Enhanced smoking cessation support for newly abstinent smokers discharged from hospital (The Hospital to Home trial): A randomised controlled trial

Background and aimsThe United Kingdom's National Institute for Health and Care Excellence guidance (NICE PH48) recommends that pharmacotherapy combined with behavioural support be provided for all smokers admitted to hospital; however, relapse to smoking after discharge remains common. This study aimed to assess the effect of adding home support for newly?abstinent smokers to conventional NICE?recommended support in smokers discharged from hospital.Designindividually?randomised parallel group trial.SettingOne UK acute hospital.Participants404 smokers aged >18 admitted to acute medical wards between June 2016 and July 2017 were randomised in equal numbers to each treatment group.Interventions and comparatorsThe intervention provided 12 weeks of at?home cessation support which included help in maintaining a smoke?free home, help in accessing and using medication, further behavioural support and personalised feedback on home air quality. The comparator was NICE PH48 care as usual.MeasuresThe primary outcome was self?reported continuous abstinence from smoking validated by an exhaled carbon monoxide level ?6ppm four?weeks after discharge from hospital.FindingsIn an intention?to?treat analysis at the four?week primary endpoint, 38 participants (18.8%) in the usual care group and 43 (21.3%) in the intervention group reported continuous abstinence from smoking (odds ratio 1.17, 95% confidence interval 0.72 to 1.90, Bayes factor 0.33). There were no significant differences in any secondary outcomes, including self?reported cessation at 3 months, having a smoke?free home, or number of cigarettes smoked per day in those who did not quit.ConclusionsProvision of a home visit and continued support to prevent relapse to smoking after hospital discharge did not appear to increase subsequent abstinence rate above usual care in accordance with UK guidance from the National Institute of Health and Care Excellence

Measurement of the Noise Resulting from the Interaction of Turbulence with a Lifting Surface

An experimental study of the noise resulting from the interaction of an airfoil with incident turbulence is presented. The test models include NACA0015 airfoils of different chord lengths, a flat plate with a sharp leading edge, and an airfoil of same section as a reference Fowler flap. The airfoils are immersed in nearly isotropic turbulence. Two approaches for performing the noise measurements are used and compared. The effects that turbulence intensity and scales, airfoil geometry, velocity and angle of attack have on the incident turbulence interaction noise are examined. Detailed directivity measurements are presented. It is found that noise spectral levels beyond the peak frequency decrease more with decreasing airfoil leading edge sharpness, and that spectral peak level (at 0 deg. angle of attack) appears to be mostly controlled by the airfoil fs thickness and chord. Increase in turbulence scale and intensity are observed to lead to a uniform increase of the noise spectral levels with an LI(sup 2) dependence (where L is the turbulence longitudinal integral scale and I is the turbulence intensity). Noise levels are found to scale with the 6th power of velocity and the 2nd power of the airfoil chord. Sensitivity to changes in angle of attack appears to have a turbulence longitudinal integral scale to chord (C) ratio dependence, with large effects on noise for L/C greater than or equal to 1 and decreased effects as L/C becomes smaller than 1. For all L/C values, the directivity pattern of the noise resulting from the incident turbulence is seen to remain symmetric with respect to the direction of the mean flow until stall, at which point, the directivity becomes symmetric with respect to the airfoil chord. It is also observed that sensitivity to angle of attack changes is more pronounced on the model suction side than on the model pressure side, and in the higher frequency range of the spectra for the largest airfoils tested (L/C less than 0.24)

Lessons from history of socioeconomic improvements: a new approach to treating multi-drug-resistant tuberculosis

Summary This study investigated the trends in tuberculosis mortality through time in Switzerland. Information on the decline in mortality before chemotherapies were introduced may be useful in developing countries where drug-resistant tuberculosis is now becoming a major problem. Swiss data were collected from historical records and comparative data were obtained from the literature for England and Wales, New York, Japan, Brazil and Sierra Leone. Logistic curves were fitted to examine the rate of decline before introduction of pharmacotherapies and these show that the decline would have continued without the introduction of chemical therapies, including antibiotics. In Switzerland, England and Wales and New York, the decline had occurred long before the introduction of specific anti-tuberculosis agents. In Brazil and Japan, chemical therapy was co-incident with the decline in tuberculosis mortality rates. Overall, it is suggested that the effective control of tuberculosis can be achieved through a combination of chemical interventions, conservative therapy (rest, good nutrition, ventilation, etc.) as well as public health interventions addressing hygiene, nutrition, reducing exposure to infections and educating the population about tuberculosis

