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Sample records for cessation interventions targeting

  1. 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....

  2. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Møller, A; Villebro, N

    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. 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...

  4. 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 a...

  5. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

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

    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 a...

  6. Tobacco Cessation Interventions for Underserved Women

    Science.gov (United States)

    Hemsing, Natalie; Greaves, Lorraine; Poole, Nancy

    2015-01-01

    Despite high rates of smoking among some subgroups of women, there is a lack of tailored interventions to address smoking cessation among women. We identify components of a women-centered approach to tobacco cessation by analyzing 3 bodies of literature: sex and gender influences in tobacco use and addiction; evidence-based tobacco cessation guidelines; and best practices in delivery of women-centered care. Programming for underserved women should be tailored, build confidence and increase motivation, integrate social justice issues and address inequities, and be holistic and comprehensive. Addressing the complexity of women’s smoking and tailoring appropriately could help address smoking among subpopulations of women.

  7. Internet-based interventions for smoking cessation

    OpenAIRE

    Civljak, Marta; Sheikh, Aziz; Stead, Lindsay F.; Car, Josip

    2010-01-01

    BackgroundThe Internet has become a regular part of daily life for the majority of people in many parts of the world. It now offers an additional means of effecting changes to behaviour such as smoking.ObjectivesTo determine the effectiveness of Internet-based interventions for smoking cessation.Search strategyWe searched theCochraneTobaccoAddictionGroup SpecializedRegister, with additional searches ofMEDLINE, EMBASE, CINAHL, PsycINFO, and Google Scholar. There were no restrictions placed on ...

  8. Smoking Cessation Intervention on Facebook: Which Content Generates the Best Engagement?

    OpenAIRE

    Thrul, Johannes; Klein, Alexandra B; Ramo, Danielle E.

    2015-01-01

    Background Social media offer a great opportunity to deliver smoking cessation treatment to young adults, but previous online and social media interventions targeting health behavior change have struggled with low participant engagement. We examined engagement generated by content based on the Transtheoretical Model of Behavior Change (TTM) in a motivationally tailored smoking cessation intervention on Facebook. Objective This study aimed to identify which intervention content based on the TT...

  9. Suicide Prevention Referrals in a Mobile Health Smoking Cessation Intervention.

    Science.gov (United States)

    Christofferson, Dana E; Hamlett-Berry, Kim; Augustson, Erik

    2015-08-01

    Automated mobile health (mHealth) programs deliver effective smoking cessation interventions through text message platforms. Smoking is an independent risk factor for suicide, so the Department of Veterans Affairs incorporated information about the Veterans Crisis Line into its SmokefreeVET smoking cessation text messaging program. Almost 7% of all SmokefreeVET enrollees have accessed this information. Because of the reach and automated nature of this and similar programs, we recommend including a referral to a suicide prevention hotline for all smoking cessation mHealth interventions. PMID:26066949

  10. Best Practices for Smoking Cessation Interventions in Primary Care

    OpenAIRE

    Andrew McIvor; John Kayser; Jean-Marc Assaad; Gerald Brosky; Penny Demarest; Philippe Desmarais; Christine Hampson; Milan Khara; Ratsamy Pathammavong; Robert Weinberg

    2009-01-01

    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 on...

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

    OpenAIRE

    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 c...

  12. A Model Curriculum for Tobacco Use Cessation and Prevention Intervention.

    Science.gov (United States)

    Geboy, Michael J.; Fried, Jacquelyn L.

    1994-01-01

    Proposes a curriculum for dental/dental hygiene schools that would teach oral health care providers how to routinely assess tobacco use, advise cessation, and provide assistance and follow-up for tobacco-using patients. The article emphasizes the importance of making tobacco interventions routine components of schools' clinical teaching programs.…

  13. The effectiveness of smoking cessation interventions prior to surgery: a systematic review.

    OpenAIRE

    Cropley, M; Theadom, A.; Pravettoni, G; WEBB, G.

    2008-01-01

    The objective of this review was to evaluate the effectiveness of smoking cessation interventions prior to surgery and examine smoking cessation rates at 6 months follow-up. The Cochrane Library Database, PsycINFO, EMBASE, Medline, and Cinahl databases were searched using the terms: smok$, smoking cessation, tobacco, cigar$, preop$, operati$, surg$, randomi*ed control$ trial, intervention, program$, cessation, abstinen$, quit. Further articles were obtained from reference lists. The search wa...

  14. Application of a CBPR Framework to Inform a Multi-level Tobacco Cessation Intervention in Public Housing Neighborhoods

    OpenAIRE

    Jeannette O. Andrews; Tingen, Martha S.; Jarriel, Stacey Crawford; Caleb, Maudesta; Simmons, Alisha; Brunson, Juanita; Mueller, Martina; Ahluwalia, Jasjit S.; Newman, Susan D.; Cox, Melissa J.; Magwood, Gayenell; Hurman, Christina

    2012-01-01

    African American women in urban, high poverty neighborhoods have high rates of smoking, difficulties with quitting, and disproportionate tobacco-related health disparities. Prior research utilizing conventional “outsider driven” interventions targeted to individuals has failed to show effective cessation outcomes. This paper describes the application of a community-based participatory research (CBPR) framework to inform a culturally situated, ecological based, multi-level tobacco cessation in...

  15. Interventions for waterpipe tobacco smoking prevention and cessation: a systematic review.

    Science.gov (United States)

    Jawad, Mohammed; Jawad, Sena; Waziry, Reem K; Ballout, Rami A; Akl, Elie A

    2016-01-01

    Waterpipe tobacco smoking is growing in popularity despite adverse health effects among users. We systematically reviewed the literature, searching MEDLINE, EMBASE and Web of Science, for interventions targeting prevention and cessation of waterpipe tobacco smoking. We assessed the evidence quality using the Cochrane (randomised studies), GRADE (non-randomised studies) and CASP (qualitative studies) frameworks. Data were synthesised narratively due to heterogeneity. We included four individual-level, five group-level, and six legislative interventions. Of five randomised controlled studies, two showed significantly higher quit rates in intervention groups (bupropion/behavioural support versus placebo in Pakistan; 6 month abstinence relative risk (RR): 2.3, 95% CI 1.4-3.8); group behavioural support versus no intervention in Egypt, 12 month abstinence RR 3.3, 95% CI 1.4-8.9). Non-randomised studies showed mixed results for cessation, behavioural, and knowledge outcomes. One high quality modelling study from Lebanon calculated that a 10% increase in waterpipe tobacco taxation would reduce waterpipe tobacco demand by 14.5% (price elasticity of demand -1.45). In conclusion, there is a lack of evidence of effectiveness for most waterpipe interventions. While few show promising results, higher quality interventions are needed. Meanwhile, tobacco policies should place waterpipe on par with cigarettes. PMID:27167891

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

    DEFF Research Database (Denmark)

    Lindström, David; Sadr Azodi, Omid; Wladis, Andreas; Tønnesen, Hanne; Linder, Stefan; Nåsell, Hans; Ponzer, Sari; Adami, Johanna

    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....

  17. 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…

  18. The development of an adolescent smoking cessation intervention—an Intervention Mapping approach to planning

    OpenAIRE

    Dalum, Peter; Schaalma, Herman; Kok, Gerjo

    2011-01-01

    The objective of this project was to develop a theory- and evidence-based adolescent smoking cessation intervention using both new and existing materials. We used the Intervention Mapping framework for planning health promotion programmes. Based on a needs assessment, we identified important and changeable determinants of cessation behaviour, specified change objectives for the intervention programme, selected theoretical change methods for accomplishing intervention objectives and finally op...

  19. Multimodal intervention raises smoking cessation rate during pregnancy

    DEFF Research Database (Denmark)

    Hegaard, Hanne K; Kjaergaard, Hanne; Møller, Lars F; Wachmann, Henrik; Ottesen, Bent

    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...

  20. Assessment of effectiveness of smoking cessation intervention among male prisoners in India: A randomized controlled trial

    OpenAIRE

    Naik, Sachin; Khanagar, Sanjeev; Kumar, Amit; Ramachandra, Sujith; Vadavadagi, Sunil V.; Dhananjaya, Kiran Murthy

    2014-01-01

    Background: Tobacco smoking is an integral part of prison life and an established part of the culture. Little attention has been paid to prevention of smoking in prison. Approximately 70–80% of prisoners have been identified as current smokers. Aim: To assess the effectiveness of smoking cessation intervention among male prisoners at Central Jail, Bangalore city. Aim: To assess the effectiveness of smoking cessation intervention among male prisoners at Central Jail, Bangalore city. Materials ...

  1. A Theory-Based Video Messaging Mobile Phone Intervention for Smoking Cessation: Randomized Controlled Trial

    OpenAIRE

    Whittaker, Robyn; Dorey, Enid; Bramley, Dale; Bullen, Chris; Denny, Simon; Elley, C Raina; Maddison, Ralph; McRobbie, Hayden; Parag, Varsha; Rodgers, Anthony; Salmon, Penny

    2011-01-01

    Background Advances in technology allowed the development of a novel smoking cessation program delivered by video messages sent to mobile phones. This social cognitive theory-based intervention (called “STUB IT”) used observational learning via short video diary messages from role models going through the quitting process to teach behavioral change techniques. Objective The objective of our study was to assess the effectiveness of a multimedia mobile phone intervention for smoking cessation. ...

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

    Science.gov (United States)

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

    2016-07-01

    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. Method We used the Intervention Mapping framework for planning health promotion programs. After 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. Results We found that "social 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 frame/positive imaging, consciousness-raising, helping relationships, stimulus control, and goal-setting as suitable methods for an Internet- and text-based adult smoking cessation program. Furthermore, we identified computer tailoring as a useful strategy for adapting the intervention to individual users. Conclusion The Intervention Mapping method, with a clear link between behavioral goals, theoretical methods, and practical strategies and materials, proved useful for systematic development of a digital smoking cessation intervention for adults. PMID:27101996

  3. 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

    that "social 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......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....... After 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...

  4. Toward an mHealth Intervention for Smoking Cessation

    OpenAIRE

    Ahsan, G. M. Tanimul; Addo, Ivor D.; Ahamed, S. Iqbal; Petereit, Daniel; Kanekar, Shalini; Burhansstipanov, Linda; Krebs, Linda U.

    2013-01-01

    The prevalence of tobacco dependence in the United States (US) remains alarming. Invariably, smoke-related health problems are the leading preventable causes of death in the US. Research has shown that a culturally tailored cessation counseling program can help reduce smoking and other tobacco usage. In this paper, we present a mobile health (mHealth) solution that leverages the Short Message Service (SMS) or text messaging feature of mobile devices to motivate behavior change among tobacco u...

  5. A qualitative evidence synthesis of employees' views of workplace smoking reduction or cessation interventions

    OpenAIRE

    Carroll, C; Rick, J; Leaviss, J.; Fishwick, D; BOOTH, A.

    2013-01-01

    Background The need to reduce smoking rates is a recognised public health policy issue in many countries. The workplace offers a potential context for offering smokers’ programmes and interventions to assist smoking cessation or reduction. A qualitative evidence synthesis of employees’ views about such programmes might explain why some interventions appear effective and others not, and can be used to develop evidence-based interventions for this population and setting. Methods A qua...

  6. 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  

  7. Learning About Intervention Target Zones

    OpenAIRE

    Michael W. Klein; 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...

  8. 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

  9. Diffusion of an Evidence-Based Smoking Cessation Intervention Through Facebook: A Randomized Controlled Trial

    Science.gov (United States)

    Cobb, Nathan K.; Jacobs, Megan A.; Wileyto, Paul; Valente, Thomas

    2016-01-01

    Objectives. To examine the diffusion of an evidence-based smoking cessation application (“app”) through Facebook social networks and identify specific intervention components that accelerate diffusion. Methods. Between December 2012 and October 2013, we recruited adult US smokers (“seeds”) via Facebook advertising and randomized them to 1 of 12 app variants using a factorial design. App variants targeted components of diffusion: duration of use (t), “contagiousness” (β), and number of contacts (Z). The primary outcome was the reproductive ratio (R), defined as the number of individuals installing the app (“descendants”) divided by the number of a seed participant’s Facebook friends. Results. We randomized 9042 smokers. App utilization metrics demonstrated between-variant differences in expected directions. The highest level of diffusion (R = 0.087) occurred when we combined active contagion strategies with strategies to increase duration of use (incidence rate ratio = 9.99; 95% confidence interval = 5.58, 17.91; P < .001). Involving nonsmokers did not affect diffusion. Conclusions. The maximal R value (0.087) is sufficient to increase the numbers of individuals receiving treatment if applied on a large scale. Online interventions can be designed a priori to spread through social networks. PMID:27077358

  10. Smoking cessation via the internet: a randomized clinical trial of an internet intervention as adjuvant treatment in a smoking cessation intervention.

    Science.gov (United States)

    Japuntich, Sandra J; Zehner, Mark E; Smith, Stevens S; Jorenby, Douglas E; Valdez, José A; Fiore, Michael C; Baker, Timothy B; Gustafson, David H

    2006-12-01

    Internet interventions for smoking cessation are ubiquitous. Yet, to date, there are few randomized clinical trials that gauge their efficacy. This study is a randomized clinical trial (N= 284, n= 140 in the treatment group, n= 144 in the control group) of an Internet smoking cessation intervention. Smokers were randomly assigned to receive either bupropion plus counseling alone, or bupropion and counseling in addition to 12 weeks of access to the Comprehensive Health Enhancement Support System for Smoking Cessation and Relapse Prevention (CHESS SCRP; a Web site which provided information on smoking cessation as well as support). We found that access to CHESS SCRP was not significantly related to abstinence at the end of the treatment period (OR= 1.13, 95% CI 0.66-2.62) or at 6 months postquit (OR= 1.48, 95% CI 0.66-2.62). However, the number of times participants used CHESS SCRP per week was related to abstinence at both end of treatment (OR= 1.79, 95% CI 1.25-2.56) and at the 6-month follow-up (OR= 1.59, 95% CI 1.06-2.38). Participants with access to CHESS SCRP logged in an average of 33.64 times (SD=30.76) over the 90-day period of access. Rates of CHESS SCRP use did not differ by ethnicity, level of education or gender (all p>.05). In sum, results suggest that participants used CHESS SCRP frequently, CHESS SCRP use was related to success, but the effects in general did not yield intergroup effects. PMID:17491172

  11. Mediators of a smoking cessation intervention for persons living with HIV/AIDS

    Science.gov (United States)

    Vidrine, Damon J.; Kypriotakis, George; Li, Liang; Arduino, Roberto C.; Fletcher, Faith E.; Tamí-Maury, Irene; Gritz, Ellen R.

    2015-01-01

    Background Cigarette smoking among persons living with HIV (PLWH) is a pressing public health concern, and efforts to evaluate cessation treatments are needed. The purpose of the present study was to assess potential mechanisms of a cell phone-delivered intervention for HIV-positive smokers. Methods Data from 350 PLWH enrolled in a randomized smoking cessation treatment trial were utilized. Participants were randomized to either usual care (UC) or a cell phone intervention (CPI) group. The independent variable of interest was treatment group membership, while the dependent variable of interest was smoking abstinence at a 3-month follow-up. The hypothesized treatment mechanisms were depression, anxiety, social support, quit motivation and self-efficacy change scores. Results Abstinence rates in the UC and CPI groups were 4.7% (8 of 172) and 15.7% (28 of 178), respectively. The CPI group (vs. UC) experienced a larger decline in depression between baseline and the 3-month follow-up, and a decline in anxiety. Self-efficacy increased for the CPI group and declined for the UC group. Quit motivation and social support change scores did not differ by treatment group. Only self-efficacy met the predefined criteria for mediation. The effect of the cell phone intervention on smoking abstinence through change in self-efficacy was statistically significant (psmoking cessation for PLWH. Additional efforts are required to disentangle the relationships between emotional, distress motivation, and efficacious smoking cessation treatment. PMID:25542824

  12. Smoking Cessation Intervention Preferences Among Urban African Americans: A Mixed Methods Approach.

    Science.gov (United States)

    Baker, Cathy J; Palmer, Sheena D; Lee, Chia-Wen Vianne

    2016-06-01

    African Americans suffer disproportionately from smoking-related morbidity and mortality and make more quit attempts but report less success in quitting. Smokers tend to identify more strongly with African American culture. Qualitative interviews were conducted to elicit perceptions toward smoking and intervention content. Seventy-one African American smokers recruited from community locations participated. The majority stated they would not use any cessation aids if trying to quit smoking, despite the availability of free nicotine replacement. Acculturative stress scores were significantly higher in younger participants and those with higher income. Higher African American acculturation did not predict smoking cessation intervention preference. Family and social relationships were cited as both reasons for wanting to quit and reasons for continuing to smoke. Based on these findings, interventions for urban African Americans should address household members continuing to smoke, social/family connections, stress management, and cultural identification in urban areas. PMID:26809884

  13. 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. PMID:25975798

  14. A Randomized Trial of Targeted Educational Materials for Smoking Cessation in African Americans Using Transdermal Nicotine

    Science.gov (United States)

    Nollen, Nicole; Ahluwalia, Jasjit S.; Mayo, Matthew S.; Richter, Kim; Choi, Won S.; Okuyemi, Kolawole S.; Resnicow, Ken

    2007-01-01

    This study examines the efficacy of targeted versus standard care smoking cessation materials among urban African American smokers. Five hundred smokers (250 to each group) are randomized to receive a culturally targeted or standard care videotape and print guide. Both groups receive 8 weeks of nicotine patches and reminder telephone calls at…

  15. A pilot study combining individual-based smoking cessation counseling, pharmacotherapy, and dental hygiene intervention

    Directory of Open Access Journals (Sweden)

    Madrid Carlos

    2010-06-01

    Full Text Available Abstract Background Dentists are in a unique position to advise smokers to quit by providing effective counseling on the various aspects of tobacco-induced diseases. The present study assessed the feasibility and acceptability of integrating dentists in a medical smoking cessation intervention. Methods Smokers willing to quit underwent an 8-week smoking cessation intervention combining individual-based counseling and nicotine replacement therapy and/or bupropion, provided by a general internist. In addition, a dentist performed a dental exam, followed by an oral hygiene treatment and gave information about chronic effects of smoking on oral health. Outcomes were acceptability, global satisfaction of the dentist's intervention, and smoking abstinence at 6-month. Results 39 adult smokers were included, and 27 (69% completed the study. Global acceptability of the dental intervention was very high (94% yes, 6% mostly yes. Annoyances at the dental exam were described as acceptable by participants (61% yes, 23% mostly yes, 6%, mostly no, 10% no. Participants provided very positive qualitative comments about the dentist counseling, the oral exam, and the resulting motivational effect, emphasizing the feeling of oral cleanliness and health that encouraged smoking abstinence. At the end of the intervention (week 8, 17 (44% participants reported smoking abstinence. After 6 months, 6 (15%, 95% CI 3.5 to 27.2 reported a confirmed continuous smoking abstinence. Discussion We explored a new multi-disciplinary approach to smoking cessation, which included medical and dental interventions. Despite the small sample size and non-controlled study design, the observed rate was similar to that found in standard medical care. In terms of acceptability and feasibility, our results support further investigations in this field. Trial Registration number ISRCTN67470159

  16. Smoking cessation intervention practices in Chinese physicians: do gender and smoking status matter?

    Science.gov (United States)

    Lam, Tai Hing; Jiang, Chaoqiang; Chan, Ya-Fen; Chan, Sophia Siu Chee

    2011-03-01

    Healthcare settings provide a major arena for administering smoking cessation interventions. However, few studies have reported differences in the frequency of practice in healthcare professionals by gender and smoking status. This might also be influenced by a difference in smoking prevalence by gender, especially in China and other developing countries. This study examined factors associated with the frequency of cessation intervention practices by smoking status among Chinese physicians in men and women. A cross-sectional survey was conducted in 2006 in physicians with direct patient contact from nine hospitals in Guangzhou with a response rate of 60.8%. Significantly more female physicians who were non-smokers (79.7%) reported "initiation and/or advice" smoking cessation interventions than male physicians who were smokers (71.2%) and non-smokers (71.6%). Factors significantly associated with "initiation and/or advice" were prior smoking cessation training (OR = 4.2, 95% CI 1.8-9.6) and lack of knowledge to help patients to quit (OR = 0.4, 95% CI 0.2-0.9) among male physicians who smoked; and organisational support (OR = 1.7, 95% CI 1.3-2.2) and successful past experience (OR = 0.4, 95% CI 0.2-1.0) among male physicians who did not smoke. Among female physicians who did not smoke, significant factors were agreeing that quitting smoking is the most cost-effective way to prevent chronic disease and cancer (OR = 3.0, 95% CI 1.4-6.1), helping patients stop smoking is part of expected role and responsibility (OR = 2.0, 95% CI 1.0-3.7), lack of knowledge to help patients to quit (OR = 0.5, 95% CI 0.2-1.0) and organisational support (OR = 1.3, 95% CI 1.0-1.6) for non-smoking female physicians. This study is the first to show that male physicians were less likely to provide smoking cessation counselling regardless of their smoking status while non-smoking female physicians were more active in advising patients on quitting. The findings highlight the need for developing

  17. Interpersonal Communication and Smoking Cessation in the Context of an Incentive-Based Program: Survey Evidence From a Telehealth Intervention in a Low-Income Population.

    Science.gov (United States)

    Parks, Michael J; Slater, Jonathan S; Rothman, Alexander J; Nelson, Christina L

    2016-01-01

    The tobacco epidemic disproportionately affects low-income populations, and telehealth is an evidence-based strategy for extending tobacco cessation services to underserved populations. A public health priority is to establish incentive-based interventions at the population level in order to promote long-term smoking cessation in low-income populations. Yet randomized clinical trials show that financial incentives tend to encourage only short-term steps of cessation, not continuous smoking abstinence. One potential mechanism for increasing long-term cessation is interpersonal communication (IPC) in response to population-level interventions. However, more research is needed on IPC and its influence on health behavior change, particularly in the context of incentive-based, population-level programs. This study used survey data gathered after a population-level telehealth intervention that offered $20 incentives to low-income smokers for being connected to Minnesota's free quitline in order to examine how perceived incentive importance and IPC about the incentive-based program relate to both short-term and long-term health behavior change. Results showed that IPC was strongly associated with initial quitline utilization and continuous smoking abstinence as measured by 30-day point prevalence rates at 7-month follow-up. Perceived incentive importance had weak associations with both measures of cessation, and all associations were nonsignificant in models adjusting for IPC. These results were found in descriptive analyses, logistic regression models, and Heckman probit models that adjusted for participant recruitment. In sum, a behavioral telehealth intervention targeting low-income smokers that offered a financial incentive inspired IPC, and this social response was strongly related to utilization of intervention services as well as continuous smoking abstinence. PMID:26166678

  18. A randomized controlled trial of a tailored group smoking cessation intervention for HIV-infected smokers

    Science.gov (United States)

    Moadel, Alyson B.; Bernstein, Steven L.; Mermelstein, Robin J.; Arnsten, Julia H.; Dolce, Eileen H.; Shuter, Jonathan

    2013-01-01

    Background More than half of persons living with HIV (PLWH) in the US smoke cigarettes, and tobacco use is responsible for considerable morbidity and mortality in this group. Little is known about the efficacy of tobacco treatment strategies in PLWH. Design Randomized controlled trial comparing Positively Smoke Free (PSF), an intensive group therapy intervention targeting HIV-infected smokers, to standard care. Methods A cohort of 145 PLWH smokers, recruited from an HIV-care center in the Bronx, New York, were randomized 1:1 into the PSF program or standard care. All were offered a 3-month supply of nicotine replacement therapy. PSF is an eight session program tailored to address the needs and concerns of HIV-infected smokers. Sessions were co-facilitated by a graduate student and an HIV-infected peer. The primary outcome was biochemically-confirmed, seven-day point-prevalence abstinence at three months. Results In the intention to treat analysis, PSF condition subjects had nearly double the quit rate of controls (19.2% vs 9.7%, P=0.11). In the complete case, as-treated analysis, assignment to PSF was associated with increased odds of quitting (ORadj 3.55, 95% CI: 1.04– 12.0). Latino ethnicity and lower loneliness score were predictive of abstinence. Subjects in the PSF condition exhibited significant decreases in daily cigarette consumption and significant increases in self-efficacy and in motivation to quit. Attendance of ≥7 sessions was associated with higher quit rates. Conclusions These findings suggest a positive effect of PSF on cessation rates in PLWH smokers. Loneliness and self-efficacy are influential factors in the smoking behaviors of PLWH. PMID:22732470

  19. Empowering smokers with a web-assisted tobacco intervention to use prescription smoking cessation medications: a feasibility trial

    OpenAIRE

    Selby, Peter; Hussain, Sarwar; Voci, Sabrina; Zawertailo, Laurie

    2015-01-01

    Background Varenicline and bupropion, efficacious smoking cessation medications, have had suboptimal impact due to barriers at the patient, practitioner and system level. This study explored the feasibility of a web-assisted tobacco intervention offering free prescription smoking cessation medication by mail if the smoker visited a physician for authorization. Methods Adult Ontarians, smoking at least 10 cigarettes daily, intending to quit within 30 days, with no contraindications to bupropio...

  20. Making the journey with me:a qualitative study of experiences of a bespoke mental health smoking cessation intervention for service users with serious mental illness

    OpenAIRE

    Knowles, Sarah; Planner, Claire; Bradshaw, Tim; Peckham, Emily; Man, Mei-See; Gilbody, Simon

    2016-01-01

    BACKGROUND: Smoking is one of the major modifiable risk factors contributing to early mortality for people with serious mental illness. However, only a minority of service users access smoking cessation interventions and there are concerns about the appropriateness of generic stop-smoking services for this group. The SCIMITAR (Smoking Cessation Intervention for Severe Mental Ill-Health Trial) feasibility study explored the effectiveness of a bespoke smoking cessation intervention delivered by...

  1. 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

  2. Community pharmacy-delivered interventions for public health priorities: a systematic review of interventions for alcohol reduction, smoking cessation and weight management, including meta-analysis for smoking cessation

    Science.gov (United States)

    Brown, Tamara J; Todd, Adam; O'Malley, Claire; Moore, Helen J; Husband, Andrew K; Bambra, Clare; Kasim, Adetayo; Sniehotta, Falko F; Steed, Liz; Smith, Sarah; Nield, Lucie; Summerbell, Carolyn D

    2016-01-01

    Objectives To systematically review the effectiveness of community pharmacy-delivered interventions for alcohol reduction, smoking cessation and weight management. Design Systematic review and meta-analyses. 10 electronic databases were searched from inception to May 2014. Eligibility criteria for selecting studies Study design: randomised and non-randomised controlled trials; controlled before/after studies, interrupted times series. Intervention: any relevant intervention set in a community pharmacy, delivered by the pharmacy team. No restrictions on duration, country, age, or language. Results 19 studies were included: 2 alcohol reduction, 12 smoking cessation and 5 weight management. Study quality rating: 6 ‘strong’, 4 ‘moderate’ and 9 ‘weak’. 8 studies were conducted in the UK, 4 in the USA, 2 in Australia, 1 each in 5 other countries. Evidence from 2 alcohol-reduction interventions was limited. Behavioural support and/or nicotine replacement therapy are effective and cost-effective for smoking cessation: pooled OR was 2.56 (95% CI 1.45 to 4.53) for active intervention vs usual care. Pharmacy-based interventions produced similar weight loss compared with active interventions in other primary care settings; however, weight loss was not sustained longer term in a range of primary care and commercial settings compared with control. Pharmacy-based weight management interventions have similar provider costs to those delivered in other primary care settings, which are greater than those delivered by commercial organisations. Very few studies explored if and how sociodemographic or socioeconomic variables moderated intervention effects. Insufficient information was available to examine relationships between effectiveness and behaviour change strategies, implementation factors, or organisation and delivery of interventions. Conclusions Community pharmacy-delivered interventions are effective for smoking cessation, and demonstrate that the pharmacy is a

  3. Health-care interventions to promote and assist tobacco cessation:A review of efficacy, effectiveness and affordability for use in national guideline development

    OpenAIRE

    West, Robert; Raw, Martin; McNeill, Ann; Stead, Lindsay; Aveyard, Paul; Bitton, John; Stapleton, John; McRobbie, Hayden; Pokhrel, Subhash; Lester-George, Adam; Borland, Ron

    2015-01-01

    Aims: This paper provides a concise review of the efficacy, effectiveness and affordability of health-care interventions to promote and assist tobacco cessation, in order to inform national guideline development and assist countries in planning their provision of tobacco cessation support. Methods: Cochrane reviews of randomized controlled trials (RCTs) of major health-care tobacco cessation interventions were used to derive efficacy estimates in terms of percentage-point increases relative t...

  4. 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.

  5. 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…

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

    OpenAIRE

    Wada, Koji; Higuchi, Yoshiyuki; Smith, Derek R

    2016-01-01

    Background 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. Metho...

  7. 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

  8. Smoking cessation interventions involving significant others: the role of social support

    OpenAIRE

    Shahab, L

    2011-01-01

    It is well established that the social environment influences smoking initiation, maintenance as well as cessation. This effect, in particular on stopping smoking, is likely to be partly mediated by social support that is provided to smokers by significant others. Indeed, observational studies investigating the natural progression towards smoking cessation show that social support is clearly associated with abstinence – positive social support generally increasing the likelihood of succ...

  9. Cost-Effectiveness Analysis of Smoking Cessation Interventions in Japan Using a Discrete-Event Simulation

    OpenAIRE

    Igarashi, Ataru; Goto,Rei; Suwa, Kiyomi; Yoshikawa, Reiko; Ward, Alexandra J; Moller, Jörgen

    2015-01-01

    Background Smoking cessation medications have been shown to yield higher success rates and sustained abstinence than unassisted quit attempts. In Japan, the treatments available include nicotine replacement therapy (NRT) and varenicline; however, unassisted attempts to quit smoking remain common. Objective The objective of this study was to compare the health and economic consequences in Japan of using pharmacotherapy to support smoking cessation with unassisted attempts and the current mix o...

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

    Directory of Open Access Journals (Sweden)

    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

  11. Effectiveness of Non-Primary Care-Based Smoking Cessation Interventions for Adults with Diabetes: A Systematic Literature Review.

    Science.gov (United States)

    Register, Shilpa J; Harrington, Kathy F; Agne, April A; Cherrington, Andrea L

    2016-09-01

    Diabetes is a chronic disease that affects over 25 million adults, many of whom are smokers. The negative health impact of diabetes and comorbid smoking is significant and requires comprehensive interdisciplinary management. The National Diabetes Education Program has identified specific providers, known as PPOD, who include pharmacists, podiatrists, optometrists, and dentists, as key individuals to improve diabetes-related clinical outcomes. These providers are encouraged to work together through interdisciplinary collaboration and to implement evidence-based strategies as outlined in the PPOD toolkit. The toolkit encourages healthcare providers to ask, advise, and assist patients in their efforts to engage in risk reduction and healthy behaviors, including smoking cessation as an important risk factor. While individual PPOD providers have demonstrated effective smoking cessation interventions in adults with other acute and chronic systemic diseases, they lack specific application and focus on adults with diabetes. This literature review examines the current role of PPOD providers in smoking cessation interventions delivered to adults with diabetes. PMID:27424070

  12. 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

  13. 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.

  14. 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

  15. User Preferences for a Text Message-Based Smoking Cessation Intervention

    Science.gov (United States)

    Bock, Beth C.; Heron, Kristin E.; Jennings, Ernestine G.; Magee, Joshua C.; Morrow, Kathleen M.

    2013-01-01

    Younger adults are more likely to smoke and less likely to seek treatment than older smokers. They are also frequent users of communication technology. In the current study, we conducted focus groups to obtain feedback about preferences for a text message-based smoking cessation program from potential users. Participants ("N" = 21, "M" age = 25.6…

  16. Effects of an Intensive Depression-Focused Intervention for Smoking Cessation in Pregnancy

    Science.gov (United States)

    Cinciripini, Paul M.; Blalock, Janice A.; Minnix, Jennifer A.; Robinson, Jason D.; Brown, Victoria L.; Lam, Cho; Wetter, David W.; Schreindorfer, Lisa; McCullough, James P., Jr.; Dolan-Mullen, Patricia; Stotts, Angela L.; Karam-Hage, Maher

    2010-01-01

    Objective: The objective of this study was to evaluate a depression-focused treatment for smoking cessation in pregnant women versus a time and contact health education control. We hypothesized that the depression-focused treatment would lead to improved abstinence and reduced depressive symptoms among women with high levels of depressive…

  17. 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. PMID:26454232

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

    OpenAIRE

    Miyazaki, Yukiko

    2015-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    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

  20. Economics of smoking cessation

    OpenAIRE

    Parrott, S; Godfrey, C

    2004-01-01

    Smoking imposes a huge economic burden on society— currently up to 15% of total healthcare costs in developed countries. Smoking cessation can save years of life, at a very low cost compared with alternative interventions. This chapter reviews some of the economic aspects of smoking cessation.

  1. Smoking cessation interventions within the context of Low-Dose Computed Tomography lung cancer screening: A systematic review.

    Science.gov (United States)

    Piñeiro, Bárbara; Simmons, Vani N; Palmer, Amanda M; Correa, John B; Brandon, Thomas H

    2016-08-01

    The integration of smoking cessation interventions (SCIs) within the context of lung cancer screening programs is strongly recommended by screening guidelines, and is a requirement for Medicare coverage of screening in the US. In Europe, there are no lung cancer screening guidelines, however, research trials are ongoing, and prominent professional societies have begun to recommend lung cancer screening. Little is known about the types and efficacy of SCIs among patients receiving low-dose computed tomography (LDCT) screening. This review addresses this gap. Based on a systematic search, we identified six empirical studies published prior to July 1, 2015, that met inclusion criteria for our review: English language, SCI for LDCT patients, and reported smoking-related outcomes. Three randomized studies and three single-arm studies were identified. Two randomized controlled trials (RCTs) evaluated self-help SCIs, whereas one pilot RCT evaluated the timing (before or after the LDCT scan) of a combined (counseling and pharmacotherapy) SCI. Among the single-arm trials, two observational studies evaluated the efficacy of combined SCI, and one retrospectively assessed the efficacy of clinician-delivered smoking assessment, advice, and assistance. Given the limited research to date, and particularly the lack of studies reporting results from RCTs, assumptions that SCIs would be effective among this population should be made with caution. Findings from this review suggest that participation in a lung screening trial promotes smoking cessation and may represent a teachable moment to quit smoking. Findings also suggest that providers can take advantage of this potentially teachable moment, and that SCIs have been successfully implemented in screening settings. Continued systematic and methodologically sound research in this area will help improve the knowledge base and implementation of interventions for this population of smokers at risk for chronic disease. PMID:27393513

  2. An evaluation study of a gender-specific smoking cessation program to help Hong Kong Chinese women quit smoking

    OpenAIRE

    Li, Ho Cheung William; Chan, Sophia Siu Chee; Wan, Zoe Siu Fung; Wang, Man Ping; Lam, Tai Hing

    2015-01-01

    Background There is a lack of population-based smoking cessation interventions targeting woman smokers in Hong Kong, and in Asia generally. This study aimed to evaluate the effectiveness of a gender-specific smoking cessation program for female smokers in Hong Kong. Methods To evaluate the effectiveness of the service, a total of 457 eligible smokers were recruited. After the baseline questionnaire had been completed, a cessation counseling intervention was given by a trained counselor accord...

  3. Could 'Aunties' Recruit Pregnant Indigenous Women Who Smoke Into a Trial and Deliver a Cessation Intervention? A Feasibility Study.

    Science.gov (United States)

    Glover, Marewa; Kira, Anette; Cornell, Tracey; Smith, Ces

    2016-06-01

    Objective Māori (indigenous New Zealand) women have the highest smoking prevalence rates in New Zealand and whilst pregnant. We hypothesized that community health workers ('Aunties') could find pregnant Māori women who smoke, recruit them into a study and deliver an acceptable cessation intervention. The aim of the study was to test the feasibility of such an intervention. Method A community health organization was engaged to, using a participatory approach, conduct a feasibility study. Participants were ten Aunties and the pregnant women the Aunties recruited. The Aunties advised their participants to abstain from smoking, offered a Quitcard (for subsidized nicotine replacement) or referral to local cessation providers. A booklet on healthy eating for pregnancy was given and discussed and the Aunties offered help if needed to register with a lead maternity carer (LMC). All women completed a baseline questionnaire. Semi-structured follow up face-to-face interviews were conducted with a subsample of women and hospital birth records were examined. Descriptive statistics were produced using quantitative data. Qualitative data was deductively analysed. Results During 4 months eight Aunties recruited 67 pregnant women who smoked, 88 % were Māori, 84 % were of low socio economic status and 73 % had up to high school education. Only 36 % of the recruited women had registered with an LMC. The participants described the Aunties as supportive, nice and non-judgmental. The only criticism was a lack of follow up. Aspects of the intervention that the Aunties thought worked well were knowing and being involved with their community, and being able to give a gift pack to the participating women. Insufficient follow up was one aspect that didn't work well. The infant's birth record was found for 54 % of the participants. Conclusion Aunties were able to identify and recruit pregnant Māori women who smoked. The study method and intervention were acceptable to Aunties and

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

    Directory of Open Access Journals (Sweden)

    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

  5. A randomised controlled trial of a theory-based interactive internet-based smoking cessation intervention ('StopAdvisor'): Study protocol

    OpenAIRE

    Michie, S.; Brown, J.; Geraghty, A.W.A.; Miller, S.; Yardley, L; Gardner, B.; Shahab, L; Stapleton, J A; West, R

    2013-01-01

    Background: Internet-based interventions can help smokers to quit compared with brief written materials or no intervention. However, they are not widely used, particularly by more disadvantaged smokers, and there is significant variation in their effectiveness. A new smoking cessation website ('StopAdvisor') has been systematically developed on the basis of PRIME theory, empirical evidence, web-design expertise and user-testing with socio-economically disadvantaged smokers. This paper reports...

  6. An Internet-Based Abstinence Reinforcement Smoking Cessation Intervention in Rural Smokers

    OpenAIRE

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

    2009-01-01

    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 intervent...

  7. Smoking cessation, physicians, and medical office staff. Clinical tobacco intervention in Prince Edward Island.

    OpenAIRE

    Rowan, M S; Coambs, R. B.; Jensen, P.; Balderston, M.; MacKenzie, D; Kothari, A.

    1998-01-01

    OBJECTIVE: To assess attitudes and self-reported behaviours of physicians and medical office staff in Prince Edward Island concerning clinical tobacco intervention (CTI). DESIGN: Mail survey of PEI primary care physicians and their medical office staff. Most surveys were not mailed back but picked up in person by research staff. SETTING: Primary care settings in PEI. PARTICIPANTS: All active primary care physicians in PEI identified in the Canadian Medical Association database and medical off...

  8. Effectiveness of training health professionals to provide smoking cessation interventions: systematic review of randomised controlled trials.

    OpenAIRE

    Silagy, C; Lancaster, T.; Gray, S.; Fowler, G

    1994-01-01

    OBJECTIVE--To assess the effectiveness of interventions that train healthcare professionals in methods for improving the quality of care delivered to patients who smoke. DESIGN--Systematic literature review. SETTING--Primary care medical and dental practices in the United States and Canada. Patients were recruited opportunistically. SUBJECTS--878 healthcare professionals and 11,228 patients who smoked and were identified in eight randomised controlled trials. In each of these trials healthcar...

  9. 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

    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......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...

  10. Factors Associated with Smoking Cessation in Pregnancy.

    Science.gov (United States)

    Moore, Elizabeth; Blatt, Kaitlin; Chen, Aimin; Van Hook, James; DeFranco, Emily A

    2016-05-01

    Objective The objective of this study was to quantify the influence of various patient characteristics on early smoking cessation to better identify target populations for focused counseling and interventions. Study Design This study was a population-based retrospective cohort study of 1,003,532 Ohio live births more than 7 years (2006-2012). Women who quit smoking in the first trimester were compared with those who smoked throughout pregnancy. Logistic regression estimated the strength of association between patient factors and smoking cessation. Results The factors most strongly associated with early smoking cessation were non-white race and Hispanic ethnicity, at least some college education, early prenatal care, marriage, and breastfeeding. Numerous factors commonly associated with adverse perinatal outcomes were found to have a negative association with smoking cessation: low educational attainment, limited or late prenatal care, prior preterm birth, age breastfeeding before discharge from the hospital are associated with increased RR of quitting early in pregnancy by 52 and 99%, respectively. Public health initiatives and interventions should focus on the importance of early access to prenatal care and education regarding smoking cessation for these particularly vulnerable groups of women who are at inherently high risk of pregnancy complications. PMID:26692202

  11. Developing cessation interventions for the social and community service setting: A qualitative study of barriers to quitting among disadvantaged Australian smokers

    OpenAIRE

    O'Brien Jon; Paul Christine; Bonevski Billie; Bryant Jamie; Oakes Wendy

    2011-01-01

    Abstract Background Smoking rates remain unacceptably high among individuals who are socially disadvantaged. Social and community service organisations (SCSO) are increasingly interested in providing smoking cessation support to clients, however little is known about the best way to assist disadvantaged smokers to quit in this setting. This study aimed to explore barriers and facilitators to quitting within the conceptual framework of the PRECEDE model to identify possible interventions appro...

  12. 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

  13. Effects of Social Support and Relapse Prevention Training as Adjuncts to a Televised Smoking-Cessation Intervention.

    Science.gov (United States)

    Gruder, Charles L.; And Others

    1993-01-01

    Smokers were assigned to either no-contact control, discussion, or social support group. All subjects received self-help manual and were encouraged to watch daily televised cessation program. Social support group and their nonsmoking buddies were trained in support and relapse prevention. Found abstinence rates highest in social support group,…

  14. Pharmaceutical care in smoking cessation.

    Science.gov (United States)

    Marín Armero, Alicia; Calleja Hernandez, Miguel A; Perez-Vicente, Sabina; Martinez-Martinez, Fernando

    2015-01-01

    As a determining factor in various diseases and the leading known cause of preventable mortality and morbidity, tobacco use is the number one public health problem in developed countries. Facing this health problem requires authorities and health professionals to promote, via specific programs, health campaigns that improve patients' access to smoking cessation services. Pharmaceutical care has a number of specific characteristics that enable the pharmacist, as a health professional, to play an active role in dealing with smoking and deliver positive smoking cessation interventions. The objectives of the study were to assess the efficacy of a smoking cessation campaign carried out at a pharmaceutical care center and to evaluate the effects of pharmaceutical care on patients who decide to try to stop smoking. The methodology was an open, analytical, pre-post intervention, quasi-experimental clinical study performed with one patient cohort. The results of the study were that the promotional campaign for the smoking cessation program increased the number of patients from one to 22, and after 12 months into the study, 43.48% of the total number of patients achieved total smoking cessation. We can conclude that advertising of a smoking cessation program in a pharmacy increases the number of patients who use the pharmacy's smoking cessation services, and pharmaceutical care is an effective means of achieving smoking cessation. PMID:25678779

  15. Smoking cessation and COPD

    Directory of Open Access Journals (Sweden)

    Philip Tønnesen

    2013-03-01

    Full Text Available The mainstay in smoking cessation is counselling in combination with varenicline, nicotine replacement therapy (NRT or bupropion SR. Varenicline and combination of two NRTs is equally effective, while varenicline alone is more effective than either NRT or bupropion SR. NRT is extremely safe but cardiovascular and psychiatric adverse events with varenicline have been reported. These treatments have also been shown to be effective in patients with chronic obstructive pulmonary disease (COPD. A model study is the Lung Health Study from the USA. Findings from this study of 5,587 patients with mild COPD showed that repeated smoking cessation for a period of 5 yrs resulted in a quit rate of 37%. After 14.5 yrs the quitters had a higher lung function and a higher survival rate. A study with a new nicotine formulation, a mouth spray, showed high relative efficacy. As 5–10% of quitters use long-term NRT, we report the results of a study where varenicline compared with placebo increased the quit rate in long-term users of NRT. Smoking cessation is the most effective intervention in stopping the progression of COPD, as well as increasing survival and reducing morbidity. This is why smoking cessation should be the top priority in the treatment of COPD.

