Effect of a workplace-based group training programme combined with financial incentives on smoking cessation:a cluster-randomised controlled trial

Prevention, Population and Disease management (PrePoD)Public Health and primary car

The FRESHAIR4Life study: Global implementation research on non-communicable disease prevention targeting adolescents’ exposure to tobacco and air pollution in disadvantaged populations

The FRESHAIR4Life study aims to reduce the non-communicable disease (NCD) burden by implementing preventive interventions targeting adolescents’ exposure to tobacco use and air pollution (AP) worldwide. This paper presents the FRESHAIR4Life methodology and initial rapid review results. The rapid review, using various databases and PubMed, aimed to guide decision-making on risk factor focus, target areas, and populations. It showed variable NCD mortality rates related to tobacco use and AP across the participating countries, with tobacco as the main risk factor in the Kyrgyz Republic, Greece, and Romania, and AP prevailing in Pakistan and Uganda. Adolescent exposure levels, sources, and correlates varied. The study will continue with an in-depth situational analysis to guide the selection, adaptation, and integration of evidence-based interventions into the FRESHAIR4Life prevention package. This package will be implemented, evaluated, assessed for cost-effectiveness, and iteratively refined. The research places a strong emphasis on co-creation, capacity building, and comprehensive communication and dissemination.<br/

Functional treatment versus plaster for simple elbow dislocations (FuncSiE): a randomized trial

Background. Elbow dislocations can be classified as simple or complex. Simple dislocations are characterized by the absence of fractures, while complex dislocations are associated with fractures. After reduction of a simple dislocation, treatment options include immobilization in a static plaster for different periods of time or so-called functional treatment. Functional treatment is characterized by early active motion within the limits of pain with or without the use of a sling or hinged brace. Theoretically, functional treatment should prevent stiffness without introducing increased joint instability. The primary aim of this randomized controlled trial is to compare early functional treatment versus plaster immobilization following simple dislocations of the elbow. Methods/Design. The design of the study will be a multicenter randomized controlled trial of 100 patients who have sustained a simple elbow dislocation. After reduction of the dislocation, patients are randomized between a pressure bandage for 5-7 days and early functional treatment or a plaster in 90 degrees flexion, neutral position for pro-supination for a period of three weeks. In the functional group, treatment is started with early active motion within the limits of pain. Function, pain, and radiographic recovery will be evaluated at regular intervals over the subsequent 12 months. The primary outcome measure is the Quick Disabilities of the Arm, Shoulder, and Hand score. The secondary outcome measures are the Mayo Elbow Performance Index, Oxford elbow score, pain level at both sides, range of motion of the elbow joint at both sides, rate of secondary interventions and complication rates in both groups (secondary dislocation, instability, relaxation), health-related quality of life (Short-Form 36 and EuroQol-5D), radiographic appearance of the elbow joint (degenerative changes and heterotopic ossifications), costs, and cost-effectiveness. Discussion. The successful completion of this trial will provide evidence on the effectiveness of a functional treatment for the management of simple elbow dislocations. Trial Registration. The trial is registered at the Netherlands Trial Register (NTR2025)

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Challenges and successes in the sustainment of Dutch community-level smoking cessation interventions for residents with a low socioeconomic position

Abstract Background When health promotion interventions are implemented, the gains are often short-lived, as interventions are seldom successfully sustained. The current study explores how and under what conditions community-level smoking cessation interventions for people with a lower socioeconomic position can be sustained, drawing upon interventions delivered in Dutch neighbourhoods with a predominantly low socioeconomic position. Methods We conducted 15 semi-structured interviews with key stakeholders from three Dutch community-level smoking cessation interventions implemented at least three years prior. The topic guide was developed based on the Determinants of Innovation framework and transcripts were analysed thematically. Results We identified several factors that promote the sustainment of smoking cessation community-level interventions: 1) structural, long-term funding through the commitment of health insurers and policy makers; 2) continued stakeholder enthusiasm and involvement; 3) training and time for professionals to discuss smoking cessation, thereby also increasing the visibility of the intervention for professionals and residents; 4) integrating the intervention with existing initiatives and adapting it to be compatible with current working practices of executive staff; and 5) planning for sustainment as a team from the outset. Conclusions The current study highlights challenges and successes in intervention sustainment for people with a lower socioeconomic position. Lack of structural funding was one of the most challenging aspects for intervention sustainment in which health insurers and policy makers can play an important role. Planning for sustainment from the outset would enable intervention coordinators to consider the abovementioned factors early on. This need not be done alone but can best be discussed within a team of stakeholders

Stochastically established resolution analysis helps to determine empirical tuning parameters in general interpolation schemes

