This document discusses supporting smoking cessation in healthcare. It explores gaps in understanding tobacco addiction and challenges in managing smoking cessation. The authors conducted a literature review and expert assessment to formulate recommendations. They found that smoking is not widely viewed as an addiction and few smokers seek help quitting from healthcare professionals. While professionals recognize advising patients to quit, barriers exist to doing so. Overall, more must be done to convince professionals that smoking is an addiction requiring treatment like other addictions.
Early tracheostomy in critically ill patientsHossam atef
This meta-analysis reviewed 14 randomized controlled trials comparing early tracheostomy (within 10 days of mechanical ventilation) to prolonged intubation in critically ill patients. The analysis found:
1) Early tracheostomy did not reduce mortality, duration of mechanical ventilation, ICU stay, or incidence of ventilator-associated pneumonia compared to prolonged intubation.
2) It did reduce the duration of sedation use but did not decrease the duration of mechanical ventilation.
3) Significantly more tracheostomy procedures were performed in the early tracheostomy group.
The study concludes that early tracheostomy before 10 days does not provide benefits and may lead to unnecessary procedures, so its routine use is not recommended. Further research
Clinic practice of nebulized therapy in China(a national questionnaire survey)Robin Jiang
This national survey investigated the use of nebulized therapy in respiratory disease treatment across China. The key findings were:
1) Nebulized therapy was used in 91.1% of hospitals surveyed, but less commonly in primary hospitals compared to tertiary and secondary hospitals.
2) The most frequently used nebulizer devices were jet and ultrasonic nebulizers. Short-acting bronchodilators and corticosteroids were the most commonly administered medicines via nebulization.
3) Respondents agreed nebulized therapy could treat acute exacerbations but saw more limited use for stable patients. Continuous medical education on nebulized therapy was deemed necessary by most respondents.
REG Interstitial Lung Disease Working Group MeetingZoe Mitchell
The meeting agenda included:
1) Introductions of working group members and REG supporters in attendance.
2) An overview of the Respiratory Effectiveness Group (REG) and its mission to conduct real-world respiratory research.
3) A discussion of potential research ideas led by Luca Richeldi, including characterizing healthcare utilization prior to ILD diagnosis, using electronic lung sounds for early diagnosis, and evaluating consistency of ILD diagnoses across multidisciplinary teams.
4) A final group discussion on other opportunities for collaboration within the ILD working group.
This document provides a summary of selected new evidence relevant to the NICE clinical guideline on the management of chronic obstructive pulmonary disease (COPD) in adults. It discusses 27 pieces of new evidence identified since the literature search was last conducted for the guideline. The evidence is grouped into the following sections: managing stable COPD, management of exacerbations, and areas not currently covered by NICE guidance. For stable COPD, the evidence discusses topics like smoking cessation, inhaled therapy, pulmonary rehabilitation, and vaccination. It finds that smoking cessation benefits may extend to more severe COPD, and counseling plus nicotine replacement or antidepressants can help patients stop smoking. For inhaled therapy, combinations of long-acting beta-
This review examines the clinical diagnosis of acute purulent sinusitis in primary care settings based on 4 studies. The review found that purulent nasal secretions as a symptom or sign, pain in the teeth, and a two-phase illness history were associated with acute purulent sinusitis. An elevated erythrocyte sedimentation rate and C-reactive protein level also contributed to the diagnosis when evaluated in the studies.
Chu et al. (2015)
The study reviewed 14 clinical studies that used quantitative sensory testing to detect hyperalgesia in chronic pain patients on long-term opioids. Most sensory modalities tested, including cold, heat, pressure, electrical, ischemic, and injection pain, failed to demonstrate hypersensitivity to test stimuli. Heat pain sensitivity showed some promising results in detecting hyperalgesia, but none of the measures reviewed met the criteria as a definitive standard. Additional studies with improved designs are needed.
The document provides guidelines for the management of thyrotoxicosis from the American Thyroid Association and American Association of Clinical Endocrinologists task force. It includes 100 evidence-based recommendations on topics such as the initial evaluation and diagnosis of thyrotoxicosis, management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery, and management of toxic multinodular goiter or toxic adenoma. The task force developed the recommendations based on a systematic review of the literature and expert consensus using a standardized grading system for strength of recommendations and quality of evidence.
