Evaluation of a student-run smoking cessation clinic for a medically underserved population

<p>Abstract</p> <p>Background</p> <p>Smoking is common among medically underserved populations. Accessible resources to encourage and support smoking cessation among these patients are limited. Volunteer medical student-run free smoking cessation clinics may provide an effective option to help these individuals achieve smoking abstinence. In order to demonstrate the feasibility and cost-effectiveness of a student-run clinic, we analyzed a case series of patients receiving care in a medical student-run Smoking Cessation Clinic (SCC) at the Rochester, Minnesota Salvation Army Good Samaritan Health Clinic (GSHC).</p> <p>Findings</p> <p>Between January 2005 and March 2009, 282 cigarette smokers seeking care at the SCC were analyzed. Student providers at the SCC conducted 1652 weekly individual counseling sessions averaging 18 minutes per encounter. Patients were offered a choice of pharmacotherapies including nicotine replacement therapy (NRT), bupropion, and varenicline for up to 12 weeks. Smoking abstinence was confirmed with exhaled carbon monoxide (CO). Thirty-two patients completed the entire 12-week program (11.3%). At last contact, 94 patients (33.3%) abstained from smoking for ≥ 7 days and 39 patients (13.8%) were continuously abstinent for ≥ 4 weeks. The 7-day point prevalence abstinence rates at last contact were 58.6% for varenicline, 41.2% for bupropion, 33.9% for NRT, and 23.5% for bupropion and NRT. Analyzing missing patients as smoking, the 7-day point prevalence abstinence rates were 7.1%, 8.9%, and 8.2%, at 1 month, 2 months, and 3 months after program enrollment, respectively. No serious adverse drug reactions were recorded.</p> <p>Conclusions</p> <p>Our medical student-run smoking cessation clinic provided an effective and safe experience for medically underserved patients who might not otherwise have access to conventional smoking cessation programs because of high cost, lack of insurance, or other disparities. Similar medical student initiatives focusing on healthy lifestyles may be feasible and beneficial for individuals with limited access to healthcare resources.</p

Quaternary development of resilient reefs on the subsiding kimberley continental margin, Northwest Australia

The Kimberley region in remote northwest Australia has poorly known reef systems of two types; coastal fringing reefs and atoll-like shelf-edge reefs. As a major geomorphic feature (from 12ºS to 18ºS) situated along a subsiding continental margin, the shelf edge reefs are in a tropical realm with warm temperatures, relatively low salinity, clear low nutrient waters lacking sediment input, and Indo-West Pacific corals of moderate diversity. Seismic architecture of the Rowley Shoals reveals that differential pre-Holocene subsidence and relative elevation of the pre-Holocene substrate have controlled lagoon sediment infill and reef morphology, forming an evolutionary series reflecting differential accommodation in three otherwise similar reef systems.The Holocene core described for North Scott Reef confirms previous seismic interpretations, and provides a rare ocean-facing reef record. It demonstrates that the Indo-Pacific reef growth phase (RG111) developed during moderate rates of sea level rise of 10 mm/year from 11 to about 7-6.5 ka BP until sea level stabilization, filling the available 27 m of pre-Holocene accommodation. Despite the medium to high hydrodynamic energy imposed by the 4m tides, swell waves and cyclones the reef-building communities represent relatively low-wave energy settings due to their southeast facing and protection afforded by the proximity of the South Reef platform. This study demonstrates the resilience of reefs on the subsiding margin whilst linking Holocene reef morphology to the relative amount of pre-Holocene subsidence

Adapting tropical Pacific fisheries and aquaculture to\ud climate change: management measures, policies and investments

This chapter sets out the information needed by stakeholders in the fisheries and aquaculture sector at all levels to reduce the threats and capitalise on the\ud opportunities created by climate change. In particular, we:\ud \ud outline the existing management regimes and initiatives for industrial and smallscale fisheries and aquaculture in the region to secure desired human development outcomes and maintain healthy fish stocks; \ud \ud identify an appropriate framework for selecting practical adaptations to address the key near-term drivers for fisheries and aquaculture, and the future effects of climate change; recommend adaptations, and suggest policy approaches, to maximise the contributions of fisheries and aquaculture to economic development, government revenue, food security and livelihoods as the climate changes; outline the value of modelling to examine interactions among adaptation options; \ud \ud explain the need to monitor the projected effects of climate change on the sector; summarise the gaps in knowledge to be filled to improve understanding of the\ud vulnerability of fisheries and aquaculture in the tropical Pacific to climate change, and to fine-tune key adaptations;\ud \ud identify priority investments needed to apply the main adaptations, fill gaps in knowledge, strengthen partnerships, monitor the projected effects of climate\ud change and measure the success of adaptations; \ud \ud and consider sources of funding to make the necessary investments.\ud \ud We emphasise that adaptations and policies to build the resilience of the Pacific communities to climate change should not be viewed just from a scientific or technical perspective – the needs and aspirations of people must also be integrated. Understanding how people are affected, and how their traditional knowledge, capacities and perspectives can help develop and implement adaptations is a vital part of the process. Communityii consultation and participation are essential to ensure that adaptations incorporate a human rights and human development approach\ud to achieve gender equality, maintain relevant traditional customs and culture, and empower young people

Open data from the first and second observing runs of Advanced LIGO and Advanced Virgo

Advanced LIGO and Advanced Virgo are monitoring the sky and collecting gravitational-wave strain data with sufficient sensitivity to detect signals routinely. In this paper we describe the data recorded by these instruments during their first and second observing runs. The main data products are gravitational-wave strain time series sampled at 16384 Hz. The datasets that include this strain measurement can be freely accessed through the Gravitational Wave Open Science Center at http://gw-openscience.org, together with data-quality information essential for the analysis of LIGO and Virgo data, documentation, tutorials, and supporting software