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

Downstream change in channel hydraulics along the River Severn, UK

An understanding of the longstream distribution of hydraulic processes is important for evaluating the mechanisms which control the catchment-scale variation of channel stability, sediment transport and siltation, flood generation and aquatic habitats. However, little attention has been given to quantifying the detailed spatial and temporal variability of channel hydraulic parameters, despite considerable attention to reach-scale processes. This study uses a combined field and modelling approach to define the distributions of channel hydraulic parameters between the source and the near-tidal limit of the River Severn, UK. Field measurements were made at 25 logarithmically-spaced sites along the Severn, under 3 flow conditions (low, medium and high) defined by exceedence frequencies. A flow event, occurring between 15-24 February 1989, was simulated by the 1-D hydraulic model, MIKE11. The simulated reach consists of cross sections spaced at 1 km intervals between 4 km and 254 km downstream from the source. Channel hydraulic parameters showed considerable variability in both space and time, reflecting cross section geometry variation downstream. Mean velocity increased with distance downstream from 0.23 m s$^{-1}$ to 1.72 m s$^{-1}$ under steady, bankfull flow conditions. However, unsteady flows simulated by MIKE11 demonstrated a longitudinal decline in the mean velocity of the wave peak associated with the rapid movement and minimal attenuation of the flood wave through the unconfined upper Severn. Flow resistance (Manning's n and Darcy-Weisbach f) decreased downstream from the source (0.32 - 0.06), although under low flow conditions it increased from 0.3 to 1.1 downstream to the non-alluvial - alluvial transition at Llanidloes; thereafter it exhibited a steady downstream decline. Reach mean shear stress and unit stream power peaked near the source (5-10 km downstream; drainage area < 50 km$^2$) at 120 N m$^{-2}$ and 290 W m-2 and further downstream at the Ironbridge Gorge (170 km) (38 N m$^{-2}$; 40 W m$^{-2}$) in response to the lithological controls on channel slope and valley width

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

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

Deep magma mobilization years before the 2021 CE Fagradalsfjall eruption, Iceland

Abstract The deep roots of volcanic systems play a key role in the priming, initiation, and duration of eruptions. Causative links between initial magmatic unrest at depth and eruption triggering remain poorly constrained. The 2021 CE eruption at Fagradalsfjall in southwestern Iceland, the first deep-sourced eruption on a spreading-ridge system monitored with modern instrumentation, presents an ideal opportunity for comparing geophysical and petrological data sets to explore processes of deep magma mobilization. We used diffusion chronometry to show that deep magmatic unrest in the roots of volcanic systems can precede apparent geophysical eruption precursors by years, suggesting that early phases of magma accumulation and reorganization can occur in the absence of significant increases in shallow seismicity (&amp;lt;7 km depth) or rapid geodetic changes. Closer correlation between geophysical and diffusion age records in the months and days prior to eruption signals the transition from a state of priming to full-scale mobilization in which magma begins to traverse the crust. Our findings provide new insights into the dynamics of near-Moho magma storage and mobilization. Monitoring approaches optimized to detect early phases of magmatic unrest in the lower crust, such as identification and location of deep seismicity, could improve our response to future eruptive crises.</jats:p