Smoke-free homes: what are the barriers, motivators and enablers? A qualitative systematic review and thematic synthesis

Objective: To thematically synthesise primary qualitative studies of the barriers, motivators and enablers of smoke-free homes (SFHs). Design: Systematic review and thematic synthesis. Data sources: Searches of MEDLINE, EBM Reviews (Cochrane Database of Systematic Reviews), PsycINFO, Global Health, CINAHL, Web of Science, Informit and EMBASE, combining terms for families, households and vulnerable populations; SFH and secondhand smoke; and qualitative research, were supplemented by searches of PhD theses, key authors, specialist journals and reference lists. Study selection: We included 22 articles, reporting on 18 studies, involving 646 participants. Inclusion criteria: peer-reviewed; English language; published from 1990 onwards (to week 3 of April 2014); used qualitative data collection methods; explored participants’ perspectives of home smoking behaviours; and the barriers, motivators and enablers to initiating and/or maintaining a SFH. Data extraction: 1 of 3 authors extracted data with checking by a second. Data synthesis: A thematic synthesis was performed to develop 7 core analytic themes: (1) knowledge, awareness and risk perception; (2) agency and personal skills/attributes; (3) wider community norms and personal moral responsibilities; (4) social relationships and influence of others; (5) perceived benefits, preferences and priorities; (6) addiction and habit; (7) practicalities. Conclusions: This synthesis highlights the complexity faced by many households in having a SFH, the practical, social, cultural and personal issues that need to be addressed and balanced by households, and that while some of these are common across study settings, specific social and cultural factors play a critical role in shaping household smoking behaviours. The findings can inform policy and practice and the development of interventions aimed at increasing SFHs. Trial registration number: CRD42014014115

Seasonal Bias in Soil Carbonate Formation and Its Implications for Interpreting High‐Resolution Paleoarchives: Evidence From Southern Utah

Pedogenic carbonate is commonly used as a paleoarchive, but its interpretation is limited by our understanding of its formation conditions. We investigated laminated soil carbonate rinds as a high‐resolution paleoarchive in Torrey, Utah, USA, by characterizing and modeling their formation conditions. We compared late Holocene (<5 ka) soil carbonate conventional (C and O) and “clumped” isotopes to modern soil environment and isotope measurements: soil CO2 partial pressure, soil temperature, soil moisture, δ13C‐soil CO2, δ18O precipitation, and δ18O‐soil water. Data unambiguously identified a strong summer seasonality bias, but modeling suggested soil carbonate formed several times throughout the year during infiltration events causing dissolution‐formation reactions. This apparent discrepancy resulted from preferential preservation of calcite formed from the largest annual infiltration events (summer) overprinting previously formed calcite. Soil carbonate therefore formed predominantly due to changes in soil water content. As soil CO2 was at its annual maximum during soil carbonate formation, assuming uniformly low soil CO2 formation conditions for soil carbonate in estimating paleoatmospheric CO2 is likely not viable. Additionally, we showed modern summer δ13C‐soil CO2 and soil CO2 measurements could not produce a modeled δ13C‐soil carbonate consistent with late Holocene observations. We suggest using multiple lines of evidence to identify nonanalogous modern conditions. Finally, a nearly linear radiocarbon age model from a laminated rind showed that rinds can be used as a high‐resolution paleoarchive if samples are from a single depth and the timing and conditions of soil carbonate formation can be constrained through time.Key PointsAt Torrey, UT, comparison between modern soil and late Holocene soil carbonate isotopes shows soil carbonate forms during the summerSummer formation seasonality occurs because calcite dissolution‐formation reactions during infiltration events overprint prior materialTorrey soil carbonate rinds are suitable material for high‐resolution paleorecords as proxies of summer soil and vegetation conditionsPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149224/1/jgrg21287_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149224/2/jgrg21287.pd

Neuromuscular junction formation in tissue-engineered skeletal muscle augments contractile function and improves cytoskeletal organization

Neuromuscular and neurodegenerative diseases are conditions that affect both motor neurons and the underlying skeletal muscle tissue. At present, the majority of neuromuscular research utilizes animal models and there is a growing need to develop novel methodologies that can be used to help understand and develop treatments for these diseases. Skeletal muscle tissue-engineered constructs exhibit many of the characteristics of the native tissue such as accurate fascicular structure and generation of active contractions. However, to date, there has been little consideration toward the integration of engineered skeletal muscle with motor neurons with the aim of neuromuscular junction (NMJ) formation, which would provide a model to investigate neuromuscular diseases and basic biology. In the present work we isolated primary embryonic motor neurons and neonatal myoblasts from Sprague-Dawley rats, and cocultured the two cell types in three-dimensional tissue-engineered fibrin hydrogels with the aim of NMJ formation. Immunohistochemistry revealed myotube formation in a fascicular arrangement and neurite outgrowth from motor neuron cell bodies toward the aligned myotubes. Furthermore, colocalization of pre- and postsynaptic proteins and chemical inhibition of spontaneous myotube twitch indicated the presence of NMJs in the innervated constructs. When electrical field stimulation was employed to evoke isometric contractions, maximal twitch and tetanic force were higher in the constructs cocultured with motor neurons, which may, in part, be explained by improved myotube cytoskeletal organization in these constructs. The fabrication of such constructs may be useful tools for investigating neuromuscular pharmaceuticals and improving the understanding of neuromuscular pathologies