Early tracheostomy in critically ill patientsHossam atef
This meta-analysis reviewed 14 randomized controlled trials comparing early tracheostomy (within 10 days of mechanical ventilation) to prolonged intubation in critically ill patients. The analysis found:
1) Early tracheostomy did not reduce mortality, duration of mechanical ventilation, ICU stay, or incidence of ventilator-associated pneumonia compared to prolonged intubation.
2) It did reduce the duration of sedation use but did not decrease the duration of mechanical ventilation.
3) Significantly more tracheostomy procedures were performed in the early tracheostomy group.
The study concludes that early tracheostomy before 10 days does not provide benefits and may lead to unnecessary procedures, so its routine use is not recommended. Further research
Clinic practice of nebulized therapy in China(a national questionnaire survey)Robin Jiang
This national survey investigated the use of nebulized therapy in respiratory disease treatment across China. The key findings were:
1) Nebulized therapy was used in 91.1% of hospitals surveyed, but less commonly in primary hospitals compared to tertiary and secondary hospitals.
2) The most frequently used nebulizer devices were jet and ultrasonic nebulizers. Short-acting bronchodilators and corticosteroids were the most commonly administered medicines via nebulization.
3) Respondents agreed nebulized therapy could treat acute exacerbations but saw more limited use for stable patients. Continuous medical education on nebulized therapy was deemed necessary by most respondents.
REG Interstitial Lung Disease Working Group MeetingZoe Mitchell
The meeting agenda included:
1) Introductions of working group members and REG supporters in attendance.
2) An overview of the Respiratory Effectiveness Group (REG) and its mission to conduct real-world respiratory research.
3) A discussion of potential research ideas led by Luca Richeldi, including characterizing healthcare utilization prior to ILD diagnosis, using electronic lung sounds for early diagnosis, and evaluating consistency of ILD diagnoses across multidisciplinary teams.
4) A final group discussion on other opportunities for collaboration within the ILD working group.
This document provides a summary of selected new evidence relevant to the NICE clinical guideline on the management of chronic obstructive pulmonary disease (COPD) in adults. It discusses 27 pieces of new evidence identified since the literature search was last conducted for the guideline. The evidence is grouped into the following sections: managing stable COPD, management of exacerbations, and areas not currently covered by NICE guidance. For stable COPD, the evidence discusses topics like smoking cessation, inhaled therapy, pulmonary rehabilitation, and vaccination. It finds that smoking cessation benefits may extend to more severe COPD, and counseling plus nicotine replacement or antidepressants can help patients stop smoking. For inhaled therapy, combinations of long-acting beta-
This review examines the clinical diagnosis of acute purulent sinusitis in primary care settings based on 4 studies. The review found that purulent nasal secretions as a symptom or sign, pain in the teeth, and a two-phase illness history were associated with acute purulent sinusitis. An elevated erythrocyte sedimentation rate and C-reactive protein level also contributed to the diagnosis when evaluated in the studies.
Chu et al. (2015)
The study reviewed 14 clinical studies that used quantitative sensory testing to detect hyperalgesia in chronic pain patients on long-term opioids. Most sensory modalities tested, including cold, heat, pressure, electrical, ischemic, and injection pain, failed to demonstrate hypersensitivity to test stimuli. Heat pain sensitivity showed some promising results in detecting hyperalgesia, but none of the measures reviewed met the criteria as a definitive standard. Additional studies with improved designs are needed.
The document provides guidelines for the management of thyrotoxicosis from the American Thyroid Association and American Association of Clinical Endocrinologists task force. It includes 100 evidence-based recommendations on topics such as the initial evaluation and diagnosis of thyrotoxicosis, management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery, and management of toxic multinodular goiter or toxic adenoma. The task force developed the recommendations based on a systematic review of the literature and expert consensus using a standardized grading system for strength of recommendations and quality of evidence.
ATS Symposium: Leukotriene Antagonists As First-line Asthma Controller For St...Zoe Mitchell
ATS Symposium session presented by Prof. David Price:
Leukotriene Antagonists As First-line Asthma Controller For Step 2
Presented May 2015 at ATS 2015, Denver, Colorado, USA
This study evaluated inhalation techniques in 60 patients with asthma or COPD using inhalers over 6 months. Most errors were related to holding breath after use and holding the inhaler upright. Post-intervention to educate on proper technique, patients' inhaler use improved. Common drugs prescribed were short-acting bronchodilators and corticosteroids. The study demonstrates the importance of educating patients on proper inhaler technique to improve treatment effectiveness.
