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
This document discusses smoking cessation strategies for patients with chronic obstructive pulmonary disease (COPD). It notes that cigarette smoking is highly addictive and the main cause of COPD. Effective smoking cessation is critical for improving outcomes for COPD patients. The document recommends that clinicians use a 5 A's approach to routinely ask about smoking status, advise patients to quit, assess willingness to quit, assist with treatment options, and arrange follow-up support. Pharmacotherapy combined with behavioral counseling is most effective for smoking cessation. Individualized treatment should address nicotine dependence and withdrawal symptoms.
This document summarizes a study on drug utilization patterns in patients with burns over 15% of their total body surface area admitted to a tertiary hospital burn ward in Nashik, India. A total of 50 patients were included in the study, with an average burn percentage of 61.96%. The mortality rate was found to be 20% for burns under 40% TBSA, 33% for 40-60% TBSA, and 95% for over 60% TBSA. The most commonly prescribed drugs were Ringer's Lactate, gentamicin, ranitidine, metronidazole, cefoperazone + sulbactam, and ciprofloxacin. The drug utilization 90% included
This study evaluated a nurse-led telephone intervention to support patients with chronic obstructive pulmonary disease (COPD) in managing their condition. 73 patients were randomly assigned to either receive standard care including a self-management plan, or to receive the self-management plan plus two telephone calls from a nurse over six weeks. The telephone calls provided education on using their self-management plan and managing exacerbations. The primary outcome was COPD symptom severity assessed before and after with the COPD Assessment Tool (CAT). Secondary outcomes included self-reported exacerbations and healthcare utilization. CAT scores significantly improved in the intervention group but not the control group. There were no significant differences in exacerbations between groups. Patient satisfaction did not differ significantly between groups
This document summarizes a study that tested the effectiveness of a brief smoking cessation intervention for surgical patients. The intervention included brief counseling, smoking cessation brochures, free nicotine patches, and referral to a quitline. It significantly increased smoking abstinence before and after surgery compared to standard care. The results suggest that even relatively simple interventions can help many surgical patients quit smoking long-term.
This study protocol describes a cluster-randomized controlled trial that will evaluate the effectiveness and cost-effectiveness of Tobacco Cessation on Prescription (TCP) compared to standard treatment for tobacco cessation in Swedish primary health care centers. Primary health care centers located in socioeconomically disadvantaged areas will be randomized to provide either TCP, which involves counseling and an individualized prescription, or standard treatment. The primary outcome is 7-day abstinence from tobacco use at 6 months. Secondary outcomes include daily tobacco consumption, quit attempts, and quality of life at 6 and 12 months. If found to be effective and cost-effective, TCP could be implemented to help more socioeconomically disadvantaged tobacco users quit.
This study investigated the association between the duration of pharmacotherapy use and successful smoking cessation using a national survey of US smokers. The study found that smokers who used prescription medication or nicotine replacement therapy (NRT) for 5+ weeks had significantly higher adjusted cessation rates of 28.8% and 27.8% respectively, compared to rates ranging from 6.2% to 14.5% for durations under 5 weeks. Smokers using only behavioral counseling or no aid had similar adjusted rates of around 16%. The results suggest that encouraging smokers to use pharmacotherapy for the recommended duration of at least 5 weeks can improve their chances of successfully quitting smoking.
This document summarizes recommendations from major clinical guidelines regarding screening for nutrition-related conditions. It reviews guidelines from the Canadian Task Force on Preventative Health Care, US Preventative Services Task Force, and Canadian Diabetes Clinical Guidelines. The recommendations are organized by age group and include the grade of recommendation and level of evidence. Several evidence-based screening recommendations are highlighted, such as screening newborns for PKU and hemoglobin screening for high-risk pregnant women. The tables provide a useful reference for practitioners on nutrition screening and suggested interventions.
We observed that 59% centers had staining facilities at the center. In 99% centers they had medicine
available all the time. 76% patients stated that the distance between centers and their residences is <1 kilometer. 97%
centers had accessible road to the centers. 76% providers knew consequences of treatment failure. 31% patients knew
the mode of transmission. 1% patients knew the duration of treatment. 73% patients knew consequences of treatment
failure.
This document discusses smoking cessation strategies for patients with chronic obstructive pulmonary disease (COPD). It notes that cigarette smoking is highly addictive and the main cause of COPD. Effective smoking cessation is critical for improving outcomes for COPD patients. The document recommends that clinicians use a 5 A's approach to routinely ask about smoking status, advise patients to quit, assess willingness to quit, assist with treatment options, and arrange follow-up support. Pharmacotherapy combined with behavioral counseling is most effective for smoking cessation. Individualized treatment should address nicotine dependence and withdrawal symptoms.
This document summarizes a study on drug utilization patterns in patients with burns over 15% of their total body surface area admitted to a tertiary hospital burn ward in Nashik, India. A total of 50 patients were included in the study, with an average burn percentage of 61.96%. The mortality rate was found to be 20% for burns under 40% TBSA, 33% for 40-60% TBSA, and 95% for over 60% TBSA. The most commonly prescribed drugs were Ringer's Lactate, gentamicin, ranitidine, metronidazole, cefoperazone + sulbactam, and ciprofloxacin. The drug utilization 90% included
This study evaluated a nurse-led telephone intervention to support patients with chronic obstructive pulmonary disease (COPD) in managing their condition. 73 patients were randomly assigned to either receive standard care including a self-management plan, or to receive the self-management plan plus two telephone calls from a nurse over six weeks. The telephone calls provided education on using their self-management plan and managing exacerbations. The primary outcome was COPD symptom severity assessed before and after with the COPD Assessment Tool (CAT). Secondary outcomes included self-reported exacerbations and healthcare utilization. CAT scores significantly improved in the intervention group but not the control group. There were no significant differences in exacerbations between groups. Patient satisfaction did not differ significantly between groups
This document summarizes a study that tested the effectiveness of a brief smoking cessation intervention for surgical patients. The intervention included brief counseling, smoking cessation brochures, free nicotine patches, and referral to a quitline. It significantly increased smoking abstinence before and after surgery compared to standard care. The results suggest that even relatively simple interventions can help many surgical patients quit smoking long-term.
This study protocol describes a cluster-randomized controlled trial that will evaluate the effectiveness and cost-effectiveness of Tobacco Cessation on Prescription (TCP) compared to standard treatment for tobacco cessation in Swedish primary health care centers. Primary health care centers located in socioeconomically disadvantaged areas will be randomized to provide either TCP, which involves counseling and an individualized prescription, or standard treatment. The primary outcome is 7-day abstinence from tobacco use at 6 months. Secondary outcomes include daily tobacco consumption, quit attempts, and quality of life at 6 and 12 months. If found to be effective and cost-effective, TCP could be implemented to help more socioeconomically disadvantaged tobacco users quit.
This study investigated the association between the duration of pharmacotherapy use and successful smoking cessation using a national survey of US smokers. The study found that smokers who used prescription medication or nicotine replacement therapy (NRT) for 5+ weeks had significantly higher adjusted cessation rates of 28.8% and 27.8% respectively, compared to rates ranging from 6.2% to 14.5% for durations under 5 weeks. Smokers using only behavioral counseling or no aid had similar adjusted rates of around 16%. The results suggest that encouraging smokers to use pharmacotherapy for the recommended duration of at least 5 weeks can improve their chances of successfully quitting smoking.
