Australian mental health care practitioners’ practices and attitudes for encouraging smoking cessation and tobacco harm reduction in smokers with severe mental illness

Reducing the burden of physical illness among people living with severe mental illnesses (SMI) is a key priority. Smoking is strongly associated with SMIs resulting in excessive smoking related morbidity and mortality in smokers with SMI. Smoking cessation advice and assistance from mental health practitioners would assist with reducing smoking and smoking-related harms in this group. This study examined the attitudes and practices of Australian mental health practitioners towards smoking cessation and tobacco harm reduction for smokers with SMI, including adherence to the 5As (ask, assess, advise, assist and arrange follow up) of smoking cessation. We surveyed 267 Australian mental health practitioners using a cross-sectional, online survey. Most practitioners (77.5%) asked their clients about smoking and provided health education (66.7%) but fewer provided direct assistance (31.1–39.7%). Most believed that tobacco harm reduction strategies are effective for reducing smoking related risks (88.4%) and that abstinence from all nicotine should not be the only goal discussed with smokers with SMI (77.9%). Many respondents were unsure about the safety (56.9%) and efficacy (39.3%) of e-cigarettes. Practitioners trained in smoking cessation were more likely (OR: 2.9, CI: 1.5–5.9) to help their clients to stop smoking. Community mental health practitioners (OR: 0.3, CI: 0.1–0.9) and practitioners who were current smokers (OR: 0.3, CI: 0.1–0.9) were less likely to adhere to the 5As of smoking cessation intervention. The results of this study emphasize the importance and need for providing smoking cessation training to mental health practitioners especially community mental health practitioners

PROTOCOL: The impact of agricultural mechanisation on women's economic empowerment: A mixed-methods systematic review

This is the protocol for a Campbell systematic review. The main objective of the review is to answer the following questions: What is the impact of mechanisation on agriculture? What is the impact of mechanisation on women's economic empowerment? The study will review the impact of mechanisation on labour demand and supply, land and labour productivity, farmers' incomes, health and women's empowerment. All literature will be considered, including nonintervention studies and studies not reporting gender-disaggregated results

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Level of endosulfan among women in Talwandi Sabo Block of Southern Punjab, India

Endosulfan is one of the most prevalent organochlorine pesticides used in the agricultural sector in the developing countries including India. It affects the physiological functioning of different organ systems including nervous, immune, hepatic, and reproductive system. Realizing the safety and health concern, restrictions have been imposed at various levels, but the usage has still continued in the plantation crops. Owing to pesticide beneficiary of north India, the cotton belt commonly called the Malwa region of Punjab was evaluated for identifying the levels of Endosulfan in the blood samples of women working in agricultural fields. Gas chromatograph with electron capture detector was used for detecting the levels of endosulfan metabolites among twenty active female workers. The mean level of endosulfan recorded in the tested population was observed to be 2.22 ppb. It is difficult to draw a certain conclusion based on these findings because the subjects were less in number. However, detection of even very low concentrations of endosulfan residues signifies its continued accessibility to the women population. Encouragement of more such population-based research needs to be adopted to determine the body burden of such pesticides in humans. The effective implementation of the ban on Endosulfan could be checked by a combined retrospective and prospective study to infer a justifiable impact

Mobile-phone text messaging (SMS) for providing oral health education to mothers of preschool children in Belgaum city

We compared the effectiveness of two media (text messages and pamphlets) in imparting health education to mothers of preschool children. Mothers and their children were randomized into two groups. There were 72 mothers and their children in the pamphlet group and 71 in the text message group. The mothers were given health education by one of the two modes for four weeks. Knowledge, attitude and practices of the mothers were assessed by a questionnaire pre- and post-intervention. Visible plaque scores of their children were also recorded pre- and post-intervention. There were significant improvements in knowledge (P , 0.001), attitude (P , 0.001) and practices (P , 0.001) in both groups. There was also a significant reduction in visible plaque scores (P , 0.001) in both groups. Text messaging was more effective than pamphlets in improving knowledge, attitude and practices of mothers, but the comparative reduction in plaque score between groups was not significant. Text messaging appears to be an effective means of imparting oral health education