Tobacco smoking among the first-year medical students

The studies have shown that despite studying medicine the rate of tobacco smokers among students is still high. Moreover, in Poland the incidence of smoking is increasing among the youngsters. The study was designed to assess the rate of smokers among the first-year students of two consecutive courses at the Medical University of Gdańsk and define their attitudes towards tobacco smoking. The voluntary, multiple-choice questionnaires were distributed among 412 students. The rate of response was 100%. Twenty one percent of responders were current smokers (17% females and 28% men), whereas 7% declared previous smoking. There was no correlation between incidence of smoking among students and their parents (p = 0.11). 61% of smokers declared the will to give up their habit and of those 94% were aware of the negative impact of cigarettes on their health. In the group which did not declare the will to quit smoking only 75% knew what the impact of cigarettes on their health was; p = 0.02. Only 23% of smokers considered anti-nicotine therapy effective. Almost a half of smokers considered nicotine replacement therapy ineffective for them in quitting cigarette smoking. Conclusion: The rate of smokers among the first-year medical students is lower than in general population, but it is still relatively high. However more than a half of smokers wants to give up their habit. Of those who are not willing to, 25% is not aware of the cigarettes’ impact on their health. These results call for further anti-nicotine actions

Postawy wobec palenia tytoniu wśród studentów I i VI roku medycyny z rocznika studiów 2002-2008

Wstęp: Zjawisko palenia tytoniu wśród studentów medycyny wskazuje, że studia medyczne nie stanowią wystarczającej bariery przed kontynuowaniem, a nawet rozpoczynaniem palenia. Celem badania była ocena postaw wobec palenia wśród studentów I i VI roku Wydziału Lekarskiego Gdańskiego Uniwersytetu Medycznego z rocznika studiów 2002-2008. Materiał i metody: Wśród studentów rocznika studiów 2002-2008 dwukrotnie, na I i VI roku, rozprowadzono ankietę zawierającą pytania na temat kwestii związanych z paleniem tytoniu. W ankiecie adresowanej do studentów VI roku zawarto dodatkowe pytania, umożliwiające ocenę zmian w postawach studentów wobec palenia w trakcie studiów, a także poznanie opinii respondentów na temat nauczania na studiach rozpoznawania i leczenia zespołu uzależnienia od tytoniu (ZUT) oraz ich samooceny posiadanej wiedzy w tym zakresie. W badaniu wzięło udział 287 studentów I roku i 175 studentów VI roku badanego rocznika. Wyniki: Wraz z końcem studiów studenci istotnie rzadziej regularnie palili papierosy niż na I roku (13% v. 21%; p = 0,022), jednak co piąta paląca osoba (20%) zaczęła palić papierosy w trakcie studiów medycznych. Odsetek palaczy, którzy palili bez większego skrępowania, był istotnie niższy, niż na początku studiów (31% v. 70%; p = 0,0006), stwierdzono także znacząco wyższe odsetki palaczy deklarujących chęć porzucenia nałogu (91% v. 61%; p = 0,013) oraz codziennych palaczy, którzy chcieliby poddać się leczeniu uzależnienia od tytoniu (54% v. 22%; p = 0,001). Ponad połowa studentów VI roku przyznała, że nie ma żadnej wiedzy na temat rozpoznawania i leczenia ZUT lub ich wiedza na ten temat jest bardzo słaba lub słaba (57%). Aż 43% badanych stwierdziło, że studia medyczne w ogóle nie były dla nich źródłem wiedzy o ZUT. Wnioski: Studia medyczne wpływają na pozytywne zmiany postaw studentów wobec palenia tytoniu. Jednak część osób podejmuje palenie na studiach, co sugeruje dominujący udział czynników genetycznych nad środowiskowymi w rozpoczynaniu palenia w tym okresie życia. W opinii przyszłych lekarzy studia medyczne nie są wystarczającym źródłem wiedzy o ZUT.Introduction: The prevalence of smoking among medical students indicates that studying medicine is an insufficient protection from tobacco use. The aim of the study was an analysis of medical students’ attitudes towards smoking at the first and sixth year of their studies. Material and methods: A questionnaire on tobacco smoking was distributed among medical students of the study year 2002-2008 at the first and sixth year of their studies. The questionnaire used on the sixth year students included additional questions designed to assess changes in their attitudes towards smoking during their studies, to ask their opinion of the teaching of diagnostics and treatment of tobacco dependence (TD), and to discover how they evaluated their knowledge of the issue. The numbers of students who participated at the two points of the study were 287 and 175 respectively. Results: Students in their sixth year significantly less frequently smoked cigarettes regularly than those starting their medical education (13% v. 21%; p = 0.022). However, 20% of smokers started smoking during their studies. The proportion of smokers saying they were not embarrassed by their smoking habit was significantly lower among sixth-year students compared to first-year students (31% v. 70%; p = 0.0006), as were the numbers who said they wanted to quit smoking (91% v. 61%). Those who wished to undergo treatment for TD (54% v. 22%) were significantly higher among sixth year students group (p = 0.013 and p = 0.001, respectively). More than half (57%) the sixth-year students claimed that they had no knowledge of the diagnostics and treatment of TD, or that their knowledge on this issue was poor or very poor. In the opinion of 43% of students, the medical curriculum was not a good source of knowledge on TD. Conclusions: Medical studies induce positively students’ attitudes towards smoking. However, a proportion of individuals start smoking during studies, which may suggest dominance of genetic influences on smoking initiation in this period of life. In sixth-year students’ opinion, medical studies are not a sufficient source of knowledge on TD

