50 results on '"Carson-Chahhoud, Kristin V."'
Search Results
2. A qualitative exploration of the provision and prioritisation of smoking cessation support to patient carers in a paediatric ward in Australia
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Moyo, Sukoluhle, Hefler, Marita, Carson-Chahhoud, Kristin V., and Thomas, David P
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- 2022
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3. The modifiable biopsychosocial drivers of psychological distress for adolescents with asthma: Implications for Clinical Care
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Sharrad, Kelsey J., Kopsaftis, Zoe A., Carson-Chahhoud, Kristin V., and Stallman, Helen M.
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- 2022
- Full Text
- View/download PDF
4. Time to rethink tobacco dependence treatment in Australia
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Buchanan, Tanya, White, Sarah L., Marshall, Henry, Carson?Chahhoud, Kristin V., Magee, Christopher A., and Kelly, Peter J.
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Smoking cessation programs -- Methods ,Health - Abstract
Despite, widespread success and reductions in smoking prevalence rates, tobacco use remains the leading modifiable risk factor for ill health in Australia accounting for 22% of the cancer burden, 12% [...]
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- 2021
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5. Authors' response to ?Vaping nicotine should be part of Australia's tobacco control policy?
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Buchanan, Tanya, White, Sarah L., Marshall, Henry, Carson?Chahhoud, Kristin V., Magee, Christopher A., and Kelly, Peter J.
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Health - Abstract
We welcome the response from Mendelsohn[sup.1] on this important public health topic. The letter from Mendelsohn contains multiple assertions that are not supported by published evidence. For example, the letter [...]
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- 2022
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6. Short-acting bronchodilators for the management of acute exacerbations of chronic obstructive pulmonary disease in the hospital setting: systematic review
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Kopsaftis, Zoe A., Sulaiman, Nur S., Mountain, Oliver D., Carson-Chahhoud, Kristin V., Phillips, Paddy A., and Smith, Brian J.
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- 2018
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7. SISTAQUIT : training health care providers to help pregnant Aboriginal and Torres Strait Islander women quit smoking. A cluster randomised controlled trial
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Gould, Gillian S, primary, Ryan, Nicole M, additional, Kumar, Ratika, additional, Stevenson, Leah C, additional, Carson‐Chahhoud, Kristin V, additional, Oldmeadow, Christopher, additional, Foster, Joley, additional, Deeming, Simon, additional, Boydell, Katherine, additional, Doran, Christopher M, additional, Searles, Andrew, additional, Mattes, Joerg, additional, Atkins, Louise, additional, and Clarke, Marilyn, additional
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- 2022
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8. The Biggest Challenges Resulting from the COVID-19 Pandemic on Gender-Related Work from Home in Biomedical Fields—World-Wide Qualitative Survey Analysis
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Bezak, Eva, primary, Carson-Chahhoud, Kristin V., additional, Marcu, Loredana G., additional, Stoeva, Magdalena, additional, Lhotska, Lenka, additional, Barabino, Gilda A., additional, Ibrahim, Fatimah, additional, Kaldoudi, Eleni, additional, Lim, Sierin, additional, Marques da Silva, Ana Maria, additional, Tan, Peck Ha, additional, Tsapaki, Virginia, additional, and Frize, Monique, additional
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- 2022
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9. Correction: Two-year efficacy of varenicline tartrate and counselling for inpatient smoking cessation (STOP study): A randomized controlled clinical trial
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Carson-Chahhoud, Kristin V., primary, Smith, Brian J., additional, Peters, Matthew J., additional, Brinn, Malcolm P., additional, Ameer, Faisal, additional, Singh, Kuljit, additional, Fitridge, Robert, additional, Litt, John, additional, Edwards, David, additional, Koblar, Simon A., additional, Jannes, Jim, additional, Veale, Antony J., additional, Goldsworthy, Sharon, additional, Hnin, Khin, additional, and Esterman, Adrian J., additional
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- 2021
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10. Interventions for smoking cessation in Indigenous populations
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Brinn, Malcolm P, additional, Peters, Matthew, additional, Veale, Antony, additional, Esterman, Adrian J, additional, Smith, Brian J, additional, and Carson-Chahhoud, Kristin V, additional
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- 2021
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11. Interventions for tobacco use prevention in Indigenous youth
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Carson-Chahhoud, Kristin V, additional, Brinn, Malcolm P, additional, Labiszewski, Nadina A, additional, Peters, Matthew, additional, Chang, Anne B, additional, Veale, Antony, additional, Esterman, Adrian J, additional, and Smith, Brian J, additional
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- 2021
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12. Identifying critical features of type two diabetes prevention interventions: A Delphi study with key stakeholders
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Ryan, Jillian C., primary, Wiggins, Bonnie, additional, Edney, Sarah, additional, Brinkworth, Grant D., additional, Luscombe-March, Natalie D., additional, Carson-Chahhoud, Kristin V., additional, Taylor, Pennie J., additional, Haveman-Nies, Annemien A., additional, and Cox, David N., additional
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- 2021
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13. Asthma self management education with regular healthcare professional review or written action plans or both in adults
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Carson-Chahhoud, Kristin V, additional, Schultz, Timothy J, additional, Kopsaftis, Zoe, additional, Brinn, Malcolm P, additional, Barton, Christopher, additional, Ali, Ahad, additional, Smith, Brian J, additional, Walters, E Haydn, additional, and Sharrad, Kelsey J, additional
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- 2021
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14. Pharmacological and surgical interventions for the treatment of gastro-oesophageal reflux in adults and children with asthma
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Kopsaftis, Zoe, additional, Yap, Hooi Shan, additional, Tin, Kyi Saw, additional, Hnin, Khin, additional, and Carson-Chahhoud, Kristin V, additional
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- 2021
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15. Electronic cigarettes: A position statement from the Thoracic Society of Australia and New Zealand*
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McDonald, Christine F., primary, Jones, Stuart, additional, Beckert, Lutz, additional, Bonevski, Billie, additional, Buchanan, Tanya, additional, Bozier, Jack, additional, Carson‐Chahhoud, Kristin V., additional, Chapman, David G., additional, Dobler, Claudia C., additional, Foster, Juliet M., additional, Hamor, Paul, additional, Hodge, Sandra, additional, Holmes, Peter W., additional, Larcombe, Alexander N., additional, Marshall, Henry M., additional, McCallum, Gabrielle B., additional, Miller, Alistair, additional, Pattemore, Philip, additional, Roseby, Robert, additional, See, Hayley V., additional, Stone, Emily, additional, Thompson, Bruce R., additional, Ween, Miranda P., additional, and Peters, Matthew J., additional
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- 2020
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16. Two-year efficacy of varenicline tartrate and counselling for inpatient smoking cessation (STOP study): A randomized controlled clinical trial
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Carson-Chahhoud, Kristin V., primary, Smith, Brian J., additional, Peters, Matthew J., additional, Brinn, Malcolm P., additional, Ameer, Faisal, additional, Singh, Kuljit, additional, Fitridge, Robert, additional, Koblar, Simon A., additional, Jannes, Jim, additional, Veale, Antony J., additional, Goldsworthy, Sharon, additional, Hnin, Khin, additional, and Esterman, Adrian J., additional
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- 2020
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17. Oxygen therapy in the pre-hospital setting for acute exacerbations of chronic obstructive pulmonary disease
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Kopsaftis, Zoe, primary, Carson-Chahhoud, Kristin V, additional, Austin, Michael A, additional, and Wood-Baker, Richard, additional
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- 2020
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18. Community pharmacy personnel interventions for smoking cessation
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Carson-Chahhoud, Kristin V, primary, Livingstone-Banks, Jonathan, additional, Sharrad, Kelsey J, additional, Kopsaftis, Zoe, additional, Brinn, Malcolm P, additional, To-A-Nan, Rachada, additional, and Bond, Christine M, additional
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- 2019
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19. Philip Morris International buys inhaler company Vectura to expand reach in electronic cigarettes.
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Carson‐Chahhoud, Kristin V., Thompson, Bruce R., and Upham, John W.
