Impact of a Reduced Nicotine Standard on Young Adult Appeal for Menthol and Non-Menthol Cigarettes

Introduction The Food and Drug Administration (FDA) announced its intention to reduce the nicotine content in cigarettes as a strategy to promote cessation and reduce smoking-related harm. A low nicotine product standard will apply to all cigarettes on the market, including menthol cigarettes. In December 2021, the FDA approved a modified risk tobacco product application for menthol and non-menthol flavoured very low nicotine cigarettes (VLNC) from the 22nd Century Group. Notably, experimentation with menthol cigarettes is linked to smoking progression, as well as greater nicotine dependence relative to non-menthol cigarette use. If menthol VLNCs are perceived as more appealing than non-menthol VLNCs, this would indicate that some aspect of menthol may maintain smoking even in the absence of nicotine and FDA’s regulatory authority to ban or restrict the sale of menthol cigarettes should apply to reduced nicotine content of cigarettes. In April 2022, the FDA announced proposed rulemaking to prohibit menthol cigarettes, however it is unclear if a menthol prohibition would apply to VLNCs. Methods and analysis This study will recruit 172 young adult menthol smokers (with a specific subsample of n=40 sexual and gender minority young adults) and measure appeal for smoking experimental menthol and non-menthol VLNCs, and the impact of proposed product standards on tobacco product purchasing behaviour using an Experimental Tobacco Marketplace. Appeal across product standards will be assessed in a controlled laboratory and using ecological momentary assessment. Ethics and dissemination The protocol was approved by the University of Oklahoma Health Sciences Center Institutional Review Board (#11865). Findings will examine the effects of a reduced nicotine standard and a menthol ban on young adult smoking and will be disseminated through peer-reviewed journal articles and presentations at scientific conferences. Trial registration number NCT04340947

Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention

Abstract Background Very little research has been conducted in the area of depression among older home care clients using personal support services. These older adults are particularly vulnerable to depression because of decreased cognition, comorbid chronic conditions, functional limitations, lack of social support, and reduced access to health services. To date, research has focused on collaborative, nurse-led depression care programs among older adults in primary care settings. Optimal management of depression among older home care clients is not currently known. The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services. Methods/Design This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective. Descriptive and qualitative data will be collected to examine the feasibility and acceptability of the intervention and identify barriers and facilitators to implementation. Discussion Data collection began in May 2010 and is expected to be completed by July 2012. A collaborative nurse-led strategy may provide a feasible, acceptable and effective means for improving the health of older home care clients by improving the prevention, recognition, and management of depression in this vulnerable population. The challenges involved in designing a practical, transferable and sustainable nurse-led intervention in home care are also discussed. Trial Registration ClinicalTrials.gov: NCT0140792

Developing and maintaining the teacher-student relationship in one to one alternative provision: the tutor's experience

This study explores and illuminates tutors' experiences of their teacher-student relationships within one-to-one alternative provision. A positive teacher-student relationship is crucial in enabling students who have been excluded from school, or are at risk of exclusion, to have positive outcomes. Yet, teachers have struggled with the emotional demands of relating to pupils with such challenging behaviour. Interpretative phenomenological analysis (IPA) was used to explore the lived experiences of the teacher-student relationships of six tutors teaching students on a one-to-one basis outside school premises, such as in the students' homes or local libraries/cafes, as part of a growing aspect of alternative provision. The IPA explored, through the lens of attachment theory, the experience of developing and maintaining these relationships. The study found that the teacher-student relationship was humanistic in nature and fundamental to student engagement in learning. However, tutors did not feel they always had the right skills or support to develop or maintain these relationships. We conclude that an understanding of attachment theory and psychodynamic concepts, together with the availability of reflective supervision, could help tutors optimise their work

A Review of Serotonin in the Developing Lung and Neonatal Pulmonary Hypertension

Serotonin (5-HT) is a bioamine that has been implicated in the pathogenesis of pulmonary hypertension (PH). The lung serves as an important site of 5-HT synthesis, uptake, and metabolism with signaling primarily regulated by tryptophan hydroxylase (TPH), the 5-HT transporter (SERT), and numerous unique 5-HT receptors. The 5-HT hypothesis of PH was first proposed in the 1960s and, since that time, preclinical and clinical studies have worked to elucidate the role of 5-HT in adult PH. Over the past several decades, accumulating evidence from both clinical and preclinical studies has suggested that the 5-HT signaling pathway may play an important role in neonatal cardiopulmonary transition and the development of PH in newborns. The expression of TPH, SERT, and the 5-HT receptors is developmentally regulated, with alterations resulting in pulmonary vasoconstriction and pulmonary vascular remodeling. However, much remains unknown about the role of 5-HT in the developing and newborn lung. The purpose of this review is to discuss the implications of 5-HT on fetal and neonatal pulmonary circulation and summarize the existing preclinical and clinical literature on 5-HT in neonatal PH

Platelet activation in experimental murine neonatal pulmonary hypertension

Serotonin (5-HT) contributes to the pathogenesis of experimental neonatal pulmonary hypertension (PH) associated with bronchopulmonary dysplasia (BPD). Platelets are the primary source of circulating 5-HT and is released upon platelet activation. Platelet transfusions are associated with neonatal mortality and increased rates of BPD. As BPD is often complicated by PH, we tested the hypothesis that circulating platelets are activated and also increased in the lungs of neonatal mice with bleomycin-induced PH associated with BPD. Newborn wild-type mice received intraperitoneal bleomycin (3 units/kg) three times weekly for 3 weeks. Platelets from mice with experimental PH exhibited increased adhesion to collagen under flow (at 300

Improved Backpacking Load Carriage System

This project developed a novel load carriage system with a suspension and pivoting hip belt for backpackers. The design was validated with a controlled study of 5 male subjects. Quantitative and qualitative results were gathered to compare the experimental backpack to a commercial backpack. The design did not meet the performance specifications for reducing oscillating load, ground reaction forces, and compression and shear at the lumbosacral joint. However, it met the specification for reducing fatigue, showing a 6% VO2max ± 4% decrease. It also induced the desired amount of forward lean, 12-30 degrees. Overall, this project was a proof of concept of a small form factor oscillating load backpack that, with improvements to the suspension, could achieve even greater functionality

A Design Evaluation of Microchannel Layers in Multi-Scale Ceramic Microsystems

Ceramatec, Inc. manufactures doped-cobaltite multi-scale ceramic microsystems for oxygen and synthesis gas production. The ceramic wafer design used by Ceramatec is comprised of a dense membrane, porous, and microchannel layers. The wafers are assembled into stacks and pressurized in a vessel for industrial-scale gas production. To increase production yields, wafer deformation due to anisotropic shrinkage during sintering needs to be minimized, while optimizing wafer strength and resistance to gas flow through the microchannels. The deformation, strength, and resistance to flow for several microchannel designs will be tested experimentally. The results from this design evaluation will be used to identify the variables that have the highest impact on ceramic wafer performance. Future work will implement this design methodology into the manufacturing process at Ceramatec, Inc