol abstinence before, during and 6 weeks after surgery. It includes a structured patient education programme and weekly interventions...

  1. Does Effectiveness of Adolescent Smoking-Cessation Intervention Endure Into Young Adulthood? 7-Year Follow-Up Results from a Group-Randomized Trial.

    Directory of Open Access Journals (Sweden)

    Arthur V Peterson

    Full Text Available The Hutchinson Study of High School Smoking was the first randomized trial to show effectiveness of a smoking cessation intervention on 6-months prolonged smoking abstinence at one year post-intervention in a large population-based sample of adolescent smokers. An important question remains: Do the positive effects from teen smoking cessation interventions seen at up to 12 months post-intervention endure into young adulthood? This study examines for the first time whether such positive early effects from teen smoking cessation intervention can endure into young adulthood in the absence of additional intervention.High school smokers (n = 2,151 were proactively recruited into the trial from fifty randomly selected Washington State high schools randomized to the experimental (Motivational Interviewing + Cognitive Behavioral Skills Training telephone counseling intervention or control (no intervention condition. These smokers were followed to 7 years post high school to ascertain rates of six-year prolonged smoking abstinence in young adulthood. All statistical tests are two-sided.No evidence of intervention impact at seven years post high school was observed for the main endpoint of six-year prolonged abstinence, neither among all smokers (14.2% in the experimental condition vs. 13.1% in the control condition, difference = +1.1%, 95% confidence interval (CI = -3.4 to 5.8, p = .61, nor among the subgroups of daily smokers and less-than-daily smokers, nor among other a priori subgroups. But, observed among males was some evidence of an intervention impact on two endpoints related to progress towards quitting: reduction in number of days smoked in the past month, and increase in the length of the longest quit attempt in the past year.There was no evidence from this trial among adolescent smokers that positive effectiveness of the proactive telephone intervention for smoking abstinence, observed previously at one year post-intervention, was sustained

  2. Research Advance in Smoking Cessation Interventions for the Smoking Diabetic Patients%吸烟糖尿病患者戒烟干预的研究进展

    Institute of Scientific and Technical Information of China (English)

    游涛; 马丽萍; 张蕾; 沈司京(综述); 吝战权(审校)

    2015-01-01

    吸烟是糖尿病发生、发展的重要危险因素。烟草中的尼古丁可通过影响胰岛素分泌、导致胰岛素抵抗和糖代谢紊乱等途径促进糖尿病的发生和发展,并加速糖尿病大血管和微血管的病变,而戒烟可降低糖尿病的患病率。有效的戒烟干预包括医务人员参与糖尿病吸烟患者的戒烟教育、制定合理的戒烟目标和对糖尿病患者进行戒烟心理干预等。该文专门针对吸烟的糖尿病患者,探讨吸烟与糖尿病的关系及如何进行戒烟干预。%Cigarette smoking is an independent risk factor for the onset and development of diabetes. Nicotine in tobacco can exacerbate the onset and progression of diabetes,and accelerate macrovascular and microvascular lesions by affecting insulin secretion ,leading to insulin resistance and glucose metabolism dis-orders,etc.Long-term smoking cessation can reduce the morbidity of diabetes .Effective smoking cessation interventions include the education on smoking cessation,developing a reasonable goal and diabetes psycho-logical intervention.Here is to discuss the relationship between smoking and diabetes,and how to conduct smoking cessation interventions for the smoking diabetic patients .

  3. Comparison of a high and a low intensity smoking cessation intervention in a dentistry setting in Sweden – a randomized trial

    Directory of Open Access Journals (Sweden)

    Rosenblad Andreas

    2009-04-01

    Full Text Available Abstract Background Tobacco is still the number one life style risk factor for ill health and premature death and also one of the major contributors to oral problems and diseases. Dentistry may be a potential setting for several aspects of clinical public health interventions and there is a growing interest in several countries to develop tobacco cessation support in dentistry setting. The aim of the present study was to assess the relative effectiveness of a high intensity intervention compared with a low intensity intervention for smoking cessation support in a dental clinic setting. Methods 300 smokers attending dental or general health care were randomly assigned to two arms and referred to the local dental clinic for smoking cessation support. One arm received support with low intensity treatment (LIT, whereas the other group was assigned to high intensity treatment (HIT support. The main outcome measures included self-reported point prevalence and continuous abstinence (≥ 183 days at the 12-month follow-up. Results Follow-up questionnaires were returned from 86% of the participants. People in the HIT-arm were twice as likely to report continuous abstinence compared with the LIT-arm (18% vs. 9%, p = 0.02. There was a difference (not significant between the arms in point prevalence abstinence in favour of the HIT-protocol (23% vs. 16%. However, point prevalence cessation rates in the LIT-arm reporting additional support were relatively high (23% compared with available data assessing abstinence in smokers trying to quit without professional support. Conclusion Screening for willingness to quit smoking within the health care system and offering smoking cessation support within dentistry may be an effective model for smoking cessation support in Sweden. The LIT approach is less expensive and time consuming and may be appropriate as a first treatment option, but should be integrated with other forms of available support in the community. The

  4. Disseminating a smoking cessation intervention to childhood and young adult cancer survivors: baseline characteristics and study design of the partnership for health-2 study

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    Levy Andrea

    2011-05-01

    Full Text Available Abstract Background Partnership for Health-2 (PFH-2 is a web-based version of Partnership for Health, an evidence-based smoking cessation intervention for childhood cancer survivors. This paper describes the PFH-2 intervention and baseline data collection. Methods 374 childhood and young adult cancer survivors were recruited from five cancer centers and participated in the baseline assessment. At baseline, participants completed measures of their smoking behavior, self-efficacy and stage of change for quitting smoking as well as psychological and environmental factors that could impact their smoking behavior. Results At baseline, 93% of survivors smoked in the past seven days; however, 89% smoked a pack or less during this period. Forty-seven percent were nicotine dependent, and 55% had made at least one quit attempt in the previous year. Twenty-two percent of survivors were in contemplation for quitting smoking; of those 45% were somewhat or very confident that they could quit within six months. Sixty-three percent were in preparation for quitting smoking; however, they had relatively low levels of confidence that they could quit smoking in the next month. In multivariate analyses, stage of change, self-efficacy, social support for smoking cessation, smoking policy at work and home, fear of cancer recurrence, perceived vulnerability, depression, BMI, and contact with the healthcare system were associated with survivors' smoking behavior. Discussions/Conclusions A large proportion of the sample was nicotine dependent, yet motivated to quit. Individual- interpersonal- and environmental-level factors were associated with survivors' smoking behavior. Smoking is particularly dangerous for childhood and young adult cancer survivors. This population may benefit from a smoking cessation intervention designed to build self-efficacy and address other known predictors of smoking behavior.

  5. Early Cessation of Adenosine Diphosphate Receptor Inhibitors Among Acute Myocardial Infarction Patients Treated With Percutaneous Coronary Intervention

    DEFF Research Database (Denmark)

    Fosbøl, Emil L; Ju, Christine; Anstrom, Kevin J

    2016-01-01

    BACKGROUND: Guidelines recommend the use of adenosine diphosphate receptor inhibitor (ADPri) therapy for 1 year postacute myocardial infarction; yet, early cessation of therapy occurs frequently in clinical practice. METHODS AND RESULTS: We examined 11 858 acute myocardial infarction patients tre...... adverse cardiovascular event risk. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01088503....

  6. The impact of a minimal smoking cessation intervention for pregnant women and their partners on perinatal smoking behaviour in primary health care: A real-life controlled study

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    Jenssen Jon A

    2008-09-01

    Full Text Available Abstract Background There is a demand for strategies to promote smoking cessation in high-risk populations like smoking pregnant women and their partners. The objectives of this study were to investigate parental smoking behaviour during pregnancy after introduction of a prenatal, structured, multi-disciplinary smoking cessation programme in primary care, and to compare smoking behaviour among pregnant women in the city of Trondheim with Bergen and Norway. Methods Sequential birth cohorts were established to evaluate the intervention programme from September 2000 to December 2004 in primary care as a part of the Prevention of Allergy among Children in Trondheim study (PACT. The primary outcome variables were self reported smoking behaviour at inclusion and six weeks postnatal. Data from the Medical Birth Registry of Norway (MBR were used to describe smoking cessation during pregnancy in Trondheim, Bergen and Norway 1999–2004. Results Maternal smoking prevalence at inclusion during pregnancy were 5% (CI 95% 4–6 in the intervention cohort compared to 7% (CI 95% 6–9, p = 0.03, in the control cohort. Of the pre-pregnancy maternal smokers 25% (CI 95% 20–31 and 32% (CI 95% 26–38, p = 0.17, were still smoking at inclusion in the intervention and control cohorts, respectively. Six weeks postnatal 72% (CI 95% 59–83 and 68% (CI 95% 57–77, p = 0.34 of the maternal smokers at inclusion still smoked. No significant difference in paternal smoking between the cohorts was found after the intervention period. Data from the MBR showed a significantly higher proportion of women who stopped smoking during pregnancy in Trondheim than in Bergen in 2003 and 2004, p = 0.03 and Conclusion No impact on parental smoking behaviour between the cohorts was observed after the smoking intervention programme. Of the women who stopped smoking during pregnancy most of them stopped smoking before the intervention. However, we observed a significantly higher quitting

  7. Effectiveness of smoking-cessation interventions for urban hospital patients: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Grossman Ellie

    2012-08-01

    Full Text Available Abstract Background Hospitalization may be a particularly important time to promote smoking cessation, especially in the immediate post-discharge period. However, there are few studies to date that shed light on the most effective or cost-effective methods to provide post-discharge cessation treatment, especially among low-income populations and those with a heavy burden of mental illness and substance use disorders. Methods/design This randomized trial will compare the effectiveness and cost-effectiveness of two approaches to smoking cessation treatment among patients discharged from two urban public hospitals in New York City. During hospitalization, staff will be prompted to ask about smoking and to offer nicotine replacement therapy (NRT on admission and at discharge. Subjects will be randomized on discharge to one of two arms: one arm will be proactive multi-session telephone counseling with motivational enhancement delivered by study staff, and the other will be a faxed or online referral to the New York State Quitline. The primary outcome is 30-day point-prevalence abstinence from smoking at 6-month follow-up post-discharge. We will also examine cost-effectiveness from a societal and a payer perspective, as well as explore subgroup analyses related to patient location of hospitalization, race/ethnicity, immigrant status, and inpatient diagnosis. Discussion This study will explore issues of implementation feasibility in a post-hospitalization patient population, as well as add information about the effectiveness and cost-effectiveness of different strategies for designing smoking cessation programs for hospitalized patients. Trial registration Clinicaltrials.gov ID# NCT01363245

  8. Personality-Targeted Interventions for Substance Use and Misuse

    OpenAIRE

    2016-01-01

    Purpose of Review Personality factors have been implicated in risk for substance use disorders through longitudinal and neurobiologic studies for over four decades. Only recently, however, have targeted interventions been developed to assist individuals with personality risk factors for substance use disorders manage their risk. This article reviews current practices in personality-targeted interventions and the eight randomised trials examining the efficacy of such approaches with respect to...

  9. Effect of Postpartum Lifestyle Interventions on Weight Loss, Smoking Cessation, and Prevention of Smoking Relapse : A Systematic Review

    NARCIS (Netherlands)

    Hoedjes, Meeke; Berks, Durk; Vogel, Ineke; Franx, Arie; Visser, Willy; Duvekot, Johannes J.; Habbema, J. Dik F.; Steegers, Eric A. P.; Raat, Hein

    2010-01-01

    Postpartum lifestyle interventions are recommended for women after pregnancies complicated by preeclampsia, intrauterine growth restriction, and/or gestational diabetes, since they are at increased cardiovascular risk. To identify potential intervention strategies to reduce this risk, a systematic r

  10. Acceptability of an Internet-based contingency management intervention for smoking cessation: views of smokers, nonsmokers, and healthcare professionals.

    Science.gov (United States)

    Raiff, Bethany R; Jarvis, Brantley P; Turturici, Marissa; Dallery, Jesse

    2013-06-01

    The acceptability of an Internet-based contingency management (CM) intervention for cigarette smoking was evaluated in two experiments. In Experiment 1, 67 participants (46% female) completed an Internet-based CM intervention and then answered questions about the intervention. Experiment 2 assessed the acceptability of the intervention among potential treatment users who had never used the intervention, (smokers, n = 164, 52% female), nonsmokers (n = 166, 73% female), and health-care providers (n = 139, 63% female). Participants in Experiment 2 were randomly assigned to either watch a video describing the standard CM intervention (no-deposit group) or to watch a video about the standard intervention plus a deposit incentive (deposit group). Overall, results of both experiments indicated high acceptability across all dimensions of the intervention. In Experiment 1, 74% (n = 26 of participants in the treatment group) of participants said they would use it if they needed to quit, as well as 92% (n = 150 among smokers) of those in Experiment 2. Of the health-care providers, 81% (n = 113) reported that they would be very likely to recommend the intervention to patients. Participants in both experiments reported that monitoring their progress and earning vouchers were strengths of the intervention. The no-deposit group rated voucher earnings, cash earnings, and cost-effectiveness of the intervention higher than the deposit group. Health-care professionals did not differ in their ratings across video conditions. Overall, the results suggest that Internet-based CM is acceptable as a method to help people quit smoking.

  11. At the Crossroads: Development and Evaluation of a Dementia Caregiver Group Intervention to Assist in Driving Cessation

    Science.gov (United States)

    Stern, Robert A.; D'Ambrosio, Lisa A.; Mohyde, Maureen; Carruth, Anastasia; Tracton-Bishop, Beth; Hunter, Jennifer C.; Daneshvar, Daniel H.; Coughlin, Joseph F.

    2008-01-01

    Deciding when an individual with dementia must reduce or stop driving can be a stressful issue for family caregivers. The purpose of this study was to develop a group intervention to assist these caregivers with driving issues and to provide a preliminary evaluation of the comparative effectiveness of this At the Crossroads intervention.…

  12. Targeting the nucleolus for cancer intervention.

    Science.gov (United States)

    Quin, Jaclyn E; Devlin, Jennifer R; Cameron, Donald; Hannan, Kate M; Pearson, Richard B; Hannan, Ross D

    2014-06-01

    The contribution of the nucleolus to cancer is well established with respect to its traditional role in facilitating ribosome biogenesis and proliferative capacity. More contemporary studies however, infer that nucleoli contribute a much broader role in malignant transformation. Specifically, extra-ribosomal functions of the nucleolus position it as a central integrator of cellular proliferation and stress signaling, and are emerging as important mechanisms for modulating how oncogenes and tumor suppressors operate in normal and malignant cells. The dependence of certain tumor cells to co-opt nucleolar processes to maintain their cancer phenotypes has now clearly been demonstrated by the application of small molecule inhibitors of RNA Polymerase I to block ribosomal DNA transcription and disrupt nucleolar function (Bywater et al., 2012 [1]). These drugs, which selectively kill tumor cells in vivo while sparing normal cells, have now progressed to clinical trials. It is likely that we have only just begun to scratch the surface of the potential of the nucleolus as a new target for cancer therapy, with "suppression of nucleolar stress" representing an emerging "hallmark" of cancer. This article is part of a Special Issue entitled: Role of the Nucleolus in Human Disease.

  13. Minimal-Intervention on smoking cessation: a Meta-analysis%简短戒烟干预研究的Meta分析

    Institute of Scientific and Technical Information of China (English)

    吴蕾; 姜斌; 曾静; 何耀

    2015-01-01

    目的 采用Meta分析评价简短戒烟干预的有效性.方法 计算机检索2000年1月至2014年9月中外生物医学数据库(The Cochrane Library、Medline、EMbase、中文期刊全文数据库、万方电子期刊数据库、维普中文科技期刊数据库和中国生物医学文献数据库)中有关简短戒烟干预随机对照试验,采用Revman 5.1软件进行Meta分析.结果 最终纳入9篇文献,随机效应模型合并RR值(95%CI)=1.57(1.01 ~ 2.44).与未进行干预的吸烟者相比,接受了简短戒烟干预的吸烟者,其戒烟的可能性提高了57%.研究对象为孕妇和就诊患者,干预时间≤10 min的亚组更易戒烟,但各亚组分析结果之间的差异均无统计学意义.结论 简短戒烟干预可提高戒烟率,但该结论尚需纳入更多高质量大样本的随机对照试验加以证实.%Objective To systematically evaluate the effectiveness of Minimal Smoking Cessation Intervention Program (MSCIP) and to provide theoretical basis for the feasibility of implementation in China.Methods Systematically,we searched data from studies published between January,2000 and September,2014 on the database that including Cochrane Library,Medline,EMbase,CNKI,Wanfang,Vip,etc.Studies related to MSCIP were designed by random controlled trials.Meta analysis was performed by Revman 5.1.Results Nine studies were included,with the Random-Effect Model Relative Risk as 1.57 (1.01-2.44),which indicated that the probability of being tobacco abstinent had increased by 57% in the treating group than in the control group.Participants who developed other diseases,being pregnant or the time of receiving intervention messages ≤ 10 minutes,were more likely to quit the program.There were no significant statistically differences noticed between the different subgroups.Conclusion Minimal smoking cessation intervention increased cessation rates,RCTs with a larger sample size are needed to draw the related conclusions.

  14. Does tailoring really make a difference? : the development and evaluation of tailored interventions aimed at benzodiazepine cessation

    NARCIS (Netherlands)

    Wolde, Geeske Brecht ten

    2008-01-01

    Because of the problems associated with chronic benzodiazepine use, there is impetus to prevent and reduce chronic benzodiazepine use. The overall aim was to develop a 'tailor-made' intervention in order to reduce chronic use. Before developing tailored patient education, it is first of all importan

  15. Development of a Twitter-Based Intervention for Smoking Cessation that Encourages High-Quality Social Media Interactions via Automessages

    OpenAIRE

    Pechmann, Cornelia; Pan, Li; Delucchi, Kevin; Lakon, Cynthia M.; Prochaska, Judith J.

    2015-01-01

    Background The medical field seeks to use social media to deliver health interventions, for example, to provide low-cost, self-directed, online self-help groups. However, engagement in online groups is often low and the informational content may be poor. Objective The specific study aims were to explore if sending automessages to online self-help groups encouraged engagement and to see if overall or specific types of engagement related to abstinence. Methods We conducted a Stage I Early Thera...

  16. Strategic targeting of advance care planning interventions: the Goldilocks phenomenon.

    Science.gov (United States)

    Billings, J Andrew; Bernacki, Rachelle

    2014-04-01

    Strategically selecting patients for discussions and documentation about limiting life-sustaining treatments-choosing the right time along the end-of-life trajectory for such an intervention and identifying patients at high risk of facing end-of-life decisions-can have a profound impact on the value of advance care planning (ACP) efforts. Timing is important because the completion of an advance directive (AD) too far from or too close to the time of death can lead to end-of-life decisions that do not optimally reflect the patient's values, goals, and preferences: a poorly chosen target patient population that is unlikely to need an AD in the near future may lead to patients making unrealistic, hypothetical choices, while assessing preferences in the emergency department or hospital in the face of a calamity is notoriously inadequate. Because much of the currently studied ACP efforts have led to a disappointingly small proportion of patients eventually benefitting from an AD, careful targeting of the intervention should also improve the efficacy of such projects. A key to optimal timing and strategic selection of target patients for an ACP program is prognostication, and we briefly highlight prognostication tools and studies that may point us toward high-value AD interventions.

  17. Gender differences in characteristics and outcomes of smokers diagnosed with psychosis participating in a smoking cessation intervention.

    Science.gov (United States)

    Filia, Sacha L; Baker, Amanda L; Gurvich, Caroline T; Richmond, Robyn; Lewin, Terry J; Kulkarni, Jayashri

    2014-03-30

    While research has identified gender differences in characteristics and outcomes of smokers in the general population, no studies have examined this among smokers with psychosis. This study aimed to explore gender differences among 298 smokers with psychosis (schizophrenia, schizoaffective and bipolar affective disorder) participating in a smoking intervention study. Results revealed a general lack of gender differences on a range of variables for smokers with psychosis including reasons for smoking/quitting, readiness and motivation to quit, use of nicotine replacement therapy, and smoking outcomes including point prevalence or continuous abstinence, and there were no significant predictors of smoking reduction status according to gender at any of the follow-up time-points. The current study did find that female smokers with psychosis were significantly more likely than males to report that they smoked to prevent weight gain. Furthermore, the females reported significantly more reasons for quitting smoking and were more likely to be driven by extrinsic motivators to quit such as immediate reinforcement and social influence, compared to the male smokers with psychosis. Clinical implications include specifically focussing on weight issues and enhancing intrinsic motivation to quit smoking for female smokers with psychosis; and strengthening reasons for quitting among males with psychosis.

  18. Perioperative smoking cessation in vascular surgery

    DEFF Research Database (Denmark)

    Kehlet, M.; Heesemann, Sabine; Tonnesen, H.;

    2015-01-01

    Background: The effect of intensive smoking cessation programs on postoperative complications has never before been assessed in soft tissue surgery when smoking cessation is initiated on the day of surgery. Methods: A single-blinded randomized clinical trial conducted at two vascular surgery...... departments in Denmark. The intervention group was offered the Gold Standard Program (GSP) for smoking cessation intervention. The control group was offered the departments' standard care. Inclusion criteria were patients with planned open peripheral vascular surgery and who were daily smokers. According...... intervention and 21 as controls. There was no difference in 30-day complication rates or 6-week abstinence rates between the two groups. Conclusions: A trial assessing the effect of smoking cessation on postoperative complications on the day of soft tissue surgery is still needed. If another trial...

  19. Physical activity as an aid to smoking cessation during pregnancy: Two feasibility studies

    Directory of Open Access Journals (Sweden)

    Marcus Bess

    2008-09-01

    Full Text Available Abstract Background Pharmacotherapies for smoking cessation have not been adequately tested in pregnancy and women are reluctant to use them. Behavioural support alone has a modest effect on cessation rates; therefore, more effective interventions are needed. Even moderate intensity physical activity (e.g. brisk walk reduces urges to smoke and there is some evidence it increases cessation rates in non-pregnant smokers. Two pilot studies assessed i the feasibility of recruiting pregnant women to a trial of physical activity for smoking cessation, ii adherence to physical activity and iii womens' perceptions of the intervention. Methods Pregnant smokers volunteered for an intervention combining smoking cessation support, physical activity counselling and supervised exercise (e.g. treadmill walking. The first study provided six weekly treatment sessions. The second study provided 15 sessions over eight weeks. Physical activity levels and continuous smoking abstinence (verified by expired carbon monoxide were monitored up to eight months gestation. Results Overall, 11.6% (32/277 of women recorded as smokers at their first antenatal booking visit were recruited. At eight months gestation 25% (8/32 of the women achieved continuous smoking abstinence. Abstinent women attended at least 85% of treatment sessions and 75% (6/8 achieved the target level of 110 minutes/week of physical activity at end-of-treatment. Increased physical activity was maintained at eight months gestation only in the second study. Women reported that the intervention helped weight management, reduced cigarette cravings and increased confidence for quitting. Conclusion It is feasible to recruit pregnant smokers to a trial of physical activity for smoking cessation and this is likely to be popular. A large randomised controlled trial is needed to examine the efficacy of this intervention.

  20. New targets for intervention in the treatment of postmenopausal osteoporosis.

    Science.gov (United States)

    Lewiecki, E Michael

    2011-09-20

    Postmenopausal osteoporosis is a disease of high bone remodeling, with an imbalance of bone resorption over bone formation, resulting in decreased bone mineral density and disruption of bone microarchitecture. With our improved understanding of the molecular and cellular regulators and mediators of bone remodeling, new targets for therapeutic intervention have been identified. Receptor activator of nuclear factor κB ligand (RANKL) is the principal regulator of osteoclast differentiation, activity, and survival; denosumab, a fully human monoclonal antibody to RANKL, inhibits bone resorption and is approved for the treatment of women with postmenopausal osteoporosis at high risk of fractures. Cathepsin K is a protease produced by activated osteoclasts that degrades the protein matrix of bone. An inhibitor of cathepsin K, odanacatib, is in phase III clinical trials for the treatment of postmenopausal osteoporosis; it decreases bone resorption while seeming to suppress bone formation less than other antiresorptive agents. Sclerostin is a cytokine produced by osteocytes that inhibits osteoblastic bone formation; investigational monoclonal antibodies to sclerostin, such as AMG 785, have osteoanabolic properties with the potential to improve clinical outcomes in patients with osteoporosis. These and other novel interventions that target newly recognized regulators of bone remodeling are promising agents for the treatment of osteoporosis.

  1. Long-term effects of a preoperative smoking cessation programme

    DEFF Research Database (Denmark)

    Villebro, Nete Munk; Pedersen, Tom; Møller, Ann M;

    2008-01-01

    Preoperative smoking intervention programmes reduce post-operative complications in smokers. Little is known about the long-term effect upon smoking cessation.......Preoperative smoking intervention programmes reduce post-operative complications in smokers. Little is known about the long-term effect upon smoking cessation....

  2. The cell's nucleolus: an emerging target for chemotherapeutic intervention.

    Science.gov (United States)

    Pickard, Amanda J; Bierbach, Ulrich

    2013-09-01

    The transient nucleolus plays a central role in the up-regulated synthesis of ribosomal RNA (rRNA) to sustain ribosome biogenesis, a hallmark of aberrant cell growth. This function, in conjunction with its unique pathohistological features in malignant cells and its ability to mediate apoptosis, renders this sub-nuclear structure a potential target for chemotherapeutic agents. In this Minireview, structurally and functionally diverse small molecules are discussed that have been reported to either interact with the nucleolus directly or perturb its function indirectly by acting on its dynamic components. These molecules include all major classes of nucleic-acid-targeted agents, antimetabolites, kinase inhibitors, anti-inflammatory drugs, natural product antibiotics, oligopeptides, as well as nanoparticles. Together, these molecules are invaluable probes of structure and function of the nucleolus. They also provide a unique opportunity to develop novel strategies for more selective and therefore better-tolerated chemotherapeutic intervention. In this regard, inhibition of RNA polymerase-I-mediated rRNA synthesis appears to be a promising mechanism for killing cancer cells. The recent development of molecules targeted at G-quadruplex-forming rRNA gene sequences, which are currently undergoing clinical trials, seems to attest to the success of this approach.

  3. Reasons for not using smoking cessation aids

    OpenAIRE

    Völzke Henry; Meyer Christian; Ulbricht Sabina; Schumann Anja; Brose Leonie; Gross Beatrice; Rumpf Hans-Jürgen; John Ulrich

    2008-01-01

    Abstract Background Few smokers use effective smoking cessation aids (SCA) when trying to stop smoking. Little is known why available SCA are used insufficiently. We therefore investigated the reasons for not using SCA and examined related demographic, smoking behaviour, and motivational variables. Methods Data were collected in two population-based studies testing smoking cessation interventions in north-eastern Germany. A total of 636 current smokers who had never used SCA and had attempted...

  4. 手机戒烟干预和网络戒烟干预的国际进展研究%Domestic and International Progress of Mobile Phone-based and Web-based Smoking Cessation Interventions

    Institute of Scientific and Technical Information of China (English)

    王立立; 王燕玲; 姜垣

    2011-01-01

    提供戒烟帮助是控烟工作的重点之一.该文对国际上新显现的手机戒烟干预和网络戒烟干预的发展进行了总结,以期为我国的控烟工作提供借鉴支持.手机和网络戒烟干预方式的共同优势在于:无时间和地域性的限制,范围更广;规避了有些人不愿意面对面交流的忧虑,保护了咨询者的隐私;成本相对较低.二者在可及性、沟通效果、成本效益等方面则各有利弊.%Providing smoking cessation assistance is a key way in tobacco control practice. This paper summarized the progress of mobile phone-based and web-based smoking cessation interventions newly emerged around internationally, which could be experience for China. The mutual advantages of these two ways of interventions were: no time limitation and as well as geography; no necessary of face to face communication for the sake of privacy; and high cost-effective ratio. Meanwhile, the two ways of interventions are different in accessibility, communication effect, and cost, etc.

  5. Smoking cessation intervention within the framework of a lung cancer screening program: preliminary results and clinical perspectives from the "Cosmos-II" Trial.

    Science.gov (United States)

    Filippo, Lococo; Principe, Rosastella; Cesario, Alfredo; Apolone, Giovanni; Carleo, Francesco; Ialongo, Pasquale; Veronesi, Giulia; Cardillo, Giuseppe

    2015-02-01

    Data coming from the literature investigating the effectiveness and interaction between smoking cessation (SC) and lung cancer screening (LCScr) are still sparse and inconsistent. Herein, we report the preliminary results from the ongoing lung cancer screening trial ("Cosmos-II") focusing our analysis on the inter-relationship between the SC program and the LCScr.

  6. Influence of Recruitment Strategy on the Reach and Effect of a Web-Based Multiple Tailored Smoking Cessation Intervention among Dutch Adult Smokers

    Science.gov (United States)

    Smit, Eline Suzanne; Hoving, Ciska; Cox, Vincent Cornelis Maria; de Vries, Hein

    2012-01-01

    This study investigated the influence of two different recruitment strategies on the reach and effect of a web-based multiple tailored smoking cessation program. From May 2009 until June 2010, Dutch adult smokers were recruited via mass media or general practices. Those who completed the baseline questionnaire were followed up during 6 weeks (two…

  7. Targeting IAP proteins for therapeutic intervention in cancer.

    Science.gov (United States)

    Fulda, Simone; Vucic, Domagoj

    2012-02-01

    Evasion of apoptosis is one of the crucial acquired capabilities used by cancer cells to fend off anticancer therapies. Inhibitor of apoptosis (IAP) proteins exert a range of biological activities that promote cancer cell survival and proliferation. X chromosome-linked IAP is a direct inhibitor of caspases - pro-apoptotic executioner proteases - whereas cellular IAP proteins block the assembly of pro-apoptotic protein signalling complexes and mediate the expression of anti-apoptotic molecules. Furthermore, mutations, amplifications and chromosomal translocations of IAP genes are associated with various malignancies. Among the therapeutic strategies that have been designed to target IAP proteins, the most widely used approach is based on mimicking the IAP-binding motif of second mitochondria-derived activator of caspase (SMAC), which functions as an endogenous IAP antagonist. Alternative strategies include transcriptional repression and the use of antisense oligonucleotides. This Review provides an update on IAP protein biology as well as current and future perspectives on targeting IAP proteins for therapeutic intervention in human malignancies.

  8. Smoking cessation and lung cancer screening

    DEFF Research Database (Denmark)

    Pedersen, Jesper Holst; Tønnesen, Philip; Ashraf, Haseem

    2016-01-01

    Smoking behavior may have a substantial influence on the overall effect of lung cancer screening. Non-randomized studies of smoking behavior during screening have indicated that computer tomography (CT) screening induces smoking cessation. Randomized studies have further elaborated that this effect...... and decrease smoking relapse rate. Also low smoking dependency and high motivation to quit smoking at baseline predicted smoking abstinence in screening trials. Lung cancer screening therefore seems to be a teachable moment for smoking cessation. Targeted smoking cessation counselling should be an integrated...... part of future lung cancer screening trials....

  9. Smoking cessation strategies in patients with COPD

    DEFF Research Database (Denmark)

    Warnier, Miriam J; van Riet, Evelien E S; Rutten, Frans H

    2013-01-01

    Smoking cessation is the cornerstone of treatment of chronic obstructive pulmonary disease (COPD) patients. This systematic review evaluates the effectiveness of behavioural and pharmacological smoking cessation strategies in COPD patients. MEDLINE was searched from January 2002 to October 2011....... Randomised controlled trials evaluating the effect of smoking cessation interventions for COPD patients, published in English, were selected. The methodological quality of included trials was assessed using the Delphi list by two reviewers independently. The relative risks of smoking cessation due...... to be of acceptable quality. Pharmacological therapy combined with behavioural counselling was more effective than each strategy separately. In COPD patients, the intensity of counselling did not seem to influence the results, nor did the choice of drug therapy make a difference. This systematic review makes clear...

  10. Huntingtin interactions with membrane phospholipids: strategic targets for therapeutic intervention?

    Science.gov (United States)

    Kegel-Gleason, Kimberly B

    2013-01-01

    The Huntington's disease gene encodes the protein huntingtin (Htt), a soluble protein that largely distributes to the cytoplasm where about half the protein is found in association with membranes. Early studies on Huntington's disease patients suggested changes in membrane phospholipids. Furthermore, changes in phospholipid biosynthetic enzymes have been found in HD cell models using genetic methods. Recent investigations prove that Htt associates with membranes by direct interactions with phospholipids in membranes. Htt contains at least two membrane binding domains, which may work in concert with each other, to target to the appropriate intracellular membranes for diverse functions. Htt has a particular affinity for a specific class of phospholipids called phosphatidylinositol phosphates; individual species of these phospholipids propagate signals promoting cell survival and regulating changes in morphology. Mutant Htt fragments can disrupt synthetic phospholipid bilayers and full-length mutant Htt shows increased binding to numerous phospholipids, supporting the idea that mutant Htt can introduce pathology at the level of phospholipid interactions. There is a great potential to develop therapeutic agents since numerous enzymes regulate the both the biosynthesis/metabolism of lipids and the post-translational modifications of Htt that direct membrane interactions. Understanding the relationship of Htt with membrane phospholipids, and the impact of mutant Htt on membrane-related functions and lipid metabolism, may help identify new modes of therapeutic intervention for Huntington's disease.

  11. Neural Regulation of Pancreatic Cancer: A Novel Target for Intervention

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Aeson [Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria 3052 (Australia); Kim-Fuchs, Corina [Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria 3052 (Australia); Department of Visceral Surgery and Medicine, University Hospital Bern, Bern 3010 (Switzerland); Le, Caroline P. [Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria 3052 (Australia); Hollande, Frédéric [Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria 3052 (Australia); Department of Pathology, University of Melbourne, Parkville 3010 (Australia); Sloan, Erica K., E-mail: erica.sloan@monash.edu [Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria 3052 (Australia); Cousins Center for PNI, UCLA Semel Institute, Jonsson Comprehensive Cancer Center, and UCLA AIDS Institute, University of California Los Angeles, Los Angeles, CA 90095 (United States); Peter MacCallum Cancer Centre, Division of Cancer Surgery, East Melbourne, Victoria 3002 (Australia)

    2015-07-17

    The tumor microenvironment is known to play a pivotal role in driving cancer progression and governing response to therapy. This is of significance in pancreatic cancer where the unique pancreatic tumor microenvironment, characterized by its pronounced desmoplasia and fibrosis, drives early stages of tumor progression and dissemination, and contributes to its associated low survival rates. Several molecular factors that regulate interactions between pancreatic tumors and their surrounding stroma are beginning to be identified. Yet broader physiological factors that influence these interactions remain unclear. Here, we discuss a series of preclinical and mechanistic studies that highlight the important role chronic stress plays as a physiological regulator of neural-tumor interactions in driving the progression of pancreatic cancer. These studies propose several approaches to target stress signaling via the β-adrenergic signaling pathway in order to slow pancreatic tumor growth and metastasis. They also provide evidence to support the use of β-blockers as a novel therapeutic intervention to complement current clinical strategies to improve cancer outcome in patients with pancreatic cancer.

  12. Cachexia and sarcopenia: mechanisms and potential targets for intervention.

    Science.gov (United States)

    Argilés, Josep M; Busquets, Silvia; Stemmler, Britta; López-Soriano, Francisco J

    2015-06-01

    Cachexia is a multi-organ syndrome associated with cancer and other chronic diseases, characterized by body weight loss, muscle and adipose tissue wasting and inflammation, being often associated with anorexia. Skeletal muscle tissue represents more than 40% of body weight and seems to be one of the main tissues involved in the wasting that occurs during cachexia. Sarcopenia is a degenerative loss of skeletal muscle mass, quality, and strength associated with healthy ageing. The molecular mechanisms behind cachexia and sarcopenia share some common trends. Muscle wasting is the result of a combination of an imbalance between synthetic and degradative protein pathways together with increased myocyte apoptosis and decreased regenerative capacity. Oxidative pathways are also altered in skeletal muscle during muscle wasting and this seems to be a consequence of mitochondrial abnormalities that include altered morphology and function, decreased ATP synthesis and uncoupling. The aim of the present review is to analyse common molecular pathways between cachexia and sarcopenia in order to put forward potential targets for intervention.

  13. MicroRNA: an Emerging Therapeutic Target and Intervention Tool

    Directory of Open Access Journals (Sweden)

    Decheng Yang

    2008-06-01

    Full Text Available MicroRNAs (miRNAs are a class of short non-coding RNAs with posttranscriptional regulatory functions. To date, more than 600 human miRNAs have been experimentally identified, and estimated to regulate more than one third of cellular messenger RNAs. Accumulating evidence has linked the dysregulated expression patterns of miRNAs to a variety of diseases, such as cancer, neurodegenerative diseases, cardiovascular diseases and viral infections. MiRNAs provide its particular layer of network for gene regulation, thus possessing the great potential both as a novel class of therapeutic targets and as a powerful intervention tool. In this regard, synthetic RNAs that contain the binding sites of miRNA have been shown to work as a “decoy” or “miRNA sponge” to inhibit the function of specific miRNAs. On the other hand, miRNA expression vectors have been used to restore or overexpress specific miRNAs to achieve a long-term effect. Further, double-stranded miRNA mimetics for transient replacement have been experimentally validated. Endogenous precursor miRNAs have also been used as scaffolds for the induction of RNA interference. This article reviews the recent progress on this emerging technology as a powerful tool for gene regulation studies and particularly as a rationale strategy for design of therapeutics.

  14. Smoking cessation medications

    Science.gov (United States)

    Smoking cessation - medications; Smokeless tobacco - medications; Medications for stopping tobacco ... Creating a plan to help you deal with smoking urges. Getting support from a doctor, counselor, or ...

  15. Legislative, educational, policy and other interventions targeting physicians’ interaction with pharmaceutical companies: a systematic review

    OpenAIRE

    Alkhaled, Lina; Kahale, Lara; Nass, Hala; Brax, Hneine; Fadlallah, Racha; Badr, Kamal; Akl, Elie A

    2014-01-01

    Background Pharmaceutical company representatives likely influence the prescribing habits and professional behaviour of physicians. Objective The objective of this study was to systematically review the effects of interventions targeting practising physicians’ interactions with pharmaceutical companies. Eligibility criteria We included observational studies, non-randomised controlled trials (non-RCTs) and RCTs evaluating legislative, educational, policy or other interventions targeting the in...

  16. Putting tobacco cessation and prevention into undergraduate medical education

    Directory of Open Access Journals (Sweden)

    Sanghamitra Pati

    2014-01-01

    Full Text Available Background: Training medical students in tobacco prevention and cessation skills is critical to have competent physicians who are prepared to address the grave levels of morbidity and mortality associated with tobacco use. However, in India, enough attention has not been given to elicit the active participation of physicians in tobacco control. Keeping this in view, a program was undertaken to develop the skills and competence of medical students with the objective of improving medical student inquiry into smoking and the delivery of advice accordingly for patients in their clinical year′s routine consultations. Methods: The targeted learners were 149 1 st -year medical and dental students of SCB Medical College, Cuttack, Orissa, India, who had appeared the second semester examination; 84 of the participants were male. Students were allowed to appear a test before the training session on knowledge of tobacco cessation and post test was done after 1.5 months of training. The knowledge score was evaluated to evaluate the learning outcome. Results: We observed that a curriculum on tobacco intervention could improve relevant knowledge, attitudes and self-confidence and be applied in students early clinical experiences. Conclusions: There is need of joint action by practicing clinicians, the medical faculty and the curriculum planners of the country to incorporate tobacco cessation into the curriculum.

  17. Evaluation of a smoking cessation program for pregnant minority women.

    Science.gov (United States)

    Lillington, L; Royce, J; Novak, D; Ruvalcaba, M; Chlebowski, R

    1995-01-01

    The purpose of this project was to develop and test culturally appropriate, low literacy, smoking cessation intervention materials designed to increase quit rates and prevent relapse postpartum for low-income African American and Hispanic women. A quasi-experimental, pretest-posttest design was used. Four Women, Infants, and Children (WIC) clinic sites in south and central Los Angeles were identified, pair-matched based on ethnic mix, and randomized to intervention (2 sites) or control status (2 sites). Participants were 18 years of age or older and either current or exsmokers (stopped smoking in the past year). The intervention group received the "Time for a Change: A Program for Healthy Moms and Babies" program including a 15-minute one-to-one counseling session and self-help guide, incorporating behavior-change strategies, booster postcard, and incentive contest. All materials were designed to match the cultural, language, and literacy needs of the target population. The smoking cessation intervention had a positive impact on both quit-smoking behavior during pregnancy and relapse prevention postpartum. Almost twice as many smokers in the intervention group (43%) reported quitting smoking at 9 months, compared to the control group (25%) (P < 0.01). At 6 weeks postpartum, 25% of the intervention baseline smokers were abstinent, compared to 12% of the control group (P < 0.01). Although no significant differences were observed for relapse during pregnancy among exsmokers at 6 weeks postpartum, a significantly higher proportion of intervention exsmokers were still abstinent (79%), compared to control exsmokers (62%) (P < 0.01). For the exsmokers, relapse prevention rates remained significant when adjusted for cotinine validated abstinence.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. The efficacy of vigorous-intensity exercise as an aid to smoking cessation in adults with elevated anxiety sensitivity: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Smits Jasper A J

    2012-11-01

    Full Text Available Abstract Background Although cigarette smoking is a leading cause of death and disability in the United States (US, over 40 million adults in the US currently smoke. Quitting smoking is particularly difficult for smokers with certain types of psychological vulnerability. Researchers have frequently called attention to the relation between smoking and anxiety-related states and disorders, and evidence suggests that panic and related anxiety vulnerability factors, specifically anxiety sensitivity (AS or fear of somatic arousal, negatively impact cessation. Accordingly, there is merit to targeting AS among smokers to improve cessation outcome. Aerobic exercise has emerged as a promising aid for smoking cessation for this high-risk (for relapse group because exercise can effectively reduce AS and other factors predicting smoking relapse (for example, withdrawal, depressed mood, anxiety, and it has shown initial efficacy for smoking cessation. The current manuscript presents the rationale, study design and procedures, and design considerations of the Smoking Termination Enhancement Project (STEP. Methods STEP is a randomized clinical trial that compares a vigorous-intensity exercise intervention to a health and wellness education intervention as an aid for smoking cessation in adults with elevated AS. One hundred and fifty eligible participants will receive standard treatment (ST for smoking cessation that includes cognitive behavioral therapy (CBT and nicotine replacement therapy (NRT. In addition, participants will be randomly assigned to either an exercise intervention (ST+EX or a health and wellness education intervention (ST+CTRL. Participants in both arms will meet 3 times a week for 15 weeks, receiving CBT once a week for the first 7 weeks, and 3 supervised exercise or health and wellness education sessions (depending on randomization per week for the full 15-week intervention. Participants will be asked to set a quit date for 6 weeks after

  19. Intervenciones de consejería para la cesación de la adicción al tabaco: revisión sistemática de la literatura Counseling interventions for smoking cessation: systematic review

    Directory of Open Access Journals (Sweden)

    Luz Helena Alba

    2013-04-01

    Full Text Available OBJETIVO: Presentar los resultados de una revisión sistemática de la literatura médica sobre eficacia y seguridad de la consejería para cesación del tabaquismo. MATERIAL Y MÉTODOS: Se siguió la metodología ADAPTE buscando guías de práctica clínica (GPC en Medline, EMBASE, CINAHL, LILACS y Cochrane. Mediante DELBI se seleccionaron GPC con puntaje mayor a 60 en rigor metodológico y aplicabilidad. Se evaluó la cesación a seis meses según proveedor, modelo y formato de consejería. De 925 referencias se seleccionaron cinco GPC que incluyen 44 revisiones sistemáticas y metaanálisis. RESULTADOS La consejería breve por médicos y la intensiva por profesionales capacitados (individual, grupal, telefónica proactiva son eficaces con incremento en la abstinencia de 2.1 a 17.4%. Únicamente el consejo práctico y la entrevista motivacional tienen eficacia en consejería intensiva. El efecto clínico es pequeño y la duración del efecto incierta. CONCLUSIÓN: Se requieren evaluaciones económicas para su implementación en programas de salud pública.OBJECTIVE: A systematic review on efficacy and safety of smoking cessation counseling was developed. MATERIALS AND METHODS: The ADAPTE methodology was used with a search of Clinical Practice Guidelines (CPG in Medline, EMBASE, CINAHL, LILACS, and Cochrane. DELBI was used to select CPG with score over 60 in methodological rigor and applicability to the Colombian health system. Smoking cessation rates at 6 months were assessed according to counseling provider, model, and format. In total 5 CPG out of 925 references were selected comprising 44 systematic reviews and metaanalyses. RESULTS: Physician brief counseling and trained health professionals' intensive counseling (individual, group, proactive telephone are effective with abstinence rates between 2.1% and 17.4%. Only practical counseling and motivational interview were found effective intensive interventions. The clinical effect of smoking

  20. Indiana family physician attitudes and practices concerning smoking cessation.

    Science.gov (United States)

    Saywell, R M; Jay, S J; Lukas, P J; Casebeer, L L; Mybeck, K C; Parchman, M L; Haley, A J

    1996-01-01

    Most physicians are aware of the health benefits of smoking cessation and agree they have a responsibility to help smokers quit. Many physicians, however, do not regularly address smoking cessation with their patients. Questionnaires were sent to 2,095 family practice physicians in Indiana. Information obtained included: demographic data; office-based smoking cessation practices; counseling; and physicians' perceptions of intervention outcomes. Most physicians (86%) asked new patients if they smoked, and 23% questioned patients about their exposure to passive smoke. Younger physicians, female physicians and urban physicians were more likely to ask new patients if they smoked. A formal smoking cessation program was used by 28% of the responding physicians. Among those not using a program, 7% reported plans to implement one in the coming year, 40% were not planning to implement one, and 53% were unsure. Physician and practice characteristics were not correlated with the use of smoking cessation programs. Only 11% of physicians considered their smoking cessation counseling skills to be excellent; 27% indicated the need for improvement in skills. One-half (52%) believed their counseling efforts were effective; almost half (45%) believed that current reimbursement policies limited their involvement in smoking cessation interventions. Most respondents have not instituted smoking cessation programs in their practices. It is likely that a combination of strategies, including both undergraduate, graduate and continuing medical education programs and reform in reimbursement practices for cessation programs, will be required to achieve significant increases in long-term smoking abstinence rates.

  1. Periostin: a promising target of therapeutical intervention for prostate cancer

    Directory of Open Access Journals (Sweden)

    Ding Weihong

    2011-06-01

    RNA-Periostin LNCap cells growed slowly in vitro and in vivo. The tissues of xenografts as PCa were verificated by HE staining. Additionally, the weak positive Periostin expressed tumor cells could be seen in the tissues of 6 xenografts from the group of down-regulated Periostin LNCap cells which had a significant decrease of the amount of Periostin compared to the other two group. Furthermore, our results demonstrated that sliencing Periostin could inhibit migration of LNCap cells in vitro. Conclusions Our data indicates that Periostin as an up-regulated protein in PCa may be a promising target of therapeutical intervention for PCa in future.

  2. Training health professionals in smoking cessation (Review)

    NARCIS (Netherlands)

    Carson, K.V.; Verbiest, M.E.; Crone, M.R.; Brinn, M.P.; Esterman, A.J.; Assendelft, W.J.J.; Smith, B.J.

    2012-01-01

    BACKGROUND: Cigarette smoking is one of the leading causes of preventable death world wide. There is good evidence that brief interventions from health professionals can increase smoking cessation attempts. A number of trials have examined whether skills training for health professionals can lead th

  3. Addressing Heavy Drinking in Smoking Cessation Treatment: A Randomized Clinical Trial

    Science.gov (United States)

    Kahler, Christopher W.; Metrik, Jane; LaChance, Heather R.; Ramsey, Susan E.; Abrams, David B.; Monti, Peter M.; Brown, Richard A.

    2008-01-01

    Heavy alcohol use frequently co-occurs with cigarette smoking and may impede smoking cessation. This clinical trial examined whether smoking cessation treatment that incorporates brief alcohol intervention can improve smoking cessation outcomes (7-day verified point prevalence abstinence) and reduce drinks consumed per week. Heavy drinkers seeking…

  4. Technology strategy for cost-effective drilling and intervention; Technology Target Areas; TTA4 - Cost effective drilling and intervention

    Energy Technology Data Exchange (ETDEWEB)

    2007-07-01

    The main goals of the OG21 initiative are to (1) develop new technology and knowledge to increase the value creation of Norwegian oil and gas resources and (2) enhance the export of Norwegian oil and gas technology. The OG21 Cost-effective Drilling and Intervention (CEDI) Technology Target Area (TTA) has identified some key strategic drilling and well intervention needs to help meet the goals of OG21. These key strategic drilling and well intervention needs are based on a review of present and anticipated future offshore-Norway drilling and well intervention conditions and the Norwegian drilling and well intervention industry. A gap analysis has been performed to assess the extent to which current drilling and well intervention research and development and other activities will meet the key strategic needs. Based on the identified strategic drilling and well intervention needs and the current industry res each and development and other activities, the most important technology areas for meeting the OG21 goals are: environment-friendly and low-cost exploration wells; low-cost methods for well intervention/sidetracks; faster and extended-reach drilling; deep water drilling, completion and intervention; offshore automated drilling; subsea and sub-ice drilling; drilling through basalt and tight carbonates; drilling and completion in salt formation. More specific goals for each area: reduce cost of exploration wells by 50%; reduce cost for well intervention/sidetracks by 50%; increase drilling efficiency by 40%; reduce drilling cost in deep water by 40 %; enable offshore automated drilling before 2012; enable automated drilling from seabed in 2020. Particular focus should be placed on developing new technology for low-cost exploration wells to stem the downward trends in the number of exploration wells drilled and the volume of discovered resources. The CEDI TTA has the following additional recommendations: The perceived gaps in addressing the key strategic drilling and

  5. Brief preoperative smoking cessation counselling in relation to breast cancer surgery: a qualitative study

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Esbensen, Bente Appel; Samuelsen, Susanne

    2009-01-01

    of cancer diagnosis was difficult for some women. They relapsed to smoking as an ingrown response to emotional distress. The smoking intervention heightened the women's awareness of their addiction to smoking; however, they expressed a need for prolonged smoking cessation support. For others, the smoking......: In newly diagnosed breast cancer patients, brief preoperative smoking intervention motivated smoking cessation. However, prolonged intervention, pre- and postoperatively, may more effectively support cessation in breast cancer patients and should therefore be evaluated in this patient population....

  6. Health service interventions targeting relatives of heart patients

    DEFF Research Database (Denmark)

    Nissen, Nina Konstantin; Madsen, Mette; Olsen Zwisler, Ann-Dorthe

    2008-01-01

    AIMS: Relatives of heart patients experience anxiety, uncertainty, and low quality of life, and the hospitalization of a heart patient is associated with increased risk of death for the partner. Relatives' physical and mental problems may be rectified by activities established by the health...... systematically reviewed to clarify what the health services do for relatives of heart patients and to assess the effects of interventions. We searched Medline, EMBASE, PsycINFO, CINAHL database, CSA and the Cochrane Library from January 2000 to March 2006. RESULTS: Only six scientific articles reported...... on interventions testing health service activities for relatives of heart patients, and one literature review scrutinized earlier studies within the field. All the interventions indicate positive effects on patients' and/or relatives' health and well-being, in accordance with nurses' assessments. Nevertheless...

  7. Knowledge gaps about smoking cessation in hospitalized patients and their doctors.

    OpenAIRE

    Raupach, Tobias; Merker, Jacqueline; Hasenfuß, Gerd; Andreas, Stefan; Pipe, Andrew

    2011-01-01

    BACKGROUND: Hospitalization is an opportune time for smoking cessation support; cessation interventions delivered by hospital physicians are effective. While general practitioners' and outpatients' knowledge and attitudes towards smoking cessation have been studied in great detail, in-patient cessation programmes have received less attention. DESIGN: Questionnaire-based survey of a convenience sample of hospital physicians and in-patients at Göttingen University Hospital, Germany. M...

  8. Engagement and attrition in Internet smoking cessation interventions: Insights from a cross-sectional survey of “one-hit-wonders”

    Directory of Open Access Journals (Sweden)

    Jessie E. Saul

    2016-09-01

    Conclusions: One third of participants that had disengaged from an Internet intervention reported abstinence at follow-up, suggesting that low levels of engagement are not synonymous with treatment failure in all cases. Paid incentives above $25 may be needed to elicit survey responses, especially among those with longer intervals of disengagement from an intervention.

  9. Interventions Targeting Attention in Young Children with Autism

    Science.gov (United States)

    Patten, Elena; Watson, Linda R.

    2011-01-01

    Purpose: The ability to focus and sustain one's attention is critical for learning. Children with autism demonstrate unusual characteristics of attention from infancy. It is reasonable to assume that early anomalies in attention influence a child's developmental trajectories. Therapeutic interventions for autism often focus on core features of…

  10. Educational Interventions Targeted at Minors in Situations of Grave Social Vulnerability and Their Families

    Science.gov (United States)

    de la Caba Collado, Mariangeles; Rojas, Isabel Bartau

    2010-01-01

    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The…

  11. Psychostimulant and Sensory Stimulation Interventions That Target the Reading and Math Deficits of Students with ADHD

    Science.gov (United States)

    Zentall, Sydney S.; Tom-Wright, Kinsey; Lee, Jiyeon

    2013-01-01

    Objective: The purpose of this review of students with attention deficit hyperactivity disorder (ADHD) was to summarize the following: (1) academic deficits in math and reading, (2) possible theoretical contributors to these deficits, and (3) psychostimulant interventions that target math and reading, as well as, parallel interventions involving…

  12. The Use and Effectiveness of a Targeted Math Intervention for Third Graders

    Science.gov (United States)

    Pool, Juli L.; Carter, Gabriel M.; Johnson, Evelyn S.; Carter, Deborah R.

    2013-01-01

    Students who fail to develop proficiency in math skills in the primary grades are more likely to experience difficulties in the math curriculum later on. These students may be in need of a more targeted intervention, or Tier 2 supports, in mathematic instruction. Although the instructional principles of an effective math intervention are becoming…

  13. Pilot Evaluation of a Web-Based Intervention Targeting Sexual Health Service Access

    Science.gov (United States)

    Brown, K. E.; Newby, K.; Caley, M.; Danahay, A.; Kehal, I.

    2016-01-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among…

  14. A SYSTEMATIC REVIEW OF INTERVENTIONS TARGETING PATERNAL MENTAL HEALTH IN THE PERINATAL PERIOD.

    Science.gov (United States)

    Rominov, Holly; Pilkington, Pamela D; Giallo, Rebecca; Whelan, Thomas A

    2016-05-01

    Interventions targeting parents' mental health in the perinatal period are critical due to potential consequences of perinatal mental illness for the parent, the infant, and their family. To date, most programs have targeted mothers. This systematic review explores the current status and evidence for intervention programs aiming to prevent or treat paternal mental illness in the perinatal period. Electronic databases were systematically searched to identify peer-reviewed studies that described an intervention targeting fathers' mental health in the perinatal period. Mental health outcomes included depression, anxiety, and stress as well as more general measures of psychological functioning. Eleven studies were identified. Three of five psychosocial interventions and three massage-technique interventions reported significant effects. None of the couple-based interventions reported significant effects. A number of methodological limitations were identified, including inadequate reporting of study designs, and issues with the timing of interventions. The variability in outcomes measures across the studies made it difficult to evaluate the overall effectiveness of the interventions. Father-focused interventions aimed at preventing perinatal mood problems will be improved if future studies utilize more rigorous research strategies.

  15. Physical activity as an aid to smoking cessation during pregnancy (LEAP trial: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ussher Michael

    2012-10-01

    Full Text Available Abstract Background Many women try to stop smoking in pregnancy but fail. One difficulty is that there is insufficient evidence that medications for smoking cessation are effective and safe in pregnancy and thus many women prefer to avoid these. Physical activity (PA interventions may assist cessation; however, trials examining these interventions have been too small to detect or exclude plausible beneficial effects. The London Exercise And Pregnant smokers (LEAP trial is investigating whether a PA intervention is effective and cost-effective when used for smoking cessation by pregnant women, and will be the largest study of its kind to date. Methods/design The LEAP study is a pragmatic, multi-center, two-arm, randomized, controlled trial that will target pregnant women who smoke at least one cigarette a day (and at least five cigarettes a day before pregnancy, and are between 10 and 24 weeks pregnant. Eligible patients are individually randomized to either usual care (that is, behavioral support for smoking cessation or usual care plus a intervention (entailing supervised exercise on a treadmill plus PA consultations. The primary outcome of the trial is self-reported and biochemically validated continuous abstinence from smoking between a specified quit date and the end of pregnancy. The secondary outcomes, measured at 1 and 4 weeks after the quit date, and at the end of pregnancy and 6 months after childbirth, are PA levels, depression, self-confidence, and cigarette withdrawal symptoms. Smoking status will also be self-reported at 6 months after childbirth. In addition, perinatal measures will be collected, including antenatal complications, duration of labor, mode of delivery, and birth and placental weight. Outcomes will be analyzed on an intention-to-treat basis, and logistic regression models used to compare treatment effects on the primary outcome. Discussion This trial will assess whether a PA intervention is effective when used for

  16. Targeting Energy Metabolic Pathways as Therapeutic Intervention for Breast Cancer

    Science.gov (United States)

    2014-12-01

    observed that the cells with knockdown of eEF-2K expression exhibited a decreased glucose consumption (Fig. 1B), as measured by flow cytometric analysis of......3. DATES COVERED 30 Sep 2011 - 20 Sep 2014 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Targeting Energy Metabolic Pathways as Therapeutic

  17. Reactions to caregiving during an intervention targeting frailty in community living older people

    Directory of Open Access Journals (Sweden)

    Aggar Christina

    2012-10-01

    Full Text Available Abstract Background The demands and consequences of caregiving are considerable. However, such outcomes are not commonly investigated in the evaluation of interventions targeting frailty. This study aims to explore family carers’ reactions to caregiving during an intervention targeting frailty in community living older people. Method A study of carers (n=119 embedded in a 12 month randomised controlled intervention targeting frailty in people 70 years or older, compared to usual care. Reactions to caregiving were measured in the domains of health, finance, self-esteem, family support and daily schedule. Anxiety and depression levels were also evaluated. Carer outcomes were measured at baseline, 6 months and 12 months and at 3 months post frailty intervention. Results Carers of frail older people in the intervention group showed a sustained improvement in health scores during the intervention targeting frailty, while health scores for carers of the frail older people in the control group, decreased and therefore their health worsened (F=2.956, p=0.034. The carers of the frail older people in the intervention group reported overall better health (F=5.303, p=0.023 and self-esteem (F=4.158, p=0.044, and co-resident carers reported higher self-esteem (F=4.088, p=0.046. Anxiety levels increased for carers in both intervention and control groups (F=2.819, p=0.04. Conclusion The inclusion of carers in trials targeting frail older people may assist in the identification of at-risk carers and facilitate the provision of information and support that will assist them to continue providing care. Further research that explores the features of frailty interventions that impact on the caregiving experience is recommended. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12608000565347

  18. 不同干预措施对战士吸烟行为的影响%Effects of psychological intervention, auricular acupuncture and smoking cessation medication on cigarette smoking behavior in soldiers: a pilot randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    姜斌; 左芳; 吴蕾; 何耀; 陈肇始; 郑家强; 林大庆

    2011-01-01

    Objective To evaluate the effects of different smoking cessation interventions on cigarette consumption for young soldiers.Methods Sixty-eight soldiers were prospectively investigated in this randomly controlled clinical trial and assigned to the psychological intervention group,auricular acupuncture group,and smoking cessation medication group.Results All the participants showed significant reduction(33.3% to 73.9%)in post-treatment cigarette consumption.The highest quit rate was found at 7 days,although this declining trend was faded over time.One-year follow-up indicated a 6-month quit rate of 16.7%,23.8% and 30.4% in three groups,respectively.Conclusion Psychological intervention,auricular acupuncture and smoking cessation medication may be effective methods of reducing cigarette consumption and improving quit rate in young soldiers.%目的 探讨和评价不同的干预措施对集体生活年轻人群吸烟行为的影响.方法 将68名吸烟战士随机分为3组,分别采取心理干预、心理干预+耳针和心理干预+药物对其吸烟行为进行干预.采用统一问卷进行基线调查,在1、3、6个月和1年进行随访,观察不同随访时点吸烟量的减少和戒烟率.结果 三组研究对象可比性较好.在1、3、6个月随访时点,各组吸烟者的吸烟量均有不同程度的下降(33.3%~73.9%).在上述各随访时点,7d时点戒烟率均较高,而持续1个月的戒烟率和持续3个月的戒炯率有随时间下降的趋势.但3组1年随访时,持续6个月的戒烟率仍可达到16.7%、23.8%、30.4%.结论 集体管理生活环境中的戒烟心理干预是年轻战士吸烟量的减少和提高戒烟成功率的有效措施之一,药物和耳针等辅助戒烟方法的使用亦有一定的促进作用.