This document summarizes recommendations from major clinical guidelines regarding screening for nutrition-related conditions. It reviews guidelines from the Canadian Task Force on Preventative Health Care, US Preventative Services Task Force, and Canadian Diabetes Clinical Guidelines. The recommendations are organized by age group and include the grade of recommendation and level of evidence. Several evidence-based screening recommendations are highlighted, such as screening newborns for PKU and hemoglobin screening for high-risk pregnant women. The tables provide a useful reference for practitioners on nutrition screening and suggested interventions.
We observed that 59% centers had staining facilities at the center. In 99% centers they had medicine
available all the time. 76% patients stated that the distance between centers and their residences is <1 kilometer. 97%
centers had accessible road to the centers. 76% providers knew consequences of treatment failure. 31% patients knew
the mode of transmission. 1% patients knew the duration of treatment. 73% patients knew consequences of treatment
failure.
This document provides learning outcomes for training stop smoking practitioners. It begins with an introduction outlining the importance of evidence-based behaviour change techniques in smoking cessation support. The document is then divided into two main sections:
1. Knowledge - Outlines the key information practitioners should understand regarding smoking and cessation. This includes topics like health effects, addiction, treatments, and the wider context.
2. Practice - Lists the competencies practitioners require to effectively assess and support clients. This involves skills like motivational interviewing, addressing cravings, promoting medication use, and building rapport. Many outcomes relate to specific behaviour change techniques shown to increase quit rates.
The document establishes a standard for high quality, evidence
This document provides learning outcomes for training stop smoking practitioners. It begins with an introduction explaining the purpose and importance of evidence-based behaviour change techniques in behavioural support.
The document is then divided into two main sections - knowledge and practice. The knowledge section lists learning outcomes related to understanding smoking patterns, health effects, challenges of quitting, and treatments. The practice section outlines competencies for assessing clients, planning support, delivering support techniques to enhance motivation, manage cravings, and use medications effectively.
Sixteen behaviour change techniques are indicated that have the strongest evidence for effectiveness. The goal is to train practitioners to competently deliver an evidence-based intervention that significantly increases a client's chances of successfully quitting smoking
This study evaluated the effectiveness of a semi-tailored facilitator intervention to support implementation of chronic disease management programs in Danish general practices. 189 practices were randomly allocated to receive the intervention in 2011 or 2012. The intervention consisted of up to three one-hour visits from a facilitator to discuss topics related to chronic care. The primary outcome was the number of annual chronic disease checkups per patient. Secondary outcomes included use of diagnostic coding, patient stratification, and other process measures. Results showed no difference between groups for the primary outcome, but some secondary outcomes favored the intervention group, such as higher reported use of diagnostic coding and earlier signup for a patient management software. The authors concluded the low-intensity intervention was unlikely to substantially improve
Stopping over-medication of People with Learning Disabilities
(STOMPLD) 2016.
Reducing Inappropriate Psychotropic Drugs in People with a Learning Disability in General Practice and Hospitals in 2016.
The National Audit of Psychological Therapies for Anxiety and Depression (NAPT) evaluated 357 psychological therapy services in England and Wales between 2010-2011. Key findings included:
- Older adults (ages 65+) were underrepresented in therapy compared to expected prevalence rates.
- 85% of patients met the 18-week waiting time standard, though waiting times varied widely between services and were a frequent concern reported by service users.
- Nearly 49% of patients with pre- and post-treatment measures recovered from their difficulties, though few services achieved effect sizes comparable to clinical trials.
Cochrane reviews: Summarising the best evidence to inform healthcare decisionsCochraneTAG
Talk given at the UKCTAS early career researcher conference Sept 2015 by Jamie Hartmann-Boyce & Nicola Lindson-Hawley of Cochrane Tobacco Addiciton Group
My top 5 papers of 2015-2017 about telehealth in copd managementFrancis Thien
Frank Thien reviewed the top 5 papers from 2015-2017 on the role of telehealth in COPD management. The papers included a review finding variable telehealth models for COPD but more evidence is needed. A large Danish RCT found telehealth did not significantly improve quality of life. A Northern Ireland RCT found telemonitoring improved quality of life but was not cost-effective. A Taiwanese RCT found telemonitoring reduced hospital readmissions. A small Norwegian pilot study found telerehabilitation improved outcomes and was feasible for long-term exercise maintenance. Further research is still needed, particularly on cost-benefit analyses and replicating successful studies.
The document discusses improving quality and productivity in healthcare through initiatives like the Quality, Innovation, Productivity and Prevention (QIPP) program. It examines expanding prescribing and medicines supply roles for allied health professionals, including independent prescribing for physiotherapists and podiatrists, and supplementary prescribing for dietitians. The document also outlines existing mechanisms for patient specific directions, patient group directions, and exemptions that some health professionals can currently use for prescribing, supplying, and administering medicines.
Prescribing, administration and supply of medicines by allied health professi...MS Trust
This presentation by Helen Marriott, AHP Medicines Project Lead, looks at prescribing and medicines supply mechanisms and the AHP Medicines Project.
It was presented at the MS Trust Annual Conference in November 2014.
- This document provides guidance for initial assessment of patients suspected of having pandemic influenza by primary care providers in Fraser Health.
- It outlines recommendations for triaging patients based on illness severity and risk factors. High-risk patients and those with severe symptoms or complications may require hospital admission.
- General advice is given on addressing patient concerns, providing information about the illness and treatment, and guidance on when further medical help is needed. Scoring systems like CRB-65 and CURB-65 are presented to help assess severity of influenza-related pneumonia.
This document describes a study that used action research to develop a feasible lifestyle intervention for patients with prediabetes in primary care settings. The study had two main goals: (1) determine the resources and competencies needed, and (2) identify effective intervention components. It involved two cycles with general practices. The first cycle explored various intervention options, and the second tested the intervention developed in cycle one. In total, 64 patients, 8 GPs, and 10 nurses participated. The study found an intervention involving six consultations over one year was feasible for practices. Nurses had the skills to deliver the core intervention. It led to clinical reductions in patients' BMI and HbA1c. The developed intervention showed potential for diabetes prevention
This study evaluated the perceptions of general practitioners (GPs) and community pharmacists (CPs) in Penang, Malaysia towards consumer reporting of Adverse Drug Reactions (ADRs). A survey was sent to 192 CPs and 400 GPs, with a response rate of 18%. The majority of respondents agreed that consumer reporting would add benefits to existing pharmacovigilance programs and increase knowledge of ADRs. However, many respondents doubted consumers' ability to write valid reports similar to healthcare professionals and believed more consumer education was needed. The study concluded that while respondents recognized the importance of consumer reporting, barriers around consumers' reporting abilities need to be addressed through increased education by media and non-governmental organizations.
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 summarizes two studies that evaluated the effectiveness of capacity building for Health Extension Workers (HEWs) in Tigray, Ethiopia. The studies compared HEWs who received additional training and support through an intervention package to a control group. The intervention led to statistically significant improvements in HEWs' nutrition knowledge, skills, service delivery activities, and screening/referral of malnourished children compared to the control group. Challenges faced by HEWs included insufficient resources, competing demands on their time, lack of support, and inadequate compensation relative to their workload. The intervention package was concluded to be an effective way to build HEW capacity and support implementation of community management of acute malnutrition.
