Smoking cessation in workplace setting: quit rates and determinants in a group behaviour therapy programme

To capitalise on the opportunities that the smoking ban legislation in Switzerland offers for the prevention of tobacco-related diseases, a smoking cessation programme in a workplace setting was developed and implemented in companies across the language and cultural regions of Switzerland. Our goal was to identify factors associated with relapse into smoking that may be overcome during training sessions or that should be considered for the optimisation of future interventions.; Between 2006 and 2012, 1287 smokers aged 16 to 68 years voluntarily attended smoking cessation training at their workplace. The intervention was based on a cognitive behavioural group therapy combined with individual proactive telephone counselling. The evaluation consisted of three anonymised questionnaires (pre- and postintervention, and 12-month follow-up). In this prospective cohort study, we investigated the association of smoking quit rates with training and participant characteristics, including withdrawal symptoms, by use of multilevel logistic regression analysis with a random intercept for training courses.; The self-reported abstinence rate was 72.4% at the end of the training, and 18.6% 1 year later. The risk of relapse during the training was positively associated with the number of years and daily cigarettes smoked, and negatively with increased appetite, sleeping troubles and satisfaction with learned techniques. Failed abstinence within the first year was associated with younger age, higher numbers of daily smoked cigarettes and unsuccessful recent quit attempts.; Our evaluation suggests that younger and more addicted smokers attending smoking cessation trainings may need additional support to achieve long lasting abstinence rates. Offering smoking cessation training in a workplace setting can achieve reasonable long-term quit rates, but a subset of employees needs additional support at the group or personal level.; Group behaviour therapy could be an effective method to achieve long-term smoking abstinence. The workplace is an important setting to reach and encourage a large number of smokers to participate in a smoking cessation programme, but only few studies investigated its potential. The findings of this study of a modern real-life workplace-based smoking cessation programme endorse the effectiveness and viability of cognitive behavioural group therapy. This group-level intervention at the workplace may be insufficient for young and heavy smokers, as well as women with increased appetite after cessation, who potentially benefit from re-intervention and additional individual level counselling

Impact of oceanic floods on particulate metal inputs to coastal and deep-sea environments: A case study in the NW Mediterranean Sea

An exceptional flood event, accompanying a marine storm, was investigated simultaneously at the entrance and the exit of the Gulf of Lion's hydrosystem (NW Mediterranean) in December 2003. Cs, Cr, Co, Ni, Cu, Zn, Cd and Pb signatures of both riverine and shelf-exported particles indicate that continental inputs and resuspended prodeltaic sediments were intensively mixed with resuspended sediments from middle/outer shelf areas during advective transport. As a result, particles leaving the Gulf of Lion inherited the mean signature of shelf bottom sediments, exporting anthropogenic Pb and Zn out into the open sea. When assessing the particulate metal budget in relation with the event, it appears that the output fluxes accounted for between 15% and 60% of the input fluxes, depending on the element and the period of reference. This trend is also observed for annual budgets, which were drawn up by compiling the data from this study and the literature. Results evidenced that, except some element fluxes during extreme output scenario, outputs never counter-balance the inputs. In its current functioning, the Gulf of Lion's shelf seems to act as a retention/sink zone for particulate metals. Regarding anthropogenic fluxes, the contribution of the oceanic flood of December 2003 to the mean annual scenario is considerable. Environmental impacts onto coastal and deep-sea ecosystems should therefore tightly depend on both the intensity and the frequency of event-dominated sediment transport

Relative validation of a food frequency questionnaire to estimate food intake in an adult population

Background: Scientifically valid descriptions of dietary intake at population level are crucial for investigating diet effects on health and disease. Food frequency questionnaires (FFQs) are the most common dietary tools used in large epidemiological studies. Objective: To examine the relative validity of a newly developed FFQ to be used as dietary assessment tool in epidemiological studies. Design: Validity was evaluated by comparing the FFQ and a 4-day weighed food record (4-d FR) at nutrient and food group levels, Spearman’s correlations, Bland–Altman analysis and Wilcoxon rank sum tests were used. Fifty-six participants completed a paper format FFQ and a 4-d FR within 4 weeks. Results: Corrected correlations between the two instruments ranged from 0.27 (carbohydrates) to 0.55 (protein), and at food group level from 0.09 (soup) to 0.92 (alcohol). Nine out of 25 food groups showed correlations > 0.5, indicating moderate validity. More than half the food groups were overestimated in the FFQ, especially vegetables (82.8%) and fruits (56.3%). Water, tea and coffee were underestimated (–14.0%). Conclusions: The FFQ showed moderate relative validity for protein and the food groups fruits, egg, meat, sausage, nuts, salty snacks and beverages. This study supports the use of the FFQ as an acceptable tool for assessing nutrition as a health determinant in large epidemiological studies

