No Ifs, No Butts: Compliance with Smoking Cessation in Secondary Care Guidance (NICE PH48) by Providers of Cancer Therapies (Radiotherapy and Chemotherapy) in the UK.

Background: Legislation preventing smoking in public places was introduced in England in July 2007. Since then, smoke-free policies have been extended to the majority of hospitals including those providing cancer therapies. Whilst studies have been conducted on the impact and effectiveness of hospital smoke-free policy in the UK and other countries, there have not been any studies with a focus on cancer care providers. Cancer patients are a priority group for smoking cessation and support and this study aimed to examine implementation of the National Institute Clinical Excellence (NICE) guidance (PH48) in acute cancer care trusts in the UK. Methods: Participants were recruited from UK radiotherapy and chemotherapy departments (total 80 sites, 65 organisations) and asked to complete a 15 min online questionnaire exploring the implementation of NICE guidance at their hospital site. Results: Considerable variability in implementation of the NICE guidance was observed. A total of 79.1% trusts were smoke-free in theory; however, only 18.6% were described as smoke-free in practice. Areas of improvement were identified in information and support for patients and staff including in Nicotine Replacement Therapy (NRT) provision, staff training and clarity on e-cigarette policies. Conclusions: While some trusts have effective smoke-free policies and provide valuable cessation support services for patients, improvements are required to ensure that all sites fully adopt the NICE guidance

Production and application of activated carbons derived from waste materials

The development of waste management legislation in the 1990's has placed great importance on the sustainability of waste disposal/treatment options. Landfill of wastes is increasingly seen as a last resort and reduction, re-use and recovery of wastes is encouraged. The wastes investigated in this study (caustic tar and sewage sludges) are often disposed of by non-sustainable methods. In addition production of sewage sludge will have doubled by 2005 and disposal options are increasingly limited. Alternative treatment options are required for both these waste types that offer re-use potential. In this study the carbonisation and activation of these wastes has been demonstrated to be an effective means of treatment that also produces adsorbents that can be safely and usefully applied to treatment of aqueous waste streams. Previous studies have examined the production of clay-carbon adsorbents from spent bleaching earth and limited studies have been conducted on producing adsorbents from sewage sludges. However, the majority of these have limited investigations to production of oils from sludge and no previous studies of caustic tar carbonisation have been conducted. Treatment of caustic tar involved neutralisation with HCl and absorption of the organic content of the waste by Fullers or Acid Activated Earth. The clay-waste mix was subsequently carbonised (375°C for 2 hours) and activated using an optimised ZnClj activation procedure (600°C for 1 hour). Activated carbons were produced from sewage sludges using carbonisation (500°C for 2 hours), CO^ activation (700°C for I hour) and ZnCl^ activation (450°C for 2 hours and 600°C for 1 hour). The adsorbents produced had well developed porosity and large surface areas (up to 225mVg for caustic tar derived carbons and up to 995mVg for sewage sludge based carbons) and were adsorptive of a range of organic pollutants common in effluents. ZnC^ activated, un-digested sewage sludges proved to be the most effective adsorbents. COj activated sewage sludges and caustic tar derived carbons had similar adsorption capacities for the organic pollutants studied. Leaching tests demonstrated that metals present in the adsorbents other than the ZnClj activated carbons were not readily leachable and would not prevent re-use of the carbons in the treatment of aqueous effluents.Imperial users onl

The relationship between workers' self-reported changes in health and their attitudes towards a workplace intervention: lessons from smoke-free legislation across the UK hospitality industry

Background: The evaluation of smoke-free legislation (SFL) in the UK examined the impacts on exposure to second-hand smoke, workers’ attitudes and changes in respiratory health. Studies that investigate changes in the health of groups of people often use self-reported symptoms. Due to the subjective nature it is of interest to determine whether workers’ attitudes towards the change in their working conditions may be linked to the change in health they report. Methods: Bar workers were recruited before the introduction of the SFL in Scotland and England with the aim of investigating their changes to health, attitudes and exposure as a result of the SFL. They were asked about their attitudes towards SFL and the presence of respiratory and sensory symptoms both before SFL and one year later. Here we examine the possibility of a relationship between initial attitudes and changes in reported symptoms, through the use of regression analyses. Results: There was no difference in the initial attitudes towards SFL between those working in Scotland and England. Bar workers who were educated to a higher level tended to be more positive towards SFL. Attitude towards SFL was not found to be related to change in reported symptoms for bar workers in England (Respiratory, p = 0.755; Sensory, p = 0.910). In Scotland there was suggestion of a relationship with reporting of respiratory symptoms (p = 0.042), where those who were initially more negative to SFL experienced a greater improvement in self-reported health. Conclusions: There was no evidence that workers who were more positive towards SFL reported greater improvements in respiratory and sensory symptoms. This may not be the case in all interventions and we recommend examining subjects’ attitudes towards the proposed intervention when evaluating possible health benefits using self-reported methods. Keywords: ‘Self-Reported Health’, Attitudes, ‘Workplace Intervention’, ‘Public Health Intervention