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.
1) The study examined the experiences of practice staff conducting diabetes screening in six general practices as part of a clinical trial.
2) Each practice implemented screening differently depending on staffing levels, workload, and practice size but all emphasized the importance of administrative support.
3) Staff found that screening involved more work than expected and extended beyond just testing to providing health information and advice to patients.
The txt2stop trial assessed the effectiveness of an automated smoking cessation program delivered via mobile phone text messaging. Over 5,800 smokers were randomly assigned to either receive the text messaging intervention providing motivational messages and support or control messages unrelated to quitting. The primary outcome of biochemically verified continuous abstinence at 6 months was significantly higher in the intervention group at 10.7% compared to 4.9% in the control group. The text messaging program significantly improved smoking cessation rates at 6 months and should be considered for inclusion in smoking cessation services.
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
BACKGROUND: Addressing TB in India is critical to meeting global targets. With the scale-up of diagnostic networks and the availability of new TB drugs, India had the opportunity to improve the detection and treatment outcomes in drug-resistant TB (DR-TB).
OBJECTIVE: To document how the introduction of new drugs and regimens is helping India improve the care of DR-TB patients.
DESIGN: In 2016, India´s National TB Programme (NTP) introduced bedaquiline (BDQ) under a Conditional Access Programme (BDQ-CAP) at six sites after providing extensive training and strengthening laboratory testing, pre-treatment evaluation, active drug safety monitoring and management (aDSM) and follow-up systems.
RESULTS: An interim analysis reflected earlier and better culture conversion rates: 83% of the 620 patients converted within a median time of 60 days. However, 248 serious adverse events were reported, including 73 deaths (12%) and 100 cardiotoxicity events (16.3%). Encouraged by the evidence of safety and efficacy of BDQ, the NTP took steps to systematically expand its access to cover the entire population by 2018.
CONCLUSION: The cautious yet focused approach used to introduce BDQ under BDQ-CAP paved the way for the rapid introduction of delamanid, as well as the shorter treatment regimen and the all-oral regimen for DR-TB.
The document discusses using blogging and email marketing together for business. It recommends setting up a blog to collect email subscribers and then nurturing those relationships through regular emailed content. Blogs allow for non-sales focused content that can still drive leads through email capture calls-to-action. Email is a powerful marketing tool as many purchases are inspired by emails, with 50% of purchases based on permission emails. The document provides tips on blogging frequency, content, and integrating blogging with other marketing strategies.
This document provides learning outcomes for training stop smoking practitioners. It begins with an introduction outlining the importance of evidence-based behaviour change techniques in smoking cessation support. The document is then divided into two main sections:
1. Knowledge - Outlines the key information practitioners should understand regarding smoking and cessation. This includes topics like health effects, addiction, treatments, and the wider context.
2. Practice - Lists the competencies practitioners require to effectively assess and support clients. This involves skills like motivational interviewing, addressing cravings, promoting medication use, and building rapport. Many outcomes relate to specific behaviour change techniques shown to increase quit rates.
The document establishes a standard for high quality, evidence
This document provides learning outcomes for training stop smoking practitioners. It begins with an introduction explaining the purpose and importance of evidence-based behaviour change techniques in behavioural support.
The document is then divided into two main sections - knowledge and practice. The knowledge section lists learning outcomes related to understanding smoking patterns, health effects, challenges of quitting, and treatments. The practice section outlines competencies for assessing clients, planning support, delivering support techniques to enhance motivation, manage cravings, and use medications effectively.
Sixteen behaviour change techniques are indicated that have the strongest evidence for effectiveness. The goal is to train practitioners to competently deliver an evidence-based intervention that significantly increases a client's chances of successfully quitting smoking
This study evaluated the effectiveness of a semi-tailored facilitator intervention to support implementation of chronic disease management programs in Danish general practices. 189 practices were randomly allocated to receive the intervention in 2011 or 2012. The intervention consisted of up to three one-hour visits from a facilitator to discuss topics related to chronic care. The primary outcome was the number of annual chronic disease checkups per patient. Secondary outcomes included use of diagnostic coding, patient stratification, and other process measures. Results showed no difference between groups for the primary outcome, but some secondary outcomes favored the intervention group, such as higher reported use of diagnostic coding and earlier signup for a patient management software. The authors concluded the low-intensity intervention was unlikely to substantially improve
Stopping over-medication of People with Learning Disabilities
(STOMPLD) 2016.
Reducing Inappropriate Psychotropic Drugs in People with a Learning Disability in General Practice and Hospitals in 2016.
The National Audit of Psychological Therapies for Anxiety and Depression (NAPT) evaluated 357 psychological therapy services in England and Wales between 2010-2011. Key findings included:
- Older adults (ages 65+) were underrepresented in therapy compared to expected prevalence rates.
- 85% of patients met the 18-week waiting time standard, though waiting times varied widely between services and were a frequent concern reported by service users.
- Nearly 49% of patients with pre- and post-treatment measures recovered from their difficulties, though few services achieved effect sizes comparable to clinical trials.
Cochrane reviews: Summarising the best evidence to inform healthcare decisionsCochraneTAG
Talk given at the UKCTAS early career researcher conference Sept 2015 by Jamie Hartmann-Boyce & Nicola Lindson-Hawley of Cochrane Tobacco Addiciton Group
My top 5 papers of 2015-2017 about telehealth in copd managementFrancis Thien
Frank Thien reviewed the top 5 papers from 2015-2017 on the role of telehealth in COPD management. The papers included a review finding variable telehealth models for COPD but more evidence is needed. A large Danish RCT found telehealth did not significantly improve quality of life. A Northern Ireland RCT found telemonitoring improved quality of life but was not cost-effective. A Taiwanese RCT found telemonitoring reduced hospital readmissions. A small Norwegian pilot study found telerehabilitation improved outcomes and was feasible for long-term exercise maintenance. Further research is still needed, particularly on cost-benefit analyses and replicating successful studies.
The document discusses improving quality and productivity in healthcare through initiatives like the Quality, Innovation, Productivity and Prevention (QIPP) program. It examines expanding prescribing and medicines supply roles for allied health professionals, including independent prescribing for physiotherapists and podiatrists, and supplementary prescribing for dietitians. The document also outlines existing mechanisms for patient specific directions, patient group directions, and exemptions that some health professionals can currently use for prescribing, supplying, and administering medicines.
Prescribing, administration and supply of medicines by allied health professi...MS Trust
This presentation by Helen Marriott, AHP Medicines Project Lead, looks at prescribing and medicines supply mechanisms and the AHP Medicines Project.
It was presented at the MS Trust Annual Conference in November 2014.
- This document provides guidance for initial assessment of patients suspected of having pandemic influenza by primary care providers in Fraser Health.
- It outlines recommendations for triaging patients based on illness severity and risk factors. High-risk patients and those with severe symptoms or complications may require hospital admission.
- General advice is given on addressing patient concerns, providing information about the illness and treatment, and guidance on when further medical help is needed. Scoring systems like CRB-65 and CURB-65 are presented to help assess severity of influenza-related pneumonia.
