Effectiveness of smoking reduction intervention for hardcore smokers

© 2015 Lam et al.; licensee BioMed Central.Background: The prevalence and correlates of hardcore smokers, who have high daily cigarette consumption, no quitting history and no intention to quit, have been studied in several western developed countries, but no previous trials of smoking cessation have tested intervention effectiveness for these smokers. The current study examined if hardcore smokers can benefit from smoking reduction intervention to achieve cessation, and explored the underlying reasons. Methods: A posteriori analysis was conducted on data from a randomized controlled trial of smoking reduction intervention on 1,154 smokers who did not want to quit. Odds ratios of 7-day point prevalence of abstinence, smoking reduction by at least 50% and quit attempt at the 6-month follow-up comparing subgroups of smokers were analyzed. Results: In hardcore smokers, the odds ratio comparing the quit rate between the intervention and control group was 4.18 (95% CI: 0.51-34.65), which was greater than non-hardcore smokers (OR = 1.58, 95% CI: 0.98-2.54). The number needed to treat for hardcore and non-hardcore smokers was 8.33 (95% CI: 5.56-16.67) and 16.67 (95% CI: 8.33-233.64), respectively. In smokers who did not have quit attempt experience and those who smoked more than 15 cigarettes daily, the odds ratio comparing intervention and control group was 3.29 (95% CI: 0.72-14.98) and 1.36 (95% CI: 0.78-2.36), respectively. Conclusions: The a posteriori analysis provided pilot results that smoking reduction intervention may be effective to help hardcore smokers to quit and reduce smoking. Having no previous quit attempt was identified as more important than having large cigarette consumption in explaining the greater effectiveness of the intervention.published_or_final_versio

Overprotection and the psychological states of cerebral palsy patients and their caretakers in Hong Kong: A preliminary report

Objective: To examine the relation between perceived overprotection and the psychological states of cerebral palsy patients and their primary caretakers in Hong Kong. Design: Cross-sectional survey, in which data of 14 pairs of cerebral palsy patients and their caretakers were analysed. Setting: Duchess of Kent Children's Hospital, Hong Kong. Participants: Cerebral palsy patients and their primary caretakers in Hong Kong. Main outcome measures: Perceived overprotection and psychological states. Results: Nearly two thirds of the 14 patients (mean age of 15 years) and 86% of the 14 primary caretakers (mean age of 47 years) perceived various levels of overprotection. For both patients and caretakers, perceived overprotection was positively associated with anxiety and unhappiness. The patients' and caretakers' psychological states and perception of overprotection were not related to the actual motor ability of the patients. Perceived overprotection of the patients was not related to that of the caretakers. Conclusion: Caretakers should be mindful that a well-meaning move may have undesirable consequences. More support and child-rearing education should be considered for caretakers.published_or_final_versio

An episode of syncope attacks in adolescent schoolgirls: Investigations, intervention and outcome

An increasing number of students in a secondary convent girls school developed syncope attacks over a time course of about two months. Fourteen students who suffered from syncope and 12 other students from the same class with no symptoms were assessed by a team of psychologists and paediatricians with the aim of identifying the cause of the problem and to formulate possible remedial action. Psychological assessments included a mental state examination, developmental, personal and psychological history, state-trait anxiety, self-esteem, hypnotic suggestibility, and students' beliefs about the cause and nature of the syncope attacks. Physical investigations included physical examination, blood pressure and electrocardiogram. The results indicated that most participants and controls had no physical or psychological pathologies. The two groups were not different on the physical and psychological measures. Analyses of the interview data, however, indicated that all the syncope sufferers belonged to a cohesive and exclusive social network. Social psychological circumstances rather than individual psychopathology were noted to be primarily responsible for the spread and maintenance of the mass hysterical influence. Intervention consisted of health education, authoritative reassurance and back-up support. Follow-up assessment after three and 12 months indicated no further syncope episodes