  19. Intervention development to reduce musculoskeletal disorders: Is the process on target?

    Science.gov (United States)

    Oakman, Jodi; Rothmore, Paul; Tappin, David

    2016-09-01

    Work related musculoskeletal disorders remain an intractable OHS problem. In 2002, Haslam proposed applying the stage of change model to target ergonomics interventions and other health and safety prevention activities. The stage of change model proposes that taking into account an individual's readiness for change in developing intervention strategies is likely to improve uptake and success. This paper revisits Haslam's proposal in the context of interventions to reduce musculoskeletal disorders. Effective MSD interventions require a systematic approach and need to take into account a combination of measures. Research evidence suggests that in practice, those charged with the management of MSDs are not consistently adopting such an approach. Consequently, intervention development may not represent contemporary best practice. We propose a potential method of addressing this gap is the stage of change model, and use a case study to illustrate this argument in tailoring intervention development for managing MSDs.

  20. Smoking Cessation: The Role of the Anesthesiologist.

    Science.gov (United States)

    Yousefzadeh, Amir; Chung, Frances; Wong, David T; Warner, David O; Wong, Jean

    2016-05-01

    Smoking increases the risk of postoperative morbidity and mortality. Smoking cessation before surgery reduces the risk of complications. The perioperative period may be a "teachable moment" for smoking cessation and provides smokers an opportunity to engage in long-term smoking cessation. Anesthesiologists as the perioperative physicians are well-positioned to take the lead in this area and improve not only short-term surgical outcomes but also long-term health outcomes and costs. Preoperative interventions for tobacco use are effective to reduce postoperative complications and increase the likelihood of long-term abstinence. If intensive interventions (counseling, pharmacotherapy, and follow-up) are impractical, brief interventions should be implemented in preoperative clinics as a routine practice. The "Ask, Advise, Connect" is a practical strategy to be incorporated in the surgical setting. All anesthesiologists should ask their patients about smoking and strongly advise smokers to quit at every visit. Directly connecting patients to existing counseling resources, such as telephone quitlines, family physicians, or pharmacists using fax or electronic referrals, greatly increases the reach and the impact of the intervention.

  1. Risks and Targeted Interventions: Firearms in Intimate Partner Violence.

    Science.gov (United States)

    Zeoli, April M; Malinski, Rebecca; Turchan, Brandon

    2016-01-01

    The use of firearms in intimate partner violence (IPV) is widely recognized as an important public health threat. However, what we know about the risks of firearm access on IPV outcomes is limited. Therefore, we conducted a systematic review to determine the state of knowledge on 1) the risks of firearm access and use in IPV and 2) the effectiveness of interventions designed specifically to reduce firearm violence in intimate relationships. Only studies published in English in peer-reviewed journals from 1990 through 2014 were included. Results of the review suggest that, when violent intimates have access to firearms, IPV increases in severity and deadliness; however, increases in severity may not be due to firearm use. Additionally, statutes prohibiting persons under domestic violence restraining orders from accessing firearms are associated with reductions in intimate partner homicide, but certain provisions of these laws and their enforcement may impact their effectiveness. Future research should focus on elucidating the link between firearm access and increased IPV severity and on investigating whether and which specific provisions of domestic violence restraining order laws impact the laws' effectiveness. Additionally, more evaluations of initiatives designed to improve the enforcement of domestic violence restraining order firearm prohibitions are needed.

  2. Outcome of a Targeted Nutritional Intervention Among Older Adults With Early-Stage Alzheimer's Disease: The Nutrition Intervention Study.

    Science.gov (United States)

    Shatenstein, Bryna; Kergoat, Marie-Jeanne; Reid, Isabelle

    2016-02-01

    A 6-month dietary intervention program was designed for community-dwelling older adults with Alzheimer's disease. Sixty-seven persons aged 70 years and above were recruited with their caregivers from six hospital memory and geriatric outpatient clinics, and allocated to intervention (n = 34 dyads) or control group (n = 33 dyads). Usual diet was assessed by a validated food frequency questionnaire and current diet by two nonconsecutive diet recalls or records corroborated by caregivers, at recruitment (T1) and exit from the study (T2). Intervention participants received targeted dietary recommendations; control participants received Canada's Food Guide leaflets. The program was assessed using paired and independent t tests and nonparametric statistics. Fat intakes increased at T2 within intervention participants (54 ± 16 vs. 67 ± 23 g, p = .013), and there was a tendency for higher energy, protein, and calcium intakes at T2 within this group. Proportions with adequate protein intakes almost doubled from T1 to T2 in intervention group women (p = .028) but decreased in female controls (p = .030). Longer follow-up is necessary to determine persistence of benefits.

  3. Long term follow-up of a tobacco prevention and cessation program in cystic fibrosis patients.

    Science.gov (United States)

    Ortega-García, Juan Antonio; Perales, Joseph E; Cárceles-Álvarez, Alberto; Sánchez-Sauco, Miguel Felipe; Villalona, Seiichi; Mondejar-López, Pedro; Pastor-Vivero, María Dolores; Mira Escolano, Pilar; James-Vega, Diana Carolina; Sánchez-Solís, Manuel

    2016-03-02

    This study evaluates the impact over time of a telephone-based intervention in tobacco cessation and prevention targeting patients with cystic fibrosis (CF) in the Mediterranean region of Murcia, Spain. We conducted an experimental prospective study with a cohort of CF patients using an integrative smoking cessation programme, between 2008 and 2013. The target population included family members and patients from the Regional CF unit. The study included an initial tobacco exposure questionnaire, measurement of lung function, urinary cotinine levels, anthropomorphic measures and the administered intervention at specific time intervals. Of the 88 patients tracked through follow-up, active smoking rates were reduced from 10.23% to 4.55% (p = 0.06). Environmental tobacco exposure was reduced in non-smoker patients from 62.03% to 36.90% (p < 0.01) during the five year follow-up. Significant reductions in the gradient of household tobacco smoke exposure were also observed with a decrease of 12.60%, from 31.65% (n = 25/79) to 19.05% (n = 16/84) in 2013 (p = <0.01). Cotinine was significantly correlated with both active and passive exposure (p<0.01) with a significant reduction of cotinine levels from 63.13 (28.58-97.69) to 20.56 (0.86-40.27) ng/ml (p<0.01). The intervention to significantly increase the likelihood of family quitting (smoke-free home) was 1.26 (1.05-1.54). Telephone based interventions for tobacco cessation and prevention is a useful tool when applied over time. Trained intervention professionals in this area are needed in the environmental health approach for the treatment of CF.

  4. 戒烟干预对消化性溃疡患者临床治疗效果的影响分析%The Clinical Treatment Effect of Smoking Cessation Intervention on the Patients With Peptic Ulcer

    Institute of Scientific and Technical Information of China (English)

    姚晨渔

    2016-01-01

    Objective To analyze the effect of smoking cessation intervention on the clinical treatment of patients with peptic ulcer, and to improve the clinical therapeutic effect of the disease.Methods 120 cases of digestive ulcer patients in gastroenterology department of our hospital from January 2014 to December 2015 were taken as the research object, according to the smoking control divided into not smoking group, smoking group and did not quit smoking group, 40 cases in each group. Three groups were given the same treatment method, compared clinical curative effect, positive rate of HP and recurrence rate among three group.Results After the treatment, the total effciency in non-smoking group was 95%, the total effciency in smoking cessation group was 87.75%, the total effective rate in did not quit smoking group was 70%, total efficiency of not smoking group and smoking group was signiifcantly higher than that in non smoking group, with statistically significant,P<0.05. Conclusion Smoking can significantly reduce the clinical curative effect of peptic ulcer, smoking cessation intervention can effectively ensure the treatment effect, reduce the recurrence rate.%目的:分析戒烟干预对消化性溃疡患者临床治疗效果的影响,以提高该病的临床治疗效果。方法以我院消化内科于2014年1月~2015年12月收治的120例消化性溃疡患者作为研究对象,根据其吸烟控制情况将其分为不吸烟组、戒烟组与未戒烟组各40例,三组均给予相同的治疗方法,对比三组患者的临床治疗效果、HP阳性率以及复发率。结果治疗后,不吸烟组的总有效率为95%;戒烟组的总有效率为87.75%;未戒烟组的总有效率为70%;不吸烟组与戒烟组的总有效率高于未戒烟组,差异具有统计学意义,P<0.05。结论吸烟会明显降低消化性溃疡的临床疗效,采取戒烟干预可以有效保证治疗效果,减少复发率。

  5. Morbilidad, mortalidad y costes sanitarios evitables mediante una estrategia de tratamiento del tabaquismo en España The effects of implementing a smoking cessation intervention in Spain on morbidity, mortality and health care costs

    Directory of Open Access Journals (Sweden)

    J. González-Enríquez

    2002-08-01

    Full Text Available Objetivo: Se valoran los efectos que tendría una intervención destinada a reducir el uso de tabaco en la población española de fumadores sobre la morbilidad, la mortalidad y los costes asociados al consumo de tabaco. Método: Se ha adaptado el modelo Health and Economic Consequences of Smoking patrocinado por la OMS y desarrollado por The Lewin Group. La intervención propuesta incluye el acceso a asistencia farmacológica de un 35% de los fumadores que intentan dejar de fumar, y obtienen una tasa global de cesación al año del 7,2%. Las enfermedades estudiadas son: cáncer de pulmón, enfermedad coronaria, enfermedad cerebrovascular, EPOC, asma y bajo peso al nacer. Se estiman los casos de enfermedad y muerte atribuibles al consumo de tabaco evitados y la reducción en el coste sanitario debidos a la intervención, proyectados a 20 años. Resultados: Sin intervención, en el año 1 del modelo 2.136.094 fumadores padecen alguna de las condiciones clínicas atribuibles al consumo de tabaco, el coste asistencial es de 4.286 millones de euros y las muertes atribuibles son 26.537. La intervención propuesta evita 2.613, 9.192, 17.415 y 23.837 casos de enfermedad atribuible al consumo de tabaco en los años 2, 5, 10 y 20 del modelo, respectivamente. Los costes asistenciales acumulados evitados son 3,5 millones de euros en el año 2 y 386 millones de euros a los 20 años. Las muertes acumuladas evitadas son 284 en el año 2 y 9.205 a los 20 años de la intervención. La intervención añade un total de 78.173 años de vida al final del período considerado. Conclusiones: La disponibilidad de nuevas intervenciones eficaces en el tratamiento del tabaquismo y el incremento de la accesibilidad a las mismas pueden contribuir de forma relevante a la reducción de la morbilidad, la mortalidad y los costes sanitarios asociados al tabaquismo en España.Objective: We estimated the effect that a smoking cessation intervention in the Spanish population of

  6. Atrial fibrillation: what are the targets for intervention?

    Science.gov (United States)

    Miller, John M; Olgin, Jeffrey E; Das, Mithilesh K

    2003-10-01

    Atrial fibrillation (AF) is a difficult and growing problem in the population. While medical therapy controls symptoms in many patients, a proportion of individuals with this common arrhythmia cannot be optimally managed with drugs alone. However, truly curative therapy for AF has always been one of the "holy grails" of electrophysiology. The surgical maze procedure was the first to offer permanent maintenance of sinus rhythm in patients with AF but subjected the patient to open heart surgery; a catheter-based translation of the maze procedure served as proof of concept that a catheterization technique could be used to treat AF. Subsequent experience has narrowed the electrophysiologist's attention to ablation of triggers of AF, most often residing in the pulmonary veins, rather than requiring more extensive ablation lines to control the arrhythmia. The following discussion deals with the development and current status of techniques for catheter ablation of atrial fibrillation, focusing on determination of appropriate target sites for ablation.

  7. Alveolar bone loss: mechanisms, potential therapeutic targets, and interventions.

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    Intini, G; Katsuragi, Y; Kirkwood, K L; Yang, S

    2014-05-01

    This article reviews recent research into mechanisms underlying bone resorption and highlights avenues of investigation that may generate new therapies to combat alveolar bone loss in periodontitis. Several proteins, signaling pathways, stem cells, and dietary supplements are discussed as they relate to periodontal bone loss and regeneration. RGS12 is a crucial protein that mediates osteoclastogenesis and bone destruction, and a potential therapeutic target. RGS12 likely regulates osteoclast differentiation through regulating calcium influx to control the calcium oscillation-NFATc1 pathway. A working model for RGS10 and RGS12 in the regulation of Ca(2+) oscillations during osteoclast differentiation is proposed. Initiation of inflammation depends on host cell-microbe interactions, including the p38 mitogen-activated protein kinase (MAPK) signaling pathway. Oral p38 inhibitors reduced lipopolysaccharide (LPS)-induced bone destruction in a rat periodontitis model but showed unsatisfactory safety profiles. The p38 substrate MK2 is a more specific therapeutic target with potentially superior tolerability. Furthermore, MKP-1 shows anti-inflammatory activity, reducing inflammatory cytokine biosynthesis and bone resorption. Multipotent skeletal stem cell (SSC) populations exist within the bone marrow and periosteum of long bones. These bone-marrow-derived SSCs and periosteum-derived SSCs have shown therapeutic potential in several applications, including bone and periodontal regeneration. The existence of craniofacial bone-specific SSCs is suggested based on existing studies. The effects of calcium, vitamin D, and soy isoflavone supplementation on alveolar and skeletal bone loss in post-menopausal women were investigated. Supplementation resulted in stabilization of forearm bone mass density and a reduced rate of alveolar bone loss over 1 yr, compared with placebo. Periodontal attachment levels were also well-maintained and alveolar bone loss suppressed during 24 wk of

  8. Targeting Cell Death Pathways for Therapeutic Intervention in Kidney Diseases.

    Science.gov (United States)

    Garg, Jay P; Vucic, Domagoj

    2016-05-01

    Precise regulation of cell death and survival is essential for proper maintenance of organismal homeostasis, development, and the immune system. Deregulated cell death can lead to developmental defects, neuropathies, infections, and cancer. Kidney diseases, especially acute pathologies linked to ischemia-reperfusion injury, are among illnesses that profoundly are affected by improper regulation or execution of cell death pathways. Attempts to develop medicines for kidney diseases have been impacted by the complexity of these pathologies given the heterogeneous patient population and diverse etiologies. By analyzing cell death pathways activated in kidney diseases, we attempt to differentiate their importance for these pathologies with a goal of identifying those that have more profound impact and the best therapeutic potential. Although classic apoptosis still might be important, regulated necrosis pathways including necroptosis, ferroptosis, parthanatos, and mitochondrial permeability transition-associated cell death play a significantly role in kidney diseases, especially in acute kidney pathologies. Although targeting receptor-interacting protein 1 kinase appears to be the best therapeutic strategy, combination with inhibitors of other cell death pathways is likely to bring superior benefit and possible cure to patients suffering from kidney diseases.

  9. Breast Cancer Survivorship Care: Targeting a Colorectal Cancer Education Intervention

    Directory of Open Access Journals (Sweden)

    Sherri G. Homan

    2015-08-01

    Full Text Available Breast cancer survivors are at risk of developing a second primary cancer. Colorectal cancer (CRC is one of the leading second primary cancers, and it is often preventable. We developed a multi-component educational tool to inform and encourage women breast cancer survivors to engage in CRC screening. To assess the strengths and weakness of the tool and to improve the relevancy to the target audience, we convened four focus groups of women breast cancer survivors in Missouri. We also assessed the potential impact of the tool on the knowledge, attitudes, and beliefs regarding CRC and collected information on the barriers to CRC screening through pre- and post-focus groups’ questionnaires. A total of 43 women breast cancer survivors participated and provided very valuable suggestions on design and content to update the tool. Through the process and comparing pre- and post-focus group assessments, a significantly higher proportion of breast cancer survivors strongly agreed or agreed that CRC is preventable (78.6% vs. 96.9%, p = 0.02 and became aware that they were at a slightly increased risk for CRC (18.6% vs. 51.7%, p = 0.003. The most cited barrier was the complexity of preparation for colonoscopy.

  10. Posture and Locomotion Coupling: A Target for Rehabilitation Interventions in Persons with Parkinson's Disease

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    Marie-Laure Mille

    2012-01-01

    Full Text Available Disorders of posture, balance, and gait are debilitating motor manifestations of advancing Parkinson's disease requiring rehabilitation intervention. These problems often reflect difficulties with coupling or sequencing posture and locomotion during complex whole body movements linked with falls. Considerable progress has been made with demonstrating the effectiveness of exercise interventions for individuals with Parkinson's disease. However, gaps remain in the evidence base for specific interventions and the optimal content of exercise interventions. Using a conceptual theoretical framework and experimental findings, this perspective and review advances the viewpoint that rehabilitation interventions focused on separate or isolated components of posture, balance, or gait may limit the effectiveness of current clinical practices. It is argued that treatment effectiveness may be improved by directly targeting posture and locomotion coupling problems as causal factors contributing to balance and gait dysfunction. This approach may help advance current clinical practice and improve outcomes in rehabilitation for persons with Parkinson's disease.

  11. Developing Internet interventions to target the individual impact of stigma in health conditions

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    Neil Thomas

    2015-09-01

    Full Text Available A number of health problems are associated with significant stigma, a social phenomenon in which individuals become the object of negative stereotypes. In addition to experiencing negative reactions from others, stigmatised individuals and groups can experience harmful consequences when they internalise these negative prevailing attitudes. The objective of this paper was to consider the potential to develop Internet-based health-related interventions explicitly targeting the effects of stigma on the individual. A review of the literature was conducted to synthesise current conceptualisations of stigma and self-stigma across a number of groups, and to identify current intervention developments. Self-stigma reduction strategies developed for in-person services include cognitive reframing, myth busting, contact with other members of the stigmatised group, and disclosure promotion. The development and provision of interventions targeting self-stigma within an online environment is in its infancy. Our review considers there to be particular potential of online interventions for this target, associated with the capacity of the Internet to promote having contact with peers within one’s stigmatised group, and for user interaction and empowerment. We conclude that self-stigma is a domain in which there is significant potential for innovation with health-related interventions, and provide a number of recommendations for online intervention development.

  12. Improving smoking cessation policy by assessing user demand for an inpatient smoking cessation service in adult psychiatric wards.

    Science.gov (United States)

    Liu, Kathy; Creamer, Andrew

    2015-01-01

    Smoking rates are higher among people with mental health conditions compared to the general population. Smoking reduces physical, mental and financial well-being, and interacts with psychotropic drugs. An inpatient admission provides an opportunity to engage and support smokers in smoking cessation. Compliance with Trust/NICE smoking cessation guidelines was assessed in two inpatient wards, and a questionnaire evaluated user demand for an inpatient smoking cessation service. A need for improved documentation of smoking status to identify and treat smokers routinely was revealed. A new electronic health form was designed and introduced, and a clear pathway for onward referrals was developed. This intervention preceded the introduction of the Trust-wide smoke free policy from October 2014. The intervention doubled rates of documentation of smoking status, cessation advice and offer of NRT/referral. There were large differences between the two wards, highlighting the need for a tailored approach.

  13. Smoking cessation in adults with diabetes: a systematic review and meta-analysis of data from randomised controlled trials

    OpenAIRE

    Nagrebetsky, Alexander; Brettell, Rachel; Roberts, Nia; Farmer, Andrew

    2014-01-01

    Objectives To evaluate the effects of more intensive smoking cessation interventions compared to less intensive interventions on smoking cessation in people with type 1 or type 2 diabetes. Design A systematic review and meta-analysis of randomised trials of smoking cessation interventions was conducted. Electronic searches were carried out on the following databases: MEDLINE, EMBASE, CINAHL and PsycINFO to September 2013. Searches were supplemented by review of trial registries and references...

  14. Towards Evaluating and Enhancing the Reach of Online Health Forums for Smoking Cessation.

    Science.gov (United States)

    Stearns, Michael; Nambiar, Siddhartha; Nikolaev, Alexander; Semenov, Alexander; McIntosh, Scott

    2014-12-01

    Online pro-health social networks facilitating smoking cessation through web-assisted interventions have flourished in the past decade. In order to properly evaluate and increase the impact of this form of treatment on society, one needs to understand and be able to quantify its reach, as defined within the widely-adopted RE-AIM framework. In the online communication context, user engagement is an integral component of reach. This paper quantitatively studies the effect of engagement on the users of the Alt.Support.Stop-Smoking forum that served the needs of an online smoking cessation community for more than ten years. The paper then demonstrates how online service evaluation and planning by social network analysts can be applied towards strategic interventions targeting increased user engagement in online health forums. To this end, the challenges and opportunities are identified in the development of thread recommendation systems using core-users as a strategic resource for effective and efficient spread of healthy behaviors, in particular smoking cessation.

  15. Metabolic effects of smoking cessation.

    Science.gov (United States)

    Harris, Kindred K; Zopey, Mohan; Friedman, Theodore C

    2016-05-01

    Smoking continues to be the leading cause of preventable death in the USA, despite the vast and widely publicized knowledge about the negative health effects of tobacco smoking. Data show that smoking cessation is often accompanied by weight gain and an improvement in insulin sensitivity over time. However, paradoxically, post-cessation-related obesity might contribute to insulin resistance. Furthermore, post-cessation weight gain is reportedly the number one reason why smokers, especially women, fail to initiate smoking cessation or relapse after initiating smoking cessation. In this Review, we discuss the metabolic effects of stopping smoking and highlight future considerations for smoking cessation programs and therapies to be designed with an emphasis on reducing post-cessation weight gain.

  16. Effect of a Targeted Women's Health Intervention in an Inner-City Emergency Department

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    Debra Houry

    2011-01-01

    Full Text Available Objective. To evaluate the effect of an Emergency Department (ED based, educational intervention for at-risk health behaviors. Methods. A randomized trial over a one-year period. African American women, aged 21–55, presenting to the ED waiting room were eligible. Each participant took a computer-based survey on health risk behaviors. Participants who screened positive on any of four validated scales (for IPV, nicotine, alcohol, or drug dependence were randomized to standard information about community resources (control or to targeted educational handouts based upon their screening results (intervention. Participants were surveyed at 3 months regarding contacts with community resources and harm-reduction actions. Results. 610 women were initially surveyed; 326 screened positive (13.7% for IPV, 40.1% for nicotine addiction, 26.6% for alcohol abuse, and 14.4% for drug abuse. 157 women were randomized to intervention and 169 to control. Among women who completed follow-up (=71, women in the Intervention Group were significantly more likely to have contacted local resources (37% versus 9%, =0.04 and were more likely to have taken risk-reducing action (97% versus 79%, =0.04. Conclusion. Targeted, brief educational interventions may be an effective method for targeting risk behaviors among vulnerable ED populations.

  17. Personality-Targeted Interventions Delay the Growth of Adolescent Drinking and Binge Drinking

    Science.gov (United States)

    Conrod, Patricia J.; Castellanos, Natalie; Mackie, Clare

    2008-01-01

    Background: Personality factors are implicated in the vulnerability to adolescent alcohol misuse. This study examined whether providing personality-targeted interventions in early adolescence can delay drinking and binge drinking in high-risk youth. Methods: A randomised control trial was carried out with 368 adolescents recruited from years 9 and…

  18. Long-Term Effects of a Personality-Targeted Intervention to Reduce Alcohol Use in Adolescents

    Science.gov (United States)

    Conrod, Patricia J.; Castellanos-Ryan, Natalie; Mackie, Clare

    2011-01-01

    Objective: To examine the long-term effects of a personality-targeted intervention on drinking quantity and frequency (QF), problem drinking, and personality-specific motivations for alcohol use in early adolescence. Method: A randomized control trial was carried out with 364 adolescents (median age 14) recruited from 13 secondary schools with…

  19. Vowel Targeted Intervention for Children with Persisting Speech Difficulties: Impact on Intelligibility

    Science.gov (United States)

    Speake, Jane; Stackhouse, Joy; Pascoe, Michelle

    2012-01-01

    Compared to the treatment of consonant segments, the treatment of vowels is infrequently described in the literature on children's speech difficulties. Vowel difficulties occur less frequently than those with consonants but may have significant impact on intelligibility. In order to evaluate the effectiveness of vowel targeted intervention (VTI)…

  20. Targeting Vulnerabilities to Risky Behavior: An Intervention for Promoting Adaptive Emotion Regulation in Adolescents

    Science.gov (United States)

    Claro, Anthony; Boulanger, Marie-Michelle; Shaw, Steven R.

    2015-01-01

    The paper examined the effectiveness of an in-school intervention for adolescents designed to target emotional regulation skills related to risky behaviors. The Cognitive Emotion Regulation Intended for Youth (CERTIFY) program was delivered to at-risk adolescents in Montreal, Canada. Participants were drawn from an alternative high school and a…

  1. Implementation of a neuropsychological intervention in secondary school: Targeting executive problems in young adolescent boys

    NARCIS (Netherlands)

    Dekker, Sanne; Krabbendam, Lydia; Gemmink, Michelle; De Groot, Renate; Jolles, Jelle

    2012-01-01

    Dekker, S. J., Krabbendam, L., Gemmink, M. M., De Groot, R. H. M., & Jolles, J. (2011, June). Implementation of a neuropsychological intervention in secondary school: Targeting executive problems in young adolescent boy. Poster presented at the 3rd Biennial Conference of the International Mind, Brai

  2. The effect of interventions on Twitter in four target groups using different measures of influence

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    Maanen, P.P. van; Wijn, R.; Boertjes, E.

    2014-01-01

    In this paper, the influence of interventions on Twitter users is studied. We define influence in (a) number of participants, (b) size of the audience, (c) amount of activity, and (d) reach. Influence is studied for four different target groups: (a) politicians, (b) journalists, (c) employees and (d

  3. Influence of controlled and uncontrolled interventions on Twitter in different target groups

    NARCIS (Netherlands)

    Maanen, P.P. van; Aarts, O.; Boertjes, E.; Wijn, R.

    2013-01-01

    In this paper the influence of interventions on Twitter users is studied. We define influence in a) number of participants, b) size of the audience, c) amount of activity, and d) reach. Influence is studied for four different target groups: a) politicians, b) journalists, c) employees and d) the gen

  4. Factors Predicting the Provision of Smoking Cessation Services Among Occupational Health Nurses in Thailand.

    Science.gov (United States)

    Chatdokmaiprai, Kannikar; Kalampakorn, Surintorn; McCullagh, Marjorie; Lagampan, Sunee; Keeratiwiriyaporn, Sansanee

    2017-01-01

    The purpose of this study was to identify factors predicting occupational health nurses' provision of smoking cessation services. Data were collected via a self-administered questionnaire distributed to 254 occupational health nurses in Thailand. Analysis by structural equation modeling revealed that self-efficacy directly and positively influenced smoking cessation services, and mediated the relationship between workplace factors, nurse factors, and smoking cessation services. The final model had good fit to the data, accounting for 20.4% and 38.0% of the variance in self-efficacy and smoking cessation services, respectively. The findings show that self-efficacy is a mediator that influences provision of smoking cessation services by occupational health nurses. Interventions to enhance nurses' self-efficacy in providing smoking cessation services are expected to promote provision of smoking cessation services to workers.

  5. Tobacco use among urban Aboriginal Australian young people: a qualitative study of reasons for smoking, barriers to cessation and motivators for smoking cessation.

    Science.gov (United States)

    Cosh, Suzanne; Hawkins, Kimberley; Skaczkowski, Gemma; Copley, David; Bowden, Jacqueline

    2015-01-01

    Smoking prevalence among Aboriginal Australian young people greatly exceeds the prevalence in the broader population of Australian young people, yet limited research has explored the social context in which young Aboriginal Australians smoke. Four focus groups were conducted in 2009 with South Australian Aboriginal smokers aged 15-29 years residing in urban areas (n = 32) to examine attitudes and experiences surrounding smoking and quitting. The primary reasons for smoking initiation and maintenance among Aboriginal Australian young people were identified as stress, social influence and boredom. Motivators for quitting were identified as pregnancy and/or children, sporting performance (males only), cost issues and, to a lesser extent, health reasons. The barriers to cessation were identified as social influence, the perception of quitting as a distant event and reluctance to access cessation support. However, it appears that social influences and stress were particularly salient contributors to smoking maintenance among Aboriginal Australian young people. Smoking cessation interventions targeted at young urban Aboriginal Australian smokers should aim to build motivation to quit by utilising the motivators of pregnancy and/or children, sporting performance (males only), cost issues and, to a lesser extent, health reasons, while acknowledging the pertinent role of social influence and stress in the lives of young urban Aboriginal Australian smokers.

  6. Meta analysis of influence of psychological interventions for smoking cessation effect in diabetic patients%心理干预对糖尿病吸烟者控烟效果影响的Meta分析

    Institute of Scientific and Technical Information of China (English)

    展恩欣; 宋欢; 柳韦华

    2016-01-01

    Objective:To evaluate the effectiveness of psychological interventions for smoking cessation in diabet-ic patients.Methods:By searching the Cochrane Library,the Joanna Briggs Institute Library,PubMed,Springer, MEDLINE,EMBASE,EBSCO,CBM,CNKI,VIP and WanFang Data from inception to August 31,2015,ran-domized controlled trials(RCTs)on psychosocial interventions versus usual care in smokers with diabetes were collected.RevMan 5.3 software was adopted for Meta analysis.Results:Twelve RCTs were included involving 2 089 patients.The results of meta analysis indicated that psychosocial interventions significantly increased the absti-nence rate at 1 months[RR=2.18,95%CI(1.28,3.71),P=0.004]and 3 months[RR=2.52,95%CI(1.32,4.80), P=0.005].However,the point prevalence abstinence rates at 4 months[RR=0.93,95%CI(0.49,1.76),P=0.82], 6 months[RR=1.32,95%CI(0.23,7.43),P=0.76;RR=1.73,95%CI(0.84,3.55),P=0.14],8 months[RR=1.24,95%CI(0.76,2.01),P=0.38]and 12 months[RR=0.77,95%CI(0.10,5.71),P=0.80;RR=1.74,95%CI(0.33,9.05),P=0.51].There were no significant differences between the two groups.Conclusions:Psycho-logical interventions are effective in short term(within 3 months)smoking cessation.However,the effective-ness is not clear for medium and long term smoking cessation.Owing to the limited quantity and quality of the included studies,more large scale high quality RCTs are required to verify the aforementioned conclusion.%[目的]评价心理干预对糖尿病吸烟者控烟效果的影响。[方法]计算机检索 the Cochrane Library,the Joanna Briggs Institute Library,PubMed,Springer,MEDLINE,EMBASE,EBSCO,中国生物医学文献服务系统(CBM)、中国知网(CNKI)、中国科技期刊数据库(VIP)和万方数据库,搜集相关随机对照(RCT)试验,进行文献质量评价后,采用 RevMan 5.3软件进行 Meta分析。[结果]共纳入12个 RCT,共2089例病人。Meta分析结果显示:与常规治疗护理措施相比,心理干预可提高糖尿病吸烟者1个月[RR=2

  7. Reasons for not using smoking cessation aids

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    Völzke Henry

    2008-04-01

    Full Text Available Abstract Background Few smokers use effective smoking cessation aids (SCA when trying to stop smoking. Little is known why available SCA are used insufficiently. We therefore investigated the reasons for not using SCA and examined related demographic, smoking behaviour, and motivational variables. Methods Data were collected in two population-based studies testing smoking cessation interventions in north-eastern Germany. A total of 636 current smokers who had never used SCA and had attempted to quit or reduce smoking within the last 12 months were given a questionnaire to assess reasons for non-use. The questionnaire comprised two subscales: "Social and environmental barriers" and "SCA unnecessary." Results The most endorsed reasons for non-use of SCA were the belief to be able to quit on one's own (55.2%, the belief that help is not necessary (40.1%, and the belief that smoking does not constitute a big problem in one's life (36.5%. One quarter of all smokers reported that smoking cessation aids are not helpful in quitting and that the aids cost too much. Smokers intending to quit agreed stronger to both subscales and smokers with lower education agreed stronger to the subscale "Social and environmental barriers". Conclusion Main reasons for non-use of SCA are being overly self-confident and the perception that SCA are not helpful. Future interventions to increase the use of SCA should address these reasons in all smokers.

  8. Effects of sixty six adolescent tobacco use cessation trials and seventeen prospective studies of self-initiated quitting

    Directory of Open Access Journals (Sweden)

    Sussman S

    2002-01-01

    Full Text Available Abstract This paper provides a review of the last two and a half decades of research in adolescent and young-adult tobacco use cessation. A total of 66 tobacco cessation intervention studies – targeted or population – are reviewed. In addition, an exhaustive review is completed of adolescent self-initiated tobacco use cessation, involving 17 prospective survey studies. Average reach and retention across the intervention studies was 61% and 78%, respectively, and was higher when whole natural units were treated (e.g., classrooms, than when units created specifically for the program were treated (e.g., school-based clinics. The mean quit-rate at a three to 12-month average follow-up among the program conditions was 12%, compared to approximately 7% across control groups. A comparison of intervention theories revealed that motivation enhancement (19% and contingency-based reinforcement (16% programs showed higher quit-rates than the overall intervention cessation mean. Regarding modalities (channels of change, classroom-based programs showed the highest quit rates (17%. Computer-based (expert system programs also showed promise (13% quit-rate, as did school-based clinics (12%. There was a fair amount of missing data and wide variation on how data points were measured in the programs' evaluations. Also, there were relatively few direct comparisons of program and control groups. Thus, it would be difficult to conduct a formal meta-analysis on the cessation programs. Still, these data suggest that use of adolescent tobacco use cessation interventions double quit rates on the average. In the 17 self-initiated quitting survey studies, key predictors of quitting were living in a social milieu that is composed of fewer smokers, less pharmacological or psychological dependence on smoking, anti-tobacco beliefs (e.g., that society should step in to place controls on smoking and feeling relatively hopeful about life. Key variables relevant to the quitting

  9. Effects of sixty six adolescent tobacco use cessation trials and seventeen prospective studies of self-initiated quitting

    Directory of Open Access Journals (Sweden)

    Sussman S

    2003-01-01

    Full Text Available Abstract This paper provides a review of the last two and a half decades of research in adolescent and young-adult tobacco use cessation. A total of 66 tobacco cessation intervention studies – targeted or population – are reviewed. In addition, an exhaustive review is completed of adolescent self-initiated tobacco use cessation, involving 17 prospective survey studies. Average reach and retention across the intervention studies was 61% and 78%, respectively, and was higher when whole natural units were treated (e.g., classrooms, than when units created specifically for the program were treated (e.g., school-based clinics. The mean quit-rate at a three to 12-month average follow-up among the program conditions was 12%, compared to approximately 7% across control groups. A comparison of intervention theories revealed that motivation enhancement (19% and contingency-based reinforcement (16% programs showed higher quit-rates than the overall intervention cessation mean. Regarding modalities (channels of change, classroom-based programs showed the highest quit rates (17%. Computer-based (expert system programs also showed promise (13% quit-rate, as did school-based clinics (12%. There was a fair amount of missing data and wide variation on how data points were measured in the programs' evaluations. Also, there were relatively few direct comparisons of program and control groups. Thus, it would be difficult to conduct a formal meta-analysis on the cessation programs. Still, these data suggest that use of adolescent tobacco use cessation interventions double quit rates on the average. In the 17 self-initiated quitting survey studies, key predictors of quitting were living in a social milieu that is composed of fewer smokers, less pharmacological or psychological dependence on smoking, anti-tobacco beliefs (e.g., that society should step in to place controls on smoking and feeling relatively hopeful about life. Key variables relevant to the quitting

  10. Smoking Cessation through Acceptance and Commitment Therapy: A Case Report

    OpenAIRE

    Ufuk Bal; Soner Cakmak; Ertan Yilmaz; Lut Tamam; Mahmut Onur Karaytug

    2015-01-01

    Smoking is one of the most common addictions with devastating biopsychosocial consequences. Both medical treatment and pschotherapy are utilized in smoking cessation. Acceptance and commitment therapy holds the notion that smoking cessation rates are determined not so much by the negative affect and withdrawal symptoms per se, but by the avoidant and inflexible responding style. Acceptance and commitment therapy, through targeting the avoidance of internal stimuli and concomitant inflexible...

  11. Systematic review of family and home-based interventions targeting paediatric overweight and obesity.

    Science.gov (United States)

    Knowlden, A P; Sharma, M

    2012-06-01

    The family and home environment is a highly influential psychosocial antecedent of paediatric obesity. The purpose of this investigation was to systematically analyze family and home-based randomized control trials aimed at treating overweight and obesity in children ages 2-7 years. In gathering materials for this review, a search of Cumulative Index to Nursing and Allied Health, MEDLINE, Education Resources Information Center, Psychology and Behavioural Sciences Collection and CENTRAL databases was conducted for the time frame of January 2001 to August 2011. The data extraction spanned three phases resulting in a total of nine interventions that met the specified inclusion criteria. Among the identified studies, eight produced significant outcomes. The majority of the programmes incorporated educational sessions targeting parents as the primary modality for intervention delivery. Less than one-quarter of the interventions included home visitations; however, all of the interventions included home-based activities to reinforce behaviour modification. Only three of the interventions applied social and behavioural theory, and only two interventions employed process evaluation. Additional research is needed to gauge the efficacy of the home and family milieu for treating paediatric obesity.

  12. 戒烟干预对慢性阻塞性肺疾病患者近期呼吸道症状的影响%Effect of Smoking Cessation Intervention on Short Term Respiratory Clinical Symptoms in Patients with Chro-nic Obstructive Pulmonary Disease

    Institute of Scientific and Technical Information of China (English)

    冯丽; 张静

    2014-01-01

    Objective:To investigate the effect of nurse-led group intervention of smoking on short term respiratory clinical symptoms in patients with chronic obstructive pulmonary disease (COPD) .Methods :Thirty-three smoking patients with stable COPD who intended to give up smoking after a brief verbal advice were recruited into the study .Weekly group intervention was performed for every participants till one month after cessation .The contents of intervention included teaching knowledge deliv-ered by the nursing staff ,counseling cessation skills ,encouraging and supervising ,companion encouragement ,and guide on in-haled medications .Smoking status ,cough ,sputum and dyspnea were recorded ,and symptoms and quality of life were evalua-ted by COPD assessment test (CAT) and the modified Medical Research Council (mMRC) scale during the study period . Results:Twenty-five subjects (75% ) reported chronic cough ,18(54 .5% ) had chronic sputum ,and 21 (63 .6% ) had dyspnea , 28 (84 .8% ) successfully maintained smoking cessation .One month after cessation ,the CAT score and mMRC score were both significantly lower than before cessation (P<0 .01) .Conclusions :Nurse-led smoking cessation group intervention in patients with COPD can achieve a high cessation rate .Respiratory symptoms and quality of life can be improved even after a short peri-od of cessation .%目的:探讨以护士为主导的戒烟群组干预对慢性阻塞性肺疾病(chronic obstructive pulmonary disease ,COPD)患者近期呼吸道症状的影响。方法:选择经过简单口头建议后产生戒烟意愿的稳定期COPD吸烟患者33例,对其进行每周1次的群组干预,直至戒断后1个月。干预内容包括由护理人员普及疾病知识、宣教戒烟技巧、辅导督促、同伴激励、吸入药物应用指导等活动,同时由护士记录患者的吸烟情况、咳嗽、咳痰和呼吸困难情况,并以COPD评估测试(COPD assessment test ,CAT )量表和改良的

  13. Educational interventions targeted at minors in situations of grave social vulnerability and their families

    Science.gov (United States)

    de La Caba Collado, Mariangeles; Bartau Rojas, Isabel

    2010-10-01

    The aim of this article is to outline and assess an educational intervention programme targeted at improving the skills of families and the personal and social development of children living in situations of grave social vulnerability. The sample comprised 10 families during the first phase of the intervention and six during the second. The design, intervention and assessment process of this study was carried out in two phases over a period of a year and a half. For both phases, three different groups—of men/fathers, women/mothers and children—were established. Study variables (parenting skills and children's personal and social development) were evaluated before and after the intervention in every group, as well as during the entire process. The results, taking into account the improvements reported by all the participants (social workers, group monitors, fathers, mothers, children) show that inter-professional involvement and coordination at all phases of the intervention is vital in order to achieve small but significant improvements.

  14. Small, medium, large or supersize? The development and evaluation of interventions targeted at portion size.

    Science.gov (United States)

    Vermeer, W M; Steenhuis, I H M; Poelman, M P

    2014-07-01

    In the past decades, portion sizes of high-caloric foods and drinks have increased and can be considered an important environmental obesogenic factor. This paper describes a research project in which the feasibility and effectiveness of environmental interventions targeted at portion size was evaluated. The studies that we conducted revealed that portion size labeling, offering a larger variety of portion sizes, and proportional pricing (that is, a comparable price per unit regardless of the size) were considered feasible to implement according to both consumers and point-of-purchase representatives. Studies into the effectiveness of these interventions demonstrated that the impact of portion size labeling on the (intended) consumption of soft drinks was, at most, modest. Furthermore, the introduction of smaller portion sizes of hot meals in worksite cafeterias in addition to the existing size stimulated a moderate number of consumers to replace their large meals by a small meal. Elaborating on these findings, we advocate further research into communication and marketing strategies related to portion size interventions; the development of environmental portion size interventions as well as educational interventions that improve people's ability to deal with a 'super-sized' environment; the implementation of regulation with respect to portion size labeling, and the use of nudges to stimulate consumers to select healthier portion sizes.

  15. Lifestyle Interventions Targeting Body Weight Changes during the Menopause Transition: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Janet Jull

    2014-01-01

    Full Text Available Objective. To determine the effectiveness of exercise and/or nutrition interventions and to address body weight changes during the menopause transition. Methods. A systematic review of the literature was conducted using electronic databases, grey literature, and hand searching. Two independent researchers screened for studies using experimental designs to evaluate the impact of exercise and/or nutrition interventions on body weight and/or central weight gain performed during the menopausal transition. Studies were quality appraised using Cochrane risk of bias. Included studies were analyzed descriptively. Results. Of 3,564 unique citations screened, 3 studies were eligible (2 randomized controlled trials, and 1 pre/post study. Study quality ranged from low to high risk of bias. One randomized controlled trial with lower risk of bias concluded that participation in an exercise program combined with dietary interventions might mitigate body adiposity increases, which is normally observed during the menopause transition. The other two studies with higher risk of bias suggested that exercise might attenuate weight loss or weight gain and change abdominal adiposity patterns. Conclusions. High quality studies evaluating the effectiveness of interventions targeting body weight changes in women during their menopause transition are needed. Evidence from one higher quality study indicates an effective multifaceted intervention for women to minimize changes in body adiposity.

  16. Pilot evaluation of a web-based intervention targeting sexual health service access.

    Science.gov (United States)

    Brown, K E; Newby, K; Caley, M; Danahay, A; Kehal, I

    2016-04-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among 13-19-year olds are reported. A pre-post questionnaire-based design was used. Matched baseline and follow-up data were identified from 148 respondents aged 13-18 years. Outcome measures were self-reported service access, self-reported intention to access services and beliefs about services and service access identified through needs analysis. Objective service access data provided by local sexual health services were also analyzed. Analysis suggests the intervention had a significant positive effect on psychological barriers to and antecedents of service access among females. Males, who reported greater confidence in service access compared with females, significantly increased service access by time 2 follow-up. Available objective service access data support the assertion that the intervention may have led to increases in service access. There is real promise for this novel digital intervention. Further evaluation is planned as the model is licensed to and rolled out by other local authorities in the United Kingdom.

  17. School-based interventions targeting stigma of mental illness: systematic review.

    Science.gov (United States)

    Mellor, Catriona

    2014-08-01

    Aims and method To systematically review the published literature on the effectiveness of classroom-based interventions to tackle the stigma of mental illness in young people, and to identify any consistent elements within successful programmes. Results Seventeen studies were included in the analysis. A minority of studies reported a positive impact on stigma or knowledge outcomes at follow-up and there were considerable methodological shortcomings in the studies reviewed. These interventions varied substanitally in content and delivery. It was not possible to use this data to draw out what aspects make a successful intervention. There is currently no strong evidence to support previous conclusions that these types of intervention work for children and adolescents. Clinical implications When anti-stigma interventions for young people are rolled out in the future, it is important that the programme design and method of delivery have evidence to prove their effectiveness, and that the audience and setting are the most appropriate to target. There is a current lack of strong evidence to inform this.

  18. The efficacy of targeted interventions for modifiable psychosocial risk factors of persistent nonspecific low back pain e A systematic review

    DEFF Research Database (Denmark)

    Kent, Peter; Kjær, Per

    2012-01-01

    of targeted psychosocial interventions. Aim: This review aimed to determine if the efficacy of interventions for psychosocial risk factors of persistent NSLBP is improved when targeted to people with particular psychosocial characteristics. Method: Bibliographic databases were searched. Inclusion criteria......Background: There is considerable interest in whether best practice management of nonspecific low back pain (NSLBP) should include the targeting of treatment to subgroups of people with identifiable clinical characteristics. However, there are no published systematic reviews of the efficacy...

  19. Tobacco smoking cessation management: integrating varenicline in current practice

    Directory of Open Access Journals (Sweden)

    Laurence M Galanti

    2008-08-01

    Full Text Available Laurence M GalantiClinique Universitaire UCL, Mont-Godinne, Yvoir, BelgiumAbstract: Tobacco smoking is widespread and is one of the world’s most prevalent modifiable risk factors for morbidity and mortality. It is important to facilitate smoking cessation better in order to reduce the health consequences of tobacco use. The most effective approach assisting smokers in their quit attempts combines both pharmacotherapy and nonpharmacological interventions. This review summarizes the latest international epidemiological data available on tobacco use, considers the associated effects on health, and reviews existing policies against tobacco use. Among the interventions for smoking cessation, the three major pharmacotherapies (which have demonstrated efficacy when combined with behavioral support are discussed: nicotine replacement therapy (NRT, bupropion, and varenicline. As the newest pharmacotherapy made available in this area, particular consideration is given to varenicline, and a review of our clinical experience is offered.Keywords: tobacco smoking cessation, nicotinic substitution, nicotine replacement therapy (NRT, bupropion, varenicline

  20. mHealth for Smoking Cessation Programs: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Koel Ghorai

    2014-07-01

    Full Text Available mHealth transforms healthcare delivery around the world due to its affordability and right time availability. It has been used for delivery of various smoking cessation programs and interventions over the past decade. With the proliferation of smartphone usage around the world, many smartphone applications are being developed for curbing smoking among smokers. Various interventions like SMS, progress tracking, distractions, peer chats and others are being provided to users through smartphone applications. This paper presents a systematic review that analyses the applications of mobile phones in smoking cessations. The synthesis of the diverse concepts within the literature on smoking cessations using mobile phones provides deeper insights in the emerging mHealth landscape.

  1. The internet and the industrial revolution in smoking cessation counselling.

    Science.gov (United States)

    Etter, Jean-François

    2006-01-01

    The internet can provide wide access to online smoking cessation programmes developed by highly qualified professionals. Compared with one-to-one counselling in smoking cessation clinics or on telephone quitlines, the mass-level dissemination of automatised, individualised counselling on the internet is comparable to the industrial revolution, when skilled craftsmen working in small shops were replaced by huge plants. Hundreds of websites provide information and advice on smoking cessation, but very few of them have been evaluated scientifically. Therefore, it is not yet known whether web-based smoking cessation interventions are effective in the long term, and which of their components are most effective for subgroups of smokers. Claims for efficacy found on some popular websites have not been evaluated. The internet is being used increasingly by tobacco companies to promote their products. The overall effect of internet smoking cessation programs on smoking prevalence is unknown. Greater efforts should be expended to improve the reach and efficacy of smoking cessation websites.

  2. Counseling Is Effective for Smoking Cessation in Head and Neck Cancer Patients

    DEFF Research Database (Denmark)

    Klemp, Ingrid; Wangsmo Steffenssen, Mia Charlotte; Bakholdt, Vivi T.

    2016-01-01

    PURPOSE: The purpose of this systematic review was to describe the efficacy of smoking cessation counseling and the resulting quit rate in patients with head and neck cancer. MATERIALS AND METHODS: A systematic literature search was conducted in the PubMed, Embase, and Cochrane databases. Predictor...... variables were smoking cessation counseling and smoking cessation interventions. The outcome was smoking cessation. Data collection and quality assessment were performed independently by 2 of the authors. Selected publications were assessed for potential risk of bias, and the level of evidence was evaluated...... in patients who received smoking cessation counseling compared with those who received usual care. CONCLUSIONS: This review shows that counseling supplemented with nicotine replacement therapy increases the possibility for smoking cessation in patients with head and neck cancer....

  3. Nonjudging facet of mindfulness predicts enhanced smoking cessation in Hispanics.

    Science.gov (United States)

    Spears, Claire Adams; Houchins, Sean C; Stewart, Diana W; Chen, Minxing; Correa-Fernández, Virmarie; Cano, Miguel Ángel; Heppner, Whitney L; Vidrine, Jennifer I; Wetter, David W

    2015-12-01

    Although most smokers express interest in quitting, actual quit rates are low. Identifying strategies to enhance smoking cessation is critical, particularly among underserved populations, including Hispanics, for whom many of the leading causes of death are related to smoking. Mindfulness (purposeful, nonjudgmental attention to the present moment) has been linked to increased likelihood of cessation. Given that mindfulness is multifaceted, determining which aspects of mindfulness predict cessation could help to inform interventions. This study examined whether facets of mindfulness predict cessation in 199 Spanish-speaking smokers of Mexican heritage (63.3% male, mean age of 39 years, 77.9% with a high school education or less) receiving smoking cessation treatment. Primary outcomes were 7-day abstinence at weeks 3 and 26 postquit (biochemically confirmed and determined using an intent-to-treat approach). Logistic random coefficient regression models were utilized to examine the relationship between mindfulness facets and abstinence over time. Independent variables were subscales of the Five Facet Mindfulness Questionnaire (Observing, Describing, Acting With Awareness, Nonjudging, and Nonreactivity). The Nonjudging subscale (i.e., accepting thoughts and feelings without evaluating them) uniquely predicted better odds of abstinence up to 26 weeks postquit. This is the first known study to examine whether specific facets of mindfulness predict smoking cessation. The ability to experience thoughts, emotions, and withdrawal symptoms without judging them may be critical in the process of quitting smoking. Results indicate potential benefits of mindfulness among smokers of Mexican heritage and suggest that smoking cessation interventions might be enhanced by central focus on the Nonjudging aspect of mindfulness.

  4. A Narrative Review of Social Media and Game-Based Nutrition Interventions Targeted at Young Adults.

    Science.gov (United States)

    Nour, Monica; Yeung, Sin Hang; Partridge, Stephanie; Allman-Farinelli, Margaret

    2017-02-23

    The increased popularity of social media and mobile gaming among young adults provides an opportunity for innovative nutrition programs. This review evaluated the efficacy of these strategies in interventions targeted at 18- to 35-year-olds. The protocol was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Ten scientific databases, information technology conference proceedings, and gray literature were searched. Two reviewers conducted screening, data extraction, and quality assessments. Interventions were included if they used social media or electronic games. Comparisons were made pre- to post-intervention, or between intervention and control arms. Outcomes of interest included change in nutrition knowledge, attitudes, behavior, or weight and/or body composition. Eleven social media-based (randomized controlled trials [RCT] n=7) and six game-based [RCT n=1]) interventions were included. Overall quality of studies was low. Social media-based strategies included forum/blogs (n=5), Facebook (n=5), Twitter (n=1), YouTube (n=1), and chat rooms (n=1). Eight (RCT n=6) of 11 social media-based studies demonstrated improvements in outcomes. Findings suggested that social media may be more effective when combined with other strategies. Virtual reality games (n=3), web-based games (n=2), and a mobile application (n=1) were used in the gaming interventions. While a significant increase in knowledge was reported by three gaming studies (RCT=1), two used nonvalidated tools and longer-term measures of weight and behavioral outcomes were limited. The use of social media and gaming for nutrition promotion is in its infancy. Preliminary evidence suggests that these strategies have some utility for intervening with young adults. Further research using high-quality study designs is required, with measurement of outcomes over longer time periods. The systematic review protocol is registered with PROSPERO (registration number: CRD42015025427).

  5. Generating political priority for regulatory interventions targeting obesity prevention: an Australian case study.

    Science.gov (United States)

    Baker, Phillip; Gill, Timothy; Friel, Sharon; Carey, Gemma; Kay, Adrian

    2017-03-01

    rationales to defer political priority. Overcoming these challenges may be important to future collective action efforts attempting to generate and sustain political priority for regulatory interventions targeting obesity.

  6. Motivational Interviewing for Smoking Cessation: A Meta-Analytic Review

    Science.gov (United States)

    Hettema, Jennifer E.; Hendricks, Peter S.

    2010-01-01

    Objective: Motivational interviewing (MI) is a treatment approach that has been widely examined as an intervention for tobacco dependence and is recommended in clinical practice guidelines. Previous reviews evaluating the efficacy of MI for smoking cessation noted effects that were modest in magnitude but included few studies. The current study is…

  7. Why use of interventions targeting outdoor biting mosquitoes will be necessary to achieve malaria elimination

    Directory of Open Access Journals (Sweden)

    Nicodem James Govella

    2012-06-01

    Full Text Available By definition, elimination of malaria means permanent reduction to zero of locally incidence of infections. Achieving this goal among other reasons, it requires fully understanding on where and when persons are most exposed to malaria vectors as these are fundamental for targeting interventions to achieve maximum impact. While elimination can be possible in some settings with low malaria transmission intensity and dominated with late and indoor biting of vectors using Long Lasting Insecticidal Nets (LLIN and Indoor Residual Spraying (IRs, it’s difficult and even impossible in areas with high and where majority of human exposure to transmission occurs outside human dwellings. Recently in response to wide spread use of LLIN and IRS, human risk of exposure to transmission is increasingly spread across the entire night so that much of it occurs outdoors and before bed time. This modification of vector populations and behaviour has now been reported from across Africa, Asia and from the Solomon Islands. Historical evidence shows that even in areas with intervention coverage exceeding 90% of human population it was so hard to even push prevalence down below the pre elimination threshold of 1% being compromised mainly with the outdoor residual transmission. Malaria control experts must however continue to deliver interventions that tackle indoor transmission but considerable amount of resources that target mosquitoes outside of houses and outside of sleeping hours will therefore be required to sustain and go beyond existing levels of malaria control and achieve elimination.

  8. Can Targeted Intervention Mitigate Early Emotional and Behavioral Problems?: Generating Robust Evidence within Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Orla Doyle

    Full Text Available This study examined the impact of a targeted Irish early intervention program on children's emotional and behavioral development using multiple methods to test the robustness of the results. Data on 164 Preparing for Life participants who were randomly assigned into an intervention group, involving home visits from pregnancy onwards, or a control group, was used to test the impact of the intervention on Child Behavior Checklist scores at 24-months. Using inverse probability weighting to account for differential attrition, permutation testing to address small sample size, and quantile regression to characterize the distributional impact of the intervention, we found that the few treatment effects were largely concentrated among boys most at risk of developing emotional and behavioral problems. The average treatment effect identified a 13% reduction in the likelihood of falling into the borderline clinical threshold for Total Problems. The interaction and subgroup analysis found that this main effect was driven by boys. The distributional analysis identified a 10-point reduction in the Externalizing Problems score for boys at the 90th percentile. No effects were observed for girls or for the continuous measures of Total, Internalizing, and Externalizing problems. These findings suggest that the impact of this prenatally commencing home visiting program may be limited to boys experiencing the most difficulties. Further adoption of the statistical methods applied here may help to improve the internal validity of randomized controlled trials and contribute to the field of evaluation science more generally.ISRCTN Registry ISRCTN04631728.

  9. What distinguishes successful from unsuccessful tobacco smoking cessation? Data from a study of young adults (TEMPO

    Directory of Open Access Journals (Sweden)

    Inès Khati

    2015-01-01

    Conclusions: Work and family circumstances, co-occurring substance use and psychological difficulties may influence smoking cessation in young adults. These characteristics should be considered by individual and collective interventions aiming to help young smokers quit successfully.

  10. A Comparative Study on Tobacco Cessation Methods: A Quantitative Systematic Review

    Directory of Open Access Journals (Sweden)

    Gholamreza Heydari

    2014-01-01

    Conclusions: Results of this review indicate that the scientific papers in the most recent decade recommend the use of NRT and Champix in combination with educational interventions. Additional research is needed to compare qualitative and quantitative studies for smoking cessation.

  11. Interventional value of total flavonoids from Rhizoma Drynariae on Cathepsin K, a potential target of osteoporosis.

    Science.gov (United States)

    Shi, Xiao-Lin; Liu, Kang; Wu, Lian-Guo

    2011-07-01

    Osteoporosis, the sixth most common disease in the world, is bringing increasingly serious harm to people's health. Cathepsin K, which plays an important role in bone resorption, is a potential target in the treatment of osteoporosis. Total flavonoids, the active ingredients in Rhizoma Drynariae, have shown obvious, therapeutic effect on osteoporosis. In previous studies, it was presumed that the mechanism for the therapeutic effect was through inhibiting the expression of Cathepsin K. However, there are still no detailed reports on some key issues such as the specific inhibitory results of total flavonoids on Cathepsin K and the pathway of inhibition and so on. Based on previous studies on total flavonoids from Rhizoma Drynariae, the pathway for the effect of, total flavonoids inhibiting Cathepsin K and their interventional value on Cathepsin K were analyzed in this paper, so as to explore the interventional feasibility and value of total flavonoids in Rhizoma Drynariae on Cathepsin K.

  12. Molecular Targets Related to Inflammation and Insulin Resistance and Potential Interventions

    Directory of Open Access Journals (Sweden)

    Sandro M. Hirabara

    2012-01-01

    Full Text Available Inflammation and insulin resistance are common in several chronic diseases, such as obesity, type 2 diabetes mellitus, metabolic syndrome, cancer, and cardiovascular diseases. Various studies show a relationship between these two factors, although the mechanisms involved are not completely understood yet. Here, we discuss the molecular basis of insulin resistance and inflammation and the molecular aspects on inflammatory pathways interfering in insulin action. Moreover, we explore interventions based on molecular targets for preventing or treating correlated disorders, advances for a better characterization, and understanding of the mechanisms and mediators involved in the different inflammatory and insulin resistance conditions. Finally, we address biotechnological studies for the development of new potential therapies and interventions.