This document describes a study that used action research to develop a feasible lifestyle intervention for patients with prediabetes in primary care settings. The study had two main goals: (1) determine the resources and competencies needed, and (2) identify effective intervention components. It involved two cycles with general practices. The first cycle explored various intervention options, and the second tested the intervention developed in cycle one. In total, 64 patients, 8 GPs, and 10 nurses participated. The study found an intervention involving six consultations over one year was feasible for practices. Nurses had the skills to deliver the core intervention. It led to clinical reductions in patients' BMI and HbA1c. The developed intervention showed potential for diabetes prevention
This study evaluated the perceptions of general practitioners (GPs) and community pharmacists (CPs) in Penang, Malaysia towards consumer reporting of Adverse Drug Reactions (ADRs). A survey was sent to 192 CPs and 400 GPs, with a response rate of 18%. The majority of respondents agreed that consumer reporting would add benefits to existing pharmacovigilance programs and increase knowledge of ADRs. However, many respondents doubted consumers' ability to write valid reports similar to healthcare professionals and believed more consumer education was needed. The study concluded that while respondents recognized the importance of consumer reporting, barriers around consumers' reporting abilities need to be addressed through increased education by media and non-governmental organizations.
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 summarizes two studies that evaluated the effectiveness of capacity building for Health Extension Workers (HEWs) in Tigray, Ethiopia. The studies compared HEWs who received additional training and support through an intervention package to a control group. The intervention led to statistically significant improvements in HEWs' nutrition knowledge, skills, service delivery activities, and screening/referral of malnourished children compared to the control group. Challenges faced by HEWs included insufficient resources, competing demands on their time, lack of support, and inadequate compensation relative to their workload. The intervention package was concluded to be an effective way to build HEW capacity and support implementation of community management of acute malnutrition.
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.
1) The study examined the experiences of practice staff conducting diabetes screening in six general practices as part of a clinical trial.
2) Each practice implemented screening differently depending on staffing levels, workload, and practice size but all emphasized the importance of administrative support.
3) Staff found that screening involved more work than expected and extended beyond just testing to providing health information and advice to patients.
The txt2stop trial assessed the effectiveness of an automated smoking cessation program delivered via mobile phone text messaging. Over 5,800 smokers were randomly assigned to either receive the text messaging intervention providing motivational messages and support or control messages unrelated to quitting. The primary outcome of biochemically verified continuous abstinence at 6 months was significantly higher in the intervention group at 10.7% compared to 4.9% in the control group. The text messaging program significantly improved smoking cessation rates at 6 months and should be considered for inclusion in smoking cessation services.
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
BACKGROUND: Addressing TB in India is critical to meeting global targets. With the scale-up of diagnostic networks and the availability of new TB drugs, India had the opportunity to improve the detection and treatment outcomes in drug-resistant TB (DR-TB).
OBJECTIVE: To document how the introduction of new drugs and regimens is helping India improve the care of DR-TB patients.
DESIGN: In 2016, India´s National TB Programme (NTP) introduced bedaquiline (BDQ) under a Conditional Access Programme (BDQ-CAP) at six sites after providing extensive training and strengthening laboratory testing, pre-treatment evaluation, active drug safety monitoring and management (aDSM) and follow-up systems.
RESULTS: An interim analysis reflected earlier and better culture conversion rates: 83% of the 620 patients converted within a median time of 60 days. However, 248 serious adverse events were reported, including 73 deaths (12%) and 100 cardiotoxicity events (16.3%). Encouraged by the evidence of safety and efficacy of BDQ, the NTP took steps to systematically expand its access to cover the entire population by 2018.
CONCLUSION: The cautious yet focused approach used to introduce BDQ under BDQ-CAP paved the way for the rapid introduction of delamanid, as well as the shorter treatment regimen and the all-oral regimen for DR-TB.
The document discusses using blogging and email marketing together for business. It recommends setting up a blog to collect email subscribers and then nurturing those relationships through regular emailed content. Blogs allow for non-sales focused content that can still drive leads through email capture calls-to-action. Email is a powerful marketing tool as many purchases are inspired by emails, with 50% of purchases based on permission emails. The document provides tips on blogging frequency, content, and integrating blogging with other marketing strategies.
This document summarizes the anatomy, histology, biomechanics, surgery, and rehabilitation of the meniscus. It discusses how meniscal injuries typically occur via a compressive force combined with tibiofemoral rotation. The goals of meniscal surgery and rehabilitation are to restore function and prevent osteoarthritis. Rehabilitation protocols focus on restoring mobility and weight bearing based on the type of surgery and individual factors. More research is still needed on outcomes for different meniscal procedures.
This document provides information and pricing for cross-stitch patterns and supplies that can be ordered from Cross My Heart in Columbus, Ohio. All orders must be placed by phone at 614-442-0820 or in person at 1141 Kenny Center by September 15, 2015 at 5 pm and include the designer name, pattern or product name, and payment. The document then lists numerous cross-stitch patterns from various designers along with their prices.
Interview mit Alexander Wild in der Zeitschrift "AIR - Aktiv im Ruhestand" des DBB Deutschen Beamtenbundes. Die AIR Ausgabe Oktober 2014 widemt sich ganz dem Thema "Senioren und Medien".
2 code of ethics for consultants of tian de Liza Alypova
This document outlines the code of ethics for consultants of TianDe Corporation. It details 14 rules consultants must adhere to, including complying with all terms, providing accurate product information to customers, resolving disputes fairly, and ensuring downline consultants are aware of the code of ethics. It also defines key terms like consultant, sponsor, structure, personal and structural volume, ranks, and bonus rebate. The document provides guidelines for consultant registration, including how to select a sponsor and restrictions for relatives, as well as consequences for code of ethics violations.
Este documento presenta una guía práctica para exportar productos agrícolas a Corea del Sur, Japón y Singapur. Incluye información sobre las autoridades sanitarias y fitosanitarias de cada país, los pasos para exportar, y los requisitos sanitarios y fitosanitarios específicos. Para Corea del Sur, detalla la estructura normativa, los organismos reguladores como el KFDA y QIA, y los requisitos para la notificación, registro e inspección de importaciones agrícolas.
el mundo desarrollado tiene un mayor indice de epilepsia, Nuevos conocimientos sobre las causas y consecuencias de la epilepsia en los países en desarrollo ofrecen oportunidad para la prevención y / o tratamiento mejorado, que se complementan con las directrices publicadas recientemente epilepsia cuidado para su uso en este entorno
La Universidad Nacional del Litoral formó una Comisión de Expertos para elaborar un informe sobre el grado de toxicidad de ciertos productos químicos usados en fumigaciones, según una orden judicial. La Comisión está compuesta por 30 profesores e investigadores de diferentes facultades de la Universidad con experiencia en temas relevantes. El informe resume conocimientos previos sobre los productos químicos en cuestión basados en investigaciones anteriores, en lugar de incluir nuevos estudios debido al corto plazo dado para su elaboración.
La Dis Crimina Cion De Itzayana Valeria Y Alejandraguest0c1f95
La discriminación es el acto de hacer una distinción o segregación que atenta contra la igualdad de oportunidades, normalmente por cuestión social, racial, religiosa, orientación sexual o razón de género. Existen varios tipos de discriminación como por edad, discapacidad, origen nacional, embarazo, raza y religión. La discriminación de género o sexismo se basa en la supuesta supremacía de uno de los géneros sobre el otro. La discriminación implica tratar a alguien de forma desfavorable debido a pre
El documento describe un fraccionamiento residencial ecológico llamado El Santuario ubicado en Valle de Bravo. El fraccionamiento cuenta con más de 600 lotes residenciales, áreas comunes como club náutico, club hípico, campo de golf, hotel y spa. El desarrollo busca preservar las áreas verdes y ofrece servicios como agua, luz y telefonía.