  16. Pharmaceutical care in smoking cessation

    Directory of Open Access Journals (Sweden)

    Marín Armero A

    2015-01-01

    Full Text Available Alicia Marín Armero,1 Miguel A Calleja Hernandez,2 Sabina Perez-Vicente,3 Fernando Martinez-Martinez4 1Community Pharmacy, Murcia, Spain; 2Hospital Pharmacy, University Hospital Virgen de las Nieves, Granada, Spain; 3Result Evaluation Unit, Institute of Biomedicine, Sevilla, Spain; 4Research Unit in Pharmaceutical Care, University of Granada, Granada, Spain Abstract: As a determining factor in various diseases and the leading known cause of preventable mortality and morbidity, tobacco use is the number one public health problem in developed countries. Facing this health problem requires authorities and health professionals to promote, via specific programs, health campaigns that improve patients’ access to smoking cessation services. Pharmaceutical care has a number of specific characteristics that enable the pharmacist, as a health professional, to play an active role in dealing with smoking and deliver positive smoking cessation interventions. The objectives of the study were to assess the efficacy of a smoking cessation campaign carried out at a pharmaceutical care center and to evaluate the effects of pharmaceutical care on patients who decide to try to stop smoking. The methodology was an open, analytical, pre–post intervention, quasi-experimental clinical study performed with one patient cohort. The results of the study were that the promotional campaign for the smoking cessation program increased the number of patients from one to 22, and after 12 months into the study, 43.48% of the total number of patients achieved total smoking cessation. We can conclude that advertising of a smoking cessation program in a pharmacy increases the number of patients who use the pharmacy’s smoking cessation services, and pharmaceutical care is an effective means of achieving smoking cessation. Keywords: community pharmacy, health campaign, tobacco cessation, nicotine replacement therapy

  17. 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...... 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, the...... services to support relatives and to enable them to handle the situation. This study systematically reviewed the literature on the latest health service interventions targeting relatives of heart patients. METHODS: The literature about interventions targeting relatives of heart patients has been...

  18. College smoking-cessation using cell phone text messaging.

    Science.gov (United States)

    Obermayer, Jami L; Riley, William T; Asif, Ofer; Jean-Mary, Jersino

    2004-01-01

    Although rates of smoking among college-aged students continue to rise, few interventions that focus on college smokers' unique motivations and episodic smoking patterns exist. The authors developed and evaluated a prototype program targeting college students that integrates Web and cell phone technologies to deliver a smoking-cessation intervention. To guide the user through the creation and initialization of an individualized quitting program delivered by means of cell phone text messaging, the program uses assessment tools delivered with the program Web site. Forty-six regular smokers were recruited from local colleges and provided access to the program. At 6-week follow-up, 43% had made at least one 24-hour attempt to quit, and 22% were quit--based on a 7-day prevalence criterion. The findings provide support for using wireless text messages to deliver potentially effective smoking-cessation behavioral interventions to college students. PMID:15495883

  19. A mixed-method systematic review and meta-analysis of mental health professionals' attitudes toward smoking and smoking cessation amongst people with mental illnesses

    OpenAIRE

    Sheals, K.; Tombor, I.; McNEILL, A.; Shahab, L

    2016-01-01

    BACKGROUND AND AIMS: People with mental illnesses and substance abuse disorders are important targets for smoking cessation interventions. Mental health professionals (MHPs) are ideally placed to deliver interventions, but their attitudes may prevent this. This systematic review therefore aimed to identify and estimate quantitatively MHPs attitudes towards smoking and main barriers for providing smoking cessation support and to explore these attitudes in-depth through qualitative synthesis. M...

  20. What works with men? A systematic review of health promoting interventions targeting men

    Directory of Open Access Journals (Sweden)

    Reid Garth

    2008-07-01

    Full Text Available Abstract Background Encouraging men to make more effective use of (preventive health services is considered one way of improving their health. The aim of this study was to appraise the available evidence of effective interventions aimed at improving men's health. Methods Systematic review of relevant studies identified through 14 electronic databases and other information resources. Results were pooled within health topic and described qualitatively. Results Of 11,749 citations screened, 338 articles were assessed and 27 met our inclusion criteria. Most studies were male sex-specific, i.e. prostate cancer screening and testicular self-examination. Other topics included alcohol, cardiovascular disease, diet and physical activity, skin cancer and smoking cessation. Twenty-three interventions were effective or partially effective and 18 studies satisfied all quality criteria. Conclusion Most of the existing evidence relates to male sex-specific health problems as opposed to general health concerns relevant to both men and women. There is little published evidence on how to improve men's uptake of services. We cannot conclude from this review that targeting men works better than providing services for all people. Large-scale studies are required to help produce evidence that is sufficiently robust to add to the small evidence base that currently exists in this field.

  1. Methods of smoking cessation.

    Science.gov (United States)

    Schwartz, J L

    1992-03-01

    Smoking-cessation treatment consists of three phases: preparation, intervention, and maintenance. Preparation aims to increase the smoker's motivation to quit and to build confidence that he or she can be successful. Intervention can take any number of forms (or a combination of them) to help smokers to achieve abstinence. Maintenance, including support, coping strategies, and substitute behaviors, is necessary for permanent abstinence. Although most smokers who successfully quit do so on their own, many use cessation programs at some point during their smoking history. Moreover, many people act on the advice of a health professional in deciding to quit. Some are also aided by a smoking-cessation kit from a public or voluntary agency, a book, a tape, or an over-the-counter product. Still others receive help from mass-media campaigns, such as the Great American Smokeout, or community programs. Counseling, voluntary and commercial clinics, nicotine replacement strategies, hypnosis, acupuncture, and behavioral programs are other methods used by smokers to break the habit. Programs that include multiple treatments are more successful than single interventions. The most cost-effective strategy for smoking cessation for most smokers is self-care, which includes quitting on one's own and might also include acting on the advice of a health profession or using an aid such as a quit-smoking guide. Heavier, more addicted smokers are more likely to seek out formal programs after several attempts to quit. Many people can quit smoking, but staying off cigarettes requires maintenance, support, and additional techniques, such as relapse prevention. Physicians, dentists, and other health professionals can provide important assistance to their patients who smoke. Quit rates can be improved if clinicians provide more help (e.g., counseling, support) than just simple advice and warnings. Clinicians also play an important role in providing nicotine replacement products such as nicotine

  2. Online Advertising as a Public Health and Recruitment Tool: Comparison of Different Media Campaigns to Increase Demand for Smoking Cessation Interventions

    OpenAIRE

    Graham, Amanda L.; Milner, Pat; Saul, Jessie E.; Pfaff, Lillian

    2008-01-01

    Background To improve the overall impact (reach × efficacy) of cessation treatments and to reduce the population prevalence of smoking, innovative strategies are needed that increase consumer demand for and use of cessation treatments. Given that 12 million people search for smoking cessation information each year, online advertising may represent a cost-efficient approach to reach and recruit online smokers to treatment. Online ads can be implemented in many forms, and surveys consistently s...

  3. Update on Smoking Cessation: E-Cigarettes, Emerging Tobacco Products Trends, and New Technology-Based Interventions.

    Science.gov (United States)

    Das, Smita; Tonelli, Makenzie; Ziedonis, Douglas

    2016-05-01

    Tobacco use disorders (TUDs) continue to be overly represented in patients treated in mental health and addiction treatment settings. It is the most common substance use disorder (SUD) and the leading cause of health disparities and increased morbidity/mortality amongst individuals with a psychiatric disorder. There are seven Food and Drug Administration (FDA) approved medications and excellent evidence-based psychosocial treatment interventions to use in TUD treatment. In the past few years, access to and use of other tobacco or nicotine emerging products are on the rise, including the highly publicized electronic cigarette (e-cigarette). There has also been a proliferation of technology-based interventions to support standard TUD treatment, including mobile apps and web-based interventions. These tools are easily accessed 24/7 to support outpatient treatment. This update will review the emerging products and counter-measure intervention technologies, including how clinicians can integrate these tools and other community-based resources into their practice. PMID:27040275

  4. Interventions targeting social isolation in older people: a systematic review

    Directory of Open Access Journals (Sweden)

    Greaves Colin J

    2011-08-01

    Full Text Available Abstract Background Targeting social isolation in older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that approximately 25% of the population will be aged 60 or above within the next 20 to 40 years. Social isolation is prevalent amongst older people and evidence indicates the detrimental effect that it can have on health and wellbeing. The aim of this review was to assess the effectiveness of interventions designed to alleviate social isolation and loneliness in older people. Methods Relevant electronic databases (MEDLINE, EMBASE, ASSIA, IBSS, PsycINFO, PubMed, DARE, Social Care Online, the Cochrane Library and CINAHL were systematically searched using an extensive search strategy, for randomised controlled trials and quasi-experimental studies published in English before May 2009. Additional articles were identified through citation tracking. Studies were included if they related to older people, if the intervention aimed to alleviate social isolation and loneliness, if intervention participants were compared against inactive controls and, if treatment effects were reported. Two independent reviewers extracted data using a standardised form. Narrative synthesis and vote-counting methods were used to summarise and interpret study data. Results Thirty two studies were included in the review. There was evidence of substantial heterogeneity in the interventions delivered and the overall quality of included studies indicated a medium to high risk of bias. Across the three domains of social, mental and physical health, 79% of group-based interventions and 55% of one-to-one interventions reported at least one improved participant outcome. Over 80% of participatory interventions produced beneficial effects across the same domains, compared with 44% of those categorised as non-participatory. Of interventions categorised as having a theoretical basis, 87

  5. Mass Media for Smoking Cessation in Adolescents

    Science.gov (United States)

    Solomon, Laura J.; Bunn, Janice Y.; Flynn, Brian S.; Pirie, Phyllis L.; Worden, John K.; Ashikaga, Takamaru

    2009-01-01

    Theory-driven, mass media interventions prevent smoking among youth. This study examined effects of a media campaign on adolescent smoking cessation. Four matched pairs of media markets in four states were randomized to receive or not receive a 3-year television/radio campaign aimed at adolescent smoking cessation based on social cognitive theory.…

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

    OpenAIRE

    Felix Naughton

    2015-01-01

    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 ...

  7. The protocol for the Be Our Ally Beat Smoking (BOABS study, a randomised controlled trial of an intensive smoking cessation intervention in a remote Aboriginal Australian health care setting

    Directory of Open Access Journals (Sweden)

    Marley Julia V

    2012-03-01

    Full Text Available Abstract Background Australian Aboriginal peoples and Torres Strait Islanders (Indigenous Australians smoke at much higher rates than non-Indigenous people and smoking is an important contributor to increased disease, hospital admissions and deaths in Indigenous Australian populations. Smoking cessation programs in Australia have not had the same impact on Indigenous smokers as on non-Indigenous smokers. This paper describes the protocol for a study that aims to test the efficacy of a locally-tailored, intensive, multidimensional smoking cessation program. Methods/Design This study is a parallel, randomised, controlled trial. Participants are Aboriginal and Torres Strait Islander smokers aged 16 years and over, who are randomly allocated to a 'control' or 'intervention' group in a 2:1 ratio. Those assigned to the 'intervention' group receive smoking cessation counselling at face-to-face visits, weekly for the first four weeks, monthly to six months and two monthly to 12 months. They are also encouraged to attend a monthly smoking cessation support group. The 'control' group receive 'usual care' (i.e. they do not receive the smoking cessation program. Aboriginal researchers deliver the intervention, the goal of which is to help Aboriginal peoples and Torres Strait Islanders quit smoking. Data collection occurs at baseline (when they enrol and at six and 12 months after enrolling. The primary outcome is self-reported smoking cessation with urinary cotinine confirmation at 12 months. Discussion Stopping smoking has been described as the single most important individual change Aboriginal and Torres Strait Islander smokers could make to improve their health. Smoking cessation programs are a major priority in Aboriginal and Torres Strait Islander health and evidence for effective approaches is essential for policy development and resourcing. A range of strategies have been used to encourage Aboriginal peoples and Torres Strait Islanders to quit

  8. Age and educational inequalities in smoking cessation due to three population-level tobacco control interventions: findings from the International Tobacco Control (ITC) Netherlands Survey

    NARCIS (Netherlands)

    G.E. Nagelhout; M.R. Crone; B. van den Putte; M.C. Willemsen; G.T. Fong; H. de Vries

    2013-01-01

    This study aimed to examine age and educational inequalities in smoking cessation due to the implementation of a tobacco tax increase, smoke-free legislation and a cessation campaign. Longitudinal data from 962 smokers aged 15 years and older were used from three survey waves of the International To

  9. Age and Educational Inequalities in Smoking Cessation Due to Three Population-Level Tobacco Control Interventions: Findings from the International Tobacco Control (ITC) Netherlands Survey

    Science.gov (United States)

    Nagelhout, Gera E.; Crone, Matty R.; van den Putte, Bas; Willemsen, Marc C.; Fong, Geoffrey T.; de Vries, Hein

    2013-01-01

    This study aimed to examine age and educational inequalities in smoking cessation due to the implementation of a tobacco tax increase, smoke-free legislation and a cessation campaign. Longitudinal data from 962 smokers aged 15 years and older were used from three survey waves of the International Tobacco Control (ITC) Netherlands Survey. The 2008…

  10. 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. PMID:24485064

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

    OpenAIRE

    Ford Daniel E; Sadasivam Rajani S; Houston Thomas K; Richman Joshua; Ray Midge N; Allison Jeroan J

    2010-01-01

    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 smoki...

  12. 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 to...... 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 is to be...

  13. 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.

  14. Ear Acupressure for Smoking Cessation: A Randomised Controlled Trial

    OpenAIRE

    Zhang, Anthony L.; Yuan Ming Di; Christopher Worsnop; Brian H. May; Cliff Da Costa; Xue, Charlie C.L.

    2013-01-01

    This study investigated the efficacy and safety of ear acupressure (EAP) as a stand-alone intervention for smoking cessation and the feasibility of this study design. Adult smokers were randomised to receive EAP specific for smoking cessation (SSEAP) or a nonspecific EAP (NSEAP) intervention which is not typically used for smoking cessation. Participants received 8 weekly treatments and were requested to press the five pellets taped to one ear at least three times daily. Participants were fol...

  15. The gut microbiome, kidney disease, and targeted interventions.

    Science.gov (United States)

    Ramezani, Ali; Raj, Dominic S

    2014-04-01

    The human gut harbors >100 trillion microbial cells, which influence the nutrition, metabolism, physiology, and immune function of the host. Here, we review the quantitative and qualitative changes in gut microbiota of patients with CKD that lead to disturbance of this symbiotic relationship, how this may contribute to the progression of CKD, and targeted interventions to re-establish symbiosis. Endotoxin derived from gut bacteria incites a powerful inflammatory response in the host organism. Furthermore, protein fermentation by gut microbiota generates myriad toxic metabolites, including p-cresol and indoxyl sulfate. Disruption of gut barrier function in CKD allows translocation of endotoxin and bacterial metabolites to the systemic circulation, which contributes to uremic toxicity, inflammation, progression of CKD, and associated cardiovascular disease. Several targeted interventions that aim to re-establish intestinal symbiosis, neutralize bacterial endotoxins, or adsorb gut-derived uremic toxins have been developed. Indeed, animal and human studies suggest that prebiotics and probiotics may have therapeutic roles in maintaining a metabolically-balanced gut microbiota and reducing progression of CKD and uremia-associated complications. We propose that further research should focus on using this highly efficient metabolic machinery to alleviate uremic symptoms. PMID:24231662

  16. Transcription factors: molecular targets for prostate cancer intervention by phytochemicals.

    Science.gov (United States)

    Kaur, Manjinder; Agarwal, Rajesh

    2007-06-01

    With increasing incidence of cancer at most of the sites, and growing economic burden and associated psychological and emotional trauma, it is becoming clearer that more efforts are needed for cancer cure. Since most of the chemotherapeutic drugs are non-selective because they are also toxic to the normal cells, new and improved strategies are needed that selectively target the killing of cancer cells. Since aberrant activation of numerous signaling pathways is a key element of cancer cell survival and growth, blocking all of them is not that practical, which leads to the step where most of them commonly converge; the transcription factors. Recent research efforts, therefore, are also directed on targeting the activity and activation of transcription factors, which ultimately control the expression of genes that are involved in almost all aspects of cell biology. One class of agents that is becoming increasingly successful, not only in targeting signaling cascades, but also transcription factors is phytochemicals present in diet and those consumed as supplement. The added advantage with these agents is that they are mostly non-toxic when compared to chemotherapeutic agents. This review focuses on the efficacy of various phytochemicals in targeting transcription factors such as AR, Sp1, STATs, E2F, Egr1, c-Myc, HIF-1 alpha, NF-kappaB, AP-1, ETS2, GLI and p53 in the context of prostate cancer intervention. PMID:17979630

  17. Smoking and cancer: smoking cessation.

    OpenAIRE

    Austoker, J; Sanders, D.; Fowler, G

    1994-01-01

    Smoking is the single most important cause of cancer. The risk of developing cancer is reduced by stopping smoking and decreases substantially after five years. Reduction in smoking must be central to any programme aimed seriously at the prevention of cancer. An individual approach, based in primary care, has the potential to bring about modest but important reductions in risk. Many randomised trials have shown the effectiveness of various smoking cessation interventions in primary care. Give...

  18. Symptom targeted intervention webinar trainings: feedback from participants.

    Science.gov (United States)

    McCool, Melissa; Boyd, Shaun; Aebel-Groesch, Kathy; Gonzalez, Teresa; Evans, Deborah

    2014-06-01

    Professional trainings through the use of webinar format are widely used, but participant feedback is seldom studied. In the spring of 2013, 83 nephrology social workers participated in weekly webinar trainings to learn how to implement Symptom Targeted Intervention (STI) into their clinical practice. At the end of the project, participants were asked to complete an online questionnaire to provide feedback on the perceived value and effectiveness of the trainings. Sixty-eight participants completed the questionnaire. The results indicate that social workers found the webinar trainings to be very useful and wanted the trainings to continue beyond the project. Based on participant feedback, clinical training and case presentation through the use of ongoing webinars is a useful education modality for nephrology professionals, but more research is indicated to evaluate how best to utilize webinars to maximize learning. PMID:25055437

  19. A study of smoking and smoking cessation on the curricula of UK medical schools

    OpenAIRE

    Roddy, E; Rubin, P.; Britton, J.

    2004-01-01

    Objectives: To identify current practice in teaching on smoking and smoking cessation in UK medical schools, and establish whether newly qualified UK doctors feel prepared to deliver smoking cessation interventions.

  20. Importance of Smoking Cessation in a Lung Cancer Screening Program

    OpenAIRE

    Munshi, Vidit; McMahon, Pamela

    2013-01-01

    Early detection of lung cancer and smoking cessation interventions can decrease lung cancer mortality, but information on the effectiveness and interaction between smoking cessation and lung cancer screening is sparse and inconsistent. This review aims to synthesize recent studies in two major areas of interest. First, we explore the interactions and potential for synergies between lung cancer screening programs and smoking cessation by summarizing reported changes in smoking behavior observe...

  1. 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 ...

  2. 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.

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

    International Nuclear Information System (INIS)

    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

  4. A placebo controlled randomized trial of the effects of phenylpropanolamine and nicotine gum on cessation rates and postcessation weight gain in women.

    Science.gov (United States)

    Cooper, Theodore V; Klesges, Robert C; Debon, Margaret W; Zbikowski, Susan M; Johnson, Karen C; Clemens, Linda H

    2005-01-01

    With smoking prevalence rates beginning to decline, studies designed to promote cessation in more challenging populations, like weight-concerned smokers, warrant attention. This study assessed the efficacy of two forms of pharmacotherapy [nicotine and phenylpropanolamine (PPA) gums] in addition to a 13-week cognitive behavioral smoking cessation program targeted for women. Participants were 439 females who met rigorous screening criteria and were randomized to one of the three treatment intervention groups (PPA gum, nicotine gum, or placebo gum). All participants attended a 13-week cognitive behavioral smoking cessation program and were given specific instructions on gum chewing. At posttest (13 weeks), and 6- and 12-month follow-ups, body weight and point prevalence abstinence were assessed. Analyses to determine potential differences between treatment groups on weight change and cessation rates were performed. Results indicated that neither change in body weight nor cessation rates significantly differed between groups. Attendance to sessions did appear to consistently increase the likelihood of quitting smoking at posttest and at each of the follow-ups. These results suggest that although the pharmacological interventions had no effect on cessation rates and postcessation weight gain, the behavioral component of the intervention was effective in increasing the odds of quitting smoking in weight-concerned women. Future efforts should focus on increasing adherence to behavioral program components, particularly session attendance. PMID:15561449

  5. Efficacy of Incorporating Experiencing Exercises into a Smoking Cessation Curriculum.

    Science.gov (United States)

    Watt, Celia A.; Manaster, Guy

    2003-01-01

    Examines the impact of experiential exercises, combined with a traditional smoking cessation intervention, on quit rates and social learning theory variables known to impact smoking cessation. Measures of self-efficacy and locus of control did not significantly differ between the experimental and control conditions. Quit rates did not differ…

  6. 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.

  7. 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

  8. 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

  9. Social communication interventions for preschoolers: targeting peer interactions during peer group entry and cooperative play.

    Science.gov (United States)

    Timler, Geralyn R; Olswang, Lesley B; Coggins, Truman E

    2005-08-01

    Some preschoolers with language impairment approach and manage peer interactions less effectively than typically developing peers. This article discusses assessment and intervention strategies for targeting preschoolers' social communication skills during peer entry and cooperative play situations. Essential features of effective interventions include identification of appropriate social communication targets, addressing and facilitating children's use of these targets during small group sessions with peers, and supporting generalization of newly acquired social communication behaviors to children's peer interactions within the classroom setting. PMID:16155855

  10. Smoking cessation strategies for patients with asthma: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Perret JL

    2016-06-01

    Full Text Available Jennifer L Perret,1–3 Billie Bonevski,4 Christine F McDonald,2,3,5 Michael J Abramson6,7 1Allergy and Lung Health Unit, The University of Melbourne, Melbourne, VIC, 2Institute for Breathing & Sleep, Melbourne, VIC, 3Department of Respiratory and Sleep Medicine, Austin Hospital, Melbourne, VIC, 4School of Medicine & Public Health, University of Newcastle, NSW, 5Department of Medicine, The University of Melbourne, Melbourne, VIC, 6School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC, 7Allergy, Immunology & Respiratory Medicine, The Alfred Hospital, Melbourne, VIC, Australia Abstract: Smoking is common in adults with asthma, yet a paucity of literature exists on smoking cessation strategies specifically targeting this subgroup. Adverse respiratory effects from personal smoking include worse asthma control and a predisposition to lower lung function and chronic obstructive pulmonary disease. Some data suggest that individuals with asthma are more likely than their non-asthmatic peers to smoke regularly at an earlier age. While quit attempts can be more frequent in smokers with asthma, they are also of shorter duration than in non-asthmatics. Considering these asthma-specific characteristics is important in order to individualize smoking cessation strategies. In particular, asthma-specific information such as “lung age” should be provided and longer-term follow-up is advised. Promising emerging strategies include reminders by cellular phone and web-based interventions using consumer health informatics. For adolescents, training older peers to deliver asthma education is another promising strategy. For smokers who are hospitalized for asthma, inpatient nicotine replacement therapy and counseling are a priority. Overall, improving smoking cessation rates in smokers with asthma may rely on a more personalized approach, with the potential for substantial health benefits to individuals and the population at large

  11. 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.

  12. Modelling return-to-work intervention strategies: A method to help target interventions

    NARCIS (Netherlands)

    C. Joling; P. Janssen; W.J.N. Groot

    2004-01-01

    The aim of this study is twofold: 1) to investigate the relationship between the probability of receiving an intervention by the occupational physician and the probability of return-to-work (RTW) of sick workers; 2) to explore the use of simultaneous modelling of the intervention and RTW process. An

  13. 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…

  14. Effects of targeting disease and medication management interventions towards patients with COPD

    NARCIS (Netherlands)

    van Boven, J F M; Stuurman-Bieze, A G G; Hiddink, E G; Postma, M J

    2016-01-01

    OBJECTIVE: Suboptimal adherence in Chronic Obstructive Pulmonary Disease (COPD) patients is associated with decreased clinical and economic outcomes. Intervention programs, targeted at patients with suboptimal adherence and exacerbations, offer opportunities for cost-effective COPD care. We have aim

  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. The Limerick Reading Initiative: A Reading Intervention Targeted at Struggling Readers in Primary School

    Science.gov (United States)

    O'Rourke, Diarmuid; Olshtroon, Aoife; O'Halloran, Claire

    2016-01-01

    In this study we examined the effectiveness of a reading intervention targeting a group of 24 struggling readers in ten primary schools in Ireland. The intervention consisted of two components; component one consisted of 15-20 minutes delivery of the Toe-by-Toe programme (a well established systematic synthetic phonics programme) and the second…

  17. The Unintended Consequences of Targeting: Young People's Lived Experiences of Social and Emotional Learning Interventions

    Science.gov (United States)

    Evans, Rhiannon; Scourfield, Jonathan; Murphy, Simon

    2015-01-01

    In the past twenty years there has been a proliferation of targeted school-based social and emotional learning (SEL) interventions. However, the lived experience of young peoples' participation is often elided, while the potential for interventions to confer unintended and even adverse effects remains under-theorised and empirically…

  18. 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…

  19. 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…

  20. Engaging African Americans in Smoking Cessation Programs

    Science.gov (United States)

    Wallen, Jacqueline; Randolph, Suzanne; Carter-Pokras, Olivia; Feldman, Robert; Kanamori-Nishimura, Mariano

    2014-01-01

    Background: African Americans are disproportionately exposed to and targeted by prosmoking advertisements, particularly menthol cigarette ads. Though African Americans begin smoking later than whites, they are less likely to quit smoking than whites. Purpose: This study was designed to explore African American smoking cessation attitudes,…

  1. 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. PMID:27184326

  2. 冠状动脉介入治疗患者戒烟状况和动机分析%Analysis on smoking cessation status and motivation in coronary intervention patients

    Institute of Scientific and Technical Information of China (English)

    韩晓宁; 丁文惠; 龚艳君; 金黎英; 刘秀芬

    2012-01-01

    Objective To investigate smoking and smoking cessation status in patients with coronary intervention (PCI) and analyze the motivation to quit smoking. Methods A questionnaire was employed to 280 outpatients post PCI for information such as gender, age, year of first time treated with PCI, smoking status, and smoking cessation motivation. Compare initial coronary intervention age of patients with different smoking status. Compare number of cigarettes consumed in different groups. Results The initial PCI age in smokers was (56.7?6.0) years, and in non-smoker is (65.5?.8) years (t = -5.457, P = 0. 000). The initial PCI age of passive smokers in the non-smoking group was (61. 8 ?10. 3) years, lower than that of the non-passive smokers in the same group, (66.4?.5) years (t= -2.278, P = 0.024). Till the time of the survey, only 10% of patients remained the original amount of smoking. 83.0% of patients quit or reduced smoking after being discharged from hospital for initial PCI. Number of cigarettes of smoking cessation group (n = 91) was 20 (10, 20) , less than of the smoking reduction group (n = 26) , 20 (20, 30) (Z = -2.734, P = 0. 006). To choose a single smoking cessation motivation is higher in smoking cessation ahead of PCI group than the other groups, and the highest proportion of which need to quit smoking was suffering from other diseases. The motivation to reduce smoking need a few. Persuading from family, friends and doctors and worrying further harm of heart disease by smoking were selected the highest rate. Conclusions The initial PCI age in smokers was significantly lower than non-smokers. The vast majority of patients with coronary heart disease quit smoking or reduced the amount of smoking after the first interventional treatment. Persuading from doctors was one of the most important motivations to quit smoking.%目的 调查冠状动脉介入(PCI)治疗患者吸烟和戒烟状态,分析患者戒烟动机.方法 对280名目前正在冠心病随访门诊

  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

    2016-01-01

    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. PMID:26990263

  4. 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

    AIM: To describe how women smokers with newly diagnosed breast cancer experienced brief preoperative smoking cessation intervention in relation to breast cancer surgery. BACKGROUND: Preoperative smoking cessation intervention is relevant for short- and long-term risk reduction in newly diagnosed ...

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

    Science.gov (United States)

    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

  7. Evaluation of a Smoking Cessation Program for HIV Infected Individuals in an Urban HIV Clinic: Challenges and Lessons Learned

    Directory of Open Access Journals (Sweden)

    Debra Chew

    2014-01-01

    Full Text Available Introduction. HIV infected persons have high prevalence of smoking and tobacco-associated health risks. Few studies describe smoking cessation programs targeting this population. The Infectious Disease Practice (IDP in Newark, New Jersey, initiated a smoking cessation program (SCP for HIV infected smokers. We report participation, abstinence rates, and predictors of abstinence. Methods. This is a prospective cohort study, comparing participants to non-SCP smokers, during April 1, 2011, to October 31, 2012. Intervention included one individualized counseling session with an offer of pharmacotherapy. Univariate and multivariate analyses were performed with self-reported seven-day point prevalence abstinence at six months as primary outcome measure. Results. Among 1545 IDP patients, 774 (51% were current smokers of whom 123 (16% participated in the SCP. Mean six-month abstinence rate amongst SCP participants was 16%. A history of cocaine or heroin use was predictive of continued smoking (odds ratio [OR] adjusted 0.20, 95% confidence interval [CI] 0.07–0.55 while smokers in the preparation stage of change were more likely abstinent at six months (OR adjusted 8.26, 95% CI 1.02–66.67. Conclusions. A low-intensity smoking cessation intervention in an HIV treatment setting is effective in a minority of participants. Further research is needed to better address barriers to smoking cessation such as substance use.

  8. The effectiveness of a proactive coping intervention targeting self-management in diabetes patients

    OpenAIRE

    Kroese, Floor M.; Marieke A. Adriaanse; Vinkers, Charlotte D W; Van de Schoot, Rens; de Ridder, Denise T. D.

    2014-01-01

    Objective: The study's aim was to investigate psychological, behavioral and medical long-term outcomes of an existing self-management intervention targeting the development of proactive coping skills (e.g. goal setting and identifying barriers) in type 2 diabetes patients. The study aimed to replicate prior research showing the intervention's effectiveness, and to extend it by (a) adding booster sessions and (b) prolonging the period of follow-up measurement to capture long-term effects.Desig...

  9. Clinician-Targeted Intervention and Patient-Reported Counseling on Physical Activity

    OpenAIRE

    Carroll, Jennifer K.; Winters, Paul C.; Sanders, Mechelle R; Decker, Francesca; Ngo, Thanh ,; Sciamanna, Christopher N.

    2014-01-01

    Introduction Limited time and lack of knowledge are barriers to physical activity counseling in primary care. The objective of this study was to examine the effectiveness of a clinician-targeted intervention that used the 5As (Ask, Advise, Agree, Assist, Arrange) approach to physical activity counseling in a medically underserved patient population. Methods Family medicine clinicians at 2 community health centers were randomized to Group 1 or Group 2 intervention. Both clinician groups partic...

  10. Flexible inflation targets, forex interventions and exchange rate volatility in emerging countries

    OpenAIRE

    Juan Carlos Berganza; Carmen Broto

    2011-01-01

    Emerging economies with inflation targets (IT) face a dilemma between fulflling the theoretical conditions of "strict IT", which implies a fully flexible exchange rate, or applying a "flexible IT", which entails a de facto managed floating exchange rate with forex interventions to moderate exchange rate volatility. Using a panel data model for 37 countries we find that, although IT lead to higher exchange rate instability than alternative regimes, forex interventions in some IT countries have...

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

    Directory of Open Access Journals (Sweden)

    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. A Pilot Test of Self-Affirmations to Promote Smoking Cessation in a National Smoking Cessation Text Messaging Program

    Science.gov (United States)

    Klein, William M.P; Ferrer, Rebecca A; Augustson, Erik; Patrick, Heather

    2016-01-01

    Background Although effective smoking cessation treatments, including mHealth interventions, have been empirically validated and are widely available, smoking relapse is likely. Self-affirmation, a process through which individuals focus on their strengths and behaviors, has been shown to reduce negative effects of self-threats and to promote engagement in healthier behavior. Objective To assess the feasibility of incorporating self-affirmations into an existing text messaging-based smoking cessation program (Smokefree TXT) and to determine whether self-affirmation led to greater engagement and higher cessation rates than the standard intervention. Methods Data were collected from smokers (n=1261) who subscribed to a free smoking cessation program and met eligibility criteria. The intervention lasted 42 days. The original design was a 2 (Baseline affirmation: 5-item questionnaire present vs absent) × 2 (Integrated affirmation: texts present vs absent) factorial design. Only 17 eligible users completed all baseline affirmation questions and these conditions did not influence any outcomes, so we collapsed across baseline affirmation conditions in analysis. In the integrated affirmation conditions, affirmations replaced approximately 20% of texts delivering motivational content. Results In all, 687 users remained enrolled throughout the 42-day intervention and 81 reported smoking status at day 42. Among initiators (n=1261), self-affirmation did not significantly improve (1) intervention completion, (2) days enrolled, (3) 1-week smoking status, or (4) 6-week smoking status (all Ps>.10); and among the 687 completers, there were no significant effects of affirmation on cessation (Ps>.25). However, among the 81 responders, those who received affirmations were more likely to report cessation at 6 weeks (97.5%; 39 of 40) than those not given affirmations (78.1%; 32 of 41; χ2(1)=7.08, P=.008). Conclusion This proof-of-concept study provides preliminary evidence that self

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

    NARCIS (Netherlands)

    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

  14. The Targeted Reading Intervention: Face-to-Face vs. Webcam Literacy Coaching of Classroom Teachers

    Science.gov (United States)

    Vernon-Feagans, L.; Bratsch-Hines, M.; Varghese, C.; Bean, A.; Hedrick, A.

    2015-01-01

    The targeted reading intervention (TRI) is a professional development program for rural kindergarten and first grade classroom teachers to help them provide effective reading strategies with struggling readers. In two randomized controlled trials, the TRI was delivered two ways: (1) literacy coaches provided support for classroom teachers through…

  15. Catch up Numeracy: A Targeted Intervention for Children Who Are Low-Attaining in Mathematics

    Science.gov (United States)

    Holmes, Wayne; Dowker, Ann

    2013-01-01

    Many children who would not be identified as having special educational needs are low-attaining in mathematics, which often has a severe impact on their progress at school and their successes in later life. This paper describes Catch Up Numeracy, a non-intensive targeted intervention for children who are low-attaining in mathematics, which is…

  16. Smoking Cessation in Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Tashkin, Donald P

    2015-08-01

    Smoking cessation is the most effective strategy for slowing down the progression of chronic obstructive pulmonary disease (COPD) and reducing mortality in the approximately 50% of patients with diagnosed COPD who continue to smoke. While behavioral interventions (including simple advice) have modest efficacy in improving smoking quit rates, the combination of counseling and pharmacotherapy is more effective than either alone. When combined with even brief counseling, nicotine replacement therapy (NRT), bupropion SR, and varenicline have all been shown to be effective in promoting smoking cessation and sustained abstinence in smokers with COPD to a degree comparable to that observed in the general smoking population. However, the recidivism rate is high after initial quitting so that at the end of 1 year, approximately 80% or more of patients are still smoking. Thus, new approaches to smoking cessation are needed. One approach is to combine different pharmacotherapies, for example, nicotine patch plus rapidly acting NRT (e.g., gum or nasal spray) and/or bupropion or even varenicline plus either NRT or bupropion, in a stepwise approach over a varying duration depending on the severity of nicotine dependence and nicotine withdrawal symptoms during the quit attempt, as proposed in the American College of Chest Physicians Tobacco Dependence Took Kit. Electronic (e)-cigarettes, which deliver vaporized nicotine without most of the noxious components in the smoke from burning tobacco cigarettes, also has potential efficacy as a smoking cessation aid, but their efficacy and safety as either substitutes for regular cigarettes or smoking cessation aids require additional study. This task is complicated because e-cigarettes are currently unregulated and hundreds of different brands are currently available. PMID:26238637

  17. Cost-Utility Analysis of Varenicline, an Oral Smoking-Cessation Drug, in Japan

    OpenAIRE

    Ataru Igarashi; Hiroki Takuma; Takashi Fukuda; Kiichiro Tsutani

    2009-01-01

    Objectives: To conduct a cost-utility analysis of two 12-week smoking-cessation interventions in Japan: smoking-cessation counselling by a physician compared with use of varenicline, an oral smoking-cessation drug, in addition to counselling. Abstract: Methods: A Markov model was constructed to analyse lifetime medical costs and QALYs from the perspective of the healthcare payer. The cycle length was 5 years. Both costs and QALYs were discounted at 3% annually. The cohort of smokers was class...

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

    OpenAIRE

    Mishra Gauravi; Majmudar Parishi; Gupta Subhadra; Rane Pallavi; Uplap Pallavi; Shastri Surendra

    2009-01-01

    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 cohor...

  19. Evaluation of knowledge change of internal medicine residents following a training program in smoking cessation

    International Nuclear Information System (INIS)

    One of the major barriers to smoking cessation practice is that many health professionals do not have the knowledge and skills on how to intervene. Objectives: To assess the effect of a training program on physicians' knowledge about tobacco dependence and cessation interventions. Subjects and Methods: A comprehensive training program was given to internal medicine residents in Cairo University Hospitals, Egypt during 2008-2009. An anonymous, 11- item questionnaire was administered before and after the training program. The training process was evaluated by participants' satisfaction using a 13- item checklist. The objective of the study was adequately explained to participants and their consensus was obtained with assured confidentiality. Results: A total of 163 internists entered the training program. Improvement in overall knowledge was evidenced by higher mean score in the post-test than pre-test (6.2 vs. 4.7; p<0.001). Significant improvement were seen in the participants' knowledge related to assessment of tobacco dependence (61% vs. 27%;p<0.001), interventions for smokers willing to quit (51.6 vs. 28.2%; p<0.001), interventions for smokers unwilling to quit (40.8 vs. 19.6%; p<0.001) and coping skills to handle withdrawal symptoms (52.9 vs. 30.7;p<0.001). Almost all participants reported that the training was very useful (96%) and applicable (85.6%) in their medical practices. Conclusions: Targeted training of health professionals has a potential to translate into improved smoking cessation counseling and to increase their inclination to intervene. Policy message: Continued medical education and regular/targeted training of health providers should be done. (author)

  20. Effectiveness of interventions targeting frequent users of emergency departments: a systematic review

    OpenAIRE

    Althaus F.

    2012-01-01

    L'article publié de le cadre de cette thèse est intitulé "Effectiveness of interventions targeting frequent users of emergency departments: A systematic review." Il a été publié par les "Annals of Emergency Medicine (AEM)" en juillet 2011. Le titre en français pourrait être: "Efficacité des interventions ciblant les utilisateurs fréquents des services d'urgence: Une revue systématique." Le titre du journal américain pourrait être: "Annales de Médecine d'Urgence". Il s'agit du journal du "Coll...

  1. Is a targeted intensive intervention effective for improvements in hypertension control?

    DEFF Research Database (Denmark)

    Reuther, Lene Ørskov; Paulsen, Maja Skov; Andersen, Morten;

    2012-01-01

    BACKGROUND: High blood pressure (BP) is one of the most important risk factors for stroke, and antihypertensive therapy significantly reduces the risk of cardiovascular morbidity and mortality. However, achieving a regulated BP in hypertensive patients is still a challenge. OBJECTIVE: To evaluate...... the impact of an intervention targeting GPs' management of hypertension. METHODS: A cluster randomized trial comprising 124 practices and 2646 patients with hypertension. In the Capital Region of Denmark, the participating GPs were randomized to an intensive or to a moderately intensive intervention...

  2. Targeted and anonymized smartphone-based public health interventions in a participatory sensing system.

    Science.gov (United States)

    Clarke, Andrew; Steele, Robert

    2014-01-01

    Public health interventions comprising information dissemination to affect behavioral adjustment have long been a significant component of public health campaigns. However, there has been limited development of public health intervention systems to make use of advances in mobile computing and telecommunications technologies. Such developments pose significant challenges to privacy and security where potentially sensitive data may be collected. In our previous work we identified and demonstrated the feasibility of using mobile devices as anonymous public health data collection devices as part of a Health Participatory Sensing Network (HPSN). An advanced capability of these networks extended in this paper would be the ability to distribute, apply, report on and analyze the usage and effectiveness of targeted public health interventions in an anonymous way. In this paper we describe such a platform, its place in the HPSN and demonstrate its feasibility through an implementation. PMID:25570789

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

    Directory of Open Access Journals (Sweden)

    Laurence M Galanti

    2008-09-01

    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

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

    OpenAIRE

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

    2014-01-01

    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 ...

  5. Targeted drugs and Psycho-oncological intervention for breast cancer patients

    OpenAIRE

    D’Abramo, Flavio; Goerling, Ute; Guastadisegni, Cecilia

    2016-01-01

    Personalized medicine is a new field based on molecular biology and genomics in which targeted tumor therapies are administered to patients. Psycho-oncology is a complementary approach that considers social and psychological aspects of patients as part of the treatments for cancer patients. The aim of this mini-review is to weigh clinical benefits for breast cancer patients of both treatments and possibily enhance benefits by modulating the use of both interventions. We have compared and eval...

  6. 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. PMID:26928566

  7. 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. PMID:25033959

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

    Science.gov (United States)

    Mille, Marie-Laure; Creath, Robert A.; Prettyman, Michelle G.; Johnson Hilliard, Marjorie; Martinez, Katherine M.; MacKinnon, Colum D.; Rogers, Mark W.

    2012-01-01

    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. “. . .postural activity should be regarded as a function in its own right and not merely as a component of movement. . .” James Purdon Martin PMID:22295253

  9. [Integrative neuroimaging for schizophrenia targeting early intervention and prevention (IN-STEP)].

    Science.gov (United States)

    Kasai, Kiyoto

    2010-11-01

    The editorial of the new-year issue of Nature 2010 features "A decade for psychiatric disorders". The DALY estimation clearly shows that psychiatric disorders are the top source for burden of diseases to the individual life and society. Schizophrenia is a most devastating psychiatric disorder in which the onset is usually at youth and the cognitive dysfunction persists for life-long in some patients. Schizophrenia is associated with neurodevelopmental abnormalities. It has been unknown whether post-onset progressive pathology is also present in schizophrenia until the recent sophistication of in vivo neuroimaging techniques. Longitudinal neuroimaging studies on first-episode schizophrenia have shown a progressive deterioration of structure and function of neocortical regions in the early stage of the disorder. Insult to dendritic spines through glutamatergic dysfunction may underlie this process, which may in turn be a promising molecular target for intervention to improve the functional outcome of schizophrenia. More recently, the question of whether early intervention can be targeted at prodromal stage of schizophrenia has called special attention in psychiatry. In University of Tokyo, the integrative neuroimaging studies for schizophrenia targeting early intervention and prevention (IN-STEP) is ongoing. Through these efforts, we would like to contribute to the establishment of "youth mental health", where every youth in the community can know, prevent, and have easy access to needs- and value-based services, and pursue mental well-being and recovery. PMID:21921453

  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. 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.

  12. 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.

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

    Science.gov (United States)

    Doyle, Orla; McGlanaghy, Edel; O’Farrelly, Christine; Tremblay, Richard E.

    2016-01-01

    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. Trial Registration: ISRCTN Registry ISRCTN04631728 PMID:27253184

  14. ROLE OF VARENICLINE IN SMOKING CESSATION: INDIAN SCENARIO

    Directory of Open Access Journals (Sweden)

    Basudev

    2014-05-01

    Full Text Available Tobacco smoking is one of the leading causes of worldwide morbidity as well as mortality which are largely preventable. Smoking cessation, though a difficult task to achieve, can lead to both immediate and long term health benefits such as reduction of the risk of lung cancer, chronic lung disease, stroke etc. This article reviews the various pharmacological interventions of smoking cessation like nicotine replacement therapy (NRT, bupropion, and nortryptiline etc., especially the role of a novel agent Varenicline in reducing nicotine dependence as well as in decreasing craving after nicotine withdrawal that holds promising effectiveness in Indian scenario.

  15. Hip Hop HEALS: Pilot Study of a Culturally Targeted Calorie Label Intervention to Improve Food Purchases of Children

    Science.gov (United States)

    Williams, Olajide; DeSorbo, Alexandra; Sawyer, Vanessa; Apakama, Donald; Shaffer, Michele; Gerin, William; Noble, James

    2016-01-01

    Objectives: We explored the effect of a culturally targeted calorie label intervention on food purchasing behavior of elementary school students. Method: We used a quasi-experimental design with two intervention schools and one control school to assess food purchases of third through fifth graders at standardized school food sales before and after…

  16. 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

  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. Effectiveness of intervention strategies exclusively targeting reductions in children's sedentary time: a systematic review of the literature.

    Science.gov (United States)

    Altenburg, Teatske M; Kist-van Holthe, Joana; Chinapaw, Mai J M

    2016-01-01

    An increasing number of interventions targeting sedentary behaviour in children have emerged in recent years. Recently published reviews included sedentary behaviour and physical activity interventions. This review critically summarizes evidence on the effectiveness of intervention strategies that exclusively targeted reducing sedentary time in children and adolescents. We performed a systematic literature search in Pubmed, Embase and the Cochrane Library through November 2015. Two independent reviewers selected eligible studies, extracted relevant data and rated the methodological quality using the assessment tool for quantitative studies. We included 21 intervention studies, of which 8 studies scored moderate on methodological quality and 13 studies scored weak. Four out of eight moderate quality studies reported significant beneficial intervention effects.Although descriptions of intervention strategies were not always clearly reported, we identified encouragement of a TV turnoff week and implementing standing desks in classrooms as promising strategies. Due to a lack of high quality studies and inconsistent findings, we found no convincing evidence for the effectiveness of existing interventions targeting solely sedentary behaviour. We recommend that future studies apply mediation analyses to explore which strategies are most effective. Furthermore, to increase the effectiveness of interventions, knowledge of children's motives to engage in sedentary behavior is required, as well as their opinion on potentially effective intervention strategies. PMID:27276873

  19. 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; Martinez, Caridad Ponce; 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

  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; Martinez, Caridad Ponce; 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. 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 such......—was 51.1%. 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...... childhood obesity is low where observed differences with respect to country, age and gender call for targeted intervention....

