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âI would love to see these big institutions⊠throwing their weight aroundâ: qualitative findings regarding health and social sector collaborations to address community-level socioeconomic adversity
BackgroundHealth and social sector organizations are increasingly working together to mitigate socioeconomic adversity within their communities. We sought to learn about the motivations, experiences, and perspectives of organizations engaged in these collaborations.MethodsWe conducted semi-structured, 60-minute interviews with 34 leaders from 25 health and social sector organizations between January-April 2021. Interviews explored motivations, benefits and challenges, and ways in which health sector organizations can most effectively address community-level socioeconomic adversity. Interviews were audio recorded and transcribed; themes were coded using Dedoose software.ResultsPartnerships were primarily motivated by mission-driven organizations and key health sector leaders who were interested in addressing root causes of poor health; policies such as certificate of need laws and value-based care incentives that aligned community-level investments with health sector organizations' financial interests facilitated these efforts. While partnerships were mostly regarded as mutually beneficial ways to increase impact (for the health sector) and resource access (for the social sector), social sector organizations voiced frustrations regarding the outsized expectations, unsustained interest, and lack of partnership from their health sector collaborators. Despite these frustrations, both health and social sector interviewees supported the health sector's continued involvement in community-level socioeconomic initiatives and expansion of policy and systems efforts.ConclusionsCross-sector, community-level socioeconomic initiatives were mutually beneficial, but social sector organizations experienced more frustrations. Policy and organizational changes within the health sector can further mobilize and sustain support for these efforts
Loss of the Ecdysteroid-Inducible E75A Orphan Nuclear Receptor Uncouples Molting from Metamorphosis in Drosophila
AbstractIsoform-specific null mutations were used to define the functions of three orphan members of the nuclear receptor superfamily, E75A, E75B, and E75C, encoded by the E75 early ecdysteroid-inducible gene. E75B mutants are viable and fertile, while E75C mutants die as adults. In contrast, E75A mutants have a reduced ecdysteroid titer during larval development, resulting in developmental delays, developmental arrests, and molting defects. Remarkably, some E75A mutant second instar larvae display a heterochronic phenotype in which they induce genes specific to the third instar and pupariate without undergoing a molt. We propose that ecdysteroid-induced E75A expression defines a feed-forward pathway that amplifies or maintains the ecdysteroid titer during larval development, ensuring proper temporal progression through the life cycle
Trends in smoking and quitting in China from 1993 to 2003: National Health Service Survey data
OBJECTIVE: China has about 350 million smokers, more commonly men. Using data from National Health Service Surveys conducted in 1993, 1998 and 2003, we (i)Â estimated trends in smoking prevalence and cessation according to sociodemographic variables and (ii)Â analysed cessation rates, quitting intentions, reasons for quitting and reasons for relapsing. METHODS: Data were collected from approximately 57â000 households and 200â000 individuals in each survey year. Household members >â15 years of age were interviewed about their smoking habits, quitting intentions and attitudes towards smoking. We present descriptive data stratified by age, sex, income level and rural versus urban residence. FINDINGS: In China, current smoking in those >â15 years old declined 60â49% in men and 5â3.2% in women over 1993â2003. The decline was more marked in urban areas. However, heavy smoking (â„â20 cigarettes daily) increased substantially overall and doubled in men. The average age of uptake also dropped by about 3Â years. In 2003, 7.9% of smokers reported intending to quit, and 6% of people who had ever smoked reported having quit. Of former smokers, 40.6% quit because of illness, 26.9% to prevent disease and 10.9% for financial reasons. CONCLUSION: Smoking prevalence declined in China over the study period, perhaps due to the combined effect of smoking cessation, reduced uptake in women and selective mortality among men over 40 years of age. However, heavy smoking increased. People in China rarely quit or intend to quit smoking, except at older ages. Further tobacco control efforts are urgently needed, especially in rural areas
Disposition and metabolism of [3H]pseudomorphine in the rat
[3H]pseudomorphine (3H-PM) was prepared by the oxidation of [3H]morphine. A method for the estimation of 3H-PM in biological materials was developed with a minimal sensitivity of 2.5 ng/ml of biologic material. Following the subcutaneous injection of 3H-PM (10 mg/kg as free base) in rats, the levels of 3H-PM in brain and spinal cord over a 2-hr period ranged between 4.6 to 17.9 ng/g and 24 to 76.5 ng/g, respectively. No detectable levels of 3H-PM were present at 4 hr in the CNS. Peak plasma levels occurred at 30 min (501 ng/ml) and then fell rapidly with no detectable amounts present at 4 hr. About 78.2 per cent of the administered 3H-PM was accounted for in the urine and feces after 48 hr. Conjugated pseudomorphine was not detected in biological material, and direct chromatography of urine provided evidence for the presence of only free 3H-PM. The existence of a polar metabolite, however, cannot be precluded. Studies on rat brain extracts following the administration of [3H]morphine (10 mg/kg as free base) provided no evidence for the formation of pseudomorphine as an oxidative metabolite of morphine in vivo.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34193/1/0000482.pd
Impact of Scottish smoke-free legislation on smoking quit attempts and prevalence
<p><b>Objectives:</b> In Scotland, legislation was implemented in March 2006 prohibiting smoking in all wholly or partially enclosed public spaces. We investigated the impact on attempts to quit smoking and smoking prevalence.</p>
<p><b>Methods:</b> We performed time series models using Box-Jenkins autoregressive integrated moving averages (ARIMA) on monthly data on the gross ingredient cost of all nicotine replacement therapy (NRT) prescribed in Scotland in 2003â2009, and quarterly data on self-reported smoking prevalence between January 1999 and September 2010 from the Scottish Household Survey.</p>
<p><b>Results:</b> NRT prescription costs were significantly higher than expected over the three months prior to implementation of the legislation. Prescription costs peaked at ÂŁ1.3 million in March 2006; ÂŁ292,005.9 (95% CI ÂŁ260,402.3, ÂŁ323,609, p<0.001) higher than the monthly norm. Following implementation of the legislation, costs fell exponentially by around 26% per month (95% CI 17%, 35%, p<0.001). Twelve months following implementation, the costs were not significantly different to monthly norms. Smoking prevalence fell by 8.0% overall, from 31.3% in January 1999 to 23.7% in JulyâSeptember 2010. In the quarter prior to implementation of the legislation, smoking prevalence fell by 1.7% (95% CI 2.4%, 1.0%, p<0.001) more than expected from the underlying trend.</p>
<p><b>Conclusions:</b> Quit attempts increased in the three months leading up to Scotland's smoke-free legislation, resulting in a fall in smoking prevalence. However, neither has been sustained suggesting the need for additional tobacco control measures and ongoing support.</p>
Should the Health Community Promote Smokeless Tobacco (Snus) as a Harm Reduction Measure?