This document discusses delivering successful corporate innovation. It identifies five key success factors for innovation success based on research, including having a relentless focus on solving customer problems, a passionate leader and team, using a common language to communicate progress, leveraging relevant skills and assets, and networking internally and externally. It also provides case studies on successful innovation initiatives at companies like BG, South Staffordshire Water Group, Abbey National and BT.
Conversión y renombrado por lotes de imágenes con fast stone photoresizerKoldo Parra
FastStone Photo Resizer es un software gratuito que permite realizar operaciones por lotes en series de imágenes, como cambiar su formato, tamaño y renombrarlas siguiendo un patrón. El documento explica cómo utilizar el programa para comprimir 952 imágenes de un viaje a Londres al 80% y renombrarlas añadiendo "Londres" y un número de tres cifras, dejando las imágenes originales intactas.
Stokesley Scene: Life in a Yorkshire market townesandelands
A presentation to the Rotary Club of Stokesley chronicling the launch on the Stokesley Scene magazine in 1978, and the limited edition book on its 30th anniversary.
Vyhodnocení projektu implementace bylo ústřední prezentací na „PLM Forum 2014
http://www.technodat.cz/3dexperience-v-konstrukta-industry-a-s
3DEXPERIENCE pro rychlý a efektivní návrh, výrobu a servis strojů
30. dubna 2014 byla podpisem akceptačního protokolu ukončena 3. etapa implementace
30 června bude ukončen monitorovaný provoz a k 30. listopadu 2014 je naplánována aktualizace řešení na verzi 2015x.
KONŠTRUKTA - Industry, a.s. nyní používá průmyslové řešení 3DEXPERIENCE pro stroje a strojní zařízení k podpoře všech svých obchodních procesů od obchodu přes návrh, výrobu a instalaci výrobku až po jeho údržbu u zákazníka.
"Na začátku devadesátých let jsme začali používat první elektronický kreslící systém, AutoCAD a postupně jsme nasazovali další, Pro/Engineer, CATIA V5, Solid Edge a Inventor."
Ing. Daniel Fraňo, vedoucí technického úseku a vývoje v KONŠTRUKTA-Industry, a.s.
"V roce 2011 přišel požadavek na sjednocení CAD systémů a nové řešení PLM. Byla oslovena firma Technodat."
Ing. Karol Breuer, vedoucí projektu implementace 3D PLM v KONŠTRUKTA-Industry, a.s.
"Výsledky BVA analýzy rozhodly o nasazení 3DEXPERIENCE řešení jako jediného a páteřního 3D/PLM systému v KONŠTRUKTA-Industry."
RNDr. Aleš Kobylík, ředitel Technodat, CAE-systémy, s.r.o.
"Z různých alternativ se nám jevilo jako optimální přistoupit ke kombinaci systémů CATIA a ENOVIA V6."
Ing. Jozef Santa, člen představenstva KONŠTRUKTA-Industry, a.s.
"V současné době KONŠTRUKTA používá téměř 100 licencí 3DEXPERIENCE platformy V6. V tomto počtu jsou licence pro oddělení konstrukce, obchodu, výroby, servisu a pro projektové manažery. Konstrukce používá 36 licencí CATIA V6. 15 licencí ENOVIA V6 je používáno projektovými manažery."
Petr Opršal, vedoucí projektu implementace 3D/PLM v KONŠTRUKTA-Industry, a.s., pracovník společnosti Technodat, CAE-systémy, s.r.o.
"Výběr firmy Technodat, jako implementátora systému, považuji za správné rozhodnutí."
Ing. Karol Breuer, vedoucí projektu implementace 3D PLM v KONŠTRUKTA-Industry, a.s.
KONŠTRUKTA - Industry, a.s., výrobce zařízení pro pneumatikářský průmysl, se rozhodl pro 3DEXPERIENCE řešení, které jí dodal a implementoval Technodat a výsledky spolupráce společně prezentovali na Hannover Messe 2014.
A study on drug utilisation evaluation of Bronchodilators using defined daily...Dr. Afreen Nasir
Conference proceeding: Nasir A. A study on drug utilisation evaluation of Bronchodilators using a defined daily dose method. Pharmacy Education Journal [Internet]. 2023 Aug;23(5):23–24. Available from: https://doi.org/10.46542/pe.2023.235.138
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
This study examined the prevalence of oral mucosal lesions (OMLs) among smokeless tobacco users in Dharwad, Karnataka, India. The study found:
1) The prevalence of OMLs was 54.18% overall, with higher rates among males (91.5%) compared to females (8.49%).
2) The most common OMLs among males were oral submucous fibrosis (26.95%), leukoplakia (10.35%), and carcinoma (9.94%). The most common lesion among females was carcinoma (28.31%).
3) Betel quid was the most common form of smokeless tobacco used among both males
Physiotherapists in primary care in the Republic of Ireland were surveyed about their assessment and management of lifestyle risk factors. The survey found that physiotherapists most commonly assessed physical activity levels, followed by dietary status. Few assessed smoking status or alcohol consumption. The main barriers to assessing these factors were lack of time, limited knowledge and expertise, and a perception that it was not part of their role. The study highlights opportunities for physiotherapists to play a greater role in addressing lifestyle risk factors through more systematic assessment and management. Training is needed to help overcome barriers identified in the survey.
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
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 Qualitative Study Of Nurses Attitudes And Practices Regarding Brief Alcoho...Claire Webber
This document summarizes a qualitative study that explored primary health care nurses' attitudes and practices regarding brief alcohol interventions. The study found that while nurses have many opportunities to address alcohol use with patients, most have received little training. As a result, nurses lack confidence in discussing alcohol-related issues and see it as an emotive topic. The study identified a need for nurses to receive clearer health messaging on alcohol, training in brief intervention skills, and support to build confidence and address negative patient reactions in order to more effectively carry out alcohol screening and brief interventions.
Research in the fields of Agricultural Sciences and Veterinary Medicine of the could be a suitable platform to consider. However, it's always advisable to visit the journal's website or contact the editorial team directly for the most current submission guidelines and other relevant information of the journal of engineering and applied science.
The Indo-American Journal of Agricultural and Veterinary Sciences appears to be a scholarly journal focused on publishing research within the fields of agriculture and veterinary sciences of the journals in research.
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.
Healthcare interventions to promote and assist tobacco cessation: a review of...Georgi Daskalov
Healthcare interventions to promote and assist tobacco cessation: a review of efficacy, effectiveness and affordability for use in national guideline development
AbstractBackground Hypertension is the most common non-.docxbartholomeocoombs
Abstract
Background:
Hypertension is the most common non-communicable disease and the leading cause of cardiovascular disease in the world. Current management of hypertension stressed the importance of salt and diet modifications. Unfortunately, many hypertensive patients do not have proper knowledge of this, which results to inadequate practice. Therefore, there is need to develop strategies that will help to improve knowledge and practice of salt and diet modifications among hypertensive.
