124 research outputs found
Evaluation of the 2017 National Professional Qualifications : Final evaluation report for the 2017-18 cohort : November 2021
Interest in and Use of Smoking Cessation Support Across Pregnancy and Postpartum.
BACKGROUND: Limited research exists on interest in and use of smoking cessation support in pregnancy and postpartum. METHODS: A longitudinal cohort of pregnant smokers and recent ex-smokers were recruited in Nottinghamshire, United Kingdom (N = 850). Data were collected at 8-26 weeks gestation, 34-36 weeks gestation, and 3 months postpartum and used as three cross-sectional surveys. Interest and use of cessation support and belief and behavior measures were collected at all waves. Key data were adjusted for nonresponse and analyzed descriptively, and multiple regression was used to identify associations. RESULTS: In early and late pregnancy, 44% (95% CI 40% to 48%) and 43% (95% CI 37% to 49%) of smokers, respectively, were interested in cessation support with 33% (95% CI 27% to 39%) interested postpartum. In early pregnancy, 43% of smokers reported discussing cessation with a midwife and, in late pregnancy, 27% did so. Over one-third (38%) did not report discussing quitting with a health professional during pregnancy. Twenty-seven percent of smokers reported using any National Health Service (NHS) cessation support and 12% accessed NHS Stop Smoking Services during pregnancy. Lower quitting confidence (self-efficacy), higher confidence in stopping with support, higher quitting motivation, and higher age were associated with higher interest in support (ps ≤ .001). A recent quit attempt and greater interest in support was associated with speaking to a health professional about quitting and use of NHS cessation support (ps ≤ .001). CONCLUSIONS: When asked in early or late pregnancy, about half of pregnant smokers were interested in cessation support, though most did not engage. Cessation support should be offered throughout pregnancy and after delivery. IMPLICATIONS: There is relatively high interest in cessation support in early and late pregnancy and postpartum among smokers; however, a much smaller proportion of pregnant or postpartum women access any cessation support, highlighting a gap between interest and engagement. Reflecting women's interest, offers of cessation support should be provided throughout pregnancy and after delivery. Increasing motivation to quit and confidence in quitting with assistance may enhance interest in support, and promoting the discussion of stopping smoking between women and health practitioners may contribute to higher support engagement rates
Smoking and quit attempts during pregnancy and postpartum: a longitudinal UK cohort.
OBJECTIVES: Pregnancy motivates women to try stopping smoking, but little is known about timing of their quit attempts and how quitting intentions change during pregnancy and postpartum. Using longitudinal data, this study aimed to document women's smoking and quitting behaviour throughout pregnancy and after delivery. DESIGN: Longitudinal cohort survey with questionnaires at baseline (8-26 weeks' gestation), late pregnancy (34-36 weeks) and 3 months after delivery. SETTING: Two maternity hospitals in one National Health Service hospital trust, Nottingham, England. PARTICIPANTS: 850 pregnant women, aged 16 years or over, who were current smokers or had smoked in the 3 months before pregnancy, were recruited between August 2011 and August 2012. OUTCOME MEASURES: Self-reported smoking behaviour, quit attempts and quitting intentions. RESULTS: Smoking rates, adjusting for non-response at follow-up, were 57.4% (95% CI 54.1 to 60.7) at baseline, 59.1% (95% CI 54.9 to 63.4) in late pregnancy and 67.1% (95% CI 62.7 to 71.5) 3 months postpartum. At baseline, 272 of 488 current smokers had tried to quit since becoming pregnant (55.7%, 95% CI 51.3 to 60.1); 51.3% (95% CI 44.7 to 58.0) tried quitting between baseline and late pregnancy and 27.4% (95% CI 21.7 to 33.2) after childbirth. The percentage who intended to quit within the next month fell as pregnancy progressed, from 40.4% (95% CI 36.1 to 44.8) at baseline to 29.7% (95% CI 23.8 to 35.6) in late pregnancy and 14.2% (95% CI 10.0 to 18.3) postpartum. Postpartum relapse was lower among women who quit in the 3 months before pregnancy (17.8%, 95% CI 6.1 to 29.4) than those who stopped between baseline and late pregnancy (42.9%, 95% CI 24.6 to 61.3). CONCLUSIONS: Many pregnant smokers make quit attempts throughout pregnancy and postpartum, but intention to quit decreases over time; there is no evidence that smoking rates fall during gestation
Longitudinal cohort survey of women's smoking behaviour and attitudes in pregnancy: study methods and baseline data.