  13. Using GIS Mapping to Target Public Health Interventions: Examining Birth Outcomes Across GIS Techniques.

    Science.gov (United States)

    MacQuillan, E L; Curtis, A B; Baker, K M; Paul, R; Back, Y O

    2016-11-24

    With advances in spatial analysis techniques, there has been a trend in recent public health research to assess the contribution of area-level factors to health disparity for a number of outcomes, including births. Although it is widely accepted that health disparity is best addressed by targeted, evidence-based and data-driven community efforts, and despite national and local focus in the U.S. to reduce infant mortality and improve maternal-child health, there is little work exploring how choice of scale and specific GIS visualization technique may alter the perception of analyses focused on health disparity in birth outcomes. Retrospective cohort study. Spatial analysis of individual-level vital records data for low birthweight and preterm births born to black women from 2007 to 2012 in one mid-sized Midwest city using different geographic information systems (GIS) visualization techniques [geocoded address records were aggregated at two levels of scale and additionally mapped using kernel density estimation (KDE)]. GIS analyses in this study support our hypothesis that choice of geographic scale (neighborhood or census tract) for aggregated birth data can alter programmatic decision-making. Results indicate that the relative merits of aggregated visualization or the use of KDE technique depend on the scale of intervention. The KDE map proved useful in targeting specific areas for interventions in cities with smaller populations and larger census tracts, where they allow for greater specificity in identifying intervention areas. When public health programmers seek to inform intervention placement in highly populated areas, however, aggregated data at the census tract level may be preferred, since it requires lower investments in terms of time and cartographic skill and, unlike neighborhood, census tracts are standardized in that they become smaller as the population density of an area increases.

  14. Impact of targeted interventions on heterosexual transmission of HIV in India

    Directory of Open Access Journals (Sweden)

    Risbud Arun

    2011-07-01

    Full Text Available Abstract Background Targeted interventions (TIs have been a major strategy for HIV prevention in India. We evaluated the impact of TIs on HIV prevalence in high HIV prevalence southern states (Tamil Nadu, Karnataka, Andhra Pradesh and Maharashtra. Methods A quasi-experimental approach was used to retrospectively compare changes in HIV prevalence according to the intensity of targeted intervention implementation. Condom gap (number of condoms required minus condoms supplied by TIs was used as an indicator of TI intensity. Annual average number of commercial sex acts per female sex worker (FSW reported in Behavioral Surveillance Survey was multiplied by the estimated number of FSWs in each district to calculate annual requirement of condoms in the district. Data of condoms supplied by TIs from 1995 to 2008 was obtained from program records. Districts in each state were ranked into quartiles based on the TI intensity. Primary data of HIV Sentinel Surveillance was analyzed to calculate HIV prevalence reductions in each successive year taking 2001 as reference year according to the quartiles of TI intensity districts using generalized linear model with logit link and binomial distribution after adjusting for age, education, and place of residence (urban or rural. Results In the high HIV prevalence southern states, the number of TI projects for FSWs increased from 5 to 310 between 1995 and 2008. In high TI intensity quartile districts (n = 30, 186 condoms per FSW/year were distributed through TIs as compared to 45 condoms/FSW/year in the low TI intensity districts (n = 29. Behavioral surveillance indicated significant rise in condom use from 2001 to 2009. Among FSWs consistent condom use with last paying clients increased from 58.6% to 83.7% (p Conclusion Targeted interventions are associated with HIV prevalence decline.

  15. Improving medication adherence with a targeted, technology-driven disease management intervention.

    Science.gov (United States)

    Lawrence, David B; Allison, Wanda; Chen, Joyce C; Demand, Michael

    2008-06-01

    Treatment adherence is critical in managing chronic disease, but achieving it remains an elusive goal across many prevalent conditions. As part of its care management strategy, BlueCross BlueShield of South Carolina (BCBSSC) implemented the Longitudinal Adherence Treatment Evaluation program, a behavioral intervention to improve medication adherence among members with cardiovascular disease and/or diabetes. The objectives of this study were to 1) assess the effectiveness of telephonic intervention in influencing reinitiation of medication therapy, and 2) evaluate the rate and timing of medication reinitiation. BCBSSC applied algorithms against pharmacy claims data to identify patients prescribed targeted medications who were 60 or more days overdue for refills. This information was provided to care managers to address during their next patient contact. Care managers received focused training on techniques for medication behavior change, readiness to change, motivational interviewing, and active listening. Training also addressed common barriers to adherence and available resources, including side effect management, mail order benefits, drug assistance programs, medication organizers, and reminder systems. Overdue refills were tracked for 12 months, with medication reinitiation followed for an additional 3 months. In the intervention group, 94 patients were identified with 123 instances of late medication refills. In the age- and gender-matched comparison group, 61 patients were identified with 76 late refills. The intervention group had a significantly higher rate of medication reinitiation (59.3%) than the control group (42.1%; P management intervention promoting patient behavior change increased the number of patients who reinitiated therapy after a period of nonadherence and decreased the time from nonadherence to adherence.

  16. Personality-Targeted Interventions Delay Uptake of Drinking and Decrease Risk of Alcohol-Related Problems when Delivered by Teachers

    Science.gov (United States)

    O'Leary-Barrett, Maeve; Mackie, Clare J.; Castellanos-Ryan, Natalie; Al-Khudhairy, Nadia; Conrod, Patricia J.

    2010-01-01

    Objective: This trial examined the efficacy of teacher-delivered personality-targeted interventions for alcohol-misuse over a 6-month period. Method: This randomized controlled trial randomly allocated participating schools to intervention (n = 11) or control (n = 7) conditions. A total of 2,506 (mean age, 13.7 years) were assessed for elevated…

  17. JOINT MARKETING AS A FRAMEWORK FOR TARGETING MEN WHO HAVE SEX WITH MEN IN CHINA : A PILOT INTERVENTION STUDY

    NARCIS (Netherlands)

    Tan, Jingguang; Cai, Rui; Lu, Zuxun; Cheng, Jinquan; de Vlas, Sake J.; Richardus, Jan Hendrik

    2013-01-01

    To apply the joint marketing principle as a new intervention approach for targeting men who have sex with men (MSM) who are often difficult to reach in societies with discrimination towards homosexuality and HIV/AIDS. A pilot intervention according to the principles of joint marketing was carried ou

  18. Joint marketing as a framework for targeting men who have sex with men in China: A pilot intervention study

    NARCIS (Netherlands)

    J. Tan (Jingguang); R. Cai (Rui); Z. Lu (Zhongbing); J. Cheng (Jianguo); S.J. de Vlas (Sake); J.H. Richardus (Jan Hendrik)

    2013-01-01

    textabstractTo apply the joint marketing principle as a new intervention approach for targeting men who have sex with men (MSM) who are often difficult to reach in societies with discrimination towards homosexuality and HIV/ AIDS. A pilot intervention according to the principles of joint marketing w

  19. Interstitial cells of Cajal as targets for pharmacological intervention in gastrointestinal motor disorders

    DEFF Research Database (Denmark)

    Huizinga, J D; Thuneberg, L; Vanderwinden, J M

    1997-01-01

    and colon. Slow waves also determine the direction and velocity of propagation of peristaltic activity, in concert with the enteric nervous system. Characterization of receptors and ion channels in the ICC membrane is under way, and manipulation of slow-wave activity markedly alters movement of contents...... through the gut organs. Here Jan Huizinga, Lars Thuneberg, Jean-Marie Vanderwinden and Jüri Rumessen, suggest that, as ICCs are unique to the gut, they might be ideal targets for pharmacological intervention in gastrointestinal motility disorders, which are very common and costly....

  20. Are Smoking Cessation Treatments Associated with Suicidality Risk? An Overview

    Science.gov (United States)

    Penberthy, J. Kim; Penberthy, J. Morgan; Harris, Marcus R.; Nanda, Sonali; Ahn, Jennifer; Ponce Martinez, Caridad; Osika, Apule O.; Slepian, Zoe A.; Forsyth, Justin C.; Starr, J. Andrew; Farrell, Jennifer E.; Hook, Joshua N.

    2016-01-01

    Risk of suicidality during smoking cessation treatment is an important, but often overlooked, aspect of nicotine addiction research and treatment. We explore the relationship between smoking cessation interventions and suicidality and explore common treatments, their associated risks, and effectiveness in promoting smoking reduction and abstinence. Although active smokers have been reported to have twofold to threefold increased risk of suicidality when compared to nonsmokers,1–4 research regarding the safest way to stop smoking does not always provide clear guidelines for practitioners wishing to advise their patients regarding smoking cessation strategies. In this article, we review pharmacological and cognitive behavioral therapy (CBT) options that are available for people seeking to quit smoking, focusing on the relationship between the ability of these therapies to reduce smoking behavior and promote abstinence and suicidality risks as assessed by reported suicidality on validated measures, reports of suicidal ideation, behaviors, actual attempts, or completed suicides. Pharmacotherapies such as varenicline, bupropion, and nicotine replacement, and CBTs, including contextual CBT interventions, have been found to help reduce smoking rates and promote and maintain abstinence. Suicidality risks, while present when trying to quit smoking, do not appear to demonstrate a consistent or significant rise associated with use of any particular smoking cessation pharmacotherapy or CBT/contextual CBT intervention reviewed. PMID:27081311

  1. Targeted home visiting intervention: the impact on mother-infant relationships.

    Science.gov (United States)

    Walker, Anne Marie; Johnson, Rebecca; Banner, Catherine; Delaney, Jill; Farley, Rita; Ford, Margaret; Lake, Helen; Douglas, Hazel

    2008-03-01

    This paper reviews and reflects on six papers, which describe various early home visiting interventions that resulted in positive outcomes, particularly in relation to the mother-infant relationship. The papers were published in a special issue of the Infant Mental Health Journal in 2006. We provide a brief overview of each paper, highlighting the conclusions drawn across the six papers. Key learning points for health visitors in the UK are explored throughout. Suggestions are described for improvements to the way in which health visiting services in the UK are structured in order to further enhance mother-infant relationships. The overall finding is that mother-infant relationships and interactions can be improved through early home visiting interventions over a period of time, and that this prevents childhood problems later on. It is recommended that specific patient groups be targeted and offered tailored programmes of interventions that have a relevant theoretical base, by trained nursing staff who are supported by an infant mental health consultant.

  2. Effectiveness of group counselling for smoking cessation in hospital staff

    Directory of Open Access Journals (Sweden)

    A. Schoonis

    2008-06-01

    Full Text Available Smoking prevalence among hospital staff is still considerable. It is well known that smoking cessation is difficult to establish without any help. Group counselling is effective for smoking cessation. In 2004, therefore, we decided to offer group counselling for smoking cessation to our hospital staff. (1 To assess the efficacy of group counselling given by a multidisciplinary team of healthcare professionals. (2 To determine the quit rate after group counselling in hospital staff. The program is based on 10 group sessions of 90 min each. Each group contains a maximum of 16 participants. The group sessions were led by a nurse specialized in smoking cessation and consisted of education and behavioural interventions provided by health care professionals (respiratory physician, psychologist and a dietician. To improve smoking cessation motivation, spirometry (FEV1 and FVC and exhaled CO were measured both at the start and at the end of the group counselling. In total, 38 participants of 3 different groups entered group counselling. The mean age was 48 years, and 71% was female. They smoked an average of 20 cigarettes per day. Based on exhaled CO measurements and self-reports, smoking cessation, the quit rates after 6 months, 1 year and 2 years were, 27/35 (77%, 25/35 (72% and 23/35 (66%, respectively. Group counselling program on smoking cessation in hospital staff based on 10 group sessions was able to induce a remarkably high amount of quitters. The hospital setting offered the opportunity to meet the group participants frequently afterwards, what might have helped in keeping the quitting results at about the same level, even after 2 years’ follow-up.

  3. TABADO: "Evaluation of a smoking cessation program among Adolescents in Vocational Training Centers": Study protocol

    Directory of Open Access Journals (Sweden)

    Martinet Yves

    2009-11-01

    Full Text Available Abstract Background Most of the efforts to reduce teenagers' tobacco addiction have focused on smoking prevention and little on smoking cessation. A smoking cessation program (TABADO study, associating pharmacologic and cognitive-behavioural strategy, on a particularly vulnerable population (vocational trainees, was developed. This study aims to evaluate the efficacy of the program which was offered to all smokers in a population aged 15 to 20 years in Vocational Training Centers (VTC. This paper presents the TABADO study protocol. Methods The study is quasi-experimental, prospective, evaluative and comparative and takes place during the 2 years of vocational training. The final population will be composed of 2000 trainees entering a VTC in Lorraine, France, during the 2008-2009 period. The intervention group (1000 trainees benefited from the TABADO program while no specific intervention took place in the "control" group (1000 trainees other than the treatment and education services usually available. Our primary outcome will be the tobacco abstinence rate at 12 months. Discussion If the program proves effective, it will be a new tool in the action against smoking in populations that have been seldom targeted until now. In addition, the approach could be expanded to other young subjects from socially disadvantaged backgrounds in the context of a public health policy against smoking among adolescents. Trial registration Clinical trial identification number is NTC00973570.

  4. Model for implementing cognitive behavioural therapy for smartphone app based smoking cessation program

    Directory of Open Access Journals (Sweden)

    Abdullah Alsharif

    2015-11-01

    Full Text Available Smoking cessation programs are widely implemented to assist smokers in the process of quitting smoking. Cognitive Behavioural Therapy (CBT is a psychological approach that is increasingly used in smoking cessation programs. CBT has also been implemented for smoking cessation programs and has been successful in helping smokers to quit. Another advantage of CBT is that it can be combined with different tools and technologies and hence made to deliver effective health intervention programs. The recent advancements in smartphone technologies have been widely explored to develop smoking cessation apps as tools to assist with quitting smoking. However, most existing smartphone apps lack follow-up and adherence to clinical guidelines for treatment. To date, there are no studies which have explored implementing CBT modules into smoking cessation apps. Therefore, there is a need for implementing behavioural change mechanisms in smoking cessation apps to help smokers quit effectively. In this study, we propose a new approach that combines mobile health technology and CBT methods to provide an effective smoking cessation program. The ubiquitous presence of smartphones and the various communication benefits they provide are utilized by our proposed system to provide a CBT paradigm into smoking cessation app systems and hence enhance their success potential. Currently, the proposed system is at the implementation stage, which is soon to be followed by a clinical trial to study the impact of this system on smoking cessation.

  5. Targeted intervention strategies to optimise diversion of BMW in the Dublin, Ireland region.

    Science.gov (United States)

    Purcell, M; Magette, W L

    2011-01-01

    Urgent transformation is required in Ireland to divert biodegradable municipal waste (BMW) from landfill and prevent increases in overall waste generation. When BMW is optimally managed, it becomes a resource with value instead of an unwanted by-product requiring disposal. An analysis of survey responses from commercial and residential sectors for the Dublin region in previous research by the authors proved that attitudes towards and behaviour regarding municipal solid waste is spatially variable. This finding indicates that targeted intervention strategies designed for specific geographic areas should lead to improved diversion rates of BMW from landfill, a requirement of the Landfill Directive 1999/31/EC. In the research described in this paper, survey responses and GIS model predictions from previous research were the basis for goal setting, after which logic modelling and behavioural research were employed to develop site-specific waste management intervention strategies. The main strategies devised include (a) roll out of the Brown Bin (Organics) Collection and Community Workshops in Dún Laoghaire Rathdown, (b) initiation of a Community Composting Project in Dublin City (c) implementation of a Waste Promotion and Motivation Scheme in South Dublin (d) development and distribution of a Waste Booklet to promote waste reduction activities in Fingal (e) region wide distribution of a Waste Booklet to the commercial sector and (f) Greening Irish Pubs Initiative. Each of these strategies was devised after interviews with both the residential and commercial sectors to help make optimal waste management the norm for both sectors. Strategy (b), (e) and (f) are detailed in this paper. By integrating a human element into accepted waste management approaches, these strategies will make optimal waste behaviour easier to achieve. Ultimately this will help divert waste from landfill and improve waste management practice as a whole for the region. This method of devising

  6. Neural correlates of message tailoring and self-relatedness in smoking cessation programming

    Science.gov (United States)

    Chua, Hannah Faye; Liberzon, Israel; Welsh, Robert C.; Strecher, Victor J.

    2011-01-01

    BACKGROUND Smoking leads to illnesses including addiction, cancer, and cardiovascular and respiratory diseases. Different intervention programs have become available. In the past decade, providing tailored smoking cessation messages has been shown to be more effective in inducing smoking cessation than one-size-fits-all interventions. However, little is known about the brain responses of smokers when they receive tailored smoking cessation messages. METHODS A neuroimaging study using blocked and event-related designs examined neural activity in 24 smokers exposed to high-tailored and low-tailored smoking cessation messages. RESULTS: In both blocked and event-related conditions, rostral medial prefrontal cortex and precuneus/posterior cingulate were engaged more during the processing of high-tailored smoking cessation messages than low-tailored smoking cessation messages. CONCLUSION The activation patterns of smokers to tailored cessation messages show involvement of brain areas commonly implicated in self-related processing. Results seem to add support to the suggested role of self-relevance in tailored cessation programs, where previous studies have shown a potential mediating role of self-relevance on smoking abstinence. The findings are relevant to understanding the cognitive mechanisms underlying tailored message processing and may point to new directions for testing response to health communications programming. PMID:18926523

  7. Smoking behavior, attitudes, and cessation counseling among healthcare professionals in Armenia

    Directory of Open Access Journals (Sweden)

    Movsisyan Narine K

    2012-11-01

    Full Text Available Abstract Background Smoking cessation counseling by health professionals has been effective in increasing cessation rates. However, little is known about smoking cessation training and practices in transition countries with high smoking prevalence such as Armenia. This study identified smoking-related attitudes and behavior of physicians and nurses in a 500-bed hospital in Yerevan, Armenia, the largest cancer hospital in the country, and explored barriers to their effective participation in smoking cessation interventions. Methods This study used mixed quantitative and qualitative methods. Trained interviewers conducted a survey with physicians and nurses using a 42-item self-administered questionnaire that assessed their smoking-related attitudes and behavior and smoking cessation counseling training. Four focus group discussions with hospital physicians and nurses explored barriers to effective smoking cessation interventions. The focus group sessions were audio-taped, transcribed, and analyzed. Results The survey response rate was 58.5% (93/159 for physicians and 72.2% (122/169 for nurses. Smoking prevalence was almost five times higher in physicians compared to nurses (31.2% vs. 6.6%, p  Conclusions This study was the first to explore differences in smoking-related attitudes and behavior among hospital physicians and nurses in Yerevan, Armenia. The study found substantial behavioral and attitudinal differences in these two groups. The study revealed a critical need for integrating cessation counseling training into Armenia’s medical education. As nurses had more positive attitudes toward cessation counseling compared to physicians, and more often reported having cessation training, they are an untapped resource that could be more actively engaged in smoking cessation interventions in healthcare settings.

  8. Public policy to maximize tobacco cessation.

    Science.gov (United States)

    McGoldrick, Daniel E; Boonn, Ann V

    2010-03-01

    Tobacco use kills more than 400,000 Americans every year. For smokers, quitting is the biggest step they can take to improve their health, but it is a difficult step. Fortunately, policy-based interventions can both encourage smokers to quit and help them succeed. Evidence shows that tobacco tax increases encourage smokers to quit-recent state and federal increases have created dramatic surges in calls to quitlines. Similarly, smokefree workplace laws not only protect workers and patrons from secondhand smoke but also encourage smokers to quit, help them succeed, and create a social environment less conducive to smoking. The impact of policy changes can be amplified by promoting quitting around the date they are implemented. Outreach to health practitioners can alert them to encourage their patients to quit. Earned and paid media can also be used to motivate smokers to quit when policy changes are put into effect. Although these policies and efforts regarding them can generate great demand for evidence-based cessation services such as counseling and medication, it is important to make these resources available for those wanting to quit. Public and private health insurance plans should provide coverage for cessation services, and states should invest tobacco tax and/or tobacco settlement dollars in smoking-cessation programs as recommended by the CDC. Finally, the Family Smoking Prevention and Tobacco Control Act has given the U.S. Food and Drug Administration new authority to regulate tobacco products and marketing, and to prevent tobacco companies from deceptively marketing new products that discourage smokers from quitting and keep them addicted.

  9. Interventions targeting sexual and reproductive health and rights outcomes of young people living with HIV: a comprehensive review of current interventions from sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Leandri Pretorius

    2015-11-01

    Full Text Available Background: A growing number of young people (ages 10–24 are living with HIV (YPLWH in sub-Saharan Africa (SSA. These YPLWH have particular needs and challenges related to their sexual and reproductive health and rights (SRHR. Contextual factors including gender inequalities, violence, stigma, and discrimination and lack of tailored services undermine YPLWH's SRHR. Objective: Understand the scope and impact of interventions targeting YPLWH to improve SRH-related outcomes in SSA. Design: We undertook a review to synthesise evaluated interventions (qualitative, quantitative, or mixed methods aimed at improving the SRH outcomes of YPLWH in SSA with outcomes based on a World Health Organization framework of comprehensive SRHR approaches for women living with HIV. Using inclusion criteria, only six interventions were identified. Results: Interventions sought to improve a range of direct and indirect SRH outcomes, including sexual behaviour, adherence, disclosure, and mental health. Four overarching issues emerged: 1 all interventions were structured according to cognitive behavioural therapy theories of behaviour change – while showing promise they do not tackle the wider gender, social, and economic contexts that shape YPLWH's SRH; 2 ‘significant others’ were included in two of the interventions, but further work needs to consider how to leverage parental/guardian support appropriately; 3 interventions only accessed young people who were already linked to care, participants were likely to have better SRH outcomes than those potentially more vulnerable YPLWH; and 4 none of the interventions explored the sexuality of young people. Conclusions: There have been a limited number of evaluated interventions to strengthen SRH of YPLWH in SSA, and gaps exist in addressing the SRHR needs of YPLWH. Intervention approaches require greater scope and depth, including the need to address structural and contextual challenges.

  10. Complement therapeutics in inflammatory diseases: promising drug candidates for C3-targeted intervention.

    Science.gov (United States)

    Mastellos, D C; Ricklin, D; Hajishengallis, E; Hajishengallis, G; Lambris, J D

    2016-02-01

    There is increasing appreciation that complement dysregulation lies at the heart of numerous immune-mediated and inflammatory disorders. Complement inhibitors are therefore being evaluated as new therapeutic options in various clinical translation programs and the first clinically approved complement-targeted drugs have profoundly impacted the management of certain complement-mediated diseases. Among the many members of the intricate protein network of complement, the central component C3 represents a 'hot-spot' for complement-targeted therapeutic intervention. C3 modulates both innate and adaptive immune responses and is linked to diverse immunomodulatory systems and biological processes that affect human pathophysiology. Compelling evidence from preclinical disease models has shown that C3 interception may offer multiple benefits over existing therapies or even reveal novel therapeutic avenues in disorders that are not commonly regarded as complement-driven, such as periodontal disease. Using the clinically developed compstatin family of C3 inhibitors and periodontitis as illustrative examples, this review highlights emerging therapeutic concepts and developments in the design of C3-targeted drug candidates as novel immunotherapeutics for oral and systemic inflammatory diseases.

  11. Targeting IAP (inhibitor of apoptosis) proteins for therapeutic intervention in tumors.

    Science.gov (United States)

    Vucic, Domagoj

    2008-03-01

    Apoptosis, or programmed cell death, is a cell suicide process with a major role in development and homeostasis in vertebrates and invertebrates. Dysregulation of apoptosis leading to early cell death or the absence of normal cell death contributes to a number of disease conditions including neurodegenerative diseases and cancer. Inhibition of apoptosis enhances the survival of cancer cells and facilitates their escape from immune surveillance and cytotoxic therapies. Inhibitor of apoptosis (IAP) proteins, a family of anti-apoptotic regulators that block cell death in response to diverse stimuli through interactions with inducers and effectors of apoptosis are among the principal molecules contributing to this phenomenon. IAP proteins are expressed in the majority of human malignancies at elevated levels and play an active role in promoting tumor maintenance through the inhibition of cellular death and participation in signaling pathways associated with malignancies. Herein, the role of IAP proteins in cancer and strategies toward targeting IAP proteins for therapeutic intervention will be discussed.

  12. Toll-like receptor modulation in cardiovascular disease: a target for intervention?

    Science.gov (United States)

    Földes, Gábor; von Haehling, Stephan; Anker, Stefan D

    2006-08-01

    Toll-like receptors (TLRs) form a family of pattern recognition receptors that have emerged as key mediators of innate immunity. These receptors sense invading microbes and initiate the immune response. TLR-mediated inflammation is an important pathogenic link between innate immunity and a diverse panel of clinical disorders. Among the processes in which TLRs play a role are cardiovascular disorders such as cardiac ischaemia, coronary artery disease, ventricular remodelling, cancer angiogenesis or transplant rejection. From these, many important opportunities for disease modification through TLR signalling manipulation can be imagined. Their role as potential targets for therapeutic intervention is just beginning to be appreciated and this article reviews the current status of these treatment strategies for cardiovascular disease.

  13. Neurocognitive Functioning in Schizophrenia and during the Early Phases of Psychosis: Targeting Cognitive Remediation Interventions

    Directory of Open Access Journals (Sweden)

    Yulia Zaytseva

    2013-01-01

    Full Text Available Recent interest in the early course of schizophrenia accentuated altered cognition prior to the onset. Ultrahigh risk (UHR individuals with attenuated positive symptoms and transient psychotic episodes demonstrate neurocognitive deficits across multiple domains such as memory, executive functioning, and processing speed which are consistent with similar disturbances identified in patients with a first episode of schizophrenia. Cognitive remediation (CR approaches representing a broad set of activities are aimed to restore or improve cognitive functioning. CR proved to be effective in modulating the cognitive dysfunction in schizophrenia but is rarely used in ultrahigh risk individuals. From the clinical prospective, a better understanding of cognitive functioning in at-risk states is essential for the development of optimal early intervention models. In the review, we highlight the intervention targets, notably the specific cognitive deficits in at risk individuals which preceed the transition to psychosis and emphasize the need of the additional studies using CR approaches in UHR group aiming to enhance cognition and therefore mediate functional improvement.

  14. Update on smoking cessation therapies.

    LENUS (Irish Health Repository)

    Glynn, Deirdre A

    2009-04-01

    As a reflection of an exponential increase in smoking rates throughout the world during the last century, the economic and human burden of mortality and morbidity related to smoking is now clearly defined. Smoking cessation is associated with health benefits for people of all ages. In this paper we provide a comprehensive review of current licensed pharmacological smoking cessation agents including efficacy and safety profiles, with comparisons of individual therapies available. Furthermore, we offer a prospective on the need for further testing of other agents including novel avenues of therapy.

  15. Nicotine vaccines for smoking cessation-present and future

    Directory of Open Access Journals (Sweden)

    Richa

    2013-01-01

    Full Text Available Background: Worldwide tobacco is the leading cause of preventable death. Anew treatment in smoking cessation and relapse prevention is nicotine vaccination which is based on active immunization against the nicotine molecule. This article aimed to review the mechanism of action, current status of research and future aspects for the development of vaccines against nicotine. Materials & Method: The literature search of publications indexed was carried out in PubMed, Medline, Google scholar databases. Total 25 animal trials, human trials under various phases of clinical trials, unpublished document and cross-sectional survey were reviewed. Results: This immunization will act on immune system to produce nicotine-specific antibodies that sequester nicotine in the blood stream, after inhaling tobacco products. Nicotine vaccines are irreversible, provide protection over years and need booster injections. Efficiency of the vaccines is directly related to the antibody levels which help to optimize the vaccine effect. Nicotine vaccines are today in an advanced stage of clinical evaluation trials. Conclusions: Though, nicotine vaccine has considerable therapeutic potential, they do not target the non pharmacological factors that maintain tobacco dependence. So combination of nicotine vaccine with behavioral interventions would be effective mode to motivate abstinence from tobacco use.

  16. The impact of hotspot-targeted interventions on malaria transmission: study protocol for a cluster-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Bousema Teun

    2013-02-01

    Full Text Available Abstract Background Malaria transmission is highly heterogeneous in most settings, resulting in the formation of recognizable malaria hotspots. Targeting these hotspots might represent a highly efficacious way of controlling or eliminating malaria if the hotspots fuel malaria transmission to the wider community. Methods/design Hotspots of malaria will be determined based on spatial patterns in age-adjusted prevalence and density of antibodies against malaria antigens apical membrane antigen-1 and merozoite surface protein-1. The community effect of interventions targeted at these hotspots will be determined. The intervention will comprise larviciding, focal screening and treatment of the human population, distribution of long-lasting insecticide-treated nets and indoor residual spraying. The impact of the intervention will be determined inside and up to 500 m outside the targeted hotspots by PCR-based parasite prevalence in cross-sectional surveys, malaria morbidity by passive case detection in selected facilities and entomological monitoring of larval and adult Anopheles populations. Discussion This study aims to provide direct evidence for a community effect of hotspot-targeted interventions. The trial is powered to detect large effects on malaria transmission in the context of ongoing malaria interventions. Follow-up studies will be needed to determine the effect of individual components of the interventions and the cost-effectiveness of a hotspot-targeted approach, where savings made by reducing the number of compounds that need to receive interventions should outweigh the costs of hotspot-detection. Trial registration NCT01575613. The protocol was registered online on 20 March 2012; the first community was randomized on 26 March 2012.

  17. Expansion of Medicaid Covered Smoking Cessation Services

    Data.gov (United States)

    U.S. Department of Health & Human Services — Expansionof Medicaid Covered Smoking Cessation Services - Maternal Smoking and Birth Outcomes. To assess whether Medicaid coverage of smoking cessation services...

  18. Successful treatment of hypovascular advanced hepatocellular carcinoma with lipiodol-targetting intervention radiology

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    We report a case of hypovascular advanced hepatocellular carcinoma (HCC) successfully treated with a novel combination therapy of percutaneous ethanollipiodol injection (PELI) and intervention radiology (IVR),lipiodol-targetting IVR (Lipi-IVR). The present case had a hypovascular HCC (3 cm in diameter) located in the S6 region of the liver. Although the tumor was not detectable at all by both of early and late phase of helical dynamic computed tomography (CT), it could be detected by ultrasonography (US) as a low echoic space occupying lesion (SOL) beside the gallbladder and right kidney. Serum levels of alpha fetoprotein (AFP)and AFP-L3 were extremely high. Combination therapy of PELI, firstly reported in our department, and IVR (PELI and IVR, lipiodol-targetting IVR) was performed twice for the treatment. PELI could effectively visualize the location of the tumor for IVR treatment and show the presence of a thin blood vessel branching from the right hepatic artery flowing into the lipiodol deposit.After treatment, the serum levels of AFP and AFP-L3 were rapidly decreased to normal and maintained for more than eight months. Thus, this case expressing the tremendous effect might give us insight into the effectiveness of the novel combination therapy of PELI and IVR for the treatment of hypovascular HCC.

  19. Metabolic Control of Type 2 Diabetes by Targeting the GLUT4 Glucose Transporter: Intervention Approaches.

    Science.gov (United States)

    Alam, Fahmida; Islam, Md Asiful; Khalil, Md Ibrahim; Gan, Siew Hua

    2016-01-01

    Type 2 diabetes mellitus (T2DM), the most common form of diabetes, is characterized by insulin resistance in the hepatic and peripheral tissues. Glucose transporter 4 (GLUT4) plays a major role in the pathophysiology of T2DM. Its defective expression or translocation to the peripheral cell plasma membrane in T2DM patients hinders the entrance of glucose into the cell for energy production. In addition to suitable drugs, an appropriate diet and/or exercise can be implemented to target the increase in GLUT4 expression, GLUT4 concentrations and GLUT4 translocation to the cell surface when managing the glucose metabolism of T2DM patients. In this review, we discussed successful intervention strategies that were individually administered or coupled with diet and/or exercise and affected the expression and translocation of GLUT4 in T2DM while reducing the excess glucose load from the blood. Additionally, some potentially good synthetic and natural compounds, which can activate the insulin-independent GLUT4 signaling pathways for the efficient management of T2DM, are highlighted as possible targets or emerging alternative sources for future anti-diabetic drug development.

  20. Targeted ethnography as a critical step to inform cultural adaptations of HIV prevention interventions for adults with severe mental illness.

    Science.gov (United States)

    Wainberg, Milton L; Alfredo González, M; McKinnon, Karen; Elkington, Katherine S; Pinto, Diana; Gruber Mann, Claudio; Mattos, Paulo E

    2007-07-01

    As in other countries worldwide, adults with severe mental illness (SMI) in Brazil are disproportionately infected with HIV relative to the general population. Brazilian psychiatric facilities lack tested HIV prevention interventions. To adapt existing interventions, developed only in the US, we conducted targeted ethnography with adults with SMI and staff from two psychiatric institutions in Brazil. We sought to characterize individual, institutional, and interpersonal factors that may affect HIV risk behavior in this population. We conducted 350 hours of ethnographic field observations in two mental health service settings in Rio de Janeiro, and 9 focus groups (n=72) and 16 key-informant interviews with patients and staff in these settings. Data comprised field notes and audiotapes of all exchanges, which were transcribed, coded, and systematically analyzed. The ethnography identified and/or characterized the institutional culture: (1) patients' risk behaviors; (2) the institutional setting; (3) intervention content; and (4) intervention format and delivery strategies. Targeted ethnography also illuminated broader contextual issues for development and implementation of HIV prevention interventions for adults with SMI in Brazil, including an institutional culture that did not systematically address patients' sexual behavior, sexual health, or HIV sexual risk, yet strongly impacted the structure of patients' sexual networks. Further, ethnography identified the Brazilian concept of "social responsibility" as important to prevention work with psychiatric patients. Targeted ethnography with adults with SMI and institutional staff provided information critical to the adaptation of tested US HIV prevention interventions for Brazilians with SMI.

  1. Isolating the Role of Psychological Dysfunction in Smoking Cessation Failure: Relations of Personality and Psychopathology to Attaining Smoking Cessation Milestones

    Science.gov (United States)

    Leventhal, Adam M.; Japuntich, Sandra J.; Piper, Megan E.; Jorenby, Douglas E.; Schlam, Tanya R.; Baker, Timothy B.

    2012-01-01

    Research exploring psychological dysfunction as a predictor of smoking cessation success may be limited by nonoptimal predictor variables (i.e., categorical psychodiagnostic measures vs. continuous personality-based manifestations of dysfunction) and imprecise outcomes (i.e., summative point prevalence abstinence vs. constituent cessation milestone measures). Accordingly, this study evaluated the unique and overlapping relations of broad-spectrum personality traits (positive emotionality, negative emotionality, and constraint) and past-year psychopathology (anxiety, mood, and substance use disorder) to point prevalence abstinence and three smoking cessation milestones: (1) initiating abstinence; (2) first lapse; and (3) transition from lapse to relapse. Participants were daily smokers (N=1365) enrolled in a smoking cessation treatment study. In single predictor regression models, each manifestation of internalizing dysfunction (lower positive emotionality, higher negative emotionality, and anxiety and mood disorder) predicted failure at one or more cessation milestone. In simultaneous predictor models, lower positive and higher negative emotionality significantly predicted failure to achieve milestones after controlling for psychopathology. Psychopathology did not predict any outcome when controlling for personality. Negative emotionality showed the most robust and consistent effects, significantly predicting failure to initiate abstinence, earlier lapse, and lower point prevalence abstinence rates. Substance use disorder and constraint did not predict cessation outcomes, and no single variable predicted lapse-to-relapse transition. These findings suggest that personality-related manifestations of internalizing dysfunction are more accurate markers of affective sources of relapse risk than mood and anxiety disorders. Further, individuals with high trait negative emotionality may require intensive intervention to promote the initiation and early maintenance of

  2. Workplace tobacco cessation program in India: A success story

    Directory of Open Access Journals (Sweden)

    Mishra Gauravi

    2009-01-01

    Full Text Available Context: This paper describes the follow-up interventions and results of the work place tobacco cessation study. Aims: To assess the tobacco quit rates among employees, through self report history, and validate it with rapid urine cotinine test; compare post-intervention KAP regarding tobacco consumption with the pre-intervention responses and assess the tobacco consumption pattern among contract employees and provide assistance to encourage quitting. Settings and Design: This is a cohort study implemented in a chemical industry in rural Maharashtra, India. Materials and Methods: All employees (104 were interviewed and screened for oral neoplasia. Active intervention in the form of awareness lectures, focus group discussions and if needed, pharmacotherapy was offered. Medical staff from the industrial medical unit and from a local referral hospital was trained. Awareness programs were arranged for the family members and contract employees. Statistical Analysis Used: Non-parametric statistical techniques and kappa. Results: Forty eight per cent employees consumed tobacco. The tobacco quit rates increased with each follow-up intervention session and reached 40% at the end of one year. There was 96% agreement between self report tobacco history and results of rapid urine cotinine test. The post-intervention KAP showed considerable improvement over the pre-intervention KAP. 56% of contract employees used tobacco and 55% among them had oral pre-cancerous lesions. Conclusions: A positive atmosphere towards tobacco quitting and positive peer pressure assisting each other in tobacco cessation was remarkably noted on the entire industrial campus. A comprehensive model workplace tobacco cessation program has been established, which can be replicated elsewhere.

  3. A randomised controlled trial linking mental health inpatients to community smoking cessation supports: A study protocol

    Directory of Open Access Journals (Sweden)

    Clancy Richard

    2011-07-01

    Full Text Available Abstract Background Mental health inpatients smoke at higher rates than the general population and are disproportionately affected by tobacco dependence. Despite the advent of smoke free policies within mental health hospitals, limited systems are in place to support a cessation attempt post hospitalisation, and international evidence suggests that most smokers return to pre-admission smoking levels following discharge. This protocol describes a randomised controlled trial that will test the feasibility, acceptability and efficacy of linking inpatient smoking care with ongoing community cessation support for smokers with a mental illness. Methods/Design This study will be conducted as a randomised controlled trial. 200 smokers with an acute mental illness will be recruited from a large inpatient mental health facility. Participants will complete a baseline survey and will be randomised to either a multimodal smoking cessation intervention or provided with hospital smoking care only. Randomisation will be stratified by diagnosis (psychotic, non-psychotic. Intervention participants will be provided with a brief motivational interview in the inpatient setting and options of ongoing smoking cessation support post discharge: nicotine replacement therapy (NRT; referral to Quitline; smoking cessation groups; and fortnightly telephone support. Outcome data, including cigarettes smoked per day, quit attempts, and self-reported 7-day point prevalence abstinence (validated by exhaled carbon monoxide, will be collected via blind interview at one week, two months, four months and six months post discharge. Process information will also be collected, including the use of cessation supports and cost of the intervention. Discussion This study will provide comprehensive data on the potential of an integrated, multimodal smoking cessation intervention for persons with an acute mental illness, linking inpatient with community cessation support. Trial Registration

  4. Interventions that target improvements in mental health for parents of children with autism spectrum disorders: A narrative review.

    OpenAIRE

    Da Paz, NS; Wallander, JL

    2017-01-01

    Prevalence of autism spectrum disorders (ASD) suggest that one in 68 children is affected. With convincing evidence that parenting a child with ASD is associated with elevated distress and mental health problems, researchers have begun to investigate treatments that directly target parents' psychological well-being. We conducted a narrative review of studies that empirically tested the effects of interventions targeting improvements in the mental health of parents of children with ASD. Follow...

  5. Process and Effects Evaluation of a Digital Mental Health Intervention Targeted at Improving Occupational Well-Being: Lessons From an Intervention Study With Failed Adoption

    Science.gov (United States)

    Ermes, Miikka

    2016-01-01

    use experienced many benefits such as relief in stressful situations. The app was perceived as a toolkit for personal well-being that gives concrete instructions on how mindfulness can be practiced. However, many barriers to participate in the intervention were identified at the individual level, such as lack of time, lack of perceived need, and lack of perceived benefits. Conclusions The findings suggest that neither the setting nor the approach used in this study were successful in adopting new digital interventions at the target organizations. Barriers were faced at both the organizational as well as the individual level. At the organizational level, top management needs to be involved in the intervention planning for fitting into the organization policies, the existing technology infrastructure, and also targeting the organizational goals. At the individual level, concretizing the benefits of the preventive intervention and arranging time for app use at the workplace are likely to increase adoption. PMID:27170553

  6. An evaluation of the range and availability of intensive smoking cessation services in Ireland.

    LENUS (Irish Health Repository)

    Currie, LM

    2009-06-27

    BACKGROUND: A review of smoking cessation (SC) services in Ireland is a necessary step in improving service planning and provision. AIMS: To assess the range and availability of intensive SC services in Ireland in 2006. METHODS: A survey of SC service providers in Ireland was conducted. Descriptive analysis and simple linear regression analysis was used. RESULTS: Response rate was 86.3% (63\\/73). All service providers surveyed are employing evidence-based interventions; the most common form of support is individual counselling with initial sessions averaging 40 min and weekly review sessions 20 min in duration. Reaching the recommended target of treating 5.0% of smokers does not seem feasible given the current distribution of resources and there appears to be regional differences in resource allocation. CONCLUSIONS: While intensive SC services are available in all four Health Service Executive Areas, it would appear that there is little uniformity or consistency countrywide in the scope and structure of these services.

  7. Intervenciones para dejar de fumar en México: análisis de disponibilidad a pagar por un método efectivo de cesación Smoking cessation interventions in Mexico: analysis of the willingness to pay for an effective method to quit

    Directory of Open Access Journals (Sweden)

    Edson E Serván-Mori

    2012-06-01

    policymakers in the design of smoking cessation interventions improving national health system interventions for quit smoking.

  8. Barriers and promoters of an evidenced-based smoking cessation counseling during prenatal care in Argentina and Uruguay.

    Science.gov (United States)

    Colomar, Mercedes; Tong, Van T; Morello, Paola; Farr, Sherry L; Lawsin, Catalina; Dietz, Patricia M; Aleman, Alicia; Berrueta, Mabel; Mazzoni, Agustina; Becu, Ana; Buekens, Pierre; Belizán, José; Althabe, Fernando

    2015-07-01

    In Argentina and Uruguay, 10.3 and 18.3 %, respectively, of pregnant women smoked in 2005. Brief cessation counseling, based on the 5A's model, has been effective in different settings. This qualitative study aims to improve the understanding of factors influencing the provision of smoking cessation counseling during pregnancy in Argentina and Uruguay. In 2010, we obtained prenatal care providers', clinic directors', and pregnant smokers' opinions regarding barriers and promoters to brief smoking cessation counseling in publicly-funded prenatal care clinics in Buenos Aires, Argentina and Montevideo, Uruguay. We interviewed six prenatal clinic directors, conducted focus groups with 46 health professionals and 24 pregnant smokers. Themes emerged from three issue areas: health professionals, health system, and patients. Health professional barriers to cessation counseling included inadequate knowledge and motivation, perceived low self-efficacy, and concerns about inadequate time and large workload. They expressed interest in obtaining a counseling script. Health system barriers included low prioritization of smoking cessation and a lack of clinic protocols to implement interventions. Pregnant smokers lacked information on the risks of prenatal smoking and underestimated the difficulty of smoking cessation. Having access to written materials and receiving cessation services during clinic waiting times were mentioned as promoters for the intervention. Women also were receptive to non-physician office staff delivering intervention components. Implementing smoking cessation counseling in publicly-funded prenatal care clinics in Argentina and Uruguay may require integrating counseling into routine prenatal care and educating and training providers on best-practices approaches.

  9. The readings of smoking fathers: a reception analysis of tobacco cessation images.

    Science.gov (United States)

    Johnson, Joy L; Oliffe, John L; Kelly, Mary T; Bottorff, Joan L; LeBeau, Karen

    2009-09-01

    The purpose of this qualitative study was to examine how new fathers decode image-based anti-smoking messages and uncover the extent to which ideals of masculinity might influence men to take up and/or disregard smoking cessation messages. The authors analyzed 5 images that had been used to promote smoking cessation and arrived at a consensus about the dominant discourse encoded by each image. During face-to-face interviews, new fathers were invited to discuss the images; these interview data were coded and analyzed using a social constructionist gender analysis. The study findings highlight how most men negotiated or opposed dominant discourses of health that communicated the dangers of smoking by reproducing dominant ideals of masculinity, including explicit disregard for self-health. They accepted dominant social discourses of fathering that reproduced traditional notions of masculinity, such as the protector and provider. The authors conclude that tobacco interventions targeted to new fathers must (a) develop more awareness of the ability of audiences to select discourses that empower their own interpretive positioning with regard to media, and (b) deconstruct and engage with context and age-specific masculine ideals to avoid providing rationales for continued tobacco use.

  10. Examining smoking and cessation during pregnancy among an Appalachian sample: a preliminary view

    Directory of Open Access Journals (Sweden)

    Berry Traci

    2007-05-01

    Full Text Available Abstract Background Several transitions that a woman experiences prenatally may influence her desire or ability to discontinue smoking. This study explores the role of smoking for young, Appalachian, nulliparous pregnant women and their plans for smoking during their pregnancies. Results The reports of women and their male partners were taken from baseline interviews conducted during the first trimester of pregnancy. Cigarette smoking appeared to be more than an isolated addictive activity; rather, smoking was interwoven in women's social and personal realms, often changing as their perceptions of self changed. Women and their partners who continued to smoke appeared to be depressed, reject authority, and perceived little control over issues related to being pregnant. Conclusion These findings support the argument that standard substance use treatments and polices based on stages-of-change theories may not be effective for all individuals particularly those experiencing significant developmental changes in their lives. Greater success might be obtained from treatment programs designed to recognize the impact of these transitions as it relates to the substance use. The changing experiences of pregnant women in terms of their identity development, views of others, and their relationships have not been adequately addressed in existing cessation programs. Empirically-based interventions targeting these lifestyle characteristics may lead to increased cessation success among pregnant women.

  11. Joint marketing as a framework for targeting men who have sex with men in China: a pilot intervention study.

    Science.gov (United States)

    Tan, Jingguang; Cai, Rui; Lu, Zuxun; Cheng, Jinquan; de Vlas, Sake J; Richardus, Jan Hendrik

    2013-04-01

    To apply the joint marketing principle as a new intervention approach for targeting men who have sex with men (MSM) who are often difficult to reach in societies with discrimination towards homosexuality and HIV/AIDS. A pilot intervention according to the principles of joint marketing was carried out by the CDC in Shenzhen, China, in MSM social venues. A self-designed questionnaire of HIV knowledge, condom use, and access to HIV-related services was used before and after the pilot intervention to evaluate its effectiveness. The CDC supported gatekeepers of MSM social venues in running their business and thereby increasing their respectability and income. In return, the gatekeepers cooperated with the CDC in reaching the MSM at the venues with health promotion messages and materials. Thus a win-win situation was created, bringing together two noncompetitive parties in reaching out to a shared customer, the MSM. The pilot intervention succeeded in demonstrating acceptability and feasibility of the joint marketing approach targeting MSM. HIV knowledge, the rate of condom use, and access to HIV-related services of participants in the pilot intervention increased significantly. The joint marketing intervention is an innovative way to create synergies between the gatekeepers of MSM social venues and public health officials for reaching and potentially changing HIV high-risk behaviors among MSM.

  12. Screening and brief intervention targeting risky drinkers in Danish general practice - a pragmatic controlled trial

    DEFF Research Database (Denmark)

    Beich, A.; Gannik, D.; Saelan, H.;

    2007-01-01

    AIMS: Recommendations for routine alcohol screening and brief counselling intervention in primary health care rest on results from intervention efficacy studies. By conducting a pragmatic controlled trial (PCT), we aimed at evaluating the effectiveness of the WHO recommendations for screening...

  13. Smoking cessation: an economic analysis and review of varenicline

    Directory of Open Access Journals (Sweden)

    Michele A Faulkner

    2009-06-01

    Full Text Available Michele A FaulknerCreighton University School of Pharmacy and Health Professions, Omaha, NE, USAAbstract: Despite efforts to decrease tobacco use, smoking continues to be a leading cause of preventable morbidity and premature death. The associated economic burden is substantial, both in the form of direct costs (healthcare expenditures and indirect costs (lost productivity, regardless of whether the burden is assessed from the standpoint of an employer, a health plan, or society as a whole. Cessation programs are considered among the most cost-effective in healthcare, and are often used as a benchmark for other medical interventions. This analysis specifically considers the cost-effectiveness of varenicline, a novel α4β2 partial agonist used for smoking cessation, in comparison to other approved therapies. Clinical trial data have demonstrated that varenicline has the ability to decrease cravings and withdrawal symptoms, and lessen positive reinforcement associated with smoking. Varenicline’s novel mechanism has translated into superior efficacy in comparison to other available therapies. For this reason, despite an initial cost that typically exceeds that of other medications, varenicline is a cost-effective option for smoking cessation.Keywords: cost-effectiveness, economic analysis, smoking cessation, varenicline 

  14. Live Webcam Coaching to Help Early Elementary Classroom Teachers Provide Effective Literacy Instruction for Struggling Readers: The Targeted Reading Intervention

    Science.gov (United States)

    Vernon-Feagans, Lynne; Kainz, Kirsten; Hedrick, Amy; Ginsberg, Marnie; Amendum, Steve

    2013-01-01

    This study evaluated whether the Targeted Reading Intervention (TRI), a classroom teacher professional development program delivered through webcam technology literacy coaching, could provide rural classroom teachers with the instructional skills to help struggling readers progress rapidly in early reading. Fifteen rural schools were randomly…

  15. School-Based Interventions Targeting Challenging Behaviors Exhibited by Young Children with Autism Spectrum Disorder: A Systematic Literature Review

    Science.gov (United States)

    Martinez, Jose R.; Werch, Brittany L.; Conroy, Maureen A.

    2016-01-01

    The purpose of this review was to critically examine and summarize the impact of school-based interventions designed to decrease challenging behaviors in young children with Autism Spectrum Disorder (ASD). Reviewed studies employed a single-case experimental design, targeted challenging behaviors, included children 3-8 years old with ASD, and took…

  16. Target vessel revascularization following percutaneous coronary intervention. A 10-year report from the Danish Percutaneous Transluminal Coronary Angioplasty Registry

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Kassis, Eli;

    2005-01-01

    OBJECTIVE: To present the rate of target vessel revascularization (TVR) in a consecutive and unselected national population over 10 years. DESIGN: From 1989 to 1998 all percutaneous coronary interventions (PCIs) performed in Denmark were recorded in the Danish PTCA Registry. RESULTS: From 1989 to...

  17. PGC-1{alpha}, A Potential Therapeutic Target for Early Intervention in Parkinson's Disease

    DEFF Research Database (Denmark)

    Zheng, B.; Liao, Z.; Locascio, J.J.;

    2010-01-01

    Parkinson's disease affects 5 million people worldwide, but the molecular mechanisms underlying its pathogenesis are still unclear. Here, we report a genome-wide meta-analysis of gene sets (groups of genes that encode the same biological pathway or process) in 410 samples from patients with sympt......Parkinson's disease affects 5 million people worldwide, but the molecular mechanisms underlying its pathogenesis are still unclear. Here, we report a genome-wide meta-analysis of gene sets (groups of genes that encode the same biological pathway or process) in 410 samples from patients...... with symptomatic Parkinson's and subclinical disease and healthy controls. We analyzed 6.8 million raw data points from nine genome-wide expression studies, and 185 laser-captured human dopaminergic neuron and substantia nigra transcriptomes, followed by two-stage replication on three platforms. We found 10 gene...... by mutant α-synuclein or the pesticide rotenone in cellular disease models. Our systems biology analysis of Parkinson's disease identifies PGC-1α as a potential therapeutic target for early intervention....

  18. Women With Early Menopause Have Higher Rates of Target Lesion Revascularization After Percutaneous Coronary Intervention.

    Science.gov (United States)

    Zhang, Linlin; Wang, Zhijian; Liu, Xiaoli; Zhou, Zhiming; Zhao, Yingxin; Shi, Dongmei; Liu, Yuyang; Liang, Jing; Yang, Lixia; Chai, Meng; Zhou, Yujie

    2016-04-01

    Early menopause has been found to be associated with higher risk of cardiovascular disease. Our objective was to investigate the impact of early menopause on clinical outcomes for women undergoing percutaneous coronary intervention (PCI). We observed female patients with coronary artery disease (CAD) undergoing PCI and found that women with early menopause (≤46 years old) were more likely to have CAD risk factors and more severe coronary lesions. During the 18-month follow-up, early menopause was associated with similar risk of death and myocardial infarction but higher risk of target lesion revascularization (TLR; 7.8% vs 5.3%, P = .003) and major adverse cardiovascular events (MACEs; 11.3% vs 9.0%, P = .007). After adjustment, early menopause was an independent risk factor for 18-month MACEs (hazard ratio [HR], 1.54; 95% confidence interval [CI] 1.18-2.00) and TLR (HR 1.61; 95% CI 1.21-2.13). In conclusion, for women undergoing PCI, early menopause is associated with higher risk of MACE, which is mainly driven by risk of TLR.

  19. Systolic Blood Pressure Intervention Trial (SPRINT) and Target Systolic Blood Pressure in Future Hypertension Guidelines.

    Science.gov (United States)

    Egan, Brent M; Li, Jiexiang; Wagner, C Shaun

    2016-08-01

    The Systolic Blood Pressure (SBP, mm Hg) Intervention Trial (SPRINT) showed that targeting SBP SPRINT has 2 implicit assumptions that could impact future US hypertension guidelines: (1) standard therapy controlled SBP similarly to that in adults with treated hypertension and (2) intensive therapy produced a lower mean SBP than in adults with treated hypertension and SBP SPRINT-like participants aged ≥50 years; group 2 consisted of participants all aged ≥18 years; and group 3 consisted of participants aged ≥18 years excluding group 1 but otherwise similar to SPRINT-like participants except high cardiovascular risk. Mean SBPs in groups 1, 2, and 3 were 133.0, 130.1, and 124.6, with 66.2%, 72.2%, and 81.9%, respectively, controlled to SBP SPRINT-like group had higher mean SBP than comparison groups, yet lower than SPRINT standard treatment group and (2) among groups 1 to 3 with SBP SPRINT intensive treatment. SPRINT results suggest that treatment should be continued and not reduced when treated SBP is SPRINT-like subset. Furthermore, increasing the percentage of treated adults with SBP SPRINT intensive treatment SBP without lowering treatment goals.

  20. Targeting Interventions: Moderators of the Effects of Expressive Writing and Assertiveness Training on the Adjustment of International University Students.

    Science.gov (United States)

    Hijazi, Alaa M; Tavakoli, Shedeh; Slavin-Spenny, Olga M; Lumley, Mark A

    2011-06-01

    Acculturative stress is a common experience for international students and is associated with psychological and physical problems. In a previous study, the authors reported that two stress reduction interventions-expressive writing (EW) and assertiveness training (AT)-had limited overall benefits among international students at an American University. The current analyses of data from that study investigated whether individual differences moderated the effects of EW and AT. Results indicate that greater acculturative stress at baseline predicted greater improvement from both interventions, compared with control. Women benefited more from AT than EW, except that EW improved women's physical symptoms. Men benefited more from EW than AT. Students with limited emotional awareness and expression tended to benefit from both interventions, relative to control. Finally, nation of origin cultural differences generally did not predict outcomes. It is concluded that the benefits of EW and AT and can be enhanced by targeting these interventions to specific subgroups of international students.

  1. Dengue vector management using insecticide treated materials and targeted interventions on productive breeding-sites in Guatemala

    Directory of Open Access Journals (Sweden)

    Rizzo Nidia

    2012-10-01

    Full Text Available Abstract Background In view of the epidemiological expansion of dengue worldwide and the availability of new tools and strategies particularly for controlling the primary dengue vector Aedes aegypti, an intervention study was set up to test the efficacy, cost and feasibility of a combined approach of insecticide treated materials (ITMs alone and in combination with appropriate targeted interventions of the most productive vector breeding-sites. Methods The study was conducted as a cluster randomized community trial using “reduction of the vector population” as the main outcome variable. The trial had two arms: 10 intervention clusters (neighborhoods and 10 control clusters in the town of Poptun Guatemala. Activities included entomological assessments (characteristics of breeding-sites, pupal productivity, Stegomyia indices at baseline, 6 weeks after the first intervention (coverage of window and exterior doorways made of PermaNet 2.0 netting, factory treated with deltamethrin at 55 mg/m2, and of 200 L drums with similar treated material and 6 weeks after the second intervention (combination of treated materials and other suitable interventions targeting productive breeding-sites i.e larviciding with Temephos, elimination etc.. The second intervention took place 17 months after the first intervention. The insecticide residual activity and the insecticidal content were also studied at different intervals. Additionally, information about demographic characteristics, cost of the intervention, coverage of houses protected and satisfaction in the population with the interventions was collected. Results At baseline (during the dry season a variety of productive container types for Aedes pupae were identified: various container types holding >20 L, 200 L drums, washbasins and buckets (producing 83.7% of all pupae. After covering 100% of windows and exterior doorways and a small number of drums (where the commercial cover could be fixed in 970 study

  2. A before-after implementation trial of smoking cessation guidelines in hospitalized veterans

    Directory of Open Access Journals (Sweden)

    Reisinger Heather

    2009-09-01

    Full Text Available Abstract Background Although most hospitalized smokers receive some form of cessation counseling during hospitalization, few receive outpatient cessation counseling and/or pharmacotherapy following discharge, which are key factors associated with long-term cessation. US Department of Veterans Affairs (VA hospitals are challenged to find resources to implement and maintain the kind of high intensity cessation programs that have been shown to be effective in research studies. Few studies have applied the Chronic Care Model (CCM to improve inpatient smoking cessation. Specific objectives The primary objective of this protocol is to determine the effect of a nurse-initiated intervention, which couples low-intensity inpatient counseling with sustained proactive telephone counseling, on smoking abstinence in hospitalized patients. Key secondary aims are to determine the impact of the intervention on staff nurses' attitudes toward providing smoking cessation counseling; to identify barriers and facilitators to implementation of smoking cessation guidelines in VA hospitals; and to determine the short-term cost-effectiveness of implementing the intervention. Design Pre-post study design in four VA hospitals Participants Hospitalized patients, aged 18 or older, who smoke at least one cigarette per day. Intervention The intervention will include: nurse training in delivery of bedside cessation counseling, electronic medical record tools (to streamline nursing assessment and documentation, to facilitate prescription of pharmacotherapy, computerized referral of motivated inpatients for proactive telephone counseling, and use of internal nursing facilitators to provide coaching to staff nurses practicing in non-critical care inpatient units. Outcomes The primary endpoint is seven-day point prevalence abstinence at six months following hospital admission and prolonged abstinence after a one-month grace period. To compare abstinence rates during the

  3. 综合干预对杭州市社区医务人员提供戒烟咨询的效果及影响因素分析%Assessment on the impact of smoking cessation counseling service and related influencing factors under comprehensive community-based intervention programs about the community medical staff in Hangzhou city

    Institute of Scientific and Technical Information of China (English)

    王胜锋; 刘清; 刘庆敏; 任艳军; 吕筠; 李立明

    2014-01-01

    Objective To evaluate the short-term impact of comprehensive community-based intervention programs on smoking cessation counseling services provided by community medical staff and related influencing factors in three districts of Hangzhou city.Methods Within the framework of Community Interventions for Health (CIH) Program,a community trial was conducted in two districts (Xiacheng and Gongshu) and a district (Xihu) as control,by a parallel comparison and random grouping based quasi-experimental design.Two independent questionnaire-based surveys of cross-sectional samples in the intervention and comparison areas were used to assess the impact of intervention.Results There were 299 and 141 medical staff in the areas of intervention and ‘ control',respectively.For the intervention area,the quantity of available resources increased from 2to 3 and the quantity of used resources increased from 1 to 3 (both P<0.001),while the area of control had a downward trend for both quantities.For the ratios of well-readiness for smoking counseling,in the intervention area were 35.5%,52.0% before and after intervention (P<0.001),while the ‘controlled' area they were 28.1%,39.3%,respectively (P=0.162).A slight increase was seen in the intervention area for the proportion of the medical staff who had been provided smoking cessation counseling,as ≥90% patients (including asking smoking status,announcing risks related to the risks of smoking and advising smoking cessation programs etc.),while the proportion decreased in the area of ‘control'.The improvement of preparedness would promote medical staff to ask their patients about smoking status (OR=1.43,P=0.007),while all factors as a whole would not influence the medical staff to inform patients about the danger of smoking and advice patients to quit smoking.Conclusion Comprehensive community-based interventions could increase the opportunities for medical staff to acquire and utilize smoking cessation resources to

  4. Physical activity as an aid to smoking cessation during pregnancy (LEAP) trial: study protocol for a randomized controlled trial

    OpenAIRE

    Ussher, M; Aveyard, P; Manyonda, I; Lewis, S.; West, R.; Lewis, B.; Marcus, B.; Taylor, AH; Barton, P.; Coleman, T

    2012-01-01

    Abstract Background Many women try to stop smoking in pregnancy but fail. One difficulty is that there is insufficient evidence that medications for smoking cessation are effective and safe in pregnancy and thus many women prefer to avoid these. Physical activity (PA) interventions may assist cessation; however, trials examining these interventions have been too small to detect or exclude plausible beneficial effects. The London Exercise And ...