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ELECTRONIC cigarettes , *INHALERS , *SMOKING cessation , *MEDICAL personnel as patients , *SMOKING - Abstract
Keywords: e-cigs; electronic cigarettes; Philip Morris International; smoking; Vectura EN e-cigs electronic cigarettes Philip Morris International smoking Vectura 328 330 3 04/19/22 20220501 NES 220501 In a controversial move, Phillip Morris International (PMI), a global leader in the cigarette supply chain, have bought out British healthcare company Vectura Group Plc to the value of more than one billion pounds. Vectura is known for manufacturing inhalation products to treat respiratory illnesses, including inhalers and nebulizers for the management of asthma and chronic obstructive pulmonary disease. [Extracted from the article]
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- 2022
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20. Psychological interventions for asthma in children and adolescents
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Sharrad, Kelsey J, primary, Sanwo, Olatokunbo, additional, Carson-Chahhoud, Kristin V, additional, and Pike, Katharine C, additional
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- 2019
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21. Psychological therapies for the treatment of depression in chronic obstructive pulmonary disease
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Pollok, Justyna, primary, van Agteren, Joep EM, additional, Esterman, Adrian J, additional, and Carson-Chahhoud, Kristin V, additional
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- 2019
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22. Consumer guidelines for chronic disease management
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Carson-Chahhoud, Kristin V, primary, Labiszewski, Nadina A, additional, Brinn, Malcolm P, additional, Esterman, Adrian J, additional, Peters, Matthew, additional, Wood-Baker, Richard, additional, and Smith, Brian J, additional
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- 2019
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23. Pharmacological interventions for the treatment of depression in chronic obstructive pulmonary disease
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Pollok, Justyna, primary, van Agteren, Joep EM, additional, and Carson-Chahhoud, Kristin V, additional
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- 2018
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24. Nurse-led versus doctor-led care for bronchiectasis
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Lawton, Kathryn, primary, Royals, Karen, additional, Carson-Chahhoud, Kristin V, additional, Campbell, Fiona, additional, and Smith, Brian J, additional
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- 2018
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25. Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults
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Carson-Chahhoud, Kristin V, primary, Wakai, Abel, additional, van Agteren, Joep EM, additional, Smith, Brian J, additional, McCabe, Grainne, additional, Brinn, Malcolm P, additional, and O'Sullivan, Ronan, additional
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- 2017
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26. Non-invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease
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Osadnik, Christian R, primary, Tee, Vanessa S, additional, Carson-Chahhoud, Kristin V, additional, Picot, Joanna, additional, Wedzicha, Jadwiga A, additional, and Smith, Brian J, additional
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- 2017
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27. Mass media interventions for preventing smoking in young people
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Carson-Chahhoud, Kristin V, primary, Ameer, Faisal, additional, Sayehmiri, Kourosh, additional, Hnin, Khin, additional, van Agteren, Joseph EM, additional, Sayehmiri, Fatemeh, additional, Brinn, Malcolm P, additional, Esterman, Adrian J, additional, Chang, Anne B, additional, and Smith, Brian J, additional
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- 2017
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28. A randomized placebo-controlled trial of paroxetine for the management of anxiety in chronic obstructive pulmonary disease (PAC Study).
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Usmani, Zafar A, Carson-Chahhoud, Kristin V, Esterman, Adrian J, and Smith, Brian J
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PAROXETINE ,OBSTRUCTIVE lung diseases ,ANXIETY treatment ,DISEASE prevalence ,QUALITY of life ,THERAPEUTICS - Abstract
Background: Despite the high prevalence of anxiety in COPD patients and its impact on quality of life, evidence to support the effectiveness of various anxiety treatment options is insufficient, leading to the need for further research in this field. Aim: The aim of this study was to assess the efficacy and safety of paroxetine for the management of anxiety in COPD and the impact of treatment on patients' quality of life and rate of hospitalization. Patients and methods: In a double-blind, randomized, controlled trial, COPD patients were allocated into groups that either received paroxetine 20 mg or placebo pills daily, for four months. Differences in outcomes were assessed based on an intention-to-treat analysis using linear mixed effects models. A chi-square test was used to compare the number of COPD-related admissions. Results: Thirty-eight participants were recruited. Twenty-two of these completed the trial. A clinically and statistically significant reduction was noted in anxiety symptoms after four months of treatment compared to the placebo. Clinically important improvement was noted in depression symptoms, with no statistically significant differences in walking distance or quality-of-life measure outcomes. The intervention group had less COPD-related admissions compared to the placebo group but experienced medication-related side effects. Conclusion: Treatment with paroxetine significantly improved anxiety levels, but this difference did not translate into improved quality of life at four months follow-up. [ABSTRACT FROM AUTHOR]
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- 2018
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29. Prolonged antibiotics for non-cystic fibrosis bronchiectasis in children and adults
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Hnin, Khin, primary, Nguyen, Chau, additional, Carson-Chahhoud, Kristin V, additional, Evans, David J, additional, Greenstone, Michael, additional, and Smith, Brian J, additional
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- 2015
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30. Asthma self management education with regular healthcare professional review or written action plans or both in adults
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Carson-Chahhoud, Kristin V, additional, Schultz, Timothy J, additional, Kopsaftis, Zoe, additional, Brinn, Malcolm P, additional, Barton, Christopher, additional, Ali, Ahad, additional, Smith, Brian J, additional, Walters, E Haydn, additional, and Sharrad, Kelsey J, additional
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- 2011
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31. Research translation to improve carer smoking cessation support in a paediatric ward of a regional hospital in the Northern Territory
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Sukoluhle Moyo, Kristin Carson-Chahhoud, David Thomas, Marita Hefler, Moyo, Sukoluhle, Hefler, Marita, Carson Chahhoud, Kristin V, and Thomas, David
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Community and Home Care ,knowledge translation ,health promotion ,child ,Public Health, Environmental and Occupational Health ,smoking cessation - Abstract
Issue addressed: Health professionals have described barriers to providing carer smoking cessation support in children's wards. This article reports the findings of a research translation process that explored opportunities and developed pathways for change Methods: A facilitated discussion workshop and scheduled stakeholder meetings were used to evaluate research evidence and translate it to an evidence-informed organisational change process, with actions for implementation. Workshop and meeting participants were senior health staff with either a pharmacist, personnel with expertise in alcohol and other drugs, medical or nursing backgrounds, and who held senior managerial roles who worked in a hospital in the Northern Territory. A qualitative approach was used. The data from the workshop were transcribed and analysed using thematic analysis. The first author took notes for meetings that were not recorded and analysed these alongside the transcripts. Results: The process was able to initiate change to overcome barriers to providing carer smoking cessation support. All participants agreed to prioritise and make carer smoking cessation everybody's responsibility and supported a systematic approach, including provision of nicotine replacement therapy, new record-keeping systems, and training to address staff knowledge deficits and skills gaps. This movement to solution-focused change continued after the workshop. Conclusions: With some preparation, a research translation workshop and meetings with selected leaders can initiate organisational change in similar settings and is consistent with theories of planned change. So what?: This article describes the use of a process to support health promotion through new policies and practices following research which identified barriers in a hospital ward. Refereed/Peer-reviewed
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- 2023
32. The modifiable biopsychosocial drivers of psychological distress for adolescents with asthma: Implications for Clinical Care
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Kristin Carson-Chahhoud, Kelsey J Sharrad, Zoe Kopsaftis, Helen M. Stallman, Sharrad, Kelsey J, Kopsaftis, Zoe A, Carson-Chahhoud, Kristin V, and Stallman, Helen M
