Essential healthcare services provided to conflict-affected internally displaced populations in low and middle-income countries: A systematic review

Background: Conflict and violent crises have resulted in over 40 million of internally displaced persons (IDPs). Most affected regions lack access to basic health resources and generally rely on humanitarian support. The objective of this review was to appraise primary health service interventions among conflict-induced internally displaced populations in low and middle income countries between 2000 and 2019. Methods: A systematic review of literature in the following databases: Embase, MEDLINE, PsyArticles, PsycINFO, Scopus, Web of Science, LILAC and CAB Articles, was performed to identify interventions implemented in conflict IDP settings.Results: Initial searches yielded 4578 papers and 30 studies met the inclusion criteria. Descriptive synthesis analysis was used, and the final selections were assessed using a customized Critical Appraisal Skills Programme (CASP) checklist. Included papers were from Sub-Saharan Africa, South Asia and the Middle East regions. Most studies were on prevention interventions, especially water treatment and maternal health. Treatment interventions mostly focused on on malaria and mental health. Only one food and nutrition study with outcome data was identified, indicating limitations in IDP health-related intervention publications. Reported interventions were conducted between one week to five years, and the study qualities were moderate. The most effective interventions were integrated programmes and common challenges were weak study methodology and data reporting. Conclusion: Regardless of the intervention types and durations, the services offered were beneficial to the IDPs. More intervention evidence are, however required as shown in gaps around food and nutrition, health education and disease surveillance

A content analysis of tobacco content in season 1 of ‘And Just Like That’

Aim: ‘Sex and the City’ regularly featured smoking as a plot device, often linked with sexuality and female empowerment. Eighteen years later, the follow up ‘And Just Like That’ was released. The aim of this paper was to explore the amount of tobacco content in the first series of ‘And Just Like That’. Subject and Methods: A 1-minute content analysis of the 10 episodes from season1 of ‘And Just Like That’. Results: The 10 episodes included 394 one-minute intervals of content, with individual episodes ranging from 35-44 minutes. Tobacco content occurred in 45 intervals (11% of the total) across all 10 episodes. Conclusion: This study demonstrates that, despite the 18-year age gap between the end of the ‘Sex and the City’ TV series and the start of ‘And just like that’, and the declining smoking rates during that time, tobacco content is still regularly featured in these programmes. Whilst viewing figures are not available for this series, we know that this was HBO Max’s most streamed show of all time and was highly popular, it is, therefore, likely that large numbers of people were exposed to tobacco content through this programme

Patients' and healthcare professionals' views on a specialist smoking cessation service delivered in a United Kingdom hospital: a qualitative study

BACKGROUND: Hospital admission provides a powerful opportunity to promote smoking cessation. We explored patients' and healthcare professionals' (HCP) views of a specialist smoking cessation service comprising systematic smoking ascertainment, default provision of pharmacotherapy and behavioural counselling at the bedside, and post-discharge follow-up, in a clinical trial in a United Kingdom teaching hospital. METHODS: Semi-structured interviews with 30 patients who were offered the intervention, and 27 HCPs working on intervention wards, were audio-recorded, transcribed verbatim and analysed using thematic analysis. RESULTS: The shock of being admitted, and awareness that smoking may have contributed to the need for hospital admission, caused many patients to reassess their quit intentions. Most patients felt the service was too good an opportunity to pass up, because having long-term support and progress monitored was more likely to result in abstinence than trying alone. Had they not been approached, many patients reported that they would have attempted to quit alone, though some would have been discouraged from doing so by pharmacotherapy costs. Service delivery by a specialist advisor was favoured by patients and HCPs, largely because HCPs lacked time and expertise to intervene. HCPs reported that in usual practice, discussions about smoking were usually limited to ascertainment of smoking status. Timing of service delivery and improved co-ordination between service staff and inpatient ward staff were matters to address. CONCLUSIONS: A hospital-based specialist smoking cessation service designed to identify smokers and initiate cessation support at the bedside was deemed appropriate by patients and HCPs. TRIAL REGISTRATION: Trial registration: ISRCTN25441641