Measurement of Young’s modulus of thin SmS films by Nanoindentation and surface acoustic wave

Nanoindentation was used to measure the elastic modulus of thin semiconducting form of Samarium Sulphide (SmS) thin films with nominal thickness of 100 nm, 200 nm and 400 nm on silicon substrate at different loads. The indentation results are fitted with modified King’s model [1] to exclude the effect of substrate, of which the Young’s moduli of films are consistent with measurement from Laser Surface Acoustic Wave system (LaWave) and calculated results from literature [2]. [1] [1] R. Saha, W. D. Nix, Acta Mater. 50 (2002) 23. [2] E. G. Soboleva et al, Appl. Mech. Mater. 770 (2015) 137; V. V. Kaminskiy et al, Sol. Sys. Res., 48 (2014) 561

Associations Between Covid-19-Related Threat, Stress, and Smoking in UK Adults Aged Under- and Over-30

It has been suggested that smoking and age are associated with higher vulnerability to Covid-19. While threat of Covid-19 may reduce or stop smoking, increased stress due to lockdown could increase smoking behaviour. This study aimed to investigate changes in smoking behaviour in relation to age, Covid-19-related threat and subjective perceived stress during the UK lockdown. A cross-sectional study was performed. Online adverts were used to recruit UK residents who smoked combustible tobacco any time from January 2020. A questionnaire measured demographic information, smoking behaviour pre- and during-lockdown, perceived subjective stress (PSS), and Covid-19 related threat. Data were collected from a total of 145 participants (58% women, 39% men, 3% non-binary; mean age: 26 years, SD = 7.7), during UK lockdown between 22nd May and 22nd June 2020. Independent of stress and Covid-19-related threat, smoking was reduced in those aged less than 30 years. In participants aged 30 and above, increases in smoking behaviour were associated with higher PSS. The results highlight the relevance of the different stages of life on the relationship between stress, threat, and smoking behaviour. Greater emphasis should be placed on stress reduction for adult smokers aged 30 and above to enable smoking cessation

Welsh Primary Schoolchildren’s Perceptions of Electronic Cigarettes: A Mixed Methods Study

There are concerns that the growing popularity of e-cigarettes promotes experimentation among children. Given the influence of the early years on attitude and habit formation, better understanding of how younger children perceive vaping before experimentation begins is needed, to prevent uptake and inform tobacco control strategies. We explored Welsh primary schoolchildren’s (aged 7–11) awareness of e-cigarettes relative to tobacco smoking, their understanding of the perceived risks and benefits and their intentions and beliefs about vaping. Data was collected using a mix of methods in June and July 2017 from 8 purposively selected primary schools across Wales. Four hundred and ninety-five children (52% female) aged 7 years (n = 165), 9 years (n = 185) and 11 years (n = 145) completed a class-administered booklet encompassing a draw and write exercise and survey. Ninety-six children participated in 24 peer discussion groups comprised of 2 boys and 2 girls from each year group. Data were analysed independently and findings triangulated. Survey analyses used frequencies, descriptive statistics and chi-squared tests. Content analysis was undertaken on the draw and write data and peer discussion groups were analysed thematically. Study findings highlight that primary schoolchildren have general awareness of e-cigarettes. Vaping was perceived to be healthier than smoking and there was some recognition that e-cigarettes were used for smoking cessation. Understanding of any health harms was limited. Few children intended to smoke or vape in the future but almost half thought it was okay for grownups. Children’s perceptions were influenced by exposure through family and friends. Findings suggest a need for e-cigarette education in primary schools, to highlight the associated risks of e-cigarette experimentation including the potential for tobacco initiation

Using discursive approaches to examine the utility and functions of language in public health and health promotion: highlighting social constructions of e-cigarettes