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Pulmonary and Respiratory Medicine ,Biopsychosocial model ,Coping (psychology) ,Adolescent ,psychological adaptation ,Psychological intervention ,Psychological Distress ,psychological distress ,health behaviour ,immune system diseases ,Psychological adaptation ,Adaptation, Psychological ,Humans ,Medicine ,Asthma ,child ,business.industry ,Psychological distress ,asthma ,medicine.disease ,Mental health ,respiratory tract diseases ,Distress ,adolescent ,Pediatrics, Perinatology and Child Health ,business ,Stress, Psychological ,mental health ,Clinical psychology - Abstract
Purpose: Overwhelming distress exceeds the capacity of healthy coping strategies to feel better using healthy coping strategies alone, resulting in the use of unhealthy coping strategies. Unhealthy coping strategies may exacerbate asthma symptoms and asthma can contribute to overwhelming distress. This study aimed to review the modifiable drivers of overwhelming distress in adolescents with asthma. Methods: The biopsychosocial drivers of psychological distress for adolescents with asthma were explored within the domains of the modifiable biopsychosocial model of health and wellbeing. Results: Asthma in adolescents is associated with problems in the domains of environment, developmental outcomes, sense of belonging, health behaviours, coping, and treatment of illness. Conclusions: The relationship between asthma and psychological distress highlights the need for holistic treatment of asthma. Further research is needed to establish causation between variables and to investigate whether interventions that address either asthma symptoms or biopsychosocial drivers of distress can improve both factors. Refereed/Peer-reviewed
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- 2022
33. Time to rethink tobacco dependence treatment in Australia
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Peter J. Kelly, Kristin Carson-Chahhoud, Henry M. Marshall, Tanya Buchanan, Christopher A. Magee, Sarah L. White, Buchanan, Tanya, White, Sarah L, Marshall, Henry, Carson-Chahhoud, Kristin V, Magee, Christopher A, and Kelly, Peter J
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business.industry ,Public Health, Environmental and Occupational Health ,Medicine ,Public aspects of medicine ,RA1-1270 ,business - Abstract
Refereed/Peer-reviewed
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- 2021
34. Philip Morris International buys inhaler company Vectura to expand reach in electronic cigarettes
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Kristin Carson-Chahhoud, John Upham, Bruce Thompson, Carson-Chahhoud, Kristin V, Thompson, Bruce R, and Upham, John W
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Pulmonary and Respiratory Medicine ,electronic cigarettes ,Nebulizers and Vaporizers ,Vectura ,Smoking ,Philip Morris International ,Humans ,e-cigs ,Electronic Nicotine Delivery Systems ,smoking - Abstract
Refereed/Peer-reviewed
- Published
- 2022
35. The Biggest Challenges Resulting from the COVID-19 Pandemic on Gender-Related Work from Home in Biomedical Fields-World-Wide Qualitative Survey Analysis
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Eva Bezak, Kristin V. Carson-Chahhoud, Loredana G. Marcu, Magdalena Stoeva, Lenka Lhotska, Gilda A. Barabino, Fatimah Ibrahim, Eleni Kaldoudi, Sierin Lim, Ana Maria Marques da Silva, Peck Ha Tan, Virginia Tsapaki, Monique Frize, School of Chemical and Biomedical Engineering, Bezak, Eva, Carson-Chahhoud, Kristin V, Marcu, Loredana G, Stoeva, Magdalena, Lhotska, Lenka, Barabino, Gilda A, Ibrahim, Fatimah, Kaldoudi, Eleni, Lim, Sierin, da Silva, Ana Maria Marques, Tan, Peck Ha, Tsapaki, Virginia, and Frize, Monique
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Bioengineering [Engineering] ,Adult ,Male ,COVID-19 Impact ,qualitative international survey analysis ,SARS-CoV-2 ,Health, Toxicology and Mutagenesis ,Teleworking ,Public Health, Environmental and Occupational Health ,COVID-19 ,Biomedical Fields ,COVID-19 impact ,working from home ,gender ,biomedical fields ,Communicable Disease Control ,Humans ,Female ,Child ,Pandemics - Abstract
(1) Background: This paper aims to present and discuss the most significant challenges encountered by STEM professionals associated with remote working during the COVID-19 lockdowns. (2) Methods: We performed a qualitative analysis of 921 responses from professionals from 76 countries to the open-ended question: "What has been most challenging during the lockdown for you, and/or your family?" (3) Findings: Participants reported challenges within the immediate family to include responsibilities for school, childcare, and children's wellbeing; and the loss of social interactions with family and friends. Participants reported increased domestic duties, blurred lines between home and work, and long workdays. Finding adequate workspace was a problem, and adaptations were necessary, especially when adults shared the same setting for working and childcare. Connectivity issues and concentration difficulties emerged. While some participants reported employers' expectations did not change, others revealed concerns about efficiency. Mental health issues were expressed as anxiety and depression symptoms, exhaustion and burnout, and no outlets for stress. Fear of becoming infected with COVID-19 and uncertainties about the future also emerged. Pressure points related to gender, relationship status, and ethnicities were also evaluated. Public policies differed substantially across countries, raising concerns about the adherence to unnecessary restrictions, and similarly, restrictions being not tight enough. Beyond challenges, some benefits emerged, such as increased productivity and less time spent getting ready for work and commuting. Confinement resulted in more quality time and stronger relationships with family. (4) Interpretation: Viewpoints on positive and negative aspects of remote working differed by gender. Females were more affected professionally, socially, and personally than males. Mental stress and the feeling of inadequate work efficiency in women were caused by employers' expectations and lack of flexibility. Working from home turned out to be challenging, primarily due to a lack of preparedness, limited access to a dedicated home-office, and lack of previous experience in multi-layer/multi-scale environments. Published version Funding has been received from the International Union for Physical and Engineering Sciences in Medicine (IUPESM) towards data analysis.
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- 2022
36. SISTAQUIT: training health care providers to help pregnant Aboriginal and Torres Strait Islander women quit smoking. a cluster randomised controlled trial
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Gillian S Gould, Nicole M Ryan, Ratika Kumar, Leah C Stevenson, Kristin V Carson‐Chahhoud, Christopher Oldmeadow, Joley Foster, Simon Deeming, Katherine Boydell, Christopher M Doran, Andrew Searles, Joerg Mattes, Louise Atkins, Marilyn Clarke, Gould, Gillian S, Ryan, Nicole M, Kumar, Ratika, Stevenson, Leah C, Carson-Chahhoud, Kristin V, Oldmeadow, Christopher, Foster, Joley, Deeming, Simon, Boydell, Katherine, Doran, Christopher M, Searles, Andrew, Mattes, Joerg, Atkins, Louise, and Clarke, Marilyn
- Subjects
Native Hawaiian or Other Pacific Islander ,health care personnel ,Health Personnel ,psychology ,smoking ,Pregnancy ,Health Services, Indigenous ,Humans ,controlled study ,Prospective Studies ,human ,procedures ,Indigenous Peoples ,Smoking ,Australia ,indigenous health care ,clinical trial ,General Medicine ,Tobacco Use Cessation Devices ,smoking cessation ,female ,multicenter study ,randomized controlled trial ,Female ,Smoking Cessation ,pregnancy ,prospective study - Abstract
Refereed/Peer-reviewed Background: About 44% of Indigenous Australian women smoke during pregnancy, compared with 12% of pregnant non-Indigenous women. Health care providers can assist smoking cessation, but they are not typically trained in culturally appropriate methods. Objectives: To determine whether a health care worker training intervention increases smoking cessation rates among Indigenous pregnant smokers compared with usual care. Methods and analysis: Supporting Indigenous Smokers to Assist Quitting (SISTAQUIT) study is a multicentre, hybrid type 1, pragmatic, cluster randomised controlled trial that compares the effects of an intervention for improving smoking cessation by pregnant Indigenous women (16 years or older, 32 weeks’ gestation or less) with usual care. Twenty-one health services caring for Indigenous people in five Australian jurisdictions were randomised to the intervention (ten sites) or control groups (eleven sites). Health care providers at intervention sites received smoking cessation care training based on the ABCD (ask/assess; brief advice; cessation; discuss psychosocial context) approach to smoking cessation for Indigenous women, an educational resource package, free oral nicotine replacement therapy for participating women, implementation support, and trial implementation training. Health care providers in control group services provided usual care. Primary outcome: abstinence from smoking (self-reported abstinence via survey, validated by carbon monoxide breath testing when possible) four weeks after enrolment in the study. Secondary outcomes: health service process evaluations; knowledge, attitudes, and practices of health care providers; and longer term abstinence, perinatal outcomes, and respiratory outcomes for babies (to six months). Ethics approval: The human research ethics committees of the University of Newcastle (H-2015-0438) and the Aboriginal Health and Medical Research Council of NSW (1140/15) provided the primary ethics approval. Dissemination of results: Findings will be disseminated in peer-reviewed publications, at local and overseas conferences, and via public and social media, and to participating health services in art-based formats and reports. Policy briefs will be communicated to relevant government organisations. Trial registration: Australia New Zealand Clinical Trials Registry, ACTRN12618000972224 (prospective).