The potential to improve ascertainment and intervention to reduce smoking in Primary Care: a cross sectional survey

<p>Abstract</p> <p>Background</p> <p>Well established clinical guidelines recommend that systematic ascertainment of smoking status and intervention to promote cessation in all smokers should be a fundamental component of all health care provision. This study aims to establish the completeness and accuracy of smoking status recording in patients' primary care medical records and the level of interest in receiving smoking cessation support amongst primary care patients in an inner city UK population.</p> <p>Methods</p> <p>Postal questionnaires were sent to all patients aged over 18 from 24 general practices in Nottingham UK who were registered as smokers or had no smoking status recorded in their medical notes.</p> <p>Results</p> <p>The proportion of patients with a smoking status recorded varied between practices from 42.4% to 100% (median 90%). Of the recorded smokers who responded to our questionnaire (35.5% of the total), a median of 20.3% reported that they had not smoked cigarettes or tobacco in the last 12 months. Of respondents with no recorded smoking status, 29.8% reported themselves to be current smokers. Of the 6856 responding individuals thus identified as current smokers, 41.4% indicated that they would like to speak to a specialist smoking adviser to help them stop smoking. This proportion increased with socioeconomic disadvantage (measured by the Townsend Index) from 39.1% in the least deprived to 44.6% in the most deprived quintile.</p> <p>Conclusion</p> <p>Whilst in many practices the ascertainment of smoking status is incomplete and/or inaccurate, failure to intervene appropriately on known status still remains the biggest challenge.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN71514078.</p

A Content Analysis and Population Exposure Estimate Of Guinness Branded Alcohol Marketing During the 2019 Guinness Six Nations

Aims: To quantify Guinness related branding in the 2019 Guinness Six Nations Championship.Methods: Content analysis of Guinness related branding (‘Guinness’ and the alibi brand ‘Greatness’) shown during active play throughout all 15 games of the 2019 Guinness Six Nations Championship. The duration of each appearance was timed to the nearest second, to provide information on the amount of time that Guinness-related branding was shown on screen. Census data and viewing figures were used to estimate gross and per capita alcohol impressions.Results: Our coding identified a total of 3719 appearances of two logos, of which 3415 (92%) were for ‘Guinness’ and 304 (8%) were for ‘Greatness’. ‘Guinness’ imagery was present for 13,640 seconds (227.3 minutes or 3.8 hours, 16% of total active play time), ‘Greatness’ for 944 seconds (15.7 minutes, 1% of total active play time), with a combined total of 14,584s across all games (243 mins or 4.05 hours, 17% of active play time). The 15 games delivered an estimated 122.4 billion Guinness-related branded impressions to the UK population, including 758 million to children aged under-16.Conclusions: Alcohol marketing was highly prevalent during the 2019 Guinness Six Nations Championship and is a significant source of exposure to alcohol marketing and advertising for children, likely influencing youth alcohol experimentation and uptake

A content analysis of tobacco content in season 1 of ‘And Just Like That’

Aim‘Sex and the City’ regularly featured smoking as a plot device, often linked with sexuality and female empowerment. Eighteen years later, the follow up ‘And Just Like That’ was released. The aim of this paper was to explore the amount of tobacco content in the first series of ‘And Just Like That’.Subject and methodsA 1-minute content analysis of the 10 episodes from season 1 of ‘And Just Like That’.ResultsThe 10 episodes included 394 one-minute intervals of content, with individual episodes ranging from 35–44 minutes. Tobacco content occurred in 45 intervals (11% of the total) across all 10 episodes.ConclusionThis study demonstrates that, despite the 18-year age gap between the end of the ‘Sex and the City’ TV series and the start of ‘And Just Like That’, and the declining smoking rates during that time, tobacco content is still regularly featured in these programmes. Whilst viewing figures are not available for this series, we know that this was HBO Max’s most streamed show of all time and was highly popular; it is, therefore, likely that large numbers of people were exposed to tobacco content through this programme

