Promoting smoking cessation in Pakistani and Bangladeshi men in the UK: pilot cluster randomised controlled trial of trained community outreach workers

<p>Abstract</p> <p>Background</p> <p>Smoking prevalence is high among Pakistani and Bangladeshi men in the UK, but there are few tailored smoking cessation programmes for Pakistani and Bangladeshi communities. The aim of this study was to pilot a cluster randomised controlled trial comparing the effectiveness of Pakistani and Bangladeshi smoking cessation outreach workers with standard care to improve access to and the success of English smoking cessation services.</p> <p>Methods</p> <p>A pilot cluster randomised controlled trial was conducted in Birmingham, UK. Geographical lower layer super output areas were used to identify natural communities where more than 10% of the population were of Pakistani and Bangladeshi origin. 16 agglomerations of super output areas were randomised to normal care controls vs. outreach intervention. The number of people setting quit dates using NHS services, validated abstinence from smoking at four weeks, and stated abstinence at three and six months were assessed. The impact of the intervention on choice and adherence to treatments, attendance at clinic appointments and patient satisfaction were also assessed.</p> <p>Results</p> <p>We were able to randomise geographical areas and deliver the outreach worker-based services. More Pakistani and Bangladeshi men made quit attempts with NHS services in intervention areas compared with control areas, rate ratio (RR) 1.32 (95%CI: 1.03-1.69). There was a small increase in the number of 4-week abstinent smokers in intervention areas (RR 1.30, 95%CI: 0.82-2.06). The proportion of service users attending weekly appointments was lower in intervention areas than control areas. No difference was found between intervention and control areas in choice and adherence to treatments or patient satisfaction with the service. The total cost of the intervention was £124,000; an estimated cost per quality-adjusted life year (QALY) gained of £8,500.</p> <p>Conclusions</p> <p>The intervention proved feasible and acceptable. Outreach workers expanded reach of smoking cessation services in diverse locations of relevance to Pakistani and Bangladeshi communities. The outreach worker model has the potential to increase community cessation rates and could prove cost-effective, but needs evaluating definitively in a larger, appropriately powered, randomised controlled trial. These future trials of outreach interventions need to be of sufficient duration to allow embedding of new models of service delivery.</p> <p>Trial registration</p> <p>Current Controlled Trials <a href="http://www.controlled-trials.com/ISRCTN82127540">ISRCTN82127540</a></p

Room Temperature Magnesite Precipitation

Magnesite (MgCO₃) is one of the most stable sinks for carbon dioxide (CO₂) and is therefore of great interest for long-term carbon storage. Although magnesite is the thermodynamically stable form of magnesium carbonate, the kinetic inhibition of low-temperature precipitation has hindered the development of carbon sequestration strategies that can be economically conducted under ambient temperature. Here, we document the precipitation of magnesite from waters (magnesite saturation index = 1.45) in batch reactors at room temperature with the aid of carboxylated polystyrene microspheres over the course of 70 days. Microspheres provide surfaces with a high density of carboxyl groups that act to bind and dehydrate Mg²⁺ ions in solution, thereby minimizing the kinetic barrier and facilitating magnesite formation. Magnesite crystals are observed on sphere surfaces and their organic matrixes. Mineral identification was confirmed by X-ray diffraction and selected area electron diffraction of a thin section obtained by focused ion beam milling. We demonstrate that kinetic barriers to magnesite formation can be overcome at ambient conditions. Incorporating surfaces with high carboxyl site densities into ex situ mineral carbonation processes and the use of such ligands for deep geologic CO₂ storage may offer novel and economically viable strategies for permanent carbon storage

Photoferrotrophy, deposition of banded iron formations, and methane production in Archean oceans