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- 2022
37. Correction: Two-year efficacy of varenicline tartrate and counselling for inpatient smoking cessation (STOP study): A randomized controlled clinical trial
- Author
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Kristin V. Carson-Chahhoud, Brian J. Smith, Matthew J. Peters, Malcolm P. Brinn, Faisal Ameer, Kuljit Singh, Robert Fitridge, John Litt, David Edwards, Simon A. Koblar, Jim Jannes, Antony J. Veale, Sharon Goldsworthy, Khin Hnin, Adrian J. Esterman, Carson-Chahhoud, Kristin V, Smith, Brian J, Peters, Matthew J, Brinn, Malcolm P, Ameer, Faisal, Singh, Kuljit, Fitridge, Robert, Koblar, Simon A, Jannes, Jim, Veale, Antony J, Goldsworthy, Sharon, Hnin, Khin, and Esterman, Adrian J
- Subjects
Male ,Nicotinic Acetylcholine Receptors ,medicine.medical_treatment ,Anti-Addiction Drug Therapy ,Social Sciences ,Biochemistry ,Habits ,0302 clinical medicine ,Outpatients ,Smoking Habits ,Medicine and Health Sciences ,Psychology ,030212 general & internal medicine ,Nicotinic Agonists ,Tartrates ,Multidisciplinary ,Pharmaceutics ,Smoking ,Middle Aged ,Chemistry ,Treatment Outcome ,Research Design ,Physical Sciences ,Medicine ,Female ,Research Article ,Signal Transduction ,Neurological Drug Therapy ,Adult ,medicine.medical_specialty ,Patients ,Transmembrane Receptors ,Clinical Research Design ,Science ,Research and Analysis Methods ,Varenicline Tartrate ,03 medical and health sciences ,Pharmacotherapy ,Drug Therapy ,Nicotine Replacement Therapy ,Internal medicine ,Tobacco ,medicine ,Tobacco Smoking ,Humans ,Adverse effect ,Aged ,Behavior ,Inpatients ,Adult patients ,business.industry ,Chemical Compounds ,Biology and Life Sciences ,Proteins ,Correction ,Odds ratio ,Cell Biology ,Nicotine replacement therapy ,Clinical trial ,Health Care ,Acetylcholine Receptors ,Smoking cessation ,Smoking Cessation ,Adverse Events ,Varenicline ,business ,030217 neurology & neurosurgery - Abstract
IntroductionVarenicline tartrate is superior for smoking cessation to other tobacco cessation therapies by 52 weeks, in the outpatient setting. We aimed to evaluate the long-term (104 week) efficacy following a standard course of inpatient-initiated varenicline tartrate plus Quitline-counselling compared to Quitline-counselling alone.MethodsAdult patients (n = 392, 20-75 years) admitted with a smoking-related illnesses to one of three hospitals, were randomised to receive either 12-weeks of varenicline tartrate (titrated from 0.5mg daily to 1mg twice-daily) plus Quitline-counselling, (n = 196) or Quitline-counselling alone, (n = 196), with continuous abstinence from smoking assessed at 104 weeks.ResultsA total of 1959 potential participants were screened for eligibility between August 2008 and December 2011. The proportion of participants who remained continuously abstinent (intention-to-treat) at 104 weeks were significantly greater in the varenicline tartrate plus counselling arm (29.2% n = 56) compared to counselling alone (18.8% n = 36; p = 0.02; odds ratio 1.78; 95%CI 1.10 to 2.86, p = 0.02). Twenty-two deaths occurred during the 104 week study (n = 10 for varenicline tartrate plus counselling and n = 12 for Quitline-counselling alone). All of these participants had known or developed underlying co-morbidities.ConclusionsThis is the first study to examine the efficacy and safety of varenicline tartrate over 104 weeks within any setting. Varenicline tartrate plus Quitline-counselling was found to be an effective opportunistic treatment when initiated for inpatient smokers who had been admitted with tobacco-related disease.
- Published
- 2021
38. Authors' response to ‘Vaping nicotine should be part of Australia's tobacco control policy’
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Tanya Buchanan, Sarah L. White, Henry Marshall, Kristin V. Carson‐Chahhoud, Christopher A. Magee, Peter J. Kelly, Buchanan, Tanya, White, Sarah L, Marshall, Henry, Carson-Chahhoud, Kristin V, Magee, Christopher A, and Kelly, Peter J
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Nicotine ,Vaping ,Tobacco ,Australia ,Public Health, Environmental and Occupational Health ,Humans ,Public Policy ,Electronic Nicotine Delivery Systems - Published
- 2022
39. Pharmacological and surgical interventions for the treatment of gastro-oesophageal reflux in adults and children with asthma
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Kristin Carson-Chahhoud, Kyi Saw Tin, Khin Hnin, Hooi Shan Yap, Zoe Kopsaftis, Kopsaftis, Zoe, Yap, Hooi Shan, Tin, Kyi Saw, Hnin, Khin, and Carson-Chahhoud, Kristin V
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gastro‐oesophageal reflux ,medicine.medical_specialty ,business.industry ,Odds ratio ,Emergency department ,asthma ,Placebo ,medicine.disease ,GORD ,Clinical trial ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Meta-analysis ,Internal medicine ,medicine ,Pharmacology (medical) ,030212 general & internal medicine ,business ,Adverse effect ,030217 neurology & neurosurgery ,Asthma - Abstract
Background: Asthma and gastro‐oesophageal reflux disease (GORD) are common medical conditions that frequently co‐exist. GORD has been postulated as a trigger for asthma; however, evidence remains conflicting. Proposed mechanisms by which GORD causes asthma include direct airway irritation from micro‐aspiration and vagally mediated oesophagobronchial reflux. Furthermore, asthma might precipitate GORD. Thus a temporal association between the two does not establish that GORD triggers asthma. Objectives: To evaluate the effectiveness of GORD treatment in adults and children with asthma, in terms of its benefits for asthma. Search methods: The Cochrane Airways Group Specialised Register, CENTRAL, MEDLINE, Embase, reference lists of articles, and online clinical trial databases were searched. The most recent search was conducted on 23 June 2020. Selection criteria: We included randomised controlled trials comparing treatment of GORD in adults and children with a diagnosis of both asthma and GORD versus no treatment or placebo. Data collection and analysis: A combination of two independent review authors extracted study data and assessed trial quality. The primary outcome of interest for this review was acute asthma exacerbation as reported by trialists. Main results: The systematic search yielded a total of 3354 citations; 23 studies (n = 2872 participants) were suitable for inclusion. Included studies reported data from participants in 25 different countries across Europe, North and South America, Asia, Australia, and the Middle East. Participants included in this review had moderate to severe asthma and a diagnosis of GORD and were predominantly adults presenting to a clinic for treatment. Only two studies assessed effects of intervention on children, and two assessed the impact of surgical intervention. The remainder were concerned with medical intervention using a variety of dosing protocols.There was an uncertain reduction in the number of participants experiencing one or more moderate/severe asthma exacerbations with medical treatment for GORD (odds ratio 0.53, 95% confidence interval (CI) 0.17 to 1.63; 1168 participants, 2 studies; low‐certainty evidence). None of the included studies reported data related to the other primary outcomes for this review: hospital admissions, emergency department visits, and unscheduled doctor visits.Medical treatment for GORD probably improved forced expiratory volume in one second (FEV₁) by a small amount (mean difference (MD) 0.10 L, 95% CI 0.05 to 0.15; 1333 participants, 7 studies; moderate‐certainty evidence) as well as use of rescue medications (MD ‐0.71 puffs per day, 95% CI ‐1.20 to ‐0.22; 239 participants, 2 studies; moderate‐certainty evidence). However, the benefit of GORD treatment for morning peak expiratory flow rate was uncertain (MD 6.02 L/min, 95% CI 0.56 to 11.47; 1262 participants, 5 studies). It is important to note that these mean improvements did not reach clinical importance. The benefit of GORD treatment for outcomes synthesised narratively including benefits of treatment for asthma symptoms, quality of life, and treatment preference was likewise uncertain. Data related to adverse events with intervention were generally underreported by the included studies, and those that were available indicated similar rates regardless of allocation to treatment or placebo. Authors' conclusions: Effects of GORD treatment on the primary outcomes of number of people experiencing one or more exacerbations and hospital utilisation remain uncertain. Medical treatment for GORD in people with asthma may provide small benefit for a number of secondary outcomes related to asthma management. This review determined with moderate certainty that with treatment, lung function measures improved slightly, and use of rescue medications for asthma control was reduced. Further, evidence is insufficient to assess results in children, or to compare surgery versus medical therapy. Refereed/Peer-reviewed
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- 2021
40. A qualitative exploration of the provision and prioritisation of smoking cessation support to patient carers in a paediatric ward in Australia
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Sukoluhle Moyo, Kristin Carson-Chahhoud, David Thomas, Marita Hefler, Moyo, Sukoluhle, Hefler, Marita, Carson-Chahhoud, Kristin V, and Thomas, David P
- Subjects
paediatric ,second hand-smoke ,hospital ,Aboriginal ,General Nursing ,smoking - Abstract
Background Hospitalisation of a child is a unique opportunity for health staff to offer smoking cessation support; that is screening for carer smoking status, discussing cessation and providing interventions to carers who smoke. This has the potential to reduce the child’s exposure to second-hand smoke, and in turn tobacco related illnesses in children. However, these interventions are not always offered in paediatric wards. The aim of this study was to explore the provision and prioritisation of smoking cessation support to patient carers in a paediatric ward with a high proportion of Aboriginal patients and carers in a regional area of Australia’s Northern Territory. Methods This is a qualitative descriptive study of data collected through semi-structured interviews with 19 health staff. The interviews were audio recorded and transcribed verbatim. Thematic analysis was performed on the transcripts. Results We found low prioritisation of addressing carer smoking due to, a lack of systems and procedures to screen for smoking and provide quitting advice and unclear systems for providing more detailed cessation support to carers. Staff were demotivated by the lack of clear referral pathways. There were gaps in skills and knowledge, and health staff expressed a need for training opportunities in smoking cessation. Conclusion Health staff perceived they would provide more cessation support if there was a systematic approach with evidence-based resources for smoking cessation. These resources would include guidelines and clinical record systems with screening tools, clear action plans and referral pathways to guide clinical practice. Health staff requested support to identify existing training opportunities on smoking cessation.