Corrigendum: A content analysis of tobacco and alcohol audio-visual content in a sample of UK reality TV programmes

Exposure to tobacco and alcohol content in audio-visual media is a risk factor for smoking and alcohol use in young people. We report an analysis of tobacco and alcohol content, and estimates of population exposure to this content, in a sample of reality television programmes broadcast in the UK. We used 1-minute interval coding to quantify tobacco and alcohol content in all episodes of five reality TV programmes aired between January and August 2018 (Celebrity Big Brother; Made in Chelsea; The Only Way is Essex; Geordie Shore and Love Island), and estimated population exposure using viewing data and UK population estimates. We coded 5219 intervals from 112 episodes. Tobacco content appeared in 110 (2%) intervals in 20 (18%) episodes, and alcohol in 2212 (42%) intervals and in all episodes. The programmes delivered approximately 214 million tobacco gross impressions to the UK population, including 47.37 million to children; and for alcohol, 4.9 billion and 580 million respectively. Tobacco, and especially alcohol, content is common in reality TV. The popularity of these programmes with young people, and consequent exposure to tobacco and alcohol imagery, represents a potentially major driver of smoking and alcohol consumption

Exploring the influence of health management processes on health outcomes among internally displaced persons (IDPs)

Background: Despite global action and policy initiatives, internally displaced persons (IDPs) experience poor living conditions and lack healthcare access compared to refugees. This study sought to understand the relationship between health management processes and health outcomes among camp-dwelling IDPs in northern Nigeria. Method: 73 individuals participated in either a focus group (n = 49) or one-to-one interview (n = 24), comprising IDPs (n = 49), camp managers (n = 9), health workers (n = 7) and government administrative authorities (n = 8). Interviews explored IDP health management processes, partners and perceptions around camp management. Data were analysed using an inductive thematic approach. Results: Four main themes were identified: opinions about healthcare organisation and management, service availability, interventions and information management, and IDP health outcomes. Though many stakeholders, partnerships, and national and international government agencies were involved in the provision of healthcare services, respondents described efforts as disjointed. Reports suggested that the coordination and management of health services and resources were not tailored to the needs of those living in all camps. And because so many national and international agencies were involved, but under weak coordination, access to services was less than optimal and adequate management of critical public health interventions was lacking. Varied allocation of resources such as funding, medication and medically trained staff were viewed as key factors in the availability and the ability to access what was considered as essential healthcare services. Conclusion: The health of IDPs in camp-like settings was compromised by uncoordinated management, treatment, and control of communicable and non-communicable diseases. Government authorities need to be aware and consider the complexity of the multiagency involvement in the management and provision of IDP healthcare services. Introducing systems to streamline, monitor and support IDP healthcare management could be cost-effective strategies for achieving optimal health care

‘You Just Went In and You Got It All Sorted Straightaway’ – What is the Appeal of a Community-Based Mobile Stop Smoking Service?:The appeal of a mobile stop smoking service

Introduction: Not enough smokers access existing stop smoking services (SSS). Developing more accessible and effective SSS is important, particularly for smokers from socioeconomically disadvantaged groups where smoking is more prevalent.Aims: To consider smokers’ reasons for accessing a community-based mobile SSS (MSSS) for initial and follow-up consultations, and to explore their experiences of the service over time.Methods: The MSSS was delivered in socioeconomically disadvantaged areas of Nottingham (UK). Thirty-six smokers were interviewed, and 11 of these also completed follow-up interviews four to six weeks after their quit date. Interviews were analysed using the framework approach.Results: Many participants had considered quitting before they had knowledge of the MSSS. Features of the MSSS participants found appealing for both initial and follow-up consultations included the drop-in format, convenient times and locations that fit around their existing routines, and that the service was informal and held in a non-health setting. Participants found visiting standard SSS, particularly clinics held in health settings, stressful and formal resulting in them feeling uncomfortable discussing smoking in these settings.Conclusions: Developing instantly accessible and convenient SSS that can be delivered in familiar and informal settings within smokers’ communities may facilitate access and help to retain service users over time.</jats:p