  2. 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. PMID:18416406

  3. A Review of Supportive Interventions Targeting Individuals or Couples Undergoing Infertility Treatment: Directions for the Development of Interventions.

    Science.gov (United States)

    Luk, Bronya Hi-Kwan; Loke, Alice Yuen

    2016-08-17

    The purpose of this systematic review is to explore the types, content, and outcomes of different psychosocial approaches used in existing interventions for infertile individuals or couples. Relevant intervention studies published in English between 2000 and 2014 were searched using the electronic databases MEDLINE, PsycINFO, and CINHAL Plus. A total of 23 articles were identified and included in this review. Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and counseling were the most commonly adopted psychosocial interventions for infertile individuals or couples. After reviewing the various approaches, directions are given on the development of interventions for couples suffering from infertility. PMID:26259844

  4. Intervention efficacy in trials targeting cannabis use disorders in patients with comorbid psychosis systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Hjorthoj, Carsten Rygaard; Baker, Amanda; Fohlmann, Allan;

    2014-01-01

    never in meta-analyses specifically regarding cannabis use. METHODS: PubMed, PsycINFO, EMBASE, and The Cochrane Central Register of Controlled Trials were searched using predefined search terms. We included randomized trials of all types of interventions targeting cannabis use disorders in patients with...... schizophrenia spectrum disorders. We extracted information on intervention types, efficacy, trial characteristics, and risk of bias. RESULTS: There was no evidence of an effect on frequency of cannabis use, but intervention effects of motivational intervention with or without cognitive behavior therapy were...

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

    International Nuclear Information System (INIS)

    Highlights: → Previous research indicates that targeted strategies designed for specific areas should lead to improved diversion. → Survey responses and GIS model predictions from previous research were the basis for goal setting. → Then logic modelling and behavioural research were employed to develop site-specific management intervention strategies. → Waste management initiatives can be tailored to specific needs of areas rather than one size fits all means currently used. - Abstract: 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 Dun 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

  6. Tobacco Use Cessation and Prevention – A Review

    Science.gov (United States)

    Doshi, Dolar; Bandari, Srikanth Reddy; Madupu, Padma Reddy; Kulkarni, Suhas

    2016-01-01

    Tobacco use is a major preventable cause of premature death and disease, currently leading to over five million deaths each year worldwide. Smoking or chewing tobacco can seriously affect general, as well as oral health. Oral health professionals play an important role in promoting tobacco free-lifestyles. They should counsel their patients not to smoke; and reinforce the anti-tobacco message and refer the patients to smoking cessation services. Dentists are in a unique position to educate and motivate patients concerning the hazards of tobacco to their oral and systemic health, and to provide intervention programs as a part of routine patient care. Tobacco cessation is necessary to reduce morbidity and mortality related to tobacco use. Strategies for tobacco cessation involves 5 A’s and 5 R’s approach, quit lines and pharmacotherapy. Additionally, tobacco cessation programs should be conducted at community, state and national levels. Various policies should be employed for better tobacco control. Governments should implement the tobacco control measures to reduce the prevalence of tobacco use and exposure to tobacco smoke. In addition, there should be availability of leaflets, brochures, continuing patient education materials regarding tobacco cessation. PMID:27437378

  7. Sensation Seeking as a Predictor of Treatment Compliance and Smoking Cessation Treatment Outcomes in Heavy Social Drinkers

    OpenAIRE

    Kahler, Christopher W.; Spillane, Nichea S.; Metrik, Jane; Leventhal, Adam M.; Monti, Peter M.

    2009-01-01

    The personality trait of sensation seeking has been positively associated with risk of smoking initiation and level of tobacco use. However, its role in smoking cessation is much less established. This study examined the association between sensation seeking and smoking cessation among 236 heavy social drinkers participating in a clinical trial testing the efficacy of incorporating brief alcohol intervention into smoking cessation treatment. As hypothesized, higher sensation seeking predicted...

  8. Approaching tobacco dependence in youngsters: impact of an interactive smoking cessation program in a population of Romanian adolescents

    OpenAIRE

    Trofor, Antigona; Mihaicuta, Stefan; Man, Milena Adina; MIRON Ramona; Esanu, Valentina; Trofor, Letitia

    2010-01-01

    Objectives: The main objective of this study was to investigate the effectiveness of an interactive smoking cessation program when first implemented in a naïve population of Romanian adolescents. The secondary objective was to assess youngsters\\' attitudes and beliefs towards tobacco dependence, their compliance to smoking cessation interventions and success rate of a standard smoking cessation pilot program. Materials and methods: A total of 231 subjects 14-19 years old particip...

  9. Persistence of Th17/Tc17 Cell Expression upon Smoking Cessation in Mice with Cigarette Smoke-Induced Emphysema

    OpenAIRE

    Min-Chao Duan; Hai-Juan Tang; Xiao-Ning Zhong; Ying Huang

    2013-01-01

    Th17 and Tc17 cells may be involved in the pathogenesis of chronic obstructive pulmonary disease (COPD), a disease caused predominantly by cigarette smoking. Smoking cessation is the only intervention in the management of COPD. However, even after cessation, the airway inflammation may be present. In the current study, mice were exposed to room air or cigarette smoke for 24 weeks or 24 weeks followed by 12 weeks of cessation. Morphological changes were evaluated by mean linear intercepts (Lm)...

  10. Measuring the costs of outreach motivational interviewing for smoking cessation and relapse prevention among low-income pregnant women

    Directory of Open Access Journals (Sweden)

    Kearney Margaret H

    2009-09-01

    Full Text Available Abstract Background Economic theory provides the philosophical foundation for valuing costs in judging medical and public health interventions. When evaluating smoking cessation interventions, accurate data on costs are essential for understanding resource consumption. Smoking cessation interventions, for which prior data on resource costs are typically not available, present special challenges. We develop a micro-costing methodology for estimating the real resource costs of outreach motivational interviewing (MI for smoking cessation and relapse prevention among low-income pregnant women and report results from a randomized controlled trial (RCT employing the methodology. Methodological standards in cost analysis are necessary for comparison and uniformity in analysis across interventions. Estimating the costs of outreach programs is critical for understanding the economics of reaching underserved and hard-to-reach populations. Methods Randomized controlled trial (1997-2000 collecting primary cost data for intervention. A sample of 302 low-income pregnant women was recruited from multiple obstetrical sites in the Boston metropolitan area. MI delivered by outreach health nurses vs. usual care (UC, with economic costs as the main outcome measures. Results The total cost of the MI intervention for 156 participants was $48,672 or $312 per participant. The total cost of $311.8 per participant for the MI intervention compared with a cost of $4.82 per participant for usual care, a difference of $307 ([CI], $289.2 to $322.8. The total fixed costs of the MI were $3,930 and the total variable costs of the MI were $44,710. The total expected program costs for delivering MI to 500 participants would be 147,430, assuming no economies of scale in program delivery. The main cost components of outreach MI were intervention delivery, travel time, scheduling, and training. Conclusion Grounded in economic theory, this methodology systematically identifies and

  11. From orphan drugs to adopted therapies: Advancing C3-targeted intervention to the clinical stage.

    Science.gov (United States)

    Mastellos, Dimitrios C; Reis, Edimara S; Yancopoulou, Despina; Hajishengallis, George; Ricklin, Daniel; Lambris, John D

    2016-10-01

    Complement dysregulation is increasingly recognized as an important pathogenic driver in a number of clinical disorders. Complement-triggered pathways intertwine with key inflammatory and tissue destructive processes that can either increase the risk of disease or exacerbate pathology in acute or chronic conditions. The launch of the first complement-targeted drugs in the clinic has undeniably stirred the field of complement therapeutic design, providing new insights into complement's contribution to disease pathogenesis and also helping to leverage a more personalized, comprehensive approach to patient management. In this regard, a rapidly expanding toolbox of complement therapeutics is being developed to address unmet clinical needs in several immune-mediated and inflammatory diseases. Elegant approaches employing both surface-directed and fluid-phase inhibitors have exploited diverse components of the complement cascade as putative points of therapeutic intervention. Targeting C3, the central hub of the system, has proven to be a promising strategy for developing biologics as well as small-molecule inhibitors with clinical potential. Complement modulation at the level of C3 has recently shown promise in preclinical primate models, opening up new avenues for therapeutic intervention in both acute and chronic indications fueled by uncontrolled C3 turnover. This review highlights recent developments in the field of complement therapeutics, focusing on C3-directed inhibitors and alternative pathway (AP) regulator-based approaches. Translational perspectives and considerations are discussed, particularly with regard to the structure-guided drug optimization and clinical advancement of a new generation of C3-targeted peptidic inhibitors. PMID:27353192

  12. Application of C-arm CT-guided targeted puncturing technique in performing non-vascular interventional biopsy or interventional therapy

    International Nuclear Information System (INIS)

    Objective: to investigate the clinical value of C-arm CT-guided targeted puncturing technique in performing non, vascular interventional biopsy or interventional therapy. Methods: Thirty, one patients, who were encountered in authors' hospital during the period from July 2010 to September 2010, were involved in this study. C-arm CT-guided percutaneous targeted puncturing biopsy or interventional therapy was performed in all 31 patients. All patients had complete clinical data. The complications and positive rate of biopsy were recorded and analyzed. Results: Under C-arm CT-guidance, percutaneous interventional therapy was carried out in 13 patients. The interventional procedures included radiofrequency ablation therapy for hepatic cellular carcinoma (n=2), pelvic abscess draining (n=1), hepatic abscess draining (n=1), ethanol injection for liver cancer (n=4), sclerotic therapy with ethanol injection for renal cyst (n=2), sclerotic therapy with ethanol injection for liver cyst (n=2) and catheter-indwelling drainage for pancreatic pseudocyst (n=1). percutaneous interventional biopsy was performed in the remaining 18 cases, including liver (n=4), lung (n=7), mediastinum (n=2), bone and soft tissue (n=4) and neck mass (n=1). All the procedures were successfully accomplished, no technique, related complications occurred during the operation. For biopsy examination in 18 cases, the positive rate was 94.4% (17/18) and false, negative results was seen in one case with lung lesion. Conclusion: The percutaneous targeted puncturing technique with C, arm CT-guidance combines the advantages of both CT scanning and fluoroscopy. The use of real, time road, mapping function can effectively guide the puncturing and therapeutic management, which can not only optimize the workflow, save the operation time, but also improve the success rate and technical safety. Therefore, it is of great value to popularize this targeted puncturing technique. (authors)

  13. A Targeted Infection Prevention Intervention in Nursing Home Residents With Indwelling Devices

    Science.gov (United States)

    Mody, Lona; Krein, Sarah L.; Saint, Sanjay K.; Min, Lillian C.; Montoya, Ana; Lansing, Bonnie; McNamara, Sara E.; Symons, Kathleen; Fisch, Jay; Koo, Evonne; Rye, Ruth Anne; Galecki, Andrzej; Kabeto, Mohammed U.; Fitzgerald, James T.; Olmsted, Russell N.; Kauffman, Carol A.; Bradley, Suzanne F.

    2015-01-01

    IMPORTANCE Indwelling devices (eg, urinary catheters and feeding tubes) are often used in nursing homes (NHs). Inadequate care of residents with these devices contributes to high rates of multidrug-resistant organisms (MDROs) and device-related infections in NHs. OBJECTIVE To test whether a multimodal targeted infection program (TIP) reduces the prevalence of MDROs and incident device-related infections. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial at 12 community-based NHs from May 2010 to April 2013. Participants were high-risk NH residents with urinary catheters, feeding tubes, or both. INTERVENTIONS Multimodal, including preemptive barrier precautions, active surveillance for MDROs and infections, and NH staff education. MAIN OUTCOMES AND MEASURES The primary outcome was the prevalence density rate of MDROs, defined as the total number of MDROs isolated per visit averaged over the duration of a resident's participation. Secondary outcomes included new MDRO acquisitions and new clinically defined device-associated infections. Data were analyzed using a mixed-effects multilevel Poisson regression model (primary outcome) and a Cox proportional hazards model (secondary outcome), adjusting for facility-level clustering and resident-level variables. RESULTS In total, 418 NH residents with indwelling devices were enrolled, with 34 174 device-days and 6557 anatomic sites sampled. Intervention NHs had a decrease in the overall MDRO prevalence density (rate ratio, 0.77; 95% CI, 0.62–0.94). The rate of new methicillin-resistant Staphylococcus aureus acquisitions was lower in the intervention group than in the control group (rate ratio, 0.78; 95% CI, 0.64–0.96). Hazard ratios for the first and all (including recurrent) clinically defined catheter-associated urinary tract infections were 0.54 (95% CI, 0.30–0.97) and 0.69 (95% CI, 0.49–0.99), respectively, in the intervention group and the control group. There were no reductions in new vancomycin

  14. 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. PMID:26332138

  15. Assessment of the Efficiency of Tobacco Cessation Counseling in Primary Care.

    Science.gov (United States)

    El-Shahawy, Omar; Shires, Deirdre A; Elston Lafata, Jennifer

    2016-09-01

    Clinical Practice Guidelines for Treating Tobacco Use and Dependence advocate for using counseling targeted at tobacco users' motivation to quit during each office visit. We evaluate tobacco use screening and counseling interventions delivered during routine periodic health examinations by 44 adult primary care physicians practicing in 22 clinics of a large health system in southeast Michigan. 484 office visits were audio-recorded and transcribed. For this study, current tobacco users (N = 91) were identified using pre-visit surveys and audio-recordings. Transcripts were coded for the delivery of tobacco-related counseling interventions. The extent to which counseling interventions were used and/or targeted to the patients' readiness to quit was the main outcome measure. The majority of tobacco users (n = 77) had their tobacco use status assessed, and most received some sort of tobacco-related counseling (n = 74). However, only 15% received the recommended counseling targeted to their readiness to quit. On the other hand, 19% received less counseling than recommended given their readiness to quit, 7% received only nonindicated counseling, and 59% received nonindicated counseling in addition to indicated counseling. Results illustrate physicians' commitment to cessation counseling and also identify potential opportunities to improve the efficiency of tobacco-related counseling in primary care. PMID:26290271

  16. 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.

  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.; Lesniak, K.A.; Roderick, S.S.; Watt, M.L.; Eklund, Aron Charles; Zhang-James, Y.; Kim, P.D.; Hauser, M.A.; Grünblatt, E.; Moran, L.B.; Mandel, S.A.; Riederer, P.; Miller, R.M.; Federoff, H.J.; Wüllner, U.; Papapetropoulos, S.; Youdim, M.B.; Cantuti-Castelvetri, I.; Young, A.B.; Vance, J.M.; Davis, R.L.; Hedreen, J.C.; Adler, S.H.; Beach, T.G.; Graeber, M.B.; Middleton, F.A.; Rochet, J.C.; Scherzer, C.R.

    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...... 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...... 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. 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.

  19. Giving up driving: does social engagement buffer declines in mental health after driving cessation in older women?

    Science.gov (United States)

    Rebok, George W; Jones, Vanya C

    2016-08-01

    Many older adults consider driving as essential to maintaining their quality of life and independence, and this may be particularly true for individuals residing in more rural areas where transportation options may be limited. Although it is normative for individuals to eventually stop driving as they age, very few plan ahead for their driving retirement (Curl et al., 2014). The process of driving cessation has been associated with a host of negative consequences for physical and mental well-being, including increased depressive symptoms, reduced network of friends, lower activity levels, and accelerated health decline (Mezuk & Rebok, 2008; Edwards et al., 2009; Curl et al., 2014). Previous studies have found that, at all ages, women are more likely to stop driving in later life than men, and often stop driving prematurely, and that various factors such as education and marital status influence the likelihood of cessation differently for women and men (Ross et al., 2009; Choi et al., 2012). Thus, factors associated with driving cessation and its consequences for older women are important to understand, particularly factors that might help buffer the negative effects of giving up driving and that might serve as early targets for preventive interventions. PMID:27374895

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

    OpenAIRE

    Rizzo Nidia; Gramajo Rodrigo; Escobar Maria; Arana Byron; Kroeger Axel; Manrique-Saide Pablo; Petzold Max

    2012-01-01

    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 ra...

  1. Know thy student! Combining learning analytics and critical reflections to develop a targeted intervention for promoting self-regulated learning.

    OpenAIRE

    Colthorpe, Kay; Zimbardi, Kirsten; Ainscough, Louise; Anderson, Stephen

    2015-01-01

    It is well established that a student’s capacity to regulate his or her own learning is a key determinant of academic success, suggesting that interventions targeting improvements in self-regulation will have a positive impact on academic performance. However, to evaluate the success of such interventions, the self-regulatory characteristics of students need to be established. This paper examines the self-regulatory characteristics of a cohort of second-year allied health students, using the ...

  2. 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...

  3. 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.

  4. Smoking Cessation and Chronic Pain: Patient and Pain Medicine Physician Attitudes

    OpenAIRE

    Hooten, W. Michael; Vickers, Kristin S.; Shi, Yu; Ebnet, Kaye L.; Townsend, Cynthia O.; Patten, Christi A.; Warner, David O.

    2011-01-01

    Although previous studies suggest that the clinical setting of an interdisciplinary pain treatment program may provide an optimal environment to promote smoking cessation, currently available smoking cessation interventions may be less effective for adults with chronic pain due, in part, to unrecognized clinical factors related to chronic pain. The specific aim of this qualitative study was to solicit information from adult smokers with chronic pain participating in an interdisciplinary pain ...

  5. 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.

  6. Race/Ethnicity and Multiple Cancer Risk Factors among Individuals Seeking Smoking Cessation Treatment

    Science.gov (United States)

    Kendzor, Darla E.; Costello, Tracy J.; Li, Yisheng; Vidrine, Jennifer Irvin; Mazas, Carlos A.; Reitzel, Lorraine R.; Cinciripini, Paul M.; Cofta-Woerpel, Ludmila M.; Businelle, Michael S.; Wetter, David W.

    2016-01-01

    Smoking in combination with other behavioral risk factors is known to have a negative influence on health, and individuals who smoke typically engage in multiple risk behaviors. However, little is known about the clustering of risk behaviors among smokers of varying race/ethnicity. The purpose of this study was to examine patterns of cancer risk behaviors and to identify predictors of multiple risk behaviors in a racially/ethnically diverse sample of individuals seeking smoking cessation treatment. Overweight/obesity, at-risk alcohol consumption, and insufficient physical activity were measured in 424 smokers (African American, n = 144; Latino, n = 141; Caucasian, n = 139). Results indicated that 90% of participants reported behavioral cancer risk factors in addition to smoking. Approximately 70% of participants were overweight or obese, 48% engaged in at-risk drinking, and 27% were insufficiently physically active. Univariate analyses indicated that race/ethnicity, p culturally sensitive interventions that target multiple risk behaviors. PMID:18990734

  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. Effectiveness of smoking cessation therapies: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Dimoulas Popey

    2006-12-01

    Full Text Available Abstract Background Smoking remains the leading preventable cause of premature deaths. Several pharmacological interventions now exist to aid smokers in cessation. These include Nicotine Replacement Therapy [NRT], bupropion, and varenicline. We aimed to assess their relative efficacy in smoking cessation by conducting a systematic review and meta-analysis. Methods We searched 10 electronic medical databases (inception to Sept. 2006 and bibliographies of published reviews. We selected randomized controlled trials [RCTs] evaluating interventions for smoking cessation at 1 year, through chemical confirmation. Our primary endpoint was smoking cessation at 1 year. Secondary endpoints included short-term smoking cessation (~3 months and adverse events. We conducted random-effects meta-analysis and meta-regression. We compared treatment effects across interventions using head-to-head trials and when these did not exist, we calculated indirect comparisons. Results We identified 70 trials of NRT versus control at 1 year, Odds Ratio [OR] 1.71, 95% Confidence Interval [CI], 1.55–1.88, P = Varenicline was superior to placebo at 1 year (4 RCTs, OR 2.96, 95% CI, 2.12–4.12, P = Conclusion NRT, bupropion and varenicline all provide therapeutic effects in assisting with smoking cessation. Direct and indirect comparisons identify a hierarchy of effectiveness.

  9. A Culturally Enhanced Smoking Cessation Study among Chinese and Korean Smokers

    Science.gov (United States)

    Ma, Grace X.; Fang, Carolyn; Shive, Steven E.; Su, Xuefen; Toubbeh, Jamil I.; Miller, Suzanne; Tan, Yin

    2005-01-01

    This study assessed the feasibility of and presents preliminary findings on a culturally enhanced, theory-driven smoking cessation intervention for adult Chinese and Korean smokers. A one-group pre-post test design was used. The intervention consisted of behavioral and nicotine replacement strategies. Participants (N=43) were recruited through…

  10. 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. PMID:23514078

  11. 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

  12. Internet-Delivered Targeted Group Intervention for Body Dissatisfaction and Disordered Eating in Adolescent Girls: A Randomized Controlled Trial

    Science.gov (United States)

    Heinicke, Brooke E.; Paxton, Susan J.; McLean, Sian A.; Wertheim, Eleanor H.

    2007-01-01

    This study evaluated a targeted intervention designed to alleviate body image and eating problems in adolescent girls that was delivered over the internet so as to increase access to the program. The program consisted of six, 90-minute weekly small group, synchronous on-line sessions and was facilitated by a therapist and manual. Participants were…

  13. The Effectiveness of Social Skills Intervention Targeting Nonverbal Communication for Adolescents with Asperger Syndrome and Related Pervasive Developmental Delays.

    Science.gov (United States)

    Barnhill, Gena P.; Cook, Katherine Tapscott; Tebbenkamp, Kelly; Myles, Brenda Smith

    2002-01-01

    A study investigated the effectiveness of an 8-week social skills intervention targeting nonverbal communication for eight adolescents with Asperger syndrome. Although minimal nonverbal communication skills development was apparent, some social relationships were developed and the ability of some participants to read the nonverbal communication of…

  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. Reported Use and Acceptability of Self-Management Interventions to Target Behavioral Outcomes

    Science.gov (United States)

    Briesch, Amy M.; Briesch, Jacquelyn M.; Mahoney, Corrine

    2014-01-01

    Although self-management interventions have a long history of empirical evaluation, attention has not been paid toward understanding actual use of this class of interventions. From a nationally representative sample of school psychology practitioners, a total of 295 respondents were presented with a description of a self-management intervention as…

  16. A semantic problem solving environment for integrative parasite research: identification of intervention targets for Trypanosoma cruzi.

    Directory of Open Access Journals (Sweden)

    Priti P Parikh

    2012-01-01

    Full Text Available BACKGROUND: Research on the biology of parasites requires a sophisticated and integrated computational platform to query and analyze large volumes of data, representing both unpublished (internal and public (external data sources. Effective analysis of an integrated data resource using knowledge discovery tools would significantly aid biologists in conducting their research, for example, through identifying various intervention targets in parasites and in deciding the future direction of ongoing as well as planned projects. A key challenge in achieving this objective is the heterogeneity between the internal lab data, usually stored as flat files, Excel spreadsheets or custom-built databases, and the external databases. Reconciling the different forms of heterogeneity and effectively integrating data from disparate sources is a nontrivial task for biologists and requires a dedicated informatics infrastructure. Thus, we developed an integrated environment using Semantic Web technologies that may provide biologists the tools for managing and analyzing their data, without the need for acquiring in-depth computer science knowledge. METHODOLOGY/PRINCIPAL FINDINGS: We developed a semantic problem-solving environment (SPSE that uses ontologies to integrate internal lab data with external resources in a Parasite Knowledge Base (PKB, which has the ability to query across these resources in a unified manner. The SPSE includes Web Ontology Language (OWL-based ontologies, experimental data with its provenance information represented using the Resource Description Format (RDF, and a visual querying tool, Cuebee, that features integrated use of Web services. We demonstrate the use and benefit of SPSE using example queries for identifying gene knockout targets of Trypanosoma cruzi for vaccine development. Answers to these queries involve looking up multiple sources of data, linking them together and presenting the results. CONCLUSION/SIGNIFICANCE: The SPSE

  17. Targeted learning in real-world comparative effectiveness research with time-varying interventions.

    Science.gov (United States)

    Neugebauer, Romain; Schmittdiel, Julie A; van der Laan, Mark J

    2014-06-30

    In comparative effectiveness research (CER), often the aim is to contrast survival outcomes between exposure groups defined by time-varying interventions. With observational data, standard regression analyses (e.g., Cox modeling) cannot account for time-dependent confounders on causal pathways between exposures and outcome nor for time-dependent selection bias that may arise from informative right censoring. Inverse probability weighting (IPW) estimation to fit marginal structural models (MSMs) has commonly been applied to properly adjust for these expected sources of bias in real-world observational studies. We describe the application and performance of an alternate estimation approach in such a study. The approach is based on the recently proposed targeted learning methodology and consists in targeted minimum loss-based estimation (TMLE) with super learning (SL) within a nonparametric MSM. The evaluation is based on the analysis of electronic health record data with both IPW estimation and TMLE to contrast cumulative risks under four more or less aggressive strategies for treatment intensification in adults with type 2 diabetes already on 2+ oral agents or basal insulin. Results from randomized experiments provide a surrogate gold standard to validate confounding and selection bias adjustment. Bootstrapping is used to validate analytic estimation of standard errors. This application does the following: (1) establishes the feasibility of TMLE in real-world CER based on large healthcare databases; (2) provides evidence of proper confounding and selection bias adjustment with TMLE and SL; and (3) motivates their application for improving estimation efficiency. Claims are reinforced with a simulation study that also illustrates the double-robustness property of TMLE. PMID:24535915

  18. 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

  19. Head-and-Neck Target Delineation Among Radiation Oncology Residents After a Teaching Intervention: A Prospective, Blinded Pilot Study

    International Nuclear Information System (INIS)

    Purpose: We conducted this study to determine the feasibility of incorporating a teaching intervention on target delineation into the educational curriculum of a radiation oncology residency program and to assess the short-term effects on resident skills. Methods and Materials: The study schema consisted of a baseline evaluation, the teaching intervention, and a follow-up evaluation. At the baseline evaluation, the participants contoured three clinical tumor volumes (CTVs) (70 Gy, 59.4 Gy, and 54 Gy) on six contrast-enhanced axial computed tomography images of a de-identified patient with Stage T2N2bM0 squamous cell carcinoma of the right base of the tongue. The participants attended a series of head-and-neck oncology and anatomy seminars. The teaching intervention consisted of a didactic lecture and an interactive hands-on practical session designed to improve the knowledge and skills for target delineation in the head and neck. At the follow-up evaluation, the residents again contoured the CTVs. Results: Of the 14 eligible residents, 11 (79%) actually participated in the study. For all participants, but especially for those who had not had previous experience with head-and-neck target delineation, the teaching intervention was associated with improvement in the delineation of the node-negative neck (CTV 54 Gy contour). Regardless of clinical experience, participants had difficulty determining what should be included in the CTV 59.4 Gy contour to ensure adequate coverage of potential microscopic disease. Conclusion: Incorporating a teaching intervention into the education curriculum of a radiation oncology residency program is feasible and was associated with short-term improvements in target delineation skills. Subsequent interventions will require content refinement, additional validation, longer term follow-up, and multi-institutional collaboration

  20. Choroidal mast cells in retinal pathology: a potential target for intervention.

    Science.gov (United States)

    Bousquet, Elodie; Zhao, Min; Thillaye-Goldenberg, Brigitte; Lorena, Viera; Castaneda, Beatriz; Naud, Marie Christine; Bergin, Ciara; Besson-Lescure, Bernadette; Behar-Cohen, Francine; de Kozak, Yvonne

    2015-08-01

    Mast cells are important in the initiation of ocular inflammation, but the consequences of mast cell degranulation on ocular pathology remain uncharacterized. We induced mast cell degranulation by local subconjunctival injection of compound 48/80. Initial degranulation of mast cells was observed in the choroid 15 minutes after the injection and increased up to 3 hours after injection. Clinical signs of anterior segment inflammation paralleled mast cell degranulation. With the use of optical coherence tomography, dilation of choroidal vessels and serous retinal detachments (SRDs) were observed and confirmed by histology. Subconjunctival injection of disodium cromoglycate significantly reduced the rate of SRDs, demonstrating the involvement of mast cell degranulation in posterior segment disorders. The infiltration of polymorphonuclear and macrophage cells was associated with increased ocular media concentrations of tumor necrosis factor-α, CXCL1, IL-6, IL-5, chemokine ligand 2, and IL-1β. Analysis of the amounts of vascular endothelial growth factor and IL-18 showed an opposite evolution of vascular endothelial growth factor compared with IL-18 concentrations, suggesting that they regulate each other's production. These findings suggest that the local degranulation of ocular mast cells provoked acute ocular inflammation, dilation, increased vascular permeability of choroidal vessels, and SRDs. The involvement of mast cells in retinal diseases should be further investigated. The pharmacologic inhibition of mast cell degranulation may be a potential target for intervention. PMID:26166807

  1. 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 and...... brief intervention (SBI) in general practice. METHODS: A randomized PCT (brief counselling intervention vs no intervention) involving 39 Danish general practitioners (GPs). Systematic screening of 6897 adults led to inclusion of 906 risky drinkers, and research follow-up on 537 of these after 12...

  2. Smoking Cessation Strategies in Pregnancy.

    Science.gov (United States)

    Leung, Lesley W S; Davies, Gregory A

    2015-09-01

    Although pregnancy often motivates women to quit smoking, 20% to 25% will continue to smoke. Smoking is associated with adverse obstetric and neonatal outcomes such as placental abruption, stillbirth, preterm birth and sudden infant death syndrome, and it is therefore important to motivate women to quit during pregnancy. In this review, we explore the efficacy and evidence for safety of strategies for smoking cessation in pregnancy, including behavioural and pharmacologic therapies. The PubMed, Medline, EMBASE, and Cochrane databases (1990 to 2014) were accessed to identify relevant studies, using the search terms "smoking cessation," "pregnancy," "medicine, behavioural," "nicotine replacement products," "bupropion," and "varenicline." Studies were selected based on the levels of evidence presented by the Canadian Task Force on Preventative Health Care. Based on our review of the evidence, incentives combined with behavioural therapy appear to show the greatest promise for abstaining from smoking in the pregnant population. Nicotine replacement therapy administered in the form of gum may be better than using transdermal forms to avoid high levels of nicotine in the fetal circulation. One small trial demonstrated that bupropion is an effective aid for smoking cessation and that it does not appear to be associated with an increased risk of major congenital malformations. The currently available studies of varenicline in pregnancy are insufficient to provide evidence for the safety or efficacy of its use. PMID:26605448

  3. Estimating the probabilities of making a smoking quit attempt in Italy: stall in smoking cessation levels, 1986-2009

    Directory of Open Access Journals (Sweden)

    Carreras Giulia

    2012-03-01

    Full Text Available Abstract Background No data on annual smoking cessation probability (i.e., the probability of successfully quit in a given year are available for Italy at a population level. Mathematical models typically used to estimate smoking cessation probabilities do not account for smoking relapse. In this paper, we developed a mathematical model to estimate annual quitting probabilities, taking into account smoking relapse and time since cessation. Methods We developed a dynamic model describing the evolution of current, former, and never smokers. We estimated probabilities of smoking cessation by fitting the model with observed smoking prevalence in Italy, 1986-2009. Results Annual cessation probabilities were higher than 5% only in elderly persons and in women aged Conclusions Over the last 20 years, cessation probabilities among Italian smokers, particularly for those aged 30-59 years, have been very low and stalled. Quitting in Italy is considered as a practicable strategy only by women in the age of pregnancy and by elderly persons, when it’s likely that symptoms of tobacco-related diseases have already appeared. In order to increase cessation probabilities, smoking cessation treatment policies (introducing total reimbursement of cessation treatments, with a further development of quitlines and smoking cessation services should be empowered and a country-wide mass media campaign targeting smokers aged 30-59 years and focusing on promotion of quitting should be implemented.

  4. Lifestyle interventions targeting changes in body weight and composition among youth with an intellectual disability: A systematic review.

    Science.gov (United States)

    Maïano, Christophe; Normand, Claude L; Aimé, Annie; Bégarie, Jérôme

    2014-08-01

    Over the past three decades, the potential effects of lifestyle interventions targeting changes in body weight and composition (weight, body mass index, fat mass, waist circumference) among adults with an intellectual disability (ID) have been examined in various systematic reviews. Nevertheless, since the middle of the 1980s, the potential effects of these interventions for youth with an ID remain an open question. The purpose of this article is to review the effects of lifestyle interventions targeting changes in body weight and composition among youth with an ID. This review will focus on changes in body weight and composition, healthy lifestyle, and secondary health conditions. A systematic review of English- and French-language studies, published between 1981 and 2013, was performed on Academic Search Complete, PsycARTICLES, Medline and Scopus. The nine studies included in this review focused mainly on: a sample with a wide age range (e.g., 7-22 years); males; overweight-obese youth having a mild-to-moderate ID with Down or Prader-Willi syndrome; physical activity interventions; cohort pre- and post-test designs with/without a control group; and changes in body weight and composition. Taken together, results from these studies suggest successful changes in weight, body mass index and fat mass. However, intervention effects on healthy lifestyle and secondary health conditions are scarce and inconclusive. Given the weaknesses of the reviewed studies, the present findings should be considered preliminary and indicative of the need for future research. PMID:24830882

  5. 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. PMID:26264661

  6. 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.

  7. Intervention Efficacy in Trials Targeting Cannabis Use Disorders in Patients with Comorbid Psychosis

    DEFF Research Database (Denmark)

    Hjorthoj, Carsten Rygaard; Baker, Amanda; Fohlmann, Allan;

    2014-01-01

    observed on quantity of use and on positive symptoms of schizophrenia. Psychosocial intervention did not have an appreciable effect on negative symptoms. Longer interventions appear to be more efficacious, and efficacy may be better in trials with comparatively few women. Larger trials may be better at...... establishing effects on positive symptoms. Conclusion: Psychosocial interventions appear moderately efficacious in reducing quantity of cannabis-use and positive symptoms....

  8. 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...

  9. SMOKING CESSATION FOR ADOLESCENTS: A REVIEW OF PHARMACOLOGICAL AND PSYCHOSOCIAL TREATMENTS

    Science.gov (United States)

    Schepis, TS; Rao, U

    2016-01-01

    Unlike the vast literature on smoking cessation in adults, research in adolescents has gained significant attention only within the last decade. Even with this increase in focus, research into pharmacological aids for smoking cessation in adolescents (e.g., nicotine replacement therapy, bupropion) is a more recent phenomenon and has produced only modest results. While more extensive, much of the research on behaviorally- or psychosocially-based adolescent smoking cessation interventions has been limited by a lack of control for contact time, biochemical verification of self-reported abstinence, and/or a theoretical focus for the interventions. The MEDLINE, PubMed, PSYCInfo CINHAL and Cochrane Systematic Review databases were searched for articles relevant to adolescent smoking cessation treatment. After briefly examining the adolescent smoking cessation research prior to 2000, more recent developments in pharmacological aids and psychological treatment will be reviewed. Investigations have made progress in elucidating efficacious treatments for adolescent smokers, but much work remains to be done in both pharmacological and non-pharmacological areas of treatment. With the current state of the literature as a guide, future directions for research into smoking cessation for adolescents will be proposed. PMID:19630713

  10. The effects of scale on the costs of targeted HIV prevention interventions among female and male sex workers, men who have sex with men and transgenders in India

    OpenAIRE

    Chandrashekar, S.; Guinness, L; Kumaranayake, L; Reddy, Bhaskar; Govindraj, Y; Vickerman, P; Alary, M

    2010-01-01

    Background The India AIDS Initiative (Avahan) project is involved in rapid scale-up of HIV-prevention interventions in high-risk populations. This study examines the cost variation of 107 non-governmental organisations (NGOs) implementing targeted interventions, over the start up (defined as period from project inception until services to the key population commenced) and first 2 years of intervention. Methods The Avahan interventions for female and male sex workers and their clients, in 62 d...

  11. 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...

  12. 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.

  13. Enhancement of in situ biodegradation of organic compounds in groundwater by targeted pump and treat intervention

    International Nuclear Information System (INIS)

    Highlights: • Pumping reduces contaminant toxicity below levels which stimulate in situ biodegradation. • Pumping increases the mixing of background oxidants into the plume for anaerobic respiration. • Bacterial sulphate reduction is very sensitive to contaminant concentrations. • Stable isotope analysis confirms the contribution of different biodegradation processes. • Targeted pump and treatment can enhance the natural attenuation of complex plumes. - Abstract: This study demonstrates the value of targeted pump and treatment (PAT) to enhance the in situ biodegradation of organic contaminants in groundwater for improved restoration. The approach is illustrated for a plume of phenolic compounds in a sandstone aquifer, where PAT is used for hydraulic containment and removal of dissolved phase contaminants from specific depth intervals. Time-series analysis of the plume hydrochemistry and stable isotope composition of dissolved species (δ34S-SO4, δ13C-CH4, δ13C-TDIC (TDIC = Total Dissolved Inorganic Carbon)) in groundwater samples from high-resolution multilevel samplers were used to deduce changes in the relative significance of biodegradation processes and microbial activity in the plume, induced by the PAT system over 3 years. The PAT system has reduced the maximum contaminant concentrations (up to 6800 mg L−1 total phenols) in the plume by 50% to ∼70% at different locations. This intervention has (i) stimulated in situ biodegradation in general, with an approximate doubling of contaminant turnover based on TDIC concentration, which has increased from <200 mg L−1 to >350 mg L−1, (ii) enhanced the activity of SO4-reducing microorganisms (marked by a declining SO4 concentration with corresponding increase in SO4-δ34S to values >7–14‰V-CDT relative to background values of 1.9–6.5‰V-CDT), and (iii) where the TDIC increase is greatest, has changed TDIC-δ13C from values of −10 to −15‰V-PDB to ∼−20‰V-PDB. This indicates an

  14. 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. PMID:26172105

  15. A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand

    OpenAIRE

    Clifford, Anton C; Christopher M. Doran; Tsey, Komla

    2013-01-01

    Background Indigenous peoples of Australia, Canada, United States and New Zealand experience disproportionately high rates of suicide. As such, the methodological quality of evaluations of suicide prevention interventions targeting these Indigenous populations should be rigorously examined, in order to determine the extent to which they are effective for reducing rates of Indigenous suicide and suicidal behaviours. This systematic review aims to: 1) identify published evaluations of suicide p...

  16. Evaluating the role of anxiety sensitivity in barriers to cessation and reasons for quitting among smokers with asthma.

    Science.gov (United States)

    McLeish, Alison C; Johnson, Adrienne L; Avallone, Kimberly M; Zvolensky, Michael J

    2016-01-01

    The aim of the present study was to examine the unique predictive ability of anxiety sensitivity (AS) in terms of perceived barriers to cessation and smoking cessation motives among daily smokers with asthma (n = 125, 54% male, Mage = 37.7 years, SD = 12.1). As hypothesized, after controlling for the effects of race, asthma control, negative affect, and smoking rate, AS significantly predicted greater barriers to cessation, and reasons for quitting related to health concerns and self-control. Contrary to hypotheses, AS did not significantly predict external reasons for quitting. These findings suggest that smokers with asthma who are fearful of physiological arousal may be a particularly 'at-risk' population for smoking cessation difficulties due, in part, to greater perceived barriers to cessation. Interventions focused on enhancing intrinsic motivation for quitting and reducing AS may be most effective for this population. PMID:26033273

  17. 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

    2015-01-01

    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

  18. 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...

  19. Evaluation of an Ecological Intervention Targeting Helpers in the Aftermath of Disasters

    OpenAIRE

    Yoder, Matthew

    2008-01-01

    Ecological interventions hold promise for meeting the needs of post-disaster communities, yet little systematic quantitative evidence is available about such programs. This study evaluated the short-term outcomes of participants in the Strategies for Trauma Awareness and Resilience (STAR) program, a novel and exemplar ecological intervention for helpers working in post-disaster settings. It is a one week training and support program for helpers working in disaster-affected communities. Chan...

  20. Pathways to Health: A Cluster Randomized Trial of Nicotine Gum and Motivational Interviewing for Smoking Cessation in Low-Income Housing

    Science.gov (United States)

    Okuyemi, Kolawole S.; James, Aimee S.; Mayo, Matthew S.; Nollen, Nicole; Catley, Delwyn; Choi, Won S.; Ahluwalia, Jasjit S.

    2007-01-01

    Despite high smoking rates among those living in poverty, few cessation studies are conducted in these populations. This cluster-randomized trial tested nicotine gum plus motivational interviewing (MI) for smoking cessation in 20 low-income housing developments (HDs). Intervention participants (10 HDs, n = 66) received educational materials, 8…

  1. 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

  2. Functional Health Literacy and Smoking Cessation Outcomes

    Science.gov (United States)

    Varekojis, Sarah M.; Miller, Larry; Schiller, M. Rosita; Stein, David

    2011-01-01

    Purpose: This paper aims to describe the relationship between functional health literacy level and smoking cessation outcomes. Design/methodology/approach: Participants in an inpatient smoking cessation program in a mid-western city in the USA were enrolled and the Short Test of Functional Health Literacy in Adults was administered while the…

  3. 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.

  4. Exploring Smoking Cessation Attitudes, Beliefs, and Practices in Occupational Health Nursing.

    Science.gov (United States)

    Ganz, Ollie; Fortuna, Grace; Weinsier, Stephanie; Campbell, Kay; Cantrell, Jennifer; Furmanski, William L

    2015-07-01

    The purpose of this study was to explore occupational health nurses' attitudes, beliefs, and practices regarding the delivery of smoking cessation services to workers. The study included 707 members of the American Association of Occupational Health Nurses (AAOHN) who completed a one-time survey during the fall of 2012. Results indicated that occupational health nurses believed that evidence-based treatments are at least somewhat effective and that they should provide smoking cessation services to their workers; however, a majority of occupational health nurses reported that they did not have appropriate smoking cessation training or guidelines in their workplaces. Occupational health nurses would benefit from training in the use of smoking cessation guidelines and evidence-based smoking cessation interventions, which could be used in their clinical practice. Employers should ensure that workplace policies, such as providing coverage for cessation services, facilitate smokers' efforts to quit. Employers can benefit from many of these policies through cost savings via reduced health care costs and absenteeism. PMID:26187173

  5. 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

  6. 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. PMID:26241373

  7. 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.

  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. Computer-assisted interventions targeting reading skills of children with reading disabilities - a longitudinal study.

    Science.gov (United States)

    Fälth, Linda; Gustafson, Stefan; Tjus, Tomas; Heimann, Mikael; Svensson, Idor

    2013-02-01

    The purpose of the present study was to examine the effects of three computerized interventions on the reading skills of children with reading disabilities in Grade 2. This longitudinal intervention study included five test sessions over 1 year. Two test points occur before the intervention, and three afterwards. The last follow-up was conducted 1 year after the first measurement. One hundred thirty children in Grade 2 participated in the study. Three groups of children with reading difficulties received computerized training programmes: one aimed at improving word decoding skills and phonological abilities, the second focused on word and sentence levels and the third was a combination of these two training programmes. A fourth group received ordinary special instruction. In addition, there was one comparison group with age-matched typical readers. All groups improved their reading skills. The group that received combined training showed greater improvement than the one with ordinary special instruction and the group of typical readers at two follow-ups. The longitudinal results indicate additional positive results for the group that received the combined training, the majority of students from that group being no longer judged to be needing special education 1 year after the intervention. PMID:23338977

  10. Efficacy of Cognitive-Behavioral Interventions Targeting Personality Risk Factors for Youth Alcohol Misuse

    Science.gov (United States)

    Conrod, Patricia J.; Stewart, Sherry H.; Comeau, Nancy; Maclean, A. Michael

    2006-01-01

    Sensation seeking, anxiety sensitivity, and hopelessness are personality risk factors for alcohol use disorders, each associated with specific risky drinking motives in adolescents. We developed a set of interventions and manuals that were designed to intervene at the level of personality risk and associated maladaptive coping strategies,…

  11. Childhood obesity prevention: an intervention targeting primary caregivers of school children.

    Science.gov (United States)

    Bruss, Mozhdeh B; Michael, Timothy J; Morris, Joseph R; Applegate, Brooks; Dannison, Linda; Quitugua, Jackie A; Palacios, Rosa T; Klein, David J

    2010-01-01

    Community-based participatory research (CBPR) was used to design and evaluate the effectiveness of a culturally relevant, science-based intervention for the prevention of childhood obesity in the Commonwealth of the Northern Mariana Islands (CNMI), a US Commonwealth in the western Pacific. This cognitive behavioral lifestyle intervention, Project Familia Giya Marianas (PFGM), was offered during the 2005-2007 school years in all CNMI public elementary schools over eight sessions to primary caregivers of 3rd grade children (N = 407). A crossover design was utilized with half of the schools offering the intervention in the Fall term, while the other half delivered the sessions in the Spring term. The primary outcome measure was change in BMI z-score. There was an intervention-dependent effect on BMI z-score, with program impact being a function of baseline BMI and the number of lessons attended. This effect was most apparent in students whose baseline BMI z-score was in healthy range (>/=5 to solutions to address a complex condition such as childhood obesity. PFGM demonstrated that community participation can be successfully utilized in the development and implementation of childhood obesity prevention programs. PMID:19424164

  12. Developmental Phenotypes and Causal Pathways in Attention Deficit/Hyperactivity Disorder: Potential Targets for Early Intervention?