Effects of scale, question location, order of response alternatives, and season on self-reported noise annoyance using ICBEN scales : a field experiment

The type of noise annoyance scale and aspects of its presentation such as response format or location within a questionnaire and other contextual factors may affect self-reported noise annoyance. By means of a balanced experimental design, the effect of type of annoyance question and corresponding scale (5-point verbal vs. 11-point numerical ICBEN (International Commission on Biological Effects of Noise) scale), presentation order of scale points (ascending vs. descending), question location (early vs. late within the questionnaire), and survey season (autumn vs. spring) on reported road traffic noise annoyance was investigated in a postal survey with a stratified random sample of 2386 Swiss residents. Our results showed that early appearance of annoyance questions was significantly associated with higher annoyance scores. Questionnaires filled out in autumn were associated with a significantly higher annoyance rating than in the springtime. No effect was found for the order of response alternatives. Standardized average annoyance scores were slightly higher using the 11-point numerical scale whereas the percentage of highly annoyed respondents was higher based on the 5-point scale, using common cutoff points. In conclusion, placement and presentation of annoyance questions within a questionnaire, as well as the time of the year a survey is carried out, have small but demonstrable effects on the degree of self-reported noise annoyance

Meat intake, cooking-related mutagens and risk of colorectal adenoma in a sigmoidoscopy-based case-control study

Reported habits of red meat consumption, particularly red meat that has been cooked to the degree termed ‘well-done', is a positive risk factor for colorectal cancer. Under high, pyrolytic temperatures, heterocyclic amines (HCA) and benzo[a]pyrene (BP) molecules can form inside and on the surface of red meat, respectively. These compounds are precursors that are metabolically converted to compounds known to act as mutagens and carcinogens in animal models, yet their role in human colorectal carcinogenesis remains to be clarified. We investigated whether intake of these compounds is associated with risk of colorectal adenoma in the context of a polyp-screening study conducted in Southern California. Using a database of individual HCAs and BP in meats of various types and subjected to specified methods and degrees of cooking, we estimated nanogram consumption of 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine, 2-amino-3,4,8-trimethylimidazo[4,5-f] quinoxaline, 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline and benzo[a]pyrene (BP). We observed a 6% increased risk of large (>1 cm) adenoma per 10 ng/day consumption of BP [OR = 1.06 (95% CI, 1.00-1.12), P (trend) = 0.04]. A major source of BP is red meat exposed to a naked flame, as occurs during the barbecuing process. Consistent with this finding an incremental increase of 10 g of barbecued red meat per day was associated with a 29% increased risk of large adenoma [OR = 1.29 (95% CI, 1.02-1.63), P (trend) = 0.04]. Individuals in the top quintile of barbecued red meat intake were at increased risk of large adenoma [OR = 1.90 (95% CI, 1.04-3.45)], compared with never consuming barbecued red meat. The consumption of oven-broiled red meat was inversely related to adenoma risk compared with non-consumers [OR = 0.49 (95% CI, 0.28-0.85)]. We did not identify any association with consumption of individual HCAs and colorectal adenoma risk. These results support the hypothesis that BP contributes to colorectal carcinogenesi

Impact of mammography screening programmes on breast cancer mortality in Switzerland, a country with different regional screening policiesty in Switzerland, a country with different regional screening policies

In the past decades, mortality due to breast cancer has declined considerably in Switzerland and other developed countries. The reasons for this decline remain controversial as several factors occurred almost simultaneously, including important advances in treatment approaches, breast cancer awareness and the introduction of mammography screening programmes in many European countries. In Switzerland, mammography screening programmes (MSPs) have existed in some regions for over 20 years but do not yet exist in others. This offers the possibility to analyse its effects with modern spatiotemporal methodology. We aimed to assess the spatiotemporal patterns and the effect of MSPs on breast cancer mortality.; Switzerland.; The study covers breast cancer deaths of the female population of Switzerland during the period 1969-2012. We retrieved data from the Swiss Federal Statistical Office aggregated on a small-area level.; We fitted Bayesian hierarchical spatiotemporal models on death rates indirectly standardised by national references. We used linguistic region, degree of urbanisation, duration of population-based screening programmes and socioeconomic index as covariates.; In Switzerland, breast cancer mortality in women slightly increased until 1989-1992 and declined strongly thereafter. Until 2009-2012, the standardised mortality ratio declined to 57% (95% CI 54% to 60%) of the 1969-1972 value. None of the other coefficients of the spatial regressions had a significant effect on breast cancer mortality. In 2009-2012, no region had significantly elevated or reduced breast cancer mortality at 95% credible interval level compared with the national mean.; There has been a strong reduction of breast cancer mortality from the 1990s onwards. No important spatial disparities were observed. The factors studied (urbanisation, language, duration of population-based MSP and socioeconomic characteristics) did not seem to have an influence on them. Low participation rates and opportunistic screening use may have contributed to the low impact of MSPs