This document is a doctoral dissertation that examines ways to improve the quality of life of patients with schizophrenia in acute psychiatric wards. It includes four studies: 1) Exploring patients' subjective quality of life, 2) Comparing two quality of life instruments, 3) Examining patients' and nurses' perceptions of interventions to support quality of life, and 4) Comparing the effects of three patient education methods on quality of life. Key findings include patients identifying health, family, leisure, work and social relationships as important quality of life areas. Both quality of life instruments showed moderate to good reliability and validity for use with schizophrenia patients. Six nursing interventions for quality of life support were identified. Patient education improved quality of life significantly
REG COPD Control Working Group MeetingZoe Mitchell
1. The REG COPD Control Working Group met on May 17th in Denver, Colorado to discuss plans to validate the concept of control in COPD through several research studies.
2. These included a non-interventional database study using the UK OPCRD, two Spanish pilot studies on changes in control versus severity and symptoms, and an international prospective study to validate the concept of control.
3. The group discussed objectives, timelines, and plans for implementation of these validation studies, as well as identifying new areas of research and disseminating results. The goal was to establish control as a valid concept that could help guide treatment decisions and motivate patients.
This document provides a summary of asthma management and prevention guidelines from the Global Initiative for Asthma (GINA). It discusses diagnosing asthma based on symptoms and lung function tests. It classifies asthma control into controlled, partly controlled, and uncontrolled. It outlines four components of asthma care: developing a patient-doctor partnership through education and action plans; identifying and reducing risk factors; assessing, treating, and monitoring asthma; and managing exacerbations. Treatment is based on a stepwise approach to achieve control. The document provides guidance on special considerations, medications, and references other GINA resources.
This document discusses how randomized clinical trials that use fixed treatment protocols can produce unintended consequences and invalidate study results when current clinical practice involves titrating treatment based on patient characteristics and disease severity. Two such studies, TRICC and ARMA, are examined. For both, the document argues the trials' results were influenced by "practice misalignments" that occurred when subgroups of patients received treatment levels contrary to standard practice based on their individual presentation. This calls into question whether the studies' conclusions reflect how patients are actually treated and responds to in clinical settings. Better trial design is needed to minimize such misalignments, potentially through methods like simulating standard practices or including a current practices comparison arm.
home based pulmonaRY REHABILITATION IN COPDSurendra Ojha
This randomized study evaluated the impact of a home-based pulmonary rehabilitation program for subjects with COPD compared to a control group. The home-based program consisted of walking, stair climbing, and arm exercises performed 3 times per week for 24 sessions. The home-based group showed significant improvements in the 6-minute walk test distance (65m increase) and treadmill endurance time (316m increase) compared to no significant changes in the control group. The home-based group also had improvements in all domains of a quality of life questionnaire, while the control group did not change. The study demonstrates that a simple, low-cost home-based pulmonary rehabilitation program can improve exercise capacity and quality of life for subjects with COPD
This document provides an overview of a study examining anthroposophic medicine as practiced in six UK general practices and one residential clinic. The study used qualitative methods including interviews and medical record analysis to understand how anthroposophic medicine is delivered and its impact on patients. Key findings include:
- Anthroposophic medicine uses a variety of non-drug therapies along with special herbal and homeopathic medicines. Therapies include massage, eurythmy (movement), art, music and counseling.
- Practices have been providing these treatments for 5-50 years, with services expanding over time. Treatments are funded through the NHS, patient fees, and charitable donations.
-
This document discusses ethics in medical research. It begins by outlining the lesson objectives which are to explain ethics, describe important historical events related to research ethics, list important guidelines, describe informed consent, and describe the role of institutional ethics committees. It then discusses the definition of ethics, important historical incidents like the Nuremberg trials, Thalidomide tragedy, and Tuskegee syphilis experiment. It also describes key documents that outline research ethics guidelines like the Nuremberg Code, Helsinki Declaration, ICH Guidelines, and ICMR Guidelines. It concludes by explaining informed consent and the responsibilities of institutional ethics committees in research.
Outcomes in Long-term Opioid Tapering and Buprenorphine Transition: A Retrosp...Paul Coelho, MD
This study analyzed outcomes for 240 patients with chronic pain who were prescribed long-term opioid therapy above 90 mg morphine-equivalent daily doses. Patients were offered an outpatient opioid taper or transition to buprenorphine if taper was not tolerated. 44.6% successfully tapered, 18.8% transitioned to buprenorphine, and 36.6% dropped out of treatment. Higher initial opioid doses predicted needing buprenorphine, and benzodiazepine/z-drug use predicted greater dropout. Pain intensity changes after treatment were mixed, with over half of tapered patients reporting increased pain and about half of transitioned patients reporting decreased pain.