Inhibition of nucleoside transporters in endothelial cells by emodin

Conference Theme: From Cell to TherapyYoung Investigator Award Poster Presentations: CP03Nucleoside transporters play critical roles in endothelial cell functions. Nucleosides are precursor molecules for ATP, nucleic acids, coenzymes and signaling molecules. However, it is known that epithelial cells have a low capacity for de novo synthesis of nucleosides, and they therefore also depend on nucleoside absorption from the extracellular fluid (i.e. salvage pathway). In addition, nucleoside transporters are important in fine tuning the extracellular concentration of adenosine (a vasodilator and anti-inflammatory agent which is ...link_to_OA_fulltextThe 15th Annual Scientific Meeting of the Institute of Cardiovascular Science and Medicine (ICSM 2011), Hong Kong, 17 September 2011. In Journal of the Hong Kong College of Cardiology, 2011, v. 19 n. 2, p. 72, abstract no. CP

Heterotopic ossification after Primary Total Hip Replacement

Conference Theme: Defying the Aging SpineConcurrent Free Papers 9: Hips and Knees 2Introduction: Heterotopic ossification (HO) is a well-recognised complication of total hip replacement (THR). Reported incidence ranged from 8 to 90% in the western literature, but the incidence in Chinese is largely unknown. This study aimed at reviewing the incidence and clinical symptoms of HO. Materials and Methods: All consecutive THRs performed between 2008 and 2012 in our centre were reviewed. All were performed in posterior approach without perioperative HO prophylaxis. Patient’s gender, age, diagnosis, and types of prosthesis were recorded. Serial postoperative X-rays were reviewed for HO and were graded according to Brooker classification if present. Results: A total of 289 primary THRs were performed on 245 patients in the study period, and all had clinical and radiological follow-up for at least 2 years. In all, 5 all-cementless THRs (3 male and 2 female, all were Chinese) were found to have HO, and the calculated incidence was 1.7%. The HO was graded as class I in 2 hips, class II in 1 hip, and class III in 2 hips. Also, 3 had underlying diagnosis of primary osteoarthritis with the remaining being rheumatoid arthritis and ankylosis spondylitis. Among the patients with HO, 3 had no pain and 2 only reported occasional ache. They had a mean postoperative Harris Hip Score of 77.5. Discussion and Conclusion: The incidence of HO in our study was low compared with that in the western literature. The patients reported minimal clinical symptoms even when complicated by HO

Does quantity of smoking reduction predict later abstinence: a posteriori evidence from a randomized control trial

Poster Session 3BACKGROUND AND AIM: Behavioral and nicotine replacement therapy (NRT) are effective in helping smokers reduce smoking first before complete cessation. We examined whether the percentage reduction in cigarette consumption predicted later abstinence. METHODS: A posteriori analysis was done on 928 smokers who did not want to quit and participated as subjects in the intervention group of a randomized controlled trial of counseling and free NRT for 8 weeks. Reduction was analysed as the percentage of decrease in self-reported daily cigarette consumption at different follow-ups (1-week, 1- & 3-month) compared with that at baseline. Logistic regression model was used to examine if smoking reduction quantity predicted quitting at 6-month follow-up. FINDINGS: Reducing smoking by less than 50% in all the early follow-ups was not significant predictors of abstinence. Smoking reduction by 50% or more at 1 week (OR=1.95, 95%CI:0.96-3.95) and 1 month (OR=5.96, 95%CI:1.37-25.98), and reduction by 75% or more at 3 months (OR=7.24, 95%CI:1.94-27.01) were predictive to abstinence. Progressively increasing the reduction quantity from 1 week to 3 months (OR=2.68, 95%CI:1.37- 5.25), or from 1 month to 3 months (OR=2.34, 95%CI:1.24-4.43) can increase the chance of abstinence. CONCLUSIONS: Greater smoking reduction predicted greater success in cessation. To increase the effectiveness of the smoking reduction intervention, clinicians should advise the smokers who do not wish to quit to reduce smoking by 50% or more, and to reduce further until total abstinence is achieved