Pre-service teachers’ engagement in a cross-curricular television news project: impact on professional identity

This paper focuses on the impact of pre-service teachers’ engagement in the annual BBC News School Report project on their emerging professional identity and on the evidence they provide as part of the process of becoming qualified. The research reported on is drawn from three years of enquiry. Respondents included pre-service teachers themselves, their tutors as representatives of teacher education providers and their mentors as representatives of schools in which they were placed. The methodological approach was interpretative and phenomenological with qualitative and quantitative data being analysed for emergent themes. Two years of evaluations were followed by a third year in which a set of case studies were developed. The research showed that professional identity is enhanced through being in a leading role in respect of curriculum and working with other staff. Through engagement in such projects, this paper moots that preservice teachers develop richer evidence of emerging professionalism as defined by standards of initial teacher training. Moreover, self-perception of role was modified to one in which they saw themselves, and were seen, as equals to qualified staff rather than subservient to or dependent on them. A new more equal power relationship developed as they took on responsibility for the project. Preservice teachers’ move to become full members of the professional community for which they are training was accelerated

Establishment of a 3D engineered skeletal muscle-motoneuron co-culture using fibrin-cast gels

The successful in vitro engineering of complex tissues such as skeletal muscle would be of great benefit in the fields of tissue engineering and regenerative medicine, muscle physiology and neuromuscular research. A number of in vitro engineered models of skeletal muscle have been described that demonstrate many structural, biochemical and physiological similarities to in vivo muscle. As yet, however, there is no truly biomimetic in vitro model of skeletal muscle. An important aspect of in vivo muscle development and maintenance is the presence of a neuronal input via neuromuscular junctions (NMJs). Here we have increased the complexity of existing muscle models by introducing primary motoneurons with the aim of engineering a functional neuronal input in an established in vitro skeletal muscle model

The One Health European Joint Programme (OHEJP), 2018-2022: an exemplary One Health initiative

OverviewOne Health is an increasingly popular approach used to tackle complex health problems. The One Health concept recognizes that human health is tightly connected to the health of animals and the environment. Although the related fields are now more aware of the benefits of collaborative working, the full benefits have not yet been realized as research efforts are often focussed on just one of these health domains. To address regional and global issues such as foodborne zoonoses (FBZ), antimicrobial resistance (AMR) and emerging infectious threats (ET), there must be transdisciplinary collaboration between the health domains, in addition to active dialogue between scientists and international policy makers. This editorial introduces the One Health European Joint Programme (OHEJP) as an example of a One Health initiative.Zoonoses, AMR and their global burdenZoonoses are infectious diseases that can be transmitted directly or indirectly between humans and animals. Although the severity of zoonotic infections varies, their global impact is undisputable. The World Bank estimates that just six zoonotic disease outbreaks between 1997 and 2009 led to a global economic loss of US$80 billion [1]. This high cost is due to medical costs, loss of individual productivity and restrictions on trade and movement during outbreaks. Despite improvements in the management and treatment of zoonotic outbreaks, high disease burdens caused by zoonotic pathogens continue to be reported globally. These problems have been amply demonstrated recently by the SARS-CoV-2 pandemic. Although it is still too soon to fully assess the total economic and societal cost of this virus, recent publications, such as Nicola et al. [2] have begun to highlight just how widespread the impact of a truly global zoonotic disease can be.Alongside zoonoses, AMR is a growing international issue. The World Health Organization (WHO) has listed AMR as one of the ten greatest global health threats in 2019 [3]. AMR is defined as the ability of microorganisms to survive the effect of antimicrobial drugs, hindering not only our ability to treat infectious diseases, but also to perform medical procedures requiring prophylactic antibiotic administration. It has been predicted that by 2050, the number of deaths due to unresponsive infections will reach 10 million annually, with the associated costs being estimated at US$ 100 trillion [4]. Increased and inappropriate use of antimicrobials has contributed to the development and spread of AMR, which can be transmitted between humans, animals and the environment.The history of the ‘One Health’ conceptThe origins of One Health go as far back as 1855, when Rudolf Virchow founded comparative pathology, which could be seen as the origin of the One Health concept. Building upon this, Calvin W. Schwabe argued in the twentieth century against compartmentalization in medical research, using the term ‘One Medicine’. The term One Health was then popularized in 2004 by the Wildlife Conservation Society at a conference in New York [5], and its use has continued to evolve since then, fostering the revival of comparative medicine (Fig. 1, and reviewed in Gibbs [6]). One Health has now been adopted by the WHO [7], the Food and Agriculture Organization (FAO) [8] and the World Organization for Animal Health (OIE) [9]

The future of social care funding: who pays?