REG ACOS Working Group Meeting 25/09/15Zoe Mitchell
The document outlines plans for a proof of concept study to estimate the prevalence of Asthma-COPD Overlap Syndrome (ACOS) using different population datasets and case definitions. It describes four population groups - COPD diagnosis, ACOS diagnosis, asthma diagnosis, and no diagnosis of asthma or COPD - that will be analyzed in eight available databases to compare ACOS prevalence between definitions. The Optimum Patient Care Research Database pilot data will also be used as a case study to categorize patients as COPD, asthma, or ACOS based on coded consultation reasons to identify overlap between the conditions.
This study assessed the safety and efficacy of the herbal cough syrup Mykoff in 50 patients with coughs of various causes. 84% of patients experienced excellent or good relief of cough symptoms. Cough severity, frequency, chest discomfort and sputum quantity all significantly decreased over the course of treatment. Most patients found the remedy acceptable. Only one adverse event occurred, deemed unlikely related to the medication. The study concluded that Mykoff is an effective and safe treatment for coughs of short duration from various etiologies.
This randomized, double-blind, placebo-controlled clinical trial tested whether a genetically-informed biomarker of nicotine metabolism (nicotine metabolite ratio or NMR) could predict responses to nicotine patch or varenicline for smoking cessation. 1246 smokers were randomized to receive placebo, nicotine patch, or varenicline. The primary outcome was 7-day point abstinence at end of treatment. For normal metabolizers, varenicline was more effective than nicotine patch, but for slow metabolizers there was no difference. Secondary outcomes and side effects also varied by treatment and NMR group. The authors concluded the NMR may help direct therapy selection to increase quit rates while decreasing side effects.
The document is the proceedings from the Australian Smoking Cessation Conference in 2013. It includes:
- An introduction welcoming attendees and emphasizing the theme of translating science into clinical practice.
- An overview by the Scientific Committee of the diverse and innovative abstracts presented on topics like tailored smoking cessation methods, novel uses of nicotine replacement therapy, and programs for vulnerable groups.
- Invited speaker abstracts on topics such as integrated treatment for substance users, a smoking cessation project for pregnant smokers, smoking rates and interventions for Aboriginal people, adolescent tobacco dependence and cessation approaches.
This poster was presented at the 45th Union World Conference on Lung Health in 2014. It outlines the interim findings of a study that tests behaviour change interventions aimed at lung health patients in Nepal
1) The study aims to evaluate the effectiveness of a smoking cessation program called TABADO for adolescents aged 15-20 in vocational training centers in France.
2) The program combines pharmacological therapy and cognitive behavioral therapy. It will be offered to the intervention group of 1000 trainees and compared to a control group of 1000 trainees receiving usual care.
3) The primary outcome is tobacco abstinence rate at 12 months follow up, as measured for all students regardless of program participation. Secondary outcomes include smoking prevalence and withdrawal rates.
Smoking cessation should be a priority for all smokers and healthcare providers should routinely evaluate smoking status and offer treatments. The document outlines smoking as an addiction that requires both brief interventions and more intensive behavioral and pharmacological treatments to increase chances of long term abstinence. It emphasizes treating tobacco dependence as a primary disorder and implementing systems to ensure all smokers are identified and receive evidence-based cessation support.
Perceived feasibility of a primary care interventionTanja Tomson
The document discusses a qualitative study that explored the perceived feasibility of a Tobacco Cessation on Prescription (TCP) intervention in Swedish primary care, targeting disadvantaged groups. Semi-structured interviews were conducted with 32 participants, including tobacco users, healthcare providers, and experts in lifestyle interventions. Interviewees suggested that TCP should include the client's information, evidence-based cessation options and choices for follow-up. They also proposed including empowerment and planning tools, as well as information on the health benefits of quitting. Perceived advantages of TCP included increased motivation to quit and support from the healthcare system. Providers saw advantages related to improved documentation and treatment facilitation. Disadvantages were mainly connected to future implementation challenges. Overall
Reducing Tobacco Use Among Adolescents Using Social Cognitive Theory and Soci...Shauna Ayres, MPH, CHES
This document discusses reducing tobacco use among adolescents using Social Cognitive Theory (SCT) and Social Network Theory (SNT). It summarizes key aspects of SCT, including its focus on personal, behavioral, and environmental factors that influence health behaviors. Studies discussed found targeting self-efficacy, normative beliefs, and intentions through programs and policies were effective in preventing or reducing tobacco use. The document suggests using a multi-strategy approach incorporating several SCT constructs is most effective for interventions.
