Time trends in access to smoking cessation support for people with depression or severe mental illness: a cohort study in English primary care

OBJECTIVES: To investigate delivery of smoking cessation interventions, recorded quit attempts and successful quitting rates within primary care in smokers with depression or severe mental illness (SMI) compared with those without. DESIGN: Longitudinal cohort study using primary healthcare records. SETTING: English primary care. PARTICIPANTS: 882 849 patients registered with participating practices recorded as current smokers during 2007-2014, including three groups: (1) 13 078 with SMI, (2) 55 630 with no SMI but recent depression and (3) 814 141 with no SMI nor recent depression. OUTCOMES: Recorded advice to quit smoking, referrals to smoking cessation services, prescriptions for smoking cessation medication, recorded quit attempts and changes of smoking status. RESULTS: The majority (>70%) of smokers had recorded smoking cessation advice. This was consistently higher in those with SMI than the other cohorts of patients, although the gap greatly reduced in more recent years. Increases in smoking cessation advice over time were not accompanied by increases in recorded attempts to quit or changes of smoking status. Overall nicotine replacement therapy prescribing by general practitioners (GPs) was higher in those with SMI (10.1%) and depression (8.7%) than those without (5.9%), but a downward time trend was observed in all groups. Bupropion and varenicline prescribing was very low and lower for those with SMI. Few smokers (<5%) had referrals to stop smoking services, though this increased over time, but no significant differences were observed between those with and without mental health problems. CONCLUSIONS: There was no evidence of consistent inequalities in access to GP-delivered smoking cessation interventions for people with mental health conditions. Smoking cessation advice was widely reported as taking place in all groups. In order to address the widening gap in smoking prevalence in those with poor mental health compared with those without, the emphasis should be on addressing the quality of advice and support given

Time trends in access to smoking cessation support for people with depression or severe mental illness: a cohort study in English primary care

Objectives: To investigate delivery of smoking cessation interventions, recorded quit attempts and successful quitting rates within primary care in smokers with depression or severe mental illness (SMI) compared with those without. Design: Longitudinal cohort study using primary healthcare records. Setting: English primary care. Participants: 882 849 patients registered with participating practices recorded as current smokers during 2007–2014, including three groups: (1) 13 078 with SMI, (2) 55 630 with no SMI but recent depression and (3) 814 141 with no SMI nor recent depression. Outcomes: Recorded advice to quit smoking, referrals to smoking cessation services, prescriptions for smoking cessation medication, recorded quit attempts and changes of smoking status. Results: The majority (>70%) of smokers had recorded smoking cessation advice. This was consistently higher in those with SMI than the other cohorts of patients, although the gap greatly reduced in more recent years. Increases in smoking cessation advice over time were not accompanied by increases in recorded attempts to quit or changes of smoking status. Overall nicotine replacement therapy prescribing by general practitioners (GPs) was higher in those with SMI (10.1%) and depression (8.7%) than those without (5.9%), but a downward time trend was observed in all groups. Bupropion and varenicline prescribing was very low and lower for those with SMI. Few smokers (<5%) had referrals to stop smoking services, though this increased over time, but no significant differences were observed between those with and without mental health problems. Conclusions: There was no evidence of consistent inequalities in access to GP-delivered smoking cessation interventions for people with mental health conditions. Smoking cessation advice was widely reported as taking place in all groups. In order to address the widening gap in smoking prevalence in those with poor mental health compared with those without, the emphasis should be on addressing the quality of advice and support given

Vibrational spectroscopy of the multianion mineral Kemmlitzite (Sr,Ce)Al3(AsO4)(SO4)(OH)6

Some minerals are colloidal and show no X-ray diffraction patterns. Vibrational spectroscopy offers one of the few methods for the assessment of the structure of these types of mineral. Among this group of minerals is kemmlitzite (Sr,Ce)Al3(AsO4)(SO4)(OH)6. The objective of this research is to determine the molecular structure of the mineral kemmlitzite using vibrational spectroscopy. Raman microscopy offers a useful method for the analysis of such colloidal minerals. Raman and infrared bands are attributed to the AsO43- , SO42- and water stretching vibrations. The Raman spectrum is dominated by a very intense sharp band at 984 cm-1 assigned to the SO42- symmetric stretching mode. Raman bands at 690, 772 and 825 cm-1 may be assigned to the AsO43- antisymmetric and symmetric stretching modes. Raman bands observed at 432 and 465 cm-1 are attributable to the doubly degenerate 2 (SO4)2- bending mode. Vibrational spectroscopy is important in the assessment of the molecular structure of the kemmlitzite, especially when the mineral is non-diffracting or poorly diffracting

A Raman spectroscopic study of the basic carbonate mineral callaghanite Cu2Mg2(CO3)(OH)6⋅2H2O

Raman spectrum of callaghanite, Cu2Mg2(CO3)(OH)6⋅2H2O, was studied and compared with published Raman spectra of azurite, malachite and hydromagnesite. Stretching and bending vibrations of carbonate and hydroxyl units and water molecules were tentatively assigned. Approximate O–H…O hydrogen bond lengths were inferred from the spectra. Because of the high content of hydroxyl ions in the crystal structure in comparison with low content of carbonate units, callaghanite should be better classified as a carbonatohydroxide than a hydroxycarbonate

Bauxite residue neutralisation precipitate stability in acidic environments

This investigation used a combination of techniques, such as X-ray diffraction, inductively coupled plasma optical emission spectroscopy and infrared spectroscopy, to determine the dissolution mechanisms of the Bayer precipitate and the associated rate of dissolution in acetic, citric and oxalic acid environments. The Bayer precipitate is a mixture of hydrotalcite, calcium carbonate and sodium chloride that forms during the seawater neutralisation of Bayer liquors (waste residue of the alumina industry). The dissolution rate of a Bayer precipitate is found to be dependent on (1) the strength of\ud the organic acid and (2) the number of donating H+ ions. The dissolution mechanism for a Bayer precipitate consists\ud of several steps involving: (1) the dissolution of CaCO3, (2) formation of whewellite (calcium oxalate) when oxalic acid is used and (3) multiple dissolution steps for hydrotalcite that are highly dependent on the pH of solution. The decomposition of the Al–OH hydrotalcite layers resulted in the immediate formation of Al(OH)3, which is stable until the pH decreases below 5.5. This investigation has found that the Bayer precipitate is stable across a wide pH range in the presence of common organic acids found in the rhizosphere, and that initial decomposition steps are likely to be beneficial in supporting plant growth through the release of nutrients such as Ca2þ and Mg2þ

Adsorption of reactive dye on seawater-neutralised bauxite refinery residue

This investigation has demonstrated the need for thermal treatment of seawater neutralised red mud (SWRM) in order to obtain reasonable adsorption of Reactive Blue dye 19 (RB 19). Thermal treatment results in a greater surface area, which results in an increased adsorption capacity due to more available adsorption sites. Adsorption of RB 19 has been found to be best achieved in acidic conditions using\ud SWNRM400 (heated to 400 �C) with an adsorption capacity of 416.7 mg/g compared to 250.0 mg/g for untreated SWNRM. Kinetic studies indicate a pseudosecond-order reaction mechanism is responsible for the adsorption of RB 19 using SWNRM, which indicates adsorption occurs by electrostatic\ud interactions

Accelerating bauxite residue remediation with microbial biotechnology

Biological neutralisation of pH, driven by the microbial fermentation of added organic carbon substrates such as glucose, has recently emerged as a promising technique for remediation of bauxite residue, dropping pH from >11 t