Objective
: To determine the effect of nursing intervention on knowledge and practice of salt and diet modifications among hypertensive patients.
Materials and Methods
: A quasi experimental design was conducted using purposive sampling to select the sample size of 38 participants. A researcher-developed questionnaire derived from the literature review and Hypertension Self-Care Activity Level Effects (H-SCALE) adapted from Warren-Find low and Seymour (2011) was used to measure knowledge and practice of salt and diet modification among the participants. Data gathered from participants were expressed using tables and percentages while research questions were answered with descriptive statistics of mean and standard deviation through statistical package for the social science software version 21.
Results
: the study revealed that higher percentage of the participants (81.6%) had poor of knowledge of salt and diet modification pre-intervention, also 92.1% of the participants reported poor practice before intervention. Intervention was given to the participants and results showed a positive change in knowledge and practice of salt and diet practice post-intervention.
Conclusion
: regular training should be given to hypertensive patients by nurses to improve their knowledge and practice of salt and diet modification for effective blood pressure control.
Keywords
:
Hypertension, Knowledge, Practice, Salt and Diet modification, Nigeria
Introduction
The burden of hypertension and other noncommunicable diseases is rapidly increasing and this poses a serious threat to the economic development of many nations. Hypertension is a global public health challenge due to its high prevalence and the associated risk of stroke and cardiovascular diseases in adults.
Globally, hypertension is implicated to be responsible for 7.1 million deaths and about 12.8% of the total annual deaths (World Health
Organization (WHO), 2018). Africa, among other WHO regions was rated highest with increased prevalence of high blood pressure, estimated at 46% from age 25 years and above in which Nigeria contributes significantly to this increase (Okwuonu, Emmanuel, & Ojimadu 2014; Ekwunife, Udeogaranya, & Nwatu, 2018; WHO, 2018). This is so in spite of the availability to safe and potent drugs for hypertension and existence of clear treatment guidelines, hypertension is still grossly not controlled in a large proportion of.
The AHSN Network Polypharmacy Programme is working with healthcare professionals to address problematic polypharmacy by supporting easier identification of patients at potential risk from harm from multiple medications.
Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely.
To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Reducing Problematic Polypharmacy in Haringey Care Homes, can be viewed here.
For more information about the polypharmacy programme, please visit https://www.ahsnnetwork.com/programmes/medicines/polypharmacy/
This randomized controlled trial evaluated the effectiveness of a perioperative smoking cessation intervention on long-term smoking abstinence rates. The intervention involved brief counseling, smoking cessation materials, referral to a quitline, and nicotine replacement therapy. At the 1-year follow-up, smoking cessation was reported in 25% of patients who received the intervention compared to 8% of control patients. Lower nicotine dependence at baseline and receiving the intervention were predictive of long-term smoking cessation. The study demonstrates that a minimally intensive perioperative smoking cessation intervention can significantly increase smoking abstinence rates not just short-term but also at 1 year postoperatively.
- Cardiovascular disease is the leading cause of death in Canada, and high blood pressure is the number one modifiable risk factor. However, many Canadians are unaware they have high blood pressure or it is not adequately controlled.
- The document outlines a strategy to improve hypertension management in Canada through initiatives targeted at primary healthcare providers and patients. It involves developing and testing education and management tools.
- An evaluation of the initial pilot phase found improvements in screening, diagnosis and control of high blood pressure among participating providers and patients compared to non-participants. Most providers also reported the strategy was effective and positively impacted their management of hypertensive patients.
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 research explores the feasibility of introducing an Outcome-Based Payment approach for new cancer drugs in England. A literature review explored the current funding landscape in England, the available evidence on existing OBP schemes internationally, and
which outcomes cancer patients value most. Two focus groups and an online survey with patients and carers, as well as interviews with NHS and government stakeholders, healthcare
professionals, and pharmaceutical industry representatives, provided additional evidence on the feasibility and suitability of OBP schemes
This study explored community stroke rehabilitation therapists' use of outcome measures in Scotland. A survey of 113 therapists found that the most commonly used measures were the Berg Balance Scale, Tinetti Balance and Gait scales for physical therapists, the Rivermead Behavioural Memory Test and Barthel Index for occupational therapists, and the Therapy Outcome Measure and Frenchay Aphasia Screening Test for speech and language therapists. The top reasons for selecting measures were that they are relevant to patients' goals, easy to use, and sensitive to change. However, over a third of therapists were dissatisfied with the relevance of available measures to patients. The study highlights tensions between best practice and constraints like financial barriers to using measures.
Drug Resistant Tuberculosis Management GuidelineNabin Bist
This document provides national guidelines for drug resistant tuberculosis (DR-TB) management in Nepal. It outlines the background and burden of multi-drug resistant TB (MDR-TB) worldwide and in Nepal. Key points include an estimated 558,000 incident cases of MDR-TB globally in 2017, with treatment success at only 55%. In Nepal, around 1500 cases of DR-TB occur annually, though only 350-450 are notified. The guidelines cover diagnosis, treatment regimens, management, and monitoring of DR-TB.
Similar to Developing and Implementing a Smoking Cessation Intervention in Primary Care in Nepal (20)
A presentation given to delegates at the Health Systems Research Symposium, Vancouver, 2016 describing our work to promote rational use of antibiotics in children under 5 and improve consultation behaviour among community health care providers in Bangladesh.
Presentation by ARK Foundation on assessing access to family planning services for the urban poor. First presented at the 12th International Conference on Urban Health 2015, Dhaka, Bangladesh.
This document assesses the appropriateness of existing data sources in Bangladesh to identify health inequities in urban areas and the health needs of the urban poor. It analyzes several major surveys including the Bangladesh Demographic and Health Survey, Urban Health Survey, Multiple Indicator Cluster Survey, and National Tuberculosis Control Programme annual report. It finds that these surveys have small urban samples not fully representative of the urban poor, use wealth indices that do not capture income/expenditures, and have challenges in accessing raw data. It recommends specific surveys of the urban poor with improved sampling methods and easier access to raw data to better identify health inequities.
The document summarizes a workshop hosted by Health Research and Social Development Forum (HERD) in Nepal to strengthen media reporting on urban health issues. HERD analyzed 450 media articles and found coverage often came from foreign sources and focused on policy proposals, with limited regional reporting. The workshop trained 52 journalists on urban health topics, provided media monitoring and writing tools. Initial impacts included improved coverage and a media award for an article supported by HERD. Future plans include expanding sensitization efforts and developing coordination between media and the health sector.
This document summarizes a study conducted in Uganda to identify barriers to the uptake of intermittent preventive treatment for malaria in pregnancy (IPTp) and test an intervention to address the key barriers. The study employed an "embedded approach" involving stakeholders throughout the research process. Formative research identified supply issues and confusion over IPTp guidelines as barriers. The study is now piloting text messages to health workers to reinforce guidelines. Early results include commitments to address identified barriers, such as providing anti-malarial drugs to private facilities and updating IPTp guidelines. The Ministry of Health is overseeing the pilot intervention and hopes to scale it nationwide if effective.