    Science.gov (United States)

    Sonuga-Barke, Edmund J. S.; Halperin, Jeffrey M.

    2010-01-01

    Early intervention approaches have rarely been implemented for the prevention of attention deficit/hyperactivity disorder (ADHD). In this paper we explore whether such an approach may represent an important new direction for therapeutic innovation. We propose that such an approach is most likely to be of value when grounded in and informed by…

  13. A Review of Motivational Smoking Cessation Programs for Adolescents in the Schools

    Science.gov (United States)

    Baker, Leigh; McClain, Mary-Catherine; Hurst, Vicie; Grossman, Steffanie; Dehili, Vincent; Flagg, Scott; Marshall, Diana; Prevatt, Frances

    2012-01-01

    This review provides a qualitative overview of school-based smoking cessation programs for adolescents, with a focus on motivationally based programs. Project-Ex and Not-On-Tobacco are two heavily studied interventions with substantial empirical support. Other programs such as use of Motivational Interviewing with the stage of change model have…

  14. 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...... 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...... 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%....

  15. Smoking cessation in patients with respiratory diseases: a high priority, integral component of therapy.

    Science.gov (United States)

    Tønnesen, P; Carrozzi, L; Fagerström, K O; Gratziou, C; Jimenez-Ruiz, C; Nardini, S; Viegi, G; Lazzaro, C; Campell, I A; Dagli, E; West, R

    2007-02-01

    Smoking cessation is the one of the most important ways to improve the prognosis of patients with respiratory disease. The Task Force on guidelines for smoking cessation in patients with respiratory diseases was convened to provide evidence-based recommendations on smoking cessation interventions in respiratory patients. Based on the currently available evidence and the consensus of an expert panel, the following key recommendations were made. 1) Patients with respiratory disease have a greater and more urgent need to stop smoking than the average smoker, so respiratory physicians must take a proactive and continuing role with all smokers in motivating them to stop and in providing treatment to aid smoking cessation. 2) Smoking cessation treatment should be integrated into the management of the patient's respiratory condition. 3) Therapies should include pharmacological treatment (i.e. nicotine replacement therapy, bupropion or varenicline) combined with behavioural support. 4) Respiratory physicians should receive training to ensure that they have the knowledge, attitudes and skills necessary to deliver these interventions or to refer to an appropriate specialist. 5) Although the cost of implementing these recommendations will partly be offset by a reduction in attendance for exacerbations, etc., a budget should be established to enable implementation. Research is needed to establish optimum treatment strategies specifically for respiratory patients. PMID:17264326

  16. 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. PMID:25045624

  17. 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.

  18. Evaluating an Adaptive and Interactive mHealth Smoking Cessation and Medication Adherence Program: A Randomized Pilot Feasibility Study

    Science.gov (United States)

    Anderson, Melissa L; Bradley, Katharine; An, Lawrence C; Catz, Sheryl L

    2016-01-01

    Background Mobile health (mHealth) interventions hold great promise for helping smokers quit since these programs can have wide reach and facilitate access to comprehensive, interactive, and adaptive treatment content. However, the feasibility, acceptability, and effectiveness of these programs remain largely untested. Objective To assess feasibility and acceptability of the My Mobile Advice Program (MyMAP) smoking cessation program and estimate its effects on smoking cessation and medication adherence to inform future research planning. Methods Sixty-six smokers ready to quit were recruited from a large regional health care system and randomized to one of two mHealth programs: (1) standard self-help including psychoeducational materials and guidance how to quit smoking or (2) an adaptive and interactive program consisting of the same standard mHealth self-help content as controls received plus a) real-time, adaptively tailored advice for managing nicotine withdrawal symptoms and medication side-effects and b) asynchronous secure messaging with a cessation counselor. Participants in both arms were also prescribed a 12-week course of varenicline. Follow-up assessments were conducted at 2 weeks post-target quit date (TQD), 3 months post-TQD, and 5 months post-TQD. Indices of program feasibility and acceptability included acceptability ratings, utilization metrics including use of each MyMAP program component (self-help content, secure messaging, and adaptively tailored advice), and open-ended feedback from participants. Smoking abstinence and medication adherence were also assessed to estimate effects on these treatment outcomes. Results Utilization data indicated the MyMAP program was actively used, with higher mean program log-ins by experimental than control participants (10.6 vs 2.7, Phttps://clinicaltrials.gov/ct2/show/NCT02136498 (Archived by WebCite at http://www.webcitation.org/6jT3UMFLj) PMID:27489247

  19. Systematic Development of the YouRAction program, a computer-tailored Physical Activity promotion intervention for Dutch adolescents, targeting personal motivations and environmental opportunities

    OpenAIRE

    Prins Richard G; van Empelen Pepijn; Beenackers Marielle A; Brug Johannes; Oenema Anke

    2010-01-01

    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 p...

  20. A cluster randomised controlled trial of a pharmacist-led collaborative intervention to improve statin prescribing and attainment of cholesterol targets in primary care

    OpenAIRE

    Richard Lowrie; Suzanne M Lloyd; Alex McConnachie; Jill Morrison

    2014-01-01

    Background Small trials with short term follow up suggest pharmacists’ interventions targeted at healthcare professionals can improve prescribing. In comparison with clinical guidance, contemporary statin prescribing is sub-optimal and achievement of cholesterol targets falls short of accepted standards, for patients with atherosclerotic vascular disease who are at highest absolute risk and who stand to obtain greatest benefit. We hypothesised that a pharmacist-led complex intervention delive...

  1. Internet-Based Physical Activity Intervention Targeting Young Adult Cancer Survivors

    OpenAIRE

    Rabin, Carolyn; Dunsiger, Shira; Ness, Kirsten K.; Marcus, Bess H

    2011-01-01

    Purpose: Young adults who have been treated for cancer face several health and psychosocial risks. To minimize these risks, is it imperative that they address any modifiable risk factors, such as sedentary lifestyle. Unfortunately, more than half of young adult cancer survivors remain sedentary. To facilitate the adoption of physical activity (PA) in this population—potentially reducing health and psychosocial risks—we developed and pilot tested an internet-based PA intervention for young sur...

  2. Assessment of the effectiveness of sustained release Bupropion and intensive physician advice in smoking cessation

    OpenAIRE

    Singh Pranav; Kumar Raj

    2010-01-01

    Background: Tobacco use is the cause of immense burden on our nation in terms of mortality and morbidity, being the single leading cause of preventable illnesses and death. Smoking cessation interventions in our country will be the most cost effective of all interventions considering that the cost incurred on the three main tobacco related illnesses (COPD, CAD, and Cancer) being around Rs 27,761 crore in the year 1999. Materials and Methods: A double blind placebo controlled trial was cond...

  3. Successful participant recruitment strategies for an online smokeless tobacco cessation program.

    Science.gov (United States)

    Gordon, Judith S; Akers, Laura; Severson, Herbert H; Danaher, Brian G; Boles, Shawn M

    2006-12-01

    An estimated 22% of Americans currently use smokeless tobacco (ST). Most live in small towns and rural areas that offer few ST cessation resources. Approximately 94 million Americans use the Internet for health-related information, and on-line access is growing among lower-income and less-educated groups. As part of a randomized clinical trial to assess the reach and effectiveness of Web-based programs for delivering an ST cessation intervention, the authors developed and evaluated several methods for overcoming the recruitment challenges associated with Web-based research. This report describes and evaluates these methods. Participants were recruited through: (a) Thematic promotional "releases" to print and broadcast media, (b) Google ads, (c) placement of a link on other Web sites, (d) limited purchase of paid advertising, (e) direct mailings to ST users, and (f) targeted mailings to health care and tobacco control professionals. Combined recruitment activities resulted in more than 23,500 hits on our recruitment website from distinct IP addresses over 15 months, which yielded 2,523 eligible ST users who completed the registration process and enrolled in the study. Self-reports revealed that at least 1,276 (50.6%) of these participants were recruited via mailings, 874 (34.6%) from Google ads or via search engines or links on another Web site, and 373 (14.8%) from all other methods combined. The use of thematic mailings is novel in research settings. Recruitment of study participants went quickly and smoothly. Google ads and mailings to media outlets were the methods that recruited the highest number of participants. PMID:17491169

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

    OpenAIRE

    Muuraiskangas, Salla; Harjumaa, Marja; Kaipainen, Kirsikka; Ermes, Miikka

    2016-01-01

    Background Digital interventions have the potential to serve as cost-effective ways to manage occupational stress and well-being. However, little is known about the adoption of individual-level digital interventions at organizations. Objectives The aim of this paper is to study the effects of an unguided digital mental health intervention in occupational well-being and the factors that influence the adoption of the intervention. Methods The intervention was based on acceptance and commitment ...

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

    DEFF Research Database (Denmark)

    Olesen, Mette Linnet; Duun-Henriksen, Anne-Katrine; Hansson, 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......PURPOSE: We investigated the effect of a person-centered intervention consisting of two to four nurse-led conversations using guided self-determination tailored to gynecologic cancer (GSD-GYN-C) on gynecological cancer survivors' quality of life (QOL), impact of cancer, distress, anxiety...

  6. Impacts of residential heating intervention measures on air quality and progress towards targets in Christchurch and Timaru, New Zealand

    Energy Technology Data Exchange (ETDEWEB)

    Scott, A.J.; Scarrott, C. [Environment Canterbury, Christchurch (New Zealand)

    2011-06-15

    Elevated wintertime particulate concentrations in the New Zealand cities of Christchurch and Timaru are mostly attributed to the burning of wood and coal for residential heating. A carrot-and-stick approach was adopted for managing air quality in Christchurch, where strict intervention measures were introduced together with a residential heater replacement programme to encourage householders to change to cleaner forms of heating. A similar approach was only recently implemented for Timaru. This paper presents the results of a partial accountability analysis, where the impact of these measures on the target source, PM10 emissions, and PM10, concentrations are quantified. A statistical model was developed to estimate trends in the concentrations, which were tested for significance after accounting for meteorological effects, and to estimate the probability of meeting air quality targets. Results for Christchurch and Timaru are compared to illustrate the impacts of differing levels of intervention on air quality. In Christchurch, approximately 34,000 (76%) open fires and old solid fuel burners were replaced with cleaner heating technology from 2002 to 2009, and total open fires and solid fuel burner numbers decreased by 45%. Over the same time period, estimated PM10 emissions reduced by 71% and PM10 concentrations by 52% (maxima), 36% (winter mean), 26% (winter median) and 41% (meteorology-adjusted winter means). In Timaru, just 3000 (50%) open fires and old solid fuel burners were replaced from 2001 to 2008, with total open fire and solid fuel burner numbers reduced by 24%. PM10 emissions declined by 32%, with low reductions in the PM10 concentrations (maxima decreased by 7%, winter means by 11% and winter medians by 3%). These findings indicate that the combination of stringent intervention measures and financial incentives has led to substantial air quality improvements in Christchurch.

  7. Translating public health knowledge into practice: development of a lay health advisor perinatal tobacco cessation program.

    Science.gov (United States)

    English, Kevin C; Merzel, Cheryl; Moon-Howard, Joyce

    2010-01-01

    The value of lay health advisor (LHA) interventions as an effective approach toward ameliorating racial, ethnic and/socioeconomic health disparities has been noted by researchers and policy makers. Translating scientific knowledge to bring state-of-the-art health promotion/disease prevention innovation to underserved populations is critical for addressing these health disparities. This article examines the experiences of a community-academic partnership in designing, developing, and implementing an evidence-based, LHA-driven perinatal tobacco cessation program for low-income, predominately African American and Hispanic women. A multimethod process evaluation was conducted to analyze three essential domains of program implementation: (1) fit of the tobacco cessation program into the broader project context, (2) feasibility of program implementation, and (3) fidelity to program implementation protocols. Findings indicate that project partners have largely succeeded in integrating an evidence-based tobacco cessation program into a community-based maternal and infant health project. The successful implementation of this intervention appears to be attributable to the following two predominant factors: (1) the utilization of a scientifically validated tobacco cessation intervention model and (2) the emphasis on continuous LHA training and capacity development. PMID:20357602

  8. Degradable Magnetic Composites for Minimally Invasive Interventions: Device Fabrication, Targeted Drug Delivery, and Cytotoxicity Tests.

    Science.gov (United States)

    Peters, Christian; Hoop, Marcus; Pané, Salvador; Nelson, Bradley J; Hierold, Christofer

    2016-01-20

    Superparamagnetic nanoparticles and a functional, degradable polymer matrix based on poly(ethylene glycol) are combined to enable fully degradable magnetic microdevices for minimally invasive biomedical applications. A bioinspired helical microrobot platform mimicking Escherichia coli bacteria is fabricated and actuated using weak rotating magnetic fields. Locomotion based on corkscrew propulsion, targeted drug delivery, and low-degradation-product cytotoxicity are demonstrated. PMID:26603856

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

    Science.gov (United States)

    Blair, Wade S; Pickford, Chris; Irving, Stephen L; Brown, David G; Anderson, Marie; Bazin, Richard; Cao, Joan; Ciaramella, Giuseppe; Isaacson, Jason; Jackson, Lynn; Hunt, Rachael; Kjerrstrom, Anne; Nieman, James A; Patick, Amy K; Perros, Manos; Scott, Andrew D; Whitby, Kevin; Wu, Hua; Butler, Scott L

    2010-01-01

    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. PMID:21170360

  10. 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

  11. Effects of smoking cessation on hypoxia and its potential impact on radiation treatment effects in lung cancer patients

    International Nuclear Information System (INIS)

    Background and purpose: smoking cessation is often attempted in the context of a lung cancer diagnosis. If cessation causes slowly continuing changes of total lung capacity and vital capacity, this may have consequences for lung volume, results of dose-volume histogram (DVH) analysis and targeting precision, in addition to changes in oxygenation, tumor biology (gene expression) and prognosis. Methods: to address the impact of smoking cessation on radiation treatment of lung cancer, a literature review was performed. Results: smoking cessation is associated with important benefits such as improved lung function and a better general health and performance status. In surgically and radiation treated patients, smoking cessation might lead to longer survival and reduced complications. Early data indicate that hypoxia in non-small cell lung cancer should be considered a poor prognostic factor. Yet, specific human data on how hypoxia is influenced by smoking status are not available. The influence of smoking history on the pneumonitis risk is not entirely clear. However, it appears that other factors outweigh the influence of smoking. The short-term effects of smoking cessation on lung function do not appear to cause relevant errors in treatment planning or targeting precision. Yet, no prospective study formally addressing this question was identified. Conclusion: smoking cessation appears to be prognostically beneficial. The role of hypoxia in this context requires more detailed evaluation. (orig.)

  12. 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. PMID:27051550

  13. HIV Capsid is a Tractable Target for Small Molecule Therapeutic Intervention

    OpenAIRE

    Blair, Wade S.; Pickford, Chris; Irving, Stephen L.; Brown, David G.; Anderson, Marie; Bazin, Richard; Cao, Joan; Ciaramella, Giuseppe; Isaacson, Jason; Jackson, Lynn; Hunt, Rachael; Kjerrstrom, Anne; Nieman, James A.; Patick, Amy K.; Perros, Manos

    2010-01-01

    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, a...

  14. Targeting Noncognitive Skills to Improve Cognitive Outcomes: Evidence from a Remedial Education Intervention

    OpenAIRE

    Holmlund, Helena; Silva, Olmo

    2014-01-01

    A growing body of research highlights the importance of non-cognitive skills as determinants of young people's cognitive outcomes at school. However, little evidence exists about the effects of policies that specifically target students' non-cognitive skills as a way to improve educational achievements. In this paper, we shed light on this issue by studying a remedial education programme aimed at English secondary school pupils at risk of school exclusion and with worsening educational trajec...

  15. 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.

  16. Basigin is a druggable target for host-oriented antimalarial interventions.

    Science.gov (United States)

    Zenonos, Zenon A; Dummler, Sara K; Müller-Sienerth, Nicole; Chen, Jianzhu; Preiser, Peter R; Rayner, Julian C; Wright, Gavin J

    2015-07-27

    Plasmodium falciparum is the parasite responsible for the most lethal form of malaria, an infectious disease that causes a large proportion of childhood deaths and poses a significant barrier to socioeconomic development in many countries. Although antimalarial drugs exist, the repeated emergence and spread of drug-resistant parasites limit their useful lifespan. An alternative strategy that could limit the evolution of drug-resistant parasites is to target host factors that are essential and universally required for parasite growth. Host-targeted therapeutics have been successfully applied in other infectious diseases but have never been attempted for malaria. Here, we report the development of a recombinant chimeric antibody (Ab-1) against basigin, an erythrocyte receptor necessary for parasite invasion as a putative antimalarial therapeutic. Ab-1 inhibited the PfRH5-basigin interaction and potently blocked erythrocyte invasion by all parasite strains tested. Importantly, Ab-1 rapidly cleared an established P. falciparum blood-stage infection with no overt toxicity in an in vivo infection model. Collectively, our data demonstrate that antibodies or other therapeutics targeting host basigin could be an effective treatment for patients infected with multi-drug resistant P. falciparum. PMID:26195724

  17. Experiences of outreach workers in promoting smoking cessation to Bangladeshi and Pakistani men: longitudinal qualitative evaluation

    Directory of Open Access Journals (Sweden)

    Barton Pelham M

    2011-06-01

    Full Text Available Abstract Background Despite having high smoking rates, there have been few tailored cessation programmes for male Bangladeshi and Pakistani smokers in the UK. We report on a qualitative evaluation of a community-based, outreach worker delivered, intervention that aimed to increase uptake of NHS smoking cessation services and tailor services to meet the needs of Bangladeshi and Pakistani men. Methods This was a longitudinal, qualitative study, nested within a phase II cluster randomised controlled trial of a complex intervention. We explored the perspectives and experiences of five outreach workers, two stop smoking service managers and a specialist stop smoking advisor. Data were collected through focus group discussions, weekly diaries, observations of management meetings, shadowing of outreach workers, and one-to-one interviews with outreach workers and their managers. Analysis was undertaken using a modified Framework approach. Results Outreach workers promoted cessation services by word of mouth on the streets, in health service premises, in local businesses and at a wide range of community events. They emphasised the reasons for cessation, especially health effects, financial implications, and the impact of smoking on the family. Many smokers agreed to be referred to cessation services, but few attended, this in part being explained by concerns about the relative inflexibility of existing service provision. Although outreach workers successfully expanded service reach, they faced the challenges of perceived lack of awareness of the health risks associated with smoking in older smokers and apathy in younger smokers. These were compounded by perceptions of "lip service" being given to their role by community organisations and tensions both amongst the outreach workers and with the wider management team. Conclusions Outreach workers expanded reach of the service through taking it to diverse locations of relevance to Pakistani and Bangladeshi

  18. Impacts of residential heating intervention measures on air quality and progress towards targets in Christchurch and Timaru, New Zealand

    Science.gov (United States)

    Scott, Angelique J.; Scarrott, Carl

    2011-06-01

    Elevated wintertime particulate concentrations in the New Zealand cities of Christchurch and Timaru are mostly attributed to the burning of wood and coal for residential heating. A carrot-and-stick approach was adopted for managing air quality in Christchurch, where strict intervention measures were introduced together with a residential heater replacement programme to encourage householders to change to cleaner forms of heating. A similar approach was only recently implemented for Timaru. This paper presents the results of a partial accountability analysis, where the impact of these measures on the target source, PM 10 emissions, and PM 10 concentrations are quantified. A statistical model was developed to estimate trends in the concentrations, which were tested for significance after accounting for meteorological effects, and to estimate the probability of meeting air quality targets. Results for Christchurch and Timaru are compared to illustrate the impacts of differing levels of intervention on air quality. In Christchurch, approximately 34,000 (76%) open fires and old solid fuel burners were replaced with cleaner heating technology from 2002 to 2009, and total open fires and solid fuel burner numbers decreased by 45%. Over the same time period, estimated PM 10 emissions reduced by 71% and PM 10 concentrations by 52% (maxima), 36% (winter mean), 26% (winter median) and 41% (meteorology-adjusted winter means). In Timaru, just 3000 (50%) open fires and old solid fuel burners were replaced from 2001 to 2008, with total open fire and solid fuel burner numbers reduced by 24%. PM 10 emissions declined by 32%, with low reductions in the PM 10 concentrations (maxima decreased by 7%, winter means by 11% and winter medians by 3%). These findings, supported by the results of the meteorology corrected trend analysis for Christchurch, strongly indicate that the combination of stringent intervention measures and financial incentives has led to substantial air quality

  19. Influence of the Target Vessel on the Location and Area of Maximum Skin Dose during Percutaneous Coronary Intervention

    International Nuclear Information System (INIS)

    Background: A number of cases involving radiation-associated patient skin injury attributable to percutaneous coronary intervention (PCI) have been reported. Knowledge of the location and area of the patient's maximum skin dose (MSD) in PCI is necessary to reduce the risk of skin injury. Purpose: To determine the location and area of the MSD in PCI, and separately analyze the effects of different target vessels. Material and Methods: 197 consecutive PCI procedures were studied, and the location and area of the MSD were calculated by a skin-dose mapping software program: Caregraph. The target vessels of the PCI procedures were divided into four groups based on the American Heart Association (AHA) classification. Results: The sites of the MSD for AHA no.1-3, AHA no.4, and AHA no.11-15 were located mainly on the right back skin, the lower right or center back skin, and the upper back skin areas, respectively, whereas the MSD sites for the AHA no. 5-10 PCI were widely spread. The MSD area for the AHA no. 4 PCI was larger than that for the AHA no. 11-15 PCI (P<0.0001). Conclusion: Although the radiation associated with PCI can be widely spread and variable, we observed a tendency regarding the location and area of the MSD when we separately analyzed the data for different target vessels. We recommend the use of a smaller radiation field size and the elimination of overlapping fields during PCI

  20. Androgen-targeted therapy induced epithelial mesenchymal plasticity and neuroendocrine transdifferentiation in prostate cancer: an opportunity for intervention

    Directory of Open Access Journals (Sweden)

    Mannan eNouri

    2014-12-01

    Full Text Available Androgens regulate biological pathways to promote proliferation, differentiation and survival of benign and malignant prostate tissue. Androgen receptor targeted therapies exploit this dependence and are used in advanced prostate cancer to control disease progression. Contemporary treatment regimens involve sequential use of inhibitors of androgen synthesis or androgen receptor function. Although targeting the androgen axis has clear therapeutic benefit, its effectiveness is temporary, as prostate tumor cells adapt to survive and grow. The removal of androgens (androgen deprivation has been shown to activate both epithelial-to-mesenchymal transition (EMT and neuroendocrine transdifferentiation programs. EMT has established roles in promoting biological phenotypes associated with tumor progression (migration/invasion, tumor cell survival, cancer stem cell-like properties, resistance to radiation and chemotherapy in multiple human cancer types. Neuroendocrine transdifferentiation in prostate cancer is associated with resistance to therapy, visceral metastasis and aggressive disease. Thus, activation of these programs via inhibition of the androgen axis provides a mechanism by which tumor cells can adapt to promote disease recurrence and progression. Brachyury, Axl, MEK and aurora kinase A are molecular drivers of these programs, and inhibitors are currently in clinical trials to determine therapeutic applications. Understanding tumor cell plasticity will be important in further defining the rational use of androgen targeted therapies clinically and provides an opportunity for intervention to prolong survival of men with metastatic prostate cancer.

  1. Influence of the Target Vessel on the Location and Area of Maximum Skin Dose during Percutaneous Coronary Intervention

    Energy Technology Data Exchange (ETDEWEB)

    Chida, K.; Fuda, K.; Kagaya, Y.; Saito, H.; Takai, Y.; Kohzuki, M.; Takahash i, S.; Yamada, S.; Zuguchi, M. [Dept. of Radiological Technology, School of Heal th Sciences, Faculty of Medicine, Tohoku Univ., Sendai (Japan)

    2007-10-15

    Background: A number of cases involving radiation-associated patient skin injury attributable to percutaneous coronary intervention (PCI) have been reported. Knowledge of the location and area of the patient's maximum skin dose (MSD) in PCI is necessary to reduce the risk of skin injury. Purpose: To determine the location and area of the MSD in PCI, and separately analyze the effects of different target vessels. Material and Methods: 197 consecutive PCI procedures were studied, and the location and area of the MSD were calculated by a skin-dose mapping software program: Caregraph. The target vessels of the PCI procedures were divided into four groups based on the American Heart Association (AHA) classification. Results: The sites of the MSD for AHA no.1-3, AHA no.4, and AHA no.11-15 were located mainly on the right back skin, the lower right or center back skin, and the upper back skin areas, respectively, whereas the MSD sites for the AHA no. 5-10 PCI were widely spread. The MSD area for the AHA no. 4 PCI was larger than that for the AHA no. 11-15 PCI (P<0.0001). Conclusion: Although the radiation associated with PCI can be widely spread and variable, we observed a tendency regarding the location and area of the MSD when we separately analyzed the data for different target vessels. We recommend the use of a smaller radiation field size and the elimination of overlapping fields during PCI.

  2. Comparison of Deep Brain Stimulation Lead Targeting Accuracy and Procedure Duration between 1.5-and 3-Tesla Interventional Magnetic Resonance Imaging Systems: An Initial 12-Month Experience

    OpenAIRE

    Southwell, DG; Narvid, JA; Martin, AJ; Qasim, SE; Starr, PA; Larson, PS

    2016-01-01

    Interventional magnetic resonance imaging (iMRI) allows deep brain stimulator lead placement under general anesthesia. While the accuracy of lead targeting has been described for iMRI systems utilizing 1.5-tesla magnets, a similar assessment of 3-tesla iMRI procedures has not been performed.To compare targeting accuracy, the number of lead targeting attempts, and surgical duration between procedures performed on 1.5- and 3-tesla iMRI systems.Radial targeting error, the number of targeting att...

  3. Cluster randomized trial in smoking cessation with intensive advice in diabetic patients in primary care : ITADI Study

    OpenAIRE

    Roura Pilar; Armengol Angelina; Advani Mamta; Martin Carlos; Prieto Gemma; Perez Santiago; Roig Lydia; Maria Manresa Josep; Briones Elena

    2010-01-01

    Abstract Background It is a priority to achieve smoking cessation in diabetic smokers, given that this is a group of patients with elevated cardiovascular risk. Furthermore, tobacco has a multiplying effect on micro and macro vascular complications. Smoking abstinence rates increase as the intensity of the intervention, length of the intervention and number and diversity of contacts with the healthcare professional during the intervention increases. However, there are few published studies ab...

  4. 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

  5. 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.

  6. 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. PMID:26617432

  7. 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.

  8. 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.

  9. Genital hygiene practices of fishermen targeted for a topical microbicide intervention against sexually transmitted infections in Kisumu, Kenya.

    Science.gov (United States)

    Kwena, Z A; Bukusi, E A; Gorbach, P; Sharma, A; Sang, N M; Holmes, K K

    2010-06-01

    Research on hygiene has been relatively limited in the current era of rigorous observational studies and clinical trials. We set out to investigate the perception and practices of genital hygiene among fishermen working on the beaches along Lake Victoria, targeted for a topical male microbicide hygiene intervention. We conducted 12 focus group discussions involving fishermen (n = 130), recording the discussions in Dholuo (the local language) and transcribing them verbatim before translating into English. Transcripts were double-coded and analysed using constant comparative analysis. Despite easy access to lake water and recognition of a link that may exist between poor genital hygiene and the risk of penile infection and poor sexual relationships, few fishermen regularly washed their genitalia due to fear/embarrassment from cleaning their genitalia in public, traditional Luo beliefs such as that washing with soap would reduce the fish catch, lack of time because of their busy schedules, laziness and lack of responsibility, and excessive consumption of alcohol and illicit drugs. Hygiene practices of the fishermen were poor and could contribute to genital infections including sexually transmitted infections. Given the fishermen's poor genital hygiene practices, they may benefit from hygiene intervention, including that provided by penile microbicides, which can be applied in the privacy of their bedrooms. PMID:20606226

  10. 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.

  11. Identification of BIRC6 as a novel intervention target for neuroblastoma therapy

    International Nuclear Information System (INIS)

    Neuroblastoma are pediatric tumors of the sympathetic nervous system with a poor prognosis. Apoptosis is often deregulated in cancer cells, but only a few defects in apoptotic routes have been identified in neuroblastoma. Here we investigated genomic aberrations affecting genes of the intrinsic apoptotic pathway in neuroblastoma. We analyzed DNA profiling data (CGH and SNP arrays) and mRNA expression data of 31 genes of the intrinsic apoptotic pathway in a dataset of 88 neuroblastoma tumors using the R2 bioinformatic platform. BIRC6 was selected for further analysis as a tumor driving gene. Knockdown experiments were performed using BIRC6 lentiviral shRNA and phenotype responses were analyzed by Western blot and MTT-assays. In addition, DIABLO levels and interactions were investigated with immunofluorescence and co-immunoprecipitation. We observed frequent gain of the BIRC6 gene on chromosome 2, which resulted in increased mRNA expression. BIRC6 is an inhibitor of apoptosis protein (IAP), that can bind and degrade the cytoplasmic fraction of the pro-apoptotic protein DIABLO. DIABLO mRNA expression was exceptionally high in neuroblastoma but the protein was only detected in the mitochondria. Upon silencing of BIRC6 by shRNA, DIABLO protein levels increased and cells went into apoptosis. Co-immunoprecipitation confirmed direct interaction between DIABLO and BIRC6 in neuroblastoma cell lines. Our findings indicate that BIRC6 may have a potential oncogenic role in neuroblastoma by inactivating cytoplasmic DIABLO. BIRC6 inhibition may therefore provide a means for therapeutic intervention in neuroblastoma

  12. Identification of BIRC6 as a novel intervention target for neuroblastoma therapy

    Directory of Open Access Journals (Sweden)

    Lamers Fieke

    2012-07-01

    Full Text Available Abstract Background Neuroblastoma are pediatric tumors of the sympathetic nervous system with a poor prognosis. Apoptosis is often deregulated in cancer cells, but only a few defects in apoptotic routes have been identified in neuroblastoma. Methods Here we investigated genomic aberrations affecting genes of the intrinsic apoptotic pathway in neuroblastoma. We analyzed DNA profiling data (CGH and SNP arrays and mRNA expression data of 31 genes of the intrinsic apoptotic pathway in a dataset of 88 neuroblastoma tumors using the R2 bioinformatic platform (http://r2.amc.nl. BIRC6 was selected for further analysis as a tumor driving gene. Knockdown experiments were performed using BIRC6 lentiviral shRNA and phenotype responses were analyzed by Western blot and MTT-assays. In addition, DIABLO levels and interactions were investigated with immunofluorescence and co-immunoprecipitation. Results We observed frequent gain of the BIRC6 gene on chromosome 2, which resulted in increased mRNA expression. BIRC6 is an inhibitor of apoptosis protein (IAP, that can bind and degrade the cytoplasmic fraction of the pro-apoptotic protein DIABLO. DIABLO mRNA expression was exceptionally high in neuroblastoma but the protein was only detected in the mitochondria. Upon silencing of BIRC6 by shRNA, DIABLO protein levels increased and cells went into apoptosis. Co-immunoprecipitation confirmed direct interaction between DIABLO and BIRC6 in neuroblastoma cell lines. Conclusion Our findings indicate that BIRC6 may have a potential oncogenic role in neuroblastoma by inactivating cytoplasmic DIABLO. BIRC6 inhibition may therefore provide a means for therapeutic intervention in neuroblastoma.

  13. BRCA1 and miRNAs: An Emerging Therapeutic Target and Intervention Tool in Breast Cancer

    Directory of Open Access Journals (Sweden)

    Mintu Pal*

    2013-01-01

    Full Text Available Reduced BRCA1 activity, either by germ-line mutations in inherited breast cancer or by epigenetic down-regulation in sporadic cancers,represents a key pathway in tumour development and progression. Although best known for its role in the maintenance of chromosome integrity, BRCA1 has recently been found to play a role in chromatin remodelling and transcriptional regulation, as well as in mammary epithelial stem cell differentiation or mammary stem cell fate decision. While BRCA1 potentially plays a significant role in both mammary tumour development and malignant progression, its function connection to tumor development is poorly understood. Recent studies have uncovered a new role of BRCA1 in the regulation of small (~19-25 nucleotides non-coding microRNA (miRNA expression in breast cancer cells. Several studies have also shown that aggressive breast cancers and breast cancer stem cells exhibit distinctive profiles of miRNA expression, suggesting that BRCA1 associated differential expression of miRNAs can regulate important cellular functions facilitating the maintenance of breast cancer stem cells and/or promoting breast cancer aggression. In this context, we will review recent progress in the understanding of the BRCA1 function, with emphasis on the implication of the development and progression of breast cancer via differential expression of miRNAs and discuss how these studies can improve our understanding of breast cancer pathogenesis. We will also discuss the perspectives of BRCA1 function through miRNAs and the role of miRNAs in regulating BRCA1 in breast cancer, more specifically tumor suppressor, miR-125 and oncogene, mir-155 as diagnostic and prognostic tools in clinical practice, and as new avenues for therapeutic interventions.

  14. 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.

  15. HOW DO THE CHARACTERISTICS OF CONTEXT INFLUENCE THE WORK OF FACILITATORS WHEN IMPLEMENTING A STANDARDISED EDUCATIONAL INTERVENTION TARGETING NURSING HOME STAFF TO REDUCE RESTRAINT IN DEMENTIA CARE?

    OpenAIRE

    2015-01-01

    This research is part of a larger study - a sequential mixed method education intervention targeting staff in 24 Nursing Homes (NHs) in Norway to reduce use of restraint and psychotropic drugs. Building on a previous successful intervention, we used the Promoting Action on Research Implementation in Health Services (PARIHS) prospectively to combine cluster randomized controlled trial, participatory action research (PAR) and ethnography to design and evaluate the effectiveness of 2 day staff e...

  16. Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention

    OpenAIRE

    Musiat, Peter; Conrod, Patricia; Treasure, Janet; Tylee, Andre; Williams, Christopher; Schmidt, Ulrike

    2014-01-01

    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) ...

  17. 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...

  18. 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.

  19. Design Considerations for Smoking Cessation Apps: Feedback From Nicotine Dependence Treatment Providers and Smokers

    Science.gov (United States)

    Hartzler, Andrea L; Catz, Sheryl L

    2016-01-01

    and social media connectivity were less important than other features. Despite these similarities, the groups had significantly different opinions about the relative importance of various features. In particular, providers rated privacy as the most important feature, whereas smokers rated low cost and the ability to adaptively tailor content as the most important features. Conclusions Smoking cessation apps hold great promise as intervention tools but only if they engage users and appropriately treat nicotine dependence. Intervention development should take into consideration the perspectives of both treatment experts and smokers. This paper highlights important perspectives from each of these groups to be considered when designing future app-based smoking cessation programs. PMID:26872940

  20. Smoking cessation among Norwegian adolescents and young adults: preferred cessation methods.

    Science.gov (United States)

    Wiium, Nora; Overland, Simon; Aarø, Leif E

    2011-04-01

    Despite generally declining smoking rates, particularly among young people, a large number of people remain smokers and many young people still pick up smoking. Helping smokers quit therefore remains a high priority for the public health sector. In the present study we examined adolescents and young adults' preferences regarding cessation methods and if these differed between genders and depended on smoking frequency. The data came from a nationally representative survey in Norway among 16-20 year olds. Only regular (weekly and daily) smokers were included in the statistical analyses (n = 509, 51% females). The findings suggest that the majority of both male (83.6%) and female (78.4%) smokers would prefer to quit smoking without help. More males than females reported that they would consider using snus as a cessation aid, while females more often reported willingness to attend cessation classes or use brochures and diaries as cessation aids. Both males and females had similar preferences albeit low, regarding the use of health services, nicotine gum or patches and internet and sms-services to quit smoking. Daily smokers would more often than weekly smokers prefer to attend cessation classes, seek help from health services, use nicotine gum or patches or use brochures and diaries. In contrast, weekly smokers preferred to use snus as a cessation aid more often than daily smokers. Identifying and making appropriate cessation methods attractive may lead to successful quitting and consequently public health gains. PMID:21054423

  1. Assessment of the effectiveness of sustained release Bupropion and intensive physician advice in smoking cessation

    Directory of Open Access Journals (Sweden)

    Singh Pranav

    2010-01-01

    Full Text Available Background: Tobacco use is the cause of immense burden on our nation in terms of mortality and morbidity, being the single leading cause of preventable illnesses and death. Smoking cessation interventions in our country will be the most cost effective of all interventions considering that the cost incurred on the three main tobacco related illnesses (COPD, CAD, and Cancer being around Rs 27,761 crore in the year 1999. Materials and Methods: A double blind placebo controlled trial was conducted to see the efficacy of Bupropion in smoking cessation. Smokers with current depression were excluded. The subjects (n = 30 were randomly assigned to receive Bupropion SR 300 mg/day or placebo for seven weeks. Target quit date was preferentially 8 th day of starting the treatment. Intensive counseling was provided by the physician at the baseline and brief counseling at every visit weekly during the treatment phase and at weeks 12 and 16. Self reported abstinence was confirmed by a carbon monoxide concentration in expired air of less than 10 ppm. Results: The seven-day point prevalence abstinence rate at the end of week 2 and week 16 in the drug group was 46.67% and 53.33 % respectively and in the placebo group was 13.33% and 20% respectively with the ′P" value of 0.04 and 0.05 respectively. Rates of continuous abstinence at weeks 4, 7 and 16 were 46.67%, 40% and 33.33% in the drug group and 13.33%, 13.33% and 13.33% in the placebo group respectively. The rates were significantly higher in the drug group till week 4 starting from week 2 of the treatment phase. The mean weight gain in drug group was found to be significant less as compared to the placebo at week 16 (P = 0.025 The mean change of depression scores from the baseline was not significantly different between the two groups at any point of time. The withdrawal symptom score increase from the baseline was not significantly higher at any point of time in the drug group but in the placebo group the

  2. 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.

  3. 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

  4. Controlling the angiogenic switch in developing atherosclerotic plaques: Possible targets for therapeutic intervention

    Directory of Open Access Journals (Sweden)

    Slevin Mark

    2009-09-01

    Full Text Available Abstract Plaque angiogenesis may have an important role in the development of atherosclerosis. Vasa vasorum angiogenesis and medial infiltration provides nutrients to the developing and expanding intima and therefore, may prevent cellular death and contribute to plaque growth and stabilization in early lesions. However in more advanced plaques, inflammatory cell infiltration, and concomitant production of numerous pro-angiogenic cytokines may be responsible for induction of uncontrolled neointimal microvessel proliferation resulting in production of immature and fragile neovessels similar to that seen in tumour development. These could contribute to development of an unstable haemorrhagic rupture-prone environment. Increasing evidence has suggested that the expression of intimal neovessels is directly related to the stage of plaque development, the risk of plaque rupture, and subsequently, the presence of symptomatic disease, the timing of ischemic neurological events and myocardial/cerebral infarction. Despite this, there is conflicting evidence regarding the causal relationship between neovessel expression and plaque thrombosis with some in vivo experimental models suggesting the contrary and as yet, few direct mediators of angiogenesis have been identified and associated with plaque instability in vivo. In recent years, an increasing number of angiogenic therapeutic targets have been proposed in order to facilitate modulation of neovascularization and its consequences in diseases such as cancer and macular degeneration. A complete knowledge of the mechanisms responsible for initiation of adventitial vessel proliferation, their extension into the intimal regions and possible de-novo synthesis of neovessels following differentiation of bone-marrow-derived stem cells is required in order to contemplate potential single or combinational anti-angiogenic therapies. In this review, we will examine the importance of angiogenesis in complicated plaque

  5. 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

  6. 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.

  7. Gender-associated genes in filarial nematodes are important for reproduction and potential intervention targets.

    Directory of Open Access Journals (Sweden)

    Ben-Wen Li

    also striking gender differences in environmental information processing and cell communication pathways. Many proteins encoded by GA genes are secreted by Brugia malayi, and these encode immunomodulatory molecules such as antioxidants and host cytokine mimics. Expression of many GA genes has been recently reported to be suppressed by tetracycline, which blocks reproduction in female Brugia malayi. Our localization of GA transcripts in filarial reproductive organs supports the hypothesis that these genes encode proteins involved in reproduction. CONCLUSIONS/SIGNIFICANCE: Genome-wide expression profiling coupled with a robust bioinformatics analysis has greatly expanded our understanding of the molecular biology of reproduction in filarial nematodes. This study has highlighted key molecules and pathways associated with reproductive and other biological processes and identified numerous potential candidates for rational drug design to target reproductive processes.

  8. [An inter-university diploma on tobacco and smoking cessation: pedagogical evaluation and professional impact].

    Science.gov (United States)

    Le Louam, A; Jung, F; Kruchen, A; Quoix, E

    2005-06-01

    The aim of the post-graduate degree course on tobacco and smoking cessation is to train professionals who have dedicated themselves to the fight against tobacco and smoking. An educational assessment of the degree programme was carried out in order to evaluate its impact on practice. A questionnaire was mailed to 60 students registered in the programme at Strasbourg University between 1997 and 2002 (with a response rate of 71.6%). The evaluation was able to shed light on the strengths and weaknesses of the teaching in the programme and the level of student satisfaction. The tobacco control and smoking cessation interventions of the students before and after completing the course were compared in order to assess the impact on their professional practice. The programme's participants came from a variety of professions including medical doctors (74.4%), paramedical staff (16.3%) and other professions (6.9%). The students acknowledged the course's high level of quality (the teachers were appreciated, and the programme was comprehensive). The structure of the course was operational; however, the students admitted that they felt that the practical application and the interactive aspects of the learning (such as case studies, role playing, training in a specific smoking cessation intervention were insufficient. They also noted a lack of emphasis on treatments that do not rely on pharmacotherapy such as behavioural therapy and psychological support. Tobacco cessation related problems or side effects of quitting like weight gain, anxiety or insomnia were not appropriately developed. The majority of students were very satisfied with the theoretical basis of the curriculum and with their internship in a tobacco cessation consultation intervention. Today, 69% of the students trained are working in smoking cessation and tobacco control. They have been able to diversify their activities, going from prevention to tobacco cessation, and vice versa. Course tracks focusing on

  9. Pilot Mobile Smoking Cessation Program Reaches Underserved — Increases Access

    Directory of Open Access Journals (Sweden)

    Gail Barouh

    2009-05-01

    Full Text Available This paper describes a pilot mobile smoking cessation programthat occurred between 2007 and 2009 across two suburban New Yorkcounties, serving 1,263 individuals. The program was designed andcarried out with three objectives: (a to assess and reduce a potential service disparity faced by adult smokers in heavily disadvantaged communities—including people marginalized by homelessness, economic distress, lack of transportation, alcoholism / drug addiction, mental illness, and/or HIV; (b to use evidence-based methods to promote smoking cessation and reduction among such adults in 14 specific lowincome Long Island, NY areas; (c to evaluate the impact and effectiveness of the program’s mobile service modality. Results of this pilot program show that meaningful percentages of the target population had: (1 never encountered a smoking cessation message prior to engagement with thismobile program (38%; (2 a demonstrated desire to quit smoking despite the heightened stresses in their lives that other people don’t face, and (3 a demonstrated ability to quit or reduce smoking when given help in a form (including mobile service that works for them. This paper concludes that Stakeholders and Policymakers in this and/or similar jurisdications would benefit from uniting to fund and design an extended mobile service delivery and data-gathering project that serves a greater number of at-risk/ multi-disadvantaged people, while seeking to quantify the financialsavings to the community that results from helping disadvantaged people to: (1 quit smoking and (2 become linked to affordable doctors for regular check-ups. This pilot program demonstrated a positive social justice impact and suggests a possible parallel positive financial impact on the community worthy of exploration.

