Cessation of smoking in people attending UK emergency departments: the COSTED RCT with economic and process evaluation.

Background: The emergency department represents a potentially valuable opportunity to support smoking cessation. Evidence is lacking around the use of e-cigarettes in opportunistic settings like the emergency department.

Objective: To undertake a randomised controlled trial in people who smoke attending United Kingdom emergency departments, testing a brief intervention which included provision of an e-cigarette versus signposting to smoking cessation services, assessing smoking abstinence.

Stop smoking intervention in emergency departments helps people quit.

The studyPope I, Clark LV, Clark A, et al. Cessation of Smoking Trial in the Emergency Department (COSTED): a multicentre randomised controlled trial. 2024;41:276-282.

The Context of the Emergency Department as a Location for a Smoking Cessation Intervention-Process Evaluation Findings From the Cessation of Smoking Trial in the Emergency Department Trial.

Introduction: Hospital emergency departments (ED) offer an opportunity to engage with large numbers of people who smoke to prompt cessation, although the acceptability of opportunistic intervention in this context has been questioned. This process evaluation study was embedded into the Cessation of Smoking Trial in the Emergency Department (COSTED) randomized controlled trial and sought to explore the context of intervention delivery within the ED.

Aims And Methods: Qualitative interviews were conducted with participants and staff across six EDs participating in the COSTED randomized controlled trial.

Predictors of Successful Tobacco Cessation After Receiving an E-Cigarette Based Smoking Cessation Intervention.

Introduction: E-cigarettes have been shown to be effective for tobacco smoking cessation. Predicting those who are most likely to achieve smoking abstinence after receiving an e-cigarette based smoking cessation intervention could help to target interventions more efficiently.

Methods: A secondary analysis of baseline characteristics of 505 people who received an emergency department based smoking cessation intervention incorporating brief advice, provision of an e-cigarette starter kit and referral to stop smoking services.

Cost-utility analysis of provision of e-cigarette starter kits for smoking cessation in emergency departments: An economic evaluation of a randomized controlled trial.

Aims: To assess the cost-effectiveness of the Cessation of Smoking Trial in Emergency Department (COSTED) intervention compared with signposting to local stop smoking service (SSS) from the National Health Service (NHS) and personal social services (PSS) perspective.

Design, Setting And Participants: This was a two-group, multi-centre, pragmatic, individually randomized controlled trial set in six Emergency Departments (EDs) in urban and rural areas in the United Kingdom. Adult (≥ 18 years) daily smokers (at least one cigarette or equivalent per day) but not daily e-cigarette users, with carbon monoxide reading ≥ 8 parts per million, attending the ED (n = 972) were included.

Theoretically framing views of people who smoke in understanding what might work to support smoking cessation in coastal communities: adapting the TIDieR checklist to qualitative analysis for complex intervention development.

Introduction: People living in coastal communities have some of the worst health outcomes in the UK, driven in part by high smoking rates. Deprived coastal communities include socially disadvantaged groups that struggle to access traditional stop smoking services. The study aimed to seek the views of people who smoke living in coastal communities, to assess the optimal smoking cessation intervention for this population.

Engagement With Stop Smoking Services After Referral or Signposting: A Mixed-Methods Study.

Introduction: Screening for smoking when people interact with healthcare services and referral of those who smoke to stop smoking services (SSSs) is a key component of efforts to tackle tobacco use. However, little is known about what happens after someone is referred or signposted to SSSs.

Methods: As part of the Cessation of Smoking Trial in the Emergency Department (NCT04854616), those randomized to intervention (n = 505) were referred to local SSSs (along with receiving brief advice and an e-cigarette starter kit) and those randomized to control (n = 502) were given contact details for the same services (signposted).

Young people's use of disposable vapes: A qualitative study.

Background And Aims: Youth use of disposable vapes has increased markedly in the United Kingdom in recent years, yet little is known about the motivations, experiences and perceptions of young people themselves. This study aimed to explore young people's experiences and use of disposable vapes.

Methods: This was a qualitative study recruiting young people reporting regularly vaping disposables, collecting data via dyad guided, individual and group interviews.

Cessation of Smoking Trial in the Emergency Department (COSTED): a multicentre randomised controlled trial.

Background: Supporting people to quit smoking is one of the most powerful interventions to improve health. The Emergency Department (ED) represents a potentially valuable opportunity to deliver a smoking cessation intervention if it is sufficiently resourced. The objective of this trial was to determine whether an opportunistic ED-based smoking cessation intervention can help people to quit smoking.

Selecting an e-cigarette for use in smoking cessation interventions and healthcare services: findings from patient and public consultation for the COSTED trial.

Objectives: The Cessation of Smoking Trial in the Emergency Department (COSTED) trial aims to ascertain whether brief advice, the provision of an e-cigarette starter kit and referral to stop smoking services (SSS), increases smoking cessation in people attending the emergency department. Patient and public involvement (PPI) and scoping work were undertaken to select an appropriate e-cigarette for the trial.

Design And Setting: PPI consultation and feasibility scoping about potential devices with a professional and lay panel, all based in England.

Do standard behavioral assays predict foraging behavior of individual Black-capped chickadees (Poecile atricapillus) in response to a predator model or calls?

Black-capped chickadees () and other species that feed at bird feeders balance the benefit of easy foraging with the added risk of predation. Individual birds respond differently to risky situations, and these differences have been attributed to the birds' personalities, which researchers commonly assess with an "open-field" behavioral assay. However, these behavioral assays in birds have not been compared to behavior in the wild in the context of foraging in the presence of a predator (i.

Biochemical Verification of Tobacco-Use as an Inclusion Criterion in Smoking Cessation Trials- Lessons From the Cessation of Smoking Trial in the Emergency Department.