1) Smoking rates are significantly higher among people living with HIV (PLHIV) compared to the general population, and smoking is associated with increased health risks for PLHIV such as lung and other infections.
2) Effective smoking cessation interventions for PLHIV include brief advice from healthcare providers combined with pharmacotherapy and behavioral support. Tailoring interventions to specific groups can improve effectiveness.
3) Interventions targeting social networks and contexts, such as the LGBTQ community, show promise for supporting smoking cessation among HIV-positive individuals.
ATS Symposium: Leukotriene Antagonists As First-line Asthma Controller For St...Zoe Mitchell
ATS Symposium session presented by Prof. David Price:
Leukotriene Antagonists As First-line Asthma Controller For Step 2
Presented May 2015 at ATS 2015, Denver, Colorado, USA
This study evaluated inhalation techniques in 60 patients with asthma or COPD using inhalers over 6 months. Most errors were related to holding breath after use and holding the inhaler upright. Post-intervention to educate on proper technique, patients' inhaler use improved. Common drugs prescribed were short-acting bronchodilators and corticosteroids. The study demonstrates the importance of educating patients on proper inhaler technique to improve treatment effectiveness.
This document is a doctoral dissertation that examines ways to improve the quality of life of patients with schizophrenia in acute psychiatric wards. It includes four studies: 1) Exploring patients' subjective quality of life, 2) Comparing two quality of life instruments, 3) Examining patients' and nurses' perceptions of interventions to support quality of life, and 4) Comparing the effects of three patient education methods on quality of life. Key findings include patients identifying health, family, leisure, work and social relationships as important quality of life areas. Both quality of life instruments showed moderate to good reliability and validity for use with schizophrenia patients. Six nursing interventions for quality of life support were identified. Patient education improved quality of life significantly
REG COPD Control Working Group MeetingZoe Mitchell
1. The REG COPD Control Working Group met on May 17th in Denver, Colorado to discuss plans to validate the concept of control in COPD through several research studies.
2. These included a non-interventional database study using the UK OPCRD, two Spanish pilot studies on changes in control versus severity and symptoms, and an international prospective study to validate the concept of control.
3. The group discussed objectives, timelines, and plans for implementation of these validation studies, as well as identifying new areas of research and disseminating results. The goal was to establish control as a valid concept that could help guide treatment decisions and motivate patients.
This document provides a summary of asthma management and prevention guidelines from the Global Initiative for Asthma (GINA). It discusses diagnosing asthma based on symptoms and lung function tests. It classifies asthma control into controlled, partly controlled, and uncontrolled. It outlines four components of asthma care: developing a patient-doctor partnership through education and action plans; identifying and reducing risk factors; assessing, treating, and monitoring asthma; and managing exacerbations. Treatment is based on a stepwise approach to achieve control. The document provides guidance on special considerations, medications, and references other GINA resources.
This document discusses how randomized clinical trials that use fixed treatment protocols can produce unintended consequences and invalidate study results when current clinical practice involves titrating treatment based on patient characteristics and disease severity. Two such studies, TRICC and ARMA, are examined. For both, the document argues the trials' results were influenced by "practice misalignments" that occurred when subgroups of patients received treatment levels contrary to standard practice based on their individual presentation. This calls into question whether the studies' conclusions reflect how patients are actually treated and responds to in clinical settings. Better trial design is needed to minimize such misalignments, potentially through methods like simulating standard practices or including a current practices comparison arm.
home based pulmonaRY REHABILITATION IN COPDSurendra Ojha
This randomized study evaluated the impact of a home-based pulmonary rehabilitation program for subjects with COPD compared to a control group. The home-based program consisted of walking, stair climbing, and arm exercises performed 3 times per week for 24 sessions. The home-based group showed significant improvements in the 6-minute walk test distance (65m increase) and treadmill endurance time (316m increase) compared to no significant changes in the control group. The home-based group also had improvements in all domains of a quality of life questionnaire, while the control group did not change. The study demonstrates that a simple, low-cost home-based pulmonary rehabilitation program can improve exercise capacity and quality of life for subjects with COPD
This document provides an overview of a study examining anthroposophic medicine as practiced in six UK general practices and one residential clinic. The study used qualitative methods including interviews and medical record analysis to understand how anthroposophic medicine is delivered and its impact on patients. Key findings include:
- Anthroposophic medicine uses a variety of non-drug therapies along with special herbal and homeopathic medicines. Therapies include massage, eurythmy (movement), art, music and counseling.