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Tobacco Smoking among the First-Year Medical Students

The studies have shown that despite studying medicine the rate of tobacco smokers among students is still high. Moreover, in Poland the incidence of smoking is increasing among the youngsters. The study was designed to assess the rate of smokers among the fi rst-year students of two consecutive courses at the Medical University of Gdańsk and defi ne their attitudes towards tobacco smoking. The voluntary, multiple-choice questionnaires were distributed among 412 students. The rate of response was 100%. Twenty one percent of responders were current smokers (17% females and 28% men), whereas 7% declared previous smoking. There was no correlation between incidence of smoking among students and their parents (p = 0.11). 61% of smokers declared the will to give up their habit and of those 94% were aware of the negative impact of cigarettes on their health. In the group which did not declare the will to quit smoking only 75% knew what the impact of cigarettes on their health was; p = 0.02. Only 23% of smokers considered anti-nicotine therapy effective. Almost a half of smokers considered nicotine replacement therapy ineffective for them in quitting cigarette smoking. Conclusion: The rate of smokers among the first-year medical students is lower than in general population, but it is still relatively high. However more than a half of smokers wants to give up their habit. Of those who are not willing to, 25% is not aware of the cigarettes’ impact on their health. These results call for further anti-nicotine actions

Medical Students’ Attitudes towards Tobacco Smoking at the First and Sixth Year of Their Studies 2002–2008

Introduction: The prevalence of smoking among medical students indicates that studying medicine is an insufficient protection from tobacco use. The aim of the study was an analysis of medical students’ attitudes towards smoking at the first and sixth year of their studies. Material and methods: A questionnaire on tobacco smoking was distributed among medical students of the study year 2002–2008 at the first and sixth year of their studies. The questionnaire used on the sixth year students included additional questions designed to assess changes in their attitudes towards smoking during their studies, to ask their opinion of the teaching of diagnostics and treatment of tobacco dependence (TD), and to discover how they evaluated their knowledge of the issue. The numbers of students who participated at the two points of the study were 287 and 175 respectively. Results: Students in their sixth year significantly less frequently smoked cigarettes regularly than those starting their medical education (13% v. 21%; p = 0.022). However, 20% of smokers started smoking during their studies. The proportion of smokers saying they were not embarrassed by their smoking habit was significantly lower among sixth-year students compared to first-year students (31% v. 70%; p = 0.0006), as were the numbers who said they wanted to quit smoking (91% v. 61%). Those who wished to undergo treatment for TD (54% v. 22%) were significantly higher among sixth year students group (p = 0.013 and p = 0.001, respectively). More than half (57%) the sixth-year students claimed that they had no knowledge of the diagnostics and treatment of TD, or that their knowledge on this issue was poor or very poor. In the opinion of 43% of students, the medical curriculum was not a good source of knowledge on TD. Conclusions: Medical studies induce positively students’ attitudes towards smoking. However, a proportion of individuals start smoking during studies, which may suggest dominance of genetic influences on smoking initiation in this period of life. In sixth-year students’ opinion, medical studies are not a sufficient source of knowledge on TD.</jats:p

Medical Students’ Attitudes towards Tobacco Smoking at the First and Sixth Year of Their Studies 2002–2008

