Have yourself a 'merry' little Christmas: Alcohol adverts and alcohol content within adverts in the run-up to Christmas.

Exposure to alcohol adverts or other audio-visual content (AVC) in the media is associated with alcohol initiation and subsequent use by adolescents and adults, especially those with or at risk of an alcohol use disorder. The Christmas period is characterised by increased alcohol consumption and there may be an increase in alcohol advertisements during this period. The current study explored the number of alcohol advertisements shown on UK television in a sample of days in the run-up to Christmas 2022 and found that alcohol advertisements were commonly shown but alcohol was also seen in advertisements for other things such as supermarkets. The amount of alcohol shown is likely to encourage drinking and make Christmas a difficult time for people with alcohol use disorders or who are in recovery.

Integrating the patients' voice in designing and delivering a research study: The Yorkshire Cancer Research funded PREHABS study's experience.

INTRODUCTION: Engaging with patients when designing a clinical or research project is beneficial; feedback from the intended audience provides invaluable insight form the patients' perspective. Working with patients can result in developing successful research grants and interventions. The benefit of including the voice of the patient in the Yorkshire Cancer Research funded PREHABS study is described in this article. METHODS: Patients were included in the PREHABS study from inception to completion. The Theory of Change methodology was used to provide a framework to implement patient feedback to refine the study intervention. RESULTS: In total, 69 patients engaged with the PREHABS project. Two patients were recruited as co-applicants on the grant and were members on the Trial Management Group. Six patients attended the pre application workshop and provided feedback on their lived experiences of being a lung cancer patient. Commentary from the patients influenced the interventions selected and the design of the prehabs study. Following ethical approval (21/EE/0048) and informed written consent, 61 patients were recruited into the PREHABS study between October 2021 and November 2022. The breakdown of recruited patients was 19 males: mean age 69.1 years (SD 8.91) and 41 females; mean age 74.9 years (SD 8.9). CONCLUSION: It is practicable and beneficial to include patients at all stages of designing and delivering a research study. Patient feedback can help refine the study interventions to allow for maximum acceptance, recruitment and retention. IMPLICATIONS FOR PRACTICE: Including patients in the design of radiotherapy research studies can provide invaluable insight that can support the selection and delivery of interventions that are acceptable to the patient cohort.

Early Diagnosis and Lung Cancer Screening.

Lung cancer remains the most significant cause of cancer death, accounting for about 20% of all cancer-related mortality. A significant reason for this is delayed diagnosis, either due to lack of symptoms in early-stage disease or presentation with non-specific symptoms common with a broad range of alternative diagnoses. More is needed in terms of increasing public awareness, providing adequate healthcare professional education and implementing clinical pathways that improve the earlier diagnosis of symptomatic lung cancer. Low-dose computed tomography screening of high-risk, asymptomatic populations has been shown to reduce lung cancer mortality, with focus now shifting towards how best to implement lung cancer screening on a wider scale in a safe, efficient and cost-effective manner. For maximum benefit, efforts must be made to optimise uptake, especially among high-risk populations with significant socioeconomic deprivation, as well as successfully incorporate tobacco-dependency treatment. Quality assured programme management will be critical to minimising screening-related harms and adequately managing incidental findings. By undertaking the above, there can be optimism that lung cancer outcomes can be improved significantly in the near future.

Prehabilitation and Rehabilitation for Patients with Lung Cancer: A Review of Where we are Today.

Lung cancer is the third most common type of cancer in the UK, with nearly 50 000 new cases diagnosed a year. Treatments for lung cancer have improved in recent years with the advent of new surgical and radiotherapy techniques and the increased use of immunotherapies. These advances have resulted in increasing numbers of patients surviving beyond the completion of their treatment. Lung cancer patients are now not dying from their cancer diagnosis, but from other co-existing pathologies. Lung cancer patients commonly present with multiple comorbidities. Mitigating the effects of poor lifestyles and changing behaviours may improve the efficacy of treatments, reduce side-effects and improve the quality of life for lung cancer patients. Published evidence supports the use of interventions to manage behavioural habits, to optimise the health of patients. There is no consensus as to what, when or how to embed these into the patient pathway. Supporting patients before, during and after their cancer treatments to increase activity, eat well and stop smoking have been seen to decrease side-effects and improve patient outcomes and wellbeing. The challenge is to provide a package of interventions that is acceptable to patients and fits within the patient pathway so as not to conflict with diagnostic and therapeutic activities. This article reviews where we are today with providing behavioural support to optimise the health of lung cancer patients undergoing treatment.

Systematic identification and treatment of smokers by hospital based cessation practitioners in a secondary care setting: cluster randomised controlled trial.