- Practices have been providing these treatments for 5-50 years, with services expanding over time. Treatments are funded through the NHS, patient fees, and charitable donations.
-
This document discusses ethics in medical research. It begins by outlining the lesson objectives which are to explain ethics, describe important historical events related to research ethics, list important guidelines, describe informed consent, and describe the role of institutional ethics committees. It then discusses the definition of ethics, important historical incidents like the Nuremberg trials, Thalidomide tragedy, and Tuskegee syphilis experiment. It also describes key documents that outline research ethics guidelines like the Nuremberg Code, Helsinki Declaration, ICH Guidelines, and ICMR Guidelines. It concludes by explaining informed consent and the responsibilities of institutional ethics committees in research.
Outcomes in Long-term Opioid Tapering and Buprenorphine Transition: A Retrosp...Paul Coelho, MD
This study analyzed outcomes for 240 patients with chronic pain who were prescribed long-term opioid therapy above 90 mg morphine-equivalent daily doses. Patients were offered an outpatient opioid taper or transition to buprenorphine if taper was not tolerated. 44.6% successfully tapered, 18.8% transitioned to buprenorphine, and 36.6% dropped out of treatment. Higher initial opioid doses predicted needing buprenorphine, and benzodiazepine/z-drug use predicted greater dropout. Pain intensity changes after treatment were mixed, with over half of tapered patients reporting increased pain and about half of transitioned patients reporting decreased pain.
REG ACOS Working Group Meeting 25/09/15Zoe Mitchell
The document outlines plans for a proof of concept study to estimate the prevalence of Asthma-COPD Overlap Syndrome (ACOS) using different population datasets and case definitions. It describes four population groups - COPD diagnosis, ACOS diagnosis, asthma diagnosis, and no diagnosis of asthma or COPD - that will be analyzed in eight available databases to compare ACOS prevalence between definitions. The Optimum Patient Care Research Database pilot data will also be used as a case study to categorize patients as COPD, asthma, or ACOS based on coded consultation reasons to identify overlap between the conditions.
This study assessed the safety and efficacy of the herbal cough syrup Mykoff in 50 patients with coughs of various causes. 84% of patients experienced excellent or good relief of cough symptoms. Cough severity, frequency, chest discomfort and sputum quantity all significantly decreased over the course of treatment. Most patients found the remedy acceptable. Only one adverse event occurred, deemed unlikely related to the medication. The study concluded that Mykoff is an effective and safe treatment for coughs of short duration from various etiologies.
This randomized, double-blind, placebo-controlled clinical trial tested whether a genetically-informed biomarker of nicotine metabolism (nicotine metabolite ratio or NMR) could predict responses to nicotine patch or varenicline for smoking cessation. 1246 smokers were randomized to receive placebo, nicotine patch, or varenicline. The primary outcome was 7-day point abstinence at end of treatment. For normal metabolizers, varenicline was more effective than nicotine patch, but for slow metabolizers there was no difference. Secondary outcomes and side effects also varied by treatment and NMR group. The authors concluded the NMR may help direct therapy selection to increase quit rates while decreasing side effects.
The document is the proceedings from the Australian Smoking Cessation Conference in 2013. It includes:
- An introduction welcoming attendees and emphasizing the theme of translating science into clinical practice.
- An overview by the Scientific Committee of the diverse and innovative abstracts presented on topics like tailored smoking cessation methods, novel uses of nicotine replacement therapy, and programs for vulnerable groups.
- Invited speaker abstracts on topics such as integrated treatment for substance users, a smoking cessation project for pregnant smokers, smoking rates and interventions for Aboriginal people, adolescent tobacco dependence and cessation approaches.
This poster was presented at the 45th Union World Conference on Lung Health in 2014. It outlines the interim findings of a study that tests behaviour change interventions aimed at lung health patients in Nepal
1) The study aims to evaluate the effectiveness of a smoking cessation program called TABADO for adolescents aged 15-20 in vocational training centers in France.
2) The program combines pharmacological therapy and cognitive behavioral therapy. It will be offered to the intervention group of 1000 trainees and compared to a control group of 1000 trainees receiving usual care.
3) The primary outcome is tobacco abstinence rate at 12 months follow up, as measured for all students regardless of program participation. Secondary outcomes include smoking prevalence and withdrawal rates.
