Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial

Objective To evaluate the impact of telling patients their estimated spirometric lung age as an incentive to quit smoking.Design Randomised controlled trial.Setting Five general practices in Hertfordshire, England.Participants 561 current smokers aged over 35.Intervention All participants were offered spirometric assessment of lung function. Participants in intervention group received their results in terms of "lung age" (the age of the average healthy individual who would perform similar to them on spirometry). Those in the control group received a raw figure for forced expiratory volume at one second (FEV1). Both groups were advised to quit and offered referral to local NHS smoking cessation services.Main outcome measures The primary outcome measure was verified cessation of smoking by salivary cotinine testing 12 months after recruitment. Secondary outcomes were reported changes in daily consumption of cigarettes and identification of new diagnoses of chronic obstructive lung disease.Results Follow-up was 89%. Independently verified quit rates at 12 months in the intervention and control groups, respectively, were 13.6% and 6.4% (difference 7.2%, P=0.005, 95% confidence interval 2.2% to 12.1%; number needed to treat 14). People with worse spirometric lung age were no more likely to have quit than those with normal lung age in either group. Cost per successful quitter was estimated at 280 pound ((euro) 365, $556). A new diagnosis of obstructive lung disease was made in 17% in the intervention group and 14% in the control group; a total of 16% (89/561) of participants.Conclusion Telling smokers their lung age significantly improves the likelihood of them quitting smoking, but the mechanism by which this intervention achieves its effect is unclear.Trial registration National Research Register N0096173751

RAMESES publication standards: realist syntheses

PMCID: PMC3558331This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Shared visiting in Equator city

In this paper we describe an infrastructure and prototype system for sharing of visiting experiences across multiple media. The prototype supports synchronous co-visiting by physical and digital visitors, with digital access via either the World Wide Web or 3-dimensional graphics

Comparing placentas from normal and abnormal pregnancies

This report describes work carried out at a Mathematics-in-Medicine Study Group. It is believed that placenta shape villous network characteristics are strongly linked to the placenta’s efficiency, and hence to pregnancy outcome. We were asked to consider mathematical ways to describe the shape and other characteristics of a placenta, as well as forming mathematical models for placenta development. In this report we propose a number of possible measure of placental shape, form, and efficiency, which can be computed from images already obtained. We also consider various models for the early development of placentas and the growth of the villous tree

Caring for the patient, caring for the record: an ethnographic study of 'back office' work in upholding quality of care in general practice

© 2015 Swinglehurst and Greenhalgh; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Additional file 1: Box 1. Field notes on summarising (Clover Surgery). Box 2. Extract of document prepared for GPs by summarisers at Clover Surgery. Box 3. Fieldnotes on coding incoming post, Clover (original notes edited for brevity).This work was funded by a research grant from the UK Medical Research Council (Healthcare Electronic Records in Organisations 07/133) and a National Institute of Health Research doctoral fellowship award for DS (RDA/03/07/076). The funders were not involved in the selection or analysis of data nor did they make any contribution to the content of the final manuscript

Inter-social-networking: Accounting for multiple identities

We argue that the current approaches to online social networking give rise to numerous challenges regarding the management of the multiple facets of people’s digital identities within and around social networking sites (SNS). We propose an architecture for enabling people to better manage their SNS identities that is informed by the way the core Internet protocols developed to support interoperation of proprietary network protocols, and based on the idea of Separation of Concerns [1]. This does not require modification of existing services but is predicated on providing a connecting layer over them, both as a mechanism to address problems of privacy and identity, and to create opportunities to open up online social networking to a much richer set of possible interactions and applications.This work is supported by Horizon Digital Economy Research, RCUK grant EP/G065802/1; and by CREATe, the Centre for Copyright and New Business Models, RCUK grant AH/K000179/1. Packages and source are available under open source licenses at github.com/CREATe-centre/.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/978-3-319-20367-6_2