Residential treatment exclusively for smoking cessation in patients with Crohn's disease: Results from a pilot study.

INTRODUCTION: Cigarette smoking is a risk factor for the induction and severity of the course of Crohn's disease (CD). Hospital admission may be required for treatment of the disease but is generally not available solely for smoking cessation. Outpatient group therapy is readily available, however long-term quit rates are limited. Residential treatment for smoking cessation may offer a more intense contact between patient and therapist, and may result in higher abstinence rates in a sensitive group of patients. The objective of this pilot study is to evaluate the feasibility of implementing a residential program with hospital admission, exclusively for smoking cessation for patients suffering from CD. METHODS: Twelve eligible smokers suffering from CD were recruited for a 9-day inpatient smoking cessation treatment. Treatment consisted of single and group behavioral therapy together with supportive measures such as exercise therapy, relaxation techniques or nutritional counselling. Nicotine replacement therapy or prescription medication was offered according to the Fagerström test for nicotine dependence (FTND) score and treatment guidelines. Quit rates were assessed by CO-testing during hospital treatment and by follow-up calls 6 months after discharge. RESULTS: All recruited participants arrived on time for treatment and collectively stopped smoking on the 2nd day after admission. All participants completed the therapy process without relapse and left the hospital smoke-free (100% quit rate on discharge, CO monitored). Self-reported abstinence rates after 6 months were 72.7% for continuous abstinence and 81.8% for 7-day point prevalence abstinence. CONCLUSIONS: Residential treatment exclusively for smoking cessation is feasible and efficient and may be a valuable treatment option for patients suffering from CD.

Can motivational interviewing for dental settings be taught online? Results of an uncontrolled interventional trial.

BACKGROUND: Motivational interviewing (MI) is an evidence-based method of promoting oral healthcare behaviour. Conventional training of MI is a time-consuming and costly aspect in the dental curriculum. Therefore, the aim of this study was to evaluate the effectiveness and acceptance of a MI-blended learning programme for dental students. MATERIALS AND METHODS: Dental students had to perform an interdisciplinary created "ecourse Motivational Interviewing in medical settings" (eMI-med). After completion, patient-student interviews were recorded and evaluated using the Motivational Interviewing Treatment Integrity Code (MITI-d). Furthermore, the students' self-efficacy regarding smoking cessation and oral hygiene motivation was examined and the acceptance of the tool was enquired. RESULTS: Forty interviews with 25 different students were analysed with the MITI-d. Students showed high levels of MI-adherent behaviour (15.45 ± 6.98), open-ended questions (9.95 ± 6.90) and reflections (10.43 ± 8.85), which were comparable to previous classroom trainings. In addition, 90% of the students preferred e-learning over classroom teaching. Furthermore, the students' therapeutical self-efficacies were significantly increased by the programme. CONCLUSION: Within the limitations of this study, the created e-learning programme was able to equip dental students with basic knowledge and MI skills. Furthermore, learning MI through e-learning may heighten the self-efficacy of dental students regarding smoking cessation and oral hygiene promotion. Students showed a high acceptance of e-learning, preferring it over traditional learning.

Implementation and effectiveness of a hospital smoking cessation service in Germany.

OBJECTIVE: Hospitalized smokers are often highly motivated to quit and receptive to assistance. There are few published accounts of hospital-based smoking cessation programmes implemented outside of a trial setting, particularly outside North America. We describe the implementation and effectiveness of a dedicated smoking cessation service in Freiburg, Germany. METHODS: Measures of implementation (e.g. number of patients referred and consenting to participate, receipt of post-discharge support) and effectiveness are presented. RESULTS: In the first 2 years of the service, 1432 patients were referred. Over half (55.3%) of counselled smokers agreed to participate. Sustained abstinence for 6 months was achieved by 28.0% (missing cases coded as smokers), whereas 7-day point prevalence rates were between 30 and 35% at 3, 6 and 12 months. Those who received 4+ post-discharge calls were more likely to achieve sustained abstinence, as were older smokers, those with higher self-efficacy, and cardiovascular patients. CONCLUSION: Hospitalized patients in Germany are receptive to the offer of bedside counselling and to phone support post-discharge, and success rates are comparable to those achieved in other countries. PRACTICE IMPLICATIONS: The findings argue strongly for the routine identification of smokers upon hospital admission, and the availability of cessation support both during hospitalization and following discharge.

[Effect of isoflurane inhalation anesthesia on postoperative pain due to castration of piglets]. / Auswirkung einer Isofluran-inhalations- narkose auf den postoperativen Kastrationsschmerz von Ferkeln.

Since April 2006 piglets in Germany can only be castrated without anesthesia in the first 7 days of life. However, a castration is a painful experience even for an animal of this young age. Whether the castration under isoflurane-anesthesia is a reasonable alternative to castration without anesthesia was tested in the following investigation at 206 4 to 6 day old piglets. The serum-cortisol-concentration was chosen as the parameter for the pain caused by castration. A part of the animals was castrated without anesthesia (group II, n = 42) or with anesthesia (group IV, n = 41). Additionally Meloxicam, a non-steroidal anti-inflammatory drug, was applicated to piglets castrated with anesthesia (group V, n = 41). For control another part of the animals were only handled without (group I, n = 41) or with anesthesia (group III, n = 41), but they were not castrated. Cortisol-concentration prior to castration was compared to the concentration 0.5, 1,4 and 24 hours after castration. In addition cortisol was compared between groups at all points of time. Cortisol did rise significantly in castrated animals with animals with or without anesthesia than in animals of the non-castrated control groups. Cortisol after castration was significantly lower in piglets with an application of Meloxicam prior to castration. The pain caused by castration is an explanation for the differences in cortisol-concentration between castrated and not-castrated animals. Regarding those results, we assume that castration with isoflurane-anesthesia does not fulfil the demand for reducing pain after castration compared to castrating piglets without anesthesia.