  10. 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...... 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...... counselling group compared with the booklet group (7.3% vs. 3.6%, OR=2.2 (95% CI 1.2-4.0)), There was no clear evidence of a difference in prolonged abstinence between the reactive telephone counselling group or the internet-based smoking cessation program and the booklet group: 1.8% vs. 3.6%, OR=0.8 (95% CI...

  11. Rapid fall in lung density following smoking cessation in COPD

    DEFF Research Database (Denmark)

    Shaker, Saher B; Stavngaard, Trine; Laursen, Lars Christian; Stoel, Berend C; Dirksen, Asger

    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....

  12. A simplified interventional mapping system (SIMS) for the selection of combinations of targeted treatments in non-small cell lung cancer

    OpenAIRE

    Lazar, Vladimir; Rubin, Eitan; Depil, Stephane; Pawitan, Yudi; 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

    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 tis...

  13. 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

  14. Effects of thirty-four adolescent tobacco use cessation and prevention trials on regular users of tobacco products.

    Science.gov (United States)

    Sussman, S; Lichtman, K; Ritt, A; Pallonen, U E

    1999-09-01

    Since 1991, adolescent tobacco use rates have increased while adult use has steadily decreased. The failure of adolescent tobacco use cessation and prevention programs to reduce this overall smoking rate indicates that research must be advanced in this area. As a start, the current status of cessation and prevention research that targets adolescent regular tobacco users should be stated. This paper contributes to that goal by reviewing the last two and a half decades of research in this area. A total of 34 programs, equally divided between cessation and prevention (targeting regular tobacco users), are presented and relevant data are provided for each. Among the cessation studies, an emphasis of programming on immediate consequences of use, and instruction in coping strategies, may have led to relatively successful programs. Prevention studies arguably may have achieved lower success rates but were applied to a larger sample with a longer follow-up period. Despite showing some success, it is apparent that the scientific status of cessation research is less refined than prevention research. More research is needed to define the most successful approaches for cessation of adolescent tobacco use. PMID:10468104

  15. 78 FR 13236 - TRICARE: Smoking Cessation Program

    Science.gov (United States)

    2013-02-27

    ... proposed rule was published in the Federal Register (76 FR 58199) dated September 20, 2011, for a 60-day... the beneficiary, of pharmaceuticals used for smoking cessation, with the limitation on the availability of such pharmaceuticals to the mail-order pharmacy program under the TRICARE program;...

  16. A model of gene-gene and gene-environment interactions and its implications for targeting environmental interventions by genotype

    Directory of Open Access Journals (Sweden)

    Wallace Helen M

    2006-10-01

    Full Text Available Abstract Background The potential public health benefits of targeting environmental interventions by genotype depend on the environmental and genetic contributions to the variance of common diseases, and the magnitude of any gene-environment interaction. In the absence of prior knowledge of all risk factors, twin, family and environmental data may help to define the potential limits of these benefits in a given population. However, a general methodology to analyze twin data is required because of the potential importance of gene-gene interactions (epistasis, gene-environment interactions, and conditions that break the 'equal environments' assumption for monozygotic and dizygotic twins. Method A new model for gene-gene and gene-environment interactions is developed that abandons the assumptions of the classical twin study, including Fisher's (1918 assumption that genes act as risk factors for common traits in a manner necessarily dominated by an additive polygenic term. Provided there are no confounders, the model can be used to implement a top-down approach to quantifying the potential utility of genetic prediction and prevention, using twin, family and environmental data. The results describe a solution space for each disease or trait, which may or may not include the classical twin study result. Each point in the solution space corresponds to a different model of genotypic risk and gene-environment interaction. Conclusion The results show that the potential for reducing the incidence of common diseases using environmental interventions targeted by genotype may be limited, except in special cases. The model also confirms that the importance of an individual's genotype in determining their risk of complex diseases tends to be exaggerated by the classical twin studies method, owing to the 'equal environments' assumption and the assumption of no gene-environment interaction. In addition, if phenotypes are genetically robust, because of epistasis

  17. Application of motivational interviewing to prenatal smoking cessation: training and implementation issues

    OpenAIRE

    Velasquez, M.; J. Hecht; V. Quinn; Emmons, K; DiClemente, C.; Dolan-Mullen, P.

    2000-01-01

    OBJECTIVE—Three of the Smoke-Free Families projects incorporated motivational interviewing (MI) into prenatal smoking cessation interventions. This paper describes the process involved in training healthcare providers to use MI and the issues encountered in implementing the protocols.
DESIGN—Health care providers at all three sites attended local training workshops in which they learned to apply the basics of MI to their study protocol. All sites followed a similar outline and schedule for tr...

  18. ‘Someone batting in my corner’: experiences of smoking-cessation support via text message

    OpenAIRE

    Douglas, Nicolas; Free, Caroline

    2013-01-01

    Background The txt2stop trial demonstrated that smoking-cessation support delivered by text message doubles biochemically verified abstinence at 6 months. There was no significant heterogeneity in any of the pre-specified subgroups. Aim To explore participants’ experiences of the txt2stop intervention via a qualitative study using telephone interviews. Design and setting Qualitative telephone interviews in the community. Method Thematic content analysis of 1283 feedback forms was conducted to...

  19. Systematic critical review of previous economic evaluations of smoking cessation during pregnancy

    OpenAIRE

    Jones, Matthew; Lewis, Sarah; Parrott, Steve; Coleman, Tim

    2015-01-01

    Objective: To identify and critically assess previous economic evaluations of smoking cessation interventions delivered during pregnancy. Design: Qualitative review of studies with primary data collection or hypothetical modelling. Quality assessed using the Quality of Health Economic Studies checklist. Data sources: Electronic search of 13 databases including Medline, Econlit, Embase, and PubMed, and manual search of the UK's National Institute of Health and Care Excellence guideline...

  20. 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.

  1. Protocol for the Proactive Or Reactive Telephone Smoking CeSsation Support (PORTSSS trial

    Directory of Open Access Journals (Sweden)

    Lorgelly Paula

    2009-04-01

    Full Text Available Abstract Background Telephone quit lines are accessible to many smokers and are used to engage motivated smokers to make quit attempts. Smoking cessation counselling provided via telephone can either be reactive (i.e. primarily involving the provision of evidence-based information, or proactive (i.e. primarily involving repeated, sequenced calls from and interaction with trained cessation counsellors. Some studies have found proactive telephone counselling more effective and this trial will investigate whether or not proactive telephone support for smoking cessation, delivered through the National Health Service (NHS Smoking Helpline is more effective or cost-effective than reactive support. It will also investigate whether or not providing nicotine replacement therapy (NRT, in addition to telephone counselling, has an adjunctive impact on smoking cessation rates and whether or not this is cost effective. Methods This will be a parallel group, factorial design RCT, conducted through the English national NHS Smoking Helpline which is run from headquarters in Glasgow. Participants will be smokers who call the helpline from any location in England and who wish to stop smoking. If 644 participants are recruited to four equally-sized trial groups (total sample size = 2576, the trial will have 90% power for detecting a treatment effect (Odds Ratio of 1.5 for each of the two interventions: i proactive versus reactive support and ii the offer of NRT versus no offer. The primary outcome measure for the study is self-reported, prolonged abstinence from smoking for at least six months following an agreed quit date. A concurrent health economic evaluation will investigate the cost effectiveness of the two interventions when delivered via a telephone helpline. Discussion The PORTSSS trial will provide high quality evidence to determine the most appropriate kind of counselling which should be provided via the NHS Smoking Helpline and also whether or not an

  2. The Targeted Reading Intervention: A Classroom Teacher Professional Development Program to Promote Effective Teaching for Struggling Readers in Kindergarten and First Grade

    Science.gov (United States)

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

    2010-01-01

    The main objective of the overall Targeted Reading Intervention (TRI) was to help the classroom teacher acquire the key reading diagnostic strategies (e.g., Cooter, 2003; Desimone, 2009; Garet et al., 2001; Timperley & Phillips, 2003) relevant to K-1 struggling readers (e.g., Desimone, 2009; Garet et al., 2001; Guskey, 2002; Joyce & Showers, 2002;…

  3. Exploring Primary Care Providers’ Interest in Using Patient Navigators to Assist in the Delivery of Tobacco Cessation Treatment to Low Income, Ethnic/Racial Minority Patients

    OpenAIRE

    Lubetkin, Erica I.; Lu, Wei-Hsin; Krebs, Paul; Yeung, Howa; Ostroff, Jamie S.

    2010-01-01

    We examined attitudes and practices regarding tobacco cessation interventions of primary care physicians serving low income, minority patients living in urban areas with a high smoking prevalence. We also explored barriers and facilitators to physicians providing smoking cessation counseling to determine the need for and interest in deploying a tobacco-focused patient navigator at community-based primary care practice sites. A self-administered survey was mailed to providers serving Medicaid ...

  4. Mechanisms of adolescent smoking cessation: roles of readiness to quit, nicotine dependence, and smoking of parents and peers.

    Science.gov (United States)

    Kleinjan, Marloes; Engels, Rutger C M E; van Leeuwe, Jan; Brug, Johannes; van Zundert, Rinka M P; van den Eijnden, Regina 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. Therefore, this prospective study tested two models among 850 adolescent smokers, specifying the direct and indirect relations between adolescents' readiness to quit smoking, levels of nicotine dependence, and smoking behavior of their parents and friends. One year later smoking cessation was assessed. Results showed that, among adolescent smokers, readiness to quit was positively associated with quit attempts, while nicotine dependence was inversely associated with successful cessation. Instead of a direct relation, parental and peers' smoking were inversely related to smoking cessation through nicotine dependence. The findings emphasize that interventions should be developed and tested within and outside the school setting, as well as within the family situation. In addition, the strong impact of nicotine dependence on successful cessation indicates that a more direct approach is needed to lower nicotine dependence among adolescents. PMID:18848408

  5. 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

  6. Analysis of effect of smoking cessation intervention on application 5A and 5R strategy for tuberculosis outpatients%应用5A和5R策略对肺结核门诊患者进行戒烟干预的实施效果分析

    Institute of Scientific and Technical Information of China (English)

    王景红; 孙业桓; 阚晓宏

    2014-01-01

    目的:针对吸烟的肺结核患者进行戒烟劝导,了解吸烟的肺结核患者对戒烟的态度、信心,评价戒烟干预效果。方法对前来就诊的肺结核患者中吸烟者应用5 A和5 R策略进行戒烟劝导,记录戒烟信心、动机分值,收集5次随访信息建立Epida-ta数据库,利用SPSS软件对数据进行分析,评价项目门诊医师劝导戒烟的效果。结果登记肺结核患者491例,其中有302例吸烟患者,可随访到的患者第2个月、第5个月、第6个月以及12个月后的戒烟率分别为32.1%、30.6%、27.9%和18.0%;第5个月、第6个月、12个月的连续3个月戒烟成功率分别为4.1%、5.0%和3.7%,采用非参数检验中的Friedman法对5次戒烟动机和信心进行比较,5次动机得分都各不相等,动机分值呈下降趋势,信心分值呈下降趋势。结论在肺结核患者接受督导治疗的同时,给予戒烟宣传、劝导的措施是可行的。%Objective By giving advice about quitting smoking to smoking patients at county tuberculosis outpatient department,to provide the basis for establishing an effective and enforceable quitting-smoking advising model.Methods The patients who visited the tuber-culosis outpatient department were registered so that their conditions of tobacco using,attitudes and willingness to quitting could be learned a-bout.Doctors conducted smoking-control intervention by using the 5 As and 5 Rs.At the same time of issuing treatment cards,smoking cessa-tion and motivation scores and confidence scores were recorded.Information was collected in five follow-ups and a database was established with Epidata.The data was analyzed with Software SPSS,and the effect of advising quitting smoking by clinic doctors was assessed.Results The project implementation lasted one year,during which 49 1 tuberculosis patients were registered in total,and 302 of them smoked.In follow up cases,smoking-quitting rate at

  7. Poor Perception of Body Weight Category amongst the Overweight and Obese with Chronic Hepatitis C: A Target for Intervention

    Directory of Open Access Journals (Sweden)

    Venessa Pattullo

    2011-01-01

    Full Text Available Obesity in chronic hepatitis C (CHC is associated with adverse hepatic and metabolic outcomes. This prospective study evaluates the agreement between self-perceived body weight (BW status and measured body mass index (BMI category and factors associated with its underestimation in CHC. Body size perception was measured with the Contour Drawing Rating Scale. Two hundred and seventy-three patients with CHC (overweight 45%, obese 18% participated in this study. Although both overweight and obese demonstrated good body size perception, agreement between perceived BW and measured BMI categories was poor (κ=0.315, 95% CI 0.231–0.399; 33% of overweight/obese respondents considered themselves normal or underweight. Male gender (OR 2.84 and overweight (OR 2.42 or obese BMI (OR 14.19 were associated with underestimation of BW category. Targeted interventions are needed to improve body weight perception, thereby enhancing the uptake of health advice on management of excess body weight in CHC.

  8. 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.

  9. 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. PMID:26375641

  10. 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...... 1998 the annual rate of PCI rose from 46 to 753 per million inhabitants. From 1995 to 1998 TVR with PCI or coronary artery bypass grafting (CABG) within 9 months from the index PCI decreased significantly (p < 0.001) from 21.2% in 1995 (CABG 8.6% vs PCI 12.6%) to 11.7% in 1998 (CABG 4.3% vs PCI 7.......4%). Independent predictors for TVR were: coronary stenting (OR 0.60; 95% CI 0.52-0.69, p < 0.001), primary success rate (OR 0.69; 95% CI 0.53-0.89, p < 0.005), pre-PCI stenosis severity (OR 1.01; 95% CI 1.00-1.01, p = 0.03), left anterior descending coronary artery (OR 2.35; 95% CI 1.73-3.19, p < 0.001), right...

  11. Editorial: 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. PMID:27018116

  12. Acute post cessation smoking. A strong predictive factor for metabolic syndrome among adult Saudis

    International Nuclear Information System (INIS)

    To determine the influence of tobacco exposure in the development of metabolic syndrome (MS) in the adult Saudi population. Six hundred and sixty-four adults (305 males and 359 females) aged 25-70 years were included in this cross-sectional study conducted at the King Abdul Aziz University Hospital, between June 2006 and May 2007. We classified the participants into non-smokers, smokers, and ex-smokers (defined as complete cessation for 1-2 years). All subjects were screened for the presence of MS using the modified American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI), International Diabetes Federation (IDF) and World Health Organization (WHO) definitions. Metabolic syndrome was highest among ex-smokers regardless of definition used. Relative risk for ex-smokers (95% CI: 2.23, 1.06-4.73) was more than twice in harboring MS as compared to non-smokers (95% CI: 2.78, 1.57-4.92) (p=0.009). Acute post-cessation smoking is a strong predictor for MS among male and female Arabs. Smoking cessation programs should include a disciplined lifestyle and dietary intervention to counteract the MS-augmenting side-effect of smoking cessation. (author)

  13. Mental health starts with physical health: current status and future directions of non-pharmacological interventions to improve physical health in first-episode psychosis.

    Science.gov (United States)

    Gates, Jesse; Killackey, Eóin; Phillips, Lisa; Álvarez-Jiménez, Mario

    2015-08-01

    People with psychotic disorders have reduced life expectancy compared with the general population. This difference is primarily due to increased prevalence of cardiovascular disease associated with antipsychotic drugs and with modifiable risk factors, including weight gain, low exercise, poor diet, and high prevalence of cigarette smoking. We review non-pharmacological interventions for physical health behaviour in patients with chronic and first-episode psychosis. Our findings suggest that weight loss and attenuation of weight gain are achievable but limited and might not persist beyond the end of an intervention. Evidence for smoking cessation interventions is scarce. The case for early intervention to prevent deterioration of physical health is strong. We propose a framework for development of interventions, which addresses three main factors largely absent in previous research: (1) examination of aetiological factors related to poor physical health, (2) theory-driven interventions that target aetiological factors, and (3) assessment of feasibility. PMID:26249304

  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. Picture Me Smokefree: A Qualitative Study Using Social Media and Digital Photography to Engage Young Adults in Tobacco Reduction and Cessation

    Science.gov (United States)

    Kelly, Mary T; Oliffe, John L; Bottorff, Joan L

    2015-01-01

    Background Young adults have high rates of tobacco use compared to other subpopulations, yet there are relatively few tobacco interventions specifically targeted to this group. Picture Me Smokefree is an online tobacco reduction and cessation intervention for young adults that uses digital photography and social networking. Objective The main goal of the project was to determine the feasibility of engaging young adults in participating in user-driven, online forums intended to provide peer support and motivate critical reflection about tobacco use and cessation among this high-use, hard-to-reach population. A related aim was to explore the influence of gender-related factors on participation, in order to determine the need for online interventions to be tailored to the specific gender preferences reflecting young men and women’s participation styles. Methods A total of 60 young adults ages 19-24 years who self-identified as current cigarette smokers or who had quit within the last year were recruited from across British Columbia, Canada, and participated in an online photo group on Facebook over a period of 12 consecutive weeks. A variety of data collection methods were used including tracking online activity, a brief online follow-up survey, and qualitative interviews with study participants. Data analysis involved descriptive statistics on recruitment, retention, and participation and qualitative (eg, narrative analysis, synthesis of feedback) feedback about participant engagement. Results Findings from this study suggest good potential for Facebook as an accessible, low-cost platform for engaging young adults to reflect on the reasons for their tobacco use, the benefits of quitting or reducing, and the best strategies for tobacco reduction. Young adults’ frequent use of mobile phones and other mobile devices to access social networking permitted ease of access and facilitated real-time peer-to-peer support across a diverse group of participants. However, our

  16. 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. PMID:22934539

  17. 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

  18. A theory-based educational intervention targeting nurses' attitudes and knowledge concerning cancer-related pain management: A study protocol of a quasi-experimental design

    Directory of Open Access Journals (Sweden)

    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

  19. 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.

  20. The Journey of Addiction: Barriers to and Facilitators of Drug Use Cessation among Street Children and Youths in Western Kenya

    OpenAIRE

    Embleton, Lonnie; Atwoli, Lukoye; Ayuku, David; Braitstein, Paula

    2013-01-01

    This mixed-methods study examined barriers to and facilitators of street children’s drug use cessation in Eldoret, Kenya utilizing a cross-sectional survey and focus group discussions with a community-based sample of street-involved children and youth. The primary objective of this study was to describe factors that may assist or impede cessation of drug use that can be utilized in developing substance use interventions for this marginalized population. In 2011, 146 children and youth ages 10...

  1. Smoking cessation with young women in public family planning clinics: the impact of physician messages and waiting room media.

    Science.gov (United States)

    Li, V C; Coates, T J; Spielberg, L A; Ewart, C K; Dorfman, S; Huster, W J

    1984-09-01

    This study evaluated the impact of a media program and a physician-delivered message in encouraging smoking cessation among young black women in public family planning clinics. Incorporated into the clinic visit, the 3- to 5-min physician message was intended to elicit a commitment from participants to take steps toward quitting, namely, to think about quitting, set a target date, enlist the help of family and friends, throw away matches and cigarettes, and to then quit "cold turkey." The media program consisted of specially designed posters in waiting rooms showing models of people in the process of quitting and a continuously run movie dealing with women and smoking. A total of 1,179 female smokers were recruited into the study when they came to three separate clinics in Baltimore, Maryland, to receive gynecological examinations and/or contraceptive services. Four separate interventions were tested: (I) a baseline questionnaire about smoking habits and related information; (II) baseline questionnaire plus media program; (III) baseline questionnaire plus physician message; and (IV) baseline questionnaire plus media program plus physician message. Conditions I and II were administered in Clinic A on alternating weeks, Condition III was administered in Clinic B, and Condition IV was administered in Clinic C. Follow-up was conducted at 3 and 12 months. Follow-up rates were 88.1% at 3 months, 79.9% at 12 months, and 84.1% for both 3 and 12 months. Among women receiving the physician message (Conditions III and IV), 9.9% reported not smoking at 12 months; the lowest selfreported cessation rate was 3.1% in Condition I. When verified through analyzing cotinine in saliva, quit rates were 0.09% in Condition I, 2.4% in Condition II, 3.7% in Condition III, and 2.1% in Condition IV. The fact that participants receiving the physician message quit smoking at a significantly greater rate than those who did not indicates the need for further study of the impact of physician

  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. The transtheoretical model use for smoking cessation

    OpenAIRE

    Eroğlu, Kafiye; 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...

  4. Smoking and Cessation Behaviors Among College Students

    Directory of Open Access Journals (Sweden)

    Janie Canty-Mitchell

    2012-11-01

    Full Text Available Smoking is a major factor in increased rates for cardiovascular and respiratory diseases. Despite numerous studies related to smoking behaviors and patterns in adolescents and adults, few studies examine both smoking behaviors and cessation patterns in college-aged students. The purpose of this study was to describe smoking and cessation patterns in undergraduate students at the University of North Carolina at Wilmington. Students (N= 159; M =20.9 years; 73% female; 91.2% white; 68% single completed a 41-question online health-related survey; 17 items pertained to smoking. Based on data analyses, 17% smoked cigarettes and 77.4% had tried to quit smoking between one time to greater than six times in the past. Students wanted to quit smoking for health and financial reasons and thought that changing habits, self-motivation, and exercise were the most effective ways to quit smoking. Results indicated a need to include physical, psychosocial and medicinal components in smoking cessation programs.

  5. A cluster randomised controlled trial of a pharmacist-led collaborative intervention to improve statin prescribing and attainment of cholesterol targets in primary care.

    Directory of Open Access Journals (Sweden)

    Richard Lowrie

    Full Text Available Small trials with short term follow up suggest pharmacists' interventions targeted at healthcare professionals can improve prescribing. In comparison with clinical guidance, contemporary statin prescribing is sub-optimal and achievement of cholesterol targets falls short of accepted standards, for patients with atherosclerotic vascular disease who are at highest absolute risk and who stand to obtain greatest benefit. We hypothesised that a pharmacist-led complex intervention delivered to doctors and nurses in primary care, would improve statin prescribing and achievement of cholesterol targets for incident and prevalent patients with vascular disease, beyond one year.We allocated general practices to a 12-month Statin Outreach Support (SOS intervention or usual care. SOS was delivered by one of 11 pharmacists who had received additional training. SOS comprised academic detailing and practical support to identify patients with vascular disease who were not prescribed a statin at optimal dose or did not have cholesterol at target, followed by individualised recommendations for changes to management. The primary outcome was the proportion of patients achieving cholesterol targets. Secondary outcomes were: the proportion of patients prescribed simvastatin 40 mg with target cholesterol achieved; cholesterol levels; prescribing of simvastatin 40 mg; prescribing of any statin and the proportion of patients with cholesterol tested. Outcomes were assessed after an average of 1.7 years (range 1.4-2.2 years, and practice level simvastatin 40 mg prescribing was assessed after 10 years.We randomised 31 practices (72 General Practitioners (GPs, 40 nurses. Prior to randomisation a subset of eligible patients were identified to characterise practices; 40% had cholesterol levels below the target threshold. Improvements in data collection procedures allowed identification of all eligible patients (n = 7586 at follow up. Patients in practices allocated to SOS were

  6. On a roll: the process of initiation and cessation of problem gambling among adolescents.

    Science.gov (United States)

    DiClemente, C C; Story, M; Murray, K

    2000-01-01

    As gambling becomes more accessible and acceptable in society, problems associated with gambling and gaming have begun to affect ever increasing numbers of adolescents. Although restricted from most forms of gambling by law, many adolescents are finding a path into problem gambling. Some are becoming compulsive gamblers early in their gambling career, facing a future filled with consequences and problems. Understanding the pathway or process by which these adolescents become engaged in gambling behavior and how they can extricate themselves from this addictive behavior can enhance the efficiency and effectiveness of our interventions. This article offers a perspective on the initiation and cessation of compulsive gambling using the basic elements of the process of intentional behavior change outlined in the Stages of Change from the Transtheoretical Model. The process of initiation of a problematic behavior is similar to the process of modification or cessation of a problematic behavior in terms of these stages of change. With adolescents it is important to distinguish between the process of initiation, which has implications for prevention of gambling problems, and the process of cessation, which often necessitates the assistance of treatment. Creating interventions that parallel the process of change offers the potential for personalizing and potentiating efforts to reduce the prevalence and consequences associated with compulsive or pathological and problem gambling. Application of this model to gambling behavior offers a heuristic that is intriguing and requires substantiation through rigorous research. PMID:14634317

  7. Cost-effectiveness of smoking cessation treatment initiated during psychiatric hospitalization: analysis from a randomized, controlled trial

    Science.gov (United States)

    Barnett, Paul G.; Wong, Wynnie; Jeffers, Abra; Hall, Sharon M.; Prochaska, Judith J.

    2016-01-01

    Objective We examined the cost-effectiveness of smoking cessation treatment for psychiatric inpatients. Method Smokers, regardless of intention to quit, were recruited during psychiatric hospitalization and randomized to receive stage-based smoking cessation services or usual aftercare. Smoking cessation services, quality of life, and biochemically-verified abstinence from cigarettes were assessed during 18-months of follow-up. Trial findings were combined with literature on changes in smoking status and the age and gender adjusted effect of smoking on health care cost, mortality, and quality of life in a Markov model of cost-effectiveness during a lifetime horizon. Results Among 223 smokers randomized between 2006 and 2008, the mean cost of smoking cessation services was $189 in the experimental treatment group and $37 in the usual care condition (p < 0.001). At the end of follow-up, 18.75% of the experimental group was abstinent from cigarettes, compared to 6.80% abstinence in the usual care group (p <0.05). The model projected that the intervention added $43 in lifetime cost and generated 0.101 additional Quality Adjusted Life Years (QALYs), an incremental cost-effectiveness ratio of $428 per QALY. Probabilistic sensitivity analysis found the experimental intervention was cost-effective against the acceptance criteria of $50,000/QALY in 99.0% of the replicates. Conclusions A cessation intervention for smokers identified in psychiatric hospitalization did not result in higher mental health care costs in the short-run and was highly cost-effective over the long-term. The stage-based intervention was a feasible and cost-effective way of addressing the high smoking prevalence in persons with serious mental illness. PMID:26528651

  8. 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

  9. 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

  10. Effect of Smoking on Joint Replacement Outcomes: Opportunities for Improvement Through Preoperative Smoking Cessation.

    Science.gov (United States)

    Wright, Erik; Tzeng, Tony H; Ginnetti, Michael; El-Othmani, Mouhanad M; Saleh, Jamal K; Saleh, Jasmine; Lane, J M; Mihalko, William M; Saleh, Khaled J

    2016-01-01

    Because orthopaedic surgeons focus on identifying serious potential complications, such as heart attack, stroke, and deep vein thrombosis, during the preoperative assessment, correctable factors, such as smoking, may be overlooked. Chronic exposure to nicotine has been correlated with perioperative complications that lead to worse outcomes, including decreased patient satisfaction, longer hospitalization periods, and an increased rate of hospital readmission. It has been proven that smoking is a negative risk factor for decreased bone mineral density, which leads to increased fracture risk, heightened pain, postoperative wound and bone healing complications, decreased fusion rates, and postoperative tendon and ligament healing complications. Physician-led preoperative smoking cessation programs that include, but are not limited to, pharmacotherapy plans have been shown to improve primary surgical outcomes and smoking cessation rates. Smoking has detrimental effects on specialty-specific physiology; however, there are many effective options for intervention that can improve primary outcomes. PMID:27049216

  11. "Let Me Get You a Nicotine Patch": Nurses' Perceptions of Implementing Smoking Cessation Guidelines for Hospitalized Veterans.

    Science.gov (United States)

    Katz, David A; Stewart, Kenda; Paez, Monica; Holman, John; Adams, Susan L; Vander Weg, Mark W; Battaglia, Catherine T; Joseph, Anne M; Titler, Marita G; Ono, Sarah

    2016-04-01

    Many hospitalized smokers do not receive guideline-recommended tobacco treatment, but little is known about the perceptions of inpatient nurses with regard to tobacco treatment. We used a sequential explanatory mixed methods design to help explain the findings of an academic detailing intervention trial on the inpatient medicine units of four Veterans Affairs (VA) hospitals. We surveyed 164 nurses and conducted semistructured interviews in a purposeful sample of 33 nurses with different attitudes toward cessation counseling. Content analysis was used to inductively characterize the issues raised by participants. Emerging themes were categorized using the knowledge-attitudes-behavior framework of guideline adherence. Knowledge-related and attitudinal barriers included perceived lack of skills in cessation counseling and skepticism about the effectiveness of cessation guidelines in hospitalized veterans. Nurses also reported multiple behavioral and organizational barriers to guideline adherence: resistance from patients, insufficient time and resources, the presence of smoking areas on VA premises, and lack of coordination with primary care. VA hospitals should train inpatient staff how to negotiate behavior change, integrate cessation counseling into nurses' workflow, develop alternative referral mechanisms for post-discharge cessation counseling, and adopt hospital policies to promote inpatient abstinence. PMID:27046185

  12. 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. PMID:23543358

  13. Use of GIS Technology in Surface Water Monitoring fro Targeted Policy Intervention in a Mountainous Catchment in Romania

    Science.gov (United States)

    Giali, Gabriela; Schneider, Petra

    2015-04-01

    USE OF GIS TECHNOLOGY IN SURFACE WATER MONITORING FOR TARGETED POLICY INTERVENTION IN A MOUNTAINOUS CATCHMENT IN ROMANIA The collection of information on surface water quality is a specific activity that takes place systematically and regularly at regional and national scale, and it is important for the assessment of the water quality as well as for water management policy-making. A data base information management using a Geographical Information System (GIS) forms an important aspect of environmental management, which provides the frame for processing and visualisation of water monitoring data and information as well as for the optimisation of monitoring concepts. This paper presents an architecture performed by a GIS which provides a grafic database and attributes the nesessary measurements of the water quality to different sections of the mountainous catchment of the Suceava river in the north of Romania. With this approach the location of the water sampling points can be optimised in terms of the selection and setting of the river sections. To facilitate the setting of the sampling locations in the various sections of water sampling in the river, the presented GIS system provides to the user different information layers with combined or isolated data according to the objectives. In the frame of the research were created 5 layers of information in the basin under study, underlying the determination of a new information layer, namely the "Hydrografic Network Graded to Hydrographic Sections". Practically, in the studied basin were established 8 sections for water sampling locations, and the water quality characterization was done by the consideration of 15 quality indicators. The GIS system presented in this research is a valuable, useful and adaptable to land use changes data base that can be exploited by any number of combinations, its capabilities justify it's role as "tool to support decision making." With this characteristics it supports the policy-making of

  14. Estimation of Cessation Rates among Danish Users of Benzodiazepines

    DEFF Research Database (Denmark)

    Støvring, Henrik; Gasse, Christiane

    cessation hazards among incident users of benzodiazepines, in particular with respect to potential changes after three months use. Methods: Follow-up on a 25% randomly selected cohort of all Danes (n = 1,612,171) in the period Jan 1, 1995, to Jul 1, 2007, identified through the Danish civil registration...... of cessation rates should be preferred over duration, as they can explicitly account for censoring and provide cause specific hazard estimates of cessation rates....

  15. Driving cessation in patients attending a memory clinic.

    OpenAIRE

    Cunningham, Conal

    2005-01-01

    PUBLISHED BACKGROUND: Driving is an increasingly important form of transport for older people. Dementia is common in later life and will eventually lead to driving cessation, which reduces the public health risk of impaired driving but also impairs access to services. The factors associated with driving cessation in dementia are uncertain. OBJECTIVE: To examine the demographic, psychometric and personal factors associated with driving cessation in patients attending a memory cli...

  16. Healthy Weight Regulation and Eating Disorder Prevention in High School Students: A Universal and Targeted Web-Based Intervention

    OpenAIRE

    Jones, Megan; Taylor Lynch, Katherine; Kass, Andrea E.; Burrows, Amanda; Williams, Joanne; Wilfley, Denise E.; Taylor, C. Barr

    2014-01-01

    Background Given the rising rates of obesity in children and adolescents, developing evidence-based weight loss or weight maintenance interventions that can be widely disseminated, well implemented, and are highly scalable is a public health necessity. Such interventions should ensure that adolescents establish healthy weight regulation practices while also reducing eating disorder risk. Objective This study describes an online program, StayingFit, which has two tracks for universal and targe...

  17. Municipalities Collaborating in Public Health: The Danish Smoking Prevention and Cessation Partnership

    OpenAIRE

    Pernille Tanggaard Andersen; Hanna Barbara Rasmussen; Walid El Ansari; Christiane Stock

    2010-01-01

    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...

  18. 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.

  19. Smoking cessation during pregnancy: the influence of partners, family and friends on quitters and non-quitters.

    Science.gov (United States)

    Koshy, P; Mackenzie, M; Tappin, D; Bauld, L

    2010-09-01

    This research compared pregnant quitters' and non-quitters' accounts of how partners, family and friends influenced their smoking cessation attempts. Qualitative secondary data analysis was carried out on a purposive sample of motivational interview transcripts undertaken by research midwives with pregnant women as part of SmokeChange, a smoking cessation intervention. Interviews with all quitters in the intervention group (n = 12) were analysed comparatively with interviews from a matched sample of non-quitters (n = 12).The discourses of both revealed similarity in how their partners, family and friends influenced their cessation efforts: salient others were simultaneously perceived by both groups of women as providing drivers and barriers to quit attempts; close associates who smoked were often perceived to be as supportive as those who did not. However, women who quit smoking during pregnancy talked more about receiving active praise/encouragement than those who did not. While close associates play an important role in women's attempts to stop smoking during pregnancy, the support they provide varies; further research is needed to develop a better understanding of how key relationships help or hinder cessation during pregnancy. PMID:20561076

  20. 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. PMID:26749012

  1. 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

  2. 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

    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...... implementation studies. DESIGN: Five focus group and 2 individual interviews. SETTING: Denmark. PARTICIPANTS: Twenty-two seventh-grade teachers from 7 of 20 intervention schools. Four schools (15 teachers) with a high implementation level and 3 (7 teachers) with a low implementation level were selected to obtain...... maximum variation in teachers' view. PHENOMENON OF INTEREST: Teacher perceptions of implementation of a curricular component. ANALYSIS: Situational Analysis including an introductory phase of systematic coding. RESULTS: Teachers' commitment to the Boost curriculum was hindered by intervention duration and...

  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. Is targeted fortification of human breast milk an optimal nutrition strategy for preterm infants? An interventional study

    OpenAIRE

    Morlacchi, Laura; Mallardi, Domenica; Giannì, Maria Lorella; Roggero, Paola; Amato, Orsola; Piemontese, Pasqua; Consonni, Dario; Mosca, Fabio

    2016-01-01

    Background Fortifying human milk contributes to the prevention of postnatal growth failure in preterm infants. Because of the natural variability of human milk, targeted fortification of human milk has been advocated. However, data regarding the efficacy and safety of prolonged targeted fortification are scarce. We aimed to assess the safety of targeted fortification of human milk in preterm infants compared with standard fortification, as well as the effects on infant growth. Methods We cond...

  5. 76 FR 58199 - TRICARE; Smoking Cessation Program Under TRICARE

    Science.gov (United States)

    2011-09-20

    ..., include the following: the availability, at no cost to the beneficiary, of pharmaceuticals used for smoking cessation, with the limitation on the availability of such pharmaceuticals to the mail-order... pharmaceuticals used for smoking cessation, with a limitation on the availability of such pharmaceuticals to...

  6. 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 §...

  7. 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…

  8. 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

  9. Reducing High-Risk Drinking among Student-Athletes: The Effects of a Targeted Athlete-Specific Brief Intervention

    Science.gov (United States)

    Cimini, M. Dolores; Monserrat, Joseph M.; Sokolowski, Karen L.; Dewitt-Parker, Joyce Y.; Rivero, Estela M.; McElroy, Lee A.

    2015-01-01

    Objective: This study examined the effects of a single-session motivational interviewing--based in-person brief alcohol intervention that contained student-athlete-specific personalized drinking feedback. Participants: Participants were 170 National Collegiate Athletic Association Division I student-athletes meeting screening criteria for heavy…

  10. 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.

    2011-01-01

    Acculturative stress is a common experience for international students and is associated with psychological and physical problems. In a previous study (Tavakoli "et al. Journal of Counseling Psychology 56":590-596, "2009"), the authors reported that two stress reduction interventions--expressive writing (EW) and assertiveness training (AT)--had…

  11. 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

    had a more stable organization as well as a management with positive beliefs of the intervention's potential benefits. Of eligible employees, 71% responded on the questionnaire and 57% consented to participate. Non-responders and non-consenters did not differ from the responders and consenters on...

  12. Identifying multi-level culturally appropriate smoking cessation strategies for Aboriginal health staff: a concept mapping approach.

    Science.gov (United States)

    Dawson, Anna P; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

    2013-02-01

    Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted individuals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs. PMID:23221591

  13. Application of the PEN-3 Model to Tobacco Initiation, Use, and Cessation Among American Indian and Alaska Native Adults.

    Science.gov (United States)

    Hiratsuka, Vanessa Y; Trinidad, Susan B; Avey, Jaedon P; Robinson, Renee F

    2016-07-01

    American Indian (AI) and Alaska Native (AN) communities confront some of the highest rates of tobacco use and its sequelae. As part of a formative research project investigating stakeholder understandings, preferences, and needs surrounding the use of pharmacogenetics toward tobacco cessation treatment, we sought to characterize sociocultural issues related to tobacco use and cessation. We used the PEN-3 cultural model to frame the research question and analysis of stakeholder interviews with 20 AI/AN patients, 12 health care providers, and 9 tribal leaders. Our study found high knowledge levels of the negative health effects of tobacco use; however, most patient participants ascribed negative health effects only to regular, heavy tobacco use and not to light use, which is more common in the population. The majority of patient participants did not endorse use of tobacco cessation treatment despite evidence of efficacy among AI/AN adults. Health promotion messaging to target low-tobacco consuming AI/AN people is needed. Additionally, messaging to promote tobacco cessation treatment using successful AI/AN former tobacco users to improve community perception of tobacco cessation treatment is recommended. PMID:27178836

  14. Robust impact of social anxiety in relation to coping motives and expectancies, barriers to quitting, and cessation-related problems.

    Science.gov (United States)

    Buckner, Julia D; Zvolensky, Michael J; Jeffries, Emily R; Schmidt, Norman B

    2014-08-01

    Although social anxiety is related to smoking and nicotine dependence, few researchers have sought to identify factors that contribute to these relations. The current study examined whether social anxiety was associated with cognitive vulnerability factors related to smoking: perceived barriers for quitting, cessation-related problems, negative-affect-reduction-outcome expectancies, and negative-affect-reduction motives. Further, we tested whether social anxiety was robustly related to these factors after controlling for cigarettes smoked per day, gender, alcohol-use frequency, lifetime cannabis-use status, panic attack frequency, anxiety sensitivity, and negative affectivity. The sample consisted of 580 (38.6% female) treatment-seeking smokers. Social anxiety was associated with perceived barriers for quitting, cessation-related problems, negative-affect-reduction-outcome expectancies, and negative-affect-reduction motives. After controlling for covariates, social anxiety was robustly related to perceived barriers for quitting, cessation-related problems, and negative-affect-reduction-outcome expectancies. Social anxiety was robustly related to negative-affect-reduction motives among men, but not women. Results indicate that social anxiety is robustly related to cognitive vulnerability factors associated with poorer cessation outcomes, suggesting that social anxiety may be an important therapeutic target during smoking cessation. PMID:24978348

  15. 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

    OpenAIRE

    Hedrick, Valisa E; Davy, Brenda M; Emily A. Myers; Wen You; Zoellner, Jamie M

    2015-01-01

    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-base...

  16. 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. PMID:24515948

  17. Pilot Implementation of a Wellness and Tobacco Cessation Curriculum in North Carolina Group Homes.

    Science.gov (United States)

    Baker, Hannah M; Ranney, Leah M; Goldstein, Adam O

    2016-05-01

    Despite a steady decline in smoking rates in recent decades, individuals with mental illness continue to smoke at disproportionately higher rates than the general population. Adults with mental illness are motivated to quit and quit with rates similar to the general population when evidence-based cessation interventions are used. To build an evidence base for a wellness and cessation curriculum aimed at individuals with mental illness, the Breathe Easy Live Well (BELW) program was pilot tested in two group homes in North Carolina in the spring of 2014. Evaluators conducted pre- and post-implementation site visits and interviews with program instructors to assess outcomes as well as barriers and facilitators to implementation. Qualitative analysis of the data indicated that implementation was successful in both group homes, and the following themes emerged: (1) Training and technical assistance provided throughout implementation was sufficient; (2) Instructors used prior professional experiences and goal setting to facilitate program success and participant engagement; (3) Fostering positive coping strategies contributed to reports of reduced smoking; (4) Curriculum length may be a barrier to recruitment. Additional results included an increased interest among group home residents in more diligently managing mental illness symptoms and one group home moving the designated smoking area out of the direct path of the entrance/exit. Results of this pilot project suggest that BELW could be a potentially useful tool for group home staff to address health and wellness along with smoking cessation among individuals with mental illness. PMID:26711097

  18. 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

  19. 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. Cancer 2016;122:1150-9. © 2016 American Cancer Society. PMID:26916412

  20. Factors associated to breastfeeding cessation before 6 months.

    Science.gov (United States)

    Roig, Antoni Oliver; Martínez, Miguel Richart; García, Julio Cabrero; Hoyos, Santiago Pérez; Navidad, Ginesa Laguna; Alvarez, Juan Carlos Flores; Pujalte, María Del Mar Calatayud; De León González, Ricardo García

    2010-01-01

    This research aimed to identify the determinants of full breastfeeding (FBF) and any breastfeeding (ABF) cessation before 6 months, through a six-month follow-up of 248 mothers going a postpartum visit. Data were collected by personal interview during the first month and telephone interviews at four and six months postpartum. Coxs proportional hazards model was used. Not having previous ABF experience, previous ABF duration cessation of ABF and FBF. Lower educational level was associated with cessation of ABF and the use of pacifiers or occasional breast-milk substitutes with cessation of FBF. Attending childbirth education was a protective factor against early FBF or ABF cessation. Activities supporting breastfeeding should be intensified for mothers with poorer access to information and with negative or without ABF previous experience. The use of pacifiers and not-medically indicated breast milk substitutes should be controlled. PMID:20721426

  1. Impact of weight gain following smoking cessation on one-yearoutcome after drug-eluting stent implantation

    Institute of Scientific and Technical Information of China (English)

    FAN Xiao-ming; L(u) An-kang; SHEN Wei-feng; WU Qi-hong; MA Xiao-ye; YANG Er-li; ZHANG Rui-Yan; ZHANG Shi-jia

    2012-01-01

    Background Weight gain following smoking cessation increases cardiovascular risk,but its effects on prognosis after percutaneous coronary intervention (PCI) remain unclear.This study aimed to investigate the relationship between weight gain post smoking cessation and one-year clinical outcome in patients who underwent PCI with drug-eluting stent (DES).Methods A total of 895 consecutive male smoking patients were divided into quitters (n=437) and continuers (n=458)according to their smoking status after PCI.Weight gain,major adverse cardiac events (MACE,including cardiac deaths,myocardial infarction and revascularization),and recurrent angina were recorded during follow-up for one year.Results Average weight gain in quitters was more than that in continuers (1.5 kg vs.-0.03 kg,P<0.001).Weight was unchanged or increased by more than 1.5 kg in 78.17% of continuers,while 50.57% of quitters had a weight gain of less than 1.5 kg.Compared with continuers,MACE in quitters was significantly reduced after PCI (6.12% vs.4.81%,P=0.049),especially recurrent angina (13.97% in continuers vs.9.84% in quitters,P=-0.027).After adjusting for weight gain and other factors,smoking cessation was independently associated with a lower risk of MACE and recurrent angina (OR=0.73,P=0.035).However,weight gain >1.5 kg (OR=1.55,P=0.026) could curtail the benefits from smoking cessation.Conclusions Weight gain may reduce the benefits of smoking cessation after PCI with DES implantation.Thus,although smoking cessation is recommended after PCI,weight control should also be highly encouraged for these patients.

  2. 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.

  3. 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.

  4. 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

  5. Update on medicines for smoking cessation.

    Science.gov (United States)

    McDonough, Mike

    2015-08-01

    Persistent cigarette smokers usually have a nicotine addiction. This addiction has a chronic relapsing and sometimes remitting course and may persist lifelong. Remission can be facilitated by the use of medication as part of a comprehensive management strategy tailored to the individual patient. Nicotine replacement therapy is a first-line drug treatment. It is available in many formulations. Varenicline is also a first-line drug treatment. It should be started before the patient stops smoking. Bupropion is a second-line therapy. It may be associated with an increased risk of seizures and drug interactions. While there is some evidence that electronic cigarettes might facilitate smoking cessation, quit rates are not yet comparable with those of the drugs approved on the Pharmaceutical Benefits Scheme. PMID:26648633

  6. 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 ...