  5. Successful malaria elimination strategies require interventions that target changing vector behaviours

    Directory of Open Access Journals (Sweden)

    Russell Tanya L

    2013-02-01

    Full Text Available Abstract Background The ultimate long-term goal of malaria eradication was recently placed back onto the global health agenda. When planning for this goal, it is important to remember why the original Global Malaria Eradication Programme (GMEP, conducted with DDT-based indoor residual spraying (IRS, did not achieve its goals. One of the technical reasons for the failure to eliminate malaria was over reliance on a single intervention and subsequently the mosquito vectors developed behavioural resistance so that they did not come into physical contact with the insecticide. Hypothesis and how to test it Currently, there remains a monolithic reliance on indoor vector control. It is hypothesized that an outcome of long-term, widespread control is that vector populations will change over time, either in the form of physiological resistance, changes in the relative species composition or behavioural resistance. The potential for, and consequences of, behavioural resistance was explored by reviewing the literature regarding vector behaviour in the southwest Pacific. Discussion Here, two of the primary vectors that were highly endophagic, Anopheles punctulatus and Anopheles koliensis, virtually disappeared from large areas where DDT was sprayed. However, high levels of transmission have been maintained by Anopheles farauti, which altered its behaviour to blood-feed early in the evening and outdoors and, thereby, avoiding exposure to the insecticides used in IRS. This example indicates that the efficacy of programmes relying on indoor vector control (IRS and long-lasting, insecticide-treated nets [LLINs] will be significantly reduced if the vectors change their behaviour to avoid entering houses. Conclusions Behavioural resistance is less frequently seen compared with physiological resistance (where the mosquito contacts the insecticide but is not killed, but is potentially more challenging to control programmes because the intervention effectiveness

  6. A trial of an iPad™ intervention targeting social communication skills in children with autism

    OpenAIRE

    Fletcher-Watson, Susan; Petrou, Alexandra; Scott-Barrett, Juliet; Dicks, Pamela; Graham, Catriona; O'Hare, Anne; Pain, Helen; Mcconachie, Helen

    2015-01-01

    This study evaluated a technology-based early intervention for social communication skills in pre-schoolers in a randomised controlled trial. Participants were 54 children aged under 6 years old with a diagnosis of autism, assigned to either intervention or control conditions. The app engaged children, who played consistently, regardless of developmental level, and was rated highly by parents. There were no significant group differences in parent-report measures post-intervention, nor in a me...

  7. Assessment of successful smoking cessation by psychological factors using the Bayesian network approach.

    Science.gov (United States)

    Yang, Xiaorong; Li, Suyun; Pan, Lulu; Wang, Qiang; Li, Huijie; Han, Mingkui; Zhang, Nan; Jiang, Fan; Jia, Chongqi

    2016-07-01

    The association between psychological factors and smoking cessation is complicated and inconsistent in published researches, and the joint effect of psychological factors on smoking cessation is unclear. This study explored how psychological factors jointly affect the success of smoking cessation using a Bayesian network approach. A community-based case control study was designed with 642 adult male successful smoking quitters as the cases, and 700 adult male failed smoking quitters as the controls. General self-efficacy (GSE), trait coping style (positive-trait coping style (PTCS) and negative-trait coping style (NTCS)) and self-rating anxiety (SA) were evaluated by GSE Scale, Trait Coping Style Questionnaire and SA Scale, respectively. Bayesian network was applied to evaluate the relationship between psychological factors and successful smoking cessation. The local conditional probability table of smoking cessation indicated that different joint conditions of psychological factors led to different outcomes for smoking cessation. Among smokers with high PTCS, high NTCS and low SA, only 36.40% successfully quitted smoking. However, among smokers with low pack-years of smoking, high GSE, high PTCS and high SA, 63.64% successfully quitted smoking. Our study indicates psychological factors jointly influence smoking cessation outcome. According to different joint situations, different solutions should be developed to control tobacco in practical intervention.

  8. Mindfulness predicts lower affective volatility among African Americans during smoking cessation.

    Science.gov (United States)

    Adams, Claire E; Chen, Minxing; Guo, Lin; Lam, Cho Y; Stewart, Diana W; Correa-Fernández, Virmarie; Cano, Miguel A; Heppner, Whitney L; Vidrine, Jennifer Irvin; Li, Yisheng; Ahluwalia, Jasjit S; Cinciripini, Paul M; Wetter, David W

    2014-06-01

    Recent research suggests that mindfulness benefits emotion regulation and smoking cessation. However, the mechanisms by which mindfulness affects emotional and behavioral functioning are unclear. One potential mechanism, lower affective volatility, has not been empirically tested during smoking cessation. This study examined longitudinal associations among mindfulness and emotional responding over the course of smoking cessation treatment among predominantly low-socioeconomic status (SES) African American smokers, who are at high risk for relapse to smoking and tobacco-related health disparities. Participants (N = 399, 51% female, mean age = 42, 48% with annual income mindfulness. Negative affect, positive affect, and depressive symptoms were assessed at five time points during smoking cessation treatment (up to 31 days postquit). Volatility indices were calculated to quantify within-person instability of emotional symptoms over time. Over and above demographic characteristics, nicotine dependence, and abstinence status, greater baseline trait mindfulness predicted lower volatility of negative affect and depressive symptoms surrounding the quit attempt and up to 1 month postquit, ps mindfulness and smoking cessation, these results are the first to show that mindfulness is linked to lower affective volatility (or greater stability) of negative emotions during the course of smoking cessation. The present study suggests that mindfulness is linked to greater emotional stability and augments the study of mindfulness in diverse populations. Future studies should examine the effects of mindfulness-based interventions on volatility and whether lower volatility explains effects of mindfulness-based treatments on smoking cessation.

  9. Individuals With Disabilities Who Have Diabetes: Do We Have Targeted Interventions?

    Science.gov (United States)

    Comer-HaGans, DeLawnia; Austin, Shamly; Ramamonjiarivelo, Zo

    2016-04-01

    According to 2010 data from the Centers for Disease Control and Prevention (CDC), diabetes is the seventh leading cause of death in the United States. It is assumed that various diabetes interventions are available to help individuals manage this chronic disease, but that is not the case. The literature is scant regarding interventions focused on people with disabilities who have diabetes. The purpose of this article is to review interventions specifically focused on people with disabilities who have diabetes and to discuss the effect of these interventions on this population.

  10. 吸烟对早期血管病变的影响及戒烟的干预作用%Impact of smoking on early arterial stiffness and the intervention of smoking cessation

    Institute of Scientific and Technical Information of China (English)

    聂福根; 李美根; 金伟

    2016-01-01

    Objective To study influence of smoking on early vascular disease and the improvement after smoking cessation. Methods These 495 young and middle-aged persons aged 33 ±6 years old,on average,were divided into three groups:Smoking group (>5 cigarettes per day and >1 year),no smoking group,smoking cessation group (stop smoking at lest one month). The three groups contained 186,157,152 cases separately. The smoking cessation group were divided into three subgroups according to smoking cessation time,which shows as follows:0. 05). Conclusion ⑴Smoking could decrease the compliance and increase the baPWV of vascular in a short time. ⑵Giving up smoking could improve the compliance of vascular,and even reach the level of no smoking group if giving up for 10 year.%目的:探讨吸烟对早期血管病变的影响及戒烟后不同时间段血管病变的改善程度。方法随机选择不同中青年人群495例[(平均年龄39±6)岁],吸烟组186例(≥5支/d,持续≥1年),不吸烟组157例(从不吸烟),戒烟组152例(停止吸烟至少1个月),戒烟组又分三组,戒烟<1年,1年≤戒烟<10,戒烟≥10年。室温下测定肱动脉一踝动脉脉搏波传导速度(baP-WV)、踝臂指数(ABI)、颈动脉内膜中层厚度(CIMT)、流量介导的肱动脉扩张(FMD),计算体重指数(BMI),测量肱动脉血压,标准方法检测总胆固醇、高密度脂蛋白、甘油三脂、血糖、肌酐。结果⑴吸烟组的baPWV及CIMT分别为1503.65±18.45及0.92±0.26,较不吸烟组明显增加(分别为1168.54±13.57及0.72±0.12),差异有统计学意义(P<0.05),吸烟组的ABI及FMD分别为0.86±0.12及9.73±1.26,较不吸烟组明显降低(分别为1.15±0.65及13.32±1.34),差异有统计学意义(P<0.05);⑵即使戒烟后,在一定时期内,戒烟组baPWV较不吸烟组仍增加;⑶戒烟10年以上组的baPWV与从不吸烟者baPWV相

  11. The 'robustness' of vocabulary intervention in the public schools: targets and techniques employed in speech-language therapy.

    Science.gov (United States)

    Justice, Laura M; Schmitt, Mary Beth; Murphy, Kimberly A; Pratt, Amy; Biancone, Tricia

    2014-01-01

    This study examined vocabulary intervention-in terms of targets and techniques-for children with language impairment receiving speech-language therapy in public schools (i.e., non-fee-paying schools) in the United States. Vocabulary treatments and targets were examined with respect to their alignment with the empirically validated practice of rich vocabulary intervention. Participants were forty-eight 5-7-year-old children participating in kindergarten or the first-grade year of school, all of whom had vocabulary-specific goals on their individualized education programmes. Two therapy sessions per child were coded to determine what vocabulary words were being directly targeted and what techniques were used for each. Study findings showed that the majority of words directly targeted during therapy were lower-level basic vocabulary words (87%) and very few (1%) were academically relevant. On average, three techniques were used per word to promote deep understanding. Interpreting findings against empirical descriptions of rich vocabulary intervention indicates that children were exposed to some but not all aspects of this empirically supported practice.

  12. Measuring participant rurality in Web-based interventions

    Directory of Open Access Journals (Sweden)

    McKay H Garth

    2007-08-01

    Full Text Available Abstract Background Web-based health behavior change programs can reach large groups of disparate participants and thus they provide promise of becoming important public health tools. Data on participant rurality can complement other demographic measures to deepen our understanding of the success of these programs. Specifically, analysis of participant rurality can inform recruitment and social marketing efforts, and facilitate the targeting and tailoring of program content. Rurality analysis can also help evaluate the effectiveness of interventions across population groupings. Methods We describe how the RUCAs (Rural-Urban Commuting Area Codes methodology can be used to examine results from two Randomized Controlled Trials of Web-based tobacco cessation programs: the ChewFree.com project for smokeless tobacco cessation and the Smokers' Health Improvement Program (SHIP project for smoking cessation. Results Using RUCAs methodology helped to highlight the extent to which both Web-based interventions reached a substantial percentage of rural participants. The ChewFree program was found to have more rural participation which is consistent with the greater prevalence of smokeless tobacco use in rural settings as well as ChewFree's multifaceted recruitment program that specifically targeted rural settings. Conclusion Researchers of Web-based health behavior change programs targeted to the US should routinely include RUCAs as a part of analyzing participant demographics. Researchers in other countries should examine rurality indices germane to their country.

  13. A Trial of an iPad™ Intervention Targeting Social Communication Skills in Children with Autism

    Science.gov (United States)

    Fletcher-Watson, Sue; Petrou, Alexandra; Scott-Barrett, Juliet; Dicks, Pamela; Graham, Catherine; O'Hare, Anne; Pain, Helen; McConachie, Helen

    2016-01-01

    This study evaluated a technology-based early intervention for social communication skills in pre-schoolers in a randomised controlled trial. Participants were 54 children aged under 6 years with a diagnosis of autism, assigned to either intervention or control conditions. The app engaged children, who played consistently, regardless of…

  14. Outcomes of a pilot obesity prevention plus intervention targeting children and parenting practices

    Science.gov (United States)

    Prevention-Plus interventions for primary care offer a venue to intervene with both children and parents for child obesity treatment. Such interventions can promote effective parenting practices that encourage healthy eating, physical activity (PA), and lower TV use among children. Test for feasibil...

  15. Structural and Functional Support in the Prediction of Smoking Cessation in Caregivers of Children with Asthma.

    Science.gov (United States)

    Tooley, Erin M; Busch, Andrew; McQuaid, Elizabeth L; Borrelli, Belinda

    2015-01-01

    Caregivers of children with asthma smoke at rates similar to the general population. Research on the relative importance of structural or functional social support in smoking cessation has been mixed. Participants were smokers (N = 154) who were caregivers of children with asthma. Both functional (Interpersonal Support Evaluation List) and structural social support (living with another smoker, partner status, and the proportion of smoking friends) were measured at baseline. Participants received an asthma-education and smoking cessation intervention based on Motivational Interviewing. Biochemically-verified abstinence was assessed at six months post treatment. Results indicated that functional support predicted smoking abstinence even when controlling for relevant covariates and structural support (OR = .896, p = .025). Exploratory analyses revealed that this effect was driven primarily by the self-esteem ISEL subscale. Smoking cessation that focuses on building general functional support, particularly self-esteem support, may be beneficial for smoking cessation in caregivers of children with asthma.

  16. Review of recent behavioral interventions targeting older adults living with HIV/AIDS.

    Science.gov (United States)

    Illa, Lourdes; Echenique, Marisa; Bustamante-Avellaneda, Victoria; Sanchez-Martinez, Mario

    2014-12-01

    Increasing attention has been paid to older adults living with HIV over the past few years given the increasing prevalence of HIV in this age group. Yet, despite numerous studies documenting psychosocial and behavioral differences between older and younger HIV-infected adults, few evidence-based behavioral interventions have been developed for this population. This review found only 12 manuscripts describing behavioral intervention studies in older HIV-positive adults published between 2011 and 2014, and they reported on a total of six interventions. Despite promising findings, there is a clear need for large-scale clinical trials to replicate these initial results and further develop additional interventions to address important clinical issues such as depression, sexual risk behaviors, cognition, and other significant issues affecting this cohort. This represents an exciting opportunity for behavioral scientists and HIV specialists to develop interventions that combine the psychological and behavioral with medical aspects of the disease.

  17. Economic assessments of small-scale drinking-water interventions in pursuit of MDG target 7C.

    Science.gov (United States)

    Cameron, John; Jagals, Paul; Hunter, Paul R; Pedley, Steve; Pond, Katherine

    2011-12-01

    This paper uses an applied rural case study of a safer water intervention in South Africa to illustrate how three levels of economic assessment can be used to understand the impact of the intervention on people's well-being. It is set in the context of Millennium Development Goal 7 which sets a target (7C) for safe drinking-water provision and the challenges of reaching people in remote rural areas with relatively small-scale schemes. The assessment moves from cost efficiency to cost effectiveness to a full social cost-benefit analysis (SCBA) with an associated sensitivity test. In addition to demonstrating techniques of analysis, the paper brings out many of the challenges in understanding how safer drinking-water impacts on people's livelihoods. The SCBA shows the case study intervention is justified economically, though the sensitivity test suggests 'downside' vulnerability.

  18. Study protocol of a Dutch smoking cessation e-health program

    Directory of Open Access Journals (Sweden)

    Bolman Catherine

    2011-11-01

    Full Text Available Abstract Background The study aims to test the differential effects of a web-based text and a web-based video-driven computer-tailored approach for lower socio-economic status (LSES and higher socio-economic status (HSES smokers which incorporate multiple computer-tailored feedback moments. The two programs differ only in the mode of delivery (video- versus text-based messages. The paper aims to describe the development and design of the two computer-tailored programs. Methods/design Respondents who smoked at the time of the study inclusion, who were motivated to quit within the following six months and who were aged 18 or older were included in the program. The study is a randomized control trial with a 2 (video/text * 2(LSES/HSES design. Respondents were assigned either to one of the intervention groups (text versus video tailored feedback or to the control group (non-tailored generic advice. In all three conditions participants were asked to fill in the baseline questionnaire based on the I-Change model. The questionnaire assessed socio-demographics, attitude towards smoking, knowledge, self-efficacy, social influence, depression, level of addiction, action planning, goal actions, intention to quit smoking, seven-day point prevalence and continued abstinence. Follow-up measurements were conducted at six and twelve months after baseline. Discussion The present paper describes the development of the two computer-tailored smoking cessation programs, their components and the design of the study. The study results reveal different working mechanisms of multiple tailored smoking cessation interventions and will help us to gain more insight into effective strategies to target different subgroups, especially smokers with a lower socio-economic status. Trial registration Dutch Trial Register NTR3102

  19. Clinical management of smoking cessation: patient factors affecting a reward-based approach.

    Science.gov (United States)

    Renaud, Jeanette M; Halpern, Michael T

    2010-12-10

    Although the majority of current smokers indicate they would like to quit, only about half of smokers make a quit attempt each year. Of those who attempt to quit, only about 5% are successful. Many effective products and programs are available to assist in smoking cessation; however those interested in quitting often do not make use of these resources. To increase use of cessation products in order to improve successful cessation rates, the Consumer Demand Roundtable has argued that smokers need to be viewed as consumers of cessation products rather than as patients needing treatment. With this consumer-based approach in mind, the current review examines how participant characteristics, perceptions, and behavior influence, and are influenced by, contingency management (CM) paradigms in various settings. Findings suggest that participant factors associated with success in these programs include demographic characteristics (eg, gender, marital status), self-efficacy, motivation to quit, and impulsivity. Overall, participants perceive incentives for successful cessation as motivating. However, such programs may involve greater withdrawal symptoms (eg, craving for cigarettes) initially, but these symptoms tend to decrease at a greater rate over time compared with nonincentive group participants. CM programs have also been shown to be successful across a number of settings (eg, communities, schools), including settings in which smokers are often considered difficult to treat (eg, substance abuse treatment centers). Overall, CM programs are perceived positively by participants and can increase rates of successful cessation. Furthermore, CM interventions have the flexibility to adapt to individual preferences and needs, leading to greater participation and likelihood of successful cessation. Thus, CM provides an important framework for addressing the need for consumer-focused smoking cessation interventions.

  20. In the Clinic. Smoking Cessation.

    Science.gov (United States)

    Patel, Manish S; Steinberg, Michael B

    2016-03-01

    This issue provides a clinical overview of smoking cessation, focusing on health consequences of smoking, prevention of smoking-related disease, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  1. Developing a multi-pollutant conceptual framework for the selection and targeting of interventions in water industry catchment management schemes.

    Science.gov (United States)

    Bloodworth, J W; Holman, I P; Burgess, P J; Gillman, S; Frogbrook, Z; Brown, P

    2015-09-15

    In recent years water companies have started to adopt catchment management to reduce diffuse pollution in drinking water supply areas. The heterogeneity of catchments and the range of pollutants that must be removed to meet the EU Drinking Water Directive (98/83/EC) limits make it difficult to prioritise areas of a catchment for intervention. Thus conceptual frameworks are required that can disaggregate the components of pollutant risk and help water companies make decisions about where to target interventions in their catchments to maximum effect. This paper demonstrates the concept of generalising pollutants in the same framework by reviewing key pollutant processes within a source-mobilisation-delivery context. From this, criteria are developed (with input from water industry professionals involved in catchment management) which highlights the need for a new water industry specific conceptual framework. The new CaRPoW (Catchment Risk to Potable Water) framework uses the Source-Mobilisation-Delivery concept as modular components of risk that work at two scales, source and mobilisation at the field scale and delivery at the catchment scale. Disaggregating pollutant processes permits the main components of risk to be ascertained so that appropriate interventions can be selected. The generic structure also allows for the outputs from different pollutants to be compared so that potential multiple benefits can be identified. CaRPow provides a transferable framework that can be used by water companies to cost-effectively target interventions under current conditions or under scenarios of land use or climate change.

  2. Training Pediatric Residents to Provide Smoking Cessation Counseling to Parents

    Directory of Open Access Journals (Sweden)

    Rebecca L. Collins

    2005-01-01

    Full Text Available The objective was to assess the effectiveness of a smoking cessation educational program on pediatric residents' counseling. Residents were randomly selected to receive the intervention. Residents who were trained were compared to untrained residents. Self-reported surveys and patient chart reviews were used. Measures included changes in self-reported knowledge, attitudes and behaviors of residents, and differences in chart documentation and caretaker-reported physician counseling behaviors. The intervention was multidimensional including a didactic presentation, a problem-solving session, clinic reminders, and provision of patient education materials. Results showed that residents who were trained were more likely to ask about tobacco use in their patients' households. They were also more likely to advise caretakers to cut down on or to quit smoking, to help set a quit date, and to follow up on the advice given at a subsequent visit. Trained residents were more likely to record a history of passive tobacco exposure in the medical record. These residents also reported improved confidence in their counseling skills and documented that they had done such counseling more often than did untrained residents. Caretakers of pediatric patients who smoke seen by intervention residents were more likely to report that they had received tobacco counseling. Following this intervention, pediatric residents significantly improved their behaviors, attitudes, and confidence in providing smoking cessation counseling to parents of their pediatric patients.

  3. The Effect of Five Smoking Cessation Pharmacotherapies on Smoking Cessation Milestones

    Science.gov (United States)

    Japuntich, Sandra J.; Piper, Megan E.; Leventhal, Adam M.; Bolt, Daniel M.; Baker, Timothy B.

    2011-01-01

    Objective: Most smoking cessation studies have used long-term abstinence as their primary outcome measure. Recent research has suggested that long-term abstinence may be an insensitive index of important smoking cessation mechanisms. The goal of the current study was to examine the effects of 5 smoking cessation pharmacotherapies using Shiffman et…

  4. Stakeholder engagement analysis - a bioethics dilemma in patient-targeted intervention: patients with temporomandibular joint disorders.

    Science.gov (United States)

    Barkhordarian, Andre; Demerjian, Gary; Jan, Allison; Sama, Nateli; Nguyen, Mia; Du, Angela; Chiappelli, Francesco

    2015-01-20

    Modern health care in the field of Medicine, Dentistry and Nursing is grounded in fundamental philosophy and epistemology of translational science. Recently in the U.S major national initiatives have been implemented in the hope of closing the gaps that sometimes exist between the two fundamental components of translational science, the translational research and translational effectiveness. Subsequent to these initiatives, many improvements have been made; however, important bioethical issues and limitations do still exist that need to be addressed. One such issue is the stakeholder engagement and its assessment and validation. Federal, state and local organizations such as PCORI and AHRQ concur that the key to a better understanding of the relationship between translational research and translational effectiveness is the assessment of the extent to which stakeholders are actively engaged in the translational process of healthcare. The stakeholder engagement analysis identifies who the stakeholders are, maps their contribution and involvement, evaluates their priorities and opinions, and accesses their current knowledge base. This analysis however requires conceptualization and validation from the bioethics standpoint. Here, we examine the bioethical dilemma of stakeholder engagement analysis in the context of the person-environment fit (PE-fit) theoretical model. This model is an approach to quantifying stakeholder engagement analysis for the design of patient-targeted interventions. In our previous studies of Alzheimer patients, we have developed, validated and used a simple instrument based on the PE-fit model that can be adapted and utilized in a much less studied pathology as a clinical model that has a wide range of symptoms and manifestations, the temporomandibular joint disorders (TMD). The temporomandibular joint (TMJ) is the jaw joint endowed with sensory and motor innervations that project from within the central nervous system and its dysfunction can

  5. Targeting reperfusion injury in the era of primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Lønborg, Jacob Thomsen

    2015-01-01

    Introduction of reperfusion therapy by primary percutaneous coronary intervention (PCI) has resulted in improved outcomes for patients presenting with ST-segment elevation myocardial infarction. Despite the obvious advantages of primary PCI, acute restoration of blood flow paradoxically also...

  6. Lifestyle Interventions Targeting Body Weight Changes during the Menopause Transition: A Systematic Review

    OpenAIRE

    Janet Jull; Dawn Stacey; Sarah Beach; Alex Dumas; Irene Strychar; Lee-Anne Ufholz; Stephanie Prince; Joseph Abdulnour; Denis Prud’homme

    2014-01-01

    Objective. To determine the effectiveness of exercise and/or nutrition interventions and to address body weight changes during the menopause transition. Methods. A systematic review of the literature was conducted using electronic databases, grey literature, and hand searching. Two independent researchers screened for studies using experimental designs to evaluate the impact of exercise and/or nutrition interventions on body weight and/or central weight gain performed during the menopausa...

  7. Targeting persons with low socioeconomic status of different ethnic origins with lifestyle interventions

    OpenAIRE

    2016-01-01

    Lifestyle intervention studies have shown that the development of cardiometabolic diseases can be partly prevented or postponed by the combination of a healthy diet and physical activity. Cardiometabolic diseases and their risk factors are particularly prevalent among individuals with low socioeconomic status and some ethnic minorities, and therefore these groups especially may benefit from participating in lifestyle interventions. Although individuals with low socioeconomic status and ethnic...

  8. Future directions for interventions targeting PTSD in HIV-infected adults

    OpenAIRE

    Applebaum, Allison J.; Bedoya, C. Andres; Hendriksen, Ellen S.; Wilkinson, Jesse L.; Safren, Steven A.; O’Cleirigh, Conall

    2014-01-01

    Although studies consistently report high rates of comorbid Post Traumatic Stress Disorder (PTSD) and HIV infection, development and testing of PTSD treatment interventions in HIV-infected adults is limited. As such, the purpose of this review was twofold. First, this review augments the 3 existing reviews of research for PTSD in HIV-infected adults conducted within the past 10 years. We found 2 empirically supported cognitive-behavioral therapy (CBT)-based interventions for the treatment of ...

  9. Using search query surveillance to monitor tax avoidance and smoking cessation following the United States' 2009 "SCHIP" cigarette tax increase.

    Directory of Open Access Journals (Sweden)

    John W Ayers

    Full Text Available Smokers can use the web to continue or quit their habit. Online vendors sell reduced or tax-free cigarettes lowering smoking costs, while health advocates use the web to promote cessation. We examined how smokers' tax avoidance and smoking cessation Internet search queries were motivated by the United States' (US 2009 State Children's Health Insurance Program (SCHIP federal cigarette excise tax increase and two other state specific tax increases. Google keyword searches among residents in a taxed geography (US or US state were compared to an untaxed geography (Canada for two years around each tax increase. Search data were normalized to a relative search volume (RSV scale, where the highest search proportion was labeled 100 with lesser proportions scaled by how they relatively compared to the highest proportion. Changes in RSV were estimated by comparing means during and after the tax increase to means before the tax increase, across taxed and untaxed geographies. The SCHIP tax was associated with an 11.8% (95% confidence interval [95%CI], 5.7 to 17.9; p<.001 immediate increase in cessation searches; however, searches quickly abated and approximated differences from pre-tax levels in Canada during the months after the tax. Tax avoidance searches increased 27.9% (95%CI, 15.9 to 39.9; p<.001 and 5.3% (95%CI, 3.6 to 7.1; p<.001 during and in the months after the tax compared to Canada, respectively, suggesting avoidance is the more pronounced and durable response. Trends were similar for state-specific tax increases but suggest strong interactive processes across taxes. When the SCHIP tax followed Florida's tax, versus not, it promoted more cessation and avoidance searches. Efforts to combat tax avoidance and increase cessation may be enhanced by using interventions targeted and tailored to smokers' searches. Search query surveillance is a valuable real-time, free and public method, that may be generalized to other behavioral, biological

  10. Neuro-intensive treatment targeting intracranial hypertension improves outcome in severe bacterial meningitis: an intervention-control study.

    Directory of Open Access Journals (Sweden)

    Martin Glimåker

    Full Text Available OBJECTIVE: To evaluate the efficacy of early intracranial pressure (ICP-targeted treatment, compared to standard intensive care, in adults with community acquired acute bacterial meningitis (ABM and severely impaired consciousness. DESIGN: A prospectively designed intervention-control comparison study of adult cases from September 2004 to January 2012. PATIENTS: Included patients were confirmed ABM-cases, aged 16-75 years, with severely impaired mental status on admission. Fifty-two patients, given ICP-targeted treatment at the neuro-intensive care unit, and 53 control cases, treated with conventional intensive care, were included. All the patients received intensive care with mechanical ventilation, sedation, antibiotics and corticosteroids according to current guidelines. Additional ICP-treatment in the intervention group included cerebrospinal fluid drainage using external ventricular catheters (n = 48, osmotherapy (n = 21, hyperventilation (n = 13, external cooling (n = 9, gram-doses of methylprednisolone (n = 3 and deep barbiturate sedation (n = 2 aiming at ICP 50 mmHg. MEASUREMENTS: The primary endpoint was mortality at two months and secondary endpoint was Glasgow outcome score and hearing ability at follow-up at 2-6 months. OUTCOMES: The mortality was significantly lower in the intervention group compared to controls, 5/52 (10% versus 16/53 (30%; relative risk reduction 68%; p<0.05. Furthermore, only 17 patients (32% in the control group fully recovered compared to 28 (54% in the intervention group (relative risk reduction 40%; p<0.05. CONCLUSIONS: Early neuro-intensive care using ICP-targeted therapy, mainly cerebrospinal fluid drainage, reduces mortality and improves the overall outcome in adult patients with ABM and severely impaired mental status on admission.

  11. 78 FR 13236 - TRICARE: Smoking Cessation Program

    Science.gov (United States)

    2013-02-27

    ... effectiveness considerations. 2. Counseling. In person smoking cessation counseling from a TRICARE authorized... review and recommend drugs based on their clinical and cost effectiveness. After this formal process... the TRICARE smoking cessation program to include a reduction of tobacco advertising in...

  12. NCI launches smoking cessation support for teens

    Science.gov (United States)

    A new effort to help teens quit smoking will use one of today’s teen’s most constant companions—the mobile phone. Developed by smoking cessation experts, SmokefreeTXT is a free text message cessation service that provides 24/7 encouragement, advice, and

  13. Dental Practitioners and Smoking Cessation in Ireland

    Directory of Open Access Journals (Sweden)

    Sheila Keogan

    2015-10-01

    Smoking prevalence is low among dentists in Ireland. Most recognized the need to provide adequate smoking cessation support and advice to patients but felt under-trained to do so. Most were not aware of existing referral pathways to specialist smoking cessation services and, thus, referral rates were low.

  14. Gender and determinants of smoking cessation

    DEFF Research Database (Denmark)

    Osler, M; Prescott, E; Godtfredsen, N;

    1999-01-01

    BACKGROUND: The less favorable trend in smoking prevalence in women compared to men may be due to lower cessation rates. We analyzed determinants of spontaneous smoking cessation with particular reference to gender differences. METHODS: Data on smoking were collected by questionnaire in three...... the relation of determinants to having quit after 5 and 10-16 years. RESULTS: The prevalence of quitting was 12 and 22% at first and second follow-up, respectively. At both reexaminations, quitting smoking was positively associated with male sex and cigar smoking and negatively associated with the amount...... of tobacco smoked, inhalation, and alcohol consumption. Furthermore, in women, smoking cessation was positively associated with level of education and body mass index (BMI). Smoking cessation was not affected by cohabitation status, leisure activity, or bronchitis symptoms. CONCLUSIONS: Smoking cessation...

  15. Cost-benefit of infection control interventions targeting methicillin-resistant Staphylococcus aureus in hospitals: systematic review.

    Science.gov (United States)

    Farbman, L; Avni, T; Rubinovitch, B; Leibovici, L; Paul, M

    2013-12-01

    Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) incur significant costs. We aimed to examine the cost and cost-benefit of infection control interventions against MRSA and to examine factors affecting economic estimates. We performed a systematic review of studies assessing infection control interventions aimed at preventing spread of MRSA in hospitals and reporting intervention costs, savings, cost-benefit or cost-effectiveness. We searched PubMed and references of included studies with no language restrictions up to January 2012. We used the Quality of Health Economic Studies tool to assess study quality. We report cost and savings per month in 2011 US$. We calculated the median save/cost ratio and the save-cost difference with interquartile range (IQR) range. We examined the effects of MRSA endemicity, intervention duration and hospital size on results. Thirty-six studies published between 1987 and 2011 fulfilled inclusion criteria. Fifteen of the 18 studies reporting both costs and savings reported a save/cost ratio >1. The median save/cost ratio across all 18 studies was 7.16 (IQR 1.37-16). The median cost across all studies reporting intervention costs (n = 31) was 8648 (IQR 2025-19 170) US$ per month; median savings were 38 751 (IQR 14 206-75 842) US$ per month (23 studies). Higher save/cost ratios were observed in the intermediate to high endemicity setting compared with the low endemicity setting, in hospitals with 6 months. Infection control intervention to reduce spread of MRSA in acute-care hospitals showed a favourable cost/benefit ratio. This was true also for high MRSA endemicity settings. Unresolved economic issues include rapid screening using molecular techniques and universal versus targeted screening.

  16. Target Gutahuka: The UN’s Strategic Information Intervention in the Democratic Republic of Congo

    Directory of Open Access Journals (Sweden)

    Jacob Udo-Udo Jacob

    2016-05-01

    Full Text Available This paper examines the nature and impacts of two information intervention radio programmes broadcast on Radio Okapi—the radio service of the UN Mission in the Democratic Republic of Congo. A matched randomization technique was used to assign Rwandan Hutus and Congolese autochthons in South Kivu to listen to either of the two programmes within their naturalistic contexts for 13 months. At the end of the treatment, participants’ perceptions of barriers to peace; descriptive and prescriptive interventions; victimhood and villainity; opportunities for personal development and civic engagement; and knowledge of repatriation processes were assessed in 16 focus groups across four contexts. The study concludes that international media intervention programmes that provide robust information and a platform for objective analyses within a multiple narrative and participatory framework can enhance greater engagement with nascent democratic reforms, positive perception of long term opportunities for personal development and empathy with the ethnic Other.

  17. Gender, smoking and tobacco reduction and cessation: a scoping review.

    Science.gov (United States)

    Bottorff, Joan L; Haines-Saah, Rebecca; Kelly, Mary T; Oliffe, John L; Torchalla, Iris; Poole, Nancy; Greaves, Lorraine; Robinson, Carole A; Ensom, Mary H H; Okoli, Chizimuzo T C; Phillips, J Craig

    2014-12-12

    Considerations of how gender-related factors influence smoking first appeared over 20 years ago in the work of critical and feminist scholars. This scholarship highlighted the need to consider the social and cultural context of women's tobacco use and the relationships between smoking and gender inequity. Parallel research on men's smoking and masculinities has only recently emerged with some attention being given to gender influences on men's tobacco use. Since that time, a multidisciplinary literature addressing women and men's tobacco use has spanned the social, psychological and medical sciences. To incorporate these gender-related factors into tobacco reduction and cessation interventions, our research team identified the need to clarify the current theoretical and methodological interpretations of gender within the context of tobacco research. To address this need a scoping review of the published literature was conducted focussing on tobacco reduction and cessation from the perspective of three aspects of gender: gender roles, gender identities, and gender relations. Findings of the review indicate that there is a need for greater clarity on how researchers define and conceptualize gender and its significance for tobacco control. Patterns and anomalies in the literature are described to guide the future development of interventions that are gender-sensitive and gender-specific. Three principles for including gender-related factors in tobacco reduction and cessation interventions were identified: a) the need to build upon solid conceptualizations of gender, b) the importance of including components that comprehensively address gender-related influences, and c) the importance of promoting gender equity and healthy gender norms, roles and relations.

  18. Smoking Cessation through Acceptance and Commitment Therapy: A Case Report

    Directory of Open Access Journals (Sweden)

    Ufuk Bal

    2015-12-01

    Full Text Available Smoking is one of the most common addictions with devastating biopsychosocial consequences. Both medical treatment and pschotherapy are utilized in smoking cessation. Acceptance and commitment therapy holds the notion that smoking cessation rates are determined not so much by the negative affect and withdrawal symptoms per se, but by the avoidant and inflexible responding style. Acceptance and commitment therapy, through targeting the avoidance of internal stimuli and concomitant inflexible responding pattern, has yielded successful results.This article presents application of acceptance and commitment therapy step by step to a chronic smoker who quitted smoking at the end of therapy sessions. [Cukurova Med J 2015; 40(4.000: 841-846

  19. A Comparison of Recruitment Methods for an mHealth Intervention Targeting Mothers: Lessons from the Growing Healthy Program

    Science.gov (United States)

    Litterbach, Eloise-Kate V; Denney-Wilson, Elizabeth A; Russell, Catherine G; Taki, Sarah; Ong, Kok-Leong; Elliott, Rosalind M; Lymer, Sharyn J; Campbell, Karen J

    2016-01-01

    Background Mobile health (mHealth) programs hold great promise for increasing the reach of public health interventions. However, mHealth is a relatively new field of research, presenting unique challenges for researchers. A key challenge is understanding the relative effectiveness and cost of various methods of recruitment to mHealth programs. Objective The objectives of this study were to (1) compare the effectiveness of various methods of recruitment to an mHealth intervention targeting healthy infant feeding practices, and (2) explore factors influencing practitioner referral to the intervention. Methods The Growing healthy study used a quasi-experimental design with an mHealth intervention group and a concurrent nonrandomized comparison group. Eligibility criteria included: expectant parents (>30 weeks of gestation) or parents with an infant advertising costs and researcher time/travel costs. Practitioner feedback relating to the recruitment process was obtained through a follow-up survey and qualitative interviews. Results A total of 300 participants were recruited to the mHealth intervention. The cost per participant recruited was lowest for online recruitment (AUD $14) and highest for practice nurse recruitment (AUD $586). Just over half of the intervention group (50.3%, 151/300) were recruited online over a 22-week period compared to practitioner recruitment (29.3%, 88/300 over 46 weeks) and face-to-face recruitment by researchers (7.3%, 22/300 over 18 weeks). No significant differences were observed in participant sociodemographic characteristics between recruitment methods, with the exception that practitioner/face-to-face recruitment resulted in a higher proportion of first-time parents (68% versus 48%, P=.002). Less than half of the practitioners surveyed reported referring to the program often or most of the time. Key barriers to practitioner referral included lack of time, difficulty remembering to refer, staff changes, lack of parental engagement

  20. Interventions that target improvements in mental health for parents of children with autism spectrum disorders: A narrative review.

    Science.gov (United States)

    Da Paz, Nikko S; Wallander, Jan L

    2017-02-01

    Prevalence of autism spectrum disorders (ASD) suggest that one in 68 children is affected. With convincing evidence that parenting a child with ASD is associated with elevated distress and mental health problems, researchers have begun to investigate treatments that directly target parents' psychological well-being. We conducted a narrative review of studies that empirically tested the effects of interventions targeting improvements in the mental health of parents of children with ASD. Following a range of search strategies, a total of 13 studies, seven randomized controlled trials (RCTs) and six pre-post test designs, met inclusion criteria. We calculated and reported effect sizes for all RCTs. On average, treatment produced medium to large effect sizes with improvements in parenting stress and general health, and reductions in depression and anxiety. Interventions that appeared promising included: Stress Management and Relaxation Techniques, Expressive Writing, Mindfulness-Based Stress Reduction, and Acceptance and Commitment Therapy. However, only one study conducted a follow-up assessment >3months post intervention. Study populations primarily consisted of English-speaking mothers, ages 39 to 42years. Conclusions were limited by small sample sizes, homogeneity of sample population, and reliance on self-report. Therefore, this body of research contains significant limitations in need of improvement for this field to move forward and benefit a sizable number of parents.

  1. Contributions of Qualitative Research in Informing HIV/AIDS Interventions Targeting Black MSM in the United States.

    Science.gov (United States)

    Wilson, Patrick A; Valera, Pamela; Martos, Alexander J; Wittlin, Natalie M; Muñoz-Laboy, Miguel A; Parker, Richard G

    2016-01-01

    This article presents a systematic review of qualitative studies focusing on human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among Black men who have sex with men (BMSM) in the United States. We reviewed studies that were published between 1980 and 2014. Qualitative methods employed in the studies reviewed include in-depth interviews, focus groups, participant observation, and ethnography. We searched several databases (PubMed, PsychINFO, JSTOR, ERIC, Sociological Abstracts, and Google Scholar) for relevant articles using the following broad terms: "Black men" "Black gay/bisexual" or "Black men who have sex with men," and "qualitative" and/or "ethnography." We include 70 studies in this review. The key themes observed across studies were (1) heterogeneity, (2) layered stigma and intersectionality, (3) risk behaviors, (4) mental health, (5) resilience, and (6) community engagement. The review suggests that sexual behavior and HIV-status disclosure, sexual risk taking, substance use, and psychological well-being were contextually situated. Interventions occurring at multiple levels and within multiple contexts are needed to reduce stigma within the Black community. Similarly, structural interventions targeting religious groups, schools, and health care systems are needed to improve the health outcomes among BMSM. Community engagement and using community-based participatory research methods may facilitate the development and implementation of culturally appropriate HIV/AIDS interventions targeting BMSM.

  2. Dropouts and Compliance in Exercise Interventions Targeting Bone Mineral Density in Adults: A Meta-Analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    George A. Kelley

    2013-01-01

    Full Text Available Background. Dropouts and compliance to exercise interventions targeting bone mineral density (BMD in adults are not well established. The purpose of this study was to address that gap. Methods. Meta-analysis of randomized controlled exercise intervention trials in adults ≥18 years of age. The primary outcomes were dropouts in the exercise and control groups as well as compliance to the exercise interventions. A random-effects model was used to pool results. Moderator analyses were conducted using mixed-effects ANOVA-like models and metaregression. Statistical significance was set at . Results. Thirty-six studies representing 3,297 participants (1,855 exercise, 1,442 control were included. Dropout rates in the exercise and control groups averaged 20.9% (95% CI 16.7%–25.9% and 15.9% (11.8%–21.1% while compliance to exercise was 76.3% (71.7%–80.3%. For both exercise and control groups, greater dropout rates were associated with studies conducted in the USA versus other countries, females versus males, premenopausal versus postmenopausal women, younger versus older participants, longer studies (controls only, and high- versus moderate-intensity training (exercisers only. Greater compliance to exercise was associated with being female, home- or facility-based exercise versus both, and shorter studies. Conclusion. These findings provide important information for researchers and practitioners with respect to exercise programs targeting BMD in adults.

  3. A Difficult Journey: Reflections on Driving and Driving Cessation From a Team of Clinical Researchers.

    Science.gov (United States)

    Liddle, Jacki; Gustafsson, Louise; Mitchell, Geoffrey; Pachana, Nancy A

    2017-02-01

    Recognizing the clinical importance and safety and well-being implications for the population, a multidisciplinary team has been researching older drivers and driving cessation issues for more than 15 years. Using empirical approaches, the team has explored quality of life and participation outcomes related to driving and nondriving for older people and has developed interventions to improve outcomes after driving cessation. The team members represent occupational therapists, medical practitioners, and clinical and neuropsychologists. While building the evidence base for driving- and driving cessation-related clinical practice, the researchers have also had first-hand experiences of interruptions to their own or parents' driving; involvement of older family members in road crashes; and provision of support during family members' driving assessment and cessation. This has led to reflection on their understandings and re-evaluation and refocusing of their perspectives in driving cessation research. This work will share the narratives of the authors and note their developing perspectives and foci within research as well as their clinical practice. Personal reflections have indicated the far-reaching implications for older drivers and family members of involvement in road crashes: the potential for interruptions to driving as a time for support and future planning and the conflicting and difficult roles of family members within the driving cessation process. Overall the lived, personal experience of the authors has reinforced the complex nature of driving and changes to driving status for the driver and their support team and the need for further research and support.

  4. Self-reported smoking cessation activities among Swiss primary care physicians

    Directory of Open Access Journals (Sweden)

    Ruffieux Christiane

    2009-03-01

    Full Text Available Abstract Background Individual counselling, pharmacotherapy, and group therapy are evidence-based interventions that help patients stop smoking. Acupuncture, hypnosis, and relaxation have no demonstrated efficacy on smoking cessation, whereas self-help material may only have a small benefit. The purpose of this study is to assess physicians' current clinical practice regarding smokers motivated to stop smoking. Methods The survey included 3385 Swiss primary care physicians. Self-reported use of nine smoking cessation interventions was scored. One point was given for each positive answer about practicing interventions with demonstrated efficacy, i.e. nicotine replacement therapy, bupropion, counselling, group therapy, and smoking cessation specialist. No points were given for the recommendation of acupuncture, hypnosis, relaxation, and self-help material. Multivariable logistic analysis was performed to identify factors associated with a good practice score, defined as ≥ 2. Results The response rate was 55%. Respondents were predominately over the age of 40 years (88%, male (79%, and resided in urban areas (74%. Seventeen percent reported being smokers. Most of the physicians prescribed nicotine replacement therapy (84%, bupropion (65%, or provided counselling (70%. A minority of physicians recommended acupuncture (26%, hypnosis (8%, relaxation (7%, or self-help material (24%. A good practice score was obtained by 85% of respondents. Having attended a smoking cessation-training program was the only significant predictor of a good practice score (odds ratio: 6.24, 95% CI 1.95–20.04. Conclusion The majority of respondents practice recommended smoking cessation interventions. However, there is room for improvement and implementing an evidence-based smoking cessation-training program could provide additional benefit.

  5. Electronic cigarettes for smoking cessation.

    Science.gov (United States)

    Bullen, Christopher

    2014-11-01

    Electronic cigarettes (e-cigarettes) are novel vaporising devices that, similar to nicotine replacement treatments, deliver nicotine but in lower amounts and less swiftly than tobacco smoking. However, they enjoy far greater popularity than these medications due in part to their behaviour replacement characteristics. Evidence for their efficacy as cessation aids, based on several randomised trials of now obsolete e-cigarettes, suggests a modest effect equivalent to nicotine patch. E-cigarettes are almost certainly far less harmful than tobacco smoking, but the health effects of long-term use are as yet unknown. Dual use is common and almost as harmful as usual smoking unless it leads to quitting. Population effects, such as re-normalising smoking behaviour, are a concern. Clinicians should be knowledgeable about these products. If patients who smoke are unwilling to quit or cannot succeed using evidence-based approaches, e-cigarettes may be an option to be considered after discussing the limitations of current knowledge.

  6. Nrf2: A Novel Biomarker of Disease Severity and Target for Therapeutic Intervention in Multiple Sclerosis

    Science.gov (United States)

    2014-10-01

    suppression of disease symptoms in EAE (Experimental Autoimmune Encephalomyelitis). In the current report we: 1) characterize the Nrf2-targeted antioxidant ...including their potential to suppress disease symptoms in EAE. In current report we first characterized the Nrf2 targeted antioxidant properties of...sclerosis, rheumatoid arthritis4 and skin inflammation.5 Further it has been reported that Celastrol can inhibit inflammatory reactions between

  7. Psychoeducational interventions targeting core symptoms to achieve remission and prevent relapses and recurrence in depression.

    NARCIS (Netherlands)

    Cuijpers, P.

    2008-01-01

    Depressive disorders have a high prevalence and incidence, and are associated with a huge burden of disease and economic costs. Most respond satisfactorily to drug therapy and/or psychological intervention, in particular to psychoeducation. By far the best-studied example of this approach is the Cop

  8. Targeting persons with low socioeconomic status of different ethnic origins with lifestyle interventions

    NARCIS (Netherlands)

    Bukman, A.J.

    2016-01-01

    Lifestyle intervention studies have shown that the development of cardiometabolic diseases can be partly prevented or postponed by the combination of a healthy diet and physical activity. Cardiometabolic diseases and their risk factors are particularly prevalent among individuals with low socioecono

  9. Costo-efectividad del uso de la Vareniclina versus las alternativas existentes para la cesación del fumado usando el modelo BENESCO en la población adulta costarricense Cost-Effectiveness of Varenicline versus all Interventions for Quitting Smoking Cessation in the Adult Population of Costa Rica using the BENESCO Model

    Directory of Open Access Journals (Sweden)

    Manfred Lutz-Ramírez

    2010-12-01

    diseases related to smoking that were included were: Coronary heart disease, chronic obstructive pulmonary disease, stroke and lung cancer. The prevalence, annual incidence and mortality were obtained and calculated from the Costa Rica Social Security data base and the Institute of Alcoholism and Pharmacodependence of Costa Rica. The costs of the diseases were calculated and updated to September, 2008. Deterministic and probabilistic sensitivity analyses were conducted. Results: Of all the strategies for smoking cessation, Varenicline was the herapeutic alternative that obtained less mortality and morbility in the years studied with the model. Regarding costs, Varenicline was also the less expensive option from the fifth year. On the second year, motivational talks were ¢3.443.167 less expensive than Varenicline. The intervention that obtained the largest number of Quality-adjusted life years and Life years gained was Varenicline. Varenicline was the most effective option in the cost-incremental analysis, this means, it was clinically more effective and less expensive. Conclusion: The results obtained suggests that Varenicline is the most cost- effective intervention for smoking cessation in comparison with Bupropion, NRT, unaided cessation and motivational talks. It was proven that the use of Varenicline represents an important economic savings for the health system and the heath institutes that use it since it reduces morbidity and the costs related to the associated-smoking diseases.

  10. An intervention study targeting energy and nutrient intake in worksite cafeterias.

    Science.gov (United States)

    Lowe, Michael R; Tappe, Karyn A; Butryn, Meghan L; Annunziato, Rachel A; Coletta, Maria C; Ochner, Christopher N; Rolls, Barbara J

    2010-08-01

    Modifying the food environment is a promising strategy for promoting healthier eating behavior. This study aimed to evaluate nutritional and weight changes in a program that used worksite cafeterias to reduce employees' calorie content of purchased foods and improve their macronutrient intake. Participants were randomly assigned to one of two conditions: 1) only environmental change (i.e., the introduction of 10 new low-energy-density (ED) foods and provision of labels for all foods sold at lunch, which listed ED, calories, and macronutrient content) or 2) the environmental change plus pricing incentives for purchasing low-ED foods and education about low-ED eating delivered in four, 1-hour group sessions. Participant lunch choices were monitored electronically at the point of purchase for 3 months before the intervention was instituted (i.e., the baseline period) and for 3 months afterward (i.e., intervention period). Participants were adults (n=96, BMI=29.7+/-6.0 kg/m(2)) who regularly ate lunch at their workplace cafeteria. There was no difference between groups in total energy intake over the study period. Across groups, energy and percent of energy from fat decreased and percent of energy from carbohydrate increased from baseline to the intervention period (all p<.01). Follow-up analyses, conducted by averaging Baseline Months 1 and 2 and comparing them to Intervention Month 3 as a conservative estimate of overall impact of the intervention, indicated that change in energy, carbohydrate, and fat intake remained significant (p<.001). Providing nutrition labels and reducing the ED of selected foods was associated with improved dietary intake.

  11. Target intervention against multiple-risk markers to reduce cardiovascular disease in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Gaede, Peter; Pedersen, Oluf

    2004-01-01

    The risk of cardiovascular disease is markedly increased in patients with type 2 diabetes with a prevalence twice as high compared to the background population. With the recognition of multiple concomitant risk factors for both microvascular as well as cardiovascular disease in type 2 diabetic...... factors for cardiovascular disease is capable of reducing the risk for a combined endpoint of cardiovascular mortality, non-fatal myocardial infarction, non-fatal stroke, coronary interventions, revascularisation to legs, and amputations by 50%....... patients, treatment strategies have changed during recent years. This review focuses on the many recent drug trials that have set the course for an effective multifactorial treatment of the disease. Thus, the Steno-2 Study has shown that an intensified multifactorial intervention targeting several risk...

  12. Stages of smoking cessation among Malaysian adults--findings from national health morbidity survey 2006.

    Science.gov (United States)

    Lim, Kuang Hock; Ibrahim, Normala; Ghazali, Sumarni Mohd; Kee, Chee Cheong; Lim, Kuang Kuay; Chan, Ying Ying; Teh, Chien Huey; Tee, Eng Ong; Lai, Wai Yee; Nik Mohamad, Mohd Haniki; Sidek, Sherina Mohd

    2013-01-01

    Increasing the rate of smoking cessation will reduce the burden of diseases related to smoking, including cancer. Understanding the process of smoking cessation is a pre-requisite to planning and developing effective programs to enhance the rate of smoking cessation.The aims of the study were to determine the demographic distribution of smokers across the initial stages of smoking cessation (the pre-contemplation and contemplation stages) and to identify the predictors of smoking cessation among Malaysian adult smokers. Data were extracted from a population-based, cross-sectional survey carried out from April 2006 to July 2006. The distribution of 2,716,743 current smokers across the pre-contemplation stage (no intention to quit smoking in the next six months) or contemplation stage (intended to quit smoking in the next six months) was described. Multivariable logistic regression analysis was used to examine the relationship between socio-demographic variables and the stages of smoking cessation. Of the 2,716,743 current smokers, approximately 30% and 70% were in the pre-contemplative and contemplative stages of smoking cessation respectively. Multivariable analysis showed that male gender, low education level, older age group, married and those from higher income group and number of cigarettes smoked were associated with higher likelihood of pre-contemplation to cease smoking in the next six months. The majority of current smokers in Malaysia were in the contemplative stage of smoking cessation. Specific interventions should be implemented to ensure the pre-contemplative smokers proceed to the contemplative stage and eventually to the preparation stage.

  13. Facebook recruitment of young adult smokers for a cessation trial: Methods, metrics, and lessons learned

    Directory of Open Access Journals (Sweden)

    Danielle E. Ramo

    2014-04-01

    Full Text Available Further understanding is needed of the functionalities and efficiency of social media for health intervention research recruitment. Facebook was examined as a mechanism to recruit young adults for a smoking cessation intervention. An ad campaign targeting young adult smokers tested specific messaging based on market theory and successful strategies used to recruit smokers in previous clinical trials (i.e. informative, call to action, scarcity, social norms, previously successful ads, and general messaging. Images were selected to target smokers (e.g., lit cigarette, appeal to the target age, vary demographically, and vary graphically (cartoon, photo, logo. Facebook's Ads Manager was used over 7 weeks (6/10/13–7/29/13, targeted by age (18–25, location (U.S., and language (English, and employed multiple ad types (newsfeed, standard, promoted posts, sponsored stories and keywords. Ads linked to the online screening survey or study Facebook page. The 36 different ads generated 3,198,373 impressions, 5895 unique clicks, at an overall cost of $2024 ($0.34/click. Images of smoking and newsfeed ads had the greatest reach and clicks at the lowest cost. Of 5895 unique clicks, 586 (10% were study eligible and 230 (39% consented. Advertising costs averaged $8.80 per eligible, consented participant. The final study sample (n = 79 was largely Caucasian (77% and male (69%, averaging 11 cigarettes/day (SD = 8.3 and 2.7 years smoking (SD = 0.7. Facebook is a useful, cost-effective recruitment source for young adult smokers. Ads posted via newsfeed posts were particularly successful, likely because they were viewable via mobile phone. Efforts to engage more ethnic minorities, young women, and smokers motivated to quit are needed.

  14. Facebook Recruitment of Young Adult Smokers for a Cessation Trial: Methods, Metrics, and Lessons Learned.

    Science.gov (United States)

    Ramo, Danielle E; Rodriguez, Theresa M S; Chavez, Kathryn; Sommer, Markus J; Prochaska, Judith J

    2014-04-01

    Further understanding is needed of the functionalities and efficiency of social media for health intervention research recruitment. Facebook was examined as a mechanism to recruit young adults for a smoking cessation intervention. An ad campaign targeting young adult smokers tested specific messaging based on market theory and successful strategies used to recruit smokers in previous clinical trials (i.e. informative, call to action, scarcity, social norms), previously successful ads, and general messaging. Images were selected to target smokers (e.g., lit cigarette), appeal to the target age, vary demographically, and vary graphically (cartoon, photo, logo). Facebook's Ads Manager was used over 7 weeks (6/10/13 - 7/29/13), targeted by age (18-25), location (U.S.), and language (English), and employed multiple ad types (newsfeed, standard, promoted posts, sponsored stories) and keywords. Ads linked to the online screening survey or study Facebook page. The 36 different ads generated 3,198,373 impressions, 5,895 unique clicks, at an overall cost of $2,024 ($0.34/click). Images of smoking and newsfeed ads had the greatest reach and clicks at the lowest cost. Of 5,895 unique clicks, 586 (10%) were study eligible and 230 (39%) consented. Advertising costs averaged $8.80 per eligible, consented participant. The final study sample (n=79) was largely Caucasian (77%) and male (69%), averaging 11 cigarettes/day (SD=8.3) and 2.7 years smoking (SD=0.7). Facebook is a useful, cost-effective recruitment source for young adult smokers. Ads posted via newsfeed posts were particularly successful, likely because they were viewable via mobile phone. Efforts to engage more ethnic minorities, young women, and smokers motivated to quit are needed.

  15. Barriers to the provision of smoking cessation assistance : a qualitative study among Romanian family physicians

    NARCIS (Netherlands)

    Panaitescu, Catalina; Moffat, Mandy A.; Williams, Sian; Pinnock, Hilary; Boros, Melinda; Oana, Cristian Sever; Alexiu, Sandra; Tsiligianni, Ioanna

    2014-01-01

    BACKGROUND: Smoking cessation is the most effective intervention to prevent and slow down the progression of several respiratory and other diseases and improve patient outcomes. Romania has legislation and a national tobacco control programme in line with the World Health Organization Framework for

  16. Cognitive-Behavioral Therapy to Promote Smoking Cessation among African American Smokers: A Randomized Clinical Trial

    Science.gov (United States)

    Webb, Monica S.; de Ybarra, Denise Rodriguez; Baker, Elizabeth A.; Reis, Isildinha M.; Carey, Michael P.

    2010-01-01

    Objective: The health consequences of tobacco smoking disproportionately affect African Americans, but research on whether efficacious interventions can be generalized to this population is limited. This study examined the efficacy of group-based cognitive-behavioral therapy (CBT) for smoking cessation among African Americans. Method: Participants…

  17. Effects of a Mindfulness-Based Smoking Cessation Program for an Adult with Mild Intellectual Disability

    Science.gov (United States)

    Singh, Nirbhay N.; Lancioni, Giulio E.; Winton, Alan S. W.; Singh, Ashvind N. A.; Singh, Judy; Singh, Angela D. A.