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- 2021
41. Identifying critical features of type two diabetes prevention interventions: A Delphi study with key stakeholders
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Jillian Ryan, Annemien Haveman-Nies, Pennie Taylor, David N. Cox, Sarah M. Edney, Grant D. Brinkworth, Bonnie Wiggins, Natalie D. Luscombe-March, Kristin Carson-Chahhoud, Ryan, Jillian C, Wiggins, Bonnie, Edney, Sarah, Brinkworth, Grant D, Luscombe-March, Natalie D, Carson-Chahhoud, Kristin V, Taylor, Pennie J, Haveman-Nies, Annemien A, and Cox, David N
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Male ,Delphi Technique ,design ,Psychological intervention ,Delphi method ,WASS ,Endocrinology ,Medical Conditions ,Medicine and Health Sciences ,Public and Occupational Health ,Consumption and Healthy Lifestyles ,education.field_of_study ,education ,Multidisciplinary ,Stakeholder ,Middle Aged ,Type 2 Diabetes ,Health Education and Awareness ,quality ,Consumptie en Gezonde Leefstijl ,Medicine ,Female ,Public Health ,Psychology ,Behavioral and Social Aspects of Health ,management ,engagement ,Research Article ,Adult ,medicine.medical_specialty ,Endocrine Disorders ,Science ,Population ,Health Promotion ,Young Adult ,Stakeholder Participation ,Mental Health and Psychiatry ,medicine ,Diabetes Mellitus ,Stakeholder analysis ,Life Science ,Humans ,care ,Exercise ,Preventive healthcare ,VLAG ,Aged ,Nutrition ,Medical education ,people ,Biology and Life Sciences ,Physical Activity ,Mental health ,Digital health ,Diet ,Health Care ,Diabetes Mellitus, Type 2 ,Metabolic Disorders ,program ,Preventive Medicine - Abstract
Aims This study aims to identify critically important features of digital type two diabetes mellitus (T2DM) prevention interventions. Methods A stakeholder mapping exercise was undertaken to identify key end-user and professional stakeholders, followed by a three-round Delphi procedure to generate and evaluate evidence statements related to the critical elements of digital T2DM prevention interventions in terms of product (intervention), price (funding models/financial cost), place (distribution/delivery channels), and promotion (target audiences). Results End-user (n = 38) and professional (n = 38) stakeholders including patients, dietitians, credentialed diabetes educators, nurses, medical doctors, research scientists, and exercise physiologists participated in the Delphi study. Fifty-two critical intervention characteristics were identified. Future interventions should address diet, physical activity, mental health (e.g. stress, diabetes-related distress), and functional health literacy, while advancing behaviour change support. Programs should be delivered digitally or used multiple delivery modes, target a range of population subgroups including children, and be based on collaborative efforts between national and local and government and non-government funded organisations. Conclusions Our findings highlight strong support for digital health to address T2DM in Australia and identify future directions for T2DM prevention interventions. The study also demonstrates the feasibility and value of stakeholder-led intervention development processes.
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- 2021
42. Electronic cigarettes: A position statement from the Thoracic Society of Australia and New Zealand
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Juliet M. Foster, Sandra Hodge, Alexander N. Larcombe, Claudia C. Dobler, Christine F McDonald, Philip Pattemore, Emily Stone, Stuart Jones, Henry M. Marshall, Miranda P. Ween, Bruce Thompson, Robert Roseby, Billie Bonevski, Paul Hamor, Kristin Carson-Chahhoud, Lutz Beckert, Hayley V. See, Tanya Buchanan, Gabrielle B. McCallum, Alistair Miller, Jack Bozier, Matthew J. Peters, Peter Holmes, David G. Chapman, McDonald, Christine F, Jones, Stuart, Beckert, Lutz, Bonevski, Billie, Carson-Chahhoud, Kristin V, and Peters, Matthew J
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Pulmonary and Respiratory Medicine ,Position statement ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Respiratory System ,Recreational use ,Electronic Nicotine Delivery Systems ,Risk Factors ,Tobacco Smoking ,Medicine ,Humans ,vaping ,Product (category theory) ,Position Statement ,e‐cigarettes ,11 Medical and Health Sciences ,Societies, Medical ,business.industry ,Public health ,Tobacco control ,Smoking ,public health ,Australia ,e-cigarettes ,Former Smoker ,United States ,smoking cessation ,Family medicine ,tobacco control ,Position (finance) ,Smoking cessation ,Female ,business ,New Zealand - Abstract
The TSANZ develops position statements where insufficient data exist to write formal clinical guidelines. In 2018, the TSANZ addressed the question of potential benefits and health impacts of electronic cigarettes (EC). The working party included groups focused on health impacts, smoking cessation, youth issues and priority populations. The 2018 report on the Public Health Consequences of E-Cigarettes from the United States NASEM was accepted as reflective of evidence to mid-2017. A search for papers subsequently published in peer-reviewed journals was conducted in August 2018. A small number of robust and important papers published until March 2019 were also identified and included. Groups identified studies that extended, modified or contradicted the NASEM report. A total of 3793 papers were identified and reviewed, with summaries and draft position statements developed and presented to TSANZ membership in April 2019. After feedback from members and external reviewers, a collection of position statements was finalized in December 2019. EC have adverse lung effects and harmful effects of long-term use are unknown. EC are unsuitable consumer products for recreational use, part-substitution for smoking or long-term exclusive use by former smokers. Smokers who require support to quit smoking should be directed towards approved medication in conjunction with behavioural support as having the strongest evidence for efficacy and safety. No specific EC product can be recommended as effective and safe for smoking cessation. Smoking cessation claims in relation to EC should be assessed by established regulators Refereed/Peer-reviewed
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- 2020
43. Oxygen therapy in the pre-hospital setting for acute exacerbations of chronic obstructive pulmonary disease
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Zoe Kopsaftis, Kristin V Carson-Chahhoud, Michael A Austin, Richard Wood-Baker, Kopsaftis, Zoe, Carson-Chahhoud, Kristin V., Austin, Michael A., and Wood-Baker, Richard
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Emergency Medical Services ,medicine.medical_specialty ,medicine.medical_treatment ,oxygen inhalation therapy ,Placebo ,Pulmonary Disease, Chronic Obstructive ,pulmonary disease, chronic obstructive therapy ,Oxygen therapy ,medicine ,Humans ,Pharmacology (medical) ,Intensive care medicine ,Aged ,Randomized Controlled Trials as Topic ,COPD ,Noninvasive Ventilation ,business.industry ,Oxygen Inhalation Therapy ,emergency medical services ,Emergency department ,medicine.disease ,Clinical trial ,Dyspnea ,Relative risk ,Meta-analysis ,Emergency medicine ,Number needed to treat ,Disease Progression ,business - Abstract
Background Chronic obstructive pulmonary disease (COPD) is a global leading cause of morbidity and mortality, characterised by acute deterioration in symptoms. During these exacerbations, people are prone to developing alveolar hypoventilation, which may be partly caused by the administration of high inspired oxygen concentrations. Objectives To determine the effect of different inspired oxygen concentrations ("high flow" compared to "controlled") in the pre-hospital setting (prior to casualty/emergency department) on outcomes for people with acute exacerbations of COPD (AECOPD). Search methods The Cochrane Airways Group Specialised Register, reference lists of articles and online clinical trial databases were searched. Authors of identified randomised controlled trials (RCTs) were also contacted for details of other relevant published and unpublished studies. The most recent search was conducted on 16 September 2019. Selection criteria We included RCTs comparing oxygen therapy at different concentrations or oxygen therapy versus placebo in the pre-hospital setting for treatment of AECOPD. Data collection and analysis Two review authors independently assessed trial quality and extracted data. The primary outcome was all-cause and respiratory-related mortality. Main results The search identified a total of 824 citations; one study was identified for inclusion and two studies are awaiting classification. The 214 participants involved in the included study were adults with AECOPD, receiving treatment by paramedics en route to hospital. The mean age of participants was 68 years. A reduction in pre/in-hospital mortality was observed in favour of the titrated oxygen group (two deaths in the titrated oxygen group compared to 11 deaths in the high-flow control arm; risk ratio (RR) 0.22, 95% confidence interval (CI) 0.05 to 0.97; 214 participants). This translates to an absolute effect of 94 per 1000 (high-flow oxygen) compared to 21 per 1000 (titrated oxygen), and a number needed to treat for an additional beneficial outcome (NNTB) of 14 (95% CI 12 to 355) with titrated oxygen therapy. Other than mortality, no other adverse events were reported in the included study. Wide confidence intervals were observed between groups for arterial blood gas (though this may be confounded by protocol infidelity in the included study for this outcome measure), treatment failure requiring invasive or non-invasive ventilation or hospital utilisation. No data were reported for quality of life, lung function or dyspnoea. Risk of bias within the included study was largely unclear, though there was high risk of bias in domains relating to performance and attrition bias. We judged the evidence to be of low certainty, according to GRADE criteria. Authors' conclusions The one included study found a reduction in pre/in-hospital mortality for the titrated oxygen arm compared to the high-flow control arm. However, the paucity of evidence somewhat limits the reliability of these findings and generalisability to other settings. There is a need for robust, well-designed RCTs to further investigate the effect of oxygen therapies in the pre-hospital setting for people with AECOPD.