Background to the debate: The tobacco control community is divided on whether or not to inform the public that using oral, smokeless tobacco (Swedish snus) is less hazardous to health than smoking tobacco. Proponents of âharm reductionâ point to the Swedish experience. Snus seems to be widely used as an alternative to cigarettes in Sweden, say these proponents, contributing to the low overall prevalence of smoking and smoking-related disease. Harm reduction proponents thus argue that the health community should actively inform inveterate cigarette smokers of the benefits of switching to snus. However, critics of harm reduction say that snus has its own risks, that no form of tobacco should ever be promoted, and that Sweden's experience is likely to be specific to that culture and not transferable to other settings. Critics also remain deeply suspicious that the tobacco industry will use snus marketing as a âgatewayâ to promote cigarettes. In the interests of promoting debate, the authors (who are collaborators on a research project on the future of tobacco control) have agreed to outline the strongest arguments for and against promoting Swedish snus as a form of harm reduction
Situating interventions to bridge the intention-behaviour gap: A framework for recruiting nonconscious processes for behaviour change
This paper presents a situated cognition framework for creating social psychological interventions to bridge the intentionâbehaviour gap and illustrates this framework by reviewing examples from the domains of health behaviour, environmental behaviour, stereotyping, and aggression. A recurrent problem in behaviour change is the fact that often, intentions are not translated into behaviour, causing the so-called intentionâbehaviour gap. Here, it is argued that this happens when situational cues trigger situated conceptualizations, such as habits, impulses, hedonic goals, or stereotypical associations, which can then guide behaviour automatically. To be effective in changing such automatic effects, behaviour change interventions can attempt to change situational cues through cueing interventions such as priming, nudging, upstream policy interventions, or reminders of social norms. Alternatively, behaviour change interventions can attempt to change the underlying situated conceptualizations through training interventions, such as behavioural inhibition training, mindfulness training, or implementation intentions. Examples of situated behaviour change interventions of both types will be discussed across domains, along with recommendations to situate interventions more strongly and thus enhance their effectiveness to change automatic behaviour. Finally, the discussion addresses the difference between tailoring and situating interventions, issues of generalization and long-term effectiveness, and avenues for further research
Is there an impact of public smoking bans on self-reported smoking status and exposure to secondhand smoke?
<p>Abstract</p> <p>Background</p> <p>Implementation of smoke free policies has potentially substantial effects on health by reducing secondhand smoke exposure. However little is known about whether the introduction of anti-smoking legislation translates into decreased secondhand smoke exposure. We examined whether smoking bans impact rates of secondhand smoke exposure in public places and rates of complete workplace smoking restriction.</p> <p>Methods</p> <p>Canadian Community Health Survey was used to obtain secondhand smoking exposure rates in 15 Ontario municipalities. Data analysis included descriptive summaries and 95% confidence intervals were calculated and compared across groups</p> <p>Results</p> <p>Across all studied municipalities, secondhand smoke exposure in public places decreased by 4.7% and workplace exposure decreased by 2.3% between the 2003 and 2005 survey years. The only jurisdiction to implement a full ban from no previous ban was also the only setting that experienced significant decreases in both individual exposure to secondhand smoke in a public place (-17.3%, 95% CI -22.8, -11.8) and workplace exposure (-18.1%, 95% CI -24.9, -11.3). Exposures in vehicles and homes declined in almost all settings over time.</p> <p>Conclusions</p> <p>Implementation of a full smoking ban was associated with the largest decreases in secondhand smoke exposure while partial bans and changes in existing bans had inconsistent effects. In addition to decreasing exposure in public places as would be expected from legislation, bans may have additional benefits by decreasing rates of current smokers and decreasing exposures to secondhand smoke in private settings.</p
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