    2011-01-01

    Smoking is a major risk factor for a number of health conditions and many smokers find it difficult to quit smoking without specific interventions. We developed and used a mindfulness-based smoking cessation program with a 31-year-old man with mild intellectual disabilities who had been a smoker for 17 years. The mindfulness-based smoking…

  18. Statewide Demonstration of Not On Tobacco: A Gender-Sensitive Teen Smoking Cessation Program.

    Science.gov (United States)

    Dino, Geri A.; Horn, Kimberly A.; Goldcamp, Jennifer; Maniar, Sameep D.; Fernandes, Ancilla; Massey, Catherine J.

    2001-01-01

    Evaluated Not On Tobacco, a gender-sensitive, smoking cessation program for adolescents, comparing experimental group and brief intervention (BI) group students. Overall, Not On Tobacco females were four times more likely to quit than BI females. Approximately 84 percent of experimental group teens quit or reduced smoking, compared to 55 percent…

  19. Nicotine receptor partial agonists for smoking cessation

    Directory of Open Access Journals (Sweden)

    Kate Cahill

    Full Text Available BACKGROUND: Nicotine receptor partial agonists may help people to stop smoking by a combination of maintaining moderate levels of dopamine to counteract withdrawal symptoms (acting as an agonist and reducing smoking satisfaction (acting as an antagonist. OBJECTIVES: The primary objective of this review is to assess the efficacy and tolerability of nicotine receptor partial agonists, including cytisine, dianicline and varenicline for smoking cessation. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group's specialised register for trials, using the terms ('cytisine' or 'Tabex' or 'dianicline' or 'varenicline' or 'nicotine receptor partial agonist' in the title or abstract, or as keywords. The register is compiled from searches of MEDLINE, EMBASE, PsycINFO and Web of Science using MeSH terms and free text to identify controlled trials of interventions for smoking cessation and prevention. We contacted authors of trial reports for additional information where necessary. The latest update of the specialized register was in December 2011. We also searched online clinical trials registers. SELECTION CRITERIA: We included randomized controlled trials which compared the treatment drug with placebo. We also included comparisons with bupropion and nicotine patches where available. We excluded trials which did not report a minimum follow-up period of six months from start of treatment. DATA COLLECTION AND ANALYSIS: We extracted data on the type of participants, the dose and duration of treatment, the outcome measures, the randomization procedure, concealment of allocation, and completeness of follow-up. The main outcome measured was abstinence from smoking at longest follow-up. We used the most rigorous definition of abstinence, and preferred biochemically validated rates where they were reported. Where appropriate we pooled risk ratios (RRs, using the Mantel-Haenszel fixed-effect model. MAIN RESULTS: Two recent cytisine trials (937 people

  20. Targeting Appropriate Interventions to Minimize Deterioration of Drinking-water Quality in Developing Countries

    OpenAIRE

    Trevett, Andrew F.; Carter, Richard C.

    2008-01-01

    In developing countries, it has been observed that drinking-water frequently becomes recontaminated following its collection and during storage in the home. This paper proposes a semi-quantified ‘disease risk index' (DRI) designed to identify communities or households that are ‘most at risk' from consuming recontaminated drinking-water. A brief review of appropriate physical and educational intervention measures is presented, and their effective use is discussed. It is concluded that incorpor...

  1. Youth tobacco use cessation: 2008 update

    Directory of Open Access Journals (Sweden)

    Sussman Steve

    2009-01-01

    Full Text Available Abstract In this paper, an empirical review of 64 teen tobacco use cessation studies is provided. Examined include program contents, delivery modalities, number of contacts, and expected quit rates. In addition, means of recruitment and retention of smokers in programming are discussed. Also, promising contemporary methods of teen smoking cessation are examined, including use of pharmacologic adjuncts, electronic technology, and cigarette price increases (and no smoking policy. Conclusions are made regarding implications for developing and implementing teen tobacco use cessation programs.

  2. Session III: Mechanisms of age-related cognitive change and targets for intervention: inflammatory, oxidative, and metabolic processes.

    Science.gov (United States)

    Craft, Suzanne; Foster, Thomas C; Landfield, Philip W; Maier, Steven F; Resnick, Susan M; Yaffe, Kristine

    2012-06-01

    There is increasing evidence from basic science and human epidemiological studies that inflammation, oxidative stress, and metabolic abnormalities are associated with age-related cognitive decline and impairment. This article summarizes selected research on these topics presented at the Cognitive Aging Summit II. Speakers in this session presented evidence highlighting the roles of these processes and pathways on age-related cognitive decline, pointing to possible targets for intervention in nondemented older adults. Specific areas discussed included age differences in the production of cytokines following injury or infection, mechanisms underlying oxidative stress-induced changes in memory consolidation, insulin effects on brain signaling and memory, and the association between metabolic syndrome and cognitive decline in older adults. These presentations emphasize advances in our understanding of mechanisms and modifiers of age-related cognitive decline and provide insights into potential targets to promote cognitive health in older adults.

  3. Adherence to the Obesity-related Lifestyle Intervention Targets in the IDEFICS Study

    DEFF Research Database (Denmark)

    Kovács, Eva; Siani, Alfonso; Konstabel, Kenn

    2014-01-01

    Background/objectives: To address behaviours associated with childhood obesity, certain target values are recommended that should be met to improve children’s health. In the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and infantS) study.......1%. The recommended amount of at least 60 min of moderate-to-vigorous physical activity per day was fulfilled by 15.2%. Family life of the child measured by various indicators was considered as satisfactory in 22.8%. Nocturnal sleep duration of 11 (10) hours or more in pre-school (school) children was achieved by 37......-containing beverages), increase fruit/vegetable consumption, reduce daily screen time, increase daily physical activity, improve the quality of family life and ensure adequate sleep duration. Internationally recommended target values were applied to determine the prevalence of children meeting these targets. Results...

  4. Self-related neural response to tailored smoking-cessation messages predicts quitting

    Science.gov (United States)

    Chua, Hannah Faye; Ho, S. Shaun; Jasinska, Agnes J.; Polk, Thad A.; Welsh, Robert C.; Liberzon, Israel; Strecher, Victor J.

    2011-01-01

    Although tailored health interventions can be more effective in eliciting positive behavior change then generic interventions, the underlying neural mechanisms are not yet understood. Ninety-one smokers participated in a functional magnetic resonance imaging (fMRI) session and a tailored smoking-cessation program. We found that increases in activations in self-related processing regions, particularly dorsomedial prefrontal cortex, to tailored messages predicted quitting during a 4-month follow-up. PMID:21358641

  5. What works for whom in pharmacist-led smoking cessation support: realist review

    OpenAIRE

    Greenhalgh, T.; Macfarlane, F; Steed, L; Walton, R.

    2016-01-01

    BACKGROUND: New models of primary care are needed to address funding and staffing pressures. We addressed the research question "what works for whom in what circumstances in relation to the role of community pharmacies in providing lifestyle interventions to support smoking cessation?" METHODS: This is a realist review conducted according to RAMESES standards. We began with a sample of 103 papers included in a quantitative review of community pharmacy intervention trials identified through sy...

  6. Targeting appropriate interventions to minimize deterioration of drinking-water quality in developing countries.

    Science.gov (United States)

    Trevett, Andrew F; Carter, Richard C

    2008-06-01

    In developing countries, it has been observed that drinking-water frequently becomes recontaminated following its collection and during storage in the home. This paper proposes a semi-quantified 'disease risk index' (DRI) designed to identify communities or households that are 'most at risk' from consuming recontaminated drinking-water. A brief review of appropriate physical and educational intervention measures is presented, and their effective use is discussed. It is concluded that incorporating a simple appraisal tool, such as the proposed DRI, into a community water-supply programme would be useful in shaping the overall strategy requiring only a minimum of organizational learning.

  7. Reading comprehension: a language intervention target from early childhood through adolescence.

    Science.gov (United States)

    Staskowski, M; Creaghead, N A

    2001-08-01

    Speech-language pathologists (SLPs) play an important role in helping children and adolescents with language impairments to construct meaning from spoken and written language. They work in collaboration with other professionals and families to provide the optimal learning experiences and to introduce strategies for seeking meaning and monitoring understanding. This article describes language intervention techniques to enhance reading comprehension, including the development and enhancement of background knowledge and schemata, vocabulary, knowledge of text structure, and strategy use. The discussion includes suggestions for young children who are developing language comprehension, as well as for elementary students and secondary students who comprehend text with increasing independence.

  8. Cerebral ischemia/stroke and small ubiquitin-like modifier (SUMO) conjugation--a new target for therapeutic intervention?

    Science.gov (United States)

    Yang, Wei; Sheng, Huaxin; Homi, H Mayumi; Warner, David S; Paschen, Wulf

    2008-08-01

    Transient cerebral ischemia/stroke activates various post-translational protein modifications such as phosphorylation and ubiquitin conjugation that are believed to play a major role in the pathological process triggered by an interruption of blood supply and culminating in cell death. A new system of post-translational protein modification has been identified, termed as small ubiquitin-like modifier (SUMO) conjugation. Like ubiquitin, SUMO is conjugated to the lysine residue of target proteins in a complex process. This review summarizes observations from recent experiments focusing on the effect of cerebral ischemia on SUMO conjugation. Transient global and focal cerebral ischemia both induced a rapid, dramatic and long-lasting rise in levels of SUMO2/3 conjugation. After transient focal cerebral ischemia, SUMO conjugation was particularly prominent in neurons located at the border of the ischemic territory where SUMO-conjugated proteins translocated to the nucleus. Many SUMO conjugation target proteins are transcription factors and sumoylation has been shown to have a major impact on the activity, stability, and cellular localization of target proteins. The rise in levels of SUMO-conjugated proteins is therefore likely to have a major effect on the fate of post-ischemic neurons. The sumoylation process could provide an exciting new target for therapeutic intervention.

  9. Predictive Malaria Risk and Uncertainty Mapping in Nchelenge District, Zambia: Evidence of Widespread, Persistent Risk and Implications for Targeted Interventions.

    Science.gov (United States)

    Pinchoff, Jessie; Chaponda, Mike; Shields, Timothy; Lupiya, James; Kobayashi, Tamaki; Mulenga, Modest; Moss, William J; Curriero, Frank C

    2015-12-01

    Malaria risk maps may be used to guide policy decisions on whether vector control interventions should be targeted and, if so, where. Active surveillance for malaria was conducted through household surveys in Nchelenge District, Zambia from April 2012 through December 2014. Households were enumerated based on satellite imagery and randomly selected for study enrollment. At each visit, participants were administered a questionnaire and a malaria rapid diagnostic test (RDT). Logistic regression models were used to construct spatial prediction risk maps and maps of risk uncertainty. A total of 461 households were visited, comprising 1,725 participants, of whom 48% were RDT positive. Several environmental features were associated with increased household malaria risk in a multivariable logistic regression model adjusting for seasonal variation. The model was validated using both internal and external evaluation measures to generate and assess root mean square error, as well as sensitivity and specificity for predicted risk. The final, validated model was used to predict and map malaria risk including a measure of risk uncertainty. Malaria risk in a high, perennial transmission setting is widespread but heterogeneous at a local scale, with seasonal variation. Targeting malaria control interventions may not be appropriate in this epidemiological setting.

  10. Attention Feedback Awareness and Control Training (A-FACT): experimental test of a novel intervention paradigm targeting attentional bias.

    Science.gov (United States)

    Bernstein, Amit; Zvielli, Ariel

    2014-04-01

    We present an experimental investigation of a novel intervention paradigm targeting attentional bias - Attention Feedback Awareness and Control Training (A-FACT). A-FACT is grounded in the novel hypothesis that training awareness of (biased) attentional allocation will lead to greater self-regulatory control of attention and thereby ameliorate attentional bias and its maladaptive sequelae. To do so, A-FACT delivers computerized, personalized, real-time feedback regarding a person's (biased) allocation of attention concurrent with its expression. In a randomized control experimental design, we tested A-FACT relative to an active placebo control condition among anxious adults (N=40, 52.5% women, M(SD)=24.3(4) years old). We found that relative to the placebo control condition, A-FACT led to: (a) reduced levels of attentional bias to threat; (b) (non-significantly) lower rate of behavioral avoidance of exposure to an anxiogenic stressor; and (c) faster rate of emotional recovery following the stressor. The findings are discussed with respect to the novelty and significance of the proposed conceptual perspective, methodology, and intervention paradigm targeting attentional bias.

  11. Smokeless tobacco: challenges, products and, cessation.

    Science.gov (United States)

    Rankin, K Vendrell; Jones, Daniel L; Benton, Elain

    2010-06-01

    Tobacco companies continue to develop and aggressively market new products for oral use. Most new products are intended to dissolve in the mouth and swallow rather than spit out the juices. These products effectively circumvent smoke-free policies, decrease tobacco cessation efforts, and create individuals who use both smokeless tobacco (ST) and cigarettes. All ST products contain nicotine, carcinogens, and pose multiple health risks. The cancer and health risks associated with ST use extend well beyond the changes in the oral cavity and the risk of oral cancer. Unlike cigarettes, the contents of ST vary widely by brand and product posing difficulty in the use of the available pharmacotherapy for cessation. Although no uniform guidelines exist for the use of pharmacotherapy for smokeless tobacco cessation, research suggests that use of these drugs is effective. The most important motivator for quitting ST cessation remains in the hands of the dentist.

  12. HIV capsid is a tractable target for small molecule therapeutic intervention.

    Directory of Open Access Journals (Sweden)

    Wade S Blair

    Full Text Available Despite a high current standard of care in antiretroviral therapy for HIV, multidrug-resistant strains continue to emerge, underscoring the need for additional novel mechanism inhibitors that will offer expanded therapeutic options in the clinic. We report a new class of small molecule antiretroviral compounds that directly target HIV-1 capsid (CA via a novel mechanism of action. The compounds exhibit potent antiviral activity against HIV-1 laboratory strains, clinical isolates, and HIV-2, and inhibit both early and late events in the viral replication cycle. We present mechanistic studies indicating that these early and late activities result from the compound affecting viral uncoating and assembly, respectively. We show that amino acid substitutions in the N-terminal domain of HIV-1 CA are sufficient to confer resistance to this class of compounds, identifying CA as the target in infected cells. A high-resolution co-crystal structure of the compound bound to HIV-1 CA reveals a novel binding pocket in the N-terminal domain of the protein. Our data demonstrate that broad-spectrum antiviral activity can be achieved by targeting this new binding site and reveal HIV CA as a tractable drug target for HIV therapy.

  13. A review on pro- and anti-angiogenic factors as targets of clinical intervention

    NARCIS (Netherlands)

    Bouis, D; Kusumanto, Y; Meijer, C; Mulder, NH; Hospers, GAP

    2006-01-01

    Angiogenesis plays an important role in physiology and pathology. It is a tightly regulated process, influenced by the microenvironment and modulated by a multitude of pro- and anti-angiogenic factors. A thorough understanding of the angiogenic process may lead to novel therapies to target ischemic

  14. Target motion predictions for pre-operative planning during needle-based interventions

    NARCIS (Netherlands)

    Buijs, op den Jorn; Abayazid, Momen; Korte, de Chris L.; Misra, Sarthak

    2011-01-01

    During biopsies, breast tissue is subjected to displacement upon needle indentation, puncture, and penetration. Thus, accurate needle placement requires pre-operative predictions of the target motions. In this paper, we used ultrasound elastography measurements to non-invasively predict elastic prop

  15. A gut microbiota-targeted dietary intervention for amelioration of chronic inflammation underlying metabolic syndrome.

    Science.gov (United States)

    Xiao, Shuiming; Fei, Na; Pang, Xiaoyan; Shen, Jian; Wang, Linghua; Zhang, Baorang; Zhang, Menghui; Zhang, Xiaojun; Zhang, Chenhong; Li, Min; Sun, Lifeng; Xue, Zhengsheng; Wang, Jingjing; Feng, Jie; Yan, Feiyan; Zhao, Naisi; Liu, Jiaqi; Long, Wenmin; Zhao, Liping

    2014-02-01

    Chronic inflammation induced by endotoxin from a dysbiotic gut microbiota contributes to the development of obesity-related metabolic disorders. Modification of gut microbiota by a diet to balance its composition becomes a promising strategy to help manage obesity. A dietary scheme based on whole grains, traditional Chinese medicinal foods, and prebiotics (WTP diet) was designed to meet human nutritional needs as well as balance the gut microbiota. Ninety-three of 123 central obese volunteers (BMI ≥ 28 kg m(-2) ) completed a self-controlled clinical trial consisting of 9-week intervention on WTP diet followed by a 14-week maintenance period. The average weight loss reached 5.79 ± 4.64 kg (6.62 ± 4.94%), in addition to improvement in insulin sensitivity, lipid profiles, and blood pressure. Pyrosequencing of fecal samples showed that phylotypes related to endotoxin-producing opportunistic pathogens of Enterobacteriaceae and Desulfovibrionaceae were reduced significantly, while those related to gut barrier-protecting bacteria of Bifidobacteriaceae increased. Gut permeability, measured as lactulose/mannitol ratio, was decreased compared with the baseline. Plasma endotoxin load as lipopolysaccharide-binding protein was also significantly reduced, with concomitant decrease in tumor necrosis factor-α, interleukin-6, and an increase in adiponectin. These results suggest that modulation of the gut microbiota via dietary intervention may enhance the intestinal barrier integrity, reduce circulating antigen load, and ultimately ameliorate the inflammation and metabolic phenotypes.

  16. Protocol for Targeted School-Based Interventions for Improving Reading and Mathematics for Students With or At-Risk of Academic Difficulties in Grade 7 to 12

    DEFF Research Database (Denmark)

    Dietrichson, Jens; Bøg, Martin; Filges, Trine;

    2016-01-01

    This systematic review will examine the effects of targeted interventions to students with or at-risk of academic difficulties in grades 7 to 12 on standardized tests in reading and mathematics. We will examine interventions such as for example tutoring, cooperative learning, computer-assisted in......This systematic review will examine the effects of targeted interventions to students with or at-risk of academic difficulties in grades 7 to 12 on standardized tests in reading and mathematics. We will examine interventions such as for example tutoring, cooperative learning, computer......-assisted instruction, and incentive programs with the objective of assessing their comparative effectiveness. As such, the review will contribute to the knowledge of what type of interventions that can be used to improve the educational achievement of students with or at-risk of academic difficulties....

  17. Barriers and Promoters of an Evidenced-Based Smoking Cessation Counseling During Prenatal Care in Argentina and Uruguay

    Science.gov (United States)

    Tong, Van T.; Morello, Paola; Farr, Sherry L.; Lawsin, Catalina; Dietz, Patricia M.; Aleman, Alicia; Berrueta, Mabel; Mazzoni, Agustina; Becu, Ana; Buekens, Pierre; Belizán, José; Althabe, Fernando

    2015-01-01

    In Argentina and Uruguay, 10.3 and 18.3 %, respectively, of pregnant women smoked in 2005. Brief cessation counseling, based on the 5A’s model, has been effective in different settings. This qualitative study aims to improve the understanding of factors influencing the provision of smoking cessation counseling during pregnancy in Argentina and Uruguay. In 2010, we obtained prenatal care providers’, clinic directors’, and pregnant smokers’ opinions regarding barriers and promoters to brief smoking cessation counseling in publicly-funded prenatal care clinics in Buenos Aires, Argentina and Montevideo, Uruguay. We interviewed six prenatal clinic directors, conducted focus groups with 46 health professionals and 24 pregnant smokers. Themes emerged from three issue areas: health professionals, health system, and patients. Health professional barriers to cessation counseling included inadequate knowledge and motivation, perceived low self-efficacy, and concerns about inadequate time and large workload. They expressed interest in obtaining a counseling script. Health system barriers included low prioritization of smoking cessation and a lack of clinic protocols to implement interventions. Pregnant smokers lacked information on the risks of prenatal smoking and underestimated the difficulty of smoking cessation. Having access to written materials and receiving cessation services during clinic waiting times were mentioned as promoters for the intervention. Women also were receptive to non-physician office staff delivering intervention components. Implementing smoking cessation counseling in publicly-funded prenatal care clinics in Argentina and Uruguay may require integrating counseling into routine prenatal care and educating and training providers on best-practices approaches. PMID:25500989

  18. Variation in Veteran Identity as a Factor in Veteran-Targeted Interventions.

    Science.gov (United States)

    Hack, Samantha M; DeForge, Bruce R; Lucksted, Alicia

    2017-03-01

    The sociocultural identities that people self-assign or accept influence their interpersonal interactions and decision making. Identity-based interventions attempt to influence individuals by associating healthy behaviors with in-group membership. Outreach and educational efforts aimed at veterans may rely on "typical" veteran identity stereotypes. However, as discussed in this Open Forum, there is evidence that veteran identity is not monolithic but rather fluctuates on the basis of personal characteristics and individual military service experiences. Overall, the impact of veteran identity on veterans' health behaviors and use of health care is not known and has been understudied. A major limiting factor is the lack of a standardized measure of veteran identity that can assess variations in salience, prominence, and emotional valence.

  19. Targeted Nutritional and Behavioral Feeding Intervention for a Child with Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Kelly Barnhill

    2016-01-01

    Full Text Available A variety of feeding issues and concerns, including food aversion, food selectivity, and complete food refusal, are not uncommon among children with autism spectrum disorder (ASD. Other underlying issues are often comorbid with the concerns for feeding and ASD. These may include food allergies, gastrointestinal issues, oral motor issues, and swallowing disorders. The refusal to consume particular foods coupled with the inability to tolerate, digest, and absorb these foods can compromise an individual’s overall nutrition status. Therefore, a child’s behavior toward food and feeding activities has great impact on dietary intake, nutritional status, and growth. This case report is the first to document combined medical, behavioral, and nutritional intervention for a toddler with ASD and comorbid feeding disorder.

  20. Targeted Nutritional and Behavioral Feeding Intervention for a Child with Autism Spectrum Disorder.

    Science.gov (United States)

    Barnhill, Kelly; Tami, Amanda; Schutte, Claire; Hewitson, Laura; Olive, Melissa L

    2016-01-01

    A variety of feeding issues and concerns, including food aversion, food selectivity, and complete food refusal, are not uncommon among children with autism spectrum disorder (ASD). Other underlying issues are often comorbid with the concerns for feeding and ASD. These may include food allergies, gastrointestinal issues, oral motor issues, and swallowing disorders. The refusal to consume particular foods coupled with the inability to tolerate, digest, and absorb these foods can compromise an individual's overall nutrition status. Therefore, a child's behavior toward food and feeding activities has great impact on dietary intake, nutritional status, and growth. This case report is the first to document combined medical, behavioral, and nutritional intervention for a toddler with ASD and comorbid feeding disorder.

  1. A person-centered intervention targeting the psychosocial needs of gynecological cancer survivors

    DEFF Research Database (Denmark)

    Olesen, Mette Linnet; Duun-Henriksen, Anne-Katrine; Hansson, Eva Helena

    2016-01-01

    , depression, self-esteem, and self-reported ability to monitor and respond to symptoms of recurrence. METHODS: We randomly assigned 165 gynecological cancer survivors to usual care (UC) plus GSD-GYN-C or UC alone. Self-reported QOL-cancer survivor (QOL-CS) total score and subscale scores on physical......, psychological, social, and spiritual well-being were assessed before randomization and at 3 and 9 months after randomization using t tests. Bonferroni and Pipper corrections were applied for multiple testing adjustments. RESULTS: At 9 months, the GSD-GYN-C plus UC group scored significantly higher on the QOL......-CS total scale (P = 0.02) and on the QOL-CS physical well-being subscale (P = 0.01), compared to women receiving UC alone. After adjusting for baseline scores, only the difference in the physical well-being subscale was statistically significant. No other measured outcomes differed between the intervention...

  2. Hyaluronic Acid as a Target for Intervention in Prostate Cancer Metastases

    Science.gov (United States)

    2012-06-01

    AD_________________ Award Number: W81XWH-08-1-0287 TITLE: Hyaluronic Acid as a Target for...DATE June 2012 2. REPORT TYPE Final 3. DATES COVERED 1 June 2008 – 31 May 2012 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Hyaluronic Acid as a...synthase (HAS) and hyaluronic acid (HA) are upregulated in metastatic prostate cancer cells. 7-Hydroxy-4-Methyl Coumarin (HMC) is an inhibitor of

  3. Curcumin: Updated Molecular Mechanisms and Intervention Targets in Human Lung Cancer

    Directory of Open Access Journals (Sweden)

    Hong Yin

    2012-03-01

    Full Text Available Curcumin, a yellow pigment derived from Curcuma longa Linn, has attracted great interest in the research of cancer during the past decades. Extensive studies documented that curcumin attenuates cancer cell proliferation and promotes apoptosis in vivo and in vitro. Curcumin has been demonstrated to interact with multiple molecules and signal pathways, which makes it a potential adjuvant anti-cancer agent to chemotherapy. Previous investigations focus on the mechanisms of action for curcumin, which is shown to manipulate transcription factors and induce apoptosis in various kinds of human cancer. Apart from transcription factors and apoptosis, emerging studies shed light on latent targets of curcumin against epidermal growth factor receptor (EGFR, microRNAs (miRNA, autophagy and cancer stem cell. The present review predominantly discusses significance of EGFR, miRNA, autophagy and cancer stem cell in lung cancer therapy. Curcumin as a natural phytochemicals could communicate with these novel targets and show synergism to chemotherapy. Additionally, curcumin is well tolerated in humans. Therefore, EGFR-, miRNA-, autophagy- and cancer stem cell-based therapy in the presence of curcumin might be promising mechanisms and targets in the therapeutic strategy of lung cancer.

  4. [Real-Life Evaluation of the Compact Program for Smoking Cessation].

    Science.gov (United States)

    Hering, T; Andres, J; Ruhr, H-J; Berkling, K

    2015-10-01

    Smoking cessation as a therapeutic intervention has largely not the significance that it should have according to its potential influence on diseases in the pulmonary practice. Barriers against smoking cessation apart from the addiction character of tobacco dependence are mainly the almost complete absence of reimbursement as well as concerns regarding low achievable long-term abstinence. The presented study shows that despite these barriers smoking cessation in pulmonology practice is successful if carried out by using a 2-step motivation of the participants. The long-term abstinence success of 46 % after 12 months (point prevalence) presented here was achieved with the use of behavioral therapy and medical support. Success factors are doctor's office setting and consequent information and encouragement for medical support (mostly varenicline).

  5. Inequities in utilization of maternal health interventions in Namibia: implications for progress towards MDG 5 targets

    Directory of Open Access Journals (Sweden)

    Kirigia Joses

    2010-06-01

    Full Text Available Abstract Background Inequities in the utilization of maternal health services impede progress towards the MDG 5 target of reducing the maternal mortality ratio by three quarters, between 1990 and 2015. In Namibia, despite increasing investments in the health sector, the maternal mortality ratio has increased from 271 per 100,000 live births in the period 1991-2000 to 449 per 100,000 live births in 1998-2007. Monitoring equity in the use of maternal health services is important to target scarce resources to those with more need and expedite the progress towards the MDG 5 target. The objective of this study is to measure socio-economic inequalities in access to maternal health services and propose recommendations relevant for policy and planning. Methods Data from the Namibia Demographic and Health Survey 2006-07 are analyzed for inequities in the utilization of maternal health. In measuring the inequities, rate-ratios, concentration curves and concentration indices are used. Results Regions with relatively high human development index have the highest rates of delivery by skilled health service providers. The rate of caesarean section in women with post secondary education is about seven times that of women with no education. Women in urban areas are delivered by skilled providers 30% more than their rural counterparts. The rich use the public health facilities 30% more than the poor for child delivery. Conclusion Most of the indicators such as delivery by trained health providers, delivery by caesarean section and postnatal care show inequities favoring the most educated, urban areas, regions with high human development indices and the wealthy. In the presence of inequities, it is difficult to achieve a significant reduction in the maternal mortality ratio needed to realize the MDG 5 targets so long as a large segment of society has inadequate access to essential maternal health services and other basic social services. Addressing inequities in

  6. Connexins in neurons and glia: targets for intervention in disease and injury

    Directory of Open Access Journals (Sweden)

    Keith B Moore

    2015-01-01

    Full Text Available Both neurons and glia throughout the central nervous system are organized into networks by gap junctions. Among glia, gap junctions facilitate metabolic homeostasis and intercellular communication. Among neurons, gap junctions form electrical synapses that function primarily for communication. However, in neurodegenerative states due to disease or injury gap junctions may be detrimental to survival. Electrical synapses may facilitate hyperactivity and bystander killing among neurons, while gap junction hemichannels in glia may facilitate inflammatory signaling and scar formation. Advances in understanding mechanisms of plasticity of electrical synapses and development of molecular therapeutics to target glial gap junctions and hemichannels offer new hope to pharmacologically limit neuronal degeneration and enhance recovery.

  7. The NR4A nuclear receptors as potential targets for anti-aging interventions.

    Science.gov (United States)

    Paillasse, Michael R; de Medina, Philippe

    2015-02-01

    The development of innovative anti-aging strategy is urgently needed to promote healthy aging and overcome the occurrence of age-related diseases such as cancer, diabetes, cardiovascular and neurodegenerative diseases. Genomic instability, deregulated nutrient sensing and mitochondrial dysfunction are established hallmark of aging. Interestingly, the orphan nuclear receptors NR4A subfamily (NR4A1, NR4A2 and NR4A3) are nutrient sensors that trigger mitochondria biogenesis and improve intrinsic mitochondrial function. In addition, NR4A receptors are components of DNA repair machinery and promote DNA repair. Members of the NR4A subfamily should also be involved in anti-aging properties of hormesis since these receptors are induced by various form of cellular stress and stimulate protective cells response such as anti-oxidative activity and DNA repair. Previous studies reported that NR4A nuclear receptors subfamily is potential therapeutic targets for the treatment of age related disorders (e.g. metabolic syndromes, diabetes and neurodegenerative diseases). Consequently, we propose that targeting NR4A receptors might constitute a new approach to delay aging and the onset of diseases affecting our aging population.

  8. Employment programmes and interventions targeting adults with autism spectrum disorder: A systematic review of the literature.

    Science.gov (United States)

    Hedley, Darren; Uljarević, Mirko; Cameron, Lauren; Halder, Santoshi; Richdale, Amanda; Dissanayake, Cheryl

    2016-08-18

    Individuals with autism spectrum disorder face significant challenges entering the workforce; yet research in this area is limited and the issues are poorly understood. In this systematic review, empirical peer-reviewed studies on employment programmes, interventions and employment-related outcomes in individuals with autism spectrum disorder over 18 years with and without intellectual disability were identified and evaluated. The review was prefaced by a summary of previous systematic reviews in the area. Web of Science, Medline, PsychINFO, ERIC and Scopus databases were systematically searched through to October 2015. From 32,829 records identified in the initial search, 10 review and 50 empirical articles, comprising N = 58,134 individuals with autism spectrum disorder, were included in the review. Selected articles were organised into the following themes: employment experiences, employment as a primary outcome, development of workplace skills, non-employment-related outcomes, assessment instruments, employer-focused and economic impact. Empirical studies were limited by poor participant characterisation, small sample size and/or a lack of randomisation and use of appropriate controls. Poor conceptualisation and measurement of outcomes significantly limited study quality and interpretation. Future research will require a multidisciplinary and multifaceted approach to explore employment outcomes on the individual, the family system, co-workers and the employer, along with the impact of individual differences on outcome.

  9. Targeting Epstein-Barr virus infection as an intervention against multiple sclerosis.

    Science.gov (United States)

    Jons, D; Sundström, P; Andersen, O

    2015-02-01

    We here review contemporary data on genetic and environmental risk factors, particularly Epstein-Barr virus infection, for multiple sclerosis. There is an important immunogenetic etiological factor for multiple sclerosis. However, a general assumption is that immune defense genes are activated by the environment, basically by infections. We contend that the relationship between infectious mononucleosis and multiple sclerosis cannot be completely explained by genetics and inverse causality. Epstein-Barr infection as indicated by positive serology is an obligatory precondition for multiple sclerosis, which is a stronger attribute than a risk factor only. Data on events in the early pathogenesis of multiple sclerosis are cumulating from bio-banks with presymptomatic specimens, but there is only little information from the critical age when Epstein-Barr infection including infectious mononucleosis is acquired, nor on the detailed immunological consequences of this infection in individuals with and without multiple sclerosis. We discuss how focused bio-banking may elaborate a rationale for the development of treatment or vaccination against Epstein-Barr virus infection. A cohort in which intervention against Epstein-Barr infections was performed should be the object of neurological follow-up.

  10. Universal Stress Proteins as New Targets for Environmental and Therapeutic Interventions of Schistosomiasis

    Directory of Open Access Journals (Sweden)

    Priscilla Masamba

    2016-09-01

    Full Text Available In spite of various control measures and eradication methods that have been in progress, schistosomiasis still prevails as one of the most prevalent debilitating parasitic diseases, typically affecting the poor and the underprivileged that are predominantly concentrated in sub-Saharan Africa. The parasitic schistosome blood fluke responsible for causing the disease completes its complex developmental cycle in two hosts: humans and freshwater snails, where they physically undergo gross modifications to endure the different conditions associated with each host. Just like any other organism, the worm possesses mechanisms that help them respond to environmental insults. It has been hypothesized that a special class of proteins known as Universal Stress Proteins (USPs are up-regulated during sudden environmental changes, thus assisting the worm to tolerate the unfavourable conditions associated with its developmental cycle. The position of praziquantel as the drug of choice against all schistosome infections has been deemed vulnerable due to mounting concerns over drug pressure and so the need for alternative treatment is now a matter of urgency. Therefore, this review seeks to explore the associations and possible roles of USPs in schistosomiasis as well as the functioning of these proteins in the schistosomulae stage in order to develop new therapeutic interventions against this disease.

  11. A follow-up of a media-based, worksite smoking cessation program.

    Science.gov (United States)

    Salina, D; Jason, L A; Hedeker, D; Kaufman, J; Lesondak, L; McMahon, S D; Taylor, S; Kimball, P

    1994-04-01

    Described an examination of data collected 2 years following the onset of a media-based, worksite smoking cessation intervention. Thirty-eight companies in Chicago were randomly assigned to one of two experimental conditions. In the initial 3-week phase, all participants in both conditions received self-help manuals and were instructed to watch a 20-day televised series designed to accompany the manual. In addition, participants in the group (G) condition received six sessions emphasizing quitting techniques and social support. In the second phase, which continued for 12 months, employees in G participated in monthly peer-led support groups and received incentives, while participants in the nongroup (NG) condition received no further treatment. Twenty-four months after pretest, 30% of employees in G were abstinent compared to only 19.5% in NG. This study is one of the few experimentally controlled worksite smoking cessation interventions to demonstrate significant program differences 2 years following the initial intervention.

  12. Factors affecting commencement and cessation of smoking behaviour in Malaysian adults

    Directory of Open Access Journals (Sweden)

    Ghani Wan

    2012-03-01

    Full Text Available Abstract Background Tobacco consumption peak in developed countries has passed, however, it is on the increase in many developing countries. Apart from cigarettes, consumption of local hand-rolled cigarettes such as bidi and rokok daun are prevalent in specific communities. Although factors associated with smoking initiation and cessation has been investigated elsewhere, the only available data for Malaysia is on prevalence. This study aims to investigate factors associated with smoking initiation and cessation which is imperative in designing intervention programs. Methods Data were collected from 11,697 adults by trained recording clerks on sociodemographic characteristics, practice of other risk habit and details of smoking such as type, duration and frequency. Smoking commencement and cessation were analyzed using the Kaplan-Meier estimates and log-rank tests. Univariate and multivariate Cox proportional hazard regression models were used to calculate the hazard rate ratios. Results Males had a much higher prevalence of the habit (61.7% as compared to females (5.8%. Cessation was found to be most common among the Chinese and those regularly consuming alcoholic beverages. Kaplan-Meier plot shows that although males are more likely to start smoking, females are found to be less likely to stop. History of betel quid chewing and alcohol consumption significantly increase the likelihood of commencement (p Conclusions Gender, ethnicity, history of quid chewing and alcohol consumption have been found to be important factors in smoking commencement; while ethnicity, betel quid chewing and type of tobacco smoked influences cessation.

  13. Smoking cessation in cardiac patients: the influence of action plans, coping plans and self-efficacy on quitting smoking.

    Science.gov (United States)

    de Hoog, Natascha; Bolman, Catherine; Berndt, Nadine; Kers, Esther; Mudde, Aart; de Vries, Hein; Lechner, Lilian

    2016-06-01

    Smoking cessation is the most effective action for cardiac patients who smoke to improve their prognosis, yet more than one-half of cardiac patients continue to smoke after hospital admission. This study examined the influence of action plans, coping plans and self-efficacy on intention to quit and smoking cessation in cardiac patients. Cardiac patients completed a baseline questionnaire (N = 245) assessing demographic characteristics, smoking behavior, intention, self-efficacy, relapse self-efficacy and action and coping plans. Six months later (N = 184) continued abstinence from smoking was assessed. Self-efficacy predicted intention to quit smoking and was an indirect predictor of continued abstinence, through intention. Intention to quit smoking and making action plans both directly influenced continued abstinence. Future interventions to facilitate smoking cessation in cardiac patients should put strong emphasis on enhancing self-efficacy and on making specific action plans to increase the likelihood of smoking cessation.

  14. The Impact of Hotspot-Targeted Interventions on Malaria Transmission in Rachuonyo South District in the Western Kenyan Highlands: A Cluster-Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Teun Bousema

    2016-04-01

    Full Text Available Malaria transmission is highly heterogeneous, generating malaria hotspots that can fuel malaria transmission across a wider area. Targeting hotspots may represent an efficacious strategy for reducing malaria transmission. We determined the impact of interventions targeted to serologically defined malaria hotspots on malaria transmission both inside hotspots and in surrounding communities.Twenty-seven serologically defined malaria hotspots were detected in a survey conducted from 24 June to 31 July 2011 that included 17,503 individuals from 3,213 compounds in a 100-km2 area in Rachuonyo South District, Kenya. In a cluster-randomized trial from 22 March to 15 April 2012, we randomly allocated five clusters to hotspot-targeted interventions with larviciding, distribution of long-lasting insecticide-treated nets, indoor residual spraying, and focal mass drug administration (2,082 individuals in 432 compounds; five control clusters received malaria control following Kenyan national policy (2,468 individuals in 512 compounds. Our primary outcome measure was parasite prevalence in evaluation zones up to 500 m outside hotspots, determined by nested PCR (nPCR at baseline and 8 wk (16 June-6 July 2012 and 16 wk (21 August-10 September 2012 post-intervention by technicians blinded to the intervention arm. Secondary outcome measures were parasite prevalence inside hotpots, parasite prevalence in the evaluation zone as a function of distance from the hotspot boundary, Anopheles mosquito density, mosquito breeding site productivity, malaria incidence by passive case detection, and the safety and acceptability of the interventions. Intervention coverage exceeded 87% for all interventions. Hotspot-targeted interventions did not result in a change in nPCR parasite prevalence outside hotspot boundaries (p ≥ 0.187. We observed an average reduction in nPCR parasite prevalence of 10.2% (95% CI -1.3 to 21.7% inside hotspots 8 wk post-intervention that was

  15. A Group Contingency Plus Self-Management Intervention Targeting At-Risk Secondary Students' Class-Work and Active Engagement.

    Science.gov (United States)

    Trevino-Maack, Sylvia I; Kamps, Debra; Wills, Howard

    2015-01-01

    The purpose of the present study is to show that an independent group contingency (GC) combined with self-management strategies and randomized-reinforcer components can increase the amount of written work and active classroom responding in high school students. Three remedial reading classes and a total of 15 students participated in this study. Students used self-management strategies during independent reading time to increase the amount of writing in their reading logs. They used self-monitoring strategies to record whether or not they performed expected behaviors in class. A token economy using points and tickets was included in the GC to provide positive reinforcement for target responses. The results were analyzed through visual inspection of graphs and effect size computations and showed that the intervention increased the total amount of written words in the students' reading logs and overall classroom and individual student academic engagement.

  16. Development and implementation of Baltimore Healthy Eating Zones: a youth-targeted intervention to improve the urban food environment.

    Science.gov (United States)

    Gittelsohn, Joel; Dennisuk, Lauren A; Christiansen, Karina; Bhimani, Roshni; Johnson, Antoinette; Alexander, Eleanore; Lee, Matthew; Lee, Seung Hee; Rowan, Megan; Coutinho, Anastasia J

    2013-08-01

    Poor accessibility to affordable healthy foods is associated with higher rates of obesity and diet-related chronic diseases. We present our process evaluation of a youth-targeted environmental intervention (Baltimore Healthy Eating Zones) that aimed to increase the availability of healthy foods and promote these foods through signage, taste tests and other interactive activities in low-income Baltimore City. Trained peer educators reinforced program messages. Dose, fidelity and reach-as measured by food stocking, posting of print materials, distribution of giveaways and number of interactions with community members-were collected in six recreation centers and 21 nearby corner stores and carryouts. Participating stores stocked promoted foods and promotional print materials with moderate fidelity. Interactive sessions were implemented with high reach and dose among both adults and youth aged 10-14 years, with more than 4000 interactions. Recreation centers appear to be a promising location to interact with low-income youth and reinforce exposure to messages.

  17. Large Dog Relinquishment to Two Municipal Facilities in New York City and Washington, D.C.: Identifying Targets for Intervention

    Directory of Open Access Journals (Sweden)

    Emily Weiss

    2014-07-01

    Full Text Available While the overall trend in euthanasia has been decreasing nationally, large dogs are at a higher risk of euthanasia than other sized dogs in most animal shelters in the United States. We hypothesized one way to increase the lives saved with respect to these large dogs is to keep them home when possible. In order to develop solutions to decrease relinquishment, a survey was developed to learn more about the reasons owners relinquish large dogs. The survey was administered to owners relinquishing their dogs at two large municipal facilities, one in New York City and one in Washington, D.C. There were 157 responses between the two facilities. We found both significant similarities and differences between respondents and their dogs from the two cities. We identified opportunities to potentially support future relinquishers and found that targets for interventions are likely different in each community.

  18. Modulation of heat shock transcription factor 1 as a therapeutic target for small molecule intervention in neurodegenerative disease.

    Directory of Open Access Journals (Sweden)

    Daniel W Neef

    2010-01-01

    Full Text Available Neurodegenerative diseases such as Huntington disease are devastating disorders with no therapeutic approaches to ameliorate the underlying protein misfolding defect inherent to poly-glutamine (polyQ proteins. Given the mounting evidence that elevated levels of protein chaperones suppress polyQ protein misfolding, the master regulator of protein chaperone gene transcription, HSF1, is an attractive target for small molecule intervention. We describe a humanized yeast-based high-throughput screen to identify small molecule activators of human HSF1. This screen is insensitive to previously characterized activators of the heat shock response that have undesirable proteotoxic activity or that inhibit Hsp90, the central chaperone for cellular signaling and proliferation. A molecule identified in this screen, HSF1A, is structurally distinct from other characterized small molecule human HSF1 activators, activates HSF1 in mammalian and fly cells, elevates protein chaperone expression, ameliorates protein misfolding and cell death in polyQ-expressing neuronal precursor cells and protects against cytotoxicity in a fly model of polyQ-mediated neurodegeneration. In addition, we show that HSF1A interacts with components of the TRiC/CCT complex, suggesting a potentially novel regulatory role for this complex in modulating HSF1 activity. These studies describe a novel approach for the identification of new classes of pharmacological interventions for protein misfolding that underlies devastating neurodegenerative disease.

  19. Connexins in neurons and glia:targets for intervention in disease and injury

    Institute of Scientific and Technical Information of China (English)

    Keith B Moore; John OBrien

    2015-01-01

    Both neurons and glia throughout the central nervous system are organized into networks by gap junctions. Among glia, gap junctions facilitate metabolic homeostasis and intercellular communication. Among neurons, gap junctions form electrical synapses that function pri-marily for communication. However, in neurodegenerative states due to disease or injury gap junctions may be detrimental to survival. Electrical synapses may facilitate hyperactivity and bystander killing among neurons, while gap junction hemichannels in glia may facilitate in-lfammatory signaling and scar formation. Advances in understanding mechanisms of plasticity of electrical synapses and development of molecular therapeutics to target glial gap junctions and hemichannels offer new hope to pharmacologically limit neuronal degeneration and en-hance recovery.

  20. Correlates of Cessation Success among Romanian Adults

    Directory of Open Access Journals (Sweden)

    Dorota Kaleta

    2014-01-01

    Full Text Available Background. Tobacco smoking and its consequences are a serious public health problem in Romania. Evidence-based data on factors associated with successful smoking cessation are crucial to optimize tobacco control. The aim of the study was to determine the sociodemographic and other factors associated with smoking cessation success among adults. Materials and Methods. Data was from a sample of 4,517 individuals derived from the Global Adult Tobacco Survey (GATS. GATS is a cross-sectional, nationally representative household survey implemented in Romania in 2011. Data was analyzed with logistic regression. Results. Among females, the quit rate was 26.3% compared with 33.1% in males (P<0.02. We found disparities in cessation success among the analyzed groups of respondents. Being economically active, being aged 40 and above, and having an awareness of smoking health consequences were associated with long-term quitting smoking among men, while initiating smoking at a later age increased the odds of quitting smoking among women. However, cohabitation with nonsmokers was the strongest predictor of successful cessation among both genders. Conclusion. Programs increasing quit rates and encourage cessation among groups less likely to quit, adopting voluntary smoke-free homes, and increasing the awareness of smoking and tobacco pollution risks are needed.

  1. Registration of MRI to intraoperative radiographs for target localization in spinal interventions

    Science.gov (United States)

    De Silva, T.; Uneri, A.; Ketcha, M. D.; Reaungamornrat, S.; Goerres, J.; Jacobson, M. W.; Vogt, S.; Kleinszig, G.; Khanna, A. J.; Wolinsky, J.-P.; Siewerdsen, J. H.

    2017-01-01

    Decision support to assist in target vertebra localization could provide a useful aid to safe and effective spine surgery. Previous solutions have shown 3D-2D registration of preoperative CT to intraoperative radiographs to reliably annotate vertebral labels for assistance during level localization. We present an algorithm (referred to as MR-LevelCheck) to perform 3D-2D registration based on a preoperative MRI to accommodate the increasingly common clinical scenario in which MRI is used instead of CT for preoperative planning. Straightforward adaptation of gradient/intensity-based methods appropriate to CT-to-radiograph registration is confounded by large mismatch and noncorrespondence in image intensity between MRI and radiographs. The proposed method overcomes such challenges with a simple vertebrae segmentation step using vertebra centroids as seed points (automatically defined within existing workflow). Forwards projections are computed using segmented MRI and registered to radiographs via gradient orientation (GO) similarity and the CMA-ES (covariance-matrix-adaptation evolutionary-strategy) optimizer. The method was tested in an IRB-approved study involving 10 patients undergoing cervical, thoracic, or lumbar spine surgery following preoperative MRI. The method successfully registered each preoperative MRI to intraoperative radiographs and maintained desirable properties of robustness against image content mismatch and large capture range. Robust registration performance was achieved with projection distance error (PDE) (median  ±  IQR)  =  4.3  ±  2.6 mm (median  ±  IQR) and 0% failure rate. Segmentation accuracy for the continuous max-flow method yielded dice coefficient  =  88.1  ±  5.2, accuracy  =  90.6  ±  5.7, RMSE  =  1.8  ±  0.6 mm, and contour affinity ratio (CAR)  =  0.82  ±  0.08. Registration performance was found to be robust for

  2. A family-based intervention targeting parents of preschool children with overweight and obesity: conceptual framework and study design of LOOPS- Lund overweight and obesity preschool study

    OpenAIRE

    Önnerfält Jenny; Erlandsson Lena-Karin; Orban Kristina; Broberg Malin; Helgason Christina; Thorngren-Jerneck Kristina

    2012-01-01

    Abstract Background As the rate of overweight among children is rising there is a need for evidence-based research that will clarify what the best interventional strategies to normalize weight development are. The overall aim of the Lund Overweight and Obesity Preschool Study (LOOPS) is to evaluate if a family-based intervention, targeting parents of preschool children with overweight and obesity, has a long-term positive effect on weight development of the children. The hypothesis is that pr...

  3. Receptors and ionic transporters in nuclear membranes: new targets for therapeutical pharmacological interventions.

    Science.gov (United States)

    Bkaily, Ghassan; Avedanian, Levon; Al-Khoury, Johny; Ahmarani, Lena; Perreault, Claudine; Jacques, Danielle

    2012-08-01

    Work from our group and other laboratories showed that the nucleus could be considered as a cell within a cell. This is based on growing evidence of the presence and role of nuclear membrane G-protein coupled receptors and ionic transporters in the nuclear membranes of many cell types, including vascular endothelial cells, endocardial endothelial cells, vascular smooth muscle cells, cardiomyocytes, and hepatocytes. The nuclear membrane receptors were found to modulate the functioning of ionic transporters at the nuclear level, and thus contribute to regulation of nuclear ionic homeostasis. Nuclear membranes of the mentioned types of cells possess the same ionic transporters; however, the type of receptors is cell-type dependent. Regulation of cytosolic and nuclear ionic homeostasis was found to be dependent upon a tight crosstalk between receptors and ionic transporters of the plasma membranes and those of the nuclear membrane. This crosstalk seems to be the basis for excitation-contraction coupling, excitation-secretion coupling, and excitation - gene expression coupling. Further advancement in this field will certainly shed light on the role of nuclear membrane receptors and transporters in health and disease. This will in turn enable the successful design of a new class of drugs that specifically target such highly vital nuclear receptors and ionic transporters.

  4. Calpains: potential targets for alternative chemotherapeutic intervention against human pathogenic trypanosomatids.

    Science.gov (United States)

    Branquinha, M H; Marinho, F A; Sangenito, L S; Oliveira, S S C; Goncalves, K C; Ennes-Vidal, V; d'Avila-Levy, C M; Santos, A L S

    2013-01-01

    The treatment for both leishmaniasis and trypanosomiasis, which are severe human infections caused by trypanosomatids belonging to Leishmania and Trypanosoma genera, respectively, is extremely limited because of concerns of toxicity and efficacy with the available anti-protozoan drugs, as well as the emergence of drug resistance. Consequently, the urgency for the discovery of new trypanosomatid targets and novel bioactive compounds is particularly necessary. In this context, the investigation of changes in parasite gene expression between drug resistant/sensitive strains and in the up-regulation of virulence-related genes in infective forms has brought to the fore the involvement of calpain-like proteins in several crucial pathophysiological processes performed by trypanosomatids. These studies were encouraged by the publication of the complete genome sequences of three human pathogenic trypanosomatids, Trypanosoma brucei, Trypanosoma cruzi and Leishmania major, which allowed in silico analyses that in turn directed the identification of numerous genes with interesting chemotherapeutic characteristics, including a large family of calpain-related proteins, in which to date 23 genes were assigned as calpains in T. brucei, 40 in T. cruzi and 33 in L. braziliensis. In the present review, we intend to add to these biochemical/biological reports the investigations performed upon the inhibitory capability of calpain inhibitors against human pathogenic trypanosomatids.

  5. Targeted interventions required against genital ulcers in African countries worst affected by HIV infection.

    Science.gov (United States)

    O'Farrell, N

    2001-01-01

    It remains unclear why there is such marked variation in the severity of the human immunodeficiency virus (HIV) epidemic between African countries. The prevalence of HIV infection has reached high levels in many parts of southern Africa but in most countries of West Africa the levels are much lower. Although there is good evidence that sexually transmitted infections (STIs) and genital ulcers in particular facilitate heterosexual transmission of HIV, there is little comparative STI data from the African countries worst affected by HIV infection. A MEDLINE search covering the period 1966 to August 2000 using the keywords "sexually transmitted diseases", "genital ulcers" and "Africa" was performed to identify factors that might be relevant to the spread of HIV infection in countries with the highest prevalences of the virus. In the countries worst affected by HIV infection, the proportions of men and women with STI who had genital ulcers lay in the ranges 45-68% and 13-68%, respectively. The proportions were much lower in countries of West Africa than in those of southern Africa. The African countries worst affected by HIV infection should adopt a more specialized approach to STI control than hitherto and specifically target the high incidence of genital ulceration. Locally, technical STI committees should draw up country-specific guidelines taking into account the prevalence of the various causes of genital ulceration. In these countries, national AIDS control programmes and donor agencies should develop a specific focus for decreasing the incidence of genital ulcer disease.

  6. Don't Say That to ME: Opposition to Targeting in Weight-Centric Intervention Messages.

    Science.gov (United States)

    Robinson, Becky; Coveleski, Samantha

    2016-12-02

    Obesity is a global health issue. Despite well-intentioned efforts by public institutions, traditional health promotion techniques often lead to offending those most in need of weight loss. For example, when Bryn Mawr College targeted overweight students to offer a free fitness and nutrition program, it was met with accusations of fat-shaming, indicating that weight-centric messages operate in a more complex sociocultural system than many public health concerns. To better understand reactions to weight-centric health messages, college-aged women evaluated the Bryn Mawr College e-mail. Using an embedded mixed-methods design, analysis revealed that reactions followed four positive themes, six negative themes, and one neutral theme. Statistical tests indicated that health literacy, feminist identification, body dissatisfaction, and body size discrepancy influenced evaluations of message offensiveness and effectiveness. Contrary to the recommendations of traditional behavior change research, these results indicate that audience segmentation and message tailoring may not be effective for promoting weight loss.

  7. A Randomized Clinical Trial of a Web-Based Tobacco Cessation Education Program

    Science.gov (United States)

    Mahabee-Gittens, E. Melinda; Andrews, Judy A.; Christiansen, Steven M.; Byron, David J.

    2013-01-01

    OBJECTIVES: We report the results of a randomized clinical trial of a 3-hour, web-based, tobacco cessation education program, the Web-Based Respiratory Education About Tobacco and Health (WeBREATHe) program, for practicing pediatric respiratory therapists (RTs), registered nurses (RNs), and nurse practitioners (NPs). METHODS: Two hundred fifteen RTs (n = 40), RNs (n = 163), and NPs (n = 12) employed at the Children’s Hospital of Philadelphia and the Children’s Hospital, University of Colorado at Denver, participated in this study. All study activities were completed online. After consenting, participants were randomly assigned to either the training (intervention) or delayed training (control) condition. The training condition consisted of a 3-hour continuing education unit course plus ongoing online resources. Participants were assessed at baseline, 1 week, and 3 months after enrollment. RESULTS: Participants in the training condition were more likely to increase their tobacco cessation intervention behaviors than their delayed training counterparts (F[1, 213] = 32.03, P < .001). Training participants showed significantly greater levels of advise (F[1, 213] = 7.22, P < .001); assess (F[1, 213] = 19.56, P < .001); and particularly assist/arrange (F[1213] = 35.52, P < .001). In addition, training condition participants rated the program highly on measures of consumer satisfaction. CONCLUSIONS: The WeBREATHe program is the first evidence-based education program in tobacco cessation designed specifically for pediatric RTs, RNs, and NPs. Engagement in WeBREATHe increased participants’ tobacco cessation-related behaviors. PMID:23319529

  8. Partial nicotinic acetylcholine (α4β2 agonists as promising new medications for smoking cessation

    Directory of Open Access Journals (Sweden)

    Singh J

    2008-01-01

    Full Text Available Objective: To review the pharmacology, clinical efficacy and safety of partial agonists of a4β 2 nicotinic acetylcholine receptor. Data Sources: Primary literature and review articles were obtained via a PUBMED search (1988-August 2006 using the key terms smoking cessation, partial agonist alpha4beta2 nicotinic acetylcholine receptor, varenicline, cytisine and SSR591813. Additional studies and abstracts were identified from the bibliographies of reviewed literature. Study Selection and Data Extraction: Studies and review articles related to varenicline, cytisine and the partial agonist alpha4beta2 nicotinic acetylcholine receptor were reviewed. Data Synthesis: Smoking is widely recognized as a serious health problem. Smoking cessation has major health benefits. According to the US Public Health Services, all patients attempting to quit smoking should be encouraged to use one or more effective pharmacotherapy. Currently, along with nicotine replacement therapy, bupropion, nortriptyline and clonidine, are the mainstay of pharmacotherapy. More than ¾ of patients receiving treatment for smoking cessation return to smoking within the first year. Nicotine, through stimulating α4β 2 nAChR, releases dopamine in the reward pathway. Partial agonist of α4β 2 nAChR elicits moderate and sustained release of dopamine, which is countered during the cessation attempts; it simultaneously blocks the effects of nicotine by binding with α4β 2 receptors during smoking. Recently, varenicline, a partial agonist at α4β 2 nAChR, has been approved by the FDA (Food and Drug Administration for smoking cessation. Conclusion: Partial agonist α4β 2 nAChR appears to be a promising target in smoking cessation. Varenicline of this group is approved for treatment of smoking cessation by the FDA in May 2006.

  9. Motivation as a strategy for smoking cessation

    Directory of Open Access Journals (Sweden)

    Lucia Soares Buss Coutinho

    2014-03-01

    Full Text Available Objective: to know the motivational aspects related to smoking cessation. Methods: semi-structured interviews were conducted with nine former smokers in their homes, located in a neighbourhood of Lages-SC, whose primary care service has a Residency Programme in Family and Community Medicine. This sample was obtained by convenience, following the inclusion criteria: patients over 18 years classified as former smokers. The analyses of the interviews were performed using the Discourse of the Collective Subject. Results: the accounts presented showed that motivation is a tool for smoking cessation, emphasizing that it is not external to the people; on the contrary, it depends on their own will. Conclusion: the process of smoking cessation is complex and multifactorial, requiring the health professional to be watchful and skilful in order to create an environment that motivates people to take care of their own health.

  10. Perspectives on Smoking Cessation in Northern Appalachia.

    Science.gov (United States)

    Rodriguez, Elisa M; Twarozek, Annamaria Masucci; Erwin, Deborah O; Widman, Christy; Saad-Harfouche, Frances G; Fox, Chester H; Underwood, Willie; Mahoney, Martin C

    2016-04-01

    This study applies qualitative research methods to explore perspectives on cessation among smokers/former smokers recruited from an area of Northern Appalachia. Six focus groups, stratified by age group (18-39 years old and 40 years and older), were conducted among participants (n = 54) recruited from community settings. Participants described varied interest in and challenges with quitting smoking. Smokers 40 years and older more readily endorsed the health risks of smoking and had greater interest in quitting assistance. Participants expressed frustration with the US government for allowing a harmful product (e.g., cigarettes) to be promoted with minimal regulation. Use of social media was robust among both age groups; participants expressed limited interest in various social media/technology platforms for promoting smoking cessation. Findings from this understudied area of northern Appalachia reflect the heterogeneity of this region and contribute novel information about the beliefs, attitudes, and experiences of current and formers smokers with regard to cessation.

  11. Do electronic cigarettes help with smoking cessation?

    Science.gov (United States)

    2014-11-01

    Smoking causes around 100,000 deaths each year in the UK, and is the leading cause of preventable disease and early mortality. Smoking cessation remains difficult and existing licensed treatments have limited success. Nicotine addiction is thought to be one of the primary reasons that smokers find it so hard to give up, and earlier this year DTB reviewed the effects of nicotine on health. Electronic cigarettes (e-cigarettes) are nicotine delivery devices that aim to mimic the process of smoking but avoid exposing the user to some of the harmful components of traditional cigarettes. However, the increase in the use of e-cigarettes and their potential use as an aid to smoking cessation has been subject to much debate. In this article we consider the regulatory and safety issues associated with the use of e-cigarettes, and their efficacy in smoking cessation and reduction.

