scholarly journals Building Evidence-Based Tobacco Treatment in the Eastern Mediterranean Region: Lessons Learned by the Syrian Center for Tobacco Studies

2016 ◽  
Vol 11 (2) ◽  
pp. 116-123 ◽  
Author(s):  
Taghrid Asfar ◽  
Kenneth D. Ward ◽  
Radwan Al-Ali ◽  
Wasim Maziak
Keyword(s):  
Smoking Cessation ◽  
Eastern Mediterranean ◽  
Healthcare Providers ◽  
Eastern Mediterranean Region ◽  
Lessons Learned ◽  
Research Infrastructure ◽  
Pharmacological Agents ◽  
Smoking Cessation Treatment ◽  
Research Activities ◽  
Tobacco Treatment

The tobacco epidemic in Syria is characterised by high rates of cigarettes smoking in men and dramatic re-emergence of waterpipe smoking, especially among youths and women. The Syrian Center for Tobacco Studies (SCTS), an NIH-funded pioneer research and capacity building institution, has developed a research infrastructure and conducted three randomised clinical trials to develop and rigorously test culturally appropriate tobacco treatment programmes integrated into primary healthcare (PHC) centres. This review aimed to discuss challenges and lessons learned from the Syrian experience. Addressing these challenges may inform future cessation research activities in Syria and other developing countries. To develop a research infrastructure, the SCTS has established Syria's first IRB and trained physicians/medical students in both tobacco treatment and research methods. Main challenges to conduct the cessation trials were difficulties of coordination between the local and international collaborators; high Smoking Rates among PHC providers; lack of pharmacological agents used in tobacco treatment; and difficulties of conducting research in a politically volatile region. Strategies to overcome these challenges were ensuring an active and regular involvement of all investigators; and advocating for a national smoking cessation plan that involves training healthcare providers in smoking cessation treatment and make pharmacological agents used in smoking cessation available.

The Christiana–Santorini–Kolumbo Volcanic Field

Elements ◽  
2019 ◽  
Vol 15 (3) ◽  
pp. 171-176 ◽  
Author(s):  
Paraskevi Nomikou ◽  
Christian Hübscher ◽  
Steven Carey
Keyword(s):  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Aegean Sea ◽  
Volcanic Eruptions ◽  
Volcanic Field ◽  
Explosive Eruptions ◽  
Human Populations ◽  
Mass Wasting ◽  
Geological Processes ◽  
Research Activities

The Christiana–Santorini–Kolumbo volcanic field in the South Aegean Sea (Greece) is one of the most important in Europe, having produced more than 100 explosive eruptions in the last 400,000 years. Its volcanic centers include the extinct Christiana Volcano and associated seamounts, Santorini caldera with its intracaldera Kameni Volcano, Kolumbo Volcano, and 24 other submarine cones of the Kolumbo chain. Earthquakes, volcanic eruptions, submarine mass wasting, neotectonics and gas releases from these centers pose significant geohazards to human populations and infrastructures of the Eastern Mediterranean region. Defining the geological processes and structures that contribute to these geohazards will provide an important framework to guide future monitoring and research activities aimed at hazard mitigation.

scholarly journals Tobacco treatment clinics in urban public housing: feasibility and outcomes of a hands-on tobacco dependence service in the community

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Panagis Galiatsatos ◽  
Alexandria Soybel ◽  
Mandeep Jassal ◽  
Sergio Axel Perez Cruz ◽  
Caroline Spartin ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Public Housing ◽  
Smoking Status ◽  
Public Places ◽  
Pharmacological Agents ◽  
Quit Smoking ◽  
Tobacco Treatment ◽  
Hands On ◽  
Treatment Clinic ◽  
Housing Units

Abstract Background As a further extension of smoke-free laws in indoor public places and workplaces, the Department of Housing and Urban Development’s declaration to propose a regulation that would make housing units smoke-free was inevitable. Of note is the challenge this regulation poses to current tenants of housing units who are active smokers. We aimed to assess the efficacy of a tobacco treatment clinic in public housing. The utilization of the clinic by tenants and tenants’ respective outcomes regarding smoking status were used to determine the intervention’s effectiveness. Methods Tobacco treatment clinics were held in two urban-based housing units for 1-year. The clinics provided on-site motivational interviewing and prescriptions for pharmacological agents if warranted. Outcomes collected include the tenants’ clinic attendance and 3- and 6-month self-reported smoking status. Results Twenty-nine tobacco treatment clinic sessions were implemented, recruiting 47 tenants to participate in smoking cessation. The mean age of the cohort was 53 ± 12.3 years old. Of the 47 tenants who participated, 21 (44.7%) attended three or more clinic sessions. At the 3-month mark, five (10.6%) tenants were identified to have quit smoking; at 6-months, 13 (27.7%) tenants had quit smoking. All 13 of the tenants who quit smoking at the end of 6-months attended three or more sessions. Conclusion An on-site tobacco treatment clinic to provide strategies on smoking cessation was feasible. Efforts are warranted to ensure more frequent follow-ups for tenants aiming to quit smoking. While further resources should be allocated to help tenants comply with smoke-free housing units’ regulations, we believe an on-site tobacco treatment clinic is impactful.