Back analysis of the 2014 San Leo Landslide using combined terrestrial laser scanning and 3D distinct element modelling

This is the author accepted manuscript. The final version is available from Springer Verlag via http://dx.doi.org/10.1007/s00603-015-0763-5© 2015 Springer-Verlag Wien Landslides of the lateral spreading type, involving brittle geological units overlying ductile terrains, are a common occurrence in the sandstone and limestone plateaux of the northern Apennines of Italy. The edges of these plateaux are often the location of rapid landslide phenomena, such as rock slides, rock falls and topples. In this paper, we present a back analysis of a recent landslide (February 2014), involving the north-eastern sector of the San Leo rock slab (northern Apennines, Emilia-Romagna Region) which is a representative example of this type of phenomena. The aquifer hosted in the fractured slab, due to its relatively higher secondary permeability in comparison to the lower clayey units leads to the development of perennial and ephemeral springs at the contact between the two units. The related piping erosion phenomena, together with slope processes in the clay-shales have led to the progressive undermining of the slab, eventually predisposing large-scale landslides. Stability analyses were conducted coupling terrestrial laser scanning (TLS) and distinct element methods (DEMs). TLS point clouds were analysed to determine the pre- and post-failure geometry, the extension of the detachment area and the joint network characteristics. The block dimensions in the landslide deposit were mapped and used to infer the spacing of the discontinuities for insertion into the numerical model. Three-dimensional distinct element simulations were conducted, with and without undermining of the rock slab. The analyses allowed an assessment of the role of the undermining, together with the presence of an almost vertical joint set, striking sub-parallel to the cliff orientation, on the development of the slope instability processes. Based on the TLS and on the numerical simulation results, an interpretation of the landslide mechanism is proposed

Variability and effectiveness of comparator group interventions in smoking cessation trials : A systematic review and meta-analysis

Funding: This work was funded by Cancer Research UK (application number C50862/A18446). The systematic review protocol was previously peer-reviewed by Cancer Research UK as part of the funding process. The funder had no role in protocol design, decision to publish, or preparation of the manuscriptPeer reviewedPublisher PD

The Relative Space: Space Measurements on a Rotating Platform

We introduce here the concept of relative space, an extended 3-space which is recognized as the only space having an operational meaning in the study of the space geometry of a rotating disk. Accordingly, we illustrate how space measurements are performed in the relative space, and we show that an old-aged puzzling problem, that is the Ehrenfest's paradox, is explained in this purely relativistic context. Furthermore, we illustrate the kinematical origin of the tangential dilation which is responsible for the solution of the Ehrenfest's paradox.Comment: 14 pages, 2 EPS figures, LaTeX, to appear in the European Journal of Physic

Relationship between spatial proximity and travel-to-work distance : the effect of the compact city

In this paper, an assessment is made of the relationship between selected aspects of spatial proximity (density, diversity, minimum commuting distance, jobs-housing balance and job accessibility) and reported commuting distances in Flanders (Belgium). Results show that correlations may depend on the considered trip end. For example, a high residential density, a high degree of spatial diversity and a high level of job accessibility are all associated with a short commute by residents, while a high job density is associated with a long commute by employees. A jobs-housing balance close to one is associated with a short commute, both by residents and by employees. In general, it appears that the alleged sustainability benefits of the compact city model are still valid in a context of continuously expanding commuting trip lengths