  12. Profiling unauthorized natural resource users for better targeting of conservation interventions.

    Science.gov (United States)

    Harrison, Mariel; Baker, Julia; Twinamatsiko, Medard; Milner-Gulland, E J

    2015-12-01

    Unauthorized use of natural resources is a key threat to many protected areas. Approaches to reducing this threat include law enforcement and integrated conservation and development (ICD) projects, but for such ICDs to be targeted effectively, it is important to understand who is illegally using which natural resources and why. The nature of unauthorized behavior makes it difficult to ascertain this information through direct questioning. Bwindi Impenetrable National Park, Uganda, has many ICD projects, including authorizing some local people to use certain nontimber forest resources from the park. However, despite over 25 years of ICD, unauthorized resource use continues. We used household surveys, indirect questioning (unmatched count technique), and focus group discussions to generate profiles of authorized and unauthorized resource users and to explore motivations for unauthorized activity. Overall, unauthorized resource use was most common among people from poor households who lived closest to the park boundary and farthest from roads and trading centers. Other motivations for unauthorized resource use included crop raiding by wild animals, inequity of revenue sharing, and lack of employment, factors that created resentment among the poorest communities. In some communities, benefits obtained from ICD were reported to be the greatest deterrents against unauthorized activity, although law enforcement ranked highest overall. Despite the sensitive nature of exploring unauthorized resource use, management-relevant insights into the profiles and motivations of unauthorized resource users can be gained from a combination of survey techniques, as adopted here. To reduce unauthorized activity at Bwindi, we suggest ICD benefit the poorest people living in remote areas and near the park boundary by providing affordable alternative sources of forest products and addressing crop raiding. To prevent resentment from driving further unauthorized activity, ICDs should be

  13. Protocol for Targeted School-Based Interventions for Improving Reading and Mathematics for Students With or At-Risk of Academic Difficulties in Grade K to 6

    DEFF Research Database (Denmark)

    Dietrichson, Jens; Bøg, Martin; Eiberg, Misja;

    2016-01-01

    This systematic review will examine the effects of targeted interventions to students with or at-risk of academic difficulties in Kindergarten to grade 6 on standardized tests in reading and mathematics. We will examine interventions such as for example tutoring, cooperative learning, computer......-assisted instruction, and incentive programs with the objective of assessing their comparative effectiveness. As such, the review will contribute to the knowledge of what type of interventions that can be used to improve the educational achievement of students with or at-risk of academic difficulties....

  14. Tobacco cessation: what role can dental professionals play?

    Directory of Open Access Journals (Sweden)

    Abhishek Mehta

    2012-06-01

    Full Text Available Introduction: Tobacco dependence is classified as a disease by the International Classification of Diseases (ICD-10, but, medical and dental professionals have neither seriously taken this fact nor made any serious attempt to tackle this disease. Apart from supporting wider tobacco control measures, oral health professionals can help patients to stop using tobacco. This may be the single most important service dentists can provide for their patients’ overall health. Objective: This review is prepared with the object to help both clinicians and oral health professionals to scale up their involvement in tobacco control activities, including advocacy and smoking cessation programs. Literature review: Studies have shown that Studies have shown that 70% smokers indicate smokers indicatethat they want to quit, but a meagre 2% succeed. The dental practice The dental practice setting provides a unique opportunity to assist tobacco users in achieving tobacco abstinence. Still, More than 40% of dentists do not routinely ask about tobacco use and 60% do not routinely advise tobacco users to quit, while 61.5% of dentists believe their patients do not expect tobacco cessation services. Conclusion: Interventions by dentist has been found to be effective in helping people to quit tobacco consumption. A step-wise approach and patience must be adopted while dealing with such patients.

  15. [Smoking cessation in Germany in 2007. Patterns of outpatient smoking cessation counselling and treatment].

    Science.gov (United States)

    Etzel, M; Mons, U; Schmitt, S; Lang, P; Pötschke-Langer, M

    2008-12-01

    A qualified and comprehensive supply of outpatient smoking cessation counselling and treatment is essential to help smokers quit. In order to assess the status quo, structure and regional differences of the smoking cessation services available in Germany, a complete market survey was conducted in 2007. Descriptive results on the structure and characteristics of smoking cessation services show that there are distinct regional differences, especially in the New Laender, where the supply is insufficient. Overall, about a quarter of the providers of smoking cessation services lack specialised additional skills required for smoking cessation counselling, treatment or therapy of addicts. Especially medical practitioners more often lack such additional skills compared to other occupational groups. The smoking cessation services generally used the programs "Rauchfrei in 10 Schritten" and "Das Rauchfrei Programm", and the method of cognitive behavioural therapy. However, more than half of the services still use a method which is not evidence-based. Since February 2008 data on all supplies and suppliers of smoking cessation services, who gave their permission, have been published online and can be accessed at www.anbieter-raucherberatung.de.

  16. Increasing obesity in treated female HIV patients from Sub-Saharan Africa: Potential causes and possible targets for intervention

    Directory of Open Access Journals (Sweden)

    Claire eMcCormick

    2014-11-01

    Full Text Available Objectives To investigate changing nutritional demographics of treated HIV-1-infected patients and explore causes of obesity, particularly in women of African origin.Methods We prospectively reviewed nutritional demographics of clinic attenders at an urban European HIV clinic during four one-month periods at 3-yearly intervals (2001, 2004, 2007, and 2010 and in two consecutive whole-year reviews (2010-11 and 2011-12. Risk-factors for obesity were assessed by multiple linear regression. A sub-study of 50 HIV-positive African female patients investigated body-size/shape perception using numerical, verbal and pictorial cues. Results We found a dramatic rise in the prevalence of obesity (BMI >30 kg/m2, from 8.5% (2001 to 28% (2011-12 for all clinic attenders, of whom 86% were on antiretroviral treatment. Women of African origin were most affected, 49% being obese, with a further 32% overweight (BMI 25-30 kg/m2, in 2012. Clinical factors strongly associated with obesity included female gender, black African ethnicity, non-smoking, age and CD4 count (all P<0.001; greater duration of cART did not predict obesity. Individual weight-time trends mostly showed slow long-term progressive weight gain. Investigating body weight perception, we found that weight and adiposity were underestimated by obese subjects, who showed a greater disparity between perceived and actual adiposity (P<0.001. Obese subjects targeted more obese target ideal body shapes (P<0.01, but were less satisfied with their body shape overall (P=0.02. Conclusions Seropositive African women on antiretroviral treatment are at heightened risk of obesity. Although multifactorial, bodyweight perception represents a potential target for intervention.

  17. Targeting TRAF3IP2 by Genetic and Interventional Approaches Inhibits Ischemia/Reperfusion-induced Myocardial Injury and Adverse Remodeling.

    Science.gov (United States)

    Erikson, John M; Valente, Anthony J; Mummidi, Srinivas; Kandikattu, Hemanth Kumar; DeMarco, Vincent G; Bender, Shawn B; Fay, William P; Siebenlist, Ulrich; Chandrasekar, Bysani

    2017-02-10

    Re-establishing blood supply is the primary goal for reducing myocardial injury in subjects with ischemic heart disease. Paradoxically, reperfusion results in nitroxidative stress and a marked inflammatory response in the heart. TRAF3IP2 (TRAF3 Interacting Protein 2; previously known as CIKS or Act1) is an oxidative stress-responsive cytoplasmic adapter molecule that is an upstream regulator of both IκB kinase (IKK) and c-Jun N-terminal kinase (JNK), and an important mediator of autoimmune and inflammatory responses. Here we investigated the role of TRAF3IP2 in ischemia/reperfusion (I/R)-induced nitroxidative stress, inflammation, myocardial dysfunction, injury, and adverse remodeling. Our data show that I/R up-regulates TRAF3IP2 expression in the heart, and its gene deletion, in a conditional cardiomyocyte-specific manner, significantly attenuates I/R-induced nitroxidative stress, IKK/NF-κB and JNK/AP-1 activation, inflammatory cytokine, chemokine, and adhesion molecule expression, immune cell infiltration, myocardial injury, and contractile dysfunction. Furthermore, Traf3ip2 gene deletion blunts adverse remodeling 12 weeks post-I/R, as evidenced by reduced hypertrophy, fibrosis, and contractile dysfunction. Supporting the genetic approach, an interventional approach using ultrasound-targeted microbubble destruction-mediated delivery of phosphorothioated TRAF3IP2 antisense oligonucleotides into the LV in a clinically relevant time frame significantly inhibits TRAF3IP2 expression and myocardial injury in wild type mice post-I/R. Furthermore, ameliorating myocardial damage by targeting TRAF3IP2 appears to be more effective to inhibiting its downstream signaling intermediates NF-κB and JNK. Therefore, TRAF3IP2 could be a potential therapeutic target in ischemic heart disease.

  18. Policy interventions to reduce the harm from smoking.

    Science.gov (United States)

    Anderson, P; Hughes, J R

    2000-01-01

    The other papers in this series on reduced smoking discuss interventions focused on individuals. This paper illustrates possible smoking reduction interventions focused on policies rather than individuals. Target 12 of the new WHO Health For All Policy aims to significantly reduce the harm from addictive substances, including tobacco, in all member states by 2015, and the WHO Third Action Plan for Tobacco-Free Europe focuses on reducing the harm from tobacco. These documents recommend five key policy strategies: market regulation, product liability, smoke-free environments, support for smoking cessation and education, public information and public opinion. Interventions such as price increases, restricting availability, advertising bans and product control could all be used to achieve harm reduction. Research on reducing the harm of smoking needs to include policy as well as treatment research.

  19. Development, dissemination, adherence, and effectiveness of a Smoking Cessation Programs offered in a public university

    Directory of Open Access Journals (Sweden)

    Fernanda Machado Lopes

    2014-08-01

    Full Text Available Smoking Cessation Programs (SCP must comprise factors that increase the chances of successful treatment, such as choice of approach and modality based on scientific evidence; adaptation of the intervention to the characteristics of target patients; records of procedures and efficacy rates; and the use of both active and reactive strategies to recruit smokers. Given this, this study was designed with the aim of describing the implementation of a SCP in a public university that has adopted a 100% smoke-free campus policy, including the evaluation of publicity methods and their possible impact in adherence rates and program success. There were 128 smokers enrolled in nine program groups offered over two years: 97 (76% attended the first meeting and 69 (71% effectively completed the SCP. The groups that underwent follow-up assessment (n = 58 achieved abstinence rates of 27% and 32%, greater than expected for solely psychological treatment and similar to rates that combined cognitive-behavioral approach to pharmacology. The recruitment strategies that combined active strategies (personal contacts, personal invitations, individual interviews and reactive strategies (posters, corporate e-mail, newspapers were the most effective to attract and gain the adherence of smokers to the SCP, corroborating the literature. We conclude that 100% smoke-free environment campaigns are opportunities that favor the effectiveness of SCPs, which can be developed and implemented by any trained health professional.

  20. Changes in body weight and food choice in those attempting smoking cessation: a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Leslie Wilma S

    2012-05-01

    Full Text Available Abstract Background Fear of weight gain is a barrier to smoking cessation and significant cause of relapse for many people. The provision of nutritional advice as part of a smoking cessation programme may assist some in smoking cessation and perhaps limit weight gain. The aim of this study was to determine the effect of a structured programme of dietary advice on weight change and food choice, in adults attempting smoking cessation. Methods Cluster randomised controlled design. Classes randomised to intervention commenced a 24-week intervention, focussed on improving food choice and minimising weight gain. Classes randomised to control received “usual care”. Results Twenty-seven classes in Greater Glasgow were randomised between January and August 2008. Analysis, including those who continued to smoke, showed that actual weight gain and percentage weight gain was similar in both groups. Examination of data for those successful at giving up smoking showed greater mean weight gain in intervention subjects (3.9 (SD 3.1 vs. 2.7 (SD 3.7 kg. Between group differences were not significant (p = 0.23, 95% CI −0.9 to 3.5. In comparison to baseline improved consumption of fruit and vegetables and breakfast cereal were reported in the intervention group. A higher percentage of control participants continued smoking (74% vs. 66%. Conclusions The intervention was not successful at minimising weight gain in comparison to control but was successful in facilitating some sustained improvements in the dietary habits of intervention participants. Improved quit rates in the intervention group suggest that continued contact with advisors may have reduced anxieties regarding weight gain and encouraged cessation despite weight gain. Research should continue in this area as evidence suggests that the negative effects of obesity could outweigh the health benefits achieved through reductions in smoking prevalence. Trial registration Current Controlled Trials

  1. Low-density lipoprotein cholesterol target goal attainment rate and related factors in patients with acute coronary syndrome after percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    张波

    2014-01-01

    Objective To observe the low-density lipoprotein cholesterol(LDL-C)target goal attainment rate and related factors in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods From March 2011 to March 2012,a total of832 ACS patients were retrospectively evaluated in the Cardiology Department of the First Affiliated Hospital of Dalian Medical University.The target goal attainment

  2. Rapid fall in lung density following smoking cessation in COPD

    DEFF Research Database (Denmark)

    Shaker, Saher B; Stavngaard, Trine; Laursen, Lars Christian;

    2011-01-01

    Whether smoking-induced lung inflammation subsides after smoking cessation is currently a matter of debate. We used computed tomography (CT) to evaluate the effect of smoking cessation on lung density in patients with COPD.......Whether smoking-induced lung inflammation subsides after smoking cessation is currently a matter of debate. We used computed tomography (CT) to evaluate the effect of smoking cessation on lung density in patients with COPD....

  3. Drug cessation in complex older adults: Time for action

    OpenAIRE

    2014-01-01

    textabstractBackground: general opinion is growing that drug cessation in complex older patients is warranted in certain situations. From a clinical viewpoint, drug cessation seems most warranted in four situations, i.e., falls, delirium, cognitive impairment and endof-life situations. To date, little information about the effects of drug cessation in these four situations is available. Objectives: to identify the effects and effectiveness of drug cessation on falls, delirium and cognitive im...

  4. The role of smoking in social networks on smoking cessation and relapse among adults: A longitudinal study.

    Science.gov (United States)

    Blok, David J; de Vlas, Sake J; van Empelen, Pepijn; van Lenthe, Frank J

    2017-02-16

    Understanding the spread of smoking cessation and relapse within social networks may offer new approaches to further curb the smoking epidemic. Whether smoking behavior among social network members determines smoking cessation and relapse of adults however, is less known. For this study, longitudinal data of 4623 adults participating in the Dutch Longitudinal Internet Studies for the Social sciences (LISS) panel were collected in March 2013 with a follow-up in 2014. Logistic regression was used to examine the association between the proportion of smokers in social networks, and (1) smoking cessation (n=762) and (2) smoking relapse (n=1905). Analyses were adjusted for the size of the network, age, sex, and education. Respondents with the largest proportion of smokers in their social network were less likely to quit smoking (OR=0.25; 95% CI=0.11-0.66) and more likely to experience a relapse (6.08; 3.01-12.00). Smoking cessation and relapse were most strongly associated with the proportion of smokers among household members and friends. The proportion of smokers in family outside the household was not related to smoking cessation and smoking relapse. In conclusion, smoking behavior in social networks, especially among household members and friends, is strongly associated with smoking cessation and relapse. These findings further support the spread of smoking within social networks, and provide evidence for network-based interventions, particularly including household members and friends.

  5. Cytisine for smoking cessation: a research agenda.

    Science.gov (United States)

    Etter, Jean-François; Lukas, Ronald J; Benowitz, Neal L; West, Robert; Dresler, Carolyn M

    2008-01-01

    Cytisine has a molecular structure somewhat similar to that of nicotine and varenicline. The concept for the new smoking cessation drug varenicline was based partly on cytisine. Like varenicline, cytisine is a partial agonist of nicotinic acetylcholine receptors, with high affinity for alpha4beta2 receptors. Cytisine has been used since the 1960s as a smoking cessation drug in Eastern and Central Europe, but has remained largely unnoticed elsewhere. Three placebo-controlled trials, conducted in East and West Germany in the 1960s and 1970s, suggest that cytisine, even with minimal behavioural support, may be effective in aiding smoking cessation. Cytisine tablets are very inexpensive to produce and could be a more affordable treatment than nicotine replacement, bupropion and varenicline. There is however a dearth of scientific research on the properties of cytisine, including safety, abuse liability and efficacy. This paper seeks to identify research priorities for molecular, animal and clinical studies. In particular, new studies are necessary to define the nicotinic receptor interaction profile of cytisine, to establish its pharmacokinetics and pharmacodynamics in humans, to determine whether animals self-administer cytisine, and to ascertain whether cytisine is safe and effective as a smoking cessation drug. Potentially, this research effort, contributing to wider use of an inexpensive drug, could save many lives.

  6. Dental students' attitudes toward tobacco cessation counseling.

    Science.gov (United States)

    Anders, Patrick L; Davis, Elaine L; McCall, W D

    2014-01-01

    The main objective of this study was to determine if level of education, gender, and tobacco history affected attitudes of dental students toward tobacco cessation counseling. A secondary objective was to examine the psychometric properties of the survey instrument. First- and fourth-year dental students at one school of dental medicine completed a survey examining attitudes toward tobacco cessation and perceived barriers to performing tobacco cessation counseling in a dental setting. Analyses were conducted to determine whether there were differences in attitudes by gender, level of education, or personal and family tobacco use. A main effect for education level was discovered. Fourth-year students were more likely than first-year students to consider the prescription of nicotine gum and transdermal patches to be within the scope and responsibility of the dental profession. No significant differences were seen with regard to gender or students' personal and family tobacco histories. Dental students were in general agreement that tobacco cessation counseling is within the responsibility of the dental profession, is within the scope of dental practice, and can be effective. Psychometric analysis revealed reliability of the survey instrument.

  7. Menthol cigarettes and smoking cessation behavior

    Directory of Open Access Journals (Sweden)

    Hoffman Allison C

    2011-05-01

    Full Text Available Abstract Although much is known about smoking cessation behavior, the vast majority of research has not assessed menthol as an independent factor. The objective of this review is to assess the effects, if any, that use of menthol cigarettes has on smoking cessation success in adults and youth. A total of 20 articles are included in this review. Although some studies have found that menthol smokers have less success in quitting smoking, others fail to find significant differences between menthol and non-menthol smokers. Some clinical trials evaluating the efficacy of various cessation treatments have suggested that menthol smokers have poorer outcomes, however two secondary data analysis studies (which used the same original dataset failed to find any difference in success rate associated with particular treatments. Although there is some suggestion that smoking menthol cigarettes is associated with worse cessation outcomes, differences are not always found. However, if there was a difference, it was always in the direction of worse outcomes for menthol smokers. Given that Black/African American smokers prefer menthol cigarettes more than White smokers, possible interactions with race/ethnicity are discussed.

  8. Program Strategies for Adolescent Smoking Cessation

    Science.gov (United States)

    Fritz, Deborah J.; Wider, Lottchen Crane; Hardin, Sally B.; Horrocks, Michelle

    2008-01-01

    School nurses who work with adolescents are in an ideal position to promote smoking cessation. This opportunity is important because research suggests teens who smoke are likely to become habitual smokers. This study characterizes adolescents' patterns and levels of smoking, describes adolescents' perceptions toward smoking, and delineates quit…

  9. Enabling the NSW health workforce to provide evidence-based smoking-cessation advice through competency-based training delivered via video conferencing.

    Science.gov (United States)

    Mitchell, Elayne N; Hawkshaw, Barbara N; Naylor, Carlie-Jane; Soewido, Dias; Sanders, John M

    2008-01-01

    Tobacco-related disease is estimated to cost the NSW health system more than $476 million in direct health care costs annually. Population-based smoking-cessation interventions, including brief intervention by health professionals, are effective and cost effective. As the prevalence of smoking in the general community declines, more highly dependent 'treatment-resistant' smokers may present a challenge to the health system. International guidelines recommend that health systems invest in training for health professionals in best practice smoking cessation. As part of the NSW Tobacco Action Plan 2005-2009, NSW Department of Health developed national competency standards in smoking cessation, designed learning and assessment materials and delivered training to more than 300 health professionals via video conference. Building the capacity of the NSW Health workforce to address smoking cessation as part of their routine practice is essential for addressing future challenges in tobacco control.

  10. A Multicomponent Schoolyard Intervention Targeting Children’s Recess Physical Activity and Sedentary Behavior: Effects After One Year

    DEFF Research Database (Denmark)

    Van Kann, Dave H.H.; de Vries, S.I.; Schipperijn, J.

    2017-01-01

    were found. In depth-analyses on intervention components showed that physical schoolyard interventions particularly predicted a decrease in time spent in sedentary behavior during recess at follow-up. Intervention intensity and school?s commitment to the project strengthened this effect. Conclusions...... The multicomponent schoolyard PA intervention was effective in making children spend a larger proportion of recess time in light PA, which was most likely the result of a shift from sedentary behavior to light PA....

  11. Predictors of long-term smoking cessation: results from the global adult tobacco survey in Poland (2009–2010

    Directory of Open Access Journals (Sweden)

    Kaleta Dorota

    2012-11-01

    Full Text Available Abstract Background Expanding the information on determinants of smoking cessation is crucial for developing and implementing more effective tobacco control measures at the national as well as European levels. Data on smoking cessation and its social correlates among adults from middle-income countries of Central and Eastern Europe are still poorly reported in the literature. The aim of the study was to analyze the association of socio-demographic indicators with long term tobacco smoking cessation (quit smoking for at least one year prior to interview among adults. Moreover, we evaluated motives for giving up smoking from former smokers. Methods Data on former as well as current smokers’ socio-demographic and smoking-related characteristics were derived from the Global Adult Tobacco Survey (GATS. GATS is a cross-sectional, nationally representative household survey implemented in Poland between 2009 and 2010. GATS collected data on a representative sample of 7,840 individuals including 1,206 individuals who met the criteria of long-term smoking cessation and 2,233 current smokers. Smoking cessation rate was calculated as the number of former smokers divided by the number of ever smokers. Logistic regression analyses were used to obtain odds ratios (ORs and 95% confidence interval (CI of the broad number of variables on successful cessation of smoking. Results Among females the quit rate was 30.4% compared to 37.9% in males (p  Conclusion Results indicated that smoking cessation policies focused on younger age groups are vital for curbing tobacco epidemic in Poland and should become a public health main concern. There is also the need for interventions to raise awareness on smoking health risks and quitting benefits are crucial to increase cessation potential among adult smokers. Nevertheless further effort needs to be done to prevent smoking uptake.

  12. Smoking cessation care among patients with head and neck cancer: a systematic review

    Science.gov (United States)

    McCarter, Kristen; Martínez, Úrsula; Britton, Ben; Baker, Amanda; Bonevski, Billie; Carter, Gregory; Beck, Alison; Wratten, Chris; Guillaumier, Ashleigh; Halpin, Sean A

    2016-01-01

    Objective To examine the effectiveness of smoking cessation interventions in improving cessation rates and smoking related behaviour in patients with head and neck cancer (HNC). Design A systematic review of randomised and non-randomised controlled trials. Methods We searched the following data sources: CENTRAL in the Cochrane Library, MEDLINE, EMBASE, PsycINFO and CINAHL up to February 2016. A search of reference lists of included studies and Google Scholar (first 200 citations published online between 2000 and February 2016) was also undertaken. The methodological quality of included studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool (EPHPP). 2 study authors independently screened and extracted data with disagreements resolved via consensus. Results Of the 5167 studies identified, 3 were eligible and included in the review. Trial designs of included studies were 2 randomised controlled trials and 1 non-randomised controlled trial. 2 studies received a weak methodological rating and 1 received a moderate methodological rating. The trials examine the impact of the following interventions: (1) nurse delivered cognitive–behaviour therapy (CBT) via telephone and accompanied by a workbook, combined with pharmacotherapy; (2) nurse and physician brief advice to quit and information booklets combined with pharmacotherapy; and (3) surgeon delivered enhanced advice to quit smoking augmented by booster sessions. Only the trial of the nurse delivered CBT and pharmacotherapy reported significant increases in smoking cessation rates. 1 study measured quit attempts and the other assessed consumption of cigarettes per day and readiness to change. There was no significant improvement in quit attempts or cigarettes smoked per day among patients in the intervention groups, relative to control. Conclusions There are very few studies evaluating the effectiveness of smoking cessation interventions that report results specific to the HNC

  13. Smoking Cessation Counselling for Pregnant and Postpartum Women among Midwives, Gynaecologists and Paediatricians in Germany

    OpenAIRE

    Wolfgang Hannöver; Kathrin Röske; Jochen René Thyrian; Ulrich John; Hans-Joachim Hannich

    2009-01-01

    The incorporation of guidelines for the treatment of tobacco smoking into routine care requires positive attitudes, counselling skills and knowledge about additional help available for smokers. The study assesses performance of smoking cessation intervention, attitudes, training status and knowledge about additional help for smokers in the care for pregnant and parenting women by midwives, gynaecologists and paediatricians. A survey of all midwives, gynaecologists and paediatricians registere...

  14. Mediated smoking cessation programs in the Stanford Five-City Project.

    Science.gov (United States)

    Sallis, J F; Flora, J A; Fortmann, S P; Taylor, C B; Maccoby, N

    1985-01-01

    Two mediated smoking cessation programs were subjected to a field evaluation. The Quit Kit is a printed self-help package, and "Calling It Quits" consists of five segments which were aired on the local television news. A sample of 239 persons requested the Quit Kit and were followed. At the 2-month and 12-month follow-ups, respectively, 13.6% and 17.9% of those surveyed reported abstinence. Results indicate the potential of mediated interventions.

  15. MAPIT: development of a web-based intervention targeting substance abuse treatment in the criminal justice system.

    Science.gov (United States)

    Walters, Scott T; Ondersma, Steven J; Ingersoll, Karen S; Rodriguez, Mayra; Lerch, Jennifer; Rossheim, Matthew E; Taxman, Faye S

    2014-01-01

    Although drug and alcohol treatment are common requirements in the U.S. criminal justice system, only a minority of clients actually initiate treatment. This paper describes a two-session, web-based intervention to increase motivation for substance abuse treatment among clients using illicit substances. MAPIT (Motivational Assessment Program to Initiate Treatment) integrates the extended parallel process model, motivational interviewing, and social cognitive theory. The first session (completed near the start of probation) targets motivation to complete probation, to make changes in substance use (including treatment initiation), and to obtain HIV testing and care. The second session (completed approximately 30days after session 1) focuses on goal setting, coping strategies, and social support. Both sessions can generate emails or mobile texts to remind clients of their goals. MAPIT uses theory-based algorithms and a text-to-speech engine to deliver custom feedback and suggestions. In an initial test, participants indicated that the program was respectful, easy to use, and would be helpful in making changes in substance use. MAPIT is being tested in a randomized trial in two large U.S. probation agencies. MAPIT addresses the difficulties of many probation agencies to maximize client involvement in treatment, in a way that is cost effective and compatible with the existing service delivery system.

  16. HIV-testing among female sex workers on the border between Brazil and French Guiana: the need for targeted interventions.

    Science.gov (United States)

    Parriault, Marie-Claire; van Melle, Astrid; Basurko, Célia; Gaubert-Marechal, Emilie; Macena, Raimunda Hermelinda Maia; Rogier, Stéphanie; Kerr, Ligia Regina Franco Sansigolo; Nacher, Mathieu

    2015-08-01

    The border between Brazil and French Guiana is a place of economic, cultural, social and sexual exchange. Female sex workers represent a high risk population for HIV in this area where sexual tourism is particularly developed. HIV testing seems to be an important element in the fight against the epidemic. Indeed, early HIV testing gives access to treatments and prevention. An HIV/AIDS knowledge, attitudes, behaviors and practices survey was conducted in 2011 among sex workers along the border between Brazil and French Guiana. A total of 213 female sex workers were interviewed. One third (31.5%) of the interviewed had never tested for HIV. Factors associated with non HIV-testing were the lack of knowledge of places where to do an HIV test, to be 30 or older, feeling at risk of HIV, not evaluating one's own risk towards HIV, and living in Oiapoque. These results clearly suggest that targeted interventions are needed to encourage and assist female sex workers to get tested regularly.

  17. Using Small-Area Analysis to Estimate County-Level Racial Disparities in Obesity Demonstrating the Necessity of Targeted Interventions

    Directory of Open Access Journals (Sweden)

    Lucy D'Agostino-McGowan

    2013-12-01

    Full Text Available Data on the national and state levels is often used to inform policy decisions and strategies designed to reduce racial disparities in obesity. Obesity-related health outcomes are realized on the individual level, and policies based on state and national-level data may be inappropriate due to the variations in health outcomes within and between states. To examine county-level variation of obesity within states, we use a small-area analysis technique to fill the void for county-level obesity data by race. Five years of Behavioral Risk Factor Surveillance System data are used to estimate the prevalence of obesity by county, both overall and race-stratified. A modified weighting system is used based on demographics at the county level using 2010 census data. We fit a multilevel reweighted regression model to obtain county-level prevalence estimates by race. We compare the distribution of prevalence estimates of non-Hispanic Blacks to non-Hispanic Whites. For 25 of the 26 states included in our analysis there is a statistically significant difference between within-state county-level average obesity prevalence rates for non-Hispanic Whites and non-Hispanic Blacks. This study provides information needed to target disparities interventions and resources to the local areas with greatest need; it also identifies the necessity of doing so.

  18. Identification of TGF-β-activated kinase 1 as a possible novel target for renal cell carcinoma intervention

    Energy Technology Data Exchange (ETDEWEB)

    Meng, Fandong; Li, Yan; Tian, Xin; Fu, Liye; Yin, Yuanqin; Sui, Chengguang; Ma, Ping; Jiang, Youhong, E-mail: youyuanhongyeah@yeah.net

    2014-10-10

    Highlights: • Inhibition of TAK1 kinase activity suppresses NF-κB activation and RCC cell survival. • TAK1 inhibitors induces apoptotic cytotoxicity against RCC cells. • RCC cells with TAK1 depletion show reduced cell viability and increased apoptosis. • TAK1 and p-NF-κB are both over-expressed in human RCC tissues. • Inhibition or depletion of TAK1 enhances the activity of vinblastine sulfate. - Abstract: Renal cell carcinoma (RCC) is common renal malignancy within poor prognosis. TGF-β-activated kinase 1 (TAK1) plays vital roles in cell survival, apoptosis-resistance and carcinogenesis through regulating nuclear factor-κB (NF-κB) and other cancer-related pathways. Here we found that TAK1 inhibitors (LYTAK1, 5Z-7-oxozeanol (5Z) and NG-25) suppressed NF-κB activation and RCC cell (786-O and A489 lines) survival. TAK1 inhibitors induced apoptotic cytotoxicity against RCC cells, which was largely inhibited by the broad or specific caspase inhibitors. Further, shRNA-mediated partial depletion of TAK1 reduced 786-O cell viability whiling activating apoptosis. Significantly, TAK1 was over-expressed in human RCC tissues, and its level was correlated with phosphorylated NF-κB. Finally, kinase inhibition or genetic depletion of TAK1 enhanced the activity of vinblastine sulfate (VLB) in RCC cells. Together, these results suggest that TAK1 may be an important oncogene or an effective target for RCC intervention.

  19. 我院戒烟成功率与戒烟策略的研究%Research and smoking cessation strategies smoking cessation success rate

    Institute of Scientific and Technical Information of China (English)

    胡斌; 王琼; 余荣环

    2013-01-01

    The harm of tobacco is one of the most serious public health problem in the world. Smoking and quit smoking as at ract sb.'s at ention. 3 years in our hospital, in creating smoke-free hospital process, how the effective smoking cessation strategies to protect and promote smoking cessation success achieved some experience. Smoking cessation strategies mainly include:clarify smoking and smoking status, the health hazards of smoking, smoking relapse rate high reason, to strengthen publicity and education;the specific method to quit smoking, including administrative intervention, rewards and punishment regulations create smoking, smoking cessation clinic, smoking cessation in patients with clubs, quit smoking patients to quit smoking exchange etc. The comprehensive measures must be used to smoking cessation education and behavior intervention combined to achieve the desired purpose.%烟草危害是当今世界最严重的公共健康问题之一。吸烟与戒烟成为引人注目的话题。我院3年来,在创建无烟医院过程中,如何通过有效可行的戒烟策略来保障和促进戒烟成功取得了一些经验。戒烟策略上主要包括:阐明吸烟与控烟现状、吸烟对健康的危害、吸烟复吸率高的原因,加强宣传和教育;戒烟的具体方法上,主要包括行政干预,戒烟奖惩条例,创建戒烟门诊,戒烟患者俱乐部,戒烟患者戒烟交流会等多方面。阐述了戒烟必须使用教育与行为干预相结合的综合措施才能达到预期目的。

  20. The relation between media promotions and service volume for a statewide tobacco quitline and a web-based cessation program

    Directory of Open Access Journals (Sweden)

    Schillo Barbara A

    2011-12-01

    Full Text Available Abstract Background This observational study assessed the relation between mass media campaigns and service volume for a statewide tobacco cessation quitline and stand-alone web-based cessation program. Methods Multivariate regression analysis was used to identify how weekly calls to a cessation quitline and weekly registrations to a web-based cessation program are related to levels of broadcast media, media campaigns, and media types, controlling for the impact of external and earned media events. Results There was a positive relation between weekly broadcast targeted rating points and the number of weekly calls to a cessation quitline and the number of weekly registrations to a web-based cessation program. Additionally, print secondhand smoke ads and online cessation ads were positively related to weekly quitline calls. Television and radio cessation ads and radio smoke-free law ads were positively related to web program registration levels. There was a positive relation between the number of web registrations and the number of calls to the cessation quitline, with increases in registrations to the web in 1 week corresponding to increases in calls to the quitline in the subsequent week. Web program registration levels were more highly influenced by earned media and other external events than were quitline call volumes. Conclusion Overall, broadcast advertising had a greater impact on registrations for the web program than calls to the quitline. Furthermore, registrations for the web program influenced calls to the quitline. These two findings suggest the evolving roles of web-based cessation programs and Internet-use practices should be considered when creating cessation programs and media campaigns to promote them. Additionally, because different types of media and campaigns were positively associated with calls to the quitline and web registrations, developing mass media campaigns that offer a variety of messages and communicate through

  1. Assessing tobacco use by cancer patients and facilitating cessation: an American Association for Cancer Research policy statement.

    Science.gov (United States)

    Toll, Benjamin A; Brandon, Thomas H; Gritz, Ellen R; Warren, Graham W; Herbst, Roy S

    2013-04-15

    When diagnosed with cancer, patients can immediately make a meaningful positive impact on their health by stopping their tobacco use. Scientific evidence clearly shows that tobacco use in patients with cancer leads to poorer outcomes. The specific biological processes driving tobacco consumption's interference in cancer therapy are the subject of continuing research, but the evidence is clear that tobacco use in patients with cancer leads to decreased treatment efficacy and safety, decreased survival, decreased quality of life, increased treatment-related toxicity, and increased risk of cancer recurrence and second primary tumors. Data suggest that tobacco cessation can improve outcomes and survival in patients with cancer, yet full execution of evidence-based cessation interventions is infrequent in oncology settings. Therefore, both improved provision of cessation assistance to all patients with cancer who use tobacco or have recently quit and further study of the deleterious effects of tobacco use and benefits of tobacco cessation on cancer progression and treatment are needed and recommended by the American Association for Cancer Research. Progress on both fronts begins with universal assessment and documentation of tobacco use as a standard of quality cancer care regardless of treatment setting and will be further facilitated through the development of reliable, valid, and standard measures of tobacco use, incorporation of evidence-based procedures into quality and accreditation procedures, and the development of appropriate training, clinical infrastructure, and incentives for delivery of tobacco cessation interventions.

  2. Experienced barriers and facilitators for integrating smoking cessation advice and support into daily dental practice. A short report

    NARCIS (Netherlands)

    Rosseel, J.P.; Jacobs, J.E.; Hilberink, S.R.; Maassen, I.M.; Segaar, D.; Plasschaert, A.J.M.; Grol, R.P.T.M.

    2011-01-01

    In a controlled study, primary care dental professionals in the intervention group were encouraged to provide smoking cessation advice and support for all smoking patients with the help of a stage-based motivational protocol. The barriers and facilitators reported by the dental professionals on two

  3. Mechanisms of adolescent smoking cessation: roles of readiness to quit, nicotine dependence, and smoking of parents and peers

    NARCIS (Netherlands)

    Kleinjan, M.; Engels, R.C.M.E.; Leeuwe, van J.; Brug, J.; Zundert, van R.M.P.; Eijn, van den R.J.J.M.

    2009-01-01

    Multiple levels of influence should be considered in interventions aimed at the adolescent smoker, including psychological, addiction, peer and parental influences. However, the mechanism by which these variables influence the process of smoking cessation in adolescents is not well elucidated. There

  4. Translating Behavioral Interventions Onto mHealth Platforms: Developing Text Message Interventions for Smoking and Alcohol.

    Science.gov (United States)

    Bock, Beth C; Rosen, Rochelle K; Barnett, Nancy P; Thind, Herpreet; Walaska, Kristen; Foster, Robert; Deutsch, Christopher; Traficante, Regina

    2015-02-24

    The development of mHealth applications is often driven by the investigators and developers with relatively little input from the targeted population. User input is commonly limited to "like/dislike" post- intervention consumer satisfaction ratings or device or application specific user analytics such as usability. However, to produce successful mHealth applications with lasting effects on health behaviors it is crucial to obtain user input from the start of each project and throughout development. The aim of this tutorial is to illustrate how qualitative methods in an iterative process of development have been used in two separate behavior change interventions (targeting smoking and alcohol) delivered through mobile technologies (ie, text messaging). A series of focus groups were conducted to assist in translating a face-to-face smoking cessation intervention onto a text message (short message service, SMS) delivered format. Both focus groups and an advisory panel were used to shape the delivery and content of a text message delivered intervention for alcohol risk reduction. An in vivo method of constructing message content was used to develop text message content that was consistent with the notion of texting as "fingered speech". Formative research conducted with the target population using a participatory framework led to important changes in our approach to intervention structure, content development, and delivery. Using qualitative methods and an iterative approach that blends consumer-driven and investigator-driven aims can produce paradigm-shifting, novel intervention applications that maximize the likelihood of use by the target audience and their potential impact on health behaviors.

  5. Smoking Cessation for Crohn's Disease: Clearing the Haze.

    Science.gov (United States)

    Kaplan, Gilaad G

    2016-03-01

    The TABACROHN Study Group conducted a multicenter prospective cohort study, demonstrating that smoking cessation improved the prognosis of Crohn's disease. Patients who continued to smoke were 50% more likely to relapse compared with non-smokers. Smoking cessation reduced the risk of flaring, regardless of exposure to anti-tumor necrosis factor agents. Despite the evidence that smoking cessation is beneficial, many patients do not quit smoking after their diagnosis of Crohn's disease. Lack of awareness, physical addiction, and social context of smoking inhibit smoking cessation. In spite of this, comprehensive smoking cessation programs have been shown to be effective and reduce costs.

  6. Group hypnotherapy versus group relaxation for smoking cessation: an RCT study protocol

    Directory of Open Access Journals (Sweden)

    Dickson-Spillmann Maria

    2012-04-01

    Full Text Available Abstract Background A significant number of smokers would like to stop smoking. Despite the demonstrated efficacy of pharmacological smoking cessation treatments, many smokers are unwilling to use them; however, they are inclined to try alternative methods. Hypnosis has a long-standing reputation in smoking cessation therapy, but its efficacy has not been scientifically proven. We designed this randomised controlled trial to evaluate the effects of group hypnosis as a method for smoking cessation, and we will compare the results of group hypnosis with group relaxation. Methods/Design This is a randomised controlled trial (RCT to compare the efficacy of a single session of hypnosis with that of relaxation performed in groups of 8-15 smokers. We intend to include at least 220 participants in our trial. The inclusion criteria include smoking at least 5 cigarettes per day, not using other cessation methods and being willing to quit smoking. The intervention is performed by a trained hypnotist/relaxation therapist. Both groups first receive 40 min of mental preparation that is based on motivational interviewing. Then, a state of deep relaxation is induced in the hypnosis condition, and superficial relaxation is induced in the control condition. Suggestions are made in the hypnosis condition that aim to switch the mental self-image of the participants from that of smokers to that of non-smokers. Each intervention lasts for 40 min. The participants also complete questionnaires that assess their smoking status and symptoms of depression and anxiety at baseline, 2 weeks and 6 months post-intervention. In addition, saliva samples are collected to assess cotinine levels at baseline and at 6 months post-intervention. We also assess nicotine withdrawal symptoms at 2 weeks post-intervention. Discussion To the best of our knowledge, this RCT is the first to test the efficacy of group hypnosis versus group relaxation. Issues requiring discussion in the outcome

  7. Targeted interventions of the Avahan program and their association with intermediate outcomes among female sex workers in Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Mainkar Mandar M

    2011-12-01

    Full Text Available Abstract Background Avahan, the India AIDS Initiative has been a partner supporting targeted interventions of high risk populations under India’s National AIDS Control Organisation (NACO since 2004 in the state of Maharashtra. This paper presents an assessment of the Avahan program among female sex workers (FSWs in Maharashtra, its coverage, outcomes achieved and their association with Avahan program. Methods An analytical framework based on the Avahan evaluation design was used, addressing assessment questions on program implementation, intermediate outcomes and association of outcomes with Avahan. Data from routine program monitoring, two rounds of cross-sectional Integrated Behavioural and Biological Assessments (IBBAs conducted in 2006 (Round 1- R1 and 2009 (Round 2 – R2 and quality assessments of program clinics were used. Bi-variate and multivariate analysis were conducted using the complex samples module in SPSS 15® (IBM, Somers NY. Results The Avahan program achieved coverage of over 66% of FSWs within four years of implementation. The IBBA data showed increased contact by peers in R2 compared to R1 (AOR:2.34; p=0.001. Reported condom use with clients increased in R2 and number of FSWs reporting zero unprotected sex acts increased from 76.2% (R1 to 94.6% (R2 [AOR: 5.1, p=0.001]. Significant declines were observed in prevalence of syphilis (RPR (15.8% to 10.8%; AOR:0.54; p=0.001, chlamydia (8% to 6.2%; AOR:.0.65; p=0.010 and gonorrohoea (7.4% to 3.9; AOR:.0.60; p=0.026 between R1 and R2. HIV prevalence increased (25.8% to 27.5%; AOR:1.29; p=0.04. District-wise analysis showed decline in three districts and increase in Mumbai and Thane districts. FSWs exposed to Avahan had higher consistent condom use with occasional (94.3% vs. 90.6%; AOR: 1.55; p=0.04 and regular clients (92.5% vs. 86.0%; AOR: 1.95, p=0.001 compared to FSWs unexposed to Avahan. Decline in high titre syphilis was associated with Avahan exposure. Conclusion The Avahan

  8. Smoking cessation counselling for pregnant and postpartum women among midwives, gynaecologists and paediatricians in Germany.

    Science.gov (United States)

    Röske, Kathrin; Hannöver, Wolfgang; Thyrian, Jochen René; John, Ulrich; Hannich, Hans-Joachim

    2009-01-01

    The incorporation of guidelines for the treatment of tobacco smoking into routine care requires positive attitudes, counselling skills and knowledge about additional help available for smokers. The study assesses performance of smoking cessation intervention, attitudes, training status and knowledge about additional help for smokers in the care for pregnant and parenting women by midwives, gynaecologists and paediatricians. A survey of all midwives, gynaecologists and paediatricians registered for primary medical care in the federal state Saarland, Germany, was conducted. Participation in the postal questionnaires was 85 %. Depending on profession, 90 % to 100 % see smoking cessation counselling as their assignment, 17 % to 80 % screen for, 48 % to 90 % document smoking status, and 55 % to 76 % offer brief or extensive counselling. 61 % to 87 % consider training to enhance their knowledge and/or counselling skills necessary. The compliance of providers with the necessity to give support in smoking cessation is very high. However, the current status of cessation counselling does not sufficiently correspond to the evidence based requirements. Reports in medical press and advanced training courses should support health care providers and establish smoking as an inherent topic of the anamnesis and treatment of current and former pregnant or parenting smokers.

  9. Smoking Cessation Counselling for Pregnant and Postpartum Women among Midwives, Gynaecologists and Paediatricians in Germany

    Directory of Open Access Journals (Sweden)

    Wolfgang Hannöver

    2009-01-01

    Full Text Available The incorporation of guidelines for the treatment of tobacco smoking into routine care requires positive attitudes, counselling skills and knowledge about additional help available for smokers.The study assesses performance of smoking cessation intervention, attitudes, training status and knowledge about additional help for smokers in the care for pregnant and parenting women by midwives, gynaecologists and paediatricians. A survey of all midwives, gynaecologists and paediatricians registered for primary medical care in the federal state Saarland, Germany, was conducted. Participation in the postal questionnaires was 85 %. Depending on profession, 90 % to 100 % see smoking cessation counselling as their assignment, 17 % to 80 % screen for, 48 % to 90 % document smoking status, and 55 % to 76 % offer brief or extensive counselling. 61 % to 87 % consider training to enhance their knowledge and/or counselling skills necessary. The compliance of providers with the necessity to give support in smoking cessation is very high. However, the current status of cessation counselling does not sufficiently correspond to the evidence based requirements. Reports in medical press and advanced training courses should support health care providers and establish smoking as an inherent topic of the anamnesis and treatment of current and former pregnant or parenting smokers.

  10. Experience of a smoking cessation program among high school students in Taiwan.

    Science.gov (United States)

    Chang, Chi-Ping; Lee, Ting-Ting; Mills, Mary Etta

    2014-01-01

    In Taiwan, the prevalence of smoking among teenagers has led to a required smoking cessation program in schools. Students caught smoking in school are required to participate in a weekly smoking cessation class. The purpose of this study was to explore the experience of high school students in a smoking cessation program. Fifteen adolescents participated in a one-on-one in-depth semistructured interview, and the content was analyzed for patterns based on the methods of Miles and Huberman. In addition, Lewin's change theory of drive forces and restraining forces was used to describe the change in behavior as a result of the program. Five major themes were identified: the onset of smoking-change influenced by families and friends; intention to quit smoking-driving force; the irresistible temptation to smoke-restraining force; limited change effects-more attention and assistance needed; and change in attitude rather than behavior-smoking remained unchanged. Changes were seen in the perceptions and attitudes of these students toward smoking at the end of the program; however, none of them were able to really quit. Most participants revealed that they used improper means to pass the carbon monoxide test requirement that was used as a measure of not smoking. Alternative future intervention strategies for further study include change in health policy to support nicotine replacement methods for heavy adolescent smoker, use of teacher support, and exercise programs to support students going through the smoking cessation period.

  11. Web-Based Antismoking Advertising to Promote Smoking Cessation: A Randomized Controlled Trial

    Science.gov (United States)

    Muennig, Peter; El-Sayed, Abdulrahman M

    2016-01-01

    Background Although hundreds of millions of dollars are spent each year on public health advertising, the advertisement content, design, and placement are usually developed by intuition rather than research. Objective The objective of our study was to develop a methodology for testing Web-based advertisements to promote smoking cessation. Methods We developed 10 advertisements that varied by their content (those that empower viewers to quit, help viewers to quit, or discuss the effects of smoking). We then conducted a series of Web-based randomized controlled trials that explored the effects of exposing users of Microsoft’s Bing search engine to antismoking advertisements that differed by content, placement, or other characteristics. Finally, we followed users to explore whether they conducted subsequent searches for smoking cessation products or services. Results The advertisements were shown 710,106 times and clicked on 1167 times. In general, empowering advertisements had the greatest impact (hazard ratio [HR] 2.6, standard error [SE] 0.09 relative to nonempowering advertisements), but we observed significant variations by gender. For instance, we found that men exposed to smoking cessation advertisements were less likely than women to subsequently conduct smoking cessation searches (HR 0.2, SE 0.07), but that this likelihood increased 3.5 times in men exposed to advertisements containing empowering content. Women were more influenced by advertisements that emphasized the health effects of smoking. We also found that appearing at the top right of the page (HR 2.1, SE 0.07) or at the bottom rather than the top of a list (HR 1.1, SE 0.02) can improve smoking cessation advertisements’ effectiveness in prompting future searches related to smoking cessation. Conclusions Advertising should be targeted to different demographic groups in ways that are not always intuitive. Our study provides a method for testing the effectiveness of Web-based antismoking

  12. A family-based intervention targeting parents of preschool children with overweight and obesity: conceptual framework and study design of LOOPS- Lund overweight and obesity preschool study

    Directory of Open Access Journals (Sweden)

    Önnerfält Jenny

    2012-10-01

    Full Text Available Abstract Background As the rate of overweight among children is rising there is a need for evidence-based research that will clarify what the best interventional strategies to normalize weight development are. The overall aim of the Lund Overweight and Obesity Preschool Study (LOOPS is to evaluate if a family-based intervention, targeting parents of preschool children with overweight and obesity, has a long-term positive effect on weight development of the children. The hypothesis is that preschool children with overweight and obesity, whose parents participate in a one-year intervention, both at completion of the one-year intervention and at long term follow up (2-, 3- and 5-years will have reduced their BMI-for-age z-score. Methods/Design The study is a randomized controlled trial, including overweight (n=160 and obese (n=80 children 4-6-years-old. The intervention is targeting the parents, who get general information about nutrition and exercise recommendations through a website and are invited to participate in a group intervention with the purpose of supporting them to accomplish preferred lifestyle changes, both in the short and long term. To evaluate the effect of various supports, the parents are randomized to different interventions with the main focus of: 1 supporting the parents in limit setting by emphasizing the importance of positive interactions between parents and children and 2 influencing the patterns of daily activities to induce alterations of everyday life that will lead to healthier lifestyle. The primary outcome variable, child BMI-for-age z-score will be measured at referral, inclusion, after 6 months, at the end of intervention and at 2-, 3- and 5-years post intervention. Secondary outcome variables, measured at inclusion and at the end of intervention, are child activity pattern, eating habits and biochemical markers as well as parent BMI, exercise habits, perception of health, experience of parenthood and level of

  13. A simplified interventional mapping system (SIMS) for the selection of combinations of targeted treatments in non-small cell lung cancer

    Science.gov (United States)

    Lazar, Vladimir; Martini, Jean-François; Gomez-Navarro, Jesus; Yver, Antoine; Kan, Zhengyin; Dry, Jonathan R.; Kehren, Jeanne; Validire, Pierre; Rodon, Jordi; Vielh, Philippe; Ducreux, Michel; Galbraith, Susan; Lehnert, Manfred; Onn, Amir; Berger, Raanan; Pierotti, Marco A.; Porgador, Angel; Pramesh, CS; Ye, Ding-wei; Carvalho, Andre L.; Batist, Gerald; Le Chevalier, Thierry; Morice, Philippe; Besse, Benjamin; Vassal, Gilles; Mortlock, Andrew; Hansson, Johan; Berindan-Neagoe, Ioana; Dann, Robert; Haspel, Joel; Irimie, Alexandru; Laderman, Steve; Nechushtan, Hovav; Al Omari, Amal S.; Haywood, Trent; Bresson, Catherine; Soo, Khee Chee; Osman, Iman; Mata, Hilario; Lee, Jack J.; Jhaveri, Komal; Meurice, Guillaume; Palmer, Gary; Lacroix, Ludovic; Koscielny, Serge; Eterovic, Karina Agda; Blay, Jean-Yves; Buller, Richard; Eggermont, Alexander; Schilsky, Richard L.; Mendelsohn, John; Soria, Jean-Charles; Rothenberg, Mace

    2015-01-01

    Non-small cell lung cancer (NSCLC) is a leading cause of death worldwide. Targeted monotherapies produce high regression rates, albeit for limited patient subgroups, who inevitably succumb. We present a novel strategy for identifying customized combinations of triplets of targeted agents, utilizing a simplified interventional mapping system (SIMS) that merges knowledge about existent drugs and their impact on the hallmarks of cancer. Based on interrogation of matched lung tumor and normal tissue using targeted genomic sequencing, copy number variation, transcriptomics, and miRNA expression, the activation status of 24 interventional nodes was elucidated. An algorithm was developed to create a scoring system that enables ranking of the activated interventional nodes for each patient. Based on the trends of co-activation at interventional points, combinations of drug triplets were defined in order to overcome resistance. This methodology will inform a prospective trial to be conducted by the WIN consortium, aiming to significantly impact survival in metastatic NSCLC and other malignancies. PMID:25944621

  14. A profile of teen smokers who volunteered to participate in school-based smoking intervention

    Directory of Open Access Journals (Sweden)

    Zhang Jianjun

    2008-08-01

    Full Text Available Abstract Objectives Although a number of population-based studies have examined the characteristics of teens who attempt to quit smoking, few have identified the characteristics of youth who participate in structured cessation interventions, particularly those with demonstrated effectiveness. The purpose of the present study is to describe the sociodemographic and smoking-related characteristics of teen smokers who participated in the American Lung Association's Not On Tobacco (N-O-T program, spanning eight years. N-O-T is the most widely used teen smoking cessation program in the nation. Methods Drawn from multiple statewide N-O-T studies, this investigation examined data from 5,892 teen smokers ages 14–19 who enrolled in N-O-T between 1998–2006. We demonstrate similarities and differences between N-O-T findings and existing data from representative samples of US teen smokers where available and relevant. Results N-O-T teens started smoking earlier, were more likely to be poly-tobacco users, were more dependent on nicotine, had made more previous attempts to quit, and were more deeply embedded in smoking contexts than comparative samples of teen smokers. Additionally, N-O-T teens were moderately ready to quit smoking, believed important people in their lives would support their quit efforts, yet had deficits in their confidence with quitting. Conclusion This profile of N-O-T teens can guide efforts for targeted recruitment strategies to enhance intervention reach for teen smoking cessation. Findings provide guidance for marketing and recruitment efforts of intensive, school-based cessation interventions among established teen smokers, particularly those who want to quit. Study results may shed light upon who is and is not enrolling in N-O-T.

  15. A theory-based educational intervention targeting nurses' attitudes and knowledge concerning cancer-related pain management: A study protocol of a quasi-experimental design

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    Gustafsson Markus

    2011-09-01

    Full Text Available Abstract Background Pain is one of the most frequent problems among patients diagnosed with cancer. Despite the availability of effective pharmacological treatments, this group of patients often receives less than optimal treatment. Research into nurses' pain management highlights certain factors, such as lack of knowledge and attitudes and inadequate procedures for systematic pain assessment, as common barriers to effective pain management. However, educational interventions targeting nurses' pain management have shown promise. As cancer-related pain is also known to have a negative effect on vital aspects of the patient's life, as well as being commonly associated with problems such as sleep, fatigue, depression and anxiety, further development of knowledge within this area is warranted. Methods/design A quasi-experimental study design will be used to investigate whether the implementation of guidelines for systematic daily pain assessments following a theory-based educational intervention will result in an improvement in knowledge and attitude among nurses. A further aim is to investigate whether the intervention that targets nurses' behaviour will improve hospital patients' perception of pain. Data regarding nurses' knowledge and attitudes to pain (primary outcome, patient perception regarding pain (secondary outcome, together with socio-demographic variables, will be collected at baseline and at four weeks and 12 weeks following the intervention. Discussion Nursing care is nowadays acknowledged as an increasingly complicated activity and "nursing complexity is such that it can be seen as the quintessential complex intervention." To be able to change and improve clinical practice thus requires multiple points of attack appropriate to meet complex challenges. Consequently, we expect the theory-based intervention used in our quasi-experimental study to improve care as well as quality of life for this group of patients and we also envisage that

  16. Priorities and needs for research on urban interventions targeting vector-borne diseases: rapid review of scoping and systematic reviews

    OpenAIRE

    Bermudez-Tamayo, Clara; Mukamana, Olive; Carabali, Mabel; Osorio, Lyda; Fournet, Florence; Dabiré, Kounbobr Roch; Turchi Marteli, Celina; Contreras, Adolfo; Ridde, Valéry

    2016-01-01

    This paper highlights the critical importance of evidence on vector-borne diseases (VBD) prevention and control interventions in urban settings when assessing current and future needs, with a view to setting policy priorities that promote inclusive and equitable urban health services. Research should produce knowledge about policies and interventions that are intended to control and prevent VBDs at the population level and to reduce inequities. Such interventions include policy, program, and ...

  17. Effectiveness of mHealth Interventions Targeting Health Care Workers to Improve Pregnancy Outcomes in Low- and Middle-Income Countries: A Systematic Review

    Science.gov (United States)

    Borgstein, Alexander Berend-Jan; Sondaal, Stephanie FV; Grobbee, Diederick E; Miltenburg, Andrea Solnes; Verwijs, Mirjam; Ansah, Evelyn K; Browne, Joyce L; Klipstein-Grobusch, Kerstin

    2016-01-01

    Background Low- and middle-income countries (LMICs) face the highest burden of maternal and neonatal deaths. Concurrently, they have the lowest number of physicians. Innovative methods such as the exchange of health-related information using mobile devices (mHealth) may support health care workers in the provision of antenatal, delivery, and postnatal care to improve maternal and neonatal outcomes in LMICs. Objective We conducted a systematic review evaluating the effectiveness of mHealth interventions targeting health care workers to improve maternal and neonatal outcomes in LMIC. Methods The Cochrane Library, PubMed, EMBASE, Global Health Library, and Popline were searched using predetermined search and indexing terms. Quality assessment was performed using an adapted Cochrane Risk of Bias Tool. A strength, weakness, opportunity, and threat analysis was performed for each included paper. Results A total of 19 studies were included for this systematic review, 10 intervention and 9 descriptive studies. mHealth interventions were used as communication, data collection, or educational tool by health care providers primarily at the community level in the provision of antenatal, delivery, and postnatal care. Interventions were used to track pregnant women to improve antenatal and delivery care, as well as facilitate referrals. None of the studies directly assessed the effect of mHealth on maternal and neonatal mortality. Challenges of mHealth interventions to assist health care workers consisted mainly of technical problems, such as mobile network coverage, internet access, electricity access, and maintenance of mobile phones. Conclusions mHealth interventions targeting health care workers have the potential to improve maternal and neonatal health services in LMICs. However, there is a gap in the knowledge whether mHealth interventions directly affect maternal and neonatal outcomes and future research should employ experimental designs with relevant outcome measures to

  18. IL-17A and serum amyloid A are elevated in a cigarette smoke cessation model associated with the persistence of pigmented macrophages, neutrophils and activated NK cells.

    Directory of Open Access Journals (Sweden)

    Michelle J Hansen

    Full Text Available While global success in cessation advocacy has seen smoking rates fall in many developed countries, persistent lung inflammation in ex-smokers is an increasingly important clinical problem whose mechanistic basis remains poorly understood. In this study, candidate effector mechanisms were assessed in mice exposed to cigarette smoke (CS for 4 months following cessation from long term CS exposure. BALF neutrophils, CD4+ and CD8+ T cells and lung innate NK cells remained significantly elevated following smoking cessation. Analysis of neutrophil mobilization markers showed a transition from acute mediators (MIP-2α, KC and G-CSF to sustained drivers of neutrophil and macrophage recruitment and activation (IL-17A and Serum Amyoid A (SAA. Follicle-like lymphoid aggregates formed with CS exposure and persisted with cessation, where they were in close anatomical proximity to pigmented macrophages, whose number actually increased 3-fold following CS cessation. This was associated with the elastolytic protease, MMP-12 (macrophage metallo-elastase which remained significantly elevated post-cessation. Both GM-CSF and CSF-1 were significantly increased in the CS cessation group relative to the control group. In conclusion, we show that smoking cessation mediates a transition to accumulation of pigmented macrophages, which may contribute to the expanded macrophage population observed in COPD. These macrophages together with IL-17A, SAA and innate NK cells are identified here as candidate persistence determinants and, we suggest, may represent specific targets for therapies directed towards the amelioration of chronic airway inflammation.

  19. [Smoking cessation in patients with COPD].