Introduction: The prevalence of smoking among medical students indicates that studying medicine is an insufficient protection from tobacco use. The aim of the study was an analysis of medical students’ attitudes towards smoking at the first and sixth year of their studies. Material and methods: A questionnaire on tobacco smoking was distributed among medical students of the study year 2002–2008 at the first and sixth year of their studies. The questionnaire used on the sixth year students included additional questions designed to assess changes in their attitudes towards smoking during their studies, to ask their opinion of the teaching of diagnostics and treatment of tobacco dependence (TD), and to discover how they evaluated their knowledge of the issue. The numbers of students who participated at the two points of the study were 287 and 175 respectively. Results: Students in their sixth year significantly less frequently smoked cigarettes regularly than those starting their medical education (13% v. 21%; p = 0.022). However, 20% of smokers started smoking during their studies. The proportion of smokers saying they were not embarrassed by their smoking habit was significantly lower among sixth-year students compared to first-year students (31% v. 70%; p = 0.0006), as were the numbers who said they wanted to quit smoking (91% v. 61%). Those who wished to undergo treatment for TD (54% v. 22%) were significantly higher among sixth year students group (p = 0.013 and p = 0.001, respectively). More than half (57%) the sixth-year students claimed that they had no knowledge of the diagnostics and treatment of TD, or that their knowledge on this issue was poor or very poor. In the opinion of 43% of students, the medical curriculum was not a good source of knowledge on TD. Conclusions: Medical studies induce positively students’ attitudes towards smoking. However, a proportion of individuals start smoking during studies, which may suggest dominance of genetic influences on smoking initiation in this period of life. In sixth-year students’ opinion, medical studies are not a sufficient source of knowledge on TD

Tobacco Smoking among the First-Year Medical Students

The studies have shown that despite studying medicine the rate of tobacco smokers among students is still high. Moreover, in Poland the incidence of smoking is increasing among the youngsters. The study was designed to assess the rate of smokers among the fi rst-year students of two consecutive courses at the Medical University of Gdańsk and defi ne their attitudes towards tobacco smoking. The voluntary, multiple-choice questionnaires were distributed among 412 students. The rate of response was 100%. Twenty one percent of responders were current smokers (17% females and 28% men), whereas 7% declared previous smoking. There was no correlation between incidence of smoking among students and their parents (p = 0.11). 61% of smokers declared the will to give up their habit and of those 94% were aware of the negative impact of cigarettes on their health. In the group which did not declare the will to quit smoking only 75% knew what the impact of cigarettes on their health was; p = 0.02. Only 23% of smokers considered anti-nicotine therapy effective. Almost a half of smokers considered nicotine replacement therapy ineffective for them in quitting cigarette smoking. Conclusion: The rate of smokers among the first-year medical students is lower than in general population, but it is still relatively high. However more than a half of smokers wants to give up their habit. Of those who are not willing to, 25% is not aware of the cigarettes’ impact on their health. These results call for further anti-nicotine actions.</jats:p

Assessment and improvement of the quality of radiotherapy treatment planning CT images using a clinically validated phantom based method and a multicentre intercomparison

Purpose: To develop a phantom method of image quality assessment for radiotherapy planning CT protocols (head and neck (H&N) and prostate) and validate results against clinical image quality. Test with data from different scanners and suggest protocol adjustments. // Methods: Macros measured patient water-equivalent diameter and noise from clinical CT images. Target transfer function (TTF), contrast, noise-power spectrum (NPS), detectability index and the edge visibility of a low contrast target were measured using Catphan 604 and bespoke phantoms. Ten centres scanned the phantoms with modified clinical protocols and collected data from patient images using the macros. Clinical experts, ranked the quality of images for contouring and correlated results against phantom metrics. // Results: Clinical image review showed a large range of results from different scanners for H&N scans and fewer differences for prostate. The phantom metrics best correlated with high clinical image scores were, for H&N: high TTF50 (r = 0.73, p = 0.003), contrast (r = 0.58, p = 0.003) and target edge visibility (r = 0.70, p = 0.004); for prostate: high TTF50 (r = 0.83, p = 0.002), low noise (r = 0.37, p = 0.26) and target edge visibility (r = 0.59, p = 0.05). Hence, optimal contrast, resolution and noise are important for good contouring image quality. Reconstruction kernel, field of view and noise, or X-ray tube current and rotation time, are possible parameters for adjustment. // Conclusions: This phantom method (using Catphan 604) was a good surrogate for clinical quality assessment of CT images for radiotherapy contouring. Results identified the poorest performing scanners, allowing recommendations for image quality improvement and confirming scan protocol optimisation is necessary in some centres