Young people's exposure to point-of-sale tobacco products and promotions

The study was funded by the UK National Institute for Health Research (NIHR, PHR 10/3000/07).Objectives. Point of sale (POS) displays are one of the most important forms of tobacco marketing still permitted in many countries. Reliable methods for measuring exposure to such displays are needed in order to assess their potential impact, particularly on smoking attitudes and uptake among young people. In this study we use a novel method for evaluating POS exposure based on young people's use of retail outlets and recall of tobacco displays and observational data on the characteristics of displays. Study design. Observational audit of retail outlets (n = 96) and school-based pupil survey (n = 1482) in four Scottish communities reflecting different levels of social deprivation and urbanisation, conducted in 2013 before legislation to remove POS displays was implemented in supermarkets. Methods. Measures were taken of: visibility and placement of tobacco displays; internal and external advertising; display unit size, branding and design; visibility of pack warnings; proximity of tobacco products to products of potential interest to children and young people; pupils' self-reported frequency of visiting retail outlets; and pupils' recall of tobacco displays. Variation in POS exposure across social and demographic groups was assessed. Results. Displays were highly visible within outlets and, in over half the stores, from the public footway outside. Tobacco products were displayed in close proximity to products of interest to children (e.g. confectionery, in 70% of stores). Eighty percent of pupils recalled seeing tobacco displays, with those from deprived areas more likely to recall displays in small shops. When confectioners, tobacconists and newsagents (CTNs) and grocery/convenience stores (two of the outlet types most often visited by young people) were examined separately, average tobacco display unit sizes were significantly larger in those outlets in more deprived areas. Conclusions. POS displays remain a key vector in most countries for advertising tobacco products, and it is important to develop robust measures of exposure. The data reported in this paper provide a baseline measure for evaluating the efficacy of legislation prohibiting such displays.Publisher PDFPeer reviewe

Initial phases of massive star formation in high infrared extinction clouds. I. Physical parameters

The earliest phases of massive star formation are found in cold and dense infrared dark clouds (IRDCs). Since the detection method of IRDCs is very sensitive to the local properties of the background emission, we present here an alternative method to search for high column density in the Galactic plane by using infrared extinction maps. We find clouds between 1 and 5 kpc, of which many were missed by previous surveys. By studying the physical conditions of a subsample of these clouds, we aim at a better understanding of the initial conditions of massive star formation. We made extinction maps of the Galactic plane based on the 3.6-4.5 microns color excess between the two shortest wavelength Spitzer IRAC bands, reaching to visual extinctions of ~100 mag and column densities of 9x10^22 cm^-2. From this we compiled a new sample of cold and compact high extinction clouds. We used the MAMBO array at the IRAM 30m telescope to study the morphology, masses and densities of the clouds and the dense clumps within them. The latter were followed up by pointed ammonia observations with the 100m Effelsberg telescope, to determine rotational temperatures and kinematic distances. Extinction maps of the Galactic plane trace large scale structures such as the spiral arms. The 1.2 mm emission maps reveal that the high extinction clouds contain extended cold dust emission, from filamentary structures to still diffuse clouds. Most of the clouds are dark in 24 microns, but several show already signs of star formation via maser emission or bright infrared sources, suggesting that the high extinction clouds contain a variety of evolutionary stages. The observations suggest an evolutionary scheme from dark, cold and diffuse clouds, to clouds with a stronger 1.2 mm peak and to finally clouds with many strong 1.2 mm peaks, which are also warmer, more turbulent and already have some star formation signposts.Comment: 26 pages, 14 figures, 9 tables. Accepted for publication in Astronomy and Astrophysics, small corrections implemente

Social marketing and healthy eating : Findings from young people in Greece

This document is the Accepted Manuscript version. The final publication is available at Springer via http://dx.doi.org/10.1007/s12208-013-0112-xGreece has high rates of obesity and non-communicable diseases owing to poor dietary choices. This research provides lessons for social marketing to tackle the severe nutrition-related problems in this country by obtaining insight into the eating behaviour of young adults aged 18–23. Also, the main behavioural theories used to inform the research are critically discussed. The research was conducted in Athens. Nine focus groups with young adults from eight educational institutions were conducted and fifty-nine participants’ views towards eating habits, healthy eating and the factors that affect their food choices were explored. The study found that the participants adopted unhealthier nutritional habits after enrolment. Motivations for healthy eating were good health, appearance and psychological consequences, while barriers included lack of time, fast-food availability and taste, peer pressure, lack of knowledge and lack of family support. Participants reported lack of supportive environments when deciding on food choices. Based on the findings, recommendations about the development of the basic 4Ps of the marketing mix, as well as of a fifth P, for Policy are proposedPeer reviewe