How do you begin to present your research findings outside of the academic community? This presentation is for researchers who face a blank sheet of paper whenever they try to rewrite their research findings to audiences outside of their academic community. The 7 rules for writing in plain English are:
1. Keep your sentences short
2. Prefer active verbs
3. Use 'you' and 'we'
4. Avoid jargon: use words that are appropriate for the reader
5. Don't be afraid to give instructions
6. Avoid nominalisations
7. Use lists where appropriate
More from COMDIS Health Service Delivery Research Consortium (Uni of Leeds) (7)
AHMR is an interdisciplinary peer-reviewed online journal created to encourage and facilitate the study of all aspects (socio-economic, political, legislative and developmental) of Human Mobility in Africa. Through the publication of original research, policy discussions and evidence research papers AHMR provides a comprehensive forum devoted exclusively to the analysis of contemporaneous trends, migration patterns and some of the most important migration-related issues.
Jennifer Schaus and Associates hosts a complimentary webinar series on The FAR in 2024. Join the webinars on Wednesdays and Fridays at noon, eastern.
Recordings are on YouTube and the company website.
https://www.youtube.com/@jenniferschaus/videos
Combined Illegal, Unregulated and Unreported (IUU) Vessel List.Christina Parmionova
The best available, up-to-date information on all fishing and related vessels that appear on the illegal, unregulated, and unreported (IUU) fishing vessel lists published by Regional Fisheries Management Organisations (RFMOs) and related organisations. The aim of the site is to improve the effectiveness of the original IUU lists as a tool for a wide variety of stakeholders to better understand and combat illegal fishing and broader fisheries crime.
To date, the following regional organisations maintain or share lists of vessels that have been found to carry out or support IUU fishing within their own or adjacent convention areas and/or species of competence:
Commission for the Conservation of Antarctic Marine Living Resources (CCAMLR)
Commission for the Conservation of Southern Bluefin Tuna (CCSBT)
General Fisheries Commission for the Mediterranean (GFCM)
Inter-American Tropical Tuna Commission (IATTC)
International Commission for the Conservation of Atlantic Tunas (ICCAT)
Indian Ocean Tuna Commission (IOTC)
Northwest Atlantic Fisheries Organisation (NAFO)
North East Atlantic Fisheries Commission (NEAFC)
North Pacific Fisheries Commission (NPFC)
South East Atlantic Fisheries Organisation (SEAFO)
South Pacific Regional Fisheries Management Organisation (SPRFMO)
Southern Indian Ocean Fisheries Agreement (SIOFA)
Western and Central Pacific Fisheries Commission (WCPFC)
The Combined IUU Fishing Vessel List merges all these sources into one list that provides a single reference point to identify whether a vessel is currently IUU listed. Vessels that have been IUU listed in the past and subsequently delisted (for example because of a change in ownership, or because the vessel is no longer in service) are also retained on the site, so that the site contains a full historic record of IUU listed fishing vessels.
Unlike the IUU lists published on individual RFMO websites, which may update vessel details infrequently or not at all, the Combined IUU Fishing Vessel List is kept up to date with the best available information regarding changes to vessel identity, flag state, ownership, location, and operations.
This report explores the significance of border towns and spaces for strengthening responses to young people on the move. In particular it explores the linkages of young people to local service centres with the aim of further developing service, protection, and support strategies for migrant children in border areas across the region. The report is based on a small-scale fieldwork study in the border towns of Chipata and Katete in Zambia conducted in July 2023. Border towns and spaces provide a rich source of information about issues related to the informal or irregular movement of young people across borders, including smuggling and trafficking. They can help build a picture of the nature and scope of the type of movement young migrants undertake and also the forms of protection available to them. Border towns and spaces also provide a lens through which we can better understand the vulnerabilities of young people on the move and, critically, the strategies they use to navigate challenges and access support.
The findings in this report highlight some of the key factors shaping the experiences and vulnerabilities of young people on the move – particularly their proximity to border spaces and how this affects the risks that they face. The report describes strategies that young people on the move employ to remain below the radar of visibility to state and non-state actors due to fear of arrest, detention, and deportation while also trying to keep themselves safe and access support in border towns. These strategies of (in)visibility provide a way to protect themselves yet at the same time also heighten some of the risks young people face as their vulnerabilities are not always recognised by those who could offer support.
In this report we show that the realities and challenges of life and migration in this region and in Zambia need to be better understood for support to be strengthened and tuned to meet the specific needs of young people on the move. This includes understanding the role of state and non-state stakeholders, the impact of laws and policies and, critically, the experiences of the young people themselves. We provide recommendations for immediate action, recommendations for programming to support young people on the move in the two towns that would reduce risk for young people in this area, and recommendations for longer term policy advocacy.
Jennifer Schaus and Associates hosts a complimentary webinar series on The FAR in 2024. Join the webinars on Wednesdays and Fridays at noon, eastern.
Recordings are on YouTube and the company website.
https://www.youtube.com/@jenniferschaus/videos
Jennifer Schaus and Associates hosts a complimentary webinar series on The FAR in 2024. Join the webinars on Wednesdays and Fridays at noon, eastern.
Recordings are on YouTube and the company website.
https://www.youtube.com/@jenniferschaus/videos
Working with data is a challenge for many organizations. Nonprofits in particular may need to collect and analyze sensitive, incomplete, and/or biased historical data about people. In this talk, Dr. Cori Faklaris of UNC Charlotte provides an overview of current AI capabilities and weaknesses to consider when integrating current AI technologies into the data workflow. The talk is organized around three takeaways: (1) For better or sometimes worse, AI provides you with “infinite interns.” (2) Give people permission & guardrails to learn what works with these “interns” and what doesn’t. (3) Create a roadmap for adding in more AI to assist nonprofit work, along with strategies for bias mitigation.
Preliminary findings _OECD field visits to ten regions in the TSI EU mining r...OECDregions
Preliminary findings from OECD field visits for the project: Enhancing EU Mining Regional Ecosystems to Support the Green Transition and Secure Mineral Raw Materials Supply.
Developing and Implementing a Smoking Cessation Intervention in Primary Care in Nepal
1. Developing and Implementing a Smoking Cessation Intervention
in Primary Care in Nepal
Sushil Baral ;Sudeepa Khanal; Shraddha Manandar; Dilip Kumar Sah; Kamran Siddiqi; Helen Elsey
BACKGROUND
Prevalence of tobacco among those over 15 years is estimated to be 31.6% overall, 52% among men and 13% among women. Use of smokeless
tobacco is also high, particularly chewing tobacco, with 38% of men and 6% of women using this form of tobacco (1). Despite this high smoking
prevalence there are no smoking cessation services in routine primary care. Respiratory conditions are one of the most common reasons for
presenting at primary care with 17.1% of male patients and 11.3% of female patients having a respiratory condition (2). There is evidence of
effectiveness and cost-effectiveness of number of psychological and pharmacological treatments for tobacco dependence, particularly where
advice is given by trained health professionals (3)
Aim: To develop and test the feasibility of a behavioural support intervention to promote smoking cessation within the in primary care in Nepal.METHODS
The study used a combination of qualitative methods
and action research to understand the barriers and
facilitators to implementation. Patients receiving the
intervention were followed up over a 3 month period
to gain their feedback on the intervention and to
identify those who had quit.
USE OF BEHAVIOUR CHANGE TECHNIQUES
The intervention drew on Michie et al’s (4) identified behaviour change
techniques (BCTs), as illustrated on the Quit Card shown below..