Smoking cessation should be a priority for all smokers and healthcare providers should routinely evaluate smoking status and offer treatments. The document outlines smoking as an addiction that requires both brief interventions and more intensive behavioral and pharmacological treatments to increase chances of long term abstinence. It emphasizes treating tobacco dependence as a primary disorder and implementing systems to ensure all smokers are identified and receive evidence-based cessation support.
Perceived feasibility of a primary care interventionTanja Tomson
The document discusses a qualitative study that explored the perceived feasibility of a Tobacco Cessation on Prescription (TCP) intervention in Swedish primary care, targeting disadvantaged groups. Semi-structured interviews were conducted with 32 participants, including tobacco users, healthcare providers, and experts in lifestyle interventions. Interviewees suggested that TCP should include the client's information, evidence-based cessation options and choices for follow-up. They also proposed including empowerment and planning tools, as well as information on the health benefits of quitting. Perceived advantages of TCP included increased motivation to quit and support from the healthcare system. Providers saw advantages related to improved documentation and treatment facilitation. Disadvantages were mainly connected to future implementation challenges. Overall
Reducing Tobacco Use Among Adolescents Using Social Cognitive Theory and Soci...Shauna Ayres, MPH, CHES
This document discusses reducing tobacco use among adolescents using Social Cognitive Theory (SCT) and Social Network Theory (SNT). It summarizes key aspects of SCT, including its focus on personal, behavioral, and environmental factors that influence health behaviors. Studies discussed found targeting self-efficacy, normative beliefs, and intentions through programs and policies were effective in preventing or reducing tobacco use. The document suggests using a multi-strategy approach incorporating several SCT constructs is most effective for interventions.
1) Smoking rates are significantly higher among people living with HIV (PLHIV) compared to the general population, and smoking is associated with increased health risks for PLHIV such as lung and other infections.
2) Effective smoking cessation interventions for PLHIV include brief advice from healthcare providers combined with pharmacotherapy and behavioral support. Tailoring interventions to specific groups can improve effectiveness.
3) Interventions targeting social networks and contexts, such as the LGBTQ community, show promise for supporting smoking cessation among HIV-positive individuals.
This document provides an overview of evidence-based strategies for preventing opioid overdose that are working in the United States. It begins with an introduction describing the purpose and creation of the document. It then outlines four guiding principles for effective overdose prevention strategies: 1) Know your epidemic and response; 2) Make collaboration your strategy; 3) Nothing about us without us; and 4) Meet people where they are. The document concludes by describing nine evidence-based strategies for preventing overdose, with the first being targeted naloxone distribution. Targeted naloxone distribution programs equip individuals at high risk of witnessing an overdose, such as people who use drugs and first responders, with naloxone kits to
This document rebuts 9 common arguments made against providing tobacco dependence treatment in hospital settings. It discusses how each argument misrepresents key facts about addiction, the efficacy of smoking cessation treatments, and the benefits of quitting smoking. The document aims to equip tobacco control advocates with strong counterarguments to respond to opposition against offering tobacco dependence treatment in healthcare facilities.
My Research Report Study About the prevalence of smoking in Health Care Provi...Dr Asad A. Babar
- The document summarizes a study on the prevalence of smoking among healthcare providers at Wapda Teaching Hospital Complex in Lahore, Pakistan.
- A total of 90 healthcare workers were surveyed using questionnaires between June-July 2012. The results found that 32 respondents (35.6%) were current smokers while 58 (64.4%) were non-smokers.
- The majority of smokers started for personal reasons like pleasure, with most smoking 1-10 cigarettes per day. Approximately half had smoking friends while 16% had restarted smoking after quitting previously.
- While most respondents were aware of smoking's health risks and their institution's non-smoking policy, the study concluded that efforts are
1) Tobacco smoking remains the leading preventable cause of disease and death worldwide. While smoking rates have decreased in developed countries, certain high risk groups have greater difficulty quitting.
2) Brief advice from doctors and other healthcare professionals on smoking cessation can more than double quit rates compared to no advice. Comprehensive treatment involving both behavioral support and pharmacotherapy is most effective for treating nicotine dependence.
3) Effective cessation medications include nicotine replacement therapy, varenicline, bupropion, and others depending on location. Behavioral support through counseling, telephone quitlines, internet programs, and motivational interviewing can also significantly increase success rates.
