Smoking behaviour predicts tobacco control attitudes in a high smoking prevalence hospital: A cross-sectional study in a Portuguese teaching hospital prior to the national smoking ban

<p>Abstract</p> <p>Background</p> <p>Several studies have investigated attitudes to and compliance with smoking bans, but few have been conducted in healthcare settings and none in such a setting in Portugal. Portugal is of particular interest because the current ban is not in line with World Health Organization recommendations for a "100% smoke-free" policy. In November 2007, a Portuguese teaching-hospital surveyed smoking behaviour and tobacco control (TC) attitudes before the national ban came into force in January 2008.</p> <p>Methods</p> <p>Questionnaire-based cross-sectional study, including all eligible staff. Sample: 52.9% of the 1, 112 staff; mean age 38.3 ± 9.9 years; 65.9% females. Smoking behaviour and TC attitudes and beliefs were the main outcomes. Bivariable analyses were conducted using chi-squared and MacNemar tests to compare categorical variables and Mann-Whitney tests to compare medians. Multilogistic regression (MLR) was performed to identify factors associated with smoking status and TC attitudes.</p> <p>Results</p> <p>Smoking prevalence was 40.5% (95% CI: 33.6-47.4) in males, 23.5% (95% CI: 19.2-27.8) in females (p < 0.001); 43.2% in auxiliaries, 26.1% in nurses, 18.9% among physicians, and 34.7% among other non-health professionals (p = 0.024). The findings showed a very high level of agreement with smoking bans, even among smokers, despite the fact that 70.3% of the smokers smoked on the premises and 76% of staff reported being frequently exposed to second-hand smoke (SHS). In addition 42.8% reported that SHS was unpleasant and 28.3% admitted complaining. MLR showed that smoking behaviour was the most important predictor of TC attitudes.</p> <p>Conclusions</p> <p>Smoking prevalence was high, especially among the lower socio-economic groups. The findings showed a very high level of support for smoking bans, despite the pro-smoking environment. Most staff reported passive behaviour, despite high SHS exposure. This and the high smoking prevalence may contribute to low compliance with the ban and low participation on smoking cessation activities. Smoking behaviour had greater influence in TC attitudes than health professionals' education. Our study is the first in Portugal to identify potential predictors of non-compliance with the partial smoking ban, further emphasising the need for a 100% smoke-free policy, effective enforcement and public health education to ensure compliance and promote social norm change.</p

Aquatic Ecosystems and Climate Changes: Data Gaps in Relation to Flooding Events

at european level the strategy on adaptatio to climate chenges promoted adaptation plans at all levels and has recommended the need to bridge the gaps through applicaitons of actions at local level. In the paper has been remarked that there are some gaps in the European legislation that should be solved through the funding of more research projects and pilot studies; for example the use of microbiological monitoring, not foreseen by the water framework directive, can help to identify and prevent effect adverse on human health. In this study we propose an operative methodology to be applied at local level with the aim to support the institutional requirements for risk management before and after flooding events, based on a multi-criteria approach. This integrated monitoring plan coul represent a shared methodology with the aim to give a contribution for the management of the risks of extreme weather events such as flooding for human health and ecosystem protection

ONLINE Special Article: Nursing care for patients with non-small cell lung cancer receiving adjuvant chemotherapy: Evidence–based implications for practice

Oncology nurses provide care to patients and their families across the cancer care continuum including counselling patients on issues related to treatment completion, providing education directed towards the prevention of side effects, assessing and managing symptoms, and follow-up. Believing that a nursing-specific perspective related to these concerns was necessary to improve care for patients with resected, non-small cell lung cancer (NSCLC) receiving adjuvant chemotherapy, a nursing guidance report was initiated. This report was developed by utilizing evidence retrieved in a practice guideline report, general principles established by CANO/ACIO, Fitch’s supportive care model, and the clinical experiences of Lung DSG members. Evidence on the toxicity and adverse events that are caused by adjuvant chemotherapy and side effects and symptoms that are amenable to nursing intervention are highlighted and discussed

Article offert EN LIGNE : Soins infirmiers pour patients atteints du cancer du poumon non à petites cellules recevant une chimiothérapie adjuvante : implications pour la pratique fondée sur les données probantes