With the UK population ageing, deciding upon a satisfactory and sustainable system for the funding of people’s long-term care (LTC) needs has long been a topic of political debate. Phase 1 of the Care Act 2014 (“the Act”) brought in some of the reforms recommended by the Dilnot Commission in 2011. However, the Government announced during 2015 that Phase 2 of “the Act” such as the introduction of a £72,000 cap on Local Authority care costs and a change in the means testing thresholds 1 would be deferred until 2020. In addition to this delay, the “freedom and choice” agenda for pensions has come into force. It is therefore timely that the potential market responses to help people pay for their care within the new pensions environment should be considered. In this paper, we analyse whether the proposed reforms meet the policy intention of protecting people from catastrophic care costs, whilst facilitating individual understanding of their potential care funding requirements. In particular, we review a number of financial products and ascertain the extent to which such products might help individuals to fund the LTC costs for which they would be responsible for meeting. We also produce case studies to demonstrate the complexities of the care funding system. Finally, we review the potential impact on incentives for individuals to save for care costs under the proposed new means testing thresholds and compare these with the current thresholds. We conclude that: ∙ Although it is still too early to understand exactly how individuals will respond to the pensions freedom and choice agenda, there are a number of financial products that might complement the new flexibilities and help people make provision for care costs. ∙ The new care funding system is complex making it difficult for people to understand their potential care costs. ∙ The current means testing system causes a disincentive to save. The new means testing thresholds provide a greater level of reward for savers than the existing thresholds and therefore may increase the level of saving for care; however, the new thresholds could still act as a barrier since disincentives still exist

Serum amyloid A primes microglia for ATP-dependent interleukin-1\u3b2 release

Acute-phase response is a systemic reaction to environmental/inflammatory insults and involves production of acute-phase proteins, including serum amyloid A (SAA). Interleukin-1\u3b2 (IL-1\u3b2), a master regulator of neuroinflammation produced by activated inflammatory cells of the myeloid lineage, in particular microglia, plays a key role in the pathogenesis of acute and chronic diseases of the peripheral nervous system and CNS. IL-1\u3b2 release is promoted by ATP acting at the purinergic P2X7 receptor (P2X7R) in cells primed with toll-like receptor (TLR) ligands

Reintroducing face-to-face support alongside remote support to form a hybrid stop smoking service in England: a formative mixed methods evaluation

Background During the COVID-19 pandemic, United Kingdom (UK) stop smoking services had to shift to remote delivery models due to social distancing regulations, later reintroducing face-to-face provision. The “Living Well Smokefree” service in North Yorkshire County Council adopted a hybrid model offering face-to-face, remote, or a mix of both. This evaluation aimed to assess the hybrid approach’s strengths and weaknesses and explore potential improvements. Methods Conducted from September 2022 to February 2023, the evaluation consisted of three components. First, qualitative interviews involved 11 staff and 16 service users, analysed thematically. Second, quantitative data from the QuitManager system that monitored the numbers and proportions of individuals selecting and successfully completing a 4-week quit via each service option. Third, face-to-face service expenses data was used to estimate the value for money of additional face-to-face provision. The qualitative findings were used to give context to the quantitative data via an “expansion” approach and complementary analysis. Results Overall, a hybrid model was seen to provide convenience and flexible options for support. In the evaluation, 733 individuals accessed the service, with 91.3% selecting remote support, 6.1% face-to-face, and 2.6% mixed provision. Remote support was valued by service users and staff for promoting openness, privacy, and reducing stigma, and was noted as removing access barriers and improving service availability. However, the absence of carbon monoxide monitoring in remote support raised accountability concerns. The trade-off in “quantity vs. quality” of quits was debated, as remote support reached more users but produced fewer carbon monoxide-validated quits. Primarily offering remote support could lead to substantial workloads, as staff often extend their roles to include social/mental health support, which was sometimes emotionally challenging. Offering service users a choice of support options was considered more important than the “cost-per-quit”. Improved dissemination of information to support service users in understanding their options for support was suggested. Conclusions The hybrid approach allows smoking cessation services to evaluate which groups benefit from remote, face-to-face, or mixed options and allocate resources accordingly. Providing choice, flexible provision, non-judgmental support, and clear information about available options could improve engagement and match support to individual needs, enhancing outcomes