OBJECTIVES: To investigate the effectiveness of the systematic default provision of smoking cessation support to all adult smokers admitted to hospital, relative to usual care. DESIGN: Open, cluster randomised controlled trial. SETTING: Acute medical wards in one large teaching hospital in the United Kingdom. PARTICIPANTS: 264 patients randomised to intervention and 229 to usual care; primary outcome data were available at four weeks for 260 and 224 patients, respectively. All adult smokers and recent ex-smokers able to give informed consent were eligible for entry into the study. INTERVENTIONS: The intervention comprised systematic smoking ascertainment and default provision of behavioural support and cessation pharmacotherapy for the duration of the hospital stay for all smokers and recent ex-smokers, with follow-up and referral to community services after discharge. Usual care comprised cessation support delivered at the initiative and discretion of clinical staff. All staff and patients were aware of group assignment. MAIN OUTCOME MEASURES: Smoking cessation at four weeks, validated by measuring exhaled carbon monoxide. Secondary outcomes were uptake of inpatient behavioural support, use of cessation pharmacotherapy, referral to and uptake of community support after discharge, and validated smoking cessation at six months. Participants lost to follow-up were assumed to have reverted to smoking. RESULTS: All patients in the intervention group received at least brief advice to quit smoking, compared to 106 (46%) patients in the usual care group. Cessation at four weeks was achieved by 38% (n=98) of intervention patients and 17% (n=37) of usual care patients (adjusted odds ratio 2.10 (95% confidence interval 0.96 to 4.61), P=0.06, number of patients needed to treat 8). Uptake of inpatient behavioural support, use of pharmacotherapy, and referral to and uptake of community support after discharge were all substantially and statistically significantly higher in the intervention group than in the usual care group. Cessation at six months was achieved by 19% (n=47) of intervention and 9% (n=19) of usual care patients, although this difference was not significant (adjusted odds ratio 1.53 (95% confidence interval 0.60 to 3.91); P=0.37). CONCLUSIONS: Substantial improvements in smoking cessation among smokers admitted to hospital can be achieved by systematic ascertainment and delivery of cessation support in secondary care. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number ISRCTN25441641.

Pediatric lung transplantation: families' need for understanding.

Fifteen parents of 12 children who had undergone lung transplantation described their relationships with others, such as members of their extended family, coworkers, and friends prior to, during, and following the transplantation. We conducted a content analysis to formulate a narrative description of the parents' relationships with others. The parents described their relationships in terms of the support they received from them. Some parents described diminishing support in the posttransplantation period, which they attributed, in part, to a lack of understanding. This finding may reflect the influence that living with a physical condition with long-term consequences, such as lung transplantation, may have on some interpersonal relationships. Pediatric lung transplantation is an increasingly common treatment regimen for children with end-stage lung or pulmonary vascular disease. Promoting understanding of what it is like to live with a lung transplantation may help to maintain support for these families.

Making the transition: pediatric lung transplantation.

INTRODUCTION: Little information exists regarding how parents whose children have undergone lung transplantation perceive the meaning of their return home to face the reality of the posttransplant experience. METHOD: A naturalistic approach was selected to investigate the meaning of the experience from the perspective of the parents. Fifteen parents of 12 children were interviewed. Colaizzi's method of phenomenologic analysis guided the analysis of the interview data. RESULTS: A theme cluster, "making the transition," emerged from the data. The themes that reflected parents' perceptions of the issues they faced in the posttransplant period included reuniting the family, assuming a new role, returning to school, facing the risk of infection, facing the threat of rejection, and striking a balance. DISCUSSION: Parents' perceptions of the situation reflected the shifting impact of uncertainty on their daily lives and coping strategies. The need exists to recognize the parents' unique and changing needs and to implement individualized nursing care to meet their needs.

A descriptive study of insight into illness reported by persons with schizophrenia.

1. Four levels of insight, ranging from lack of insight to complete insight, emerged from the interview data and field notes. Insight has many dimensions although it has previously been assessed as a unidimensional indicator of illness. 2. Persons with schizophrenia differ in insight or ability to recognize that they have an illness and the ramifications of the illness. Successful participation in rehabilitation requires some degree of insight into the illness. 3. Consistent family support, medications, and cognitive efforts by the person contributed to the developing of insight by the persons interviewed. Nevertheless, these conditions were not always sufficient for developing insight.

Parents call for concerned and collaborative care.

Parents' perceptions and expectations of health care providers within the context of the pediatric lung transplant experience were investigated using a phenomenological approach. Fifteen parents of 12 children were interviewed. Two theme clusters, concerned care and collaborative care, were formulated. Themes that reflected parents' perceptions of concerned care included: being treated as an individual, seeing familiar faces, feeling that their children really mattered, and conversely, experiencing a feeling of abandonment. Parents' perceptions of collaborative care included: being part of the team, and conversely, feeling caught in the middle. The theme cluster, concerned care, reflected the value parents place on continuity of care. Humanistic nursing theory provided the link between study results and nursing practice.

Conceptualization and measurement of insight.

