Gender Differences: Smokers With and Without Substance Abuse History

poster abstractPrevious research suggests that individuals with chemical dependence history experience more intense nicotine addiction, and during smoking cessation may be more likely to demonstrate increased negative affect and unfavorable scores on psychometric assessments. It is unknown how men and women may differ in their susceptibilities to such undesirable outcomes. From 1992-2004, The Indiana University Nicotine Dependence Program (IUNDP) treated over 1200 patients using a Mayo Clinic-based protocol which assesses the behavioral, social, and physiological aspects of nicotine dependence. The IUNDP was instituted at Fairbanks Hospital’s addictions center to address tobacco use among the patients and staff. Charts of individuals who completed nicotine dependence treatment (1992-2011) were selected from IU School of Dentistry and Fairbanks Hospital for retrospective analysis. Chart selection criteria consisted of the availability of complete pre-and post quit measures for a minimum of four total appointments and two post-quit appointments. Reviewed were 107 charts from patients without a history of chemical dependence (ND) and 123 from those with a chemical dependence history (CD), including 120 men and 110 women. Student researchers used a standardized protocol to capture 16 tobacco use and demographic variables and 12 post-quit measures. Comparisons between CD and ND groups were made using Pearson chi-square tests for binary data, Wilcoxon rank sum tests for all other data, and Wilcoxon signed rank tests for changes between time periods. Despite similarities among CD and ND smokers, males and females appear to face distinct challenges. Results suggest CD males are significantly more negative in mood, and are more likely to have increased withdrawal symptoms at the end of treatment. Males were also more likely to experience adverse events with NRT. Both CD males and females experienced more increased appetite than their ND counterparts. Females scored higher on addiction-related sensorimotor manipulation and may have increased propensity for psychological dependence

Retail promotions and perceptions of R.J. Reynolds' novel dissolvable tobacco in a US test market

<p>Abstract</p> <p>Background</p> <p>With declining cigarette sales, tobacco manufacturers have been developing and marketing new smokeless products, such as R. J. Reynolds' dissolvable tobacco, Camel Sticks, Strips and Orbs. This study assessed the availability, price and point-of-purchase promotional strategies for Camel Dissolvables, and investigated consumer awareness, interest and perception of these products in the Indiana test market.</p> <p>Methods</p> <p>An exploratory retail audit of point-of-purchase promotions was conducted in a random sample of retailers from 6 store categories (n = 81) in the test market area. Data included: store type, location, product placement, forms/flavors carried, price, types and locations of advertisements and promotions, and ad messages. An Awareness-Attitude-Usage (AAU) survey was used to gauge consumer awareness and knowledge of tobacco products including Camel Dissolvables. Respondents were shown promotional materials from a package onsert and perceptions and interest in the Camel Dissolvables were assessed. An Intended Target Survey (ITS) compared subjects' perceptions of ad targets for several non-tobacco products, as well as Camel Snus, Camel No. 9 and Camel Dissolvables. Respondents were asked to identify each ad's intended target category, perceived targetedness, and purchase intent.</p> <p>Results</p> <p>The products were carried by 46% of stores, most frequently gas stations (100%) and convenience stores (75%). They were shelved near smokeless tobacco (70%), cigarettes (25%) or candy (5%). Prices ranged from $3.59 -$4.19 per package; most stores carried at least 1 promotional item. Ad messages included: "Dissolvable Tobacco" (60%). "Free Trial" (24%), "Special Price" (24%), "What's Your Style?" (22%). At 14% of stores, free trial packs of Camel Dissolvables were offered with another Camel purchase. Awareness was reported by 42% of respondents (n = 243), and trial by 3%. Consumer interest was very low, but younger respondents (< 40 years) were more familiar with Camel Dissolvables (60% vs. 45% for those > 40 years, p < .01). Males, as well as current and former smokers had higher rates of interest and trial; only 1% of never smokers reported trial. In the ITS, only for the 3 tobacco product ads, was perceived targetedness for smokers significantly higher than for non-smokers. Smokers and nonsmokers perceived that the ads targeted smokers.</p> <p>Conclusions</p> <p>Current retail promotional strategies for Camel Sticks, Strips & Orbs appear to be targeting a select audience, primarily current smokers. Overall, consumer awareness, interest and trial were low.</p

Residents' Knowledge regarding Recreational Drug Screening Immunoassays at a Swiss Hospital Group.

INTRODUCTION In case of suspected acute recreational drug toxicity, immunoassays are commonly used as diagnostic tools. Although easy to handle, understanding of their limitations is necessary for a correct interpretation of the results. The aim of this project was to investigate residents' knowledge regarding drug screening immunoassays at a Swiss hospital group. METHODS All residents of a large hospital group in Switzerland were invited by e-mail to participate in an anonymous survey. Following ten multiple choice questions on drug screening tests, the participants were also asked about their demographics, whether they used drug screening tests on a regular basis, and how confident they felt in their ability to interpret test results. RESULTS The ten knowledge questions were answered by 110 of the 1026 residents (11%). Among the 108 participants with available demographics, 90% were 25-35 years old, 63% were female, and 70% were at least in their 4th year of residency. The median score of correct answers was 4 out of 10 (range 0-7) and in 50% of the questions, the correct answer was the most frequently selected response. No significant differences in the knowledge scores were found based on the training, confidence level, or the frequency of drug tests used in daily work. CONCLUSION This survey revealed widespread knowledge gaps among residents regarding the interpretation of immunoassay-based drug test results. These findings can be used to implement educational measures on this topic and might provide a basis for targeted information on common pitfalls to be included in laboratory reports

The roles of the atmosphere and ocean in driving Arctic warming due to European aerosol reductions