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- 2020
44. Psychological interventions for asthma in children and adolescents
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Kristin Carson-Chahhoud, Olatokunbo Sanwo, Katharine Pike, Kelsey J Sharrad, Sharrad, Kelsey J, Sanwo, Olatokunbo, Carson-Chahhoud, Kristin V, and Pike, Katharine C
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Medicine General & Introductory Medical Sciences ,medicine.medical_specialty ,business.industry ,education ,Psychological intervention ,asthma ,medicine.disease ,respiratory tract diseases ,children ,Family medicine ,medicine ,Pharmacology (medical) ,psychological interventions for children with asthma ,business ,Asthma - Abstract
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: Main objectives To determine the efficacy of psychological interventions in modifying health and behavioural outcomes in children with asthma, compared with usual treatment. Secondary objectives To compare efficacy of different types of psychological interventions for children with asthma. To assess the comparative efficacy of individual and group formats of psychological therapy for children with asthma Refereed/Peer-reviewed
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- 2019
45. Nurse-led versus doctor-led care for bronchiectasis
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Kristin Carson-Chahhoud, Fiona Campbell, Kathryn Lawton, Karen Royals, Brian J. Smith, Lawton, Kathryn, Royals, Karen, Carson-Chahhoud, Kristin V, Campbell, Fiona, and Smith, Brian J
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Medicine General & Introductory Medical Sciences ,medicine.medical_specialty ,business.industry ,Attendance ,MEDLINE ,Context (language use) ,Emergency department ,law.invention ,Clinical trial ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,030228 respiratory system ,Randomized controlled trial ,law ,Family medicine ,Health care ,medicine ,bronchiectasis management ,Pharmacology (medical) ,030212 general & internal medicine ,nurse-led care ,doctor-led care ,business - Abstract
Background: Specialist nursing roles to manage stable disease populations are being used to meet the needs of both patients and health services. With increasing cost pressures on health departments, alternative models such as nurse-led care are gaining momentum as a substitute for traditional doctor-led care. This review evaluates the safety, effectiveness, and health outcomes of nurses practising in autonomous roles while using advanced practice skills, within the context of bronchiectasis management in subacute, ambulatory, and/or community care. Objectives To compare the effectiveness of nurse-led care versus doctor-led care in the management of stable bronchiectasis. Search methods We searched the Cochrane Airways Group Specialised Register and bibliographies of selected papers in addition to grey literature such as electronic clinical trials registries. Searches were current as of March 2018. Selection criteria Randomised controlled trials were eligible for inclusion in the review. Data collection and analysis Two reviewers extracted and entered data from included studies. Primary outcomes were numbers of exacerbations requiring treatment with antibiotics, hospital admissions, and emergency department attendances. Main results We included one United Kingdom (UK) study in the review. In this randomised controlled trial, a total of 80 participants, with a mean age of 58 years, were treated for 12 months by a specialist nurse or doctor, then were crossed over to the other clinician for the next 12 months. Two participants died during the study period. Six participants failed to cross over to nurse-led care because of unstable bronchiectasis. Overall, the level of study completion was high.Data show no difference in the numbers of exacerbations requiring treatment with antibiotics (rate ratio 1.09, 95% confidence interval(CI) 0.91 to 1.30, 80 participants, moderate-certainty evidence). Investigators reported more hospital admissions in the nurse-led care group (rate ratio 1.52, 95% CI 1.04 to 2.23, 80 participants, moderate-certainty evidence) and did not report emergency department attendance.For secondary outcomes, participants in the nurse-led care group used more healthcare resources during the first year of the trial.Increased admissions and greater use of resources made treatment costs for nurse-led groups’ higher. Total costs for both years of the study were £8,464 and £5,228 for nurse-led care compared with doctor-led care. However, by the second year, treatment costs were almost equitable between the two groups, which may reflect the nurses’ learning of how to better treat people with bronchiectasis. No statistically significant changes were observed in quality of life, exercise capacity, mortality, or lung function. Wide confidence intervalsled to uncertainty regarding these results. Adverse events were not an outcome for this review. Authors’ conclusions This update of the review shows that only one trial met review criteria. Review authors were unable to demonstrate effectiveness of nurse led care compared with doctor-led care on the basis of findings of a single study. The included study reported no significant differences,but limited evidence means that differences in clinical outcomes between nurse-led care and usual care within the setting of a specialist clinic remain unclear. Further research is required to determine whether nurse-led care is cost-effective, if guidelines and protocols for bronchiectasis management are followed does this increases costs and how effective nurse-led management of bronchiectasis is in otherclinical settings such as inpatient and outreach. Refereed/Peer-reviewed
- Published
- 2018
46. Short-acting bronchodilators for the management of acute exacerbations of chronic obstructive pulmonary disease in the hospital setting: systematic review
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Brian J. Smith, Nur S. Sulaiman, Paddy A. Phillips, Oliver D. Mountain, Zoe Kopsaftis, Kristin Carson-Chahhoud, Kopsaftis, Zoe A, Sulaiman, Nur S, Mountain, Oliver D, Carson-Chahhoud, Kristin V, Phillips, Paddy A, and Smith, Brian J
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medicine.medical_specialty ,Acute exacerbation of chronic obstructive pulmonary disease ,Exacerbation ,Hospital setting ,MEDLINE ,lcsh:Medicine ,Medicine (miscellaneous) ,SBA ,Cholinergic Antagonists ,chronic obstructive pulmonary disease ,Pulmonary Disease, Chronic Obstructive ,Hospital ,03 medical and health sciences ,0302 clinical medicine ,exacerbation ,SAMA ,systematic review ,Administration, Inhalation ,medicine ,Humans ,030212 general & internal medicine ,hospital ,Adverse effect ,Intensive care medicine ,Adrenergic beta-2 Receptor Agonists ,business.industry ,Ipratropium ,Research ,Chronic obstructive pulmonary disease ,Inhaler ,lcsh:R ,dose ,short-acting bronchodilators ,Short-acting bronchodilators ,medicine.disease ,SABA ,Hospitalization ,Clinical trial ,030228 respiratory system ,Dose ,Systematic review ,Drug Therapy, Combination ,Guideline Adherence ,delivery ,business ,Delivery - Abstract
Background Currently, there is a lack of guidelines for the use of short-acting bronchodilators (SABD) in people admitted to hospital for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), despite routine use in practice and risk of cardiac adverse events. Aim To review the evidence that underpins use and optimal dose, in terms of risk versus benefit, of SABD for inpatient management of AECOPD and collate the results for future guidelines. Methods Medline, Embase, the Cochrane Central Register of Controlled Trials, clinicaltrials.gov and International Clinical Trials Registry Platform were searched (inception to November 2017) for published and ongoing studies. Included studies were randomised controlled trials or controlled clinical trials investigating the effect of SABD (β2-agonist and/or ipratropium) on inpatients with a diagnosis of AECOPD. This review was undertaken in accordance with PRISMA guidelines and a pre-defined protocol. Due to heterogeneous methodologies, meta-analysis was not possible so the results were synthesised qualitatively. Results Of 1378 studies identified, 10 met inclusion criteria. Narrative synthesis of 10 studies revealed no significant differences in most outcomes of interest relative to dose, delivery via inhaler or nebuliser, and type of β2-agonist used. However, some evidence demonstrated significantly increased cardiac side effects with increased dosage of β2-agonist (45% versus 24%), P
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- 2018
47. Non-invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease
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Joanna Picot, Brian J. Smith, Kristin Carson-Chahhoud, Jadwiga A. Wedzicha, Vanessa Tee, Christian R. Osadnik, Osadnik, Christian R, Tee, Vanessa S, Carson-Chahhoud, Kristin V, Picot, Joanna, Wedzicha, Jadwiga A, and Smith, Brian J
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Acute exacerbation of chronic obstructive pulmonary disease ,Pediatrics ,Exacerbation ,CONVENTIONAL MECHANICAL VENTILATION ,law.invention ,Positive-Pressure Respiration ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Randomized controlled trial ,law ,Positive airway pressure ,Risk of mortality ,Pharmacology (medical) ,030212 general & internal medicine ,acute hypercapnic respiratory failure ,Randomized Controlled Trials as Topic ,non-invasive ventilation ,Pulmonary Disease, Chronic Obstructive [*complications] ,11 Medical And Health Sciences ,RANDOMIZED CONTROLLED-TRIAL ,Intensive care unit ,Respiratory Insufficiency [etiology ,therapy] ,Number needed to treat ,FACE MASK VENTILATION ,Respiratory Insufficiency ,Life Sciences & Biomedicine ,CRITICALLY-ILL PATIENTS ,Medicine General & Introductory Medical Sciences ,Adult ,medicine.medical_specialty ,AIR-FLOW LIMITATION ,chronic obstructive pulmonary disease ,03 medical and health sciences ,Medicine, General & Internal ,General & Internal Medicine ,Internal medicine ,COPD PATIENTS ,medicine ,Humans ,TERM-FOLLOW-UP ,Science & Technology ,POSITIVE-PRESSURE VENTILATION ,business.industry ,respiratory failure ,medicine.disease ,030228 respiratory system ,Relative risk ,PROPORTIONAL ASSIST VENTILATION ,business ,STANDARD MEDICAL THERAPY ,Positive-Pressure Respiration [*methods] - Abstract