Les infirmières en oncologie prodiguent des soins aux patients et à leur famille dans tout le continuum des soins de cancérologie, notamment en offrant des services de counseling aux patients relativement à l’achèvement du traitement, en dispensant de l’enseignement en vue de prévenir les effets secondaires, en évaluant et en gérant les symptômes et en effectuant le suivi nécessaire. Comme nous jugions qu’il était nécessaire d’explorer ces préoccupations du point de vue des soins infirmiers en vue d’améliorer les soins aux patients atteints d’un cancer du poumon non à petites cellules (CPNPC) avec résection tumorale recevant une chimiothérapie adjuvante, nous avons amorcé la préparation d’un rapport d’orientation pour les soins infirmiers. Ce dernier a été élaboré à partir des données d’un rapport sur les lignes directrices de pratique, des principes généraux établis par l’Association canadienne des infirmières en oncologie (ACIO), du modèle des soins de soutien de Fitch et de l’expérience clinique des membres du Groupe spécialisé dans le cancer pulmonaire. On y souligne et aborde les résultats liés à la toxicité et aux événements indésirables causés par la chimiothérapie adjuvante et les effets secondaires et symptômes qui peuvent se prêter à une intervention infirmière

Mercury (Hg) and methylmercury (MeHg) in sediment and biota: A case study in a lagoon in Central Italy

A quantification of total mercury (Hgtot) and methylmercury (MeHg) concentrations in sediment and mussels was carried out in the east basin of the Orbetello lagoon in order to assess their bioaccumulation potential. The sediment was sampled in four macroareas, mussels were transplanted in the same sites and collected after seven weeks. The results show that Hgtot concentrations in sediments exceeded (0.21–16.9 mg/kg dry weight (dw)) the environmental quality standard of the Italian legislation (0.3 mg/kg dw). The Hgtot concentration in mussels (0.050–0.324 mg/kg wet weight (ww)) does not exceed the limit values (0.5 mg/kg ww) of the European food legislation. The biota–sediment accumulation factors (BSAFs) derived for MeHg (80–306.7) and a biomagnification factor (BMF) greater than 1 for Hgtot demonstrate that in the lagoon, these compounds can be transferred in the upper levels of the trophic chain and pose a risk to human health

Interventions to address sexual problems in people with cancer: American society of clinical oncology clinical practice guideline adaptation of cancer care Ontario guideline

© 2017 by American Society of Clinical Oncology. Purpose The adaptation of the Cancer Care Ontario (CCO) guideline Interventions to Address Sexual Problems in People With Cancer provides recommendations to manage sexual function adverse effects that occur as a result of cancer diagnosis and/or treatment. Methods ASCO staf reviewed the guideline for developmental rigor and updated the literature search. An ASCO Expert Panel (Table A1)was assembled to reviewthe guideline content and recommendations. Results The ASCO Expert Panel determined that the recommendations from the 2016 CCO guideline are clear, thorough, and based upon the most relevant scientific evidence. ASCO statements and modifications were added to adapt the CCO guideline for a broader audience. Recommendations It is recommended that there be a discussion with the patient, initiated by a member of the health care team, regarding sexual health and dysfunction resulting from cancer or its treatment. Psychosocial and/or psychosexual counseling should be offered to all patients with cancer, aiming to improve sexual response, body image, intimacy and relationship issues, and overall sexual functioning and satisfaction. Medical and treatable contributing factors should be identified and addressed first. In women with symptoms of vaginal and/or vulvar atrophy, lubricants in addition to vaginal moisturizers may be tried as a first option. Low-dose vaginal estrogen, lidocaine, and dehydroepiandrosterone may also be considered in some cases. In men, medication such as phosphodiesterase type 5 inhibitors may be beneficial, and surgery remains an option for those with symptoms or treatment complications refractory to medical management. Both women and men experiencing vasomotor symptoms should be offered interventions for symptomatic improvement, including behavioral options such as cognitive behavioral therapy, slow breathing and hypnosis, and medications such as venlafaxine and gabapentin.Additional information is available at: Www.asco. org/survivorship-guidelines and www.asco.org/guidelineswiki