Smoking behaviour, involuntary smoking, attitudes towards smoke-free legislations, and tobacco control activities in the European Union

The six most important cost-effective policies on tobacco control can be measured by the Tobacco Control Scale (TCS). The objective of our study was to describe the correlation between the TCS and smoking prevalence, self-reported exposure to secondhand smoke (SHS) and attitudes towards smoking restrictions in the 27 countries of the European Union (EU27)

The role of middle managers in tobacco control after a national smoke-free hospital campus ban

Background: Much of the recent health services research on tobacco control implementation has explored general views and perceptions of health professionals and has rarely taken into account middle management's perspectives. We state that middle managers may facilitate the implementation of smoke-free campus bans and thereby improve their effectiveness. The aim of this study was to assess middle managers' behaviors to enforce a new national smoke-free hospital campus ban, to evaluate their perceptions of the level of compliance of the new regulation, and to explore their attitudes towards how smoking affects the work environment. Methods: We used a cross-sectional survey, conducted online to evaluate middle managers of a general hospital in Catalonia, Spain. Close-ended and open-ended questions were included. Results were analyzed by using quantitative and qualitative methods. The managers' open opinions to the proposed topics were assessed using UCINET, and a graph was generated in NetDraw. Results: Sixty-three of the invited managers (78.7 %) participated in the survey. 87.2 % of them agreed that the hospital complied with the smoke-free campus ban and 79.0 % agreed that managers have an important role in enforcing the ban. They also perceived that smoking disturbs the dynamics of work, is a cause of conflict between smokers and non-smokers, and harms both the professional and the organization images. However, 96.8 % of respondents have never given out fines or similar measures and their active role in reminding others of the policy was limited; in addition, 68.2 % considered that hospitals should provide tobacco cessation treatments. Smoker middle managers were more likely than non-smokers to perceive that smoking has little impact on work. Conclusions: Middle managers play a limited role in controlling tobacco consumption; smokers are less prone to think that smoking disturbs work dynamics than non-smokers. Tailored training and clear proceedings for middle managers could encourage more active roles

Vinculación de las empresas en la reducción de la pobreza a partir del BOP: revisión

91 páginasEste documento pretende reunir los elementos que constituyen la actual lucha contra la pobreza, repasando tanto la evolución del concepto, la pasada responsabilidad exclusiva del Estado, la transformación que ha vinculado a actores privados así como su posicionamiento como objetivo primordial de todos los actores económicos. De igual manera, se procura exponer las diferentes prácticas realizadas por las empresas para contribuir y generar bienestar, llegando finalmente al concepto de Mercados Base de la Pirámide (revelando algunas experiencias de estos mercados en países como la India, Brasil, y Colombia) y concluir sobre su incidencia en la pobreza y su estado actual.The present document aims to collect the elements of the current battle against the poverty, making a journey through the evolution of the concept, the states’ traditional exclusive responsibility, the private sector`s new relation with the phenomenon of poverty and its recognition as a main topic in the economy. In that way, it shows different corporative activities to contribute positively in this battle, specially the Base of the Pyramid methodology and examples of it in countries like India, Brazil and Colombia.Doctor en Estudios PolíticosDoctorad

The Tobacco Control Scale as a research tool to measure country level tobacco control policy implementation

Introduction: The Tobacco Control Scale (TCS) was designed for advocacy purposes but has also been used as a research tool. In the present study, we characterized TCS use, its limitations and strengths, and critically assessed its use as a research instrument. Methods: We conducted an extensive search of the biomedical databases PubMed and Web of Science for the keyword 'tobacco control scale' in all fields. The search was limited to studies published in the period March 2006 to December 2019. Out of 69 hits, 32 studies met the inclusion criteria. Two reviewers independently extracted information from each publication regarding their general characteristics, publication and research aspects, and the characteristics of the use of the TCS. Results: We found that researchers have used the TCS as a tool to monitor tobacco control policies mainly in cross-sectional observational studies with ecological and multilevel designs directed to advocacy and the promotion of further research. Different outcomes, such as smoking prevalence and quit ratios, have been associated with tobacco control policy scores. The main reported limitations of the TCS were a low variance across countries and a failure to express enforcement and to incorporate the most recent legislation. Conclusions: The TCS has been commonly used to assess differences in outcomes according to tobacco control policies. However, there are still areas for improvement in its use in research regarding the lack of comparability of TCS scores across time. The lessons that have been learned should be used to adapt and expand the TCS overseas