Introduction: Biochemical verification of smoking status prior to recruitment into smoking cessation trials is widely used to confirm smoking status, most commonly using exhaled carbon monoxide (CO). There is variation in the level of CO used as a biochemical inclusion criterion, and thus the possibility for people reporting to be current smokers to be incorrectly excluded from trials.

Methods: As part of the Cessation of Smoking Trial in the Emergency Department, people attending the Emergency Department (ED) who reported being current daily smokers underwent CO testing to confirm eligibility.

Cessation of smoking trial in the emergency department (CoSTED): protocol for a multicentre randomised controlled trial.

Introduction: Attendees of emergency departments (EDs) have a higher than expected prevalence of smoking. ED attendance may be a good opportunity to prompt positive behaviour change, even for smokers not currently motivated to quit. This study aims to determine whether an opportunist smoking cessation intervention delivered in the ED can help daily smokers attending the ED quit smoking and is cost-effective.

Feasibility and evaluation of an emergency department-based general practitioner streaming and treatment service.

Rationale: Offering a primary care service that can provide good quality primary care at emergency departments may reduce pressure on usual emergency department (ED) services.

Aims And Objectives: To evaluate the acceptability, satisfaction, and potential impacts of a co-located primary care service at an emergency department.

Methods: This is a prospective feasibility study and service evaluation comprising a narrative summary of activity, satisfaction, well-being, and safety, and comparisons of wait times for ED services by patient category ('minor', 'majors', 'paediatric' or 'resus') before and during the service operation.

Microscopic resection margins adversely influence survival rates after surgery for colorectal liver metastases: An open ambidirectional Cohort Study.

Background: Liver resection is the most effective treatment for patients with colorectal liver metastases (CRLMs). Patients with tumour at the resection margin (R1) are reported to have worse survival compared to those with an uninvolved resection margin (R0). Recent data has questioned this finding.

Short-stay admissions at an inner city hospital: a cross-sectional analysis.

Objective: To investigate factors predictive of short hospital admissions and appropriate placement to inpatient versus clinical decision units (CDUs).

Method: This is a retrospective analysis of attendance and discharge data from an inner-city ED in England for December 2013. The primary outcome was admission for less than 48 hours either to an inpatient unit or CDU.

A qualitative study exploring the factors influencing admission to hospital from the emergency department.

Objective: The number of emergency admissions to hospital in England and Wales has risen sharply in recent years and is a matter of concern to clinicians, policy makers and patients alike. However, the factors that influence this decision are poorly understood. We aimed to ascertain how non-clinical factors can affect hospital admission rates.

Risk factors for admission at three urban emergency departments in England: a cross-sectional analysis of attendances over 1 month.

Objective: To investigate factors associated with unscheduled admission following presentation to emergency departments (EDs) at three hospitals in England.

Design And Setting: Cross-sectional analysis of attendance data for patients from three urban EDs in England: a large teaching hospital and major trauma centre (site 1) and two district general hospitals (sites 2 and 3). Variables included patient age, gender, ethnicity, deprivation score, arrival date and time, arrival by ambulance or otherwise, a variety of ED workload measures, inpatient bed occupancy rates and admission outcome.

National health policy-makers' views on the clarity and utility of Countdown to 2015 country profiles and reports: findings from two exploratory qualitative studies.

Background: The use of sets of indicators to assess progress has become commonplace in the global health arena. Exploratory research has suggested that indicators used for global monitoring purposes can play a role in national policy-making, however, the mechanisms through which this occurs are poorly understood. This article reports findings from two qualitative studies that aimed to explore national policy-makers' interpretation and use of indicators from country profiles and reports developed by Countdown to 2015.

Hydrocele of the canal of Nuck--an old problem revisited.

Herein the authors describe the case of a young woman presenting with a tender lump in her groin. Clinically the differential was of either a reactive lymph node or a femoral hernia. Ultrasound scan was urgently arranged and showed a cystic lesion.

Soil erosion and sediment fluxes analysis: a watershed study of the Ni Reservoir, Spotsylvania County, VA, USA.

Anthropogenic forces that alter the physical landscape are known to cause significant soil erosion, which has negative impact on surface water bodies, such as rivers, lakes/reservoirs, and coastal zones, and thus sediment control has become one of the central aspects of catchment management planning. The revised universal soil loss equation empirical model, erosion pins, and isotopic sediment core analyses were used to evaluate watershed erosion, stream bank erosion, and reservoir sediment accumulation rates for Ni Reservoir, in central Virginia. Land-use and land cover seems to be dominant control in watershed soil erosion, with barren land and human-disturbed areas contributing the most sediment, and forest and herbaceous areas contributing the least.

Blunt abdominal trauma - An important cause of portal venous pseuodoaneurysm.

Aneurysms and pseudoaneurysms of the portal venous system are rarely seen following abdominal trauma but clinicians need to be aware of them as possible vascular complications following blunt trauma. This case report of a 10 year old boy following a handlebar injury demonstrates a clear causal relationship between trauma and portal venous pseudoaneurysm. Portal venous aneurysms have a prevalence of less than 0.

The clinical impact of magnetic resonance imaging in diagnosing focal hepatic lesions and suspected cancer.

Aims: To compare the clinical utility of contrast enhanced magnetic resonance imaging (MRI) to ultrasound (USS) and computed tomography (CT) in focal hepatic lesions (FHLs)

Methods: This retrospective study analysed 125 consecutive iron oxide enhanced (SPIO) MRI.

Results: MRI made a difference in 74% of patients who had USS and in 42% of patients who had a CT scan. In suspected cancer, MRI changed diagnosis in 58% and 37% (13/35), respectively.