Weak smoking cessation awareness in primary health care before surgery: a real-world, retrospective cohort study

Objective: Tobacco smoking is a well-established risk factor for postoperative complications. Research on preoperative smoking cessation in primary health care is scarce. Design: This was a retrospective cohort study. Setting: The Stop Smoking before Surgery Project (SSSP) started in Porvoo, Finland, in May of 2016, involving both primary health care and specialized health care. The goals of the project were smoking awareness and preoperative smoking cessation. Subjects: Our study involved 1482 surgical patients operated at Porvoo Hospital between May and December of 2016. Main outcome measures: We studied the recording of smoking status in all patients, and ICD-10 diagnosis of nicotine dependency and the initiation of preoperative smoking cessation in current smokers. Variables were studied from electronic patient records, comparing primary health care referrals and surgical outpatient clinic records. Results: Smoking status was visible in 14.2% of primary health care referrals, and in 18.4% of outpatient clinic records. Corresponding rates for current smokers (n = 275) were 0.0 and 8.7% for ICD-10 diagnosis of nicotine dependence, and 2.2 and 15.3% for initiation of preoperative smoking cessation. The differences between primary health care referrals and outpatient clinic records were statistically significant for all three variables (p <= .001). Conclusion: In primary health care, very little attention was paid to preoperative smoking cessation. Rates were significantly better at the surgical outpatient clinic, but still low. We could not demonstrate any certain effect of the intervention. Our results call for future research on ways to improve smoking cessation rates

Physical working conditions and subsequent sickness absence : a record linkage follow-up study among 19-39-year-old municipal employees

Purpose Physical work exposures are associated with sickness absence among older employees. We aimed to examine if they similarly contribute to all-cause sickness absence during early and mid-careers. Methods We used questionnaire data on physical work exposures linked to register data on sickness absence from 3542 municipal employees aged 19-39 years. Follow-up for the number of sickness absence days was 12 months. Exposures to physical workload, occupational environmental hazards, and sedentary work were divided into quartiles. In addition, duration of daily exposure to heavy work was included. Negative binomial regression models were used. Results Higher exposure to physical workload or hazardous exposures was associated with a higher number of sickness absence days. The age and gender adjusted rate ratios for sickness absence days among the participants whose exposure to physical workload was in the highest exposure quartile were 2.1 (95% CI 1.8-2.5) compared with those whose exposure was in the lowest quartile. In addition, rate ratios for sickness absence days among participants who reported that they do heavy physical work 1.1-2.0 h, 2.1-4.0 h or over 4 h daily were 1.6 (1.3-1.9), 1.5 (1.3-1.8) and 1.7 (1.5-2.1), respectively, compared with those who reported not doing physical work. Further adjustment for lifestyle factors or health characteristics attenuated the associations only slightly. Conclusion Exposure to physically demanding work is associated with a higher number of sickness absence days among municipal employees below 40 years of age. Physical working conditions should be considered when aiming to support later work ability.Peer reviewe

Long-term traffic air and noise pollution in relation to mortality and hospital readmission among myocardial infarction survivors.

BACKGROUND: There is relatively little evidence of health effects of long-term exposure to traffic-related pollution in susceptible populations. We investigated whether long-term exposure to traffic air and noise pollution was associated with all-cause mortality or hospital readmission for myocardial infarction (MI) among survivors of hospital admission for MI. METHODS: Patients from the Myocardial Ischaemia National Audit Project database resident in Greater London (n = 1 8,138) were followed for death or readmission for MI. High spatially-resolved annual average air pollution (11 metrics of primary traffic, regional or urban background) derived from a dispersion model (resolution 20 m × 20 m) and road traffic noise for the years 2003-2010 were used to assign exposure at residence. Hazard ratios (HR, 95% confidence interval (CI)) were estimated using Cox proportional hazards models. RESULTS: Most air pollutants were positively associated with all-cause mortality alone and in combination with hospital readmission. The largest associations with mortality per interquartile range (IQR) increase of pollutant were observed for non-exhaust particulate matter (PM(10)) (HR = 1.05 (95% CI 1.00, 1.10), IQR = 1.1 μg/m(3)); oxidant gases (HR = 1.05 (95% CI 1.00, 1.09), IQR = 3.2 μg/m(3)); and the coarse fraction of PM (HR = 1.05 (95% CI 1.00, 1.10), IQR = 0.9 μg/m(3)). Adjustment for traffic noise only slightly attenuated these associations. The association for a 5 dB increase in road-traffic noise with mortality was HR = 1.02 (95% CI 0.99, 1.06) independent of air pollution. CONCLUSIONS: These data support a relationship of primary traffic and regional/urban background air pollution with poor prognosis among MI survivors. Although imprecise, traffic noise appeared to have a modest association with prognosis independent of air pollution