A harm minimization approach to substance abuse treatment has three main objectives: 1) To minimize harm to individuals and communities from drug use, 2) To reduce hazardous drug use patterns in the community, and 3) To prevent initiation of harmful drug use especially among youth. Examples of harm reduction strategies include needle exchange programs, opioid substitution therapy, and overdose prevention programs. Research on therapeutic communities shows benefits for those who complete treatment, though dropout rates are high, suggesting multiple treatment attempts may be needed. Relapse prevention therapy aims to reduce relapse risk by addressing cravings, thoughts, and high-risk situations. Effective substance abuse treatment is individualized, readily available, and addresses multiple needs through continual assessment and modification.
This study performed a systematic review to identify evidence-based guidelines for the management of adult tracheostomy patients. A search of several databases and websites yielded 80 guidelines, of which only 5 met criteria for rigorous development. Of those, 3 addressed the full spectrum of tracheostomy care. The results indicate a lack of high-quality evidence-based guidelines for tracheostomy management, highlighting a need for more clinical research and international consensus on best practices.
This document discusses treatment options for alcohol use disorders. It notes that while treatment options have expanded beyond 12-step programs like Alcoholics Anonymous, most people with alcohol use disorders remain untreated. It summarizes recent research exploring improved diagnosis, medications, behavioral therapies, and ways to broaden treatment access, such as through primary care settings and emerging technologies like online therapy programs.
The australian quit coach published versionAlexander Li
The document compares users of the QuitCoach, an online smoking cessation program, to smokers in general and users of telephone quitlines. It finds that QuitCoach users are more likely to be female, younger, and have higher daily cigarette consumption than average smokers. QuitCoach users are also younger than quitline users, though less likely to be under 20. Half of QuitCoach users access it after setting a quit date. Usage increases during periods of anti-smoking advertising campaigns. The study concludes the QuitCoach successfully targets moderately addicted smokers but more promotion is needed to increase awareness and usage.
Brief Interventions for alcohol problems. OECD meeting.Antoni Gual
Lecture on efficacy & effectiveness of Brief Interventions for Alcohol problems, given in to the OECD - HEALTH COMMITTEE, 16th Session.PARIS, DECEMBER 9th, 2014
NICE provides national guidance on promoting good health and preventing disease. It produces public health guidance on issues like substance abuse in young people. The guidance development process involves scoping the issue, reviewing evidence, developing recommendations, and allowing public consultation. Current public health guidance topics under development include alcohol education in schools and preventing youth smoking.
MICAS is a brief questionnaire which clients can fill out. As a result, the fidelity of their coach/HCP in the delivery of motivational interviewing will be reliably measured, within the framework of physical activity stimulation.
Addiction and Motivation; what works?
Presentation at the 2012 Europad conference in Barcelona.
Three main points:
- Evidence base for Motivational Interviewing
- Practitioner competency
- Implementation issues
1) Motivational interviewing (MI) arose from research on therapist empathy that found empathy strongly predicted client drinking outcomes.
2) MI was then developed as a clinical method focused on differentially responding to client speech to evoke and strengthen their own motivations for change.
3) Research found that MI alone or added to other treatments significantly increased client abstinence and retention in treatment programs for substance use issues. However, outcomes have varied across populations and studies.
Motivational Interviewing is an approach that uses a guiding style to engage patients and elicit their own motivations for behavior change. It has been shown to be effective across healthcare settings. Key aspects include practicing an engaging rather than directing style, developing strategies to understand patient motivations, and refining listening skills to encourage change talk. The approach aims to promote patient autonomy and work with their strengths to find solutions, rather than just focusing on problems.
This document introduces the inaugural issue of the journal Motivational Interviewing: Training, Research, Implementation, Practice. It provides a brief history of publications related to motivational interviewing, from the original Motivational Interviewing Newsletter for Trainers to the current journal. It explains that the journal aims to provide an outlet for the worldwide MI community and allow communication among members. The introduction welcomes readers and contributors to share in the open and creative spirit that characterizes both MI and its community.
The study analyzed weekly hospital admissions data in England from 2002-2008 to assess the short-term impact of smoke-free legislation introduced in July 2007. It found:
1) After adjusting for trends, seasonality, population size, temperature, and flu rates, emergency admissions for myocardial infarction (heart attacks) decreased by 2.4% (equivalent to 1,200 fewer admissions) following the legislation.
2) The reduction was greater in men and women aged 60 and over (3.1% for men, 3.8% for women) than in younger groups, though men under 60 also saw a significant decrease.
3) In total, the legislation was estimated to have prevented around 1,600
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.