The Eye and the Chikungunya Virus

Ocular involvement in chikungunya virus (CHIKV) infection can be present as mild and vision-threatening ocular complications with unilateral or bilateral compromise in both gender and all ages. Precise prevalence and incidence are unknown, but ocular involvement of CHIKV infection is uncommon. Anterior uveitis is the most common syndromic manifestation; nevertheless the infection could manifest posterior segment repercussion, such as retinitis which is the other most usual clinical manifestation. At the beginning of the systemic disease, main ophthalmologic symptoms are conjunctival injection, retro-ocular pain, and photophobia. Ocular pathogenesis of CHIKV infection is not totally clarified; however, findings related to an immune dysregulation and proinflammatory processes are the most accepted theories. The diagnosis of CHIKV is based on polymerase chain reaction, virus isolation, or detection of viral antigens which should be used before the eighth day of systemic illness. After 8 days, chikungunya serologic tests such as IgM ELISA/rapid tests or IgG paired must be used. Actual management is focused according to the clinical context of each patient. While in most instances recovery of vision to normal occurs, CHIKV infection can result in blindness, the visual prognosis depends on various factors, but the common one is the early onset of corticosteroid treatment

Creating Methodological Design Processes for Empowering Artisans of Cali, Colombia

This paper describes how, from an academic exercise, Industrial Design students assume the role of social intrapreneurs (Cabana, 2018: 90-91) to become aware of the potential of design and the richness in non-academic learning that this type of dynamics can generate. In Colombia, there is sometimes a dependency between the artisan and the designer, because some professionals hired by state entities or third-sector agencies carry out design processes for the artisans, considering their skills, but these designs are not generated in a participatory manner. What is sought with this exercise is to empower artisans through the search for a design process according to their needs, where collectively the designer facilitates the artisan the incorporation of elements of the design process proper to the design into the empirical exercise of the artisan. This way, the artisan meets the creative requirements of customers and the local market, which allows them to increase their competitiveness and not depend on the designers to achieve a product portfolio that guarantees economic, cultural, and social sustainability

Secondhand smoke in outdoor settings: smokers' consumption, non-smokers' perceptions, and attitudes towards smoke-free legislation in Spain

Objective: to describe where smokers smoke outdoors, where non-smokers are exposed outdoors to secondhand smoke (SHS), and attitudes towards smoke-free outdoor areas after the implementation of national smoke-free legislation. Design: this cross-sectional study was conducted between June 2011 and March 2012 (n=1307 participants). Setting: Barcelona Participants: representative, random sample of the adult (≥16 years) population. Primary and secondary outcomes: proportion of smoking and prevalence of exposure to SHS in the various settings according to type of enclosure. Percentages of support for outdoor smoke-free policies according to smoking status. Results: smokers reported smoking outdoors most in bars and restaurants (54.8%), followed by outdoor places at work (46.8%). According to non-smokers, outdoor SHS exposure was highest at home (42.5%) and in bars and restaurants (33.5%). Among non-smoking adult students, 90% claimed exposure to SHS on university campuses. There was great support for banning smoking in the majority of outdoor areas, which was stronger among non-smokers than smokers. Over 70% of participants supported smoke-free playgrounds, school and high school courtyards, and the grounds of healthcare centres. Conclusions: extending smoking bans to selected outdoor settings should be considered in further tobacco control interventions to protect non-smokers from SHS exposure and to establish a positive model for youth. The majority of public support for some outdoor smoke-free areas suggests that it is feasible to extend smoking bans to additional outdoor settings

Efeito da correspondência entre descrições de contingências e contingências sobre o comportamento de escolha sob o paradigma de autocontrole