OBJECTIVES: To report the methods used to assemble a contemporary pregnancy cohort for investigating influences on smoking behaviour before, during and after pregnancy and to report characteristics of women recruited. DESIGN: Longitudinal cohort survey. SETTING: Two maternity hospitals, Nottingham, England. PARTICIPANTS: 3265 women who attended antenatal ultrasound scan clinics were offered cohort enrolment; those who were 8-26 weeks pregnant and were currently smoking or had recently stopped smoking were eligible. Cohort enrollment took place between August 2011 and August 2012. PRIMARY AND SECONDARY OUTCOME MEASURES: Prevalence of smoking at cohort entry and at two follow-up time points (34-36 weeks gestation and 3 months postnatally); response rate, participants' sociodemographic characteristics. RESULTS: 1101 (33.7%, 95% CI 32.1% to 35.4%) women were eligible for inclusion in the cohort, and of these 850 (77.2%, 95% CI 74.6% to 79.6%) were recruited. Within the cohort, 57.4% (N=488, 95% CI 54.1% to 60.7%) reported to be current smokers. Current smokers were significantly younger than ex-smokers (p<0.05), more likely to have no formal qualifications and to not be in current paid employment compared to recent ex-smokers (p<0.001). CONCLUSIONS: This contemporary cohort, which seeks very detailed information on smoking in pregnancy and its determinants, includes women with comparable sociodemographic characteristics to those in other UK cross-sectional studies and cohorts. This suggests that future analyses using this cohort and aimed at understanding smoking behaviour in pregnancy may produce findings that are broadly generalisable
Report on the Workshop on Transversal Variables. (Linking economic and biological effort data (call) design). 19th -23rd January 2015
The Workshop on the Transversal Variables took place in Zagreb from the 19th to 23rd of January, 2015 mainly to tackle the issues related to the increasing need of having fisheries fleet economic data and fisheries biologic data on a level of disaggregation that would allow a proper interoperability between datasets to underpin bioeconomic modelling. For that, several analyses were carried out and conclusions taken. These analyses were : 1. comparison of economic and biological effort data calls both with respect to their level of resolution and the landings and effort values obtained from equivalent aggregations was performed. This was compared to what would be needed in order to undertake bioeconomic modelling for a chosen management plan. 2. The description of how MS are calculating effort variables and a proposal on the way forward to harmonize approaches, 3. Conclusions on how to harmonize levels of resolution, the variable definitions and the codification in use amongst data calls, in order to make them comparable and based on coherent standard codifications.JRC.G.3-Maritime affair
an individual participant data meta-analysis
Background The impact of neuraminidase inhibitors (NAIs) on influenza-related
pneumonia (IRP) is not established. Our objective was to investigate the
association between NAI treatment and IRP incidence and outcomes in patients
hospitalised with A(H1N1)pdm09 virus infection. Methods A worldwide meta-
analysis of individual participant data from 20 634 hospitalised patients with
laboratory-confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n =
613) ‘pandemic influenza’. The primary outcome was radiologically confirmed
IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling,
adjusting for NAI treatment propensity, antibiotics and corticosteroids.
Results Of 20 634 included participants, 5978 (29·0%) had IRP; conversely,
3349 (16·2%) had confirmed the absence of radiographic pneumonia (the
comparator). Early NAI treatment (within 2 days of symptom onset) versus no
NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06;
P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none
did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or
likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P =
0·537)], but early treatment versus later significantly reduced mortality
[adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring
ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. Conclusions Early
NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection
versus no treatment did not reduce the likelihood of IRP. However, in patients
who developed IRP, early NAI treatment versus later reduced the likelihood of
mortality and needing ventilatory support
Epithelial damage and tissue γδ T cells promote a unique tumor-protective IgE response
IgE is an ancient and conserved immunoglobulin isotype with potent immunological function. Nevertheless, the regulation of IgE responses remains an enigma, and evidence of a role for IgE in host defense is limited. Here we report that topical exposure to a common environmental DNA-damaging xenobiotic initiated stress surveillance by γδTCR+ intraepithelial lymphocytes that resulted in class switching to IgE in B cells and the accumulation of autoreactive IgE. High-throughput antibody sequencing revealed that γδ T cells shaped the IgE repertoire by supporting specific variable-diversity-joining (VDJ) rearrangements with unique characteristics of the complementarity-determining region CDRH3. This endogenous IgE response, via the IgE receptor FcεRI, provided protection against epithelial carcinogenesis, and expression of the gene encoding FcεRI in human squamous-cell carcinoma correlated with good disease prognosis. These data indicate a joint role for immunosurveillance by T cells and by B cells in epithelial tissues and suggest that IgE is part of the host defense against epithelial damage and tumor development
Predictors of children's secondhand smoke exposure at home: a systematic review and narrative synthesis of the evidence
BACKGROUND: Children's exposure to secondhand smoke (SHS) has been causally linked to a number of childhood morbidities and mortalities. Over 50% of UK children whose parents are smokers are regularly exposed to SHS at home. No previous review has identified the factors associated with children's SHS exposure in the home.
AIM: To identify by systematic review, the factors which are associated with children's SHS exposure in the home, determined by parent or child reports and/or biochemically validated measures including cotinine, carbon monoxide or home air particulate matter.
METHODS: Electronic searches of MEDLINE, EMBASE, PsychINFO, CINAHL and Web of Knowledge to July 2014, and hand searches of reference lists from publications included in the review were conducted.
FINDINGS: Forty one studies were included in the review. Parental smoking, low socioeconomic status and being less educated were all frequently and consistently found to be independently associated with children's SHS exposure in the home. Children whose parents held more negative attitudes towards SHS were less likely to be exposed. Associations were strongest for parental cigarette smoking status; compared to children of non-smokers, those whose mothers or both parents smoked were between two and 13 times more likely to be exposed to SHS.
CONCLUSION: Multiple factors are associated with child SHS exposure in the home; the best way to reduce child SHS exposure in the home is for smoking parents to quit. If parents are unable or unwilling to stop smoking, they should instigate smoke-free homes. Interventions targeted towards the socially disadvantaged parents aiming to change attitudes to smoking in the presence of children and providing practical support to help parents smoke outside the home may be beneficial
- …