Banded iron formation (BIF) deposition was the likely result of oxidation of ferrous iron in seawater by either oxygenic photosynthesis or iron-dependent anoxygenic photosynthesis-photoferrotrophy. BIF deposition, however, remains enigmatic because the photosynthetic biomass produced during iron oxidation is conspicuously absent from BIFs. We have addressed this enigma through experiments with photosynthetic bacteria and modeling of biogeochemical cycling in the Archean oceans. Our experiments reveal that, in the presence of silica, photoferrotroph cell surfaces repel iron (oxyhydr)oxides. In silica-rich Precambrian seawater, this repulsion would separate biomass from ferric iron and would lead to large-scale deposition of BIFs lean in organic matter. Excess biomass not deposited with BIF would have deposited in coastal sediments, formed organic-rich shales, and fueled microbial methanogenesis. As a result, the deposition of BIFs by photoferrotrophs would have contributed fluxes of methane to the atmosphere and thus helped to stabilize Earth's climate under a dim early Sun

A depositional model for hydromagnesite-magnesite playas near Atlin, British Columbia, Canada

This study formulates a comprehensive depositional model for hydromagnesite-magnesite playas. Mineralogical, isotopic and hydrogeochemical data are coupled with electron microscopy and field observations of the hydromagnesite-magnesite playas near Atlin, British Columbia, Canada. Four surface environments are recognized: wetlands, grasslands, localized mounds (metre-scale) and amalgamated mounds composed primarily of hydromagnesite [Mg(CO)(OH)·4HO], which are interpreted to represent stages in playa genesis. Water chemistry, precipitation kinetics and depositional environment are primary controls on sediment mineralogy. At depth (average ≈ 2 m), Ca-Mg-carbonate sediments overlay early Holocene glaciolacustrine sediments indicating deposition within a lake post-deglaciation. This mineralogical change corresponds to a shift from siliciclastic to chemical carbonate deposition as the supply of fresh surface water (for example, glacier meltwater) ceased and was replaced by alkaline groundwater. Weathering of ultramafic bedrock in the region produces Mg-HCO groundwater that concentrates by evaporation upon discharging into closed basins, occupied by the playas. An uppermost unit of Mg-carbonate sediments (hydromagnesite mounds) overlies the Ca-Mg-carbonate sediments. This second mineralogical shift corresponds to a change in the depositional environment from subaqueous to subaerial, occurring once sediments 'emerged' from the water surface. Capillary action and evaporation draw Mg-HCO water up towards the ground surface, precipitating Mg-carbonate minerals. Evaporation at the water table causes precipitation of lansfordite [MgCO·5HO] which partially cements pre-existing sediments forming a hardpan. As carbonate deposition continues, the weight of the overlying sediments causes compaction and minor lateral movement of the mounds leading to amalgamation of localized mounds. Radiocarbon dating of buried vegetation at the Ca-Mg-carbonate boundary indicates that there has been ca 8000 years of continuous Mg-carbonate deposition at a rate of 0·4 mm yr. The depositional model accounts for the many sedimentological, mineralogical and geochemical processes that occur in the four surface environments; elucidating past and present carbonate deposition

Habitat use by nightingales in a scrub-woodland mosaic at the edge of the range

Capsule Nightingales Luscinia megarhynchos with song territories in scrub vegetation also used adjacent woodland. Aims To examine spatial use by Nightingales of vegetation mosaics and associated selection of vegetation height classes. Methods We examined habitat selection by male Nightingales through territory mapping and radiotracking within a mosaic of dry scrub and woodland adjacent to water-filled gravel pits in eastern England. Results Fourteen song territories were exclusively in scrub, 2 were exclusively in woodland, and 13 comprised both habitat types. Densities were greatest in scrub vegetation of 3–5 m height. Best-supported models for territory density indicated the importance of considering optimal vegetation height within management prescriptions. Despite song territories being in scrub, kernel home-ranges of all radiotracked Nightingales contained areas of mature trees. Birds also spent more time there than expected based on availability of woodland within kernels. Conclusions Habitat quality has been implicated in the decline of Nightingales in lowland woodland in Britain (and an associated increase in the proportion found in scrub). Our results indicate that woodland habitat characteristics provide resources for Nightingales with song territories located in dry scrub and may be a factor in territory establishment, and are therefore relevant for conservation practitioners at such sites