  7. 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.

  8. Integrating smoking cessation and alcohol use treatment in homeless populations: study protocol for a randomized controlled trial

    OpenAIRE

    Ojo-Fati, Olamide; John, Florence; Thomas, Janet; Joseph, Anne M; Nancy C. Raymond; Cooney, Ned L.; Pratt, Rebekah; Rogers, Charles R.; Everson-Rose, Susan A.; Luo, Xianghua; Okuyemi, Kolawole S.

    2015-01-01

    Background Despite progress in reducing cigarette smoking in the general U.S. population, smoking rates, cancer morbidity and related heart disease remain strikingly high among the poor and underserved. Homeless individuals’ cigarette smoking rate remains an alarming 70 % or greater, and this population is generally untreated with smoking cessation interventions. Furthermore, the majority of homeless smokers also abuse alcohol and other drugs, which makes quitting more difficult and magnifies...

  9. Assessing the effectiveness of High Intensity Interval Training (HIIT) for smoking cessation in women: HIIT to quit study protocol

    OpenAIRE

    Pavey, Toby G; Gartner, Coral E.; Coombes, Jeff S; Brown, Wendy J.

    2015-01-01

    Background Smoking and physical inactivity are major risk factors for heart disease. Linking strategies that promote improvements in fitness and assist quitting smoking has potential to address both these risk factors simultaneously. The objective of this study is to compare the effects of two exercise interventions (high intensity interval training (HIIT) and lifestyle physical activity) on smoking cessation in female smokers. Method/design This study will use a randomised controlled trial d...

  10. 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

    , catastrophisation, anxiety and depression). Results and conclusion: Four studies met the inclusion criteria and collectively investigated nine hypotheses about targeted treatment on 28 subgroup/treatment outcomes. There were only two statistically significant results. Graded activity plus Treatment Based...... Classification targeted to people with high movement-related fear was more effective than Treatment Based Classification at reducing movement-related fear at 4 weeks. Active rehabilitation (physical exercise classes with cognitivebehavioural principles) was more effective than usual GP care at reducing activity...

  11. Identification of novel cellular targets for therapeutic intervention against Ebola virus infection by siRNA screening.

    Science.gov (United States)

    Kolokoltsov, Andrey A; Saeed, Mohammad F; Freiberg, Alexander N; Holbrook, Michael R; Davey, Robert A

    2009-06-01

    While much progress has been made in developing drugs against a few prominent viruses such as HIV, few examples exist for emerging infectious agents. In some cases broad spectrum anti-viral drugs, such as ribavirin, are effective, but for some groups of viruses, these show little efficacy in animal models. Traditional methods focus on screening small molecule libraries to identify drugs that target virus factors, with the intention that side-effects to the host can be minimized. However, this greatly limits potential drug targets and virus genes can rapidly mutate to avoid drug action. Recent advances in siRNA gene targeting technologies have provided a powerful tool to specifically target and suppress the expression of cell genes. Since viruses are completely dependent upon host cell proteins for propagation, siRNA screening promises to reveal novel cell proteins and signaling pathways that may be viable targets for drug therapy regimens. Here we used an siRNA screening approach to identify gene products that play critical roles in Ebola virus infection. By gene cluster analysis, proteins in phosphatidylinositol-3-kinase and calcium/calmodulin kinase related networks were identified as important for Zaire Ebola virus infection and prioritized for further evaluation. Key roles of each were confirmed by testing available drugs specific for members of each pathway. Interestingly, both sets of proteins are also important in cancer and subject to intense investigation. Thus development of new drugs against these cancer targets may also prove useful in combating Ebola virus. PMID:20930947

  12. 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

  13. 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…

  14. Exploring primary care providers' interest in using patient navigators to assist in the delivery of tobacco cessation treatment to low income, ethnic/racial minority patients.

    Science.gov (United States)

    Lubetkin, Erica I; Lu, Wei-Hsin; Krebs, Paul; Yeung, Howa; Ostroff, Jamie S

    2010-12-01

    We examined attitudes and practices regarding tobacco cessation interventions of primary care physicians serving low income, minority patients living in urban areas with a high smoking prevalence. We also explored barriers and facilitators to physicians providing smoking cessation counseling to determine the need for and interest in deploying a tobacco-focused patient navigator at community-based primary care practice sites. A self-administered survey was mailed to providers serving Medicaid populations in New York City's Upper Manhattan and areas of the Bronx. Provider counseling practices were measured by assessing routine delivery (≥80% of the time) of a brief tobacco cessation intervention (i.e., "5 A's"). Provider attitudes were assessed by a decisional balance scale comprising 10 positive (Pros) and 10 negative (Cons) perceptions of tobacco cessation counseling. Of 254 eligible providers, 105 responded (41%). Providers estimated 22% of their patients currently use tobacco and nearly half speak Spanish. A majority of providers routinely asked about tobacco use (92%) and advised users to quit (82%), whereas fewer assisted in developing a quit plan (32%) or arranged follow-up (21%). Compared to providers reporting navigation services at their practices. Although most providers believe they can help patients quit smoking, they also recognize the potential benefit of having a patient navigator connect their patients with evidence-based cessation services in their community. PMID:20336355

  15. Patient and professional user experiences of simple telehealth for hypertension, medication reminders and smoking cessation: a service evaluation

    Science.gov (United States)

    Cottrell, Elizabeth; Cox, Tracey; O'Connell, Phil; Chambers, Ruth

    2015-01-01

    Objectives To establish patient and professional user satisfaction with the Advice & Interactive Messaging (AIM) for Health programme delivered using a mobile phone-based, simple telehealth intervention, ‘Florence’. Design A service evaluation using data extracted from Florence and from a professional user electronic survey. Setting 425 primary care practices across 31 Clinical Commissioning Groups in England. Participants 3381 patients registered on 1 of 10 AIM protocols between March 2013 and January 2014 and 77 professional users. Intervention The AIM programme offered 10 clinical protocols, in three broad groups: (1) hypertension diagnosis/monitoring, (2) medication reminders and (3) smoking cessation. Florence sent patients prompts to submit clinical information, educational messages and user satisfaction questions. Patient responses were reviewed by their primary healthcare providers. Primary outcome measures Patients and professional user experiences of using AIM, and within this, Florence. Results Patient activity using Florence was generally good at month 1 for the hypertension protocols (71–80%), but reduced over 2–3 months (31–60%). For the other protocols, patient activity was 0–39% at 3 months. Minimum target days of texting were met for half the hypertension protocols. 1707/2304 (74%) patients sent evaluative texts responded at least once. Among responders, agreement with the adapted friends and family statement generally exceeded preproject aspirations. Professional responders were generally positive or equivocal about the programme. Conclusions Satisfaction with AIM appeared optimal when patients were carefully selected for the protocol; professional users were familiar with the system, the programme addressed a problem with the previous service delivery that was identified by users and users took an active approach to achieve clinical goals. However, there was a significant decrease in patients’ use of Florence over time. Future

  16. The use of bupropion SR in cigarette smoking cessation

    Directory of Open Access Journals (Sweden)

    Scott Wilkes

    2008-03-01

    Full Text Available Scott WilkesDepartment of Primary and Community Care, School of Health, Natural and Social Sciences, University of Sunderland, Sunderland, United KingdomAbstract: Cigarette smoking remains the largest preventable cause of premature death in developed countries. Until recently nicotine replacement therapy (NRT has been the only recognised form of treatment for smoking cessation. Bupropion, the first non-nicotine based drug for smoking cessation was licensed in the United States of America (US in 1997 and in the United Kingdom (UK in 2000 for smoking cessation in people aged 18 years and over. Bupropion exerts its effect primarily through the inhibition of dopamine reuptake into neuronal synaptic vesicles. It is also a weak noradrenalin reuptake inhibitor and has no effect on the serotonin system. Bupropion has proven efficacy for smoking cessation in a number of clinical trials, helping approximately one in five smokers to stop smoking. Up to a half of patients taking bupropion experience side effects, mainly insomnia and a dry mouth, which are closely linked to the nicotine withdrawal syndrome. Bupropion is rarely associated with seizures however care must be taken when co-prescribing with drugs that can lower seizure threshold. Also, bupropion is a potent enzyme inhibitor and can raise plasma levels of some drugs including antidepressants, antiarrhythmics and antipsychotics. Bupropion has been shown to be a safe and cost effective smoking cessation agent. Despite this, NRT remains the dominant pharmacotherapy to aid smoking cessation.Keywords: bupropion, smoking cessation, nicotine addiction

  17. 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.

  18. 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...

  19. Risk reduction: perioperative smoking intervention

    DEFF Research Database (Denmark)

    Møller, Ann; Tønnesen, Hanne

    2006-01-01

    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 of...... 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...

  20. Target for improvement: a cluster randomised trial of public involvement in quality-indicator prioritisation (intervention development and study protocol

    Directory of Open Access Journals (Sweden)

    Burgers Jako

    2011-05-01

    Full Text Available Abstract Background Public priorities for improvement often differ from those of clinicians and managers. Public involvement has been proposed as a way to bridge the gap between professional and public clinical care priorities but has not been studied in the context of quality-indicator choice. Our objective is to assess the feasibility and impact of public involvement on quality-indicator choice and agreement with public priorities. Methods We will conduct a cluster randomised controlled trial comparing quality-indicator prioritisation with and without public involvement. In preparation for the trial, we developed a 'menu' of quality indicators, based on a systematic review of existing validated indicator sets. Participants (public representatives, clinicians, and managers will be recruited from six participating sites. In intervention sites, public representatives will be involved through direct participation (public representatives, clinicians, and managers will deliberate together to agree on quality-indicator choice and use and consultation (individual public recommendations for improvement will be collected and presented to decision makers. In control sites, only clinicians and managers will take part in the prioritisation process. Data on quality-indicator choice and intended use will be collected. Our primary outcome will compare quality-indicator choice and agreement with public priorities between intervention and control groups. A process evaluation based on direct observation, videorecording, and participants' assessment will be conducted to help explain the study's results. The marginal cost of public involvement will also be assessed. Discussion We identified 801 quality indicators that met our inclusion criteria. An expert panel agreed on a final set of 37 items containing validated quality indicators relevant for chronic disease prevention and management in primary care. We pilot tested our public-involvement intervention with 27

  1. [Smoking cessation--a "must have" in medical curricula. The European HERMES project--a supportive argument].

    Science.gov (United States)

    Trofor, Antigona; Mihăescu, Traian

    2009-01-01

    Respiratory Medicine is a complex domain of activity, moreover has enlarged its content in last decades by numerous areas of expertise, among which also smoking cessation, a field aiming to assist individuals to quit or prevent tobacco use. Introducing routinely this preoccupation in Romanian doctors' work is supposed to legitimate nicotine dependence as a disease, as already classified by world medical organizations. In agreement with HERMES project, an European Respiratory Society initiative to harmonize education in respiratory medicine across Europe, we recommend smoking cessation to be mandatory in Romanian medical curricula. Thus, students will earn theoretical, practical and behavioral skills to approach health effects of tobacco use, treatment and approach of smokers. Yet, considering real life situation in our country, for actual generations of practitioners we suggest intensive training in two modules: a basic one to cover lack of elementary knowledge during previous years and an advanced module for specialists. To future generations, a continuous, more coherent approach is to be settled, aiming to create brief advice expertise during medical university years of study. When graduating, future doctors willing to become smoking cessation experts will be provided postgraduate training to achieve this degree. Hopefully, within next two generations, many Romanian doctors will become capable to routinely deliver smoking cessation interventions, at European standards. PMID:19817311

  2. How pragmatic or explanatory is the randomized, controlled trial? The application and enhancement of the PRECIS tool to the evaluation of a smoking cessation trial

    OpenAIRE

    Selby Peter; Brosky Gerald; Oh Paul I; Raymond Vincent; Ranger Suzanne

    2012-01-01

    Abstract Background Numerous explanatory randomized trials support the efficacy of chronic disease interventions, including smoking cessation treatments. However, there is often inadequate adoption of these interventions for various reasons, one being the limitation of generalizability of the explanatory studies in real-world settings. Randomized controlled trials can be rated as more explanatory versus pragmatic along 10 dimensions. Pragmatic randomized clinical trials generate more realisti...

  3. A Critical Review of Repurposing Apomorphine for Smoking Cessation.

    Science.gov (United States)

    Morales-Rosado, Joel A; Cousin, Margot A; Ebbert, Jon O; Klee, Eric W

    2015-12-01

    Tobacco use disorder is the leading cause of preventable death and disability in the United States, with one in five Americans currently smoking cigarettes. Only two non-nicotine medications are FDA approved for treating tobacco use disorder, and advances in drug discovery are profoundly outpaced by the morbidity and mortality caused by tobacco dependence. Drug repurposing may provide an approach for addressing this health hazard, offering hope to tobacco users attempting to quit who have failed existing therapies. The focus of this review is to evaluate the potential role of apomorphine (APO) in treating tobacco dependence. Previously described in the literature as a non-specific dopamine agonist effective in treating Parkinson's disease and erectile dysfunction, APO's dopaminergic targeting activity may be effective in counteracting the modified response arising from tobacco use. Here, the literature describing APO's activity is reviewed and presented in the context of known nicotine-induced response in neurotransmitter systems. Based on these data, whether APO may be an effective smoking cessation agent by ameliorating a tobacco user's anhedonic state is critically appraised, along with withdrawal symptoms and the chemical reinforcement associated with drug-seeking behaviors. PMID:26690764

  4. Varenicline: a novel pharmacotherapy for smoking cessation.

    Science.gov (United States)

    Jiménez-Ruiz, Carlos; Berlin, Ivan; Hering, Thomas

    2009-07-01

    Varenicline is an orally administered small molecule with partial agonist activity at the alpha4beta2 nicotinic acetylcholine receptor. Varenicline was approved by both the US FDA and the European Medicines Agency of the EU in 2006 as an aid to smoking cessation. Subsequently, varenicline has been approved in over 80 other countries. Varenicline is almost entirely absorbed following oral administration, and absorption is unaffected by food, smoking or the time of day. Varenicline undergoes only minimal metabolism and approximately 90% of the drug is excreted in the urine unchanged. Varenicline has a mean elimination half-life after repeated administration of approximately 24 hours in smokers. The area under the plasma concentration-time curve is increased in patients with moderate or severe renal failure. No clinically relevant varenicline-drug interactions have been identified. In two identical, randomized, double-blind, phase III clinical trials in healthy, motivated-to-quit, mainly Caucasian smokers aged 18-75 years in the US, 12 weeks of treatment with varenicline 1 mg twice daily was associated with significantly higher abstinence rates over weeks 9-12 than sustained-release bupropion 150 mg twice daily or placebo. In a separate phase III trial, an additional 12 weeks of treatment in smokers achieving abstinence in the first 12 weeks was associated with greater abstinence through to week 52 than placebo treatment. Varenicline treatment was also associated with significantly higher rates of abstinence than placebo treatment in randomized, double-blind, clinical trials in smokers in China, Japan, Korea, Singapore, Taiwan and Thailand. In a randomized, open-label, multi-national, phase III trial, varenicline treatment was associated with a significantly higher rate of abstinence than transdermal nicotine-replacement therapy. In these trials, varenicline treatment was associated with lower urge to smoke and satisfaction from smoking in relapsers than placebo or

  5. 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

  6. Countdown to 2015: Tracking Maternal and Child Health Intervention Targets Using Lot Quality Assurance Sampling in Bauchi State Nigeria

    Science.gov (United States)

    Abegunde, Dele; Orobaton, Nosa

    2015-01-01

    Background 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. Methods 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. Results 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. Conclusions 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

  7. Targeted IgA Fc receptor I (FcαRI) therapy in the early intervention and treatment of pristane-induced lupus nephritis in mice.

    Science.gov (United States)

    Liu, C; Kanamaru, Y; Watanabe, T; Tada, N; Horikoshi, S; Suzuki, Y; Liu, Z; Tomino, Y

    2015-09-01

    The Fc receptor I for IgA (FcαRI) down-regulates humoral immune responses and modulates the risk of autoimmunity. This study aimed to investigate whether FcαRI targeting can affect progression of pristine-induced lupus nephritis. In the first experiment (early intervention), four groups of animals were evaluated: untreated FcαRI/FcRγ transgenic (Tg) mice and Tg mice administered control antibody (Ctr Fab), saline and anti-FcαRI Fab [macrophage inflammatory protein (MIP)-8a], respectively, three times a week for 29 weeks, after being injected once intraperitoneally with 0·5 ml pristane. In the second experiment, antibody injection started after the onset of nephritis and was carried out for 2 months, with similar groups as described above. MIP-8a improved proteinuria, decreased the amounts of glomerular injury markers, serum interleukin (IL)-6, IL-1 and monocyte chemoattractant protein (MCP)-1, and F4/80 macrophages in the interstitium and glomeruli, in both experiments. When MIP-8a was used as early intervention, a decrease in mouse serum anti-nuclear antibody (ANA) titres and reduced deposition of immunoglobulins in glomeruli were observed. This effect was associated with reduced serum titres of immunoglobulin (Ig)G2a but not IgG1, IgG2b and IgG3. Furthermore, pathological analysis showed lower glomerular activity index and less fibronectin in MIP-8a treated mice. This study suggests that FcαRI targeting could halt disease progression and lupus activation by selective inhibition of cytokine production, leucocyte recruitment and renal inflammation. Our findings provide a basis for the use of FcαRI as a molecular target for the treatment of lupus. PMID:25907714

  8. Health-related quality of life among veterans in addictions treatment: identifying behavioral targets for future intervention

    Science.gov (United States)

    Oppezzo, Marily A.; Michalek, Anne K.; Delucchi, Kevin; Baiocchi, Michael T. M.; Barnett, Paul G.

    2016-01-01

    Background US veterans report lower health-related quality of life (HRQoL) relative to the general population. Identifying behavioral factors related to HRQoL that are malleable to change may inform interventions to improve well-being in this vulnerable group. Purpose The current study sought to characterize HRQoL in a largely male sample of veterans in addictions treatment, both in relation to US norms and in association with five recommended health behavior practices: regularly exercising, managing stress, having good sleep hygiene, consuming fruits and vegetables, and being tobacco free. Methods We assessed HRQoL with 250 veterans in addictions treatment (96 % male, mean age 53, range 24–77) using scales from four validated measures. Data reduction methods identified two principal components reflecting physical and mental HRQoL. Model testing of HRQoL associations with health behaviors adjusted for relevant demographic and treatment-related covariates. Results Compared to US norms, the sample had lower HRQoL scores. Better psychological HRQoL was associated with higher subjective social standing, absence of pain or trauma, lower alcohol severity, and monotonically with the sum of health behaviors (all p management, and sleep hygiene. Regular exercise also related to better physical HRQoL. The models explained >40 % of the variance in HRQoL. Conclusions Exercise, sleep hygiene, and stress management are strongly associated with HRQoL among veterans in addictions treatment. Future research is needed to test the effect of interventions for improving well-being in this high-risk group. PMID:26886926

  9. 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.

  10. 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

  11. A Concept for a Low Pressure Noble Gas Fill Intervention in the IFE Fusion Test Facility (FTF) Target Chamber

    International Nuclear Information System (INIS)

    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

  12. OLD FIELD SUCCESSIONAL DYNAMICS FOLLOWING CESSATION OF CHRONIC DISTURBANCE

    Science.gov (United States)

    In grasslands dominated by warm-season grasses, community composition and successional patterns can be altered by disturbance and exotic species invasions. Our objective was to describe vegetation dynamics following cessation of a chronic disturbance (heavy grazing by cattle) in...

  13. Complementary Health Approaches for Smoking Cessation: What the Science Says

    Science.gov (United States)

    ... study on the effects of tai chi for smoking cessation suggest that tai chi may be an effective method for enhancing mindfulness and awareness for breaking cycles of addiction and habit. Safety ...

  14. 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...

  15. Identification of novel cellular targets for therapeutic intervention against Ebola virus infection by siRNA screening

    OpenAIRE

    Kolokoltsov, Andrey A.; Saeed, Mohammad F.; Freiberg, Alexander N.; Holbrook, Michael R.; Davey, Robert A.

    2009-01-01

    While much progress has been made in developing drugs against a few prominent viruses such as HIV, few examples exist for emerging infectious agents. In some cases broad spectrum anti-viral drugs, such as ribavirin, are effective, but for some groups of viruses, these show little efficacy in animal models. Traditional methods focus on screening small molecule libraries to identify drugs that target virus factors, with the intention that side-effects to the host can be minimized. However, this...

  16. 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.

  17. The use of bupropion SR in cigarette smoking cessation

    OpenAIRE

    Scott Wilkes

    2008-01-01

    Scott WilkesDepartment of Primary and Community Care, School of Health, Natural and Social Sciences, University of Sunderland, Sunderland, United KingdomAbstract: Cigarette smoking remains the largest preventable cause of premature death in developed countries. Until recently nicotine replacement therapy (NRT) has been the only recognised form of treatment for smoking cessation. Bupropion, the first non-nicotine based drug for smoking cessation was licensed in the United States of America (US...

  18. Cessation of injecting drug use among street-based youth

    OpenAIRE

    Steensma, Colin; Boivin, Jean-François; Blais, Lucie; Roy, Élise

    2005-01-01

    Young injecting drug users (IDUs) are at high risk for a number of negative health outcomes such as hepatitis B, hepatitis C, and human immunodeficiency virus (HIV) infection. However, very little is known about injecting drug-use patterns among this population, particularly with respect to cessation of injection. We sought to identify the factors associated with cessation of injection in a population of young street-based IDUs. A prospective cohort study design was used to assess long-term (...

  19. Regulating Advertisements: The Case of Smoking Cessation Products

    OpenAIRE

    Rosemary J. Avery; Donald S. Kenkel; Lillard, Dean R.; Alan D. Mathios

    2006-01-01

    In this paper we investigate how direct-to-consumer (DTC) advertising of pharmaceutical products in affected by regulations of the Food and Drug Administration and by market conditions. We focus on a relatively under-studied segment of the pharmaceutical market -- the market for smoking cessation products. Because of their proven effectiveness, these products could be the key to meeting public health goals to reduce smoking. However, in many ways, smoking cessation products have been more hea...

  20. Effects of Opium Smoking Cessation on the Nasopharyngeal Microbial Flora

    OpenAIRE

    Golshiri, Ali; Mokhtaree, Mohammad Reza; Shabani, Ziba; Tabatabaee, Sayed Taghi; Rahnama, Amir; Moradi, Mohammad; Sayadi, Ahamad Reza; Faezi, Hadi

    2009-01-01

    Background: To determine the effect of opium smoking cessation on the frequency and type of microorganisms in the nasopharynx of opium smokers. Methods: This was a cross-sectional study performed in psychology and ENT department of Moradi Hospital of Rafsanjan University of Medical Sciences in 2008 (Kerman, Iran). Nasopharyngeal cultures were taken from 50 opium smokers before and 2 to 3 months after cessation of opium smoking. Potential pathogens were identified. Findings: Eight potential pa...

  1. National Survey of the Smoking Cessation Services in Italy

    OpenAIRE

    Pucchio, Alessandra Di; Pizzi, Enrica; Carosi, Giordano; Mazzola, Monica; Mattioli, Donatella; Pacifici, Roberta; Pichini, Simona

    2009-01-01

    This investigation is aimed at providing information about structural and organizational characteristics of smoking cessation services (SCS) set up within the Italian National Health Service. Local health units and hospitals are the main institutions connected with SCS which are mainly located within the Department of Drug Addiction and the Department of Lung and Breath Care. SCS provide different tobacco-use cessation programs. Although pharmacotherapy is always used, a combination of therap...

  2. Smoking cessation support in Iran: Availability, sources & predictors

    OpenAIRE

    Toghianifar, Nafiseh; Sarrafzadegan, Nizal; Roohafza, Hamidreza; Sadeghi, Masoumeh; Eshrati, Babak; Sadri, Gholamhossein

    2011-01-01

    Background & objectives: Smoking cessation advice is known as an important factor in motivating smokers to quit smoking. We investigated the extent, sources and predictors of receiving unsolicited advice and seeking active advice for smoking cessation in Iran. Methods: A cross-sectional study was performed as a part of Isfahan Healthy Heart Program (IHHP) on 9093 adult individuals (both men and women) in 2004-2005. Demographic characteristics, smoking status, sources and preferences for smoki...

  3. The Computer-Assisted Brief Intervention for Tobacco (CABIT) Program: A Pilot Study

    OpenAIRE

    Boudreaux, Edwin D.; Bedek, Kristyna L; Byrne, Nelson J; Baumann, Brigitte M.; Lord, Sherrill A.; Grissom, Grant

    2012-01-01

    Background Health care providers do not routinely carry out brief counseling for tobacco cessation despite the evidence for its effectiveness. For this intervention to be routinely used, it must be brief, be convenient, require little investment of resources, require little specialized training, and be perceived as efficacious by providers. Technological advances hold much potential for addressing the barriers preventing the integration of brief interventions for tobacco cessation into the he...

  4. Craving and nicotine withdrawal in a Spanish smoking cessation sample.

    Science.gov (United States)

    Piñeiro, Bárbara; López-Durán, Ana; Fernández del Río, Elena; Martínez, Úrsula; Brandon, Thomas H; Becoña, Elisardo

    2014-01-01

    Craving and nicotine withdrawal syndrome (NWS) are components of the tobacco use disorder in DSM-5. They both appear after smoking cessation or an abrupt reduction in tobacco use, and they are associated with both short and long-term smoking-cessation outcomes. The aim of the present study was to examine the association of craving and withdrawal with smoking cessation at the end of the treatment and relapse at 3 months follow-up in a Spanish sample of smokers. The sample comprised 342 smokers (37.7% men; 62.3% women) receiving a cognitive-behavioral treatment for smoking cessation. The assessments of craving and withdrawal were conducted using the Minnesota Nicotine Withdrawal Scale. Abstainers at the end of the treatment, compared to non abstainers, showed significantly lower post-treatment withdrawal, and post-treatment craving. Furthermore, they had lower scores in pre-treatment nicotine dependence. Among abstainers, craving decreased significantly from pre-cessation levels, while in those participants who did not quit smoking it remained on the same levels. High nicotine dependence was a predictor of smoking at the end of the treatment, whereas high nicotine withdrawal predicted relapse at 3 months. Findings support the robust role of craving and NWS in smoking cessation and relapse, although they differ in their specific patterns of change over time. PMID:25314038

  5. Online Social Networks and Smoking Cessation: A Scientific Research Agenda

    OpenAIRE

    Cobb, Nathan K; Graham, Amanda L.; Byron, M. Justin; Niaura, Raymond S.; Abrams, David B.; ,

    2011-01-01

    Background Smoking remains one of the most pressing public health problems in the United States and internationally. The concurrent evolution of the Internet, social network science, and online communities offers a potential target for high-yield interventions capable of shifting population-level smoking rates and substantially improving public health. Objective Our objective was to convene leading practitioners in relevant disciplines to develop the core of a strategic research agenda on onl...

  6. Persistence of Th17/Tc17 Cell Expression upon Smoking Cessation in Mice with Cigarette Smoke-Induced Emphysema

    Directory of Open Access Journals (Sweden)

    Min-Chao Duan

    2013-01-01

    Full Text Available Th17 and Tc17 cells may be involved in the pathogenesis of chronic obstructive pulmonary disease (COPD, a disease caused predominantly by cigarette smoking. Smoking cessation is the only intervention in the management of COPD. However, even after cessation, the airway inflammation may be present. In the current study, mice were exposed to room air or cigarette smoke for 24 weeks or 24 weeks followed by 12 weeks of cessation. Morphological changes were evaluated by mean linear intercepts (Lm and destructive index (DI. The frequencies of CD8+IL-17+(Tc17 and CD4+IL-17+(Th17 cells, the mRNA levels of ROR gamma and IL-17, and the levels of IL-8, TNF-alpha, and IFN-gamma in lungs or bronchoalveolar lavage fluid of mice were assayed. Here we demonstrated that alveolar enlargement and destruction induced by cigarette smoke exposure were irreversible and that cigarette smokeenhanced these T-cell subsets, and related cytokines were not significantly reduced after smoking cessation. In addition, the frequencies of Th17 and Tc17 cells in lungs of smoke-exposed mice and cessation mice were positively correlated with emphysematous lesions. More important, the frequencies of Tc17 cells were much higher than Th17 cells, and there was a significantly positive correlation between Th17 and Tc17. These results suggested that Th17/Tc17 infiltration in lungs may play a critical role in sustaining lung inflammation in emphysema. Blocking the abnormally increased numbers of Tc17 and Th17 cells may be a reasonable therapeutic strategy for emphysema.

  7. Persistence of Th17/Tc17 cell expression upon smoking cessation in mice with cigarette smoke-induced emphysema.

    Science.gov (United States)

    Duan, Min-Chao; Tang, Hai-Juan; Zhong, Xiao-Ning; Huang, Ying

    2013-01-01

    Th17 and Tc17 cells may be involved in the pathogenesis of chronic obstructive pulmonary disease (COPD), a disease caused predominantly by cigarette smoking. Smoking cessation is the only intervention in the management of COPD. However, even after cessation, the airway inflammation may be present. In the current study, mice were exposed to room air or cigarette smoke for 24 weeks or 24 weeks followed by 12 weeks of cessation. Morphological changes were evaluated by mean linear intercepts (Lm) and destructive index (DI). The frequencies of CD8(+)IL-17(+)(Tc17) and CD4(+)IL-17(+)(Th17) cells, the mRNA levels of ROR gamma and IL-17, and the levels of IL-8, TNF-alpha, and IFN-gamma in lungs or bronchoalveolar lavage fluid of mice were assayed. Here we demonstrated that alveolar enlargement and destruction induced by cigarette smoke exposure were irreversible and that cigarette smokeenhanced these T-cell subsets, and related cytokines were not significantly reduced after smoking cessation. In addition, the frequencies of Th17 and Tc17 cells in lungs of smoke-exposed mice and cessation mice were positively correlated with emphysematous lesions. More important, the frequencies of Tc17 cells were much higher than Th17 cells, and there was a significantly positive correlation between Th17 and Tc17. These results suggested that Th17/Tc17 infiltration in lungs may play a critical role in sustaining lung inflammation in emphysema. Blocking the abnormally increased numbers of Tc17 and Th17 cells may be a reasonable therapeutic strategy for emphysema. PMID:24489575

  8. 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

  9. Future perspectives of a cardiac non-neuronal acetylcholine system targeting cardiovascular diseases as an adjunctive tool for metabolic intervention.

    Science.gov (United States)

    Kakinuma, Yoshihiko

    2015-11-01

    It has been several years since the function of the non-neuronal cholinergic system was independently reported in cardiomyocytes by several research groups. Although these findings initially seemed to be negligible and insignificant, extraordinary findings about cardiomyocytes were subsequently reported in studies involving the knockdown of the non-neuronal cholinergic system. These studies provide the evidence that this system may be indispensable for maintaining principal cardiac functions. Despite the absence of an appropriate and reliable technology to detect cellular ACh in real time in cardiomyocytes, studies of this system have progressed, albeit very slowly, to gradually consolidate the significance of this system. Based on the many significant findings regarding this system, these will be critical to develop adjunctive intervention therapy against cardiovascular diseases, including peripheral artery disease and heart failure. In this study, previous studies focusing on the non-neuronal cholinergic system are reviewed along with our studies, both indicating the biologically significant roles of the cardiac non-neuronal acetylcholine system from a clinical perspective. PMID:26028150

  10. 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.

  11. Smoking cessation counseling for Asian immigrants with serious mental illness: using RE-AIM to understand challenges and lessons learned in primary care-behavioral health integration.

    Science.gov (United States)

    Saw, Anne; Kim, Jin; Lim, Joyce; Powell, Catherine; Tong, Elisa K

    2013-09-01

    Engagement in modifiable risk behaviors, such as tobacco use, substantially contributes to early mortality rates in individuals with serious mental illness (SMI). There is an alarmingly high prevalence of tobacco use among subgroups of Asian Americans, such as immigrants and individuals with SMI, yet there are no empirically supported effective smoking cessation interventions that have been tailored to meet the unique cultural, cognitive, and psychological needs of Asian immigrants with SMI. In this article, we share the experiences of clinicians in the delivery of smoking cessation counseling to Asian American immigrants with SMI, in the context of an Asian-focused integrated primary care and behavioral health setting. Through a qualitative analysis of clinician perspectives organized with the RE-AIM framework, we outline challenges, lessons learned, and promising directions for delivering smoking cessation counseling to Asian American immigrant clients with SMI. PMID:23667056

  12. Effect of Smoking Reduction Therapy on Smoking Cessation for Smokers without an Intention to Quit: An Updated Systematic Review and Meta-Analysis of Randomized Controlled

    Directory of Open Access Journals (Sweden)

    Lei Wu

    2015-08-01

    Full Text Available Objective: Effective strategies are needed to encourage smoking cessation for smokers without an intention to quit. We systematically reviewed the literature to investigate whether smoking reduction therapy can increase the long-term cessation rates of smokers without an intention to quit. Methods: PubMed, Embase, and CENTRAL (Cochrane Central Register of Controlled Trials were searched for randomized controlled trials (RCTs on the effect of smoking reduction therapy on long-term smoking cessation in smokers without an intention to quit. The primary outcome was the cessation rate at the longest follow-up period. A random effects model was used to calculate pooled relative risks (RRs and 95% confidence intervals (CIs. Results: Fourteen trials with a total of 7981 smokers were included. The pooled analysis suggested that reduction support plus medication significantly increased the long-term cessation of smokers without an intention to quit compared to reduction support plus placebo (RR, 1.97; 95% CI, 1.44–2.7; I2, 52% or no intervention (RR, 1.93; 95% CI, 1.41–2.64; I2, 46%. In a subgroup of smokers who received varenicline or nicotine replacement therapy (NRT, the differences were also statistically significant. This suggests the safety of using NRT. The percentage of smokers with serious adverse events who discontinued because of these events in the non-NRT group was slightly significantly different than in the control group. Insufficient evidence is available to test the efficacy of reduction behavioural support in promoting long-term cessation among this population. Conclusions: The present meta-analysis indicated the efficacy of NRT- and varenicline-assisted reduction to achieve complete cessation among smokers without an intention to quit. Further evidence is needed to assess the efficacy and safety of reduction behavioural support and bupropion.

  13. Targeting poly(ADP-ribose)polymerase1 in neurological diseases: A promising trove for new pharmacological interventions to enter clinical translation.

    Science.gov (United States)

    Sriram, Chandra Shekhar; Jangra, Ashok; Kasala, Eshvendar Reddy; Bodduluru, Lakshmi Narendra; Bezbaruah, Babul Kumar

    2014-10-01

    The highly conserved abundant nuclear protein poly(ADP-ribose)polymerase1 (PARP1) functions at the center of cellular stress response and is mainly implied in DNA damage repair mechanism. Apart from its involvement in DNA damage repair, it does sway multiple vital cellular processes such as cell death pathways, cell aging, insulator function, chromatin modification, transcription and mitotic apparatus function. Since brain is the principal organ vulnerable to oxidative stress and inflammatory responses, upon stress encounters robust DNA damage can occur and intense PARP1 activation may result that will lead to various CNS diseases. In the context of soaring interest towards PARP1 as a therapeutic target for newer pharmacological interventions, here in the present review, we are attempting to give a silhouette of the role of PARP1 in the neurological diseases and the potential of its inhibitors to enter clinical translation, along with its structural and functional aspects. PMID:25049175

  14. 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

    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......, and that the two municipalities were heterogenic in respect to organizational issues and working methods. Other impediments included the lack of continuity in leadership, the lack of clarity regarding the form of collaboration and roles, as well as different expectations of the stakeholders. We......-site evaluation; health professions education; leadership...

  15. Caspase dependent programmed cell death in developing embryos: a potential target for therapeutic intervention against pathogenic nematodes.

    Directory of Open Access Journals (Sweden)

    Alok Das Mohapatra

    2011-09-01

    developing embryos can be a potential approach for therapeutic intervention against pathogenic nematodes and flow cytometry can be used to address different issues of biological importance during embryogenesis of parasitic worms.

  16. The practice characterization model: the importance of organizational life cycles and targeted interventions in general medical practice.

    Science.gov (United States)

    Atkins, E M; Duffy, M C; Bain, D J

    2001-01-01

    In response to a climate of constant change and increasing demand for services, general practice in the UK has undergone significant modification over the last 10 years. It has become a multi-disciplinary organisation encouraged by funding bodies to plan for service delivery using a more structured team based approach. In Tayside in 1996, practices were charged with producing formal Practice Development Plans (PDPs) which would focus on priority areas aligned with the Health Boards own strategic plan--those were teamwork, information management and technology, and clinical service delivery. The University of Dundee's Department of General Practice successfully applied for funding to develop ways of facilitating practices so that they could a) identify their own development priorities, and b) plan and implement action and learning to see these priorities through. Using action research methodology, the project attempted to create a climate for change, provide support and training to see the changes implemented, and ensure commitment to the changes from all members of the practice team. The Facilitator adopted a flexible style varying her role between expert, guide and support. Analysis of progress made by different practices, coupled with the Facilitator's in depth knowledge of them, suggested the importance of certain key aspects of practice organisation and culture. A practice characterisation model identified practices which were stable, currently coping, proactive and ready to face the challenge of change as best placed to engage in a full scale development programme. Other profiles suggested a range of alternative interventions as more likely to be acceptable and productive. PMID:11499046

  17. Smoking cessation can improve quality of life among COPD patients: Validation of the clinical COPD questionnaire into Greek

    Directory of Open Access Journals (Sweden)

    Linardis Apostolos

    2011-02-01

    Full Text Available Abstract Background Chronic obstructive pulmonary disease (COPD remains a major public health problem that affects the quality of life of patients, however smoking cessation may emeliorate the functional effects of COPD and alter patient quality of life. Objective-design The aim of this study was to validate the Clinical COPD Questionnaire (CCQ into Greek and with such to evaluate the quality of life in patients with different stages of COPD, as also assess their quality of life before and after smoking cessation. Results The internal validity of questionnaire was high (Cronbach's a = 0.92. The reliability of equivalent types in 16 stabilized patients also was high (ICC = 0.99. In general the domains within the CCQ were strongly correlated with each other, while each domain in separate was strongly correlated with the overall CCQ score (r2 = 0.953, r2 = 0.915 and r2 = 0.842 in regards to the functional, symptomatic and mental domain, respectively. The CCQ scores were also correlated with FEV1, (r2 = -0.252, p 1/FVC, (r2 = -0.135, p 2 = -0.384, p Conclusions The self administered CCQ indicates satisfactory validity, reliability and responsiveness and may be used in clinical practice to assess patient quality of life. Moreover the CCQ indicated the health related quality of life gains attributable to smoking cessation among COPD patients, projecting smoking cessation as a key target in COPD patient management.

  18. Maintenance Effects of a DVD-Delivered Exercise Intervention on Physical Function in Older Adults

    Science.gov (United States)

    Wójcicki, Thomas R.; Fanning, Jason; Awick, Elizabeth A.; Olson, Erin A.; Motl, Robert W.

    2015-01-01

    Background. Exercise training has been demonstrated to enhance physical function and to have a protective effect against functional limitations and disability in older adults. Purpose. The objective of this study was to determine whether the effects of a home-based, DVD-delivered exercise intervention on functional performance and limitations were maintained 6-month postintervention termination. Methods. Follow-up assessments of functional performance and limitations were conducted in a sample of community-dwelling older adults (N = 237) who participated in a 6-month randomized controlled exercise trial. Participants were initially randomized to a DVD-delivered exercise intervention or an attentional control condition. The Short Physical Performance Battery, measures of flexibility and strength, and functional limitations were assessed immediately before and after the intervention and then again 6 months later. Analyses of covariance were conducted to examine changes in physical function between the two conditions at the end of the intervention to 6-month follow-up. Results. There were statistically significant adjusted group differences in the Short Physical Performance Battery (η2 = 0.03, p = .01), upper-body strength (η2 = 0.03, p = .005), and lower-body flexibility (η2 = 0.02, p = .05), indicating that gains brought about by the intervention were maintained 6 months later. Conclusions. A DVD-delivered exercise program specifically designed to target elements of functional fitness in older adults can produce clinically meaningful gains in physical function that are maintained beyond intervention cessation. PMID:25324220

  19. Clinical trial on the efficacy of exhaled carbon monoxide measurement in smoking cessation in primary health care

    Directory of Open Access Journals (Sweden)

    Ripoll Joana

    2012-07-01

    Full Text Available Abstract Background Smoking cessation is beneficial for our health at any point in life, both in healthy people and in people already suffering from a smoking-related disease. Any help to quit smoking can produce considerable benefits for Public Health. The purpose of the present study is to evaluate the efficacy of the CO-oximetry technique together with brief advice in smoking cessation, in terms of reduction of the number of cigarettes or in the variation of the motivation to quit smoking at month 12 compared with brief advice alone. Methods/Design Randomised, parallel, single-blind clinical trial in a primary health care setting in Majorca (Spain. Smokers in contemplation or pre-contemplation phase will be included in the study. Exclusion criteria: Smokers in preparation phase, subjects with a terminal illness or whose health status does not allow them to understand the study or complete the informed consent, and pregnant or breastfeeding women. The subjects will be randomly assigned to the control group (CG or the intervention group (IG. The CG will receive brief advice, and the IG will receive brief advice together with a measurement of exhaled CO. There will be follow-up evaluations at 6 and 12 months after inclusion. 471 subjects will be needed per group in order to detect a difference between groups ≥ 5%. Primary outcome: sustained smoking cessation (at 6 and 12 months confirmed by urine cotinine test. Secondary outcomes: point smoking cessation at 6 and 12 months both confirmed by urine cotinine analysis and self-reported, reduction in cigarette consumption, and variation in phase of smoking cessation. Discussion CO-oximetry is an inexpensive, non-invasive, fast technique that requires little technical training; making it a technique for risk assessment in smokers that can be easily applied in primary care and, if proven effective, could serve as a reinforcement aid in smoking cessation intervention activities. Trial

  20. 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

  1. Psychological distress related to smoking cessation in patients with acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Thyego Mychell Moreira-Santos

    2016-02-01

    Full Text Available Among all causes of preventable deaths, smoking is responsible for the greatest number of deaths worldwide and predisposes to fatal, noncommunicable diseases, especially cardiovascular diseases. Lifestyle changes are effective in the treatment of patients with smoking-related diseases and assist in the prevention of premature mortality. Our objective was to investigate the available scientific evidence regarding the psychological distress related to smoking cessation in patients who have had acute myocardial infarction. To that end, we conducted an integrative review of the literature in order to summarize relevant studies on this topic. The selected databases were Scopus, PubMed Central, Institute for Scientific Information Web of Science (Core Collection, ScienceDirect, EMBASE, SciELO, LILACS e PsycINFO. On the basis of the inclusion and exclusion criteria adopted for this study, 14 articles were selected for analysis. Those studies showed that the prevalence of psychological distress is higher among smokers than among nonsmokers, and distress-related symptoms are much more common in smokers with acute myocardial infarction than in those without. Smoking cessation depends on the active participation of the smoker, whose major motivation is the underlying disease. Most studies have shown that there is a need to create treatment subgroups as a means of improving the treatment provided. This review article expands the knowledge regarding smoking cessation and shows the need to invest in future research that investigates subgroups of smokers diagnosed with the major smoking-related comorbidities, such as acute myocardial infarction, in order to develop specific interventions and psychological support strategies.

  2. Pilot Cases of Combined Cognitive Processing Therapy and Smoking Cessation for Smokers With Posttraumatic Stress Disorder.

    Science.gov (United States)

    Dedert, Eric A; Resick, Patricia A; McFall, Miles E; Dennis, Paul A; Olsen, Maren; Beckham, Jean C

    2016-01-01

    Posttraumatic stress disorder (PTSD) and smoking are often comorbid, and both problems are in need of improved access to evidence-based treatment. The combined approach could address two high-priority problems and increase patient access to both treatments, but research is needed to determine whether this is feasible and has promise for addressing both PTSD and smoking. We collected data from 15 test cases that received a treatment combining two evidence-based treatments: cognitive processing therapy-cognitive version (CPT-C) for PTSD and integrated care for smoking cessation (ICSC). We explored two combined treatment protocols including a brief (six-session) CPT-C with five follow-up in-person sessions focused on smoking cessation (n=9) and a full 12-session CPT-C protocol with ICSC (n=6). The combined interventions were feasible and acceptable to patients with PTSD making a quit attempt. Initial positive benefits of the combined treatments were observed. The six-session dose of CPT-C and smoking cessation resulted in 6-month bioverified smoking abstinence in two of nine participants, with clinically meaningful PTSD symptom reduction in three of nine participants. In the second cohort (full CPT-C and smoking treatment), both smoking and PTSD symptoms were improved, with three of six participants abstinent from smoking and four of six participants reporting clinically meaningful reduction in PTSD symptoms. Results suggested that individuals with PTSD who smoke are willing to engage in concurrent treatment of these problems and that combined treatment is feasible. PMID:26763497

  3. Using the VAHIRR Radar Algorithm to Investigate Lightning Cessation

    Science.gov (United States)

    Stano, Geoffrey T.; Schultz, Elise V.; Petersen, Walter A.

