Motivation to quit smoking among parents of urban children with asthma

Objective

To identify factors associated with motivation to quit smoking among parents of urban children with asthma.

Methods

We analyzed data from parents who smoke and had a child enrolled in the School-Based Asthma Therapy (SBAT) trial. We assessed asthma symptoms, children's cotinine, and parent smoking behaviors. Motivation to quit smoking was assessed by a 10-point continuous measure (1, not at all motivated; 10, very motivated).

Results

209 parents smoked (39% of sample), and children's mean cotinine was 2.48 ng/ml. Motivation to quit was on average 6.9, and 47% of parents scored ≥8 on the scale. Parents who believed their child's asthma was not under good control, and parents who strongly agreed their child's asthma symptoms would decrease if they stop smoking had higher motivation to quit compared to their counterparts (p < .05). In a multivariate analysis, parents who believed their child's asthma was not under control had more than twice the odds of reporting high motivation to quit.

Conclusion

Parents’ perception of the risks of smoking to their child with asthma is associated with motivation to quit.

Practice implications

Raising awareness about the effect of smoking and quitting on children's asthma might increase motivation to quit among parents.     

Vancomycin and meropenem in acrylic cement: elution kinetics of in vitro bactericidal action

The Authors present a paper with a dual goal: in vitro evaluation of the elution of vancomycin and monitoring of its bactericidal action when the antibiotic is used in acrylic cement. Discs of cement with different concentrations of vancomycin alone or combined with meropenem were prepared. To assess the elution of vancomycin the discs were kept in physiological solution and periodically sampled for five weeks. The bactericidal action was assessed by putting the antibiotic discs in contact with colonies of Staphylococcus, Enterococcus, Pseudomonas and Escherichia coli. Two combinations of antibiotic-loaded cement were tested: the first one to act as a spacer and the second to stabilise the revision prosthesis.     

Relationship between baseline impedance levels and esophageal mucosal integrity in children with erosive and non-erosive reflux disease

Background Baseline impedance measurement has been reported to be related to esophageal acid exposure and hypothesized to be a marker of microscopic changes of the esophageal mucosa. Aims of the study were to establish whether any relationship existed between the magnitude of intercellular space diameter (ISD) of esophageal mucosa and baseline impedance levels in children with gastro‐esophageal reflux disease (GERD), and to compare baseline impedance levels between children with non erosive (NERD) and erosive (ERD) reflux disease. Methods Fifteen children (median age: 11.2 years) with NERD, and 11 with ERD (median age: 9.6 years) were prospectively studied. All patients underwent upper endoscopy. Biopsies were taken 2–3 cm above the Z‐line, and ISD was measured using transmission electron microscopy. All patients underwent impedance pH‐monitoring, and baseline impedance levels were assessed in the most distal impedance channel. Key Results Mean (±SD) ISD did not differ between NERD (1.0 ± 0.3 μm) and ERD (1.1 ± 0.3 μm, ns). Considering all patients together, no correlation was found between distal baseline impedance and ISD (r: ?0.15; ns). Conversely, negative correlations were found between distal baseline impedance and acid exposure time (r: ?0.76; P < 0.001), long‐lasting reflux episodes (r: ?0.78; P < 0.001), acid reflux episodes (r: ?0.62; P < 0.001), and acid clearance time (r: ?0.79; P < 0.001). Distal baseline impedance was significantly lower in ERD [1455 (947–2338) Ω] than in NERD children [3065 (2253–3771) Ω; P < 0.01]. Conclusions & Inferences In children with GERD baseline impedance levels are not useful in predicting reflux‐induced ultrastructural changes in the esophageal mucosa, despite their ability to discriminate between NERD and ERD.     

Behavioural and social oral health intervention research: Looking to the future

Behavioural and social oral health intervention has made great strides in intervention development and testing. Future research should focus on applying successful methods and interventions of disciplines outside oral health to oral health research and practice as well as focus on raising the visibility of oral health research by applying our established methods and interventions to outside domains. Behavioural and social oral health is strategically positioned to be a leader across several research domains, perhaps most prominently in digital health, disparities and developing and testing theories and frameworks, given the progress that has already been made, and significant investment in these areas from funders like the National Institute for Craniofacial Research.     

Theoretical and methodological approaches in designing,developing, and delivering interventions for oral health behaviour change

Oral health behaviour change interventions are gaining momentum on a global scale. After lagging behind other disciplines, oral health behaviour change is becoming an area of fast and important development. Theories used in medicine and healthcare more generally are now being applied to oral health behaviour change with varying results. Despite the importance of using theories when designing and developing interventions, the variety and variation of theories available to choose from create a series of dilemmas and potential hazards. Some theories, like the COM-B (Capability, Opportunity, Motivation-Behaviour) model, and frameworks, like the Behaviour Change Wheel might represent areas of opportunity for oral health behaviour change interventions with careful consideration vital. Different methodological approaches to intervention development are actively utilized in oral health with a wide host of potential opportunities. The issue of co-designing and co-developing interventions with intended users and stakeholders from the start is an important component for successful and effective interventions, one that oral health behaviour change interventions need to consistently implement. Oral health behaviour change interventions are utilizing technology-based approaches as a major vehicle for intervention delivery and, innovative solutions are implemented across a wide host of oral health behaviour change interventions. With multiple options for designing, developing, and delivering interventions, careful selection of appropriate, user-inclusive, and adaptable approaches is essential. With a lot of available information and evidence from other disciplines, oral health behaviour change interventions need to reflect on lessons learned in other fields whilst also maximizing the potential of the wide variety of theories, frameworks, methodologies, and techniques available at present.