Clean air policies can have significant impacts on climate in remote regions. Previous modeling studies have shown that the temperature response to European sulfate aerosol reductions is largest in the Arctic. Here, we investigate the atmospheric and ocean roles in driving this enhanced Arctic warming using a set of fully‐coupled and slab‐ocean simulations (specified ocean heat convergence fluxes) with the Norwegian Earth system model (NorESM), under scenarios with high and low European aerosol emissions relative to year 2000. We show that atmospheric processes drive most of the Arctic response. The ocean pathway plays a secondary role inducing small temperature changes mostly in the opposite direction of the atmospheric response. Important modulators of the temperature response patterns are changes in sea‐ice extent and subsequent turbulent heat flux exchange, suggesting that a proper representation of Arctic sea‐ice and turbulent changes are key to predicting the Arctic response to mid‐latitude aerosol forcing

Evaluating a Modular Decision Support Application For Colorectal Cancer Screening

BACKGROUND: There is a need for health information technology evaluation that goes beyond randomized controlled trials to include consideration of usability, cognition, feedback from representative users, and impact on efficiency, data quality, and clinical workflow. This article presents an evaluation illustrating one approach to this need using the Decision-Centered Design framework. OBJECTIVE: To evaluate, through a Decision-Centered Design framework, the ability of the Screening and Surveillance App to support primary care clinicians in tracking and managing colorectal cancer testing. METHODS: We leveraged two evaluation formats, online and in-person, to obtain feedback from a range primary care clinicians and obtain comparative data. Both the online and in-person evaluations used mock patient data to simulate challenging patient scenarios. Primary care clinicians responded to a series of colorectal cancer-related questions about each patient and made recommendations for screening. We collected data on performance, perceived workload, and usability. Key elements of Decision-Centered Design include evaluation in the context of realistic, challenging scenarios and measures designed to explore impact on cognitive performance. RESULTS: Comparison of means revealed increases in accuracy, efficiency, and usability and decreases in perceived mental effort and workload when using the Screening and Surveillance App. CONCLUSION: The results speak to the benefits of using the Decision-Centered Design approach in the analysis, design, and evaluation of Health Information Technology. Furthermore, the Screening and Surveillance App shows promise for filling decision support gaps in current electronic health records

Puffing Topography and Interpersonal Bonding Behavior Observed Among Recovering Drug Addicts Versus General Smokers

poster abstractSmokers can inherently manipulate nicotine doses on a puff-by-puff basis. The character of smoking behavior may be determined by using complex forms of smoking topography in laboratory settings or by unobtrusively observing the time spent smoking a single cigarette, the number of puffs taken, interpuff intervals and smokers’ behaviors. The purpose of this study was to observe and compare smoking topography and interpersonal bonding behaviors of recovering drug addicts to that of general smokers in a natural setting (introduction). Following a variable chemical substance detox/treatment period, Fairbanks addiction treatment patients spend 3-12 weeks in follow-up treatment in two groups: Partial Hospitalized Patients (PHP) and Intensive Outpatients (IOP). PHP and IOP form tight interpersonal bonds and friendships with each other. Patients are periodically released and they meet and smoke together at an approved outdoor smoking area. From a distance, PHP and IOP (20 men and 20 women) cigarette puffing behaviors were unobtrusively observed and recorded. Two calibrated investigators, using a stop watch monitored the exact time of lighting and the extinguishing of each cigarette. For each subject, the number of puffs taken was recorded and the interpuff interval was calculated. The same protocol was followed for a population of general smokers observed on the campus of IUPUI (methods). The mean interpuff intervals were IUPUI men: 25.2 seconds (SD 11.93); IUPUI women: 30.9 seconds (SD 16.0); Fairbanks men: 16.2 seconds (SD 6.21); and Fairbanks women: 21.1 seconds (SD 6.51). There was a statistically significant difference in interpuff intervals between the general smokers and the recovering addicts (p<0.001) and this effect was not dependent upon gender. Behavioral observations between general smokers versus recovering addicts will be presented (results). Smokers who were recovering from chemical drug addiction smoked more intensely than the general smoking population and their smoking behaviors were often quite different (conclusions)

Poor health and functioning in patients with axial spondyloarthritis during the COVID-19 pandemic and lockdown: REUMAVID study (phase 1)

To evaluate the overall health and functioning in patients with axial spondyloarthritis (axSpA) and related factors affecting these during the COVID-19 pandemic and lockdown measure

Ovine leukocyte microparticles generated by the CentriMag ventricular assist device in vitro

Ventricular assist devices (VADs) are a life-saving form of mechanical circulatory support in heart failure patients. However, VADs have not yet reached their full potential due to the associated side effects (thrombosis, bleeding, infection) related to the activation and damage of blood cells and proteins caused by mechanical stress and foreign materials. Studies of the effects of VADs on leukocytes are limited, yet leukocyte activation and damage including microparticle generation can influence both thrombosis and infection rates. Therefore, the aim was to develop a multicolour flow cytometry assessment of leukocyte microparticles (LMPs) using ovine blood and the CentriMag VAD as a model for shear stress. Ovine blood was pumped for 6 hours in the CentriMag and regular samples analysed for haemolysis, complete blood counts and leukocyte microparticles by flow cytometry during three different pump operating conditions (low flow, standard, high speed). The high speed condition caused significant increases in plasma-free haemoglobin; decreases in total leukocytes, granulocytes, monocytes and platelets; increases in CD45+ LMPs as well as two novel LMP populations: CD11bbright/HLA-DR- and CD11bdull/HLA-DR+, both of which were CD14-/CD21-. CD11bbright/HLA-DR- LMPs appeared to respond to an increase in shear magnitude whereas the CD11bdull/HLA-DR+ LMPs significantly increased in all pumping conditions. We propose that these two populations are released from granulocytes and T cells, respectively, but further research is needed to better characterise these two populations