    2012-01-01

    Accurately determining the threat posed by lightning is a major area for improved operational forecasts. Most efforts have focused on the initiation of lightning within a storm, with far less effort spent investigating lightning cessation. Understanding both components, initiation and cessation, are vital to improving lightning safety. Few organizations actively forecast lightning onset or cessation. One such organization is the 45th Weather Squadron (45WS) for the Kennedy Space Center (KSC) and Cape Canaveral Air Force Station (CCAFS). The 45WS has identified that charged anvil clouds remain a major threat of continued lightning and can greatly extend the window of a potential lightning strike. Furthermore, no discernable trend of total lightning activity has been observed consistently for all storms. This highlights the need for more research to find a robust method of knowing when a storm will cease producing lightning. Previous lightning cessation work has primarily focused on forecasting the cessation of cloud-to -ground lightning only. A more recent, statistical study involved total lightning (both cloud-to-ground and intracloud). Each of these previous works has helped the 45WS take steps forward in creating improved and ultimately safer lightning cessation forecasts. Each study has either relied on radar data or recommended increased use of radar data to improve cessation forecasts. The reasoning is that radar data is able to either directly or by proxy infer more about dynamical environment leading to cloud electrification and eventually lightning cessation. The authors of this project are focusing on a two ]step approach to better incorporate radar data and total lightning to improve cessation forecasts. This project will utilize the Volume Averaged Height Integrated Radar Reflectivity (VAHIRR) algorithm originally developed during the Airborne Field Mill II (ABFM II) research project. During the project, the VAHIRR product showed a trend of increasing

  4. Logical network of genotoxic stress-induced NF-kappaB signal transduction predicts putative target structures for therapeutic intervention strategies

    Directory of Open Access Journals (Sweden)

    Rainer Poltz

    2009-12-01

    Full Text Available Rainer Poltz1, Raimo Franke1,#, Katrin Schweitzer1, Steffen Klamt2, Ernst-Dieter Gilles2, Michael Naumann11Institute of Experimental Internal Medicine, Otto von Guericke University, Magdeburg, Germany; 2Max Planck Institute for Dynamics of Complex Technical Systems, Magdeburg, Germany; #Present address: Department of Chemical Biology, Helmholtz Centre for Infection Research, Braunschweig, GermanyAbstract: Genotoxic stress is induced by a broad range of DNA-damaging agents and could lead to a variety of human diseases including cancer. DNA damage is also therapeutically induced for cancer treatment with the aim to eliminate tumor cells. However, the effectiveness of radio- and chemotherapy is strongly hampered by tumor cell resistance. A major reason for radio- and chemotherapeutic resistances is the simultaneous activation of cell survival pathways resulting in the activation of the transcription factor nuclear factor-kappa B (NF-κB. Here, we present a Boolean network model of the NF-κB signal transduction induced by genotoxic stress in epithelial cells. For the representation and analysis of the model, we used the formalism of logical interaction hypergraphs. Model reconstruction was based on a careful meta-analysis of published data. By calculating minimal intervention sets, we identified p53-induced protein with a death domain (PIDD, receptor-interacting protein 1 (RIP1, and protein inhibitor of activated STAT y (PIASy as putative therapeutic targets to abrogate NF-κB activation resulting in apoptosis. Targeting these structures therapeutically may potentiate the effectiveness of radio- and chemotherapy. Thus, the presented model allows a better understanding of the signal transduction in tumor cells and provides candidates as new therapeutic target structures.Keywords: apoptosis, Boolean network, cancer therapy, DNA-damage response, NF-κB

  5. An exploration of health beliefs and attitudes of smokers with vascular disease who participate in or decline a smoking cessation program.

    Science.gov (United States)

    Clarke, Kim E; Aish, Arlene

    2002-09-01

    The descriptive cross-sectional aspect of this study compared a group of smokers with peripheral arterial disease who chose to participate in a smoking intervention with a group of smokers with peripheral arterial disease who declined to participate. The longitudinal aspect of this study used Ajzen and Fishbein's(1) Theory of Reasoned Action, Keeney's(2) Expected Utility Decision Theory, and Prochaska and DiClemente's(3) Transtheoretical Model of Change to describe the influence of this smoking cessation program on the beliefs and attitudes about smoking in group 1. Smokers completed a smoking beliefs questionnaire with vascular disease at baseline and after 13 weeks of smoking cessation intervention. Smokers who did not want to participate in the smoking cessation program also completed this questionnaire for comparison. Statistically significant differences were found to differentiate people who enrolled in the smoking cessation program from those who did not. Subjects in group 2 smoked less per day, were less educated, were less often diagnosed as having peripheral arterial disease, were found to be more in the precontemplation stage of change in smoking cessation, cared more about what their physician and family thought they should do, and perceived themselves to be at less risk for developing more severe circulatory problems if they did not quit smoking. After 13 weeks, participants in both groups 1 and 2 were found to smoke significantly less per day. No support was found for the expectation that the smoking intervention would influence stage of change in smoking behavior or attitudes and beliefs about the risks of smoking to the participants' health after 13 weeks. PMID:12370691

  6. Smoking cessation can improve quality of life among COPD patients: Validation of the clinical COPD questionnaire into Greek

    Science.gov (United States)

    2011-01-01

    Background Chronic obstructive pulmonary disease (COPD) remains a major public health problem that affects the quality of life of patients, however smoking cessation may emeliorate the functional effects of COPD and alter patient quality of life. Objective-design The aim of this study was to validate the Clinical COPD Questionnaire (CCQ) into Greek and with such to evaluate the quality of life in patients with different stages of COPD, as also assess their quality of life before and after smoking cessation. Results The internal validity of questionnaire was high (Cronbach's a = 0.92). The reliability of equivalent types in 16 stabilized patients also was high (ICC = 0.99). In general the domains within the CCQ were strongly correlated with each other, while each domain in separate was strongly correlated with the overall CCQ score (r2 = 0.953, r2 = 0.915 and r2 = 0.842 in regards to the functional, symptomatic and mental domain, respectively). The CCQ scores were also correlated with FEV1, (r2 = -0.252, p < 0.001), FEV1/FVC, (r2 = -0.135, p < 0.001) as also with the quality of life questionnaire SF-12 (r2 = -0.384, p < 0.001). Smoking cessation also lead to a significant reduction in CCQ score and increase in the SF-12 score. Conclusions The self administered CCQ indicates satisfactory validity, reliability and responsiveness and may be used in clinical practice to assess patient quality of life. Moreover the CCQ indicated the health related quality of life gains attributable to smoking cessation among COPD patients, projecting smoking cessation as a key target in COPD patient management. PMID:21352544

  7. The rationale for early intervention in schizophrenia and related disorders

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Jeppesen, Pia; Petersen, Lone;

    2009-01-01

    , adherence to treatment, comorbid drug abuse, relapse and readmission. Some benefits persist after cessation of the intervention. Conclusions: Early intervention in schizophrenia is justified to reduce the negative personal and social impact of prolonged periods of untreated symptoms. Furthermore, phase......Abstract Aim: To examine the rationale and evidence supporting an early intervention approach in schizophrenia. Methods: A selective literature review was conducted. Results: During the onset of schizophrenia, there is often a significant delay between the emergence of psychotic symptoms and the...

  8. A randomized controlled trial of an exercise intervention targeting cardiovascular and metabolic risk factors for prostate cancer patients from the RADAR trial

    International Nuclear Information System (INIS)

    Androgen deprivation therapy leads to a number of adverse effects including deterioration of the musculoskeletal system and increased risk factors for cardiovascular and metabolic complications. The purpose of this study is to determine the effects, efficacy, retention and compliance of a physical exercise intervention in a large established cohort of prostate cancer patients from the Randomised Androgen Deprivation and Radiotherapy (RADAR) study. Specifically, we aim to compare short- and long-term effects of a prostate cancer-specific supervised exercise program to a standard public health physical activity strategy utilizing printed resources on cardiovascular and metabolic risk factors. Our primary outcomes are cardiorespiratory capacity, abdominal obesity, and lipid and glycemic control, while secondary outcomes include self-reported physical activity, quality of life and psychological distress. Multi-site randomized controlled trial of 370 men from the RADAR study cohort undergoing treatment or previously treated for prostate cancer involving androgen deprivation therapy in the cities of Perth and Newcastle (Australia), and Wellington (New Zealand). Participants will be randomized to (1) supervised resistance/aerobic exercise or (2) printed material comprising general physical activity recommendations. Participants will then undergo progressive training for 6 months. Measurements for primary and secondary endpoints will take place at baseline, 6 months (end of intervention), and at 6 months follow-up. This study uses a large existent cohort of patients and will generate valuable information as to the continuing effects of exercise specifically targeting cardiovascular function and disease risk, insulin metabolism, abdominal obesity, physical function, quality of life and psychological distress. We expect dissemination of the knowledge gained from this project to reduce risk factors for the development of co-morbid diseases commonly associated with androgen

  9. A randomized controlled trial of an exercise intervention targeting cardiovascular and metabolic risk factors for prostate cancer patients from the RADAR trial

    Directory of Open Access Journals (Sweden)

    Joseph David

    2009-12-01

    Full Text Available Abstract Background Androgen deprivation therapy leads to a number of adverse effects including deterioration of the musculoskeletal system and increased risk factors for cardiovascular and metabolic complications. The purpose of this study is to determine the effects, efficacy, retention and compliance of a physical exercise intervention in a large established cohort of prostate cancer patients from the Randomised Androgen Deprivation and Radiotherapy (RADAR study. Specifically, we aim to compare short- and long-term effects of a prostate cancer-specific supervised exercise program to a standard public health physical activity strategy utilizing printed resources on cardiovascular and metabolic risk factors. Our primary outcomes are cardiorespiratory capacity, abdominal obesity, and lipid and glycemic control, while secondary outcomes include self-reported physical activity, quality of life and psychological distress. Methods/Design Multi-site randomized controlled trial of 370 men from the RADAR study cohort undergoing treatment or previously treated for prostate cancer involving androgen deprivation therapy in the cities of Perth and Newcastle (Australia, and Wellington (New Zealand. Participants will be randomized to (1 supervised resistance/aerobic exercise or (2 printed material comprising general physical activity recommendations. Participants will then undergo progressive training for 6 months. Measurements for primary and secondary endpoints will take place at baseline, 6 months (end of intervention, and at 6 months follow-up. Discussion This study uses a large existent cohort of patients and will generate valuable information as to the continuing effects of exercise specifically targeting cardiovascular function and disease risk, insulin metabolism, abdominal obesity, physical function, quality of life and psychological distress. We expect dissemination of the knowledge gained from this project to reduce risk factors for the

  10. Obesity and early cessation of breastfeeding in Denmark

    DEFF Research Database (Denmark)

    Kronborg, Hanne; Væth, Michael; Rasmussen, Kathleen M.

    2013-01-01

    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...... 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...... breastfeeding, and were more frequently characterised by socio-demographic-, psychosocial-, perinatal- and behavioural factors known to increase the risk of early breastfeeding cessation. In the adjusted analyses (n = 1226) the association between BMI and duration of exclusive breastfeeding depended on parity...

  11. Impact of Nicotine Replacement Therapy on Post-Cessation Mood Profile by Pre-Cessation Depressive Symptoms

    Directory of Open Access Journals (Sweden)

    Kinnunen Taru H

    2006-08-01

    Full Text Available Abstract We evaluated the effects of Nicotine Replacement Therapy (NRT on the Profile of Mood States (POMS, testing whether pre-cessation depressive symptoms modify NRT's effects on POMS. Out of 608 smokers attempting to quit with NRT, this secondary analysis included 242 participants abstinent for at least two weeks. We measured pre-cessation depressive symptoms with the Center for Epidemiological Studies Depression Scale. At 1, 7, and 14 post-cessation days we examined 6 self-reported POMS, i.e. feeling 'anxious', 'sad', 'confused', 'angry', 'energetic' and 'fatigue'. The results of the ANCOVA models suggested no NRT effects on feeling anxious, energetic or fatigue. We found that pre-cessation depression modified NRT effects in some specific mood states, such as depression by NRT- interaction effects on feeling confused and feeling angry. On average, the depressed participants in the placebo groups had the highest symptom scores. However, those depressed in NRT conditions did not have significantly higher symptom scores compared to the non-depressed groups. In treating those negative moods NRT may be particularly important for persons with depressive symptoms before cessation.

  12. Estimation of the burden of cardiovascular disease attributable to modifiable risk factors and cost-effectiveness analysis of preventative interventions to reduce this burden in Argentina

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    Martí Sebastián

    2010-10-01

    Full Text Available Abstract Background Cardiovascular disease (CVD is the primary cause of mortality and morbidity in Argentina representing 34.2% of deaths and 12.6% of potential years of life lost (PYLL. The aim of the study was to estimate the burden of acute coronary heart disease (CHD and stroke and the cost-effectiveness of preventative population-based and clinical interventions. Methods An epidemiological model was built incorporating prevalence and distribution of high blood pressure, high cholesterol, hyperglycemia, overweight and obesity, smoking, and physical inactivity, obtained from the Argentine Survey of Risk Factors dataset. Population Attributable Fraction (PAF of each risk factor was estimated using relative risks from international sources. Total fatal and non-fatal events, PYLL and Disability Adjusted Life Years (DALY were estimated. Costs of event were calculated from local utilization databases and expressed in international dollars (I$. Incremental cost-effectiveness ratios (ICER were estimated for six interventions: reducing salt in bread, mass media campaign to promote tobacco cessation, pharmacological therapy of high blood pressure, pharmacological therapy of high cholesterol, tobacco cessation therapy with bupropion, and a multidrug strategy for people with an estimated absolute risk > 20% in 10 years. Results An estimated total of 611,635 DALY was lost due to acute CHD and stroke for 2005. Modifiable risk factors explained 71.1% of DALY and more than 80% of events. Two interventions were cost-saving: lowering salt intake in the population through reducing salt in bread and multidrug therapy targeted to persons with an absolute risk above 20% in 10 years; three interventions had very acceptable ICERs: drug therapy for high blood pressure in hypertensive patients not yet undergoing treatment (I$ 2,908 per DALY saved, mass media campaign to promote tobacco cessation amongst smokers (I$ 3,186 per DALY saved, and lowering cholesterol with

  13. Investigating maternal risk factors as potential targets of intervention to reduce socioeconomic inequality in small for gestational age: a population-based study

    Directory of Open Access Journals (Sweden)

    Hayward Irene

    2012-06-01

    Full Text Available Abstract Background The major aim of this study was to investigate whether maternal risk factors associated with socioeconomic status and small for gestational age (SGA might be viable targets of interventions to reduce differential risk of SGA by socioeconomic status (socioeconomic SGA inequality in the metropolitan area of Vancouver, Canada. Methods This study included 59,039 live, singleton births in the Vancouver Census Metropolitan Area (Vancouver from January 1, 2006 to September 17, 2009. To identify an indicator of socioeconomic SGA inequality, we used hierarchical logistic regression to model SGA by area-level variables from the Canadian census. We then modelled SGA by area-level average income plus established maternal risk factors for SGA and calculated population attributable SGA risk percentages (PAR% for each variable. Associations of maternal risk factors for SGA with average income were investigated to identify those that might contribute to SGA inequality. Finally, we estimated crude reductions in the percentage and absolute differences in SGA risks between highest and lowest average income quintiles that would result if interventions on maternal risk factors successfully equalized them across income levels or eliminated them altogether. Results Average income produced the most linear and statistically significant indicator of socioeconomic SGA inequality with 8.9% prevalence of SGA in the lowest income quintile compared to 5.6% in the highest. The adjusted PAR% of SGA for variables were: bottom four quintiles of height (51%, first birth (32%, bottom four quintiles of average income (14%, oligohydramnios (7%, underweight or hypertension, (6% each, smoking (3% and placental disorder (1%. Shorter height, underweight and smoking during pregnancy had higher prevalence in lower income groups. Crude models assuming equalization of risk factors across income levels or elimination altogether indicated little potential change in relative

  14. Overviews and Advances in Studies of Target Concentration Intervention%目标浓度干预概况及研究进展

    Institute of Scientific and Technical Information of China (English)

    凌静; 焦正; 钟明康

    2013-01-01

    目的 综述目标浓度干预(target concentration intervention,TCI)理论,为临床个体化给药提供依据.方法 查阅国内外相关文献和实践案例,进行分析、归纳、总结及评述.结果 20世纪60年代,治疗药物监测(therapeutic drug monitoring,TDM)进入临床实践,并协助个体化用药.但随着治疗药物监测实践的发展,逐渐显现出一些局限性,如忽视个体间变异及药效,因此不能达到安全有效使用药物的目的.目标浓度干预理论利用患者和疾病的所有相关信息,综合药动学、药效学原理,可分析和解释体内药物浓度和药物效应之间的关系及相关影响因素,克服了治疗药物监测的缺陷,为个体化给药提供了一个完整的方法和策略.结论 目标浓度干预理论是在治疗药物监测基础上的进一步延伸与发展,对临床个体化给药具有重要意义.%OBJECTIVE To review the target concentration intervention (TCI) theory and provide reliable evidences for the optimization of drug treatment in clinical practice.METHODS Relevant literatures were extensively and comprehensively reviewed.RESULTS Since 1960s,therapeutic drug monitoring (TDM) had been applied in clinical practice to realize individualized drug administration.Due to some potential limitations of TDM such as neglecting inter-individual variability and failure to take drug effects into account,more and more scholars proposed a new theory which is called TCI as an alternative of TDM.The TCI approach takes advantage of known patient variables,pharmacokinetics and pharmacodynamics to interpret drug effect and concentration observations.It not only overcomes the defects of TDM,but also provides a complete strategy for individual administration.CONCLUSION TCI is an extension of TDM,which has clinical significance for individualized therapy.

  15. A home-visiting intervention targeting determinants of infant mental health: the study protocol for the CAPEDP randomized controlled trial in France

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    Tubach Florence

    2012-08-01

    Full Text Available Abstract Background Several studies suggest that the number of risk factors rather than their nature is key to mental health disorders in childhood. Method and design The objective of this multicentre randomized controlled parallel trial (PROBE methodology is to assess the impact in a multi-risk French urban sample of a home-visiting program targeting child mental health and its major determinants. This paper describes the protocol of this study. In the study, pregnant women were eligible if they were: living in the intervention area; able to speak French, less than 26 years old; having their first child; less than 27 weeks of amenorrhea; and if at least one of the following criteria were true: less than twelve years of education, intending to bring up their child without the presence of the child’s father, and 3 low income. Participants were randomized into either the intervention or the control group. All had access to usual care in mother-child centres and community mental health services free of charge in every neighbourhood. Psychologists conducted all home visits, which were planned on a weekly basis from the 7th month of pregnancy and progressively decreasing in frequency until the child’s second birthday. Principle outcome measures included child mental health at 24 months and two major mediating variables for infant mental health: postnatal maternal depression and the quality of the caring environment. A total of 440 families were recruited, of which a subsample of 120 families received specific attachment and caregiver behaviour assessment. Assessment was conducted by an independent assessment team during home visits and, for the attachment study, in a specifically created Attachment Assessment laboratory. Discussion The CAPEDP study is the first large-scale randomised, controlled infant mental health promotion programme to take place in France. A major specificity of the program was that all home visits were conducted by

  16. The CareWell-primary care program: design of a cluster controlled trial and process evaluation of a complex intervention targeting community-dwelling frail elderly

    Directory of Open Access Journals (Sweden)

    Ruikes Franca GH

    2012-12-01

    Full Text Available Abstract Background With increasing age and longevity, the rising number of frail elders with complex and numerous health-related needs demands a coordinated health care delivery system integrating cure, care and welfare. Studies on the effectiveness of such comprehensive chronic care models targeting frail elders show inconclusive results. The CareWell-primary care program is a complex intervention targeting community-dwelling frail elderly people, that aims to prevent functional decline, improve quality of life, and reduce or postpone hospital and nursing home admissions of community dwelling frail elderly. Methods/design The CareWell-primary care study includes a (cost- effectiveness study and a comprehensive process evaluation. In a one-year pragmatic, cluster controlled trial, six general practices are non-randomly recruited to adopt the CareWell-primary care program and six control practices will deliver ‘care as usual’. Each practice includes a random sample of fifty frail elders aged 70 years or above in the cost-effectiveness study. A sample of patients and informal caregivers and all health care professionals participating in the CareWell-primary care program are included in the process evaluation. In the cost-effectiveness study, the primary outcome is the level of functional abilities as measured with the Katz-15 index. Hierarchical mixed-effects regression models / multilevel modeling approach will be used, since the study participants are nested within the general practices. Furthermore, incremental cost-effectiveness ratios will be calculated as costs per QALY gained and as costs weighed against functional abilities. In the process evaluation, mixed methods will be used to provide insight in the implementation degree of the program, patients’ and professionals’ approval of the program, and the barriers and facilitators to implementation. Discussion The CareWell-primary care study will provide new insights into the (cost

  17. Ten Years Down the Road: Predictors of Driving Cessation

    OpenAIRE

    Edwards, Jerri D.; Bart, Edward; O’Connor, Melissa L.; Cissell, Gayla

    2009-01-01

    Purpose: Recent prospective studies have found that cognition is a more salient predictor of driving cessation than physical performance or demographic factors among community-dwelling older adults. However, these studies have been limited to 5 years of follow-up. The current study used data from the Maryland Older Drivers Project to examine predictors of driving cessation in older adults over a 10-year period. Design and Methods: Participants (N = 1,248) completed baseline and 5-year assessm...

  18. The Effect of Program Design on Engagement With an Internet-Based Smoking Intervention: Randomized Factorial Trial

    OpenAIRE

    McClure, Jennifer B.; Shortreed, Susan M.; Bogart, Andy; Derry, Holly; Riggs, Karin; St. John, Jackie; Nair, Vijay; An, Larry

    2013-01-01

    Background Participant engagement influences treatment effectiveness, but it is unknown which intervention design features increase treatment engagement for online smoking cessation programs. Objective We explored the effects of 4 design features (ie, factors) on early engagement with an Internet-based, motivational smoking cessation program. Methods Smokers (N=1865) were recruited from a large health care organization to participate in an online intervention study, regardless of their intere...

  19. 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

    resultó ser la opción menos dispendiosa a partir de los 5 años. A los 2 años, las charlas resultaron ¢3.443.167 más económicas con respecto a Vareniclina. La alternativa que obtuvo la mayor cantidad de años ganados ajustados por calidad de vida, y de años de vida ganados, fue Vareniclina. La Vareniclina resultó ser la opción más efectiva en función del costoincremental, es decir, la alternativa clínicamente más efectiva y menos costosa. Conclusión: Los resultados obtenidos sugieren que Vareniclina es la alternativa más costoefectiva para la cesación del fumado en comparación con Bupropión, terapia de reemplazo de Nicotina, la autodeterminación y las charlas de motivación. Se comprobó que el uso de Vareniclina significa un ahorro económico importante para el sistema de salud y las instituciones de salud que la utilicen ya que reduce la morbilidad y los costos relacionados con las enfermedades asociadas al tabaco.Aim: Smoking is one of the most serious health problems worldwide and it is a preventable addiction; this is why the availability of treatments to quit smoking represents important benefits to each individual’s health as well as to the institutional systems. Given the arrival of new treatments, especially Varenicline, the alternatives available in Costa Rica must be evaluated comparatively because it is not clear which therapeutic option is the best. The objective of this study is to model the cost-effectiveness of the therapeutic options for smoking cessation available in Costa Rica using the BENESCO model. Methods: The BENESCO model was used to simulate the morbidity and mortality of the smoking population of Costa Rica, in both genders, between 18 and 99 years old. In this model, each smoker makes only one attempt to quit smoking at the beginning of the simulation. The strategies to quit smoking that were compared were: Varenicline, Bupropion, Nicotine replacement therapy, self determination cessation and motivational talks. The

  20. Pertinence of the recent school-based nutrition interventions targeting fruit and vegetable consumption in the United States:a systematic review

    OpenAIRE

    Christopher R. Aloia; Taylor A. Shockey; Nahar, Vinayak K.; Knight, Kathy B.

    2016-01-01

    Background: Schools are the major locations for implementing children’s dietary behavior related educational or interventional programs. Recently, there has been an increase in school-based nutrition interventions. The objective of this systematic review was to overview the evidence for the effectiveness of school-based nutrition intervention on fruit and vegetable consumption. Methods: PubMed was used to search for articles on school-based nutrition interventions that measured students’ f...

  1. Effect of Smoking Cessation on Gestational and Postpartum Weight Gain and Neonatal Birth Weight

    DEFF Research Database (Denmark)

    Rode, Line; Kjærgaard, Hanne; Damm, Peter;

    2013-01-01

    To examine the association among smoking cessation, gestational and postpartum weight gain, and neonatal birth weight.......To examine the association among smoking cessation, gestational and postpartum weight gain, and neonatal birth weight....

  2. The total lifetime health cost savings of smoking cessation to society

    DEFF Research Database (Denmark)

    Rasmussen, Gitte Susanne; Prescott, Eva; Sørensen, Thorkild I A; Søgaard, Jes

    2005-01-01

    Smoking cessation has major immediate and long-term health benefits. However, ex-smokers' total lifetime health costs and continuing smokers' costs remain uncompared, and hence the economic savings of smoking cessation to society have not been determined....

  3. A Prospective, Randomized Trial in The Emergency Department Of Suggestive Audio-Therapy Under Deep Sedation for Smoking Cessation

    Directory of Open Access Journals (Sweden)

    Shah, Sushma

    2007-08-01

    Full Text Available Objectives: In a sample of patients undergoing procedural deep sedation in the emergency department (ED, we conducted a prospective, randomized, single-blinded trial of audio-therapy for smoking cessation. Methods: We asked subjects about their smoking, including desire to quit (0-10 numerical scale and number of cigarettes smoked per day. Subjects were randomized to either a control tape (music alone or a tape with repeated smoking-cessation messages over music. Tapes were started with first doses of sedation and stopped with patient arousal. Telephone follow-up occurred between two weeks and three months to assess the number of cigarettes smoked per day. Study endpoints were self-reported complete cessation and decrease of half or more in total cigarettes smoked per day. Results: One hundred eleven patients were enrolled in the study, 54 to intervention and 57 to control. Mean desire to quit was 7.15 ± 2.6 and mean cigarettes per day was 17.5 ± 12.1. We successfully contacted 69 (62% patients. Twenty-seven percent of intervention and 26% of control patients quit (mean difference = 1%; 95% CI: –22.0% to 18.8%. Thirty-seven percent of intervention and 51% of control patients decreased smoking by half or more (mean difference = 14.6%; 95% CI: –8.7% to 35.6%. Conclusion: Suggestive audio-therapy delivered during deep sedation in the ED did not significantly decrease self-reported smoking behavior.

  4. 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 also attended the 1-year follow-up. We investigated if SR or SC had improved the self-reported pulmonary symptoms, using logistic regression analyses. Results: Almost 34% of the smokers had chronic cough at baseline and 24.5% had chronic phlegm. Thirty-seven persons with cough at baseline and 24...

  5. Time trends of smoking cessation analyzed with six mathematical survival models.

    Science.gov (United States)

    Elketroussi, M; Fan, D P

    1991-01-01

    In this paper, six mathematical models were applied to model time trends of smoking cessation. Both statistical and non-statistical methods were used and included the exponential, ideodynamic, log-logistic, Pareto, sickle and Weibull models. All models included the possibilities of both permanent abstinence and relapse to smoking. Time trends from all models were compared with data from the Multiple Risk Factor Intervention Trial (MRFIT) program. The Pareto, log-logistic, Weibull and ideodynamic models yielded satisfactory fits to the data while the sickle and exponential models did not. Even though the data used in this paper were not sufficient to distinguish among these four models, the methodology will be useful for further narrowing the model choices as additional data for the testing become available. PMID:2050432

  6. Quit in General Practice: a cluster randomised trial of enhanced in-practice support for smoking cessation

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    Zwar Nicholas

    2010-08-01

    Full Text Available Abstract Background This study will test the uptake and effectiveness of a flexible package of smoking cessation support provided primarily by the practice nurse (PN and tailored to meet the needs of a diversity of patients. Methods/Design This study is a cluster randomised trial, with practices allocated to one of three groups 1 Quit with Practice Nurse 2 Quitline referral 3 GP usual care. PNs from practices randomised to the intervention group will receive a training course in smoking cessation followed by access to mentoring. GPs from practices randomised to the Quitline referral group will receive information about the study and the process of written referral and GPs in the usual care group will receive information about the study. Eligible patients are those aged 18 and over presenting to their GP who are daily or weekly smokers and who are able to give informed consent. Patients on low incomes in all three groups will be able to access free nicotine patches. Primary outcomes are sustained abstinence and point prevalence abstinence at the three month and 12 month follow-up points; and incremental cost effectiveness ratios at 12 months. Process evaluation on the reach and acceptability of the intervention approached will be collected through Computer Assisted Telephone Interviews (CATI with patients and semi-structured interviews with PNs and GPs. The primary analysis will be by intention to treat. Cessation outcomes will be compared between the three arms at three months and 12 month follow-up using multiple logistic regression. The incremental cost effectiveness ratios will be estimated for the 12 month quit rate for the intervention groups compared to usual care and to each other. Analysis of qualitative data on process outcomes will be based on thematic analysis. Discussion High quality evidence on effectiveness of practice nurse interventions is needed to inform health policy on development of practice nurse roles. If effective

  7. Varenicline: a selective alpha4beta2 nicotinic acetylcholine receptor partial agonist approved for smoking cessation.

    Science.gov (United States)

    Lam, Sum; Patel, Priti N

    2007-01-01

    Tobacco smoking remains a significant health problem in the United States. It has been associated with staggering morbidity and mortality, specifically due to malignancies and cardiovascular disease. Smoking cessation can be difficult and frequently requires pharmacologic interventions in addition to nonpharmacologic measures. Previously available agents are nicotine replacement products and bupropion, which increased quit rates by about 2-fold compared with placebo. Varenicline is the first drug in a new class known as the selective alpha4beta2 nicotinic receptor partial agonists. In several randomized, double-blind, 52-week clinical trials involving healthy chronic smokers, varenicline demonstrated superiority to placebo and bupropion in terms of efficacy measures. Additionally, it improved tobacco withdrawal symptoms and reinforcing effects of smoking in relapsed patients. Patients should start therapy in combination with tobacco cessation counseling 1 week before quit date and continue the regimen for 12 weeks. The dose of varenicline should be titrated to minimize nausea. The recommended dosage is 0.5 mg once daily (QD) on days 1-3; titrate to 0.5 mg twice daily (BID) on days 4-7; and 1 mg BID starting on day 8. An additional 12-week maintenance therapy may be considered for those who achieve abstinence. The most common side effects are nausea (30%), insomnia (18%), headache (15%), abnormal dreams (13%), constipation (8%), and abdominal pain (7%). Overall, varenicline is a breakthrough in the management of tobacco addiction and has demonstrated good efficacy in motivated quitters. It also provides an option for smokers who cannot tolerate other pharmacologic interventions. PMID:17438382

  8. Psychological barriers to tobacco cessation in Indian buprenorphine-naloxone maintained patients: A pilot study

    Directory of Open Access Journals (Sweden)

    Piyali Mandal

    2015-01-01

    Full Text Available Context: The prevalence of smoking in opioid agonist treatment programmes remains high, leading to significant tobacco related health hazards and mortality. This is the first study from India addressing tobacco cessation and related barriers among recipients of buprenorphine-naloxone maintenance treatment. Aims: The purpose of the study was to investigate Indian buprenorphine-naloxone maintained patients′ willingness to quit tobacco use, to determine its possible association with demographic, agonist maintenance treatment, tobacco use related variables and personal health and risk perceptions related to health hazards associated with tobacco use. Settings and Design: The study was cross-sectional, observational. It was conducted in the out-patient department of a national level de-addiction centre in India. Materials and Methods: Fifty-five males on buprenorphine-naloxone treatment were assessed using Tobacco Use Characteristics, Fagerstrom Test for Nicotine Dependence (FTND and FTND-ST, Readiness to Change questionnaire (RCQ, Smoker′s Perceived Health Risk Evaluation (SPHERE, Importance of Intervention scale and a semi-structured questionnaire. Statistical Analysis: Descriptive statistics, Kruskal-Wallis Chi-square test, Spearman rank order correlation, paired-t test, ANOVA (STATA 9.2 statistical package. Results: Around 65.4% of the subjects were smokers, 9% were using smokeless tobacco only whereas 25.6% were using both. Mean duration of tobacco use was 20 ± 1.5 years. Only 20% had past quit attempts. Only 24% were in action phase of change. Personal health and risk perceptions were poor and only 61.62% considered intervention tobacco smoking cessation important. Conclusions: Higher severity of nicotine dependence, low perception of harm from tobacco warrant immediate attention and need for on-site treatment opportunity.

  9. Effectiveness of proactive telephone counselling for smoking cessation in parents: Study protocol of a randomized controlled trial

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    Bricker Jonathan B

    2011-09-01

    Full Text Available Abstract Background Smoking is the world's fourth most common risk factor for disease, the leading preventable cause of death, and it is associated with tremendous social costs. In the Netherlands, the smoking prevalence rate is high. A total of 27.7% of the population over age 15 years smokes. In addition to the direct advantages of smoking cessation for the smoker, parents who quit smoking may also decrease their children's risk of smoking initiation. Methods/Design A randomized controlled trial will be conducted to evaluate the effectiveness of proactive telephone counselling to increase smoking cessation rates among smoking parents. A total of 512 smoking parents will be proactively recruited through their children's primary schools and randomly assigned to either proactive telephone counselling or a control condition. Proactive telephone counselling will consist of up to seven counsellor-initiated telephone calls (based on cognitive-behavioural skill building and Motivational Interviewing, distributed over a period of three months. Three supplementary brochures will also be provided. In the control condition, parents will receive a standard brochure to aid smoking cessation. Assessments will take place at baseline, three months after start of the intervention (post-measurement, and twelve months after start of the intervention (follow-up measurement. Primary outcome measures will include sustained abstinence between post-measurement and follow-up measurement and 7-day point prevalence abstinence and 24-hours point prevalence abstinence at both post- and follow-up measurement. Several secondary outcome measures will also be included (e.g., smoking intensity, smoking policies at home. In addition, we will evaluate smoking-related cognitions (e.g., attitudes towards smoking, social norms, self-efficacy, intention to smoke in 9-12 year old children of smoking parents. Discussion This study protocol describes the design of a randomized

  10. Plasma suPAR is lowered by smoking cessation

    DEFF Research Database (Denmark)

    Eugen-Olsen, Jesper; Ladelund, Steen; Sørensen, Lars Tue

    2016-01-01

    46 never smokers (1·9 ng/mL (1·7-2·2)). In smokers randomized to smoking cessation, suPAR levels after 4 weeks of stopping were decreased and no longer significantly different from the never smokers values. SuPAR decreased in both those who received a placebo as well as nicotine patch. Interestingly...

  11. Extended Treatment with Bupropion SR for Cigarette Smoking Cessation

    Science.gov (United States)

    Killen, Joel D.; Fortmann, Stephen P.; Murphy, Greer M.; Hayward, Chris; Arredondo, Christina; Cromp, DeAnn; Celio, Maria; Abe, Laurie; Wang, Yun; Schatzberg, Alan F.

    2006-01-01

    The authors present results of a randomized clinical trial of the efficacy of extended treatment with bupropion SR in producing longer term cigarette smoking cessation. Adult smokers (N = 362) received open-label treatment (11 weeks) that combined relapse prevention training, bupropion SR, and nicotine patch followed by extended treatment (14…

  12. Cost-effectiveness of varenicline for smoking cessation

    DEFF Research Database (Denmark)

    Keiding, Hans

    2009-01-01

    Smoking cessation therapies are among the most cost-effective preventive healthcare measures. Varenicline is a relatively new drug developed especially for this purpose, and it has been shown to achieve better quit rates than nicotine replacement therapies and the non-nicotine-based drug, bupropion...

  13. Coping Strategies Used by Adolescents during Smoking Cessation

    Science.gov (United States)

    Jannone, Laura; O'Connell, Kathleen A.

    2007-01-01

    The purpose of this study was to examine coping strategies used by teens as they attempted to quit smoking. The teens were attending a school-based cessation program titled "Quit 2 Win" that was offered in four high schools. This study examined situations in which teens were tempted to smoke. The study compares coping strategies teens reported in…

  14. Breastfeeding cessation and symptoms of anxiety and depression: a longitudinal cohort study

    OpenAIRE

    Ystrom Eivind

    2012-01-01

    Abstract Background Neonatal anxiety and depression and breastfeeding cessation are significant public health problems. There is an association between maternal symptoms of anxiety and depression and early breastfeeding cessation. In earlier studies, the causality of this association was interpreted both ways; symptoms of anxiety and depression prepartum significantly impacts breastfeeding, and breastfeeding cessation significantly impacts symptoms of anxiety and depression. First, we aimed t...

  15. Do Smoking Cessation Websites Meet the Needs of Smokers with Severe Mental Illnesses?

    Science.gov (United States)

    Brunette, Mary F.; Ferron, Joelle C.; Devitt, Timothy; Geiger, Pamela; Martin, Wendy M.; Pratt, Sarah; Santos, Meghan; McHugo, Gregory J.

    2012-01-01

    Many people learn about smoking cessation through information on the Internet. Whether people with severe mental illnesses, who have very high rates of smoking, are able to use currently available websites about smoking cessation is unknown. The study reported here assessed whether four smoking cessation websites met usability guidelines and…

  16. Integrating the promotion of physical activity within a smoking cessation programme: Findings from collaborative action research in UK Stop Smoking Services

    OpenAIRE

    Taylor, Adrian H; Everson-Hock, Emma S; Ussher, Michael

    2010-01-01

    Background Within the framework of collaborative action research, the aim was to explore the feasibility of developing and embedding physical activity promotion as a smoking cessation aid within UK 6/7-week National Health Service (NHS) Stop Smoking Services. Methods In Phase 1 three initial cycles of collaborative action research (observation, reflection, planning, implementation and re-evaluation), in an urban Stop Smoking Service, led to the development of an integrated intervention in whi...

  17. Smoking cessation support for pregnant women: role of mobile technology

    Directory of Open Access Journals (Sweden)

    Heminger CL

    2016-04-01

    Full Text Available Christina L Heminger, Jennifer M Schindler-Ruwisch, Lorien C AbromsDepartment of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA Background: Smoking during pregnancy has deleterious health effects for the fetus and mother. Given the high risks associated with smoking in pregnancy, smoking cessation programs that are designed specifically for pregnant smokers are needed. This paper summarizes the current landscape of mHealth cessation programs aimed at pregnant smokers and where available reviews evidence to support their use. Methods: A search strategy was conducted in June–August 2015 to identify mHealth programs with at least one component or activity that was explicitly directed at smoking cessation assistance for pregnant women. The search for text messaging programs and applications included keyword searches within public health and medical databases of peer-reviewed literature, Google Play/iTunes stores, and gray literature via Google. Results: Five unique short message service programs and two mobile applications were identified and reviewed. Little evidence was identified to support their use. Common tools and features identified included the ability to set your quit date, ability to track smoking status, ability to get help during cravings, referral to quitline, and tailored content for the individual participant. The theoretical approach utilized was varied, and approximately half of the programs included pregnancy-related content, in addition to cessation content. With one exception, the mHealth programs identified were found to have low enrollment. Conclusion: Globally, there are a handful of applications and text-based mHealth programs available for pregnant smokers. Future studies are needed that examine the efficacy of such programs, as well as strategies to best promote enrollment. Keywords: mHealth, smoking cessation, pregnancy, text messaging

  18. Smoking prevalence and smoking cessation services for pregnant women in Scotland

    Directory of Open Access Journals (Sweden)

    Shipton Debbie

    2010-01-01

    Full Text Available Abstract Background Over 20% of women smoke throughout pregnancy despite the known risks to mother and child. Engagement in face-to-face support is a good measure of service reach. The Scottish Government has set a target that by 2010 8% of smokers will have quit via NHS cessation services. At present less than 4% stop during pregnancy. We aimed to establish a denominator for pregnant smokers in Scotland and describe the proportion who are referred to specialist services, engage in one-to-one counselling, set a quit date and quit 4 weeks later. Methods This was a descriptive epidemiological study using routinely collected data supplemented by questionnaire information from specialist pregnancy cessation services. Results 13266 of 52370 (25% pregnant women reported being current smokers at maternity booking and 3133/13266 (24% were referred to specialist cessation services in 2005/6. Two main types of specialist smoking cessation support for pregnant women were in place in Scotland. The first involved identification using self-report and carbon monoxide breath test for all pregnant women with routine referral (1936/3352, 58% referred to clinic based support (386, 11.5% engaged. 370 (11% women set a quit date and 116 (3.5% had quit 4 weeks later. The second involved identification by self report and referral of women who wanted help (1195/2776, 43% referred for home based support (377/1954, 19% engaged. 409(15% smokers set a quit date and 119 (4.3% had quit 4 weeks later. Cost of home-based support was greater. In Scotland only 265/8062 (3.2% pregnant smokers identified at maternity booking, living in areas with recognised specialist or good generic services, quit smoking during 2006. Conclusions In Scotland, a small proportion of pregnant smokers are supported to stop. Poor outcomes are a product of current limitations to each step of service provision - identification, referral, engagement and treatment. Many smokers are not asked about smoking

  19. Cluster randomized trial in smoking cessation with intensive advice in diabetic patients in primary care. ITADI Study

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    Roura Pilar

    2010-02-01

    Full Text Available Abstract Background It is a priority to achieve smoking cessation in diabetic smokers, given that this is a group of patients with elevated cardiovascular risk. Furthermore, tobacco has a multiplying effect on micro and macro vascular complications. Smoking abstinence rates increase as the intensity of the intervention, length of the intervention and number and diversity of contacts with the healthcare professional during the intervention increases. However, there are few published studies about smoking cessation in diabetics in primary care, a level of healthcare that plays an essential role in these patients. Therefore, the aim of the present study is to evaluate the effectiveness of an intensive smoking cessation intervention in diabetic patients in primary care. Methods/Design Cluster randomized trial, controlled and multicentric. Randomization unit: Primary Care Team. Study population: 546 diabetic smokers older than 14 years of age whose disease is controlled by one of the primary care teams in the study. Outcome Measures: Continuous tobacco abstinence (a person who has not smoked for at least six months and with a CO level of less than 6 ppm measured by a cooximeter , evolution in the Prochaska and DiClemente's Transtheoretical Model of Change, number of cigarettes/day, length of the visit. Point of assessment: one- year post- inclusion in the study. Intervention: Brief motivational interview for diabetic smokers at the pre-contemplation and contemplation stage, intensive motivational interview with pharmacotherapy for diabetic smokers in the preparation-action stage and reinforcing intevention in the maintenance stage. Statistical Analysis: A descriptive analysis of all variables will be done, as well as a multilevel logistic regression and a Poisson regression. All analyses will be done with an intention to treatment basis and will be fitted for potential confounding factors and variables of clinical importance. Statistical packages

  20. A multimodal approach to investigate biomarkers for psychosis in a clinical setting: the integrative neuroimaging studies in schizophrenia targeting for early intervention and prevention (IN-STEP) project.