    Science.gov (United States)

    Andreas, S; Batra, A; Behr, J; Chenot, J-F; Gillissen, A; Hering, T; Herth, F J F; Kreuter, M; Meierjürgen, R; Mühlig, S; Nowak, D; Pfeifer, M; Raupach, T; Schultz, K; Sitter, H; Walther, J W; Worth, H

    2014-04-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. Cigarette smoking is the main cause of COPD. Quitting smoking is thus the most effective treatment strategy and central in COPD prevention. A number of guidelines on prevention, diagnosis, therapy and rehabilitation of COPD have been published. To help implementing and standardizing smoking cessation in COPD a guideline was published 2008 in Germany focusing on this complex issue. The present guideline is an update of the 2008 guideline and has a high grade of evidence (S3 according to the AWMF; Arbeitsgemeinschaft wissenschaftlicher medizinischer Fachgesellschaften). The guideline gives comprehensive and practical information on how to integrate smoking cessation as an central part of COPD therapy.

  20. The transtheoretical model use for smoking cessation

    OpenAIRE

    Kafiye EROĞLU; Koyun, Ayşe

    2014-01-01

    Available Online at http://iassr.org/journal 2013 (c) EJRE published by International Association of Social Science Research - IASSR European Journal of Research on Education ISSN: 2147-6284 European Journal of Research on Education, 2014, Special Issue: Contemporary Studies in Social Science, 130-134 The transtheoretical model use for smoking cessation Ayşe Koyun a *, Kafiye Eroğlu b aAfyon Kocatepe University, Afyon School of Health, Afyonkarahisar, 03200...

  1. Theory and model use in social marketing health interventions.

    Science.gov (United States)

    Luca, Nadina Raluca; Suggs, L Suzanne

    2013-01-01

    The existing literature suggests that theories and models can serve as valuable frameworks for the design and evaluation of health interventions. However, evidence on the use of theories and models in social marketing interventions is sparse. The purpose of this systematic review is to identify to what extent papers about social marketing health interventions report using theory, which theories are most commonly used, and how theory was used. A systematic search was conducted for articles that reported social marketing interventions for the prevention or management of cancer, diabetes, heart disease, HIV, STDs, and tobacco use, and behaviors related to reproductive health, physical activity, nutrition, and smoking cessation. Articles were published in English, after 1990, reported an evaluation, and met the 6 social marketing benchmarks criteria (behavior change, consumer research, segmentation and targeting, exchange, competition and marketing mix). Twenty-four articles, describing 17 interventions, met the inclusion criteria. Of these 17 interventions, 8 reported using theory and 7 stated how it was used. The transtheoretical model/stages of change was used more often than other theories. Findings highlight an ongoing lack of use or underreporting of the use of theory in social marketing campaigns and reinforce the call to action for applying and reporting theory to guide and evaluate interventions.

  2. Yoga as a complementary treatment for smoking cessation: rationale, study design and participant characteristics of the Quitting-in-Balance study

    Directory of Open Access Journals (Sweden)

    Jennings Ernestine

    2010-04-01

    Full Text Available Abstract Background Tobacco smoking remains the leading preventable cause of death among American women. Exercise has shown promise as an aid to smoking cessation because it reduces weight gain and weight concerns, improves affect, and reduces nicotine withdrawal symptoms and cigarette craving. Studies have shown that the practice of yoga improves weight control, and reduces perceived stress and negative affect. Yoga practice also includes regulation of breathing and focused attention, both of which may enhance stress reduction and improve mood and well-being and may improve cessation outcomes. Methods/Design This pilot efficacy study is designed to examine the rates of cessation among women randomized to either a novel, 8-week Yoga plus Cognitive Behavioral Therapy (CBT smoking cessation intervention versus a Wellness program plus the same CBT smoking cessation intervention. Outcome measures include 7-day point prevalence abstinence at end of treatment, 3 and 6 months follow up and potential mediating variables (e.g., confidence in quitting smoking, self-efficacy. Other assessments include measures of mindfulness, spirituality, depressive symptoms, anxiety and perceived health (SF-36. Discussion Innovative treatments are needed that address barriers to successful smoking cessation among men and women. The design chosen for this study will allow us to explore potential mediators of intervention efficacy so that we may better understand the mechanism(s by which yoga may act as an effective complementary treatment for smoking cessation. If shown to be effective, yoga can offer an alternative to traditional exercise for reducing negative symptoms that often accompany smoking cessation and predict relapse to smoking among recent quitters. Trial Registration ClinicalTrials NCT00492310

  3. Establishing a model workplace tobacco cessation program in India

    Directory of Open Access Journals (Sweden)

    Mishra Gauravi

    2009-01-01

    Full Text Available Background: Tobacco use is highly prevalent and culturally accepted in rural Maharashtra, India. Aims: To study the knowledge, attitude, and practices (KAP regarding tobacco consumption, identify reasons for initiation and continuation of tobacco use, identify prevalence of tobacco consumption and its relation with different precancerous lesions, provide professional help for quitting tobacco, and develop local manpower for tobacco cessation activities. Settings, Design, Methods and Material: The present study was conducted for one year in a chemical industrial unit in Ratnagiri district. All employees (104 were interviewed and screened for oral neoplasia. Their socio-demographic features, habits, awareness levels etc. were recorded. Active intervention in the form of awareness lectures, focus group discussions, one-to-one counseling and, if needed, pharmacotherapy was offered to the tobacco users. Results: All employees actively participated in the program. Overall, 48.08% of the employees were found to use tobacco, among which the smokeless forms were predominant. Peer pressure and pleasure were the main reasons for initiation of tobacco consumption, and the belief that, though injurious, it would not harm them, avoiding physical discomfort on quitting and relieving stress were important factors for continuation of the habit. Employees had poor knowledge regarding the ill-effects of tobacco. 40% of tobacco users had oral precancerous lesions, which were predominant in employees consuming smokeless forms of tobacco. Conclusions: Identifying reasons for initiation and continuation of tobacco consumption along with baseline assessment of knowledge, attitudes, and practices regarding tobacco use, are important in formulating strategies for a comprehensive workplace tobacco cessation program.

  4. A computer-assisted protocol for endovascular target interventions using a clinical MRI system for controlling untethered microdevices and future nanorobots.

    Science.gov (United States)

    Martel, Sylvain; Mathieu, Jean-Baptiste; Felfoul, Ouajdi; Chanu, Arnaud; Aboussouan, Eric; Tamaz, Samer; Pouponneau, Pierre; Yahia, L'Hocine; Beaudoin, Gilles; Soulez, Gilles; Mankiewicz, Martin

    2008-11-01

    The possibility of automatically navigating untethered microdevices or future nanorobots to conduct target endovascular interventions has been demonstrated by our group with the computer-controlled displacement of a magnetic sphere along a pre-planned path inside the carotid artery of a living swine. However, although the feasibility of propelling, tracking and performing real-time closed-loop control of an untethered ferromagnetic object inside a living animal model with a relatively close similarity to human anatomical conditions has been validated using a standard clinical Magnetic Resonance Imaging (MRI) system, little information has been published so far concerning the medical and technical protocol used. In fact, such a protocol developed within technological and physiological constraints was a key element in the success of the experiment. More precisely, special software modules were developed within the MRI software environment to offer an effective tool for experimenters interested in conducting such novel interventions. These additional software modules were also designed to assist an interventional radiologist in all critical real-time aspects that are executed at a speed beyond human capability, and include tracking, propulsion, event timing and closed-loop position control. These real-time tasks were necessary to avoid a loss of navigation control that could result in serious injury to the patient. Here, additional simulation and experimental results for microdevices designed to be targeted more towards the microvasculature have also been considered in the identification, validation and description of a specific sequence of events defining a new computer-assisted interventional protocol that provides the framework for future target interventions conducted in humans.

  5. Systematic Development of the YouRAction program, a computer-tailored Physical Activity promotion intervention for Dutch adolescents, targeting personal motivations and environmental opportunities

    Directory of Open Access Journals (Sweden)

    Prins Richard G

    2010-08-01

    Full Text Available Abstract Background Increasing physical activity (PA among adolescents is an important health promotion goal. PA has numerous positive health effects, but the majority of Dutch adolescents do not meet PA requirements. The present paper describes the systematic development of a theory-based computer-tailored intervention, YouRAction, which targets individual and environmental factors determining PA among adolescents. Design The intervention development was guided by the Intervention Mapping protocol, in order to define clear program objectives, theoretical methods and practical strategies, ensure systematic program planning and pilot-testing, and anticipate on implementation and evaluation. Two versions of YouRAction were developed: one that targets individual determinants and an extended version that also provides feedback on opportunities to be active in the neighbourhood. Key determinants that were targeted included: knowledge and awareness, attitudes, self-efficacy and subjective norms. The extended version also addressed perceived availability of neighbourhood PA facilities. Both versions aimed to increase levels of moderate-to-vigorous PA among adolescents. The intervention structure was based on self-regulation theory, comprising of five steps in the process of successful goal pursuit. Monitoring of PA behaviour and behavioural and normative feedback were used to increase awareness of PA behaviour; motivation was enhanced by targeting self-efficacy and attitudes, by means of various interactive strategies, such as web movies; the perceived environment was targeted by visualizing opportunities to be active in an interactive geographical map of the home environment; in the goal setting phase, the adolescents were guided in setting a goal and developing an action plan to achieve this goal; in the phase of active goal pursuit adolescents try to achieve their goal and in the evaluation phase the achievements are evaluated. Based on the results

  6. Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention.

    Directory of Open Access Journals (Sweden)

    Peter Musiat

    Full Text Available BACKGROUND: A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders. AIMS: To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students. METHOD: Students were recruited online (n=1047, age: M=21.8, SD=4.2 and categorised into being at high or low risk for mental disorders based on their personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n=519 or a control intervention (n=528 using computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225. Participants were blinded and outcomes were self-assessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and anxiety, assessed on the Patient Health Questionnaire (PHQ9 and Generalised Anxiety Disorder Scale (GAD7. Secondary outcome measures focused on alcohol use, disordered eating, and other outcomes. RESULTS: Students at high risk were successfully identified using personality indicators and reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 (p<.001, 95%CI [5.19, 1.98] and anxiety scores by 2.87 (p=.018, 95%CI [1.31, 4.43] in students at high risk. In high-risk students, between group effect sizes were 0.58 (depression and 0.42 (anxiety. In addition, self-esteem was improved. No changes were observed regarding the use of alcohol or disordered eating. CONCLUSIONS

  7. Targeting the specific vocabulary needs of at-risk preschoolers: a randomized study of the effectiveness of an educator-implemented intervention.

    Science.gov (United States)

    Vuattoux, Delphine; Japel, Christa; Dion, Eric; Dupéré, Véronique

    2014-04-01

    This randomized study examined the effectiveness of a preschool stimulation program created to teach words that had been selected by considering the needs of the target population of children. Twenty-two educators and their group of at-risk preschoolers (N = 222, M age = 4.27 years) were assigned to one of two conditions: control or intervention. In the latter condition, educators had to read specifically developed storybooks to their group and conduct stimulation activities. Despite the training and support they received, educators implemented the intervention with varying degrees of fidelity. Nonetheless, intent-to-treat comparison of the two conditions indicates that children in the intervention condition learned the meaning of a much greater number of words than their peers in the control condition. In addition, efficacy subset analyses that took into account fidelity of implementation show that the greatest gains were made by children who had an educator who had implemented the intervention reliably. Strategies for scaling up the intervention and optimizing its implementation are discussed.

  8. The Effect of a Pro-Breastfeeding and Healthy Complementary Feeding Intervention Targeting Adolescent Mothers and Grandmothers on Growth and Prevalence of Overweight of Preschool Children.

    Directory of Open Access Journals (Sweden)

    Renata Schwartz

    Full Text Available The pattern and duration of breastfeeding (BF and the age at onset of complementary feeding, as well as its quality, have been associated with the prevalence of overweight in childhood.To assess the effect of a pro-BF and healthy complementary feeding intervention, targeted to adolescent mothers and maternal grandmothers, on growth and prevalence of overweight and obesity in children at preschool age. This intervention had a positive impact on duration of BF and timing of onset of complementary feeding.This randomized clinical trial involved 323 adolescent mothers, their infants, and the infants' maternal grandmothers, when they cohabited. Mothers and grandmothers in the intervention group received counseling sessions on BF and healthy complementary feeding at the maternity ward and at home (7, 15, 30, 60, and 120 days after delivery. When children were aged 4 to 7 years, they underwent anthropometric assessment and collection of data on dietary habits. Multivariable Poisson regression with robust estimation was used for analysis.BMI-for-age and height-for-age were similar in the intervention and control groups, as was the prevalence of overweight (39% vs. 31% respectively; p=0.318. There were no significant between-group differences in dietary habits.Although the intervention prolonged the duration of exclusive BF and delayed the onset of complementary feeding, it had no impact on growth or prevalence of overweight at age 4 to 7 years.ClinicalTrials.gov NCT00910377.

  9. Neural Responses to Elements of a Web-Based Smoking Cessation Program

    Science.gov (United States)

    CHUA, Hannah Faye; POLK, Thad; WELSH, Robert; LIBERZON, Israel; STRECHER, Victor

    2010-01-01

    An increasing number of smokers are obtaining information from the web to help them quit smoking. In this study, we examined how smokers process different types of messages similar to those from a web-based smoking cessation program: personalization/feedback (“Jane, you are a 23-year old female smoker”), motivational (“If you quit smoking, you could save $1200 a year”), and instructional (“When you feel angry, talk to someone instead of smoking”) messages. Using functional magnetic resonance imaging, smokers were exposed to the messages. On a later session, participants completed an online tailored smoking cessation program and started on a 10-week course of nicotine patch. Results show that participants indeed process the messages differently, activating brain regions associated with self-related processing (personalization/feedback), anticipated reward processing (motivational messages) and rules processing (instructional messages). This research is relevant for advancing web-based tailored interventions for substance use. PMID:19592758

  10. Effect of smoking cessation on non-surgical periodontal therapy: Results after 24 months

    DEFF Research Database (Denmark)

    Francisca Rosa, Ecinele; Corraini, Priscila; Inoue, Gislene

    2014-01-01

    AIM: The aim of this 24-month prospective study was to assess the effect of smoking cessation on non-surgical periodontal therapy (NSPT) in adult subjects with chronic periodontitis. MATERIALS AND METHODS: Relative to a previous 12-month follow-up study, recruitment and follow-up period were...... extended, resulting in 116 eligible among the 286 screened subjects. They received NSPT and concurrent smoking cessation interventions. Periodontal maintenance was performed every three months. A calibrated examined, blinded to smoking status, performed full-mouth periodontal examination in six sites per...... continued smoking (NQ) and 11 oscillated (O) at 24 months of follow-up. Thereby, Q showed significantly higher mean CAL gain in diseased sites and higher reduction in sites with CAL ≥ 3 mm, when compared to NQ. In addition, Q presented significantly higher mean probing depth reduction relative to NQ(p≤ 0...

  11. Do counselor techniques predict quitting during smoking cessation treatment? A component analysis of telephone-delivered Acceptance and Commitment Therapy.

    Science.gov (United States)

    Vilardaga, Roger; Heffner, Jaimee L; Mercer, Laina D; Bricker, Jonathan B

    2014-10-01

    No studies to date have examined the effect of counselor techniques on smoking cessation over the course of treatment. To address this gap, we examined the degree to which the use of specific Acceptance and Commitment Therapy (ACT) counseling techniques in a given session predicted smoking cessation reported at the next session. The data came from the ACT arm of a randomized controlled trial of a telephone-delivered smoking cessation intervention. Trained raters coded 139 counseling sessions across 44 participants. The openness, awareness and activation components of the ACT model were rated for each telephone counseling session. Multilevel logistic regression models were used to estimate the predictive relationship between each component during any given telephone session and smoking cessation at the following telephone session. For every 1-unit increase in counselors' use of openness and awareness techniques there were 42% and 52% decreases in the odds of smoking at the next counseling session, respectively. However, there was no significant predictive relationship between counselors' use of activation techniques and smoking cessation. Overall, results highlight the theoretical and clinical value of examining therapists' techniques as predictors of outcome during the course of treatment.

  12. Barriers and Facilitators for Teachers' Implementation of the Curricular Component of the Boost Intervention Targeting Adolescents' Fruit and Vegetable Intake

    DEFF Research Database (Denmark)

    Jørgensen, Thea Suldrup; Krølner, Rikke; Aarestrup, Anne Kristine

    2014-01-01

    and extra workload and motivated by a pre-intervention workshop and the thoroughness of the project. Detailed implementation manuals were helpful for some teachers but a barrier to others because they limited opportunities for adaptation. CONCLUSIONS AND IMPLICATIONS: Implementation of curricular activities...... in school-based interventions may be supported by a predefined teaching schedule, detailed teacher manuals, clear learning objectives, and a pre-intervention workshop to enhance motivation. Situational Analysis may contribute to future implementation studies by highlighting the importance of contextual......OBJECTIVE: To examine barriers and facilitators to teachers' implementation of the curricular component of the school-based, multicomponent Boost intervention to promote fruit and vegetable intake among 13-year-olds guided by concepts of Diffusion of Innovations Theory and findings of previous...

  13. Depressive Symptoms, Drinking Problems, and Smoking Cessation in Older Smokers

    OpenAIRE

    Kenney, Brent A.; Holahan, Charles J.; Holahan, Carole K.; Brennan, Penny L.; Schutte, Kathleen K.; Moos, Rudolf H.

    2009-01-01

    This study modeled the predictive association between depressive symptoms and smoking cessation in a sample of 442 late-middle-aged smokers; assessments occurred at four time-points across a 10-year period. In addition, the study examined the role of baseline drinking problems in moderating the relationship between depressive symptoms and smoking cessation. Findings supported hypotheses. More depressive symptoms prospectively predicted a lower likelihood of smoking cessation. In addition, the...

  14. A Cluster-Randomized Controlled Trial Evaluating the Effectiveness and Cost-Effectiveness of Tobacco Cessation on Prescription in Swedish Primary Health Care: A Protocol of the Motivation 2 Quit (M2Q) Study

    Science.gov (United States)

    Lindgren, Peter; Sundberg, Carl Johan; Petzold, Max; Tomson, Tanja

    2016-01-01

    Background In Sweden, the prevalence of tobacco use is disproportionately high among socioeconomically disadvantaged groups. Previous research and clinical experience suggest that prescribed lifestyle interventions in the primary health care (PHC) setting such as Physical Activity on Prescription are effective in changing behavior. However, there is a lack of evidence for if and how such a prescription approach could be effectively transferred into the tobacco cessation context. Objective The aim of this trial is to evaluate the effectiveness and cost-effectiveness of Tobacco Cessation on Prescription (TCP) compared to current practice for tobacco cessation targeting socioeconomically disadvantaged groups in the PHC setting in Sweden. Methods The design is a pragmatic cluster-randomized controlled trial. The sample will consist of 928 daily tobacco users with Swedish social security numbers and permanent resident permits, recruited from 14-20 PHC centers located in socioeconomically disadvantaged areas in Stockholm County. The primary outcome will be measured in self-reported 7-day abstinence at 6 and 12 months after the intervention. The secondary outcomes will be measured in daily tobacco consumption, number of quit attempts, and health-related quality of life at 6 and 12 months after the intervention. Data will be collected through questionnaires and review of electronic medical records. Cost-effectiveness will be estimated through decision analytic modeling and measured by the incremental cost per quality-adjusted life year. Results In the first set of PHC centers participating in the study, eight centers have been included. Recruitment of individual study participants is currently ongoing. Inclusion of a second set of PHC centers is ongoing with expected study start in September 2016. Conclusions If TCP is found effective and cost-effective compared to standard treatment, the method could be implemented to facilitate tobacco cessation for socioeconomically

  15. The Process of Cessation Among Current Tobacco Smokers: A Cross-Sectional Data Analysis From 21 Countries, Global Adult Tobacco Survey, 2009-2013.

    Science.gov (United States)

    Mbulo, Lazarous; Palipudi, Krishna M; Nelson-Blutcher, Glenda; Murty, Komanduri S; Asma, Samira

    2015-09-17

    We analyzed data from the Global Adult Tobacco Survey (GATS) from 21 countries to categorize smokers by stages of cessation and highlight interventions that could be tailored to each stage. GATS is a nationally representative household survey that measures tobacco use and other key indicators by using a standardized protocol. The distribution of smokers into precontemplation, contemplation, and preparation stages varied by country. Using the stages of change model, each country can design and implement effective interventions suitable to its cultural, social, and economic situations to help smokers advance successfully through the stages of cessation.

  16. Targeting children of substance-using parents with the community-based group intervention TRAMPOLINE: A randomised controlled trial - design, evaluation, recruitment issues

    Directory of Open Access Journals (Sweden)

    Bröning Sonja

    2012-03-01

    Full Text Available Abstract Background Children of substance-abusing parents are at risk for developing psychosocial development problems. In Germany it is estimated that approx. 2.65 million children are affected by parental substance abuse or dependence. Only ten percent of them receive treatment when parents are treated. To date, no evaluated programme for children from substance-affected families exists in Germany. The study described in this protocol is designed to test the effectiveness of the group programme TRAMPOLINE for children aged 8-12 years with at least one substance-abusing or -dependent caregiver. The intervention is specifically geared to issues and needs of children from substance-affected families. Methods/Design The effectiveness of the manualised nine-session group programme TRAMPOLINE is tested among N = 218 children from substance-affected families in a multicentre randomised controlled trial. Outpatient counselling facilities across the nation from different settings (rural/urban, Northern/Southern/Eastern/Western regions of the country will deliver the interventions, as they hold the primary access to the target group in Germany. The control condition is a group programme with the same duration that is not addiction-specific. We expect that participants in the intervention condition will show a significant improvement in the use of adaptive coping strategies (in general and within the family compared to the control condition as a direct result of the intervention. Data is collected shortly before and after as well as six months after the intervention. Discussion In Germany, the study presented here is the first to develop and evaluate a programme for children of substance-abusing parents. Limitations and strengths are discussed with a special focus on recruitment challenges as they appear to be the most potent threat to feasibility in the difficult-to-access target group at hand (Trial registration: ISRCTN81470784.

  17. Targeting children of substance-using parents with the community-based group intervention TRAMPOLINE: A randomised controlled trial - design, evaluation, recruitment issues

    Science.gov (United States)

    2012-01-01

    Background Children of substance-abusing parents are at risk for developing psychosocial development problems. In Germany it is estimated that approx. 2.65 million children are affected by parental substance abuse or dependence. Only ten percent of them receive treatment when parents are treated. To date, no evaluated programme for children from substance-affected families exists in Germany. The study described in this protocol is designed to test the effectiveness of the group programme TRAMPOLINE for children aged 8-12 years with at least one substance-abusing or -dependent caregiver. The intervention is specifically geared to issues and needs of children from substance-affected families. Methods/Design The effectiveness of the manualised nine-session group programme TRAMPOLINE is tested among N = 218 children from substance-affected families in a multicentre randomised controlled trial. Outpatient counselling facilities across the nation from different settings (rural/urban, Northern/Southern/Eastern/Western regions of the country) will deliver the interventions, as they hold the primary access to the target group in Germany. The control condition is a group programme with the same duration that is not addiction-specific. We expect that participants in the intervention condition will show a significant improvement in the use of adaptive coping strategies (in general and within the family) compared to the control condition as a direct result of the intervention. Data is collected shortly before and after as well as six months after the intervention. Discussion In Germany, the study presented here is the first to develop and evaluate a programme for children of substance-abusing parents. Limitations and strengths are discussed with a special focus on recruitment challenges as they appear to be the most potent threat to feasibility in the difficult-to-access target group at hand (Trial registration: ISRCTN81470784). PMID:22439919

  18. MRI-based Medical Nanorobotic Platform for the Control of Magnetic Nanoparticles and Flagellated Bacteria for Target Interventions in Human Capillaries.

    Science.gov (United States)

    Martel, Sylvain; Felfoul, Ouajdi; Mathieu, Jean-Baptiste; Chanu, Arnaud; Tamaz, Samer; Mohammadi, Mahmood; Mankiewicz, Martin; Tabatabaei, Nasr

    2009-09-01

    Medical nanorobotics exploits nanometer-scale components and phenomena with robotics to provide new medical diagnostic and interventional tools. Here, the architecture and main specifications of a novel medical interventional platform based on nanorobotics and nanomedicine, and suited to target regions inaccessible to catheterization are described. The robotic platform uses magnetic resonance imaging (MRI) for feeding back information to a controller responsible for the real-time control and navigation along pre-planned paths in the blood vessels of untethered magnetic carriers, nanorobots, and/or magnetotactic bacteria (MTB) loaded with sensory or therapeutic agents acting like a wireless robotic arm, manipulator, or other extensions necessary to perform specific remote tasks. Unlike known magnetic targeting methods, the present platform allows us to reach locations deep in the human body while enhancing targeting efficacy using real-time navigational or trajectory control. The paper describes several versions of the platform upgraded through additional software and hardware modules allowing enhanced targeting efficacy and operations in very difficult locations such as tumoral lesions only accessible through complex microvasculature networks.

  19. Do financial incentives for delivering health promotion counselling work? Analysis of smoking cessation activities stimulated by the quality and outcomes framework

    Directory of Open Access Journals (Sweden)

    Coleman Tim

    2010-03-01

    Full Text Available Abstract Background A substantial fraction of UK general practitioners' salaries is now intended to reflect the quality of care provided. This performance-related pay system has probably improved aspects of primary health care but, using the observational data available, disentangling the impacts of different types of targets set within this unique payment system is challenging. Discussion Financial incentives undoubtedly influence GPs' activities, however, those aimed at encouraging GPs' delivery of health promotion counselling may not always have the effects intended. There is strong, observational evidence that targets and incentives intended to increase smoking cessation counselling by GPs have merely increased their propensity to record this activity in patients' medical records. The limitations of using financial incentives to stimulate the delivery of counselling in primary care are discussed and a re-appraisal of their use within UK GPs' performance-related pay system is argued for. Summary The utility of targets employed by the system for UK General Practitioners' performance related pay may be inappropriate for encouraging the delivery of health promotion counselling interventions. An evaluation of these targets is essential before they are further developed or added to.

  20. Runners with patellofemoral pain have altered biomechanics which targeted interventions can modify: A systematic review and meta-analysis.

    Science.gov (United States)

    Neal, Bradley S; Barton, Christian J; Gallie, Rosa; O'Halloran, Patrick; Morrissey, Dylan

    2016-03-01

    Patellofemoral pain (PFP) is the most prevalent running pathology and associated with multi-level biomechanical factors. This systematic review aims to guide treatment and prevention of PFP by synthesising prospective, observational and intervention studies that measure clinical and biomechanical outcomes in symptomatic running populations. Medline, Web of Science and CINAHL were searched from inception to April 2015 for prospective, case-control or intervention studies in running-related PFP cohorts. Study methodological quality was scored by two independent raters using the modified Downs and Black or PEDro scales, with meta-analysis performed where appropriate. 28 studies were included. Very limited evidence indicates that increased peak hip adduction is a risk factor for PFP in female runners, supported by moderate evidence of a relationship between PFP and increased peak hip adduction, internal rotation and contralateral pelvic drop, as well as reduced peak hip flexion. Limited evidence was also identified that altered peak force and time to peak at foot level is a risk factor for PFP development. Limited evidence from intervention studies indicates that both running retraining and proximal strengthening exercise lead to favourable outcomes in both pain and function, but only running retraining significantly reduces peak hip adduction, suggesting a possible kinematic mechanism. Put together, these findings highlight limited but coherent evidence of altered biomechanics which interventions can alter with resultant symptom change in females with PFP. There is a clear need for high quality prospective studies of intervention efficacy with measurement of explanatory mechanisms.

  1. Who to target in sudden unexpected death in epilepsy prevention and how? Risk factors, biomarkers, and intervention study designs.

    Science.gov (United States)

    Tomson, Torbjörn; Surges, Rainer; Delamont, Robert; Haywood, Serena; Hesdorffer, Dale C

    2016-01-01

    The risk of dying suddenly and unexpectedly is increased 24- to 28-fold among young people with epilepsy compared to the general population, but the incidence of sudden unexpected death in epilepsy (SUDEP) varies markedly depending on the epilepsy population. This article first reviews risk factors and biomarkers for SUDEP with the overall aim of enabling identification of epilepsy populations with different risk levels as a background for a discussion of possible intervention strategies. The by far most important clinical risk factor is frequency of generalized tonic-clonic seizures (GTCS), but nocturnal seizures, early age at onset, and long duration of epilepsy have been identified as additional risk factors. Lack of antiepileptic drug (AED) treatment or, in the context of clinical trials, adjunctive placebo versus active treatment is associated with increased risks. Despite considerable research, reliable electrophysiologic (electrocardiography [ECG] or electroencephalography [EEG]) biomarkers of SUDEP risk remain to be established. This is an important limitation for prevention strategies and intervention studies. There is a lack of biomarkers for SUDEP, and until validated biomarkers are found, the endpoint of interventions to prevent SUDEP must be SUDEP itself. These interventions, be they pharmacologic, seizure-detection devices, or nocturnal supervision, require large numbers. Possible methods for assessing prevention measures include public health community interventions, self-management, and more traditional (and much more expensive) randomized clinical trials.

  2. [Effectiveness of smoking cessation in group-based behavioral treatment in association to health status and motivation of participants--own research findings].

    Science.gov (United States)

    Broszkiewicz, Marzenna; Drygas, Wojciech

    2009-01-01

    The efficacy and cost-effectiveness of behavioral treatments compare favorably with the pharmacotherapies and community-based interventions. Group-based behavioral programs have been scientifically proven as the effective smoking cessation intervention. Aim of the study was identifying predictors of the efficacy of smoking cessation in health factors: health status and motivation and doctor's advice. Program is a multicomponent group-based behavioral intervention with the elements recommended by the US Public Health Service as the most effective. 517 smokers were included into the program in the outpatient clinic setting in years 2001-2007. A point prevalence abstinence (PPA) was estimated by self-reported smoking cessation. Three homogeneous groups of patients according to their status health were established: participants with tobacco-related diseases n = 182, with psychiatric disorders n = 101 and healthy ones n = 150. 59.6% of participants stopped smoking during four-week program. Program was effective in smoking cessation both for sick and healthy participants. Motivational factors, among others health motivation did not distinguish for whole population as well as for participants with tobacco-related diseases. Lack of doctor's advice increased efficacy of smoking cessation both for the whole population and for group with tobacco-related diseases. Nor health status and motivation neither doctor's advice were predictors of behavioral group-based treatment for tobacco smokers.

  3. Design of a randomized controlled study of a multi-professional and multidimensional intervention targeting frail elderly people

    Directory of Open Access Journals (Sweden)

    Gosman-Hedström Gunilla

    2011-05-01

    Full Text Available Abstract Background Frail elderly people need an integrated and coordinated care. The two-armed study "Continuum of care for frail elderly people" is a multi-professional and multidimensional intervention for frail community-dwelling elderly people. It was designed to evaluate whether the intervention programme for frail elderly people can reduce the number of visits to hospital, increase satisfaction with health and social care and maintain functional abilities. The implementation process is explored and analysed along with the intervention. In this paper we present the study design, the intervention and the outcome measures as well as the baseline characteristics of the study participants. Methods/design The study is a randomised two-armed controlled trial with follow ups at 3, 6 and 12 months. The study group includes elderly people who sought care at the emergency ward and discharged to their own homes in the community. Inclusion criteria were 80 years and older or 65 to 79 years with at least one chronic disease and dependent in at least one activity of daily living. Exclusion criteria were acute severely illness with an immediate need of the assessment and treatment by a physician, severe cognitive impairment and palliative care. The intention was that the study group should comprise a representative sample of frail elderly people at a high risk of future health care consumption. The intervention includes an early geriatric assessment, early family support, a case manager in the community with a multi-professional team and the involvement of the elderly people and their relatives in the planning process. Discussion The design of the study, the randomisation procedure and the protocol meetings were intended to ensure the quality of the study. The implementation of the intervention programme is followed and analysed throughout the whole study, which enables us to generate knowledge on the process of implementing complex interventions. The

  4. [Smoking cessation in pneumological routine care].

    Science.gov (United States)

    Hering, Th; Andres, J; Gebhardt, R; Grah, Ch; Schultz, Th

    2011-11-01

    Continuous cigarette smoking clearly influences the course and prognosis of diseases like COPD/emphysema and asthma bronchiale in an adverse manner. However smoking cessation as a therapy measure is not a common part of general health-care in Germany as reimbursement of the central component of psychosocial support (behavioural therapy - BT) is allowed only to a minor degree and of pharmacotherapy support (nicotine replacement, varenicline, bupropione) is completely excluded by the legislator. This prospective "real-life" study with 198 participants shows, that with the abolition of the reimbursement barrier for cognitive behavioural therapy in the setting of a pneumological practice/clinic a high long-term abstinence of 45.4 % (point prevalence after 12 months) can be achieved. Apart from the reimbursement of BT, predominant success factors were the implementation of the measure in the practice/clinic, where patients are under long-term treatment and the application of a two-stage motivational model for the participation. Reimbursement of smoking cessation pharmacotherapy was not possible in this study. Thus, pharmacotherapy was applied to fewer than necessary patients and was predominantly too short and in a too low dosage.

  5. The Pap smear screening as an occasion for smoking cessation and physical activity counselling: baseline characteristics of women involved in the SPRINT randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Chellini Elisabetta

    2011-12-01

    Full Text Available Abstract Background Gender-specific smoking cessation strategies have rarely been developed. Evidence of effectiveness of physical activity (PA promotion and intervention in adjunct to smoking cessation programs is not strong. SPRINT study is a randomized controlled trial (RCT designed to evaluate a counselling intervention on smoking cessation and PA delivered to women attending the Italian National Health System Cervical Cancer Screening Program. This paper presents study design and baseline characteristics of the study population. Methods/Design Among women undergoing the Pap examination in three study centres (Florence, Turin, Mantua, participants were randomized to the smoking cessation counselling [S], the smoking cessation + PA counselling [S + PA], or the control [C] groups. The program under evaluation is a standard brief counselling on smoking cessation combined with a brief counselling on increasing PA, and was delivered in 2010. A questionnaire, administered before, after 6 months and 1 year from the intervention, was used to track behavioural changes in tobacco use and PA, and to record cessation rates in participants. Discussion Out of the 5,657 women undergoing the Pap examination, 1,100 participants (55% of smokers were randomized in 1 of the 3 study groups (363 in the S, 366 in the S + PA and 371 in the C groups. The three arms did not differ on any demographic, PA, or tobacco-use characteristics. Recruited smokers were older, less educated than non-participant women, more motivated to quit (33% vs.9% in the Preparation stage, p p p Trial registration number ISRCTN: ISRCTN52660565

  6. Effectiveness of interventions targeting physical activity, nutrition and healthy weight for university and college students: a systematic review and meta-analysis.

    Science.gov (United States)

    Plotnikoff, Ronald C; Costigan, Sarah A; Williams, Rebecca L; Hutchesson, Melinda J; Kennedy, Sarah G; Robards, Sara L; Allen, Jennifer; Collins, Clare E; Callister, Robin; Germov, John

    2015-04-01

    To examine the effectiveness of interventions aimed at improving physical activity, diet, and/or weight-related behaviors amongst university/college students. Five online databases were searched (January 1970 to April 2014). Experimental study designs were eligible for inclusion. Data extraction was performed by one reviewer using a standardized form developed by the researchers and checked by a second reviewer. Data were described in a narrative synthesis and meta-analyses were conducted when appropriate. Study quality was also established. Forty-one studies were included; of these, 34 reported significant improvements in one of the key outcomes. Of the studies examining physical activity 18/29 yielded significant results, with meta-analysis demonstrating significant increases in moderate physical activity in intervention groups compared to control. Of the studies examining nutrition, 12/24 reported significantly improved outcomes; only 4/12 assessing weight loss outcomes found significant weight reduction. This appears to be the first systematic review of physical activity, diet and weight loss interventions targeting university and college students. Tertiary institutions are appropriate settings for implementing and evaluating lifestyle interventions, however more research is needed to improve such strategies.

  7. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial

    Science.gov (United States)

    Anderson, Jacqueline; Dolk, Anders; Torgerson, Jarl; Nyberg, Svante; Skau, Tommy; Forsberg, Birger C.; Werr, Joachim; Öhlen, Gunnar

    2016-01-01

    Background A small group of frequent visitors to Emergency Departments accounts for a disproportionally large fraction of healthcare consumption including unplanned hospitalizations and overall healthcare costs. In response, several case and disease management programs aimed at reducing healthcare consumption in this group have been tested; however, results vary widely. Objectives To investigate whether a telephone-based, nurse-led case management intervention can reduce healthcare consumption for frequent Emergency Department visitors in a large-scale setup. Methods A total of 12 181 frequent Emergency Department users in three counties in Sweden were randomized using Zelen’s design or a traditional randomized design to receive either a nurse-led case management intervention or no intervention, and were followed for healthcare consumption for up to 2 years. Results The traditional design showed an overall 12% (95% confidence interval 4–19%) decreased rate of hospitalization, which was mostly driven by effects in the last year. Similar results were achieved in the Zelen studies, with a significant reduction in hospitalization in the last year, but mixed results in the early development of the project. Conclusion Our study provides evidence that a carefully designed telephone-based intervention with accurate and systematic patient selection and appropriate staff training in a centralized setup can lead to significant decreases in healthcare consumption and costs. Further, our results also show that the effects are sensitive to the delivery model chosen. PMID:25969342

  8. [Web-based interventions targeting cardiovascular risk factors in older people; a systematic review and meta-analysis

    NARCIS (Netherlands)

    Beishuizen, C.R.; Gool, W.A. van; Busschers, W.B.; Peters, R.J.; Moll- van Charante, E.; Richard, E.

    2016-01-01

    OBJECTIVE: To evaluate whether web-based interventions for cardiovascular risk factor management reduce the risk of cardiovascular disease in older people. DESIGN: Systematic review and meta-analysis. METHOD: Embase, Medline, Cochrane Library and CINAHL were systematically searched from January 1995

  9. 20 CFR 410.432 - Cessation of disability.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Cessation of disability. 410.432 Section 410..., TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.432 Cessation of disability. (a) Where it has been determined that a miner is totally disabled under §...

  10. The public health impact of smoking and smoking cessation

    NARCIS (Netherlands)

    Mulder, I.

    2003-01-01

    Despite the overwhelming evidence that smoking cessation reduces the risk for several chronic diseases, information on the magnitude of these public health benefits is scarce. It has furthermore been suggested that smoking cessation also improves health-related quality of life, but this has not been

  11. Successful Smoking Cessation in COPD : Association with Comorbidities and Mortality

    NARCIS (Netherlands)

    Kupiainen, H; Kinnula, V L; Lindqvist, A; Postma, D S; Boezen, H M; Laitinen, T; Kilpeläinen, M

    2012-01-01

    Smoking cessation is the cornerstone of COPD management, but difficult to achieve in clinical practice. The effect of comorbidities on smoking cessation and risk factors for mortality were studied in a cohort of 739 COPD patients recruited in two Finnish University Hospitals. The diagnosis of COPD w

  12. Internet and Cell Phone Based Smoking Cessation Programs among Adolescents

    Science.gov (United States)

    Mehta, Purvi; Sharma, Manoj

    2010-01-01

    Smoking cessation among adolescents is a salient public health issue, as it can prevent the adoption of risky health behaviors and reduce negative impacts on health. Self-efficacy, household and social support systems, and perceived benefits are some important cessation determinants. With the popular use of the Internet and cell phone usage among…

  13. Drug cessation in complex older adults: Time for action

    NARCIS (Netherlands)

    T.J.M. van der Cammen (Tischa); C. Rajkumar (Chakravarthi); G. Onder (Graziano); C.S. Sterke (Carolyn); M. Petrovic (Mirko)

    2014-01-01

    textabstractBackground: general opinion is growing that drug cessation in complex older patients is warranted in certain situations. From a clinical viewpoint, drug cessation seems most warranted in four situations, i.e., falls, delirium, cognitive impairment and endof-life situations. To date, litt

  14. Impairment-Based 3-D Robotic Intervention Improves Upper Extremity Work Area in Chronic Stroke: Targeting Abnormal Joint Torque Coupling With Progressive Shoulder Abduction Loading

    Science.gov (United States)

    Ellis, Michael D.; Sukal-Moulton, Theresa M.; Dewald, Julius P. A.

    2010-01-01

    The implementation of a robotic system (ACT3D) that allowed for a quantitative measurement of abnormal joint torque coupling in chronic stroke survivors and, most importantly, a quantitative means of initiating and progressing an impairment-based intervention, is described. Individuals with chronic moderate to severe stroke (n = 8) participated in this single-group pretest-posttest design study. Subjects were trained over eight weeks by progressively increasing the level of shoulder abduction loading experienced by the participant during reaching repetitions as performance improved. Reaching work area was evaluated pre- and postintervention for ten different shoulder abduction loading levels along with isometric single-joint strength and a qualitative clinical assessment of impairment. There was a significant effect of session (pre versus post) with an increase in reaching work area, despite no change in single-joint strength. This data suggests that specifically targeting the abnormal joint torque coupling impairment through progressive shoulder abduction loading is an effective strategy for improving reaching work area following hemiparetic stroke. Application of robotics, namely, the ACT3D, allowed for quantitative control of the exercise parameters needed to directly target the synergistic coupling impairment. The targeted reduction of abnormal joint torque coupling is likely the key factor explaining the improvements in reaching range of motion achieved with this intervention. PMID:20657711

  15. Interventional procedure based on nanorobots propelled and steered by flagellated magnetotactic bacteria for direct targeting of tumors in the human body.

    Science.gov (United States)

    Martel, Sylvain; Felfoul, Ouajdi; Mohammadi, Mahmood; Mathieu, Jean-Baptiste

    2008-01-01

    Flagellated bacteria used as bio-actuators may prove to be efficient propulsion mechanisms for future hybrid medical nanorobots when operating in the microvasculature. Here, we briefly describe a medical interventional procedure where flagellated bacteria and more specifically MC-1 Magnetotactic Bacteria (MTB) can be used to propel and steer micro-devices and nanorobots under computer control to reach remote locations in the human body. In particular, we show through experimental results the potential of using MTB-tagged robots to deliver therapeutic agents to tumors even the ones located in deep regions of the human body. We also show that such bacterial nanorobots can be tracked inside the human body for enhanced targeting under computer guidance using MRI as imaging modality. MTB can not only be guided and controlled directly towards a specific target, but we also show experimentally that these flagellated bacterial nanorobots can be propelled and steered in vivo deeply through the interstitial region of a tumor. The targeting efficacy is increased when combined with larger ferromagnetic micro-carriers being propelled by magnetic gradients generated by a MRI platform to carry and release nanorobots propelled by a single flagellated bacterium near the arteriocapillar entry. Based on the experimental data obtained and the experience gathered during several experiments conducted in vivo with this new approach, a general medical interventional procedure is briefly described here in a biomedical engineering context.

  16. Profile and motivation for smoking cessation in surgical inpatients

    Directory of Open Access Journals (Sweden)

    Ana Paula Almeida Corrêa

    Full Text Available The aim of this cross-sectional study was to describe the profile of smokers hospitalized for surgery, and investigate their motivation to quit. The sample consisted of 100 patients recruited from a university hospital in southern Brazil. Data were collected between February and May 2013, and analyzed using descriptive statistics. The sample was predominantly male (n=58; 58% and had a mean age of 54.5±13.8 years. Seventy-nine (79% of the participants were white, 38(38% were married and 67(67% had primary education only. Patients started smoking at a mean age of 17±6.6 years, smoked approximately 20(10 to 28.7 cigarettes/day and had been smoking for a mean of 37.4±14.4 years. Ninety-one (91% patients wanted to stop smoking, 57(57% were in the preparation phase, 36(36% had low nicotine dependence and 35(35% had been encouraged to quit. We concluded that, although hospitalization is a good moment to address smoking cessation, health care professionals do not enact effective and systematic interventions in this regard.

  17. Traditional and innovative promotional strategies of tobacco cessation services: a review of the literature.

    Science.gov (United States)

    Momin, Behnoosh; Neri, Antonio; McCausland, Kristen; Duke, Jennifer; Hansen, Heather; Kahende, Jennifer; Zhang, Lei; Stewart, Sherri L

    2014-08-01

    An estimated 43.5 million American adults currently smoke cigarettes. Well-designed tobacco education campaigns with adequate reach increase cessation and reduce tobacco use. Smokers report great interest in quitting but few use effective treatments including quitlines (QLs). This review examined traditional (TV, radio, print ads) versus innovative tobacco cessation (internet, social media) promotions for QL services. Between November 2011 and January 2012, searches were conducted on EBSCO, PubMed, Wilson, OCLC, CQ Press, Google Scholar, Gale, LexisNexis, and JSTOR. Existing literature shows that the amount of radio and print advertising, and promotion of free cessation medications increases QL call volume. Television advertising volume seems to be the best predictor of QL service awareness. Much of the literature on Internet advertising compares the characteristics of participants recruited for studies through various channels. The majority of the papers indicated that Internet-recruited participants were younger; this was the only demographic characteristic with high agreement across studies. Traditional media was only studied within mass media campaigns with TV ads having a consistent impact on increasing calls to QLs, therefore, it is hard to distinguish the impact of traditional media as an independent QL promotion intervention. With innovative media, while many QL services have a presence on social media sites, there is no literature on evaluating the effectiveness of these channels for quitline promotion.

  18. Results from a Community-Based Smoking Cessation Treatment Program for LGBT Smokers

    Directory of Open Access Journals (Sweden)

    Alicia K. Matthews

    2013-01-01

    Full Text Available Introduction. Little is known about lesbian, gay, bisexual, and transgender (LGBT people’s response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. Methods. A total of N=198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association’s “Freedom from Smoking Program” (ALA-FFS and were tailored to LGBT smokers’ needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Results. Participants (M age = 40.5 were mostly White (70.4% and male (60.5% and had at least a college degree (58.4%. Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions. Higher educational attainment and use of nicotine replacement therapy (NRT were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45, use of NRT (OR = 4.24, and lower nicotine dependency (OR = 0.73 were positively associated with quitting smoking. Conclusions. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake.

  19. Culturally-Tailored Smoking Cessation for American Indians: Study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Shireman Theresa I

    2011-05-01

    Full Text Available Abstract Background Cigarette smoking is the number one cause of preventable death among American Indian and Alaska Natives, AI/ANs. Two out of every five AI/AN will die from tobacco-related diseases if the current smoking rates of AI/ANs (40.8% persist. Currently, there is no proven, effective culturally-tailored smoking cessation program designed specifically for a heterogeneous population of AI. The primary aim of this group randomized clinical trial is to test the efficacy of "All Nations Breath of Life" (ANBL program compared to a non-tailored "Current Best Practices" smoking cessation program among AI smokers. Methods We will randomize 56 groups (8 smokers per group to the tailored program or non-tailored program for a total sample size of 448 American Indian smokers. All participants in the proposed study will be offered pharmacotherapy, regardless of group assignment. This study is the first controlled trial to examine the efficacy of a culturally-tailored smoking cessation program for American Indians. If the intervention is successful, the potential health impact is significant because the prevalence of smoking is the highest in this population. Trial Registration ClinicalTrials.gov: NCT01106456

  20. Traditional and Innovative Promotional Strategies of Tobacco Cessation Services: A Review of the Literature

    Science.gov (United States)

    Momin, Behnoosh; Neri, Antonio; McCausland, Kristen; Duke, Jennifer; Hansen, Heather; Kahende, Jennifer; Zhang, Lei; Stewart, Sherri L.

    2017-01-01

    Introduction An estimated 43.5 million American adults currently smoke cigarettes. Well-designed tobacco education campaigns with adequate reach increase cessation and reduce tobacco use. Smokers report great interest in quitting but few use effective treatments including quitlines. This review examined traditional (TV, radio, print ads) versus innovative tobacco cessation (internet, social media) promotions for quitline services. Methods Between November 2011 and January 2012, searches were conducted on EBSCO, PubMed, Wilson, OCLC, CQ Press, Google Scholar, Gale, LexisNexis, and JSTOR. Results Existing literature shows that the amount of radio and print advertising, and promotion of free cessation medications increases quitline (QL) call volume. Television advertising volume seems to be the best predictor of QL service awareness. Much of the literature on Internet advertising compares the characteristics of participants recruited for studies through various channels. The majority of the papers indicated that Internet-recruited participants were younger; this was the only demographic characteristic with high agreement across studies. Conclusions Traditional media was only studied within mass media campaigns with TV ads having a consistent impact on increasing calls to quitlines, therefore, it is hard to distinguish the impact of traditional media as an independent QL promotion intervention. With innovative media, while many QL services have a presence on social media sites, there is no literature on evaluating the effectiveness of these channels for quitline promotion. PMID:24515948

  1. Cost-effectiveness of varenicline and three different behavioral treatment formats for smoking cessation.

    Science.gov (United States)

    Javitz, Harold S; Zbikowski, Susan M; Deprey, Mona; McAfee, Timothy A; McClure, Jennifer B; Richards, Julie; Catz, Sheryl L; Jack, Lisa M; Swan, Gary E

    2011-03-01

    There is a lack of evidence of the relative cost-effectiveness of proactive telephone counseling (PTC) and Web-based delivery of smoking cessation services in conjunction with pharmacotherapy. We calculated the differential cost-effectiveness of three behavioral smoking cessation modalities with varenicline treatment in a randomized trial of current smokers from a large health system. Eligible participants were randomized to one of three smoking cessation interventions: Web-based counseling (n=401), PTC (n=402), or combined PTC-Web counseling (n=399). All participants received a standard 12-week course of varenicline. The primary outcome was a 7-day point prevalent nonsmoking at the 6month follow-up. The Web intervention was the least expensive followed by the PTC and PTC-Web groups. Costs per additional 6-month nonsmoker and per additional lifetime quitter were $1,278 and $2,601 for Web, $1,472 and $2,995 for PTC, and $1,617 and $3,291 for PTC-Web. Cost per life-year (LY) and quality-adjusted life-year (QALY) saved were $1,148 and $1,136 for Web, $1,320 and $1,308 for PTC, and $1,450 and $1,437 for PTC-Web. Based on the cost per LY and QALY saved, these interventions are among the most cost-effective life-saving medical treatments. Web, PTC, and combined PTC-Web treatments were all highly cost-effective, with the Web treatment being marginally more cost-effective than the PTC or combined PTC-Web treatments.

  2. Short day-mediated cessation of growth requires the downregulation of AINTEGUMENTALIKE1 transcription factor in hybrid aspen.

    Directory of Open Access Journals (Sweden)

    Anna Karlberg

    2011-11-01

    Full Text Available Day length is a key environmental cue regulating the timing of major developmental transitions in plants. For example, in perennial plants such as the long-lived trees of the boreal forest, exposure to short days (SD leads to the termination of meristem activity and bud set (referred to as growth cessation. The mechanism underlying SD-mediated induction of growth cessation is poorly understood. Here we show that the AIL1-AIL4 (AINTEGUMENTALIKE transcription factors of the AP2 family are the downstream targets of the SD signal in the regulation of growth cessation response in hybrid aspen trees. AIL1 is expressed in the shoot apical meristem and leaf primordia, and exposure to SD signal downregulates AIL1 expression. Downregulation of AIL gene expression by SDs is altered in transgenic hybrid aspen plants that are defective in SD perception and/or response, e.g. PHYA or FT overexpressors. Importantly, SD-mediated regulation of growth cessation response is also affected by overexpression or downregulation of AIL gene expression. AIL1 protein can interact with the promoter of the key cell cycle genes, e.g. CYCD3.2, and downregulation of the expression of D-type cyclins after SD treatment is prevented by AIL1 overexpression. These data reveal that execution of SD-mediated growth cessation response requires the downregulation of AIL gene expression. Thus, while early acting components like PHYA and the CO/FT regulon are conserved in day-length regulation of flowering time and growth cessation between annual and perennial plants, signaling pathways downstream of SD perception diverge, with AIL transcription factors being novel targets of the CO/FT regulon connecting the perception of SD signal to the regulation of meristem activity.

  3. Targeting, out-scaling and prioritising climate-smart interventions in agricultural systems: Lessons from applying a generic framework to the livestock sector in sub-Saharan Africa.

    Science.gov (United States)

    Notenbaert, An; Pfeifer, Catherine; Silvestri, Silvia; Herrero, Mario

    2017-02-01

    As a result of population growth, urbanization and climate change, agricultural systems around the world face enormous pressure on the use of resources. There is a pressing need for wide-scale innovation leading to development that improves the livelihoods and food security of the world's population while at the same time addressing climate change adaptation and mitigation. A variety of promising climate-smart interventions have been identified. However, what remains is the prioritization of interventions for investment and broad dissemination. The suitability and adoption of interventions depends on a variety of bio-physical and socio-economic factors. Also their impacts, when adopted and out-scaled, are likely to be highly heterogeneous. This heterogeneity expresses itself not only spatially and temporally but also in terms of the stakeholders affected, some might win and some might lose. A mechanism that can facilitate a systematic, holistic assessment of the likely spread and consequential impact of potential interventions is one way of improving the selection and targeting of such options. In this paper we provide climate smart agriculture (CSA) planners and implementers at all levels with a generic framework for evaluating and prioritising potential interventions. This entails an iterative process of mapping out recommendation domains, assessing adoption potential and estimating impacts. Through examples, related to livestock production in sub-Saharan Africa, we demonstrate each of the steps and how they are interlinked. The framework is applicable in many different forms, scales and settings. It has a wide applicability beyond the examples presented and we hope to stimulate readers to integrate the concepts in the planning process for climate-smart agriculture, which invariably involves multi-stakeholder, multi-scale and multi-objective decision-making.

  4. Pairing smoking-cessation services with lung cancer screening: A clinical guideline from the Association for the Treatment of Tobacco Use and Dependence and the Society for Research on Nicotine and Tobacco.

    Science.gov (United States)

    Fucito, Lisa M; Czabafy, Sharon; Hendricks, Peter S; Kotsen, Chris; Richardson, Donna; Toll, Benjamin A

    2016-04-15

    Smoking cessation is crucial for reducing cancer risk and premature mortality. The US Preventive Services Task Force (USPSTF) has recommended annual lung cancer screening with low-dose computed tomography (LDCT), and the Center for Medicare and Medicaid Services recently approved lung screening as a benefit for patients ages 55 to 77 years who have a 30 pack-year history. The Society for Research on Nicotine and Tobacco (SRNT) and the Association for the Treatment of Tobacco Use and Dependence (ATTUD) developed the guideline described in this commentary based on an illustrative literature review to present the evidence for smoking-cessation health benefits in this high-risk group and to provide clinical recommendations for integrating evidence-based smoking-cessation treatment with lung cancer screening. Unfortunately, extant data on lung cancer screening participants were scarce at the time this guideline was written. However, in this review, the authors summarize the sufficient evidence on the benefits of smoking cessation and the efficacy of smoking-cessation interventions for smokers ages 55 to 77 years to provide smoking-cessation interventions for smokers who seek lung cancer screening. It is concluded that smokers who present for lung cancer screening should be encouraged to quit smoking at each visit. Access to evidence-based smoking-cessation interventions should be provided to all smokers regardless of scan results, and motivation to quit should not be a necessary precondition for treatment. Follow-up contacts to support smoking-cessation efforts should be arranged for smokers. Evidence-based behavioral strategies should be used at each visit to motivate smokers who are unwilling to try quitting/reducing smoking or to try evidence-based treatments that may lead to eventual cessation.

  5. Progression of antiphospholipid antibody syndrome to catastrophic antiphospholipid antibody syndrome acutely with cessation of antithrombotic therapy.

    Science.gov (United States)

    Katikireddi, V S; Kandiah, D A

    2012-05-01

    Catastrophic antiphospholipid antibody syndrome (CAPS) is a serious condition that is often unrecognised with a high mortality. Cessation of anticoagulation in antiphospholipid antibody syndrome (APS) can have devastating consequences with progression to CAPS. Making a diagnosis of APS can however be challenging because of the evolving diagnostic criteria and difficulty in confirming thromboses. Management of these patients can also be complex, especially in those with coexistent thrombocytopenia. New potential treatments are emerging targeted on the immunomodulation of APS rather than just prevention of thrombosis. This article aims to highlight these diagnostic and management difficulties by reporting and discussing three cases of APS with progression to CAPS following cessation of anticoagulation, one with fatal consequences, with confirmation of CAPS on autopsy, and two with successful treatment and outcomes.

  6. Municipalities collaborating in public health: The Danish Smoking Prevention and Cessation Partnership

    DEFF Research Database (Denmark)

    Andersen, Pernille Tanggaard; El Ansari, Walid; Rasmussen, Hanna Barbara

    2010-01-01

    ; and the fourth factor is the bearing of personal/individual factors on the partnership e.g., personal engagement in the project. Early attention to these four factors could contribute to more effective partnership working. Keywords: partnership; coalition; smoking cessation; Denmark; multi-site evaluation......This study explored the Smoking Prevention and Cessation Partnership (SPCP) which builds upon a collaboration between two Danish municipalities targeted at the prevention of tobacco smoking. The aim of the study was to describe the processes of SPCP, to examine the difficulties this collaboration...... faced, and to assess how these experiences could be used to improve future partnership collaboration. We employed qualitative methodology comprising 12 semi-structured one-to-one interviews with SPCP‘s stakeholders and an analysis of the partnership documents and reports. The findings suggested...

  7. The effectiveness of telephone counselling and internet- and text-message-based support for smoking cessation

    DEFF Research Database (Denmark)

    Skov-Ettrup, Lise S; Dalum, Peter; Bech, Mickael

    2016-01-01

    AIM: To compare the effectiveness of proactive telephone counselling, reactive telephone counselling and an internet- and text messages-based intervention with a self-help booklet for smoking cessation. DESIGN: A randomised controlled trial with equal allocation to four conditions: 1) Proactive...... prolonged abstinence for 12 months. No clear evidence of an effect of reactive telephone counselling or the internet- and text-message-based intervention was found compared with the self-help booklet. This article is protected by copyright. All rights reserved....... telephone counselling (n=452), 2) Reactive telephone counselling (n=453), 3) Internet- and text-message-based intervention (n=453), 4) Self-help booklet (control) (n=452) SETTING: Denmark PARTICIPANTS: Smokers who had previously participated in two national health surveys were invited. Eligibility criteria...

  8. Adoption of workplaces and reach of employees for a multi-faceted intervention targeting low back pain among nurses' aides

    DEFF Research Database (Denmark)

    Rasmussen, Charlotte Diana Nørregaard; Larsen, Anne Konring; Holtermann, Andreas;

    2014-01-01

    eligible workplaces. From the adopted workplaces reach was calculated among eligible employees as the percentage who responded on a questionnaire. Responders were compared with non-responders using data from company registrations. Among responders, comparisons based on questionnaire data were performed......BACKGROUND: Workplace adoption and reach of health promotion are important, but generally poorly reported. The aim of this study is therefore to evaluate the adoption of workplaces (organizational level) and reach of employees (individual level) of a multi-faceted workplace health promotion...... between those consenting to participate in the intervention (consenters) and those not consenting to participate in the intervention (non-consenters). Comparisons were done using Student's t-test for the continuous variables, Fisher's exact test for dichotomous variables and the Pearson's chi(2...

  9. Changes in the Healthy Beverage Index in Response to an Intervention Targeting a Reduction in Sugar-Sweetened Beverage Consumption as Compared to an Intervention Targeting Improvements in Physical Activity: Results from the Talking Health Trial.