BackgroundNon-invasive ventilation (NIV) with bi-level positive airway pressure (BiPAP) is commonly used to treat patients admitted to hospital with acute hypercapnic respiratory failure (AHRF) secondary to an acute exacerbation of chronic obstructive pulmonary disease (AECOPD).ObjectivesTo compare the efficacy of NIV applied in conjunction with usual care versus usual care involving no mechanical ventilation alone in adults with AHRF due to AECOPD. The aim of this review is to update the evidence base with the goals of supporting clinical practice and providing recommendations for future evaluation and research.Search methodsWe identified trials from the Cochrane Airways Group Specialised Register of trials (CAGR), which is derived from systematic searches of bibliographic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED), and PsycINFO, and through handsearching of respiratory journals and meeting abstracts. This update to the original review incorporates the results of database searches up to January 2017.Selection criteriaAll randomised controlled trials that compared usual care plus NIV (BiPAP) versus usual care alone in an acute hospital setting for patients with AECOPD due to AHRF were eligible for inclusion. AHRF was defined by a mean admission pH < 7.35 and mean partial pressure of carbon dioxide (PaCO2) > 45 mmHg (6 kPa). Primary review outcomes were mortality during hospital admission and need for endotracheal intubation. Secondary outcomes included hospital length of stay, treatment intolerance, complications, changes in symptoms, and changes in arterial blood gases.Data collection and analysisTwo review authors independently applied the selection criteria to determine study eligibility, performed data extraction, and determined risk of bias in accordance with Cochrane guidelines. Review authors undertook meta-analysis for data that were both clinically and statistically homogenous, and analysed data as both one overall pooled sample and according to two predefined subgroups related to exacerbation severity (admission pH between 7.35 and 7.30 vs below 7.30) and NIV treatment setting (intensive care unit-based vs ward-based). We reported results for mortality, need for endotracheal intubation, and hospital length of stay in a 'Summary of findings' table and rated their quality in accordance with GRADE criteria.Main resultsWe included in the review 17 randomised controlled trials involving 1264 participants. Available data indicate that mean age at recruitment was 66.8 years (range 57.7 to 70.5 years) and that most participants (65%) were male. Most studies (12/17) were at risk of performance bias, and for most (14/17), the risk of detection bias was uncertain. These risks may have affected subjective patient-reported outcome measures (e.g. dyspnoea) and secondary review outcomes, respectively.Use of NIV decreased the risk of mortality by 46% (risk ratio (RR) 0.54, 95% confidence interval (CI) 0.38 to 0.76; N = 12 studies; number needed to treat for an additional beneficial outcome (NNTB) 12, 95% CI 9 to 23) and decreased the risk of needing endotracheal intubation by 65% (RR 0.36, 95% CI 0.28 to 0.46; N = 17 studies; NNTB 5, 95% CI 5 to 6). We graded both outcomes as 'moderate' quality owing to uncertainty regarding risk of bias for several studies. Inspection of the funnel plot related to need for endotracheal intubation raised the possibility of some publication bias pertaining to this outcome. NIV use was also associated with reduced length of hospital stay (mean difference (MD) -3.39 days, 95% CI -5.93 to -0.85; N = 10 studies), reduced incidence of complications (unrelated to NIV) (RR 0.26, 95% CI 0.13 to 0.53; N = 2 studies), and improvement in pH (MD 0.05, 95% CI 0.02 to 0.07; N = 8 studies) and in partial pressure of oxygen (PaO2) (MD 7.47 mmHg, 95% CI 0.78 to 14.16 mmHg; N = 8 studies) at one hour. A trend towards improvement in PaCO2 was observed, but this finding was not statistically significant (MD -4.62 mmHg, 95% CI -11.05 to 1.80 mmHg; N = 8 studies). Post hoc analysis revealed that this lack of benefit was due to the fact that data from two studies at high risk of bias showed baseline imbalance for this outcome (worse in the NIV group than in the usual care group). Sensitivity analysis revealed that exclusion of these two studies resulted in a statistically significant positive effect of NIV on PaCO2. Treatment intolerance was significantly greater in the NIV group than in the usual care group (risk difference (RD) 0.11, 95% CI 0.04 to 0.17; N = 6 studies). Results of analysis showed a non-significant trend towards reduction in dyspnoea with NIV compared with usual care (standardised mean difference (SMD) -0.16, 95% CI -0.34 to 0.02; N = 4 studies). Subgroup analyses revealed no significant between-group differences.Authors' conclusionsData from good quality randomised controlled trials show that NIV is beneficial as a first-line intervention in conjunction with usual care for reducing the likelihood of mortality and endotracheal intubation in patients admitted with acute hypercapnic respiratory failure secondary to an acute exacerbation of chronic obstructive pulmonary disease (COPD). The magnitude of benefit for these outcomes appears similar for patients with acidosis of a mild (pH 7.30 to 7.35) versus a more severe nature (pH < 7.30), and when NIV is applied within the intensive care unit (ICU) or ward setting.
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- 2017
48. Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults
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Ronan O'Sullivan, Kristin Carson-Chahhoud, Abel Wakai, Joseph van Agteren, Malcolm P Brinn, Gráinne McCabe, Brian J. Smith, Carson-Chahhoud, Kristin V, Wakai, Abel, van Agteren, Joseph EM, Smith, Brian J, McCabe, Grainne, Brinn, Malcolm P, and O'Sullivan, Ronan
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Medicine General & Introductory Medical Sciences ,Pediatrics ,medicine.medical_specialty ,MEDLINE ,Cochrane Library ,Suction ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Patient satisfaction ,Medicine, General & Internal ,Randomized controlled trial ,intercostal tube drainage ,law ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Randomized Controlled Trials as Topic ,simple aspiration ,business.industry ,spontaneous pneumothorax ,Pneumothorax ,Length of Stay ,medicine.disease ,Confidence interval ,Clinical trial ,030228 respiratory system ,Patient Satisfaction ,Relative risk ,Chest Tubes ,Drainage ,business - Abstract
Background: For management of pneumothorax that occurs without underlying lung disease, also referred to as primary spontaneous pneumothorax, simple aspiration is technically easier to perform than intercostal tube drainage. In this systematic review, we seek to compare the clinical efficacy and safety of simple aspiration versus intercostal tube drainage for management of primary spontaneous pneumothorax. This review was first published in 2007 and was updated in 2017. Objectives: To compare the clinical efficacy and safety of simple aspiration versus intercostal tube drainage for management of primary spontaneous pneumothorax. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 1) in the Cochrane Library; MEDLINE (1966 to January 2017); and Embase (1980 to January 2017). We searched the World Health Organization (WHO) International Clinical Trials Registry for ongoing trials (January 2017). We checked the reference lists of included trials and contacted trial authors. We imposed no language restrictions. Selection criteria: We included randomized controlled trials (RCTs) of adults 18 years of age and older with primary spontaneous pneumothorax that compared simple aspiration versus intercostal tube drainage. Data collection and analysis: Two review authors independently selected studies for inclusion, assessed trial quality, and extracted data. We combined studies using the random-effects model. Main results: Of 2332 publications obtained through the search strategy, seven studies met the inclusion criteria; one study was ongoing and six studies of 435 participants were eligible for inclusion in the updated review. Data show a significant difference in immediate success rates of procedures favouring tube drainage over simple aspiration for management of primary spontaneous pneumothorax (risk ratio (RR) 0.78, 95% confidence interval (CI) 0.69 to 0.89; 435 participants, 6 studies; moderate-quality evidence). Duration of hospitalization however was significantly less for patients treated by simple aspiration (mean difference (MD) -1.66, 95% CI -2.28 to -1.04; 387 participants, 5 studies; moderate-quality evidence). A narrative synthesis of evidence revealed that simple aspiration led to fewer adverse events (245 participants, 3 studies; low-quality evidence), but data suggest no differences between groups in terms of one-year success rate (RR 1.07, 95% CI 0.96 to 1.18; 318 participants, 4 studies; moderate-quality evidence), hospitalization rate (RR 0.60, 95% CI 0.25 to 1.47; 245 participants, 3 studies; very low-quality evidence), and patient satisfaction (median between-group difference of 0.5 on a scale from 1 to 10; 48 participants, 1 study; low-quality evidence). No studies provided data on cost-effectiveness. Authors' conclusions: Available trials showed low to moderate-quality evidence that intercostal tube drainage produced higher rates of immediate success, while simple aspiration resulted in a shorter duration of hospitalization. Although adverse events were reported more commonly for patients treated with tube drainage, the low quality of the evidence warrants caution in interpreting these findings. Similarly, although this review observed no differences between groups when early failure rate, one-year success rate, or hospital admission rate was evaluated, this too needs to be put into the perspective of the quality of evidence, specifically, for evidence of very low and low quality for hospitalization rate and patient satisfaction, respectively. Future adequately powered research is needed to strengthen the evidence presented in this review. Refereed/Peer-reviewed