Umsorgt werden und umsorgen - Leben mit mehreren Langzeiterkrankungen (Leila) : eine qualitative Studie zum Beitrag von APN in integrierter Versorgung

Hintergrund: Das Leben mit mehreren chronischen Krankheiten ist komplex und führt zu einer erhöhten Pflege- und Betreuungsbedürftigkeit. Zur Förderung der integrierten Versorgung wurde ein dreijähriges Projekt namens «Leben mit Langzeiterkrankung» (Leila) initiiert. Ziel: Das Projekt hatte zum Ziel, Leistungen von Pflegeexpertinnen in Advanced Practice Nursing (APN) für chronisch erkrankte Menschen in Zusammenarbeit mit Hausarztpraxen zu entwickeln. Folgende Fragestellungen wurden untersucht: 1. Wie erleben Patient(inn)en, Zuweisende und Pflegeexpertinnen APN das Leila-Dienstleistungsangebot? 2. Wie gestalten sich Zuweisungsprozesse? 3. Wie erleben die Beteiligten die Zusammenarbeit und die APN-Rollenausübung? Methode: Es wurde ein qualitativer Ansatz gemäß Grounded Theory nach Corbin und Strauss gewählt, um Erfahrungen mit Leila und Interaktionen der an Leila beteiligten Personen zu untersuchen. Dabei wurden 38 Interviews mit Patient(inn)en, die mit multiplen chronischen Krankheiten leben, deren betreuende Pflegeexpertinnen APN und zuweisenden Ärzt(inn)en durchgeführt und evaluiert. Ergebnisse: «Umsorgt werden und umsorgen» zeigte sich als zentrale Kategorie. Diese beschreibt wie auf die Patient(inn)en eingegangen wurde, sie einbezogen und ernst genommen wurden. Die Hauptkategorie «Den Alltag gestalten» zeigt, dass die Patient(inn)en lernten, mit den Folgen chronischer Erkrankungen im Alltag umzugehen. «Alle Ressourcen nutzen» legt dar, wie Potenziale und Stärken eingesetzt wurden. Schlussfolgerungen: Die Ergebnisse zu Zuweisungs- und Kooperationsprozessen ergaben, dass die APN-Rollenanerkennung und -ausübung noch ausgehandelt werden muss. Zukünftige APN-Angebote für diese Patient(inn)engruppe sollten nebst Ärztenetzwerken in weitere Dienstleistungen und die Spitex integriert werden. Background: Living with multiple chronic diseases is complex and leads to enhanced care needs. To foster integrated care a project called “Living with chronic disease” (Leila) was initiated. Aim: The aim was to develop an Advanced Practice Nursing (APN) service in collaboration with medical centers for persons who are living with multiple chronic diseases. The following research questions were addressed: 1. What are patients' experiences, referring physicians and APNs with the Leila-Service? 2. How are referral processes performed? 3. How do the involved groups experience collaboration and APN role development? Methods: A qualitative approach according grounded theory of Corbin and Strauss was used to explore the experiences with the Leila project and the interaction of the persons involved. 38 interviews were conducted with patients who are living with multiple chronic diseases, their APN's and the referring physicians. Results: The findings revealed “Being cared for and caring” as main category. The data demonstrated how patients responded to their involvement into care and that they were taken as serious partners in the care process. The category “organizing everyday life” describes how patients learned to cope with the consequences of living with multiple chronic diseases. “Using all resources” as another category demonstrates how capabilities and strengths were adopted. Conclusions: The results of the cooperation- and allocation processes showed that the APN recognition and APN role performance have to be negotiated. Prospective APN-services for this patient population should be integrated along with physician networks and other service providers including community health nursing

The effect of the cyclin D1 (CCND1) A870G polymorphism on colorectal cancer risk is modified by glutathione-S-transferase polymorphisms and isothiocyanate intake in the Singapore Chinese Health Study

