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Journal club: Cytisine for smoking cessation

Stream Journal club: Cytisine for smoking cessation by BMJ talk medicine from desktop or your mobile device  
SoundCloud
almost 5 years ago
Foo20151013 2023 1dozpdh?1444774176
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149

Imagine a world where procrastination became a productive pastime…

Imagine a world where procrastination became a productive pastime… Procrastination, as it stands, is a core feature of the ‘human condition’ and most would argue that it is here to stay. However, what if we could hijack the time we spend playing Candy Crush saga and trick ourselves into contributing towards something tangible. Today, I wish to explore this possibility with you. The phrase ‘gamification’ is not a new or made up word (I promise) although I agree it does sound jarring and I certainly wouldn’t recommend trying to use it in a game of scrabble (yet). The phrase itself refers to the process of applying game thinking and game mechanics to non-game contexts to engage users in solving problems. For our purposes and for the purposes of this blog ‘problems’ will equate to promoting healthy living for our patients and maintaining our own medical education. For one reason or another, most people show addictive behaviour towards games especially when they incorporate persistent elements of progression, achievement and competition with others. The underlying psychology won’t be discussed here; call it escapism, call it procrastination, call it whatever you will. What I want you to realise is that every day millions of people spend hours tending to virtual farms and cyber families whilst competing vigorously with ‘online’ friends. If we can take the addictive aspects of these popular games and incorporate them in to the non-game contexts I indicated to above, we could potentially trick ourselves, and even perhaps our patients, into a better way of life. The first time I heard the phrase ‘gamification’ was only last year. I was in Paris attending the Doctors 2.0 conference listening to talks on how cutting edge technologies and the Internet had been (or were going to be) incorporated into healthcare. One example that stood out to me was a gaming app that intended to engage people with diabetes to record their blood sugars more regularly and also compete with themselves to achieve better sugar control. People who have the condition of Diabetes Mellitus are continuously reminded of their diet and their blood sugar levels. I am not diabetic myself, but it is not hard to realise that diet and sugar control is going to be an absolute nightmare for people with diabetes both from a practical and psychological standpoint. Cue the mySugr Compainion, an FDA approved mobile application that was created to incorporate the achievement and progression aspects of game design to help encourage people with diabetes to achieve better sugar control. The app was a novel concept that struck a chord with me due to its potential to appeal to the part in everyone’s brain that makes them sit down and play ‘just one more level’ of their favorite game or app. There are several other apps on the market that are games designed to encourage self testing of blood sugar levels in people with diabetes. There is even a paediatric example titled; “Monster Manor,” which was launched by the popular Sanofi UK (who previously released the FDA / CE approved iBGStar iPhone blood glucose monitor). So applying aspects of game design into disease management apps has anecdotally been shown to benefit young people with Diabetes. However, disease management is just one area where game-health apps have emerged. We are taught throughout medical school and beyond that disease prevention is obviously beneficial to both our patients and the health economy. Unsurprisingly, one of the best ways to prevent disease is to maintain health (either through exercise and / or healthy eating). A prominent example of an app that helps to engage users in exercising is ‘RunKeeper,’ a mobile app that enables people to track and publish their latest jog-around-the-park. The elements of game design are a little more subtle in this example but the ability to track your own progress and compete with others via social media share buttons certainly reminds me of similar features seen in most of today’s online games. Other examples of ‘healthy living apps’ are rife amongst the respective ‘app stores,’ and there seems to be ample opportunity for the appliance of gamification in this field. An example might be to incorporate aspects of game design into a smoking cessation app or weight loss helper. Perhaps the addictive quality of a well designed game-app could overpower the urge for confectionary or that ‘last cigarette’… The last area where I think ‘gamification’ could have a huge benefit is in (medical) education. Learning and revising are particularly susceptible to the rot of procrastination, so it goes without saying that many educational vendors have already attempted to incorporate fresh ways in which they can engage their users to put down the TV remote and pick up some knowledge for the exams. Meducation itself already has an area on its website entitled ‘Exam Room,’ where you can test yourself, track your progress and provide feedback on the questions you are given. I have always found this a far more addictive way to revise than sitting down with pen and paper to revise from a book. However, I feel there could be a far greater incorporation of game design in the field of medical education. Perhaps the absolute dream for like-minded gamers out there would be a super-gritty medical simulator that exposes you to common medical emergencies from the comfort of your own computer screen. I mean, my shiny new gaming console lets me pretend to be an elite solider deep behind enemy lines so why not let me pretend and practice to be a doctor too? You could even have feedback functionality to indicate where your management might have deviated from the optimum. Perhaps more sensibly, the potential also exists to build on the existing banks of online medical questions to incorporate further aspects of social media interaction, achievement unlocks and inter-player competition (because in case you hadn’t noticed, medics are a competitive breed). I have given a couple of very basic examples on how aspects of game design have emerged in recent health-related apps. I feel this phenomenon is in its infancy. The technology exists for so much more than the above, we just need to use our imagination… and learn how to code.  
Dr. Luke Farmery
almost 6 years ago
Www.bmj
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Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium

Objective To investigate the impact of smoking and smoking cessation on cardiovascular mortality, acute coronary events, and stroke events in people aged 60 and older, and to calculate and report risk advancement periods for cardiovascular mortality in addition to traditional epidemiological relative risk measures.  
feeds.bmj.com
over 4 years ago
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Chantix could affect patients' alcohol tolerance, warn FDA

People taking the smoking cessation drug are advised to reduce the amount of alcohol they drink until they know how Chantix affects their capacity to tolerate alcohol.  
medicalnewstoday.com
over 4 years ago
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Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium

Objective To investigate the impact of smoking and smoking cessation on cardiovascular mortality, acute coronary events, and stroke events in people aged 60 and older, and to calculate and report risk advancement periods for cardiovascular mortality in addition to traditional epidemiological relative risk measures.  
feeds.bmj.com
over 4 years ago
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Journal club: Cytisine for smoking cessation

Stream Journal club: Cytisine for smoking cessation by BMJ talk medicine from desktop or your mobile device  
feeds.bmj.com
over 4 years ago
Www.bmj
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Experts call for tobacco industry to pay for smoking cessation work

The tobacco industry should be forced to pay towards smoking cessation efforts in England as part of a new national tobacco control strategy, a multi-agency report has claimed.  
feeds.bmj.com
over 4 years ago
Www.bmj
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Experts call for tobacco industry to pay for smoking cessation work

The tobacco industry should be forced to pay towards smoking cessation efforts in England as part of a new national tobacco control strategy, a multi-agency report has claimed.  
feeds.bmj.com
over 4 years ago
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Psychosocial smoking cessation interventions help patients with heart attacks to quit. | Cochrane

Smoking is a risk factor for heart attacks and stopping smoking is recommended for patients after a heart attack. Psychosocial smoking cessation interventions like counseling can help such patients to stop smoking, if they are provided for over one month. Psychosocial interventions can help such patients to quit within 6 months but studies about the long term effects did not support the beneficial short-term findings. Most trials used a mixture of different intervention strategies, therefore no single strategy showed superior efficacy.  
cochrane.org
over 4 years ago
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Can users of waterpipes be helped to quit through smoking cessation interventions? | Cochrane

Waterpipe smoking is a traditional method of tobacco use, especially in the Eastern Mediterranean Region, but its use is now spreading worldwide. It is smoked socially and often shared between friends or family at home, or in bars and cafes that provide waterpipes to patrons. In the absence of relevant data, many waterpipe tobacco smokers believe this form of tobacco use is less lethal and addictive than other methods of tobacco smoking, because the smoke passes through water on its way to the user. At least in some cultures, women and girls are more likely to use a waterpipe than other forms of tobacco, and it is popular among younger smokers. Current evidence suggests that waterpipe smoking may be as addictive as other forms of tobacco use, that some users have difficulty quitting on their own and that they may experience similar risks to health as cigarette smokers.  
cochrane.org
over 4 years ago
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Action is needed to boost uptake of stop smoking services, say campaigners

Smoking cessation campaigners are calling for action to reverse the current downward trend in people seeking support from specialist stop smoking services. They emphasised that smokers who get support from local stop smoking services are four times more likely to quit than by going “cold turkey.”  
feeds.bmj.com
about 4 years ago
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Smoking cessation and reduction in people with chronic mental illness

The high prevalence of cigarette smoking and tobacco related morbidity and mortality in people with chronic mental illness is well documented. This review summarizes results from studies of smoking cessation treatments in people with schizophrenia, depression, anxiety disorders, and post-traumatic stress disorder. It also summarizes experimental studies aimed at identifying biopsychosocial mechanisms that underlie the high smoking rates seen in people with these disorders. Research indicates that smokers with chronic mental illness can quit with standard cessation approaches with minimal effects on psychiatric symptoms. Although some studies have noted high relapse rates, longer maintenance on pharmacotherapy reduces rates of relapse without untoward effects on psychiatric symptoms. Similar biopsychosocial mechanisms are thought to be involved in the initiation and persistence of smoking in patients with different disorders. An appreciation of these common factors may aid the development of novel tobacco treatments for people with chronic mental illness. Novel nicotine and tobacco products such as electronic cigarettes and very low nicotine content cigarettes may also be used to improve smoking cessation rates in people with chronic mental illness.  
feeds.bmj.com
about 4 years ago
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Final US Smoking Cessation Recommendations Released

In new smoking cessation recommendations, the US Preventive Services Task Force calls on providers to ask all patients about smoking and provide evidence-based resources for quitting.  
medscape.com
about 4 years ago
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Report Endorsing e-Cigarettes Called Into Question

A report by the government public health agency in England supporting the use of e-cigarettes as a smoking cessation aid is based on insufficient evidence, two experts say.  
medscape.com
about 4 years ago
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E-Cigarette Use for Smoking Cessation: Controversy Continues CME/CE

: An analysis criticizes a report by Public Health England regarding evidence on the efficacy and safety of using electronic cigarettes to quit smoking.  
medscape.org
about 4 years ago
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Smoking and Seizures: Where the Evidence Stands

Dr Wilner describes the epidemiology of smoking among people with epilepsy, the potential effects of nicotine on seizures, and seizure risks among smoking cessation medications.  
medscape.com
about 4 years ago
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Factors in Older Adults' Smoking Cessation

This study examined the impact of several factors, including newly diagnosed health problems, depression, and social isolation, on smoking cessation in older adults.  
medscape.com
almost 4 years ago
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Stop smoking services are under threat owing to budget cuts

Funding for smoking cessation services is being cut in around 40% of local authorities in England, a report by Action on Smoking and Health, commissioned by Cancer Research UK, has found.1  
feeds.bmj.com
almost 4 years ago
Www.bmj
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Similar quit rates are found with three smoking cessation options

The drug varenicline (Champix) was found to be no better than combination nicotine replacement therapy or a standard nicotine patch in helping adults to stop smoking in the long term, a randomised controlled trial published in JAMA has shown.1  
feeds.bmj.com
almost 4 years ago
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Similar quit rates are found with three smoking cessation options

The drug varenicline (Champix) was found to be no better than combination nicotine replacement therapy or a standard nicotine patch in helping adults to stop smoking in the long term, a randomised controlled trial published in JAMA has shown.1  
feeds.bmj.com
almost 4 years ago