Insight is a complex phenomenon which has been conceptualized variously as a symptom of schizophrenia and as awareness of illness, making comparisons of studies measuring insight difficult. Furthermore, attempts to establish a correlation between insight and successful treatment outcomes are fraught with methodological problems. Specifically, categorical judgments fail to capture important information about the quality of insight; inappropriate inferential statistics have been used; and validity of instruments to measure insight has not been established. In future research, the concept of insight needs to be clarified. Nonparametric statistical analysis should be considered for small, nonnormally distributed samples. Qualitative exploratory research is needed.

King's conceptual framework applied to a transitional living program.

TOPIC: How Imogene King's theory of Goal Attainment was used as a theoretical framework for conceptualizing the role and function of a Transitional Residential Program for severely and persistently mentally ill homeless individuals. PURPOSE: To demonstrate how a nursing theory can be applied in the development of mental health services. SOURCE: King's theory and associated concepts of personal system, perception, communication, interaction, transaction, role, time, space, growth, and development. CONCLUSION: Achievement of client goals is possible within a social system characterized by mutual goal setting between clients and staff.

Evaluation of a transitional residential programme for homeless chronically mentally ill people.

This paper reports a successful transitional programme in the USA. The research programme evaluation covered 5.5 years and 228 severely and persistently mentally ill homeless clients who lived in a transitional residential centre. Forty-eight per cent of the residents achieved the Programme's goals of obtaining and maintaining permanent housing and a disability pension or a job. Achievement of client goals was positively related to length of stay of 3 months or more, to five or more previous psychiatric hospitalizations, and to participation in two or more ongoing activities whilst in the programme. Psychiatric diagnosis was not directly related to goal attainment in this programme.

Phosphate-binding properties and electrolyte content of aluminum hydroxide antacids.

The phosphate-binding capacities of 19 liquid and solid aluminum hydroxide gel antacids were determined in vitro under varying pH conditions. The resulting data provide a basis explaining the phosphate-binding characteristics observed when patients are treated with long-term aluminum hydroxide therapy. No antacid, liquid or solid, showed significant binding at pH 1.0. Maximum phosphate binding (expressed as phosphorus; P) was observed at pH 2.0 and 3.0 for most antacids and decreased markedly at alkaline pH. The liquid antacids showed a significantly greater phosphate-binding capacity than did tablets or capsules (p less than 0.01). At pH 2.0, the liquid antacids bound a mean of 22.3 mg P/5 ml. At pH 8.0 binding was reduced to a mean of 7.3 mg P/5 ml. Significant interbrand differences were observed. At pH 2.0, the solid antacids bound a mean of 15.3 mg P/tablet or capsule. At pH 8.0, binding was reduced to a mean of 5.8 mg P/tablet or capsule. Interbrand differences, while substantial, were less than those observed among the liquid antacids. Variations in sodium and potassium content were clinically insignificant for most of the antacids in this study, while the differences in phosphate-binding properties were sufficient to warrant attention in the patient with renal failure.

Body composition changes in the critically ill patient: emphasis on water balance.

The moisture contents of foods, fluids, and parenteral solutions taken in and of all samples excreted, the water of oxidation of fuel mixtures burned, and the evaporative water loss must be determined in order to obtain a quantitative picture of water balance. Because there is a tendency to retain water after trauma, surgery, or an acute illness, changes in the water compartment of the body may lead to changes in body weight that may be considered erroneously as changes in energy or protein stores. Measurement of water balance, in addition to calorie and nitrogen balance is one of the most accurate means of accounting for these changes in body composition. Fluid and electrolyte therapy and nutritional supplementation can be tailored to meet the patient's specific needs by utilizing this information. Application of these principles to the care of hospitalized patients outside of the research setting will be discussed.

The occurrence of actinlike filaments in association with migrating pigment granules in frog retinal pigment epithelium.

In the retina of the frog and certain other animals, melanin pigment granules move in response to light so as to shield photoreceptor outer segments. The granules are contained within the cells of the pigment epithelium (PE) which lie as a continuous sheet between the neural retina and the choroid. Moderate illumination of the eye causes the melanin granules to move from a region within a PE cell body into numerous fingerlike extensions of the cell which interdigitate with the receptor outer segments. This migration takes many minutes and is reversed when the light falling on the eye increases in intensity. Several reviews are concerned with the early descriptions of this phenomenon (6,30) and with more recent experiments (1,5,19). The mechanism of the pigment granule motion is undetermined although there are studies concerning PE ultrastructure (8, 23, 31), scanning electron microscopy of the fingerlike extensions of the PE cells (27), the role of the PE in photoreceptor phagocytosis (32), the nature of the pigment granules (19), and the action spectrum of the light which induces the migration (16). This study reports the presence of a system of microfilaments associated with the pigment granules in the fingerlike extensions processes of the PE cells. We demonstrate by heavy meromyosin (HMM) labeling that the filaments are actinlike in character and suggest that these filaments could be responsible for the migration of the melanin pigment granules.