Avoiding the danger that stop smoking services may exacerbate health inequalities: building equity into performance assessment

<p>Abstract</p> <p>Background</p> <p>The UK is the only developed country to have established a nation-wide stop smoking treatment service. Apart from addressing tobacco dependence, which is the leading preventable cause of ill health and premature death, smoking cessation has been identified by the UK department of health as a service priority for reducing gaps in health between disadvantaged groups and the country as a whole. However smoking cessation tends to be more successful among affluent than disadvantaged groups. This means that for stop smoking services there is a trade-off to be had in terms of maximising the number of quitters and reducing socioeconomic inequalities in smoking prevalence. Current performance targets for the national stop smoking services in the UK are set only in terms of numbers of quitters, which does not encourage the adoption of strategies to reduce socioeconomic inequalities in smoking prevalence.</p> <p>Discussion</p> <p>This paper proposes an assessment framework, which allows the two dimensions of overall reduction in smoking prevalence and reductions of inequalities in smoking prevalence to be assessed together. The framework is used to assess the performance over time of a stop smoking service in Derwentside, a former Primary Care Trust in the North East of England, both in terms of meeting targets for the overall number of quitters and in terms of reducing socioeconomic inequalities in smoking prevalence.</p> <p>The example demonstrates how the proposed assessment framework can be applied in practice given existing records kept by stop smoking services in England and the available information on smoking prevalence at small area level. For Derwentside it is shown that although service expansion was successful in increasing the overall number of quitters, the service continued to exacerbate inequality in smoking prevalence between deprived and affluent wards.</p> <p>Summary</p> <p>The Secretary of State for Health in the UK has warned about the dangers of health promotion services and messages being taken up more readily by the better-off, thus exacerbating health inequalities. Because smokers from affluent backgrounds are more successful at quitting than those living in deprived circumstances, it is important to build an equity element into the monitoring of individual stop smoking services. Otherwise the danger highlighted by the Secretary of State for Health will go undetected and unaddressed.</p

Effect of pre-drying temperature on content of glycoalcaloids and nitrates (V) during laboratory production of dehydrated cooked potatoes

Celem pracy było określenie wpływu różnych temperatur podsuszania, stosowanych podczas laboratoryjnej produkcji suszu z ziemniaków gotowanych, na zawartość glikoalkaloidów (α-chakoniny i α-solaniny) i azotanów(V) w próbach pobranych z poszczególnych etapów doświadczenia technologicznego. Materiałem badawczym były ziemniaki pobierane bezpośrednio z przechowalni zakładu produkcyjnego. Z ziemniaków otrzymywano susz metodą laboratoryjną. Z każdego etapu produkcyjnego pobierano próby do oznaczeń laboratoryjnych, czyli: ziemniaki nieobrane, po obraniu, po blanszowaniu i schłodzeniu, po parowaniu oraz po wysuszeniu. Próby, oprócz ziemniaków wysuszonych, liofilizowano przy użyciu liofilizatora firmy Edwards. W ziemniakach, półproduktach, w produktach finalnych oraz w liofilizatach oznaczono suchą masę metodą suszarkową w temperaturze 102 ºC. W gotowych i zliofilizowanych produktach oznaczono zawartość azotanów(V) metodą kolorymetryczną, a zawartość α-solaniny i α-chakoniny metodą chromatografii cieczowej HPLC. Stwierdzono, że proces laboratoryjnej produkcji suszu z ziemniaka gotowanego miał wpływ na zawartość glikoalkaloidów i azotanów(V) w ziemniakach. Najwięcej glikoalkaloidów i azotanów ubyło po procesie obierania, blanszowania i suszenia. Ubytki glikoalkaloidów po procesie obierania ręcznego wynosiły 49 %, po blanszowaniu 7 %, a po wysuszeniu 10 %. Natomiast zawartość azotanów(V) po obraniu zmniejszyła się o 28 %, po blanszowaniu o 16 %, a po wysuszeniu o 17 %. Podsuszanie ziemniaków w różnych temperaturach wpłynęło na zmiany zawartości glikoalkaloidów w próbach. Najwięcej tych związków ubyło w temperaturze 160 ºC. Różnice pod względem zawartości α-chakoniny wynosiły 19 % (między produktem podsuszanym w temp. 130 i 160 ºC), a α-solaniny 23 %, natomiast temperatury podsuszania nie wpłynęły na zawartość azotanów. W gotowych produktach pozostało około 22 % początkowej zawartości α-chakoniny, 25 % α-solaniny i 28 % azotanów.The objective of this research study was to determine the effect of different pre-drying temperatures, applied during the laboratory production of dehydrated cooked potatoes, on the content of glycoalkaloids (α-chaconine and α-solanine) and nitrates(V) in the samples taken from individual phases of the technological experiment. The research material included potatoes taken directly in the production plant’s storage facility. Dried potatoes were produced using a laboratory method. Potato samples for assays in the laboratory were taken from every individual production phase, i.e.: unpeeled potatoes and potatoes after peeling, blanching, and cooling, as well as after steaming and drying. Except for the dried potatoes, the potato samples were lyophilized with the use of a liophilizator made by an Edwards Company. The content of dry matter was determined in the potatoes, semi-finished products, ready-to-eat products, and lyophilized products using a drying method at a temperature of 102 ºC. The content of nitrates(V) in the ready and lyophilized products was determined using a colorimetric method, and the content of α-solanine and α-chaconine therein by a liquid chromatography method (HPLC). It was found that the process of laboratory production of dehydrated cooked potato impacted the content of glycoalkaloids and nitrates(V) in the potatoes. After the peeling, blanching, and drying processes, the decrease in the content of glycoalkaloids and nitrates (V) was the highest. After the manual peeling process, the decrease in the content of glycoalkaloids was 49 %, after blanching: 7 %, and after drying: 10 %. However, the content of nitrates(V) after blanching decreased by 28 %, after blanching by 16 %, and after drying by 17 %. The pre-drying of the potatoes at different temperatures impacted the changes in the content of glycoalkaloids in the samples. The highest decrease in the content of those compounds took place at a temperature of 160 ºC. The differences as regards the content of α-chaconine were 19 % (between the product dried at a temperature of 130 ºC and 160 ºC), and as regards the content of α-solanine, those differences amounted to 23 %; yet, the temperatures did not impact the content of nitrates(V). In the ready-to-eat products, the content of α-chaconine remaining after the processes performed was ca. 22 % of its initial content, the content of α-solanine was 25 %, and of nitrates(V) was 28 %