- Published
- 2007
49. Community pharmacy personnel interventions for smoking cessation
- Author
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Kristin V Carson-Chahhoud, Jonathan Livingstone-Banks, Kelsey J Sharrad, Zoe Kopsaftis, Malcolm P Brinn, Rachada To-A-Nan, Christine M Bond, Carson-Chahhoud, Kristin V., Livingstone-Banks, Jonathan, Sharrad, Kelsey J, Kopsaftis, Zoe, Brinn, Malcolm P, To-A-nan, Rachada, and Bond, Christine M
- Subjects
Counseling ,medicine.medical_specialty ,medicine.medical_treatment ,Psychological intervention ,Pharmacist ,MEDLINE ,Smoking Prevention ,Pharmacy ,Health Promotion ,Pharmacists ,Nursing ,Behavior Therapy ,medicine ,Humans ,Pharmacology (medical) ,health care economics and organizations ,Randomized Controlled Trials as Topic ,Pharmacies ,business.industry ,Nicotine replacement therapy ,Tobacco Use Cessation Devices ,Health promotion ,Community pharmacy ,Family medicine ,Smoking cessation ,Smoking Cessation ,business - Abstract
Smoking cessation is a potentially appropriate role for community pharmacists because they are encouraged to advise on the correct use of nicotine replacement therapy (NRT) products and to provide behavioural support to aid smoking cessation.This review assessed the effectiveness of interventions by community pharmacy personnel to assist clients to stop smoking.A search was made of the Cochrane Tobacco Addiction Group database for smoking cessation studies conducted in the community pharmacy setting, using the search terms pharmacist* or pharmacy or pharmacies. Date of the most recent search: March 2003.Randomized trials which compared interventions by community pharmacy personnel to promote smoking cessation amongst their clients who were smokers compared to usual pharmacy support or any less intensive programme. The main outcome measure was smoking cessation rates at six months or more after the start of the intervention.Data were extracted by one author and checked by the second, noting: the country of the trial, details of participant community pharmacies, method of subject recruitment, smoking behaviour and characteristics of participants on recruitment, method of randomization, description of the intervention and of any pharmacy personnel training, and the outcome measures. Methodological quality was assessed according to the extent to which the allocation to intervention or control was concealed. Because of the potentially important cluster effects, we also rated trials according to whether they checked for or adjusted for these but, in the absence of consensus on how to pool cluster level data, we adopted a narrative approach to synthesizing the data, rather than a formal meta-analysis.We identified two trials which met our selection criteria. They included a total of 976 smokers. Both trials were set in the UK and involved a training intervention which included the Stages of Change Model; they then compared a support programme involving counselling and record keeping against a control receiving usual pharmacy support. In both studies a high proportion of intervention and control participants began using NRT. Both studies reported smoking cessation outcomes at three time points. However, the follow-up points were not identical (three, six and 12 months in one, and one, four and nine months in the other), and the trend in abstinence over time was not linear in either study, so the data could not be combined. One study showed a significant difference in self-reported cessation rates at 12 months: 14.3% versus 2.7% (p0.001); the other study showed a positive trend at each follow-up with 12.0% versus 7.4% (p = 0.09) at nine months.The limited number of studies to date suggests that trained community pharmacists, providing a counselling and record keeping support programme for their customers, may have a positive effect on smoking cessation rates. The strength of evidence is limited because only one of the trials showed a statistically significant effect.
- Published
- 2004
50. Psychological interventions for asthma in children and adolescents.
- Author
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Sharrad KJ, Sanwo O, Cuevas-Asturias S, Kew KM, Carson-Chahhoud KV, and Pike KC
- Subjects
- Child, Female, Male, Humans, Adolescent, Anxiety therapy, Anxiety Disorders, Administrative Personnel, Psychosocial Intervention, Asthma therapy
- Abstract
Background: Rates of asthma are high in children and adolescents, and young people with asthma generally report poorer health outcomes than those without asthma. Young people with asthma experience a range of challenges that may contribute to psychological distress. This is compounded by the social, psychological, and developmental challenges experienced by all people during this life stage. Psychological interventions (such as behavioural therapies or cognitive therapies) have the potential to reduce psychological distress and thus improve behavioural outcomes such as self-efficacy and medication adherence. In turn, this may reduce medical contacts and asthma attacks., Objectives: To determine the efficacy of psychological interventions for modifying health and behavioural outcomes in children with asthma, compared with usual treatment, treatment with no psychological component, or no treatment., Search Methods: We searched the Cochrane Airways Group Specialised Register (including CENTRAL, CRS, MEDLINE, Embase, PsycINFO, CINAHL EBSCO, AMED EBSCO), proceedings of major respiratory conferences, reference lists of included studies, and online clinical databases. The most recent search was conducted on 22 August 2022., Selection Criteria: We included randomised controlled trials (RCTs) comparing psychological interventions of any duration with usual care, active controls, or a waiting-list control in male and female children and adolescents (aged five to 18 years) with asthma., Data Collection and Analysis: We used standard Cochrane methods. Our primary outcomes were 1. symptoms of anxiety and depression, 2. medical contacts, and 3. asthma attacks. Our secondary outcomes were 1. self-reported asthma symptoms, 2. medication use, 3. quality of life, and 4. adverse events/side effects., Main Results: We included 24 studies (1639 participants) published between 1978 and 2021. Eleven studies were set in the USA, five in China, two in Sweden, three in Iran, and one each in the Netherlands, UK, and Germany. Participants' asthma severity ranged from mild to severe. Three studies included primary school-aged participants (five to 12 years), two included secondary school-aged participants (13 to 18 years), and 18 included both age groups, while one study was unclear on the age ranges. Durations of interventions ranged from three days to eight months. One intervention was conducted online and the rest were face-to-face. Meta-analysis was not possible due to clinical heterogeneity (interventions, populations, outcome tools and definitions, and length of follow-up). We tabulated and summarised the results narratively with reference to direction, magnitude, and certainty of effects. The certainty of the evidence was very low for all outcomes. A lack of information about scale metrics and minimal clinically important differences for the scales used to measure anxiety, depression, asthma symptoms, medication use, and quality of life made it difficult to judge clinical significance. Primary outcomes Four studies (327 participants) reported beneficial or mixed effects of psychological interventions versus controls for symptoms of anxiety, and one found little to no difference between groups (104 participants). Two studies (166 participants) that evaluated symptoms of depression both reported benefits of psychological interventions compared to controls. Three small studies (92 participants) reported a reduction in medical contacts, but two larger studies (544 participants) found little or no difference between groups in this outcome. Two studies (107 participants) found that the intervention had an important beneficial effect on number of asthma attacks, and one small study (22 participants) found little or no effect of the intervention for this outcome. Secondary outcomes Eleven studies (720 participants) assessed asthma symptoms; four (322 participants) reported beneficial effects of the intervention compared to control, five (257 participants) reported mixed or unclear findings, and two (131 participants) found little or no difference between groups. Eight studies (822 participants) reported a variety of medication use measures; six of these studies (670 participants) found a positive effect of the intervention versus control, and the other two (152 participants) found little or no difference between the groups. Across six studies (653 participants) reporting measures of quality of life, the largest three (522 participants) found little or no difference between the groups. Where findings were positive or mixed, there was evidence of selective reporting (2 studies, 131 participants). No studies provided data related to adverse effects., Authors' Conclusions: Most studies that reported symptoms of anxiety, depression, asthma attacks, asthma symptoms, and medication use found a positive effect of psychological interventions versus control on at least one measure. However, some findings were mixed, it was difficult to judge clinical significance, and the evidence for all outcomes is very uncertain due to clinical heterogeneity, small sample sizes, incomplete reporting, and risk of bias. There is limited evidence to suggest that psychological interventions can reduce the need for medical contact or improve quality of life, and no studies reported adverse events. It was not possible to identify components of effective interventions and distinguish these from interventions showing no evidence of an effect due to substantial heterogeneity. Future investigations of evidence-based psychological techniques should consider standardising outcomes to support cross-comparison and better inform patient and policymaker decision-making., (Copyright © 2024 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)
- Published
- 2024
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