Coulombically Interacting Electrons in a One-dimensional Quantum Dot

The spectral properties of up to four interacting electrons confined within a quasi one--dimensional system of finite length are determined by numerical diagonalization including the spin degree of freedom. The ground state energy is investigated as a function of the electron number and of the system length. The limitations of a description in terms of a capacitance are demonstrated. The energetically lowest lying excitations are physically explained as vibrational and tunneling modes. The limits of a dilute, Wigner-type arrangement of the electrons, and a dense, more homogeneous charge distribution are discussed.Comment: 10 pages (excl. Figures), Figures added in POSTSCRIPT, LaTe

Rotational spectra of isotopic species of methyl cyanide, CH3_3CN, in their ground vibrational states up to terahertz frequencies

Methyl cyanide is an important trace molecule in star-forming regions. It is one of the more common molecules used to derive kinetic temperatures in such sources. As preparatory work for Herschel, SOFIA, and in particular ALMA we want to improve the rest frequencies of the main as well as minor isotopologs of methyl cyanide. The laboratory rotational spectrum of methyl cyanide in natural isotopic composition has been recorded up to 1.63 THz. Transitions with good signal-to-noise ratio could be identified for CH$_3$CN, $^{13}$CH$_3$CN, CH$_3^{13}$CN, CH$_3$C$^{15}$N, CH$_2$DCN, and $^{13}$CH$_3^{13}$CN in their ground vibrational states up to about 1.2 THz. The main isotopic species could be identified even in the highest frequency spectral recordings around 1.6 THz. The highest $J'$ quantum numbers included in the fit are 64 for $^{13}$CH$_3^{13}$CN and 89 for the main isotopic species. Greatly improved spectroscopic parameters have been obtained by fitting the present data together with previously reported transition frequencies. The present data will be helpful to identify isotopologs of methyl cyanide in the higher frequency bands of instruments such as the recently launched Herschel satellite, the upcoming airplane mission SOFIA or the radio telescope array ALMA.Comment: 13 pages, 2 figures, article appeared; CDMS links update

Rate enhancement in collisions of sulfuric acid molecules due to long-range intermolecular forces

Collisions of molecules and clusters play a key role in determining the rate of atmospheric new particle formation and growth. Traditionally the statistics of these collisions are taken from kinetic gas theory assuming spherical noninteracting particles, which may significantly underestimate the collision coefficients for most atmospherically relevant molecules. Such systematic errors in predicted new particle formation rates will also affect large-scale climate models. We studied the statistics of collisions of sulfuric acid molecules in a vacuum using atomistic molecular dynamics simulations. We found that the effective collision cross section of the H2SO4 molecule, as described by an optimized potentials for liquid simulation (OPLS). OPLS all-atom force field, is significantly larger than the hard-sphere diameter assigned to the molecule based on the liquid density of sulfuric acid. As a consequence, the actual collision coefficient is enhanced by a factor of 2.2 at 300 K compared with kinetic gas theory. This enhancement factor obtained from atomistic simulation is consistent with the discrepancy observed between experimental formation rates of clusters containing sulfuric acid and calculated formation rates using hard-sphere kinetics. We find reasonable agreement with an enhancement factor calculated from the Langevin model of capture, based on the attractive part of the atomistic intermolecular potential of mean force.Peer reviewe

Long-term exposure to traffic pollution and hospital admissions in London.

Evidence on the effects of long-term exposure to traffic pollution on health is inconsistent. In Greater London we examined associations between traffic pollution and emergency hospital admissions for cardio-respiratory diseases by applying linear and piecewise linear Poisson regression models in a small-area analysis. For both models the results for children and adults were close to unity. In the elderly, linear models found negative associations whereas piecewise models found non-linear associations characterized by positive risks in the lowest and negative risks in the highest exposure category. An increased risk was observed among those living in areas with the highest socioeconomic deprivation. Estimates were not affected by adjustment for traffic noise. The lack of convincing positive linear associations between primary traffic pollution and hospital admissions agrees with a number of other reports, but may reflect residual confounding. The relatively greater vulnerability of the most deprived populations has important implications for public health

Persistent Currents in Small, Imperfect Hubbard Rings

We have done a study with small, imperfect Hubbard rings with exact diagonalization. The results for few-electron rings show, that the imperfection, whether localized or not, nearly always decrease, but can also \emph{increase} the persistent current, depending on the character of the imperfection and the on-site interaction. The calculations are generally in agreement with more specialized studies. In most cases the electron spin plays an important role.Comment: 6 pages, 4 figure