Cyclin D1 (CCND1) regulates cellular decision between proliferation and growth arrest. Despite the functional relevance of the CCND1 A870G single nucleotide polymorphism (SNP) published results on its association with colorectal cancer (CRC) were inconsistent. We examined the association between this CCND1 genotype and CRC in the Singapore Chinese Health Study, a prospective investigation of diet and cancer in 63 000 Chinese men and women. We explored the hypothesis that inconsistency regarding the CCND1/CRC association may be attributable to the modifying effect of additional CRC risk factors. Since GSTM1/GSTT1 genotype and dietary isothiocyanate (ITC) intake had previously been identified as CRC risk factors in this cohort, we now explored if they influenced the CCND1/CRC association. In a nested case-control study within the Singapore Cohort, genomic DNA collected from 300 incident CRC cases and 1169 controls was examined for CCND1, GSTM1, GSTT1 and GSTP1 polymorphisms. Unconditional logistic regression was used to assess genotype effects on cancer risk. No main effect of CCND1 was observed, yet the CCND1 effect was influenced by ITC intake and GST genotypes. The presence of at least one CCND1 A-allele was associated with increased risk among low dietary ITC consumers (intake below median value for the cohort) with a high-activity GST profile (≥2 of the 3 GST genotypes classified non-null or high-activity) [odds ratio (OR) = 2.05; 95% confidence interval (CI), 1.10-3.82]. In contrast, the presence of at least one A-allele was associated with a decreased risk among all remaining subjects (OR = 0.56; 0.36-0.86) (P for interaction = 0.01). Recent studies indicate that ITCs inhibit cell proliferation and cause apoptosis through pro-oxidant properties. The results of our current study on CRC and those of our previous breast cancer study are compatible with the notion of oxidative stress in target cells as important determinant of direction and magnitude of the CCND1 effec

Associations between dietary patterns and post-bronchodilation lung function in the SAPALDIA cohort

Background: Chronic obstructive pulmonary disease (COPD) is not restricted to smokers. Dietary habits may contribute to the disease occurrence. Epidemiological studies point to a protective effect of fruit and vegetable intake against COPD. Objective: To investigate the associations between dietary patterns and parameters of lung function related to COPD in the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA). Methods: Data were included from the second follow-up assessment of the SAPALDIA cohort in 2010-2011 using a food frequency questionnaire. Principal component factor analysis was used to derive dietary patterns, whose association with FEV1, FEV1/FVC, FEF2575, and COPD was investigated by applying multivariate regression analyses. Results: After adjustment for potential confounders, the “prudent dietary pattern” characterised by the predominant food groups vegetables, fruits, water, tea and coffee, fish, and nuts was positively associated with FEV1 (increase of 40 mL per SD, p < 0.001). Also for factor 3 (“high-carbohydrate diet”), we found a significant positive association with FEV1 (with an increase per SD of 36 mL, p = 0.006). Conclusions: The main results are consistent with a protective effect of a diet rich in fruits, vegetables, fish, and nuts against age-related chronic respiratory disease. If confirmed in prospective cohorts, our results may guide nutritional counselling towards respiratory health promotion

PTEN expression is a strong predictor of survival in mesothelioma patients

Background: Malignant pleural mesothelioma (MPM) is a highly aggressive tumour with poor prognosis and limited response to therapy. MPM is characterised by complex chromosomal aberrations, including chromosome 10 losses. The tumour suppressor gene phosphatase and tensin homologue deleted from chromosome 10 (PTEN) located on chromosome 10q23 plays an important role in different cancer, but its relevance for MPM is unclear. Patients and methods: In the present tissue microarray-based study, 341 MPM were studied for PTEN expression by immunohistochemistry using a monoclonal mouse PTEN antibody. Expression levels were semiquantitatively scored (negative, weak, moderate, strong). Expression of PTEN was correlated to overall survival. Results: Clinical data from 206 patients were available. One hundred and five patients were stage T4 and 92 patients presented with regional and mediastinal lymph node metastasis. Loss of PTEN expression was observed in 62% of the cases. The survival time was correlated to PTEN expression in 126 cases with complete follow-up data. Comparing any PTEN expression versus no expression, median survival time was significantly longer (log rank test p=0.0001) in patients with PTEN expression (15.5 months; 95% CI: 3.8; 27.2 vs 9.7 months; 95% CI: 7.9; 11.7). Cox regression analysis revealed an association between PTEN expression and survival (p=0.003) independently from the histological subtype (p=0.7). Conclusion: PTEN is an independent prognostic biomarker in mesothelioma patients. The frequent loss of expression of the tumour suppressor gene PTEN suggests involvement of the PI3K-AKT/protein kinase B (PKB) pathway in MPMs, which may be relevant for future mesothelioma treatmen