scholarly journals Influencing Readiness and Intentions to Offer Tobacco Dependence Treatment Through Training: King Hussein Cancer Center and Global Bridges Promoting an Underutilised Specialty in the Eastern Mediterranean Region

2016 ◽  
Vol 12 (3) ◽  
pp. 173-181
Author(s):  
Feras I. Hawari ◽  
Rasha K. Bader ◽  
Nour A. Obeidat ◽  
Hiba S. Ayub ◽  
Iyad M. Ghonimat ◽  
...  
Keyword(s):  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Healthcare Providers ◽  
Eastern Mediterranean Region ◽  
Tobacco Dependence ◽  
Training Programme ◽  
Positive Change ◽  
Cancer Center ◽  
Tobacco Dependence Treatment ◽  
Evaluation Mechanism

Introduction: Although tobacco dependence treatment (TDT) is key to tobacco control, there continues to be a shortage of services in the Eastern Mediterranean Region (EMR). Barriers to offering services include the lack of training and education.Aims: To create a network of healthcare providers (HCPs) capable of advancing TDT, King Hussein Cancer Center – the regional host for Global Bridges in the EMR – developed, implemented, and evaluated a regional TDT training programme.Methods: The programme employed a predisposing–enabling–reinforcing framework, and utilised a combination of learning techniques. The evidence-informed curriculum aimed to influence knowledge, confidence, and competence, and the evaluation mechanism was aligned with these aims.Results and discussion: Training produced a 37% and 23% gain in knowledge and TDT-specific competencies, respectively. The majority of participants reported that the workshops enhanced confidence, and 72% reported intentions for positive change. Participants rated the workshops highly, and anticipated value from joining Global Bridges network. Immediate outcomes indicate success in advancing participants’ self-efficacy and readiness to treat. Intentions for positive change may potentially be the first step in modifying practice.Conclusion: Capacity building in TDT could be the first step in meeting the need for trained HCPs through positively influencing knowledge, confidence, competence, and intentions.

scholarly journals Smoking cessation treatment outcomes among people with and without mental and substance use disorders: An observational real-world study

2018 ◽  
Vol 52 ◽  
pp. 22-28 ◽  
Author(s):  
João Mauricio Castaldelli-Maia ◽  
Aline Rodrigues Loreto ◽  
Bruna Beatriz Sales Guimarães-Pereira ◽  
Carlos Felipe Cavalcanti Carvalho ◽  
Felipe Gil ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Tobacco Use ◽  
Psychiatric Treatment ◽  
Nicotine Patch ◽  
Treatment Success ◽  
Smoking Cessation Treatment ◽  
Tobacco Treatment ◽  
Cessation Treatment

AbstractBackground:There is a lack of studies evaluating smoking cessation treatment protocols which include people with and without mental and substance use disorders (MSUD), and which allows for individuals with MSUD undergoing their psychiatric treatment.Methods:We compared treatment success between participants with (n = 277) and without (n = 419) MSUD among patients in a 6-week treatment provided by a Brazilian Psychosocial Care Center (CAPS) from 2007 to 2013. Sociodemographic, medical and tobacco use characteristics were assessed at baseline. Tobacco treatment consisted of 1) group cognitive behavior therapy, which included people with and without MSUD in the same groups, and 2) pharmacotherapy, which could include either nicotine patches, nicotine gum, bupropion or nortriptyline. For participants with MSUD, tobacco treatment was integrated into their ongoing mental health treatment. The main outcome was 30-day point prevalence abstinence, measured at last day of treatment.Results:Abstinence rates did not differ significantly between participants with and without MSUD (31.1% and 34.4%, respectively). Variables that were significantly associated with treatment success included years smoking, the Heaviness of Smoking Index, and use of nicotine patch or bupropion.Conclusions:The inclusion of individuals with and without MSUD in the same protocol, allowing for individuals with MSUD undergoing their psychiatric treatment, generates at least comparable success rates between the groups. Predictors of treatment success were similar to those found in the general population. Facilities that treat patients with MSUD should treat tobacco use in order to reduce the disparities in morbidity and mortality experienced by this population.

scholarly journals Health promotion/education interventions in the Eastern Mediterranean Region: a rapid evidence review

2021 ◽  
Author(s):  
Tahir Turk ◽  
Wasiq Khan
Keyword(s):  
Health Promotion ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Lessons Learned ◽  
Noncommunicable Disease ◽  
Rapid Review ◽  
High Quality ◽  
Health Promotion And Education ◽  
Evidence Review