    Science.gov (United States)

    Hedrick, Valisa E; Davy, Brenda M; Myers, Emily A; You, Wen; Zoellner, Jamie M

    2015-12-04

    The recently developed Healthy Beverage Index (HBI) was designed to evaluate overall beverage intake quality (including total fluid consumption and beverage calories), yet no known intervention studies have assessed longitudinal changes to the HBI. The objective of this investigation was to assess changes in HBI scores in response to a sugar-sweetened beverage (SSB) reduction trial as compared to a physical activity comparison group. Participants were enrolled into a six-month, community-based, controlled behavioral trial and randomized into either a SSB reduction group (SIPsmartER) or a physical activity group (MoveMore). Correlations and multilevel mixed-effects linear regression with intention-to-treat analyses are presented. Total HBI score significantly increased for SIPsmartER (n = 149) (mean increase = 7.5 points (5.4, 9.7), p ≤ 0.001) and MoveMore (n = 143) (mean increase = 3.4 points (1.6, 5.2), p ≤ 0.001) participants, with a significant between group effect (p ≤ 0.05), over the six-month intervention. Other significant changes in HBI components for SIPsmartER included increased SSB and total beverage calorie scores, and decreased low-fat milk and diet soda scores. Changes in total HBI scores were significantly correlated with changes in total Healthy Eating Index-2010 scores (r = 0.15, p ≤ 0.01). Our findings suggest that individual HBI component scores, beyond the SSB component, are influenced by intervention strategies that primarily focus on SSB reduction.

  10. Changes in the Healthy Beverage Index in Response to an Intervention Targeting a Reduction in Sugar-Sweetened Beverage Consumption as Compared to an Intervention Targeting Improvements in Physical Activity: Results from the Talking Health Trial

    Directory of Open Access Journals (Sweden)

    Valisa E. Hedrick

    2015-12-01

    Full Text Available The recently developed Healthy Beverage Index (HBI was designed to evaluate overall beverage intake quality (including total fluid consumption and beverage calories, yet no known intervention studies have assessed longitudinal changes to the HBI. The objective of this investigation was to assess changes in HBI scores in response to a sugar-sweetened beverage (SSB reduction trial as compared to a physical activity comparison group. Participants were enrolled into a six-month, community-based, controlled behavioral trial and randomized into either a SSB reduction group (SIPsmartER or a physical activity group (MoveMore. Correlations and multilevel mixed-effects linear regression with intention-to-treat analyses are presented. Total HBI score significantly increased for SIPsmartER (n = 149 (mean increase = 7.5 points (5.4, 9.7, p ≤ 0.001 and MoveMore (n = 143 (mean increase = 3.4 points (1.6, 5.2, p ≤ 0.001 participants, with a significant between group effect (p ≤ 0.05, over the six-month intervention. Other significant changes in HBI components for SIPsmartER included increased SSB and total beverage calorie scores, and decreased low-fat milk and diet soda scores. Changes in total HBI scores were significantly correlated with changes in total Healthy Eating Index-2010 scores (r = 0.15, p ≤ 0.01. Our findings suggest that individual HBI component scores, beyond the SSB component, are influenced by intervention strategies that primarily focus on SSB reduction.

  11. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial

    OpenAIRE

    2016-01-01

    Background A small group of frequent visitors to Emergency Departments accounts for a disproportionally large fraction of healthcare consumption including unplanned hospitalizations and overall healthcare costs. In response, several case and disease management programs aimed at reducing healthcare consumption in this group have been tested; however, results vary widely. Objectives To investigate whether a telephone-based, nurse-led case management intervention can reduce healthcare consumptio...

  12. Impact of Interventions Targeting Unhealthy Alcohol Use in Kenya on HIV Transmission and AIDS-Related Deaths

    OpenAIRE

    Braithwaite, R. Scott; Nucifora, Kimberly A; KESSLER, Jason; Toohey, Christopher; Mentor, Sherry M; Uhler, Lauren M.; Roberts, Mark S.; Bryant, Kendall

    2014-01-01

    Background HIV remains a major cause of preventable morbidity and mortality in Kenya. The effects of behaviors that accompany unhealthy alcohol consumption are a pervasive risk factor for HIV transmission and progression. Our objective was to estimate the portion of HIV infections attributable to unhealthy alcohol use and to evaluate the impact of hypothetical interventions directed at unhealthy alcohol use on HIV infections and deaths. Methods We estimated outcomes over a time horizon of 20 ...

  13. A systematic review of peer-support programs for smoking cessation in disadvantaged groups.

    Science.gov (United States)

    Ford, Pauline; Clifford, Anton; Gussy, Kim; Gartner, Coral

    2013-10-28

    The burden of smoking is borne most by those who are socially disadvantaged and the social gradient in smoking contributes substantially to the health gap between the rich and poor. A number of factors contribute to higher tobacco use among socially disadvantaged populations including social (e.g., low social support for quitting), psychological (e.g., low self-efficacy) and physical factors (e.g., greater nicotine dependence). Current evidence for the effectiveness of peer or partner support interventions in enhancing the success of quit attempts in the general population is equivocal, largely due to study design and lack of a theoretical framework in this research. We conducted a systematic review of peer support interventions for smoking cessation in disadvantaged groups. The eight studies which met the inclusion criteria showed that interventions that improve social support for smoking cessation may be of greater importance to disadvantaged groups who experience fewer opportunities to access such support informally. Peer-support programs are emerging as highly effective and empowering ways for people to manage health issues in a socially supportive context. We discuss the potential for peer-support programs to address the high prevalence of smoking in vulnerable populations and also to build capacity in their communities.

  14. A Systematic Review of Peer-Support Programs for Smoking Cessation in Disadvantaged Groups

    Directory of Open Access Journals (Sweden)

    Coral Gartner

    2013-10-01

    Full Text Available The burden of smoking is borne most by those who are socially disadvantaged and the social gradient in smoking contributes substantially to the health gap between the rich and poor. A number of factors contribute to higher tobacco use among socially disadvantaged populations including social (e.g., low social support for quitting, psychological (e.g., low self-efficacy and physical factors (e.g., greater nicotine dependence. Current evidence for the effectiveness of peer or partner support interventions in enhancing the success of quit attempts in the general population is equivocal, largely due to study design and lack of a theoretical framework in this research. We conducted a systematic review of peer support interventions for smoking cessation in disadvantaged groups. The eight studies which met the inclusion criteria showed that interventions that improve social support for smoking cessation may be of greater importance to disadvantaged groups who experience fewer opportunities to access such support informally. Peer-support programs are emerging as highly effective and empowering ways for people to manage health issues in a socially supportive context. We discuss the potential for peer-support programs to address the high prevalence of smoking in vulnerable populations and also to build capacity in their communities.

  15. Implementation of a Smoking Cessation Treatment Study at Substance Abuse Rehabilitation Programs: Smoking Behavior and Treatment Feasibility Across Varied Community-based Outpatient Programs.

    Science.gov (United States)

    Reid, Malcolm S; Fallon, Bryan; Sonne, Susan; Nunes, Edward V; Lima, Jennifer; Jiang, Huiping; Tyson, Clare; Hiott, Robert; Arfken, Cynthia; Bohs, Rhonda; Orr, Deborah; Muir, Joan; Pihlgren, Eric; Loree, Amy; Fuller, Brett E; Giordano, Louis; Robinson, James; Rotrosen, John

    2007-09-01

    Cigarette smoking is widely prevalent among individuals in treatment for drug or alcohol dependence; however, the treatment of nicotine addiction in this population has numerous obstacles at both programmatic and patient levels. Despite these difficulties, recent studies have demonstrated moderate success in implementing smoking cessation treatment in drug rehabilitation programs. The National Drug Abuse Treatment Clinical Trials Network sponsored a smoking cessation study in 13 community-based outpatient substance abuse rehabilitation programs across the country. The study evaluated the effectiveness of smoking cessation treatment provided as an adjunct to substance abuse treatment-as-usual. This report summarizes the practical and clinical experiences encountered at each of the study sites with regard to implementing the smoking cessation treatment intervention. Smoking behavior of the treatment clientele was assessed by anonymous survey at each site. In addition, sites were systematically characterized by using program review and assessment tools completed by the respective staff and program directors at the site. Survey and recruitment data indicated that cigarette smoking is more prevalent and that smoking cessation treatment is more feasible, in methadone maintenance treatment programs. Other factors associated with smoking behavior and with the recruitment of drug- and alcohol-dependent individuals into the smoking cessation treatment study are described.

  16. Assessment of Assistance in Smoking Cessation Therapy by Pharmacies in Collaboration with Medical Institutions- Implementation of a Collaborative Drug Therapy Management Protocol Based on a Written Agreement between Physicians and Pharmacists.

    Science.gov (United States)

    Watanabe, Fumiyuki; Shinohara, Kuniko; Dobashi, Akira; Amagai, Kenji; Hara, Kazuo; Kurata, Kaori; Iizima, Hideo; Shimakawa, Kiyoshi; Shimada, Masahiko; Abe, Sakurako; Takei, Keiji; Kamei, Miwako

    2016-01-01

    This study built a protocol for drug therapy management (hereinafter "the protocol") that would enable continuous support from the decision making of smoking cessation therapy to the completion of therapy through the collaboration of physicians and community pharmacists, after which we evaluated whether the use of this protocol would be helpful to smoking cessation therapy. This study utilized the "On the Promotion of Team-Based Medical Care", a Notification by the Health Policy Bureau as one of the resources for judgment, and referred to collaborative drug therapy management (CDTM) in the United States. After the implementation of this protocol, the success rate of smoking cessation at the participating medical institutions rose to approximately 70%, approximately 28-point improvement compared to the rate before the implementation. In addition to the benefits of the standard smoking cessation program, this result may have been affected by the intervention of pharmacists, who assisted in continuing cessation by advising to reduce drug dosage as necessary approximately one week after the smoking cessation, when side effects and the urge to smoke tend to occur. Additionally, the awareness survey for the intervention group revealed that all respondents, including patients who failed to quit smoking, answered that they were satisfied to the question on general satisfaction. The question about the reason for successful cessation revealed that the support by pharmacists was as important as, or more important than, that by physicians and nurses. This infers that the pharmacists' active engagement in drug therapy for individual patients was favorably acknowledged.

  17. Smoking reduction and cessation reduce chronic cough in a general population: the Inter99 study

    DEFF Research Database (Denmark)

    Pisinger, Charlotta; Godtfredsen, Nina; Jørgensen, Torben

    2008-01-01

    Background: Chronic cough can be the first sign of chronic obstructive disease. A few, and mostly selected, studies exploring the effect of reduced daily tobacco consumption have shown a small effect on pulmonary symptoms. Aim: The aim of this study was to examine if smoking reduction (SR) (>= 50......% of daily tobacco consumption) or smoking cessation (SC) had an effect on chronic cough and phlegm. Methods: A total of 2408 daily smokers were included in a Danish population-based intervention study, Inter99. In the analyses, we included smokers with self-reported chronic cough or phlegm at baseline who...

  18. Smoking cessation treatment in community-based substance abuse rehabilitation programs.

    Science.gov (United States)

    Reid, Malcolm S; Fallon, Bryan; Sonne, Susan; Flammino, Frank; Nunes, Edward V; Jiang, Huiping; Kourniotis, Eva; Lima, Jennifer; Brady, Ron; Burgess, Cynthia; Arfken, Cynthia; Pihlgren, Eric; Giordano, Louis; Starosta, Aron; Robinson, James; Rotrosen, John

    2008-07-01

    Nicotine dependence is highly prevalent among drug- and alcohol-dependent patients. A multisite clinical trial of smoking cessation (SC) treatment was performed at outpatient community-based substance abuse rehabilitation programs affiliated with the National Drug Abuse Treatment, Clinical Trials Network. Cigarette smokers (N=225) from five methadone maintenance programs and two drug and alcohol dependence treatment programs were randomly assigned in a 2:1 ratio to receive either (1) SC treatment as an adjunct to substance abuse treatment-as-usual (TAU) or (2) substance abuse TAU. Smoking cessation treatment consisted of 1 week of group counseling before the target quit date and 8 weeks of group counseling plus transdermal nicotine patch treatment (21 mg/day for Weeks 1-6 and 14 mg/day for Weeks 7 and 8) after the target quit date. Smoking abstinence rates in SC, 10%-11% during treatment and 5%-6% at the 13- and 26-week follow-up visits, were significantly better than those in TAU during treatment (p< .01). In addition, SC was associated with significantly greater reductions as compared with TAU in cigarettes smoked per day (75% reduction, p< .001), exhaled carbon monoxide levels (p< .001), cigarette craving (p< .05), and nicotine withdrawal (p< .05). Smoking cessation did not differ from TAU on rates of retention in substance abuse treatment, abstinence from primary substance of abuse, and craving for primary substance of abuse. Compliance with SC treatment, moderate at best, was positively associated with smoking abstinence rates. Smoking cessation treatment resulted in significant reductions in daily smoking and modest smoking abstinence rates without having an adverse impact on substance abuse rehabilitation when given concurrently with outpatient substance abuse treatment. Substance abuse treatment programs should not hesitate to implement SC for established patients.

  19. Effect of self-administered auricular acupressure on smoking cessation --a pilot study

    Directory of Open Access Journals (Sweden)

    Leung Lawrence

    2012-02-01

    Full Text Available Abstract Background Tobacco smoking is still a worldwide health risk. Current pharmacotherapies have at best, a success rate of no more than 50%. Auricular (ear acupressure has been purported to be beneficial in achieving smoking cessation in some studies, while in others has been deemed insignificant. We hereby describe the protocol for a three-arm randomised controlled trial to examine the possible benefits of self-administered acupressure for smoking cessation. Methods Sixty consenting participants with confirmed habit of tobacco smoking will be recruited and randomized into three arms to receive either auricular acupressure at five true acupoints (NADA protocol, auricular acupressure at five sham points, or no auricular acupressure at all. Participants having auricular acupressure will exert firm pressure to each acupoint bilaterally via the bead in the attached plasters whenever they feel the urge to smoke. The treatment phase will last for six weeks during which all participants will be assessed weekly to review their smoking log, state of abstinence, end-exhalation carbon monoxide levels and possible adverse effects including withdrawal reactions and stress levels. At any time, a successful quit date will be defined with continuous abstinence for the following consecutive 7 days. From then on, participants will be evaluated individually for continuous abstinence rate (CAR, end-exhalation carbon monoxide levels and adverse effects of stress and withdrawal at specified intervals up to 26 weeks. Expectancy of treatment will be assessed with a four-item Borkovec and Nau self-assessment credibility scale during and after intervention. Discussion We incorporate validated outcome measures of smoking cessation into our randomised controlled trial design with the objectives to evaluate the feasibility and possible benefits of self-administered auricular acupressure as a non-invasive alternative to pharmacotherapy for smoking cessation. Trial

  20. Cost-effectiveness of smoking cessation to prevent age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Matthews Jane P

    2008-09-01

    Full Text Available Abstract Background Tobacco smoking is a risk factor for age-related macular degeneration, but studies of ex-smokers suggest quitting can reduce the risk. Methods We fitted a function predicting the decline in risk of macular degeneration after quitting to data from 7 studies involving 1,488 patients. We assessed the cost-effectiveness of smoking cessation in terms of its impact on macular degeneration-related outcomes for 1,000 randomly selected U.S. smokers. We used a computer simulation model to predict the incidence of macular degeneration and blindness, the number of quality-adjusted life-years (QALYs, and direct costs (in 2004 U.S. dollars until age 85 years. Cost-effectiveness ratios were based on the cost of the Massachusetts Tobacco Control Program. Costs and QALYs were discounted at 3% per year. Results If 1,000 smokers quit, our model predicted 48 fewer cases of macular degeneration, 12 fewer cases of blindness, and a gain of 1,600 QALYs. Macular degeneration-related costs would decrease by $2.5 million if the costs of caregivers for people with vision loss were included, or by $1.1 million if caregiver costs were excluded. At a cost of $1,400 per quitter, smoking cessation was cost-saving when caregiver costs were included, and cost about $200 per QALY gained when caregiver costs were excluded. Sensitivity analyses had a negligible impact. The cost per quitter would have to exceed $77,000 for the cost per QALY for smoking cessation to reach $50,000, a threshold above which interventions are sometimes viewed as not cost-effective. Conclusion Smoking cessation is unequivocally cost-effective in terms of its impact on age-related macular degeneration outcomes alone.

  1. Healthy babies through infant-centered feeding protocol: an intervention targeting early childhood obesity in vulnerable populations

    Directory of Open Access Journals (Sweden)

    Horodynski Mildred A

    2011-11-01

    Full Text Available Abstract Background Poor feeding practices during infancy contribute to obesity risk. As infants transition from human milk and/or formula-based diets to solid foods, these practices interfere with infant feeding self-regulation and healthy growth patterns. Compared with other socioeconomic groups, lower-income mothers are more likely to experience difficulty feeding their infants. This may include misinterpreting feeding cues and using less-than-optimal feeding styles and practices, such as pressuring infants during mealtimes and prematurely introducing solid food and sweetened beverages. The Healthy Babies trial aims to determine the efficacy of a community-based randomized controlled trial of an in-home intervention with economically and educationally disadvantaged mother-infant dyads. The educational intervention is being conducted during the infant's first 6 months of life to promote healthy transition to solids during their first year and is based on the theory of planned behavior. Methods/Design We will describe our study protocol for a multisite randomized control trial being conducted in Colorado and Michigan with an anticipated sample of 372 economically and educationally disadvantaged African American, Hispanic, and Caucasian mothers with infants. Participants are being recruited by county community agency staff. Participants are randomly assigned to the intervention or the control group. The intervention consists of six in-home visits by a trained paraprofessional instructor followed by three reinforcement telephone contacts when the baby is 6, 8, and 10 months old. Main maternal outcomes include a maternal responsiveness, b feeding style, and c feeding practices. Main infant outcome is infant growth pattern. All measures occur at baseline and when the infant is 6 and 12 months old. Discussion If this project is successful, the expected outcomes will address whether the home-based early nutrition education intervention is effective

  2. Targeting Feeding and Eating Behaviors: Development of the Feeding Dynamic Intervention for Caregivers of 2- to 5-Year-Old Children

    Directory of Open Access Journals (Sweden)

    Ihuoma U. Eneli

    2015-01-01

    Full Text Available Targeting feeding dynamics, a concept centered on the roles and interaction of the caregiver and child in a feeding relationship, may have significant potential for obesity intervention. The aim of this paper is to describe the 3-phase development of the Feeding Dynamics Intervention (FDI, an acceptability and feasibility study on implementing the feeding dynamic roles (Study 1, development of the FDI content (Study 2, and a pilot study on use of the 6-lesson FDI to promote behaviors consistent with a feeding dynamic approach (Study 3. Sample population was mothers with young children, 2–5 years old. An effect size (Hedges’ g greater than 0.20 was seen in more than half (57% of maternal feeding behaviors, with the largest effect sizes (Hedges’ g≥0.8 occurring with behaviors that represent the mother adopting her roles of determining what food is served, not using food as a reward, and not controlling her child’s intake. There was a significant decline in Pressure to Eat behaviors (2.9 versus 2.2, p<0.01 and Monitoring (4.1 versus 3.5, p<0.001. The FDI emerged as an acceptable and implementable intervention. Future studies need to investigate effects of the FDI on the child’s eating behaviors, self-regulation of energy intake, and anthropometrics.

  3. An Exploratory Study of the Effects of Mind-Body Interventions Targeting Sleep on Salivary Oxytocin Levels in Cancer Survivors.

    Science.gov (United States)

    Lipschitz, David L; Kuhn, Renee; Kinney, Anita Y; Grewen, Karen; Donaldson, Gary W; Nakamura, Yoshio

    2015-07-01

    Cancer survivors experience high levels of distress, associated with a host of negative psychological states, including anxiety, depression, and fear of recurrence, which often lead to sleep problems and reduction in quality of life (QOL) and well-being. As a neuropeptide hormone associated with affiliation, calmness, and well-being, oxytocin may be a useful biological measure of changes in health outcomes in cancer survivors. In this exploratory study, which comprised a subset of participants from a larger study, we evaluated (a) the feasibility and reliability of salivary oxytocin (sOT) levels in cancer survivors and (b) the effects of 2 sleep-focused mind-body interventions, mind-body bridging (MBB) and mindfulness meditation (MM), compared with a sleep hygiene education (SHE) control, on changes in sOT levels in 30 cancer survivors with self-reported sleep disturbance. Interventions were conducted in 3 sessions, once per week for 3 weeks. Saliva samples were collected at baseline, postintervention (~1 week after the last session), and at the 2-month follow-up. In this cancer survivor group, we found that intra-individual sOT levels were fairly stable across the 3 time points, of about 3 months' duration, and mean baseline sOT levels did not differ between females and males and were not correlated with age. Correlations between baseline sOT and self-report measures were weak; however, several of these relationships were in the predicted direction, in which sOT levels were negatively associated with sleep problems and depression and positively associated with cancer-related QOL and well-being. Regarding intervention effects on sOT, baseline-subtracted sOT levels were significantly larger at postintervention in the MBB group as compared with those in SHE. In this sample of cancer survivors assessed for sOT, at postintervention, greater reductions in sleep problems were noted for MBB and MM compared with that of SHE, and increases in mindfulness and self

  4. Does Acceptance and Relationship Focused Behavior Therapy Contribute to Bupropion Outcomes? A Randomized Controlled Trial of Functional Analytic Psychotherapy and Acceptance and Commitment Therapy for Smoking Cessation

    Science.gov (United States)

    Gifford, Elizabeth V.; Kohlenberg, Barbara S.; Hayes, Steven C.; Pierson, Heather M.; Piasecki, Melissa P.; Antonuccio, David O.; Palm, Kathleen M.

    2011-01-01

    This study evaluated a treatment combining bupropion with a novel acceptance and relationship focused behavioral intervention based on the acceptance and relationship context (ARC) model. Three hundred and three smokers from a community sample were randomly assigned to bupropion, a widely used smoking cessation medication, or bupropion plus…

  5. Situational temptation scores and smoking cessation in general care.

    Science.gov (United States)

    Breitling, Lutz Philipp; Twardella, Dorothee; Raum, Elke; Brenner, Hermann

    2009-06-01

    The construct of self-efficacy, which is assessed either in confidence- or temptation-related instruments, presumably predicts transitions between the transtheoretical model stages of change and ultimately smoking cessation outcome. To elucidate its predictive potential for smoking cessation in a general care setting, we examined the association of baseline scores of the situational temptations inventory with month 12 smoking status in 577 heavy smokers participating in a cluster-randomized study of physician training and financial incentives for smoking cessation in Germany. At follow-up, abstinence could be validated in 56 patients. The temptation sub- and total scores were not bivariately associated with altered odds of smoking cessation, in contrast to established predictors like the Fagerstrom test of nicotine dependence and the stages of change. They were associated with the Fagerstrom scores, but not with the stages of change. Controlling for both cessation predictors, in particular the positive/social temptation subscore was associated with quitting. Additional studies are needed to fully understand how situational temptations relate to smoking cessation outcomes and explain variance beyond that of more established predictors of cessation.

  6. Menthol Cigarettes, Time to First Cigarette, and Smoking Cessation

    Directory of Open Access Journals (Sweden)

    Sanders Edward

    2017-01-01

    Full Text Available The goal of the present work is to determine if menthol and non-menthol cigarette smokers differ with respect to time to first cigarette (TTFC and successful smoking cessation via a meta-analysis of published results. For 13 independent estimates, menthol smokers were slightly but statistically significantly more likely to exhibit TTFC ≤ 5 min (random-effects odds ratio (OR = 1.12; 95% confidence interval (CI, 1.04–1.21, while 17 independent estimates provided a non-significant difference for TTFC ≤ 30 min (random-effects OR = 1.06; 95% CI, 0.96–1.16. For cessation studies, meta-analysis of 30 published estimates indicated a decreased likelihood for menthol cigarette smokers to quit (random-effects OR = 0.87; 95% CI, 0.80–0.96. There was no difference between cessation rates for Caucasian menthol and non-menthol cigarette smokers, but the results support that African American menthol cigarette smokers find it more difficult to quit. Adjustment of cessation for socioeconomic status eliminated any statistically significant advantage for smoking cessation in non-menthol smokers. In conclusion, these results suggest that the observed differences in cessation rates between menthol and non-menthol cigarette smokers are likely explained by differences in socioeconomic status and also suggest that TTFC may not be a robust predictor of successful smoking cessation.

  7. Negative rebound in hippocampal neurogenesis following exercise cessation.

    Science.gov (United States)

    Nishijima, Takeshi; Kamidozono, Yoshika; Ishiizumi, Atsushi; Amemiya, Seiichiro; Kita, Ichiro

    2017-03-01

    Physical exercise can improve brain function, but the effects of exercise cessation are largely unknown. This study examined the time-course profile of hippocampal neurogenesis following exercise cessation. Male C57BL/6 mice were randomly assigned to either a control (Con) or an exercise cessation (ExC) group. Mice in the ExC group were reared in a cage with a running wheel for 8 wk and subsequently placed in a standard cage to cease the exercise. Exercise resulted in a significant increase in the density of doublecortin (DCX)-positive immature neurons in the dentate gyrus (at week 0). Following exercise cessation, the density of DCX-positive neurons gradually decreased and was significantly lower than that in the Con group at 5 and 8 wk after cessation, indicating that exercise cessation leads to a negative rebound in hippocampal neurogenesis. Immunohistochemistry analysis suggests that the negative rebound in neurogenesis is caused by diminished cell survival, not by suppression of cell proliferation and neural maturation. Neither elevated expression of ΔFosB, a transcription factor involved in neurogenesis regulation, nor increased plasma corticosterone, were involved in the negative neurogenesis rebound. Importantly, exercise cessation suppressed ambulatory activity, and a significant correlation between change in activity and DCX-positive neuron density suggested that the decrease in activity is involved in neurogenesis impairment. Forced treadmill running following exercise cessation failed to prevent the negative neurogenesis rebound. This study indicates that cessation of exercise or a decrease in physical activity is associated with an increased risk for impaired hippocampal function, which might increase vulnerability to stress-induced mood disorders.

  8. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students), Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study

    Science.gov (United States)

    Piotrowicz, Karolina; Rewiuk, Krzysztof; Halicka, Monika; Kalwak, Weronika; Rybak, Paulina

    2017-01-01

    Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. Results. 130 patients (38.4% males) participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. Conclusion. Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward. PMID:28164113

  9. Factors associated with cessation of sunbed use among Danish women

    DEFF Research Database (Denmark)

    Wøhlk, Ida Marie Rye; Philipsen, Peter Alshede; Wulf, Hans Christian

    2016-01-01

    with cessation were: age above 24, medium to high level of education, non-smoking, not being bothered by appearing white on the beach, and being unconcerned about friends' sunbed use. Binary logistic regression further showed a significant association between cessation and low income, after adjusting for age....... The most indicated reason for cessation was fear of skin cancer. CONCLUSION: Sunbed use could possibly be reduced by introducing a lower age limit of 18 and demanding staffed tanning salons. The age limit would allow young people to become more mature and self-confident before deciding on using a sunbed...

  10. Countdown to 2015: Tracking Maternal and Child Health Intervention Targets Using Lot Quality Assurance Sampling in Bauchi State Nigeria.

    Directory of Open Access Journals (Sweden)

    Dele Abegunde

    Full Text Available Improving maternal and child health remains a top priority in Nigeria's Bauchi State in the northeastern region where the maternal mortality ratio (MMR and infant mortality rate (IMR are as high as 1540 per 100,000 live births and 78 per 1,000 live births respectively. In this study, we used the framework of the continuum of maternal and child care to evaluate the impact of interventions in Bauchi State focused on improved maternal and child health, and to ascertain progress towards the achievement of Millennium Development Goals (MDGs 4 and 5.At baseline (2012 and then at follow-up (2013, we randomly sampled 340 households from 19 random locations in each of the 20 Local Government Areas (LGA of Bauchi State in Northern Nigeria, using the Lot Quality Assurance Sampling (LQAS technique. Women residents in the households were interviewed about their own health and that of their children. Estimated LGA coverage of maternal and child health indicators were aggregated across the State. These values were then compared to the national figures, and the differences from 2012 to 2014 were calculated.For several of the indicators, a modest improvement from baseline was found. However, the indicators in the continuum of care neither reached the national average nor attained the 90% globally recommended coverage level. The majority of the LGA surveyed were classifiable as high priority, thus requiring intensified efforts and programmatic scale up.Intensive scale-up of programs and interventions is needed in Bauchi State, Northern Nigeria, to accelerate, consolidate and sustain the modest but significant achievements in the continuum of care, if MDGs 4 and 5 are to be achieved by the end of 2015. The intentional focus of LGAs as the unit of intervention ought to be considered a condition precedent for future investments. Priority should be given to the re-allocating resources to program areas and regions where coverage has been low. Finally, systematic

  11. Risk reduction: perioperative smoking intervention

    DEFF Research Database (Denmark)

    Møller, Ann; Tønnesen, Hanne

    2006-01-01

    of postoperative intensive care admission. Even passive smoking is associated with increased risk at operation. Preoperative smoking intervention 6-8 weeks before surgery can reduce the complications risk significantly. Four weeks of abstinence from smoking seems to improve wound healing. An intensive, individual......Smoking is a well-known risk factor for perioperative complications. Smokers experience an increased incidence of respiratory complications during anaesthesia and an increased risk of postoperative cardiopulmonary complications, infections and impaired wound healing. Smokers have a greater risk...... approach to smoking intervention results in a significantly better postoperative outcome. Future research should focus upon the effect of a shorter period of preoperative smoking cessation. All smokers admitted for surgery should be informed of the increased risk, recommended preoperative smoking cessation...

  12. Risk reduction: perioperative smoking intervention

    DEFF Research Database (Denmark)

    Møller, Ann; Tønnesen, Hanne

    2006-01-01

    Smoking is a well-known risk factor for perioperative complications. Smokers experience an increased incidence of respiratory complications during anaesthesia and an increased risk of postoperative cardiopulmonary complications, infections and impaired wound healing. Smokers have a greater risk...... of postoperative intensive care admission. Even passive smoking is associated with increased risk at operation. Preoperative smoking intervention 6-8 weeks before surgery can reduce the complications risk significantly. Four weeks of abstinence from smoking seems to improve wound healing. An intensive, individual...... approach to smoking intervention results in a significantly better postoperative outcome. Future research should focus upon the effect of a shorter period of preoperative smoking cessation. All smokers admitted for surgery should be informed of the increased risk, recommended preoperative smoking cessation...

  13. Disparities in Prevalence of Smoking and Smoking Cessation during Pregnancy: A Population-Based Study

    Directory of Open Access Journals (Sweden)

    Josiane L. Dias-Damé

    2015-01-01

    Full Text Available Objective. To examine time trends in prevalence of smoking and smoking cessation during pregnancy by family income, maternal level of education, skin color, and age. Methods. We conducted three population-based surveys in 2007, 2010, and 2013 with newly delivered mothers living in the municipality of Rio Grande, Southern Brazil. Data were collected using questionnaires administered after delivery in all (two maternity units in the city, at Dr. Miguel Riet Corrêa Júnior Hospital and at Santa Casa de Misericórdia. Time trends were analyzed using chi-square test for linear trend. Results. Data of 7,572 women showed that the prevalence of smoking before pregnancy decreased from 28% (26.2–29.7 in 2007 to 22% (20.8–24.0 in 2013 (P<0.001. Prevalence of smoking during pregnancy decreased from 22% (20.4–23.7 in 2007 to 18% (16.6–19.5 in 2013 (P<0.001. This reduction varied across income ranging from 17% (poorest to 35% (richest (P<0.001. The lower the income, the higher the smoking prevalence during pregnancy. Smoking cessation was more prevalent among women of higher level of education and income. Conclusions. Smoking before and during pregnancy is still highly prevalent and the prevalence of cessation is low pointing to a need to strengthen actions targeting low-income, less educated, black pregnant women.

  14. A Concept for a Low Pressure Noble Gas Fill Intervention in the IFE Fusion Test Facility (FTF) Target Chamber

    Energy Technology Data Exchange (ETDEWEB)

    Gentile, C. A.; Blanchard, W. R.; Kozub, T. A.; Aristova, M.; McGahan, C.; Natta, S.; Pagdon, K.; Zelenty, J.

    2010-01-14

    An engineering evaluation has been initiated to investigate conceptual engineering methods for implementing a viable gas shield strategy in the Fusion Test Facility (FTF) target chamber. The employment of a low pressure noble gas in the target chamber to thermalize energetic helium ions prior to interaction with the wall could dramatically increase the useful life of the first wall in the FTF reactor1. For the purpose of providing flexibility, two target chamber configurations are addressed: a five meter radius sphere and a ten meter radius sphere. Experimental studies at Nike have indicated that a low pressure, ambient gas resident in the target chamber during laser pulsing does not appear to impair the ability of laser light from illuminating targets2. In addition, current investigations into delivering, maintaining, and processing low pressure gas appear to be viable with slight modification to current pumping and plasma exhaust processing technologies3,4. Employment of a gas fill solution for protecting the dry wall target chamber in the FTF may reduce, or possibly eliminate the need for other attenuating technologies designed for keeping He ions from implanting in first wall structures and components. The gas fill concept appears to provide an effective means of extending the life of the first wall while employing mostly commercial off the shelf (COTS) technologies. Although a gas fill configuration may provide a methodology for attenuating damage inflicted on chamber surfaces, issues associated with target injection need to be further analyzed to ensure that the gas fill concept is viable in the integrated FTF design5. In the proposed system, the ambient noble gas is heated via the energetic helium ions produced by target detonation. The gas is subsequently cooled by the chamber wall to approximately 800oC, removed from the chamber, and processed by the chamber gas processing system (CGPS). In an optimized scenario of the above stated concept, the chamber

  15. Issues to consider when setting intervention targets with limited data for low-moisture food commodities: a peanut case study.

    Science.gov (United States)

    Schaffner, Donald W; Buchanan, Robert L; Calhoun, Stephen; Danyluk, Michelle D; Harris, Linda J; Djordjevic, Darinka; Whiting, Richard C; Kottapalli, Bala; Wiedmann, Martin

    2013-02-01

    Peanuts and peanut-containing products have been linked to at least seven salmonellosis outbreaks worldwide in the past two decades. In response, the Technical Committee on Food Microbiology of the North American Branch of the International Life Sciences Institute collaborated with the American Peanut Council to convene a workshop to develop a framework for managing risk in low-moisture food commodities where large data sets are unavailable (using peanuts as the example). Workshop attendees were charged with answering questions regarding the appropriate statistical and scientific methods for setting log reduction targets with limited pathogen prevalence and concentration data, suitable quantities of data needed for determining appropriate log reduction targets, whether the requirement of a 5-log reduction in the absence of data to establish a target log reduction is appropriate, and what targeted log reduction would protect public health. This report concludes that the judgment about sufficient data is not solely scientific, but is instead a science-informed policy decision that must weigh additional societal issues. The participants noted that modeling efforts should proceed with sampling efforts, allowing one to compare various assumptions about prevalence and concentration and how they are combined. The discussions made clear that data and risk models developed for other low-moisture foods like almonds and pistachios may be applicable to peanuts. Workshop participants were comfortable with the use of a 5-log reduction for controlling risk in products like peanuts when the level of contamination of the raw ingredients is low (food safety community may eventually conclude that as additional data, assumptions, and models are developed, alternatives to a 5-log reduction might also result in the desired level of protection for peanuts and peanut products.

  16. Obesity and early cessation of breastfeeding in Denmark

    DEFF Research Database (Denmark)

    Kronborg, Hanne; Væth, Michael; Rasmussen, Kathleen M.

    2013-01-01

    the association between high BMI and early cessation of breastfeeding Methods: We used data from a randomized trial of 1597 Danish mothers of singleton infants. Self-reported Maternal postnatal weight and height were available from 1375 (86 %). High BMI was defined as body mass index ≥32 kg/m2 at ~ 17 d after......Background: Obesity is associated with early cessation of breastfeeding. Breastfeeding is multi-factorial and several factors contribute to this association. Our aim was to investigate to what extent socio-demographic and psychosocial characteristics, parity and prenatal conditions could explain...... delivery. Outcome was cessation of exclusive breastfeeding by 17 wk postpartum used in proportional hazards regression models. Results: In the unadjusted analysis mothers with high postpartum BMI compared to other mothers had a significantly higher rate of cessation of exclusive breastfeeding, and were...

  17. Medicaid Coverage Of Cessation Treatments And Barriers To Treatments

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2008-2016. American Lung Association. Cessation Coverage. Medicaid data compiled by the Centers for Disease Control and Prevention’s Office on Smoking and Health...

  18. Smoking cessation in women: findings from qualitative research.

    Science.gov (United States)

    Puskar, M

    1995-11-01

    The purpose of this descriptive exploratory study is to describe the experience of successful smoking cessation in adult women. The convenience sample included 10 women, ages 25 to 42, who had abstained from smoking for at least 6 months but not longer than 3 years. A semistructured interview format was used to elicit descriptions of the experience of successful smoking cessation from these subjects. The interview format explored the experience, including initial contemplation, the process of quitting, and maintenance of smoking abstinence. Interviews were audiotaped, transcribed, and then analyzed using methods outlined by Miles and Huberman [1]. Four themes emerged from the data: evolving commitment to health and personal growth, being stigmatized, changing conceptualization of smoking, and smoking cessation as a relational phenomenon. These findings were consistent with Pender's Health Promotion Model and have implications for nurse practitioners who counsel women on smoking cessation.

  19. Depressive Symptoms, Drinking Problems, and Smoking Cessation in Older Smokers

    Science.gov (United States)

    Kenney, Brent A.; Holahan, Charles J.; Holahan, Carole K.; Brennan, Penny L.; Schutte, Kathleen K.; Moos, Rudolf H.

    2009-01-01

    This study modeled the predictive association between depressive symptoms and smoking cessation in a sample of 442 late-middle-aged smokers; assessments occurred at four time-points across a 10-year period. In addition, the study examined the role of baseline drinking problems in moderating the relationship between depressive symptoms and smoking cessation. Findings supported hypotheses. More depressive symptoms prospectively predicted a lower likelihood of smoking cessation. In addition, the presence of baseline drinking problems strengthened the relationship between depressive symptoms and a lower likelihood of smoking cessation. Understanding the mechanisms underlying depression and cigarette smoking among older adults is applicable to secondary prevention and treatment and suggests additional public health benefits from treating depression in older persons. PMID:19372009

  20. Real-world uptake of a tailored, text message pregnancy smoking cessation programme (MiQuit) when offered online

    OpenAIRE

    Emery, Joanne; Coleman, Tim; Sutton, Stephen; Cooper, Sue; Leonardi-Bee, Jo; Jones, Matthew; Naughton, Felix

    2016-01-01

    Background: Prenatal smoking is a major public health concern and uptake of NHS cessation support is low in this group. Text message-based self-help is a promising intervention for this population but little is known about its likely real-world uptake, an essential parameter for estimating public health impact. Aims were to explore uptake (including cost) of a tailored, theory-guided, text message intervention for pregnant smokers (‘MiQuit’) when offered online. Methods: Links to a website pr...

  1. Assessment of professional competency and need of smoking cessation counseling for dental students

    Directory of Open Access Journals (Sweden)

    Rajani A. Dable

    2014-10-01

    Full Text Available Purpose: The aim of this study was to analyze the smoking prevalence among dental students and to assess the need for promoting tobacco education and intervention by exploring their knowledge about smoking related risk factors. The study also examined the attitudes and practices of the students toward tobacco consumption, and their responsibilities toward the community. Methods: In total, 53 male students participated in the study (21 juniors and 32 seniors. The training program was divided into three modules, and the questionnaire was administered before and after the counseling sessions, which provided the comparative data on the students’ views about smoking cessation. Results: The most commonly practiced mode of tobacco consumption was found to be cigarette smoking (90.6 %, while a few consumed Gutkha (9.4%. All the junior students (100% reported to have been benefitted by the counseling program, while 68.8% of the students from the senior group reported the same. Bivariate statistical analysis was conducted using the Pearson’s chi-square test for testing the difference across the age groups. P-values less than 0.05 were considered statistically significant. Conclusion: Curbing tobacco influence on dental students in their initial days can ensure a smoke-free life for them, as well as prevents them from feeling embarrassed or experiencing a lack of confidence while seeing their patients. Thus, tobacco education and intervention programs can motivate the students and increase their potential to be credible advisors regarding smoking cessation.

  2. Association between Positivity and Smoking Cessation

    Directory of Open Access Journals (Sweden)

    Maria Caterina Grassi

    2014-01-01

    Full Text Available The literature documents that personality characteristics are associated with healthy lifestyles, including smoking. Among positive traits, Positivity (POS, defined as a general disposition conducive to facing experience under a positive outlook has shown robust associations with psychological health. Thus, the present study investigated the extent to which POS is able to predict (i relapse after quitting smoking and (ii the desire to smoke again. All participants (481 had previously attended a Group Counselling Program (GCP for Smoking Cessation (from 2005 through 2010. They were contacted through telephone interview. Among participants, 244 were ex-smokers (age: years 56.3±10.08, 52% female and 237 were still-smokers (age: years 55.0±9.63; 63.5% female. The association of POS with “craving to smoke” levels was assessed with multivariate linear regression analysis while controlling also for important differences in personality such as conscientiousness and general self-efficacy, as well as for gender and age. Results showed that POS was significantly and negatively associated with smoking status and with craving to smoke. Among covariates (i.e., conscientiousness, generalized self-efficacy, gender was associated with smoking status and with craving to smoke. Altogether these findings corroborate the idea that POS plays a significant role in sustaining individuals' efforts to quit smoking.

  3. Psychosocial, behavioural, and health determinants of successful smoking cessation

    DEFF Research Database (Denmark)

    Osler, M; Prescott, E

    1998-01-01

    OUTCOME MEASURE: Smoking status (abstinent for one year or more) at follow up. RESULTS: At follow up 15% of the baseline smokers had been abstinent for one year or more. In multivariate analysis, successful smoking cessation was associated with older age, high social status, low prior tobacco consumption...... with no such motivation. Age, social status, spouse/cohabitant's smoking behaviour, and the daily consumption of tobacco predict success in smoking cessation, irrespective of smokers' former motivation to stop....

  4. The effectiveness of workplace smoking cessation programmes: a meta-analysis of recent studies

    Science.gov (United States)

    Smedslund, G; Fisher, K; Boles, S; Lichtenstein, E

    2004-01-01

    Data sources: ABI/Inform, BRS, CHID, Dissertation Abstracts International, ERIC, Medline, Occupational Health and Safety Database, PsycInfo, Smoking and Health Database, SSCI, and Sociological Abstracts. Study selection: Controlled smoking cessation interventions at the workplace with at least six months follow up published from 1989 to 2001 and reporting quit rates (QRs). Data extraction: Two reviewers independently scanned titles/abstracts of relevant reports, and we reached consensus regarding inclusion/exclusion of the full text reports by negotiation. A third reviewer resolved disagreements. Two reviewers extracted data according to a coding manual. Consensus was again reached through negotiation and the use of a third reviewer. Data synthesis: 19 journal articles were found reporting studies conforming to the study's inclusion criteria. Interventions included self help manuals, physician advice, health education, cessation groups, incentives, and competitions. A total of 4960 control subjects were compared with 4618 intervention subjects. The adjusted random effects odds ratio was 2.03 (95% confidence interval 1.42 to 2.90) at six months follow up, 1.56 (95% CI 1.17 to 2.07) at 12 months, and 1.33 (95% CI 0.95 to 1.87) at more than 12 months follow up. Funnel plots were consistent with strong publication bias at the first two follow ups but not the third. In Fisher et al's 1990 study, the corresponding ORs were 1.18, 1.66, and 1.18. Conclusions: Smoking cessation interventions at the worksite showed initial effectiveness, but the effect seemed to decrease over time and was not present beyond 12 months. Compared to the Fisher (1990) analysis, the effectiveness was higher for the six month follow up. Disappointingly, we found methodological inadequacies and insufficient reporting of key variables that were similar to those found in the earlier meta-analysis. This prevented us from determining much about the most effective components of interventions. It is

  5. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students, Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study

    Directory of Open Access Journals (Sweden)

    Stanislaw Gorski

    2017-01-01

    Full Text Available Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students, targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards. Every day trained volunteers delivered a multicomponent standardized intervention targeted at risk factors of in-hospital complications to the intervention group. The control group, selected using a retrospective individual matching strategy (1 : 1 ratio, regarding age, gender, and time of hospitalization, received standard care. Outcome Measures. Hospitalization time, deaths, falls, delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. Results. 130 patients (38.4% males participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. Conclusion. Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward.

  6. Accuracy of self-reported smoking cessation during pregnancy

    Science.gov (United States)

    TONG, VAN T.; ALTHABE, FERNANDO; ALEMÁN, ALICIA; JOHNSON, CAROLYN C.; DIETZ, PATRICIA M.; BERRUETA, MABEL; MORELLO, PAOLA; COLOMAR, MERCEDES; BUEKENS, PIERRE; SOSNOFF, CONNIE S.; FARR, SHERRY L.; MAZZONI, AGUSTINA; CIGANDA, ALVARO; BECÚ, ANA; GONZALEZ, MARIA G. BITTAR; LLAMBI, LAURA; GIBBONS, LUZ; SMITH, RUBEN A.; BELIZÁN, JOSÉ M.

    2015-01-01

    Evidence of bias of self-reported smoking cessation during pregnancy is reported in high-income countries but not elsewhere. We sought to evaluate self-reported smoking cessation during pregnancy using biochemical verification and to compare characteristics of women with and without biochemically confirmed cessation in Argentina and Uruguay. In a cross-sectional study from October 2011 to May 2012, women who attended one of 21 prenatal clinics and delivered at selected hospitals in Buenos Aires, Argentina and Montevideo, Uruguay, were surveyed about their smoking cessation during pregnancy. We tested saliva collected from women <12 h after delivery for cotinine to evaluate self-reported smoking cessation during pregnancy. Overall, 10.0% (44/441) of women who self-reported smoking cessation during pregnancy had biochemical evidence of continued smoking. Women who reported quitting later in pregnancy had a higher percentage of nondisclosure (17.2%) than women who reported quitting when learning of their pregnancy (6.4%). PMID:25350478

  7. How Do Perceptions About Cessation Outcomes Moderate the Effectiveness of a Gain-Framed Smoking Cessation Telephone Counseling Intervention?

    OpenAIRE

    Latimer-Cheung, Amy E.; Fucito, Lisa M.; Carlin-Menter, Shannon; Rodriguez, Jocelyn; Raymond, Lindsey; Salovey, Peter; Makuch, Robert; Cummings, K. Michael; Toll, Benjamin A.

    2012-01-01

    The distinction between prevention and detection behaviors provides a useful guideline for appropriately framing health messages in terms of gains or losses. However, this guideline assumes that everyone perceives the outcomes associated with a behavior in a consistent manner, as prevention or detection. Individuals’ perceptions of a behavior vary, and so the effects of framed messages may be optimized by considering individuals’ perceptions rather than the prevention or detection function of...

  8. Obesity, systemic inflammation, and increased risk for cardiovascular disease and diabetes among adolescents: a need for screening tools to target interventions.

    Science.gov (United States)

    DeBoer, Mark D

    2013-02-01

    Cardiovascular disease (CVD) and type 2 diabetes mellitus have their roots in childhood, particularly in obese children and adolescents, raising important opportunities for early lifestyle intervention in at-risk individuals. However, not all obese individuals are at the same risk for disease progression. Accurate screening of obese adolescents may identify those in greatest need for intensive intervention to prevent or delay future disease. One potential screening target is obesity-related inflammation, which contributes to insulin resistance, metabolic syndrome, and CVD. In adults, the inflammatory marker high-sensitivity C-reactive protein (hsCRP) has utility for risk stratification and treatment initiation in individuals of intermediate CVD risk. In adolescents, hsCRP shares many of the associations of hsCRP in adults regarding the degree of insulin resistance, metabolic syndrome, and carotid artery media thickness. However, long-term data linking increased hsCRP levels-and increased insulin or decreased adiponectin-in childhood to adult disease outcomes are lacking at this time. Future efforts continue to be needed to identify childhood clinical and laboratory characteristics that could be used as screening tests to predict adult disease progression. Such tests may have utility in motivating physicians and patients' families toward lifestyle changes, ultimately improving prevention efforts.

  9. Targeting Feeding and Eating Behaviors: Development of the Feeding Dynamic Intervention for Caregivers of 2- to 5-Year-Old Children.

    Science.gov (United States)

    Eneli, Ihuoma U; Tylka, Tracy L; Watowicz, Rosanna P; Hummel, Jessica; Ritter, Jan; Lumeng, Julie C

    2015-01-01

    Targeting feeding dynamics, a concept centered on the roles and interaction of the caregiver and child in a feeding relationship, may have significant potential for obesity intervention. The aim of this paper is to describe the 3-phase development of the Feeding Dynamics Intervention (FDI), an acceptability and feasibility study on implementing the feeding dynamic roles (Study 1), development of the FDI content (Study 2), and a pilot study on use of the 6-lesson FDI to promote behaviors consistent with a feeding dynamic approach (Study 3). Sample population was mothers with young children, 2-5 years old. An effect size (Hedges' g) greater than 0.20 was seen in more than half (57%) of maternal feeding behaviors, with the largest effect sizes (Hedges' g ≥ 0.8) occurring with behaviors that represent the mother adopting her roles of determining what food is served, not using food as a reward, and not controlling her child's intake. There was a significant decline in Pressure to Eat behaviors (2.9 versus 2.2, p eating behaviors, self-regulation of energy intake, and anthropometrics.

  10. Neuroprotective and cognitive enhancing effects of a multi-targeted food intervention in an animal model of neurodegeneration and depression.

    Science.gov (United States)

    Borre, Yuliya E; Panagaki, Theodora; Koelink, Pim J; Morgan, Mary E; Hendriksen, Hendrikus; Garssen, Johan; Kraneveld, Aletta D; Olivier, Berend; Oosting, Ronald S

    2014-04-01

    Rising neurodegenerative and depressive disease prevalence combined with the lack of effective pharmaceutical treatments and dangerous side effects, has created an urgent need for the development of effective therapies. Considering that these disorders are multifactorial in origin, treatments designed to interfere at different mechanistic levels may be more effective than the traditional single-targeted pharmacological concepts. To that end, an experimental diet composed of zinc, melatonin, curcumin, piperine, eicosapentaenoic acid (EPA, 20:5, n-3), docosahexaenoic acid (DHA, 22:6, n-3), uridine, and choline was formulated. This diet was tested on the olfactory bulbectomized rat (OBX), an established animal model of depression and cognitive decline. The ingredients of the diet have been individually shown to attenuate glutamate excitoxicity, exert potent anti-oxidant/anti-inflammatory properties, and improve synaptogenesis; processes that all have been implicated in neurodegenerative diseases and in the cognitive deficits following OBX in rodents. Dietary treatment started 2 weeks before OBX surgery, continuing for 6 weeks in total. The diet attenuated OBX-induced cognitive and behavioral deficits, except long-term spatial memory. Ameliorating effects of the diet extended to the control animals. Furthermore, the experimental diet reduced hippocampal atrophy and decreased the peripheral immune activation in the OBX rats. The ameliorating effects of the diet on the OBX-induced changes were comparable to those of the NMDA receptor antagonist, memantine, a drug used for the management of Alzheimer's disease. This proof-of-concept study suggests that a diet, which simultaneously targets multiple disease etiologies, can prevent/impede the development of a neurodegenerative and depressive disorders and the concomitant cognitive deficits.

  11. Smoking patterns and predictors of smoking cessation in elderly populations in Lebanon

    Science.gov (United States)

    Chaaya, M.; Mehio-Sibai, A.; El-Chemaly, S.

    2006-01-01

    SUMMARY OBJECTIVE To investigate smoking patterns in an elderly, low-income population and to identify predictors of smoking cessation, in addition to analyzing the importance of smoking in relation to other risk factors for hospitalization. DESIGN The data were part of an urban health study conducted among 740 individuals aged ≥60 years in three suburban communities of low socio-economic status in Beirut, one of them a refugee camp. A detailed interview schedule was administered that included comprehensive social and health information. RESULTS The overall prevalence of current smokers was 28.1%. Almost half of the group were ever smokers, of whom 44% had quit smoking when they experienced negative health effects. Having at least one chronic illness and having a functional disability significantly increased the odds of smoking cessation. In addition, being a former smoker increased the likelihood of hospital admission. CONCLUSIONS This study is of particular importance, as it has implications for similar low-income and refugee communities in the region and elsewhere. There is a need for more concerted efforts by public health officials to target elderly individuals as a group for smoking cessation interventions, particularly now that mortality and health benefits have been well documented. RÉSUMÉ OBJECTIF Investiguer les types de tabagisme dans une population âgée à faibles revenus et identifier les facteurs prédictifs de l’arrêt du tabagisme, tout en analysant l’importance du tabagisme par rapport aux autres facteurs de risque d’hospitalisation. SCHÉMA Les données constituent une fraction de l’étude de santé urbaine menée chez 740 personnes âgées de ≥60 ans à Beyrouth dans trois collectivités suburbaines à faible statut socio-économique dont une des trois se situe dans un camp de réfugiés. Un schéma détaillé d’interview a été utilisé comportant des informations complètes sur le plan social et celui de la santé. R

  12. Dynamics of p53 and NF-κB regulation in response to DNA damage and identification of target proteins suitable for therapeutic intervention

    Directory of Open Access Journals (Sweden)

    Poltz Rainer

    2012-09-01

    Full Text Available Abstract Background The genome is continuously attacked by a variety of agents that cause DNA damage. Recognition of DNA lesions activates the cellular DNA damage response (DDR, which comprises a network of signal transduction pathways to maintain genome integrity. In response to severe DNA damage, cells undergo apoptosis to avoid transformation into tumour cells, or alternatively, the cells enter permanent cell cycle arrest, called senescence. Most tumour cells have defects in pathways leading to DNA repair or apoptosis. In addition, apoptosis could be counteracted by nuclear factor kappa B (NF-κB, the main anti-apoptotic transcription factor in the DDR. Despite the high clinical relevance, the interplay of the DDR pathways is poorly understood. For therapeutic purposes DNA damage signalling processes are induced to induce apoptosis in tumour cells. However, the efficiency of radio- and chemotherapy is strongly hampered by cell survival pathways in tumour cells. In this study logical modelling was performed to facilitate understanding of the complexity of the signal transduction networks in the DDR and to provide cancer treatment options. Results Our comprehensive discrete logical model provided new insights into the dynamics of the DDR in human epithelial tumours. We identified new mechanisms by which the cell regulates the dynamics of the activation of the tumour suppressor p53 and NF-κB. Simulating therapeutic intervention by agents causing DNA single-strand breaks (SSBs or DNA double-strand breaks (DSBs we identified candidate target proteins for sensitization of carcinomas to therapeutic intervention. Further, we enlightened the DDR in different genetic diseases, and by failure mode analysis we defined molecular defects putatively contributing to carcinogenesis. Conclusion By logic modelling we identified candidate target proteins that could be suitable for radio- and chemotherapy, and contributes to the design of more effective

  13. A survey of the prevalence of smoking and smoking cessation advice received by inpatients in a large teaching hospital in Ireland.

    LENUS (Irish Health Repository)

    Bartels, C

    2012-01-06

    BACKGROUND: The adverse effects of smoking are well documented and it is crucial that this modifiable risk factor is addressed routinely. Professional advice can be effective at reducing smoking amongst patients, yet it is not clear if all hospital in-patient smokers receive advice to quit. AIMS: To explore smoking prevalence amongst hospital in-patients and smoking cessation advice given by health professionals in a large university teaching hospital. METHODS: Interviews were carried out over 2 weeks in February 2011 with all eligible in-patients in Beaumont Hospital. RESULTS: Of the 205 patients who completed the survey, 61% stated they had been asked about smoking by a healthcare professional in the past year. Only 44% of current\\/recent smokers stated they had received smoking cessation advice from a health professional within the same timeframe. CONCLUSIONS: Interventions to increase rates of healthcare professional-provided smoking cessation advice are urgently needed.

  14. Widespread inequalities in smoking & smokeless tobacco consumption across wealth quintiles in States of India: Need for targeted interventions

    Directory of Open Access Journals (Sweden)

    J S Thakur

    2015-01-01

    indicate that tobacco control policy and public health interventions need to consider widespread socio-economic inequities in tobacco consumption across the States in India.

  15. Automated tracking of tumor-stroma morphology in microtissues identifies functional targets within the tumor microenvironment for therapeutic intervention

    Science.gov (United States)

    Åkerfelt, Malin; Bayramoglu, Neslihan; Robinson, Sean; Toriseva, Mervi; Schukov, Hannu-Pekka; Härmä, Ville; Virtanen, Johannes; Sormunen, Raija; Kaakinen, Mika; Kannala, Juho; Eklund, Lauri; Heikkilä, Janne; Nees, Matthias

    2015-01-01

    Cancer-associated fibroblasts (CAFs) constitute an important part of the tumor microenvironment and promote invasion via paracrine functions and physical impact on the tumor. Although the importance of including CAFs into three-dimensional (3D) cell cultures has been acknowledged, computational support for quantitative live-cell measurements of complex cell cultures has been lacking. Here, we have developed a novel automated pipeline to model tumor-stroma interplay, track motility and quantify morphological changes of 3D co-cultures, in real-time live-cell settings. The platform consists of microtissues from prostate cancer cells, combined with CAFs in extracellular matrix that allows biochemical perturbation. Tracking of fibroblast dynamics revealed that CAFs guided the way for tumor cells to invade and increased the growth and invasiveness of tumor organoids. We utilized the platform to determine the efficacy of inhibitors in prostate cancer and the associated tumor microenvironment as a functional unit. Interestingly, certain inhibitors selectively disrupted tumor-CAF interactions, e.g. focal adhesion kinase (FAK) inhibitors specifically blocked tumor growth and invasion concurrently with fibroblast spreading and motility. This complex phenotype was not detected in other standard in vitro models. These results highlight the advantage of our approach, which recapitulates tumor histology and can significantly improve cancer target validation in vitro. PMID:26375443

  16. Targeting sphingosine 1-phosphate (S1P) levels and S1P receptor functions for therapeutic immune interventions.

    Science.gov (United States)

    Gräler, Markus H

    2010-01-01

    Sphingosine 1-phosphate (S1P) is an important regulator of many different immune functions including lymphocyte circulation, antigen presentation, and T cell development. It stimulates five G protein-coupled receptors designated S1P(1-5), which are also expressed by immune cells. S1P receptors couple to different heterotrimeric G proteins including G alpha i, q, and 12/13, and elicit cellular signalling events by activating the small GTPases Rac and Rho and protein kinases Akt, ERK, and JNK, and by inducing cellular calcium flux and inhibiting cAMP accumulation, amongst others. S1P is the exit signal for lymphocytes leaving lymphoid organs and present in blood and lymph at high nanomolar concentrations due to the S1P-producing activity of sphingosine kinases (SK). The S1P-degrading enzyme S1P-lyase maintains low amounts of S1P in lymphoid organs. Disrupting this concentration difference by S1P receptor agonists and antagonists like FTY720, SEW2871, and VPC23019, by an anti-S1P antibody, or by inhibiting the S1P-lyase has therapeutic potential for autoimmune diseases like multiple sclerosis (MS) and rheumatoid arthritis and for many other disorders like cancer, fibrosis, inflammation, macular degeneration, diabetic retinopathy, and glaucoma. This report aims to provide a brief overview of concepts, approaches, pharmaceutical compounds, and targets that are currently used to modulate S1P-driven immune functions.

  17. Clinical trial on the efficacy of exhaled carbon monoxide measurement in smoking cessation in primary health care