This article uses discursive approaches to examine the utility and functions of language in public health, focusing on social constructions of e-cigarettes. Due to the ambiguity surrounding the use of e-cigarettes, understanding may be negotiated collaboratively through co-construction in talk. Ten participants, three men and seven women aged 26–47 years, took part in two focus groups in Manchester, UK, where they discussed e-cigarettes. Data were analysed using blended discourse analysis, with a view to identifying dominant repertoires used by speakers. Participants drew from two discursive frameworks to communicate perceptions of e-cigarettes: (1) uncertainty and risk and (2) the social acceptability and stigma spectrum. The ambiguity surrounding e-cigarettes was reflected in the linguistic devices used in talk. This article demonstrates the value of drawing on discourse analysis to better understand the impact of health-related communication by providing insight into how existing messages are interpreted, co-constructed, and assigned meaning through shared interactions

Reconstruction of primary vertices at the ATLAS experiment in Run 1 proton–proton collisions at the LHC

This paper presents the method and performance of primary vertex reconstruction in proton–proton collision data recorded by the ATLAS experiment during Run 1 of the LHC. The studies presented focus on data taken during 2012 at a centre-of-mass energy of √s=8 TeV. The performance has been measured as a function of the number of interactions per bunch crossing over a wide range, from one to seventy. The measurement of the position and size of the luminous region and its use as a constraint to improve the primary vertex resolution are discussed. A longitudinal vertex position resolution of about 30μm is achieved for events with high multiplicity of reconstructed tracks. The transverse position resolution is better than 20μm and is dominated by the precision on the size of the luminous region. An analytical model is proposed to describe the primary vertex reconstruction efficiency as a function of the number of interactions per bunch crossing and of the longitudinal size of the luminous region. Agreement between the data and the predictions of this model is better than 3% up to seventy interactions per bunch crossing

The Impact of Environmental Tobacco Smoke Exposure on Cardiorespiratory Fitness in Children: A Pilot Study

Environmental tobacco smoke (ETS) in indoor air is a substantial risk factor for many health issues. Children are particularly susceptible to ETS with increased risk of asthma attacks, respiratory infections and sudden infant death syndrome. The health effects of ETS are well researched in adults, but few studies examine the impact on children’s cardiorespiratory fitness (CRF). CRF has been shown to be a useful biomarker for monitoring health effects which would normally be too subtle to identify at rest. In adults, ETS has been shown to reduce CRF, and children may be at greater risk due to high respiration rates and developing organs. This preliminary research tests the hypothesis that ETS has a detrimental impact on CRF in children. Twenty-five children (9–11 years) from one Merseyside primary school were recruited. ETS exposure was determined by parental surveys and coupled with children’s exhaled carbon monoxide concentration. CRF was determined using a VO2 peak test, with lung function assessed using standard spirometry, and fractional exhaled nitric oxide (FeNO) provided an indication of lung inflammation. Initial results show that children exposed to ETS had statically lower CRF scores (p = 0.048) and were more likely to be classified as ‘unfit’ compared to children not exposed. A negative correlation was found between the number of cigarettes smoked at home and children’s CRF (r = −0.526, p = 0.008), suggesting a possible dose–response relationship. Spirometry and FeNO values were not statistically different between groups. Results indicate that ETS exposure is likely to be detrimental to children’s CRF. They highlight the need for further work, on a larger dataset that will allow more robust analysis with greater statistical power. To the author’s knowledge, this study is the first of its kind to use laboratory-based fitness measurements to explore associations between ETS and CRF in childre

Evaluation of [13N]ammonia positron emission tomography as a potential method for quantifying glutamine synthetase activity in the human brain

Purpose The conversion of synaptic glutamate to glutamine in astrocytes by glutamine synthetase (GS) is critical to maintaining healthy brain activity and may be disrupted in several brain disorders. As the GS catalysed conversion of glutamate to glutamine requires ammonia, we evaluated whether [13N]ammonia positron emission tomography (PET) could reliability quantify GS activity in humans. Methods In this test–retest study, eight healthy volunteers each received two dynamic [13N]ammonia PET scans on the morning and afternoon of the same day. Each [13N]ammonia scan was preceded by a [15O]water PET scan to account for effects of cerebral blood flow (CBF). Results Concentrations of radioactive metabolites in arterial blood were available for both sessions in five of the eight subjects. Our results demonstrated that kinetic modelling was unable to reliably distinguish estimates of the kinetic rate constant k3 (related to GS activity) from K1 (related to [13N]ammonia brain uptake), and indicated a non-negligible back-flux of [13N] to blood (k2). Model selection favoured a reversible one-tissue compartmental model, and [13N]ammonia K1 correlated reliably (r2 = 0.72–0.92) with [15O]water CBF. Conclusion The [13N]ammonia PET method was unable to reliably estimate GS activity in the human brain but may provide an alternative index of CBF