Background: Health promotion and education (HPE) can be a valuable component of initiatives to promote health and prevent disease in the Eastern Mediterranean Region (EMR). Aims: To assess the type and scope of HPE interventions in the EMR and synthesize lessons learned. Methods: A rapid review was conducted with a PICOS (participants, interventions, comparisons, outcomes and study approaches) framework guiding approaches. Results: A growing interest in HPE approaches in the EMR was identified, with the majority of studies published within the past 5 years. Few high-quality studies were identified. Formative research predominated with nearly half of the studies recommending the need for scaling up of HPE interventions. There was also an underemphasis on implementation and evaluation of priority HPE interventions contributing to the major burdens of disease. Conclusion: The findings highlight the need to: (1) up-scale resource-efficient HPE interventions; (2) implement HPE programmes addressing noncommunicable disease priorities; and (3) capacity building to operationalize high-quality interventions and evaluations.

scholarly journals Leverage points to improve smoking cessation treatment in a large tertiary care hospital: a systems-based mixed methods study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030066 ◽  
Author(s):  
Alex T Ramsey ◽  
Donna Prentice ◽  
Ellis Ballard ◽  
Li-Shiun Chen ◽  
Laura J Bierut
Keyword(s):  
Smoking Cessation ◽  
Online Survey ◽  
Model Building ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Group Model ◽  
Care Hospital ◽  
Smoking Cessation Treatment ◽  
Large Tertiary Care ◽  
Hospitalised Patients

ObjectivesTo generate system insights on patient and provider levers and strategies that must be activated to improve hospital-based smoking cessation treatment.DesignMixed methods study including a series of in-depth group model building sessions, which informed the design of an online survey completed by healthcare providers and a structured interview protocol administered at the bedside to patients who smoke.SettingLarge, tertiary care hospital in the Midwestern United States.ParticipantsGroup model building: 28 healthcare providers and 22 previously-hospitalised patients;Online survey: 308 healthcare providers;Bedside interviews: 205 hospitalised patients.Primary and secondary outcome measuresHypothesis-generating, participatory qualitative methods informed the examination of the following quantitative outcomes: patient interest versus provider perception of patient interest in smoking cessation and treatment; patient-reported receipt versus provider-reported offering of inpatient smoking cessation interventions; and priority ratings of importance and feasibility of strategies to improve treatment.ResultsSystem insightsincluded patients frequently leaving the floor to smoke, which created major workflow disruption.Leverage pointsincluded interventions to reduce withdrawal symptoms, andaction ideasincluded nurse-driven protocols for timely administration of nicotine replacement therapy. Quantitative data corroborated system insights; for instance, 80% of providers reported that patients frequently leave the floor to smoke, leading to safety risks, missed assessments and inefficient use of staff time. Patients reported significantly lower rates of receiving any smoking cessation interventions, compared with provider reports (mean difference=17.4%–33.7%, p<0.001). Although 92% of providers cited patient interest as a key barrier, only 4% of patients indicated no interest in quitting or reducing smoking.ConclusionsEngaging hospital providers and patients in participatory approaches to develop an implementation strategy revealed discrepant perceptions of patient interest and frequency of hospital-based treatment for smoking. These findings spurred adoption of standardised point-of-care treatment for cigarette smoking, which remains highly prevalent yet undertreated among hospitalised patients.

scholarly journals Understanding the Perceptions of Omani Women Regarding Life After a Breast Cancer Diagnosis

2020 ◽  
Vol 20 (4) ◽  
pp. e360-367
Author(s):  
Asya Al-Riyami ◽  
Nadia N. Abdulhadi ◽  
Mohammed Al-Azri
Keyword(s):  
Breast Cancer ◽  
Coping Strategies ◽  
Cancer Diagnosis ◽  
Qualitative Content Analysis ◽  
Eastern Mediterranean ◽  
Healthcare Providers ◽  
Eastern Mediterranean Region ◽  
Breast Cancer Diagnosis ◽  
Health Concern ◽  
Structured Interviews

Objectives: There is a rising burden of breast cancer (BC) in the Eastern Mediterranean Region (EMR), and its sociopsychological impact is a quickly growing health concern in this region. Because understanding cancer patients’ perceptions of life is integral to their treatment, they are also a concern for healthcare providers. This qualitative study, therefore, explored changes in Omani women’s perceptions of life after a BC diagnosis. Methods: Semi-structured interviews were conducted individually with 21 Omani women undergoing treatment for BC at the Oncology Ward of Muscat’s Royal Hospital from March to May 2017. The collected data were subjected to qualitative content analysis. Results: After their cancer diagnosis, the women appeared to pass through three main stages in their coping processes. First, they passed through a stage of severe psychosocial distress and diminishment in personal identity. Next, they evolved strategies for coping based on cultural, religious and family resources. Finally, the women experienced acceptance and submission to the reality of the cancer as God’s will with changes in attitudes and perceptions of the meaning of life. Conclusion: A BC diagnosis impacts Omani women severely, affecting their lives dramatically. They adopt coping strategies based on cultural, religious and spiritual beliefs. Healthcare providers need to acknowledge and facilitate women’s spiritual and cultural coping strategies as an integral part of their treatment which holds potential to improve their prognosis. Such strategies should be individualised to suit each woman’s experiences, perceptions and needs. Keywords: Breast Neoplasm; Culture; Perceptions; Life; Women; Oman.  

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