    Science.gov (United States)

    Koike, Shinsuke; Takano, Yosuke; Iwashiro, Norichika; Satomura, Yoshihiro; Suga, Motomu; Nagai, Tatsuya; Natsubori, Tatsunobu; Tada, Mariko; Nishimura, Yukika; Yamasaki, Syudo; Takizawa, Ryu; Yahata, Noriaki; Araki, Tsuyoshi; Yamasue, Hidenori; Kasai, Kiyoto

    2013-01-01

    Longitudinal clinical investigations and biological measurements have determined not only progressive brain volumetric and functional changes especially around the onset of psychosis but also the abnormality of developmental pathways based on gene-environment interaction model. However, these studies have contributed little to clinical decisions on their diagnosis and therapeutic choices because of subtle differences between patients and healthy controls. A multi-modal approach may resolve this limitation and is favorable to explore the pathophysiology of psychosis. The integrative neuroimaging studies for schizophrenia targeting early intervention and prevention (IN-STEP) is a research project aimed at exploring the pathophysiological features of the onset of psychosis and investigating possible predictive biomarkers for the clinical treatment of psychosis. Since 2008, we have adopted blood sampling, neurocognitive batteries, neurophysiological assessment, structural imaging, and functional imaging longitudinally for help-seeking ultra-high-risk (UHR) individuals and patients with first-episode psychosis (FEP). Here, we intend to introduce the IN-STEP research study protocol and present preliminary clinical findings. Thirty-seven UHR individuals and 30 patients with FEP participated in this study. Six months later, there was no difference in objective and subjective scores between the groups, which suggests that young people having symptoms and functional deficits should be cared for regardless of their history of psychosis according to their clinical stages. The rate of transition to psychosis was 7.1%, 8.0%, and 35.3% (at 6, 12, and 24months, respectively). Through this research project, we expect to clarify the pathophysiological features around the onset of psychosis and improve the prognosis of psychosis through clinical application. PMID:23219075

  1. Testing Stage-Specific Effects of a Stage-Matched Intervention: A Randomized Controlled Trial Targeting Physical Exercise and Its Predictors

    Science.gov (United States)

    Lippke, Sonia; Schwarzer, Ralf; Ziegelmann, Jochen P.; Scholz, Urte; Schuz, Benjamin

    2010-01-01

    Health education interventions can be tailored toward stages of change. This strategy is based on theories that predict at which stage which variables are indicative of subsequent behavior change processes. For example, planning is regarded as being effective in intenders. However, rather few studies have tested whether matched interventions are…

  2. A Parent-Mediated Intervention that Targets Responsive Parental Behaviors Increases Attachment Behaviors in Children with ASD: Results from a Randomized Clinical Trial

    Science.gov (United States)

    Siller, Michael; Swanson, Meghan; Gerber, Alan; Hutman, Ted; Sigman, Marian

    2014-01-01

    The current study is a randomized clinical trial evaluating the efficacy of Focused Playtime Intervention (FPI) in a sample of 70 children with Autism Spectrum Disorder. This parent-mediated intervention has previously been shown to significantly increase responsive parental communication (Siller et al. in "J Autism Dev Disord"…

  3. Interventions to cope with alcohol abuse: integrative review

    Directory of Open Access Journals (Sweden)

    Fernanda Jorge Guimarães

    2015-09-01

    Full Text Available Alcohol is the most consumed drug in the world, which could generate social and health problems, affecting users, people living with them and the society in general. The aim was to identify the best evidence of interventions to reduce alcohol abuse. An integrative review of the literature, conducted on LILACS, CINAHL, PUBMED and SCOPUS, through the descriptors “intervention studies” and “alcoholism”. Nineteen articles were selected, most of them classified as two regarding level of evidence. They involved interventions with alcohol users, the most efficient were short interventions, internet-based interventions and counselling. Although cessation of alcohol use was not proved through the interventions, results point to a significant reduction in consumption, increase of the availability to change drinking habit and effective impact of short interventions when compared to usual treatments. Short interventions constitute the best interventions to reduce alcohol abuse.

  4. Improvement in idiopathic nonspecific interstitial pneumonia after smoking cessation

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    Tsutomu Shinohara

    2015-01-01

    Full Text Available Although cigarette smoking has been recognized as a risk factor for the development of several interstitial lung diseases, the relationship between smoking and nonspecific interstitial pneumonia (NSIP has not yet been fully elucidated. We here present a case of fibrotic NSIP with mild emphysema in an elderly male with normal pulmonary function, whose symptoms, serum KL-6 level, and high-resolution computed tomography findings of interstitial changes markedly improved without medication following the cessation of smoking. Our case suggests that smoking may be an etiological factor in some patients with NSIP and that early smoking cessation before a clinically detectable decline in pulmonary function may be critical for smokers with idiopathic NSIP.

  5. Improvement in idiopathic nonspecific interstitial pneumonia after smoking cessation.

    Science.gov (United States)

    Shinohara, Tsutomu; Kadota, Naoki; Hino, Hiroyuki; Naruse, Keishi; Ohtsuki, Yuji; Ogushi, Fumitaka

    2015-01-01

    Although cigarette smoking has been recognized as a risk factor for the development of several interstitial lung diseases, the relationship between smoking and nonspecific interstitial pneumonia (NSIP) has not yet been fully elucidated. We here present a case of fibrotic NSIP with mild emphysema in an elderly male with normal pulmonary function, whose symptoms, serum KL-6 level, and high-resolution computed tomography findings of interstitial changes markedly improved without medication following the cessation of smoking. Our case suggests that smoking may be an etiological factor in some patients with NSIP and that early smoking cessation before a clinically detectable decline in pulmonary function may be critical for smokers with idiopathic NSIP. PMID:26029566

  6. Comparing tailored and untailored text messages for smoking cessation

    DEFF Research Database (Denmark)

    Skov-Ettrup, Lise; Ringgaard, L W; Dalum, Peter;

    2014-01-01

    The aim was to compare the effectiveness of untailored text messages for smoking cessation to tailored text messages delivered at a higher frequency. From February 2007 to August 2009, 2030 users of an internet-based smoking cessation program with optional text message support aged 15-25 years were...... consecutively randomized to versions of the program that offered either tailored or untailored text messages. Thirty-day point abstinence from smoking was measured self-reportedly at 12-months follow-up. Response rates were 36.3% and 38.1% in the tailored and untailored group, respectively. We analyzed the...... entire study population, as well as those opting for text messages (n = 1619). In intention-to-treat analysis with multiple imputation of missing data, the odds ratio for 30-day point abstinence was 1.28 (95% CI 0.91-2.08) for the tailored compared with untailored messages. When restricting the analysis...

  7. Smoking cessation: the role of the foot and ankle surgeon.

    Science.gov (United States)

    Greenhagen, Robert M; Johnson, Adam R; Bevilacqua, Nicholas J

    2010-02-01

    Tobacco cigarette smoking causes many negative effects on the body, and it is the leading preventable cause of death in the United States. These negative effects are a concern for the foot and ankle surgeon, as smoking can increase the risk of diabetes and peripheral artery disease and delay healing of surgical incisions and ulcerations of the lower extremities. Tobacco cigarette smoking can also increase the risk of avascular necrosis and delayed union and nonunions of fractures and osteotomies. Smoking cessation is an important component in the overall treatment of conditions affecting the foot and ankle. Smoking cessation can be a difficult goal to achieve, but proper education and support can help patients reach this goal. PMID:20400436

  8. Contributions of auriculotherapy in smoking cessation: a pilot study

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    Roberta de Paiva Silva

    2014-10-01

    Full Text Available Objective To evaluate the contribution of auriculotherapy in smoking cessation. Method Double-blind randomized controlled trial, conducted with 30 smokers allocated into two groups: Experimental Group (21 participants received 10 sessions of auriculotherapy at specific points for smoking and Control Group (nine participants received auriculotherapy in points that have no effect on the focus of research. Results Auriculotherapy contributed in reducing the number of cigarettes smoked in 61.9% of participants (p=0.002, in reducing the difficult to abstain from smoking in places where it is forbidden by 38% (p=0.050 and in not smoking when ill 23.8% (p=0.025. Conclusion Given the efficacy only in terms of reducing the number of cigarettes smoked and other parameters, we suggest that future studies consider the use of auriculotherapy combined with other treatment methods, in order to achieve better results in cessation/abstinence.

  9. Smoking cessation support for pregnant women: role of mobile technology

    OpenAIRE

    Heminger CL; Schindler-Ruwisch JM; Abroms LC

    2016-01-01

    Christina L Heminger, Jennifer M Schindler-Ruwisch, Lorien C AbromsDepartment of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA Background: Smoking during pregnancy has deleterious health effects for the fetus and mother. Given the high risks associated with smoking in pregnancy, smoking cessation programs that are designed specifically for pregnant smokers are needed. This paper summarizes the current landscap...

  10. Clinical deterioration after sildenafil cessation in patients with pulmonary hypertension

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    Anne M Keogh

    2008-06-01

    Full Text Available Anne M Keogh, Andrew Jabbour, Christopher S Hayward, Peter S MacdonaldHeart Lung Transplant Unit, St Vincent’s Hospital, Sydney, New South Wales, AustraliaAbstract: Sildenafil is a selective inhibitor of phosphodiesterase type 5 (PDE-5. Its chronic administration has been shown to improve exercise capacity, World Health Organization functional class, and haemodynamics in patients with symptomatic pulmonary arterial hypertension (PAH. There is however, no data describing the clinical consequences of sudden cessation of sildenafil treatment. In this series, 9 patients with NYHA Class II–IV PAH who were stable on 2 months of sildenafil monotherapy, had their sildenafil ceased to accommodate a 2-week washout period, required for enrollment in research involving an endothelin receptor antagonist. Six minute walk distance (SMWD and clinical assessments were performed before cessation of sildenafil, and again 2 weeks later. Over the course of this 2-week washout period, 6 of the 9 patients reported increased breathlessness and fatigue, 1 of these was hospitalized with worsening right heart failure. The SMWD fell in 6 patients, with falls of greater than 100 m recorded in 4 patients. This was accompanied by a worsening of NYHA Class from 2.5 ± 0.2 to 3.1 ± 0.1 (mean ± SEM, p = 0.01. These data indicate that sudden cessation of sildenafil monotherapy, in patients with PAH, carries with it a significant and unpredictable risk of rapid clinical deterioration. We recommend that if sildenafil needs to be ceased, it would be more prudent to consider concurrent vasodilator therapy before the gradual cessation of sildenafil.Keywords: sildenafil, pulmonary hypertension, phosphodiesterase inhibitor

  11. Examining sustainability in a hospital setting: Case of smoking cessation

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    Reece Robin

    2011-09-01

    Full Text Available Abstract Background The Ottawa Model of Smoking Cessation (OMSC is a hospital-based smoking cessation program that is expanding across Canada. While the short-term effectiveness of hospital cessation programs has been documented, less is known about long-term sustainability. The purpose of this exploratory study was to understand how hospitals using the OMSC were addressing sustainability and determine if there were critical factors or issues that should be addressed as the program expanded. Methods Six hospitals that differed on OMSC program activities (identify and document smokers, advise quitting, provide medication, and offer follow-up were intentionally selected, and two key informants per hospital were interviewed using a semi-structured interview guide. Key informants were asked to reflect on the initial decision to implement the OMSC, the current implementation process, and perceived sustainability of the program. Qualitative analysis of the interview transcripts was conducted and themes related to problem definition, stakeholder influence, and program features emerged. Results Sustainability was operationalized as higher performance of OMSC activities than at baseline. Factors identified in the literature as important for sustainability, such as program design, differences in implementation, organizational characteristics, and the community environment did not explain differences in program sustainability. Instead, key informants identified factors that reflected the interaction between how the health problem was defined by stakeholders, how priorities and concerns were addressed, features of the program itself, and fit within the hospital context and resources as being influential to the sustainability of the program. Conclusions Applying a sustainability model to a hospital smoking cessation program allowed for an examination of how decisions made during implementation may impact sustainability. Examining these factors during

  12. Psychosocial, behavioural, and health determinants of successful smoking cessation

    DEFF Research Database (Denmark)

    Osler, M; Prescott, E

    1998-01-01

    , baseline motivation to stop smoking, and having a non-smoking spouse/cohabitant. The same result was obtainedwhen the analyses were repeated separately for smokers with and without motivation to stop. CONCLUSIONS: Smokers motivated to stop are more likely to quit and remain abstinent than smokers 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....

  13. Benefits of smoking cessation for coronary heart disease patients

    OpenAIRE

    Adi Hidayat

    2015-01-01

    Cardiovascular disease (CVD) incidence increases with age and is frequently higher in the elderly.(1) Therefore prevention of CVD in the elderly through management of risk factors is important in order to reduce the risk of coronary heart disease (CHD). There are several risk factors of CVD that can be modified, such as smoking, physical activity, and unhealthy diet. Cessation of smoking is the most potent measure to prevent thousands of CVD events and death

  14. Cessation of contraction induces cardiomyocyte remodeling during zebrafish cardiogenesis

    OpenAIRE

    Yang, Jingchun; Hartjes, Katherine A.; Nelson, Timothy J; Xu, Xiaolei

    2013-01-01

    Contraction regulates heart development via a complex mechanotransduction process controlled by various mechanical forces. Here, we exploit zebrafish embryos as an in vivo animal model to discern the contribution from different mechanical forces and identify the underlying mechanotransductive signaling pathways of cardiogenesis. We treated 2 days postfertilization zebrafish embryos with Blebbistatin, a myosin II inhibitor, to stop cardiac contraction, which induces a response termed cessation...

  15. Family History of Lung Cancer and Contemplation of Smoking Cessation

    OpenAIRE

    Madlensky, Lisa; Bousman, Chad A.

    2010-01-01

    Introduction The prevalence of cigarette smoking in the United States has decreased, but current rates remain above nationally set objectives. A family history of lung cancer may motivate adult smokers to quit and contribute to further reductions in smoking prevalence. Methods We surveyed adult smokers (N = 838) interviewed as part of the 2005 Health Information National Trends Survey. We examined the association between family history of lung cancer and smoking cessation precontemplation (no...

  16. Determinants of smoking and smoking cessation among health professionals in Serbia: A cross-sectional study

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    Krstev Srmena

    2014-01-01

    Full Text Available Background/Aim. Bearing in mind a high smoking prevalence in Serbia (34% in adult population; men 38%, women 30% and leading role of health professionals in intervention and prevention, a cross-sectional study was performed smong the representative sample of health professionals in Serbia. The aim of the study was to identify predictors of smoking and smoking cessation prior to the total smoking ban in November 2010. Methods. In this nationwide study, 3,084 physicians and nurses from 4 types of institutions and four geographical regions were selected and 2,282 included (response rate 74.0%. Data were collected using a self-administered structured questionnaire. Standard statistical methods were used to calculate prevalence rates, and multivariate logistic regressions to evaluate independent predictors of smoking pattern. Risks were expressed as odds ratios (OR which represent approximation of relative risks of exposed persons with 95% confidence intervals (95% CI. Results. We found a high smoking prevalence of 38.0%, the same for women and men (37.8% and 37.6%, respectively; p = 0.138, higher among nurses (41.7% than physicians (29.1% (p = 0.000, as well as among those employed in general hospitals (42.6% and institutes of public health (43.8% (p = 0.000. Significantly increased risk of being an ever or current smoker was noticed for nurses (OR = 1.75, 95% CI 1.42-2.14; and OR = 1.91, 95% CI 1.52-2.40, respectively, those employed in general hospitals (OR = 1.37, 95% CI 1.09-1.73 and OR = 1.40, 95% CI 1.09-1.79, respectively, and with worse self-estimated health (OR = 1.15, 95% CI 1.02-1.30; and OR = 1.17, 95% CI 1.02-1.34, respectively. Intentions to quit smoking or to reduce the number of cigarettes were more frequent in women (OR = 1.51, 95% CI 1.01-2.27 and participants who worse evaluated their health (OR = 1.74, 95% CI 1.39- 2.18. Conclusion. High smoking prevalence in health professionals could be a barrier for the full implementation of

  17. Smoking cessation and reduction in people with chronic mental illness

    Science.gov (United States)

    Miller, Mollie E

    2015-01-01

    The high prevalence of cigarette smoking and tobacco related morbidity and mortality in people with chronic mental illness is well documented. This review summarizes results from studies of smoking cessation treatments in people with schizophrenia, depression, anxiety disorders, and post-traumatic stress disorder. It also summarizes experimental studies aimed at identifying biopsychosocial mechanisms that underlie the high smoking rates seen in people with these disorders. Research indicates that smokers with chronic mental illness can quit with standard cessation approaches with minimal effects on psychiatric symptoms. Although some studies have noted high relapse rates, longer maintenance on pharmacotherapy reduces rates of relapse without untoward effects on psychiatric symptoms. Similar biopsychosocial mechanisms are thought to be involved in the initiation and persistence of smoking in patients with different disorders. An appreciation of these common factors may aid the development of novel tobacco treatments for people with chronic mental illness. Novel nicotine and tobacco products such as electronic cigarettes and very low nicotine content cigarettes may also be used to improve smoking cessation rates in people with chronic mental illness. PMID:26391240

  18. Smoking cessation after 12 months with multi-component therapy.

    Science.gov (United States)

    Raich, Antònia; Martínez-Sánchez, Jose Maria; Marquilles, Emili; Rubio, Lídia; Fu, Marcela; Fernández, Esteve

    2015-01-01

    Smoking is one of the most important causes of morbidity and mortality in developed countries. One of the priorities of public health programmes is the reduction of its prevalence, which would involve millions of people quitting smoking, but cessation programs often have modest results, especially within certain population groups. The aim of this study was to analyze the variables determining the success of a multicomponent therapy programme for smoking cessation. We conducted the study in the Smoking Addiction Unit at the Hospital of Manresa, with 314 patients (91.4% of whom had medium or high-level dependency). We observed that higher educational level, not living with a smoker, following a multimodal programme or smoking cessation with psychological therapy, and pharmacological treatment are relevant factors for quitting smoking. Abstinence rates are not associated with other factors, such as sex, age, smoking behaviour characteristics or psychiatric history. The combination of pharmacological and psychological treatment increased success rates in multicomponent therapy. Psychological therapy only also obtained positive results, though somewhat more modest. PMID:25879476

  19. A systematic review of interventions in primary care to improve health literacy for chronic disease behavioral risk factors

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    Taggart Jane

    2012-06-01

    Full Text Available Abstract Background To evaluate the effectiveness of interventions used in primary care to improve health literacy for change in smoking, nutrition, alcohol, physical activity and weight (SNAPW. Methods A systematic review of intervention studies that included outcomes for health literacy and SNAPW behavioral risk behaviors implemented in primary care settings. We searched the Cochrane Library, Johanna Briggs Institute, Medline, Embase, CINAHL, Psychinfo, Web of Science, Scopus, APAIS, Australasian Medical Index, Google Scholar, Community of Science and four targeted journals (Patient Education and Counseling, Health Education and Behaviour, American Journal of Preventive Medicine and Preventive Medicine. Study inclusion criteria: Adults over 18 years; undertaken in a primary care setting within an Organisation for Economic Co-operation and Development (OECD country; interventions with at least one measure of health literacy and promoting positive change in smoking, nutrition, alcohol, physical activity and/or weight; measure at least one outcome associated with health literacy and report a SNAPW outcome; and experimental and quasi-experimental studies, cohort, observational and controlled and non-controlled before and after studies. Papers were assessed and screened by two researchers (JT, AW and uncertain or excluded studies were reviewed by a third researcher (MH. Data were extracted from the included studies by two researchers (JT, AW. Effectiveness studies were quality assessed. A typology of interventions was thematically derived from the studies by grouping the SNAPW interventions into six broad categories: individual motivational interviewing and counseling; group education; multiple interventions (combination of interventions; written materials; telephone coaching or counseling; and computer or web based interventions. Interventions were classified by intensity of contact with the subjects (High ≥ 8 points of contact

  20. Compliance and Effectiveness of Smoking Cessation Program Started on Hospitalized Patients

    Science.gov (United States)

    Shin, Gun Hee; Yi, Sung Won; Park, Eal Whan; Choi, Eun Young

    2016-01-01

    Background Varenicline is now very useful medication for cessation; however, there is only little result of researches with varenicline for cessation of hospitalized patients. This research attempted to analyze the cessation effect of medication and compliance of hospitalized patients. Methods This research included data for 52 patients who were prescribed varenicline among 280 patients who were consulted for cessation during their admission period. This research checked whether smoking was stopped or not after six months and analyzed their compliance, the factors for succeeding in smoking cessation. Results One hundred and ninety hospitalized patients participated in smoking cessation counseling among 280 patients who included consultation from their admission departments. And varenicline was prescribed for only 80 patients after counseling. Nineteen smokers were successful in smoking cessation among 52 final participants representing the rating of success of 36.5%. The linkage between compliance of varenicline and rate of smoking successful has no statistical significance. The factors for succeeding in smoking of hospitalized patients are admission departments, diseases, and economic states. Conclusion Smoking cessation program has low inpatient compliance. Cooperation of each departments is very important for better compliance. Success rate of cessation was relatively high (36.5%). Cessation attempt during hospitalization is very effective strategy.

  1. The Effects and Measures of Auricular Acupressure and Interactive Multimedia for Smoking Cessation in College Students

    Directory of Open Access Journals (Sweden)

    Mei-Ling Yeh

    2014-01-01

    Full Text Available The earlier one starts to smoke, the more likely it is that one’s tobacco use will increase. Either auricular acupressure or multimedia education could improve physiological health status and reduce smoking for young smokers. This study aimed to evaluate the effects of a 10-week auricular acupressure (AA and interactive multimedia (IM on smoking cessation in college smokers. A pre- and posttest control research design with two experiments (AA and IM and one control was used. Thirty-two participants were in each of three groups. A significant difference from pretest to posttest among three groups was exhibited on carbon monoxide (CO, cotinine, and nicotine dependence. Scheffe’s post hoc test found significances on CO in the AA between the IM and the control and cotinine and nicotine dependence between the AA and the control. After controlling the covariates, the main effect of the group was no difference in all outcomes. The interventions, especially AA, may contribute to a decrease of CO, cotinine, and nicotine dependence along with the time change. An analysis without controlling influences may overestimate interventional effects.

  2. Representativeness of two sampling procedures for an internet intervention targeting cancer-related distress: a comparison of convenience and registry samples

    OpenAIRE

    Owen, Jason E.; Bantum, Erin O'Carroll; Criswell, Kevin; Bazzo, Julie; Gorlick, Amanda; Stanton, Annette L.

    2013-01-01

    Internet interventions often rely on convenience sampling, yet convenience samples may differ in important ways from systematic recruitment approaches. The purpose of this study was to evaluate potential demographic, medical, and psychosocial differences between Internet-recruited and registry-recruited cancer survivors in an Internet-based intervention. Participants were recruited from a cancer registry (n = 80) and via broad Internet outreach efforts (n = 160). Participants completed a set ...

  3. Impact of connecting tuberculosis directly observed therapy short-course with smoking cessation on health-related quality of life

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    Awaisu Ahmed

    2012-02-01

    Full Text Available Abstract Background With evolving evidence of association between tuberculosis (TB and tobacco smoking, recommendations for the inclusion of tobacco cessation interventions in TB care are becoming increasingly important and more widely disseminated. Connecting TB and tobacco cessation interventions has been strongly advocated as this may yield better outcomes. However, no study has documented the impact of such connection on health-related quality of life (HRQoL. The objective of this study was to document the impact of an integrated TB directly observed therapy short-course (DOTS plus smoking cessation intervention (SCI on HRQoL. Methods This was a multi-centered non-randomized controlled study involving 120 TB patients who were current smokers at the time of TB diagnosis in Malaysia. Patients were assigned to either of two groups: the usual TB-DOTS plus SCI (SCIDOTS group or the usual TB-DOTS only (DOTS group. The effect of the novel strategy on HRQoL was measured using EQ-5D questionnaire. Two-way repeated measure ANOVA was used to examine the effects. Results When compared, participants who received the integrated intervention had a better HRQoL than those who received the usual TB care. The SCIDOTS group had a significantly greater increase in EQ-5D utility score than the DOTS group during 6 months follow-up (mean ± SD = 0.98 ± 0.08 vs. 0.91 ± 0.14, p = 0.006. Similarly, the mean scores for EQ-VAS showed a consistently similar trend as the EQ-5D indices, with the scores increasing over the course of TB treatment. Furthermore, for the EQ-VAS, there were significant main effects for group [F (1, 84 = 4.91, p = 0.029, η2 = 0.06], time [F (2, 168 = 139.50, p = 2 = 0.62] and group x time interaction [F (2, 168 = 13.89, p = 2 = 0.14]. Conclusions This study supports the evidence that an integrated TB-tobacco treatment strategy could potentially improve overall quality of life outcomes among TB patients who are smokers.

  4. Within a smoking-cessation program, what impact does genetic information on lung cancer need to have to demonstrate cost-effectiveness?

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    Gordon Louisa G

    2010-09-01

    Full Text Available Abstract Background Many smoking-cessation programs and pharmaceutical aids demonstrate substantial health gains for a relatively low allocation of resources. Genetic information represents a type of individualized or personal feedback regarding the risk of developing lung cancer, and hence the potential benefits from stopping smoking, may motivate the person to remain smoke-free. The purpose of this study was to explore what the impact of a genetic test needs to have within a typical smoking-cessation program aimed at heavy smokers in order to be cost-effective. Methods Two strategies were modelled for a hypothetical cohort of heavy smokers aged 50 years; individuals either received or did not receive a genetic test within the course of a usual smoking-cessation intervention comprising nicotine replacement therapy (NRT and counselling. A Markov model was constructed using evidence from published randomized controlled trials and meta-analyses for estimates on 12-month quit rates and long-term relapse rates. Epidemiological data were used for estimates on lung cancer risk stratified by time since quitting and smoking patterns. Extensive sensitivity analyses were used to explore parameter uncertainty. Results The discounted incremental cost per QALY was AU$34,687 (95% CI $12,483, $87,734 over 35 years. At a willingness-to-pay of AU$20,000 per QALY gained, the genetic testing strategy needs to produce a 12-month quit rate of at least 12.4% or a relapse rate 12% lower than NRT and counselling alone for it to be equally cost-effective. The likelihood that adding a genetic test to the usual smoking-cessation intervention is cost-effective was 20.6% however cost-effectiveness ratios were favourable in certain situations (e.g., applied to men only, a 60 year old cohort. Conclusions The findings were sensitive to small changes in critical variables such as the 12-month quit rates and relapse rates. As such, the cost-effectiveness of the genetic testing

  5. Comparative analysis of smoking cessation smartphone applications available in 2012 versus 2014

    OpenAIRE

    Ubhi, H. K.; Kotz, D; Michie, S; van Schayck, O. C.; Sheard, D.; Selladurai, A.; West, R.

    2016-01-01

    BACKGROUND AND AIMS: Smartphone applications (apps) offer a potentially cost-effective and a wide-reach aid to smoking cessation. In 2012, a content analysis of smoking cessation apps suggested that most apps did not adopt behaviour change techniques (BCTs), which according to previous research had suggested would promote higher success rates in quitting smoking. This study examined whether or not, this situation had changed by 2014 for free smoking cessation apps available in the Apple App S...

  6. Comparative analysis of smoking cessation smartphone applications available in 2012 versus 2014

    OpenAIRE

    Ubhi, Harveen Kaur; Kotz, Daniel; Michie, Susan; Onno C P van Schayck; Sheard, David; Selladurai, Abiram; West, Robert

    2016-01-01

    Background and aims Smartphone applications (apps) offer a potentially cost-effective and a wide-reach aid to smoking cessation. In 2012, a content analysis of smoking cessation apps suggested that most apps did not adopt behaviour change techniques (BCTs), which according to previous research had suggested would promote higher success rates in quitting smoking. This study examined whether or not, this situation had changed by 2014 for free smoking cessation apps available in the Apple App St...

  7. Physicians discuss the risks of smoking with their patients, but seldom offer practical cessation support

    OpenAIRE

    Keto, Jaana; Jokelainen, Jari; Timonen, Markku; Linden, Kari; Ylisaukko-Oja, Tero

    2015-01-01

    Background Our aim was to study the smoking cessation-related 1) attitudes & experiences and 2) consultation practices of Finnish physicians and to determine if there is a relationship between the two. Methods An online survey on smoking cessation was sent to 39 % of all Finnish physicians, with emphasis on physicians working in fields relevant to smoking cessation. A total of 1141 physicians (response rate 15 %) responded to the online survey, 53 % of whom were employed in primary health car...

  8. Delivering evidence-based smoking cessation treatment in primary care practice

    Science.gov (United States)

    Papadakis, Sophia; Gharib, Marie; Hambleton, Josh; Reid, Robert D.; Assi, Roxane; Pipe, Andrew L.

    2014-01-01

    Abstract Objective To report on the delivery of evidence-based smoking cessation treatments (EBSCTs) within a sample of 40 Ontario family health teams (FHTs). Design In each FHT, consecutive patients were screened for smoking status and eligible patients completed a questionnaire immediately following their clinic visits (index visits). Multilevel analysis was used to examine FHT-level, provider-level, and patient-level predictors of EBSCT delivery. Setting Forty FHTs in Ontario. Participants Across the 40 participating FHTs, 24 033 patients were screened and 2501 eligible patients contributed data. Main outcome measures Provider performance in the delivery of EBSCTs during the preceding 12 months and during the index visits was assessed. Results The rate of provider delivery of EBSCT for the previous 12 months was 74.0% for the advise strategy. At the index visit, rates of EBSCT strategy delivery were 56.8% for ask; 46.9% for advise; 38.7% for assist; 11.6% for prescribing pharmacotherapy; and 11.3% for arrange follow-up. Significant intra-FHT and intraprovider variability in the rates of EBSCT delivery was identified. Family health teams with a physician champion (odds ratio [OR] 2.0; 95% CI 1.1 to 3.6; P < .01) and providers who highly ranked the importance of smoking cessation (OR 1.7; 95% CI 1.1 to 2.7; P < .01) were more likely to deliver EBSCTs. Patient readiness to quit (OR 1.6; 95% CI 1.3 to 1.9; P < .001), presence of smoking-related illness (OR 1.6; 95% CI 1.2 to 2.1; P < .01), and presenting for an annual health examination (OR 2.0; 95% CI 1.6 to 2.5; P < .001) were associated with the delivery of EBSCTs. Conclusion Rates of smoking cessation advice were higher than previously reported for Canadian physicians; however, rates of assistance with quitting were lower. Future quality improvement initiatives should specifically target increasing the rates of screening and advising among low-performing FHTs and providers within FHTs, with a particular emphasis

  9. HIV seropositivity and sexuality: cessation of sexual relations among men and women living with HIV in five countries.

    Science.gov (United States)

    Bernier, Adeline; Lefèvre, Marie; Henry, Emilie; Verdes, Ludmila; Acosta, Maria-Elena; Benmoussa, Amal; Mukumbi, Henri; Cissé, Mamadou; Otis, Joanne; Préau, Marie

    2016-03-01

    The sexuality of people living with HIV (PLHIV) is a key issue in the fight against HIV, as it influences both the dynamic of the epidemic and the quality of life of PLHIV. The present study examined the factors associated with cessation of sexual relations after HIV diagnosis among men and women in five countries: Mali, Morocco, Democratic Republic of the Congo, Romania and Ecuador. A community-based cross-sectional study was implemented by a mixed consortium [researchers/community-based organizations (CBO)]. Trained CBO members interviewed 1500 PLHIV in contact with CBOs using a 125-item questionnaire. A weighted multivariate logistic regression and a separate gender analysis were performed. Among the 1413 participants, 471 (33%) declared that they stopped having sexual relations after their HIV diagnosis, including 318 women (42%) and 153 men (23%) (p < .001). Concerning women, variables associated with the cessation of sexual relations in the final multivariate model were mainly related with relational factors and the possibility of getting social support (e.g., needing help to disclose HIV serostatus, feeling lonely every day, not finding support in CBOs, not being in a couple). Men's sexual activity was more associated with their representations and their perception of the infection (e.g., thinking they will have their HIV infection for the rest of their life, perceiving the HIV infection as a mystery, perceiving the infection as serious). Furthermore, the following variables were associated with both men and women sexual behaviours: being older, having suffered from serious social consequences after serostatus disclosure and not being able to regularly discuss about HIV with their steady partner. Results suggested clear differences between men and women regarding cessation of sexual relations and highlighted the importance of implementing gender-based tailored interventions that promote safe and satisfying sexuality, as it is known to have a positive

  10. HIV seropositivity and sexuality: cessation of sexual relations among men and women living with HIV in five countries

    Science.gov (United States)

    Bernier, Adeline; Lefèvre, Marie; Henry, Emilie; Verdes, Ludmila; Acosta, Maria-Elena; Benmoussa, Amal; Mukumbi, Henri; Cissé, Mamadou; Otis, Joanne; Préau, Marie

    2016-01-01

    ABSTRACT The sexuality of people living with HIV (PLHIV) is a key issue in the fight against HIV, as it influences both the dynamic of the epidemic and the quality of life of PLHIV. The present study examined the factors associated with cessation of sexual relations after HIV diagnosis among men and women in five countries: Mali, Morocco, Democratic Republic of the Congo, Romania and Ecuador. A community-based cross-sectional study was implemented by a mixed consortium [researchers/community-based organizations (CBO)]. Trained CBO members interviewed 1500 PLHIV in contact with CBOs using a 125-item questionnaire. A weighted multivariate logistic regression and a separate gender analysis were performed. Among the 1413 participants, 471 (33%) declared that they stopped having sexual relations after their HIV diagnosis, including 318 women (42%) and 153 men (23%) (p < .001). Concerning women, variables associated with the cessation of sexual relations in the final multivariate model were mainly related with relational factors and the possibility of getting social support (e.g., needing help to disclose HIV serostatus, feeling lonely every day, not finding support in CBOs, not being in a couple). Men's sexual activity was more associated with their representations and their perception of the infection (e.g., thinking they will have their HIV infection for the rest of their life, perceiving the HIV infection as a mystery, perceiving the infection as serious). Furthermore, the following variables were associated with both men and women sexual behaviours: being older, having suffered from serious social consequences after serostatus disclosure and not being able to regularly discuss about HIV with their steady partner. Results suggested clear differences between men and women regarding cessation of sexual relations and highlighted the importance of implementing gender-based tailored interventions that promote safe and satisfying sexuality, as it is known to have a

  11. A multi-faceted workplace intervention targeting low back pain was effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence

    DEFF Research Database (Denmark)

    Rasmussen, Charlotte Diana Nørregaard; Holtermann, Andreas; Jørgensen, Marie Birk;

    2016-01-01

    trial with 594 nurses' aides was conducted. The intervention lasted 12 weeks and consisted of physical training (12 sessions), cognitive behavioural training (two sessions) and participatory ergonomics (five sessions). Occupational lifting, fear avoidance, physical exertion, muscle strength, support....... Results: Significant reduction in occupational lifting (-0.35 (95% confidence interval -0.61 to -0.08)), and improvement in two measures of fear avoidance ((-0.75 (95% confidence interval -1.05 to -0.45) and -0.45 (95% confidence interval -0.80 to -0.11)) were found for the intervention group compared...

  12. Reduction in oxidatively generated DNA damage following smoking cessation

    Directory of Open Access Journals (Sweden)

    Freund Harold G

    2011-05-01

    Full Text Available Abstract Background Cigarette smoking is a known cause of cancer, and cancer may be in part due to effects of oxidative stress. However, whether smoking cessation reverses oxidatively induced DNA damage unclear. The current study sought to examine the extent to which three DNA lesions showed significant reductions after participants quit smoking. Methods Participants (n = 19 in this study were recruited from an ongoing 16-week smoking cessation clinical trial and provided blood samples from which leukocyte DNA was extracted and assessed for 3 DNA lesions (thymine glycol modification [d(TgpA]; formamide breakdown of pyrimidine bases [d(TgpA]; 8-oxo-7,8-dihydroguanine [d(Gh] via liquid chromatography tandem mass spectrometry (LC-MS/MS. Change in lesions over time was assessed using generalized estimating equations, controlling for gender, age, and treatment condition. Results Overall time effects for the d(TgpA (χ2(3 = 8.068, p fpA (χ2(3 = 8.477, p h (χ2(3 = 37.599, p gpA and d(PfpA lesions show relatively greater rebound at Week 16 compared to the d(Gh lesion (88% of baseline for d(TgpA, 64% of baseline for d(PfpA, vs 46% of baseline for d(Gh. Conclusions Overall, results from this analysis suggest that cigarette smoking contributes to oxidatively induced DNA damage, and that smoking cessation appears to reduce levels of specific damage markers between 30-50 percent in the short term. Future research may shed light on the broader array of oxidative damage influenced by smoking and over longer durations of abstinence, to provide further insights into mechanisms underlying carcinogenesis.

  13. Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers

    Directory of Open Access Journals (Sweden)

    Murtomaa Heikki

    2011-05-01

    Full Text Available Abstract Background Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. Methods A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73 and dental hygienists (n = 22 in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%. We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Results Internal consistency values for theoretical domains varied from 0.50 ('emotion' to 0.71 ('environmental context and resources'. The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4 and was identified as a potential implementation difficulty. The domain emotion

  14. The influence of in-pregnancy smoking cessation programmes on partner quitting and women's social support mobilization: a randomized controlled trial [ISRCTN89131885

    Directory of Open Access Journals (Sweden)

    Evans Olga

    2005-07-01

    Full Text Available Abstract Background Smoking cessation interventions in pregnancy could influence a woman's social behaviour and her partner's smoking behaviour, but this has not been examined in any published randomized trials. Method 918 women smoking at booking for antenatal care were enrolled in a cluster-randomized trial of three interventions: standard care, self-help manual and enhanced stage-based counselling, or self-help manual, enhanced stage-based counselling and use of an interactive computer program. The outcomes were change in social support received by women between booking for maternity care and 30 weeks gestation and 10 days postpartum and reported cessation in the woman's partner at these times. Results Few pregnant women's partners stopped smoking (4.1% at 30 weeks of gestation and 5.8% at 10 days postpartum and the probability of quitting did not differ significantly by trial arm. Women's scores on the Inventory of Socially Supportive Behaviors showed a slight decline from booking to 30 weeks gestation, and a slight increase to 10 days postpartum, but these changes did not differ significantly by trial arm. Conclusion The stage-based interventions tested in this trial aimed partly to influence women's mobilization of support and might have influenced partners' quitting, but there was no evidence that they did so. Given that women and their partners often stopped smoking together, future interventions to prevent smoking in pregnant women could encourage both partners to quit together.

  15. Bupropion SR and Contingency Management for Adolescent Smoking Cessation

    OpenAIRE

    Gray, Kevin M.; Carpenter, Matthew J.; Baker, Nathaniel L.; Hartwell, Karen J.; Lewis, A. Lee; Hiott, D. Walter; Deas, Deborah; Upadhyaya, Himanshu P.

    2010-01-01

    There is a significant need for evidence-based treatments for adolescent smoking cessation. Prior research, though limited, has suggested potential roles for bupropion SR and contingency management (CM), but no previous studies have assessed their combined effect. In a double-blind, placebo-controlled design, 134 adolescent smokers were randomized to receive a 6-week course of bupropion SR + CM, bupropion SR + non-CM, placebo + CM, or placebo + non-CM, with final follow-up at 12 weeks. The pr...

  16. Distinct coping strategies differentially predict urge levels and lapses in a smoking cessation attempt.

    Science.gov (United States)

    Brodbeck, Jeannette; Bachmann, Monica S; Znoj, Hansjörg

    2013-06-01

    This study analysed mechanisms through which stress-coping and temptation-coping strategies were associated with lapses. Furthermore, we explored whether distinct coping strategies differentially predicted reduced lapse risk, lower urge levels, or a weaker association between urge levels and lapses during the first week of an unassisted smoking cessation attempt. Participants were recruited via the internet and mass media in Switzerland. Ecological momentary assessment (EMA) with mobile devices was used to assess urge levels and lapses. Online questionnaires were used to measure smoking behaviours and coping variables at baseline, as well as smoking behaviour at the three-month follow-up. The sample consisted of 243 individuals, aged 20 to 40, who reported 4199 observations. Findings of multilevel regression analyses show that coping was mainly associated with a reduced lapse risk and not with lower urge levels or a weaker association between urge levels and lapses. 'Calming down' and 'commitment to change' predicted a lower lapse risk and also a weaker relation between urge levels and lapses. 'Stimulus control' predicted a lower lapse risk and lower urge levels. Conversely, 'task-orientation' and 'risk assessment' were related to higher lapse risk and 'risk assessment' also to higher urge levels. Disengagement coping i.e. 'eating or shopping', 'distraction', and 'mobilising social support' did not affect lapse risk. Promising coping strategies during the initial stage of smoking cessation attempt are targeted directly at reducing the lapse risk and are characterised by engagement with the stressor or one's reactions towards the stressor and a focus on positive consequences instead of health risks. PMID:23501139

  17. Increased Functional Connectivity in an Insula-Based Network is Associated with Improved Smoking Cessation Outcomes.

    Science.gov (United States)

    Addicott, Merideth A; Sweitzer, Maggie M; Froeliger, Brett; Rose, Jed E; McClernon, Francis J

    2015-10-01

    Little is known regarding the underlying neurobiology of smoking cessation. Neuroimaging studies indicate a role for the insula in connecting the interoceptive awareness of tobacco craving with a larger brain network that motivates smoking. We investigated differences in insula-based functional connectivity between smokers who did not relapse during a quit attempt vs those who relapsed. Smokers (n=85) underwent a resting-state functional connectivity scan and were then randomized into two groups (either smoking usual brand cigarettes or smoking very low nicotine cigarettes plus nicotine replacement therapy) for 30 days before their target quit date. Following the quit date, all participants received nicotine replacement therapy and their smoking behavior was observed for 10 weeks. Participants were subsequently classified as nonrelapsed (n=44) or relapsed (i.e., seven consecutive days of smoking ⩾1 cigarette/day; n=41). The right and left insula, as well as insula subdivisions (posterior, ventroanterior, and dorsoanterior) were used as seed regions of interest in the connectivity analysis. Using the right and left whole-insula seed regions, the nonrelapsed group had greater functional connectivity than the relapsed group with the bilateral pre- and postcentral gyri. This effect was isolated to the right and left posterior insula seed regions. Our results suggest that relapse vulnerability is associated with weaker connectivity between the posterior insula and primary sensorimotor cortices. Perhaps greater connectivity in this network improves the ability to inhibit a motor response to cigarette cravings when those cravings conflict with a goal to remain abstinent. These results are consistent with recent studies demonstrating a positive relationship between insula-related functional connectivity and cessation likelihood among neurologically intact smokers. PMID:25895453

  18. Parent Inclusion in Early Intensive Behavioral Intervention: The Influence of Parental Stress, Parent Treatment Fidelity and Parent-Mediated Generalization of Behavior Targets on Child Outcomes

    Science.gov (United States)

    Strauss, Kristin; Vicari, Stefano; Valeri, Giovanni; D'Elia, Lidia; Arima, Serena; Fava, Leonardo

    2012-01-01

    Although early intensive behavior interventions have been efficient in producing positive behavior outcome in young children with Autism Spectrum Disorder, there is a considerable variety in the children's progress. Research has suggested that parental and treatment factors are likely to affect children's response to treatment. The purpose of the…

  19. A brief motivational intervention based on positive experience and temporary smoking abstinence: Feasibility in a psychiatric hospital

    Directory of Open Access Journals (Sweden)

    Ineke Keizer

    2012-06-01

    Full Text Available Background and Objectives: Feasible interventions promoting tobacco cessation need to be implemented in psychiatric hospitals, where high proportions of patients are heavy smokers. This pilot study examined the feasibility of a new brief motivational intervention associating positive experiences with temporary smoking cessation. Methods: One-day interventions were proposed to 19 smokers hospitalized for severe mental disorders. The multicomponent intervention comprised a 25-hour tobacco cessation period, information about smoking, attending thermal baths and music therapy sessions, intensive group support and feedback sessions. Expired carbon monoxide was monitored and nicotine replacement was available. Patients were evaluated before, during and after the intervention. Results: Most participants were heavy smokers (68.4% and precontemplative about smoking cessation (52.6%. Rates of successful smoking abstinence were 78.9% after 10 hours and 47.4% at 25 hours; 15.8% stopped for 3 days or more. Median CO level decreased from 24 to 9 ppm. Patients reported high levels of general well-being and satisfaction during the abstinence day. Psychiatric condition did not deteriorate and frequency of withdrawal symptoms was low. 84% of patients used nicotine replacement. Significantly reduced cigarette consumption persisted for at least one week after the intervention. Conclusions: A brief motivational intervention based on the association between positive experience and temporary smoking abstinence is feasible in a psychiatric hospital. The reported positive experience calls for further development and validation of integrative interventions, which are currently lacking.

  20. Predictors of Middle School Students’ Interest in Participating in an Incentive-Based Tobacco Prevention and Cessation Program in Connecticut

    Directory of Open Access Journals (Sweden)

    Meghan E. Morean

    2014-01-01

    Full Text Available Behavioral incentives have been used to encourage smoking cessation in older adolescents, but the acceptability of incentives to promote a smoke-free lifestyle in younger adolescents is unknown. To inform the development of novel, effective, school-based interventions for youth, we assessed middle school students’ interest in participating in an incentive-based tobacco abstinence program. We surveyed 988 students (grades 6–8 attending three Connecticut middle schools to determine whether interest in program participation varied as a function of (1 intrapersonal factors (i.e., demographic characteristics (sex, age, race, smoking history, and trait impulsivity and/or (2 aspects of program design (i.e., prize type, value, and reward frequency. Primary analyses were conducted using multiple regression. A majority of students (61.8% reported interest in program participation. Interest did not vary by gender, smoking risk status, or offering cash prizes. However, younger students, non-Caucasian students, behaviorally impulsive students, and students with higher levels of self-regulation were more likely to report interest. Inexpensive awards (e.g., video games offered monthly motivated program interest. In sum, middle school students reported high levels of interest in an incentive-based program to encourage a tobacco-free lifestyle. These formative data can inform the design of effective, incentive-based smoking cessation and prevention programs in middle schools.