在地球物理及環境研究問題中，解析度評估對空間分析具有重要的意義，但經常受到學界所忽略。通過解析度的評估與分析能夠正確的解釋與判斷不同的空間分析方法所產生之結果。對於以層析成像為例的地球物理逆推問題而言，解析度分析的限制主要在於計算上無法取得完整的逆矩陣，以與理論斐謝核(Frechet kernel)組成解析矩陣。隨機模擬(stochastic simulation)是解決此一困境，用以估計大型逆推問題中經驗解析長度(empirical resolution length)的潛勢方法。尤其有趣的延伸則是針對傳統上最廣為應用的若干空間分析方法，如克力金法(Kriging)、最小曲率法(minimum curvature)之屬，在其方法的架構上本來就沒有解析的外顯(explicit)資料算核(data kernel)，傳統意義的解析度分析因此無法進行，也從未受到應有的重視。我們針對這些普遍使用，但從不討論解析能力的空間分析方法，推廣隨機模擬方法來求得解析長度，並以實際地球物理資料的插值問題來凸顯這種新解析分析方法的應用。值得注意的是在克利金法以及最小曲率法中，存在一些僅憑經驗或者任意決定的控制參數，例如克力金法中的影響範圍(influence range)以及最小曲率法的張力參數(tension parameter)等，本研究嘗試憑藉經驗解析長度來瞭解不同的插值方法以及採用不同的經驗控制參數設定的推估模型在解析尺度中的實際規範為何，而經由解析度的分析亦能幫助我們挑選推估模型或是經驗控制參數的決定。Resolution analysis has been a crucial appraisal procedure in general estimation problems to help with the correct interpretation. However, complete resolution information is usually inaccessible due to the sizeable matrix inversion involved with the construction of the resolution matrix. Furthermore, there are not explicit forward kernels embedded within formulations for popular interpolation algorithms such as the Kriging and the minimum curvature gridding schemes. Stochastic simulation has been proposed to make the resolution evaluation for sizeable inverse problems tractable. We generalize the method of getting resolution information for the popular interpolation schemes. Furthermore, there are usually certain empirically determined tuning parameters involved in these interpolation schemes, for example, the ideal function and influence range for fitting the semi-variogram in the Kriging method and the tension parameter in the minimum curvature gridding scheme. In this study, we will show that our proposed resolution analysis not only provide the crucial spatial resolution variation, more importantly, it helps to determine those critical tuning parameters that have been determined empirically and arbitrarily.口試委員會審定書 i 誌謝 ii 摘要 iii Abstract iv 目錄 v 圖目錄 vii 第一章 緒論 1 1.1 前言 1 1.2 研究目的 2 1.2.1 研究目的一:使用隨機模擬方法計算插值分析方法之解析尺度 2 1.2.2 研究目的二: 利用隨機模擬建立的解析度評估法幫助決定插值方法中的經驗控制參數設定 2 第二章 研究方法 4 2.1利用隨機模擬方法估計逆推問題之解析尺度 4 2.1.1 解析度分析 4 2.1.2以隨機模擬估計經驗的解析長度 8 2.1.3隨機模型數量與估計誤差 12 2.2隨機模擬方法估計插值問題中的經驗解析長度 13 2.3 插值方法 15 2.3.1 克力金法 15 2.3.2 最小曲率樣條插值法 23 第三章 研究結果與討論 26 3.1 克利金法之研究結果 33 3.1.1 克利金法於問題a之研究結果 33 3.1.2 克利金法於問題b之研究結果 34 3.1.3 克利金法於問題c之研究結果 35 3.2 最小曲率法之研究結果 42 3.2.1 最小曲率法於問題a之研究結果 42 3.2.2最小曲率法於問題b之研究結果 43 3.2.3最小曲率法於問題c之研究結果 44 3.3 克利金法與最小曲率法之比較 52 3.4 經驗解析長度的系統性變化與控制參數的選擇方式 53 3.5 使用經驗解析長度可能產生的誤判情況 56 3.6 隨機模型數量與估計誤差範圍之討論 56 3.7 此隨機模擬方法的可靠程度 57 第四章 結論 58 參考文獻 6

"Secretly, it's a competition": a qualitative study investigating what helped employees quit smoking during a workplace smoking cessation group training programme with incentives

Objectives Smoking cessation programmes in combination with financial incentives have shown to increase quit rates in smokers, but it is not clear which elements of this intervention help smokers to succeed in their quit attempt. The aim of this study was to explore the view of successful and unsuccessful quitters about which factors had affected their ability to quit smoking.Design Semistructured qualitative interviews were conducted and analysed using the Framework method.Setting Interviews were conducted in 2017 with employees from nine different Dutch companies.Participants 24 successful and unsuccessful quitters from the intervention group of a cluster randomised controlled trial (RCT) who participated in a workplace smoking cessation group training programme in which smoking abstinence was rewarded with financial incentives.Results Themes that emerged were the workplace setting, quitting with colleagues, motivation, family support, strategies and the financial incentives. The interviewees reported that the smoking cessation programme was appreciated in general, was convenient, lowered the threshold to sign up, stimulated peer support and competition and provided strategies to resist smoking. Personal motivation and a mind set to never smoke again were regarded as important factors for quit success. The financial incentives were not considered as a main motivator to quit smoking, which contradicts the results from the RCT. The financial incentives were considered as more attractive to smokers with a low income.Conclusions According to participants, contributors to quitting smoking were the workplace cessation programme, personal motivation and peer support, but not the incentives. More research is needed on the contradiction between the perceived effects of financial incentives on quit success and the actual difference in quit rates.Trial registration number NTR5657.</p