Neste trabalho, analisa-se o efeito da história de correspondência entre as descrições de contingências e contingências sobre o comportamento de escolha sob o paradigma de autocontrole com 85 participantes entre 10 e 11 anos de idade, por meio de duas experiências intrassujeito, uma realizada em contexto de laboratório, e outra, numa situação natural simulada. Os resultados indicam que é possível afetar o comportamento de escolha entre um reforçador imediato -de menor magnitude- e outro demorado -de maior proporção- em favor da segunda alternativa a partir de uma história experimental de correspondência entre as descrições de contingências e contingências. Em ambas as experiências, a maioria de participantes escolheu o reforçador demorado depois de experimentar os ensaios de correspondência entre descrições e contingências, e o reforçador imediato depois de enfrentar os ensaios de correspondência ausente, embora as situações de treinamento tenham sido formal e funcionalmente diferentes com relação à tarefa estabelecida para avaliar o comportamento de escolha. Os resultados foram analisados à luz da Teoria das Molduras Relacionais, especificamente quanto à alteração das funções da linguagem.In this paper, the effect of correspondence history between contingency and contingency descriptions on the behavior of choice under the self-control paradigm is analyzed in 85 participants between the ages of 10 and 11, through two intrasubject experiments, one carried out in a laboratory context and another in a simulated natural situation. The results indicate that it is possible to affect the behavior of choice between an immediate reinforcer of lesser magnitude and a delayed one of greater magnitude in favor of the second alternative, from an experimental history of correspondence between descriptions of contingencies and contingencies. In both experiments, most of participants chose the delayed reinforcer after undergoing correspondence tests between descriptions and contingencies, and the immediate reinforcer after facing the correspondence absent trials, even though the training situations were formally and functionally different in relation with the task established to evaluate the conduct of choice. The results are analyzed in light of the "Relational Frame Theory", specifically, in relation with the alteration of the functions of the language.En este trabajo se analiza el efecto de la historia de correspondencia entre las descripciones de contingencias y las contingencias sobre la conducta de elección bajo paradigma de autocontrol en 85 participantes de entre 10 y 11 años de edad, por medio de dos experimentos intrasujeto, uno realizado en contexto de laboratorio y otro en una situación natural simulada. Los resultados indican que es posible afectar la conducta de elección entre un reforzador inmediato -de menor magnitud- y otro demorado -de mayor proporción- en favor de la segunda alternativa a partir de una historia experimental de correspondencia entre las descripciones de contingencias y las contingencias. En ambos experimentos, la mayoría de participantes eligió el reforzador demorado después de experimentar los ensayos de correspondencia entre descripciones y contingencias, y el reforzador inmediato después de enfrentar los ensayos de correspondencia ausente pese a que las situaciones de entrenamiento fueron formal y funcionalmente diferentes en relación con la tarea establecida para evaluar la conducta de elección. Los resultados se analizan a la luz de la Teoría de los Marcos Relaciónales, específicamente en relación con la alteración de las funciones del lenguaje

Secondhand smoke risk perception and smoke-free rules in homes: a cross-sectional study in Barcelona (Spain)

Objective: to describe the voluntary adoption of smoke-free homes in Spain among general population and to identify variables associated with its voluntary adoption. Methods: cross-sectional study of a representative sample (n=731) of the adult population (>26 years) of Barcelona, Spain, in 2013-2014. We defined smoking rules inside the households as complete indoor rules (when smoking was not allowed inside the house), and partial or absent indoor rules (when smoking was allowed in some designated places inside the house or when smoking was allowed everywhere) and described them according to the perceived risk of the secondhand smoke (SHS) exposure. We calculated the prevalence and prevalence ratios (PR) according to sociodemographic variables. Results: 57.4% of households had complete indoor smoke-free rules. The prevalence of households with complete indoor rules was higher among women (PRa: 1.15; 95% CI 1.00 to 1.33), married (PRa: 1.18; 95% CI 1.01 to 1.38), never-smokers (PRa: 2.68; 95% CI 2.06 to 3.50) and in households where a minor lived (PRa: 1.40; 95% CI: 1.20-1.65). Believe that breathing tobacco smoke from smokers is dangerous for non-smokers (PRa: 1.77; 95% CI: 1.06-2.97) is associated with the voluntary adoption of complete indoor smoke-free home. Conclusions: risk perceptions of SHS exposure were associated with the voluntary adoption of indoor smoke-free homes

Smoking cessation after 12 months with multi-component therapy

El tabaquismo es una de las causas de morbimortalidad más importantes en los países desarrollados. Uno de los objetivos prioritarios de los programas de salud pública es la disminución de su prevalencia lo que implica que millones de personas dejen de fumar, sin embargo los programas de cesación a menudo tienen resultados discretos, especialmente con algunos grupos de población. El objetivo de este estudio fue analizar la eficacia de un tratamiento de cesación tabáquica multicomponente realizado en una unidad de tabaquismo hospitalaria. Fue realizado en la Unidad de Tabaquismo del Hospital de Manresa, e incluyó 314 pacientes (91,4% presentaban un nivel de dependencia medio o alto). Se observó que el nivel de estudios, no convivir con fumadores, seguir la terapia multicomponente y utilizar tratamiento farmacológico son factores relevantes en el éxito al dejar de fumar. La tasa de abstinencia no se asocia con otras características como el sexo, la edad, las características del hábito tabáquico o el presentar antecedentes psiquiátricos. La combinación del tratamiento farmacológico y psicológico aumentó las tasas de éxito en la terapia multicomponente. La terapia psicológica única también obtuvo resultados positivos aunque más modestos