FOLLOW UP RESULTS
It was only possible to trace a total of 27 patients out of the 44
who had received the counselling from the health worker. All
patients provided a CO sample, completed a questionnaire and
provided feedback on the different aspects of the intervention and
their experience of trying to quit. Patients were defined as having
quit if they had a CO reading of ≤ 9 ppm and had smoked no more
than 5 cigarettes since their quit day.
ACTION RESEARCH
To understand the barriers and facilitators to implementation
in primary care, researchers facilitated action research
meetings with the health workers in the 3 PHCCs. The groups
reflected on the implementation process and tried different
strategies to overcome any challenges over a 3 month period.
Key Findings from the Action Research
1) Intervention for all patients: Initially the intervention was
planned for respiratory patients only. However, health
workers in all 3 PHCCs were adamant that the intervention
should be made available to all patients. The materials
were changed to include risk of tobacco use to cardio-
vascular health and during pregnancy. The intervention
was then offered to all patients in OPD.
2) Identifying smokers: Although health workers were keen
to open the intervention to all patients, in reality this was
challenging to implement due to the high patient numbers
particularly in clinics for reproductive and child health.
Patients were reluctant to admit to smoking when asked
by the health worker. The overcrowded consultation room
and manner of the health worker were identified as
undermining patients’ willingness to admit their habit. To
overcome this the team tried the use of volunteers to
sensitise communities of the availability of the cessation
programme and the use of PHCC support staff to
encourage patients to be open. However limited numbers
of smokers were identified, particularly as a proportion of
all out patients in the PHCCs.
3) Recording and reporting: The main register in the PHCCs
did not have space to record smoking status. As these
PHCCs were implementing WHO’s PAL approach, the PAL
register was used to record smoking, however health
workers did not fully understand the categories or
Fagerstrom assessment tool in the PAL register as this was
in English and had not been covered in depth in their PAL
training. The researchers supported the health workers in
this aspect. The Government of Nepal now plans to
including smoking status in the main PHCC register.
4) High use of Smokeless Tobacco: the original intervention
materials did not include chewing tobacco. Given the high
prevalence in the two Terai PHCCs, warnings of the
dangers of chewing tobacco were added to the materials.
QUALITATIVE FINDINGS
CONCLUSIONS
The study demonstrates that it is feasible to implement a smoking cessation intervention in primary
care, particularly if the intervention is target at those patients who are motivated to quit. The
patients who received the counselling felt the intervention helped them to quit.
Greater attention to the ‘not a puff’ rule was needed in the training and subsequent patient
counselling sessions. In areas with high prevalence of smokeless tobacco, particular attention is
needed within the intervention to ensure that quitters do not take up chewing tobacco to
compensate for cigarettes.
A limitation of the study is the low number of smokers identified and receiving the intervention. This
means that conclusions about effectiveness can not be drawn from this small sample.
Embedding smoking cessation within routine primary care is key to successful delivery. This requires
effective reporting and supervision mechanisms within the health system.
Please be in touch: Helen Elsey (University of Leeds) h.elsey@leeds.ac.uk Sudeepa Khanal
(Health Research and Social Development Forum, HERD, Nepal)
sudeepa.khanal@herd.org.np
REFERENCES
1. Ministry of Health and Population (2012) Nepal Demographic and Health Survey 2011 Population
DivisionGovernment of Nepal, New ERA Nepal and ICF International, U.S.A
2.WHO (2008) Report on the Global Tobacco Epidemic, 2008:. Geneva, World Health Organization, 2008.
3. Gorin SS & Heck JE (2004) Meta-analysis of the efficacy of tobacco counselling by health care providers. Cancer
Epidemiology and Biomarkers Preventions 13, 2012–2022.
4.Michie et al (2008) From Theory to Intervention: Mapping Theoretically Derived Behavioural Determinants to
Behaviour Change Techniques Applied psychology: an international review, 2008, 57 (4), 660–680
,
Phase 3
Fine-tune intervention
Follow up at 3 months
Fagerstrom and CO monitors
Phase 2
Intervention development
workshop
Action Research & Baseline
Fagerstrom and CO
Phase 1
Evidence Review
21 qualitative Interviews with
lung health patients and FGDs
with PHC staff
INTERVENTION
Intervention design drew on initial ;qualitative work with smokers with
respiratory conditions and focus groups with health workers. Ministry of
Health and Population staff participated in a design workshop and
ultimately endorsed all materials. Training was provided to all the health
workers in their facilities.
BCT 24: Keeping
motivation by
identifying and
recording why
they want to quit.
BCT 5: identifying
barriers and coping
strategies to build
self efficacy and
skills to overcome
barriers
BCT 6 : provide general
encouragement for self
efficacy and motivation
BCT 12 : prompt
self monitoring
behaviour by
ticking days quit.
BCT 4 &10 : prompt
specific goal setting
by setting quit day.
Patient Flow through
the Intervention
Materials include:
•Posters on the dangers of smoking and
chewing tobacco
•Poster advertising the smoking cessation
service in primary health clinics
•Leaflets for patients on the dangers of
smoking and chewing tobacco
•Flip book to be used by health workers in a
brief counselling session
•Quit card to support abstinence
•DVD is under development
SETTING
The intervention was tested in 3 primary health care centres (PHCCs)
selected based on sufficient patient flow, training of staff in WHO’s
Practical Approach to Lung Health. 2 PHCCs were in a rural location in
the Terai plains and 1 PHCC was in urban Kathmandu. Quit Card showing use of
Behaviour Change Techniques
5) Motivation of Health Workers: only a few health workers were motivated to deliver the
intervention. As the intervention was not seen as a part of core activities and was not a
performance indicator for the PHCC, the health workers did not prioritise the intervention.
This lack of motivation impacted on the number of identified and counselled and the quality
of the counselling provided. Establishing smoking cessation as a core, routine service with
monitoring from central and district health departments is needed to essential for the
effective and sustainable implementation of the programme.
Urban PHCC Rural PHCC 1 Rural PHCC 2 Total
Total out patients
over 3 month
period
4416 5062 2852 12330
Smokers identified
(as a % of total out
patients)
56 (1.3%) 29 (0.6%) 19 (0.7%) 104 (0.8%)
Smokers receiving
counselling (as a %
of identified
smokers)
13 (23.2%) 18 (62.1%) 13 (68.4%) 44 (42.3%)
Those. traced at 3
months follow up
(as a % of those
counselled)
5 (38.5%) 12 (66.7%) 10 (76.9%) 27 (61.4%)
Smokers who quit
(as a % of those
counselled)
1 (20%) 5 (41.7%) 4 (40%) 10 (37%)
Feedback on the Intervention
The majority of patients (74%) were satisfied by the health workers
support during counselling. Where patients complained about their
interaction with the health worker, they lost motivation to quit.
The majority of patients, particularly those with low literacy levels,
did not find the quit card useful and had lost their card.
While two patients reported that they had stopped chewing tobacco,
three admitted taking up chewing to substitute cigarettes.
Patients preferred graphic pictures and photographs of the physical damage caused by smoking or
chewing tobacco.
Confusion over ‘Not a puff’ message: Many patients had managed to reduce the number of cigarettes
smoked, but had not appreciated the need to identify a quit day and not smoke again.
The most common barrier to quitting identified was being encouraged to smoke by friends. Conversely,
when families were supportive, this was a facilitator to quitting.