Data on flower resources for pollinators in Romanian semi-natural grasslands mown at different times

Semi-natural grasslands are hotspots of biodiversity in Europe and provide amounts of flower resources for pollinators. We present data on composition and spatial turnover of herb species and flower resources in and between semi-natural grasslands in Romania mown at different times during the growth season (early, intermediate, late). The data include herb species occurrences, their phenological stage, flower resources, and measures of spatial turnover of the species occurrences and flower resources based on Detrended Correspondence Analyses (DCA), in the start of August. The dataset is provided as supplementary material and associated with the research article “Traditional semi-natural grassland management with heterogeneous mowing times enhances flower resources for pollinators in agricultural landscapes” [1] Johansen et al.. See Johansen et al. for data interpretation.

'Despite Circumstance': The Principles of Medical Ethics and the Role of Hope

In this paper, I will examine how the role of hope can inform our interpretation of the classical principles of medical ethics. Defining hope as a future-oriented expectation for the good, I will look at how it can shape our understanding of justice, beneficence, respect for autonomy and non-maleficence. I will suggest that ethically engaging with these principles in medical practice requires placing value on the patient-practitioner relation as a mode of hope. Engaging the writings of Emmanuel Lévinas and Søren Kierkegaard, I will show how hope reveals itself through responsible and expectant relationship, even in the midst of suffering.

The Potentiality of a Healthy Self: Evaluating Progressively Empowered Internalisation and Diagnosis through the Lens of Existential Epistemology

In this article I will examine how the language of diagnosis can engage with existential epistemology to develop a concept of Progressively Empowered Internalisation (PEI). This, I will argue, challenges conceptualisations of diagnosis as articulating and maintaining a static self-concept. It enables the individual to synthesise the language of a particular mental experience within the wider engagement of their own active process of self-becoming. I will suggest that this construction of PEI addresses the limitations of stigmatisation and static self-concepts. In seeing the language of diagnosis as a helpful tool for understanding a part of one's self-experience, it presents an alternative to the illness-based model of mental health. This conceptualisation engages with Kierkegaard's existential epistemology, as a means of using language to understand the task of becoming oneself and relating to others. Furthermore, it explores how mental health diagnosis requires communal engagement to enable the wellbeing of its members. Diagnosis is thereby seen as a process of further empowering the individual with the language to explain a particular part of their experience within the overall movement of developing an integrated self-concept.

The harms of prostitution: critiquing Moen's argument of no-harm

In this short critical analysis, the author examines the recent argument by Moen in his article 'Is Prostitution Harmful?' In highlighting why prostitution does not cause harm to either member involved in the act, Moen argues that prostitution is not an ethical concern. However, while Moen is able to clearly challenge contemporary objections to prostitution, the author of this review will suggest that Moen's argument is itself incomplete as it does not address essential key ontological issues. This critical analysis will briefly suggest why this omission weakens Moen's argument. Finally, it will conclude with examining why prostitution differs substantially from other professions through the type of harm that it causes to the moral agents involved.

Are evolving human rights harmless? An examination of English legislation, prostitution and its effect on human relatedness

This paper addresses key philosophical and social questions that shape the contemporary discourse on prostitution. The initial section outlines the contemporary challenges facing legislative practice on prostitution in England. This involves analysing moral and legal framework surrounding prostitution that has made the current legislative dilemma surrounding prostitution practice possible. The second part of the paper then outlines the history of the philosophy of human rights from Aquinas to the Universal Declaration of Human Rights (1948). The paper concludes by analysing whether the current ontology employed by human rights theory is effective in creating a system of just relatedness between agents, made visible in concrete legislative guidance. I argue that legislation guided by a fragmented teleology and ontological anthropology enables asymmetrical patterns of relatedness that can cause genuine physical and psychological harm to individuals.

Some health physics aspects of working with 203Hg in university research

The radioisotope 203Hg is used in university toxicology research experiments. When our commercial vendor ceased the production of the high specific activity 203Hg we required, an alternative source was sought. Other commercial sources were investigated without success leaving the synthesis of this radioisotope to us. This paper outlines the method we used to synthesize 203Hg and provides a summary of our results to date and a discussion of our experiences.

Smoking reduction with oral nicotine inhalers: double blind, randomised clinical trial of efficacy and safety

OBJECTIVES

To determine whether use of an oral nicotine inhaler can result in long term reduction in smoking and whether concomitant use of nicotine replacement and smoking is safe.

DESIGN

Double blind, randomised, placebo controlled trial. Four month trial with a two year follow up.

SETTING

Two university hospital pulmonary clinics in Switzerland.

PARTICIPANTS

400 healthy volunteers, recruited through newspaper advertisements, willing to reduce their smoking but unable or unwilling to stop smoking immediately.

INTERVENTION

Active or placebo inhaler as needed for up to 18 months, with participants encouraged to limit their smoking as much as possible.

MAIN OUTCOME MEASURES

Number of cigarettes smoked per day from week six to end point. Decrease verified by a measurement of exhaled carbon monoxide at each time point compared with measurement at baseline.

RESULTS

At four months sustained reduction of smoking was achieved in 52 (26%) participants in the active group and 18 (9%) in the placebo group (P<0.001; Fisher's test). Corresponding figures after two years were 19 (9.5%) and 6 (3.0%) (P=0.012).

CONCLUSION

Nicotine inhalers effectively and safely achieved sustained reduction in smoking over 24 months. Reduction with or without nicotine substitution may be a feasible first step towards smoking cessation in people not able or not willing to stop abruptly.

Open randomised trial of intermittent very low energy diet together with nicotine gum for stopping smoking in women who gained weight in previous attempts to quit

OBJECTIVE

To determine whether attempts to prevent weight gain will increase success rates for stopping smoking.

DESIGN

16 week, open, randomised study with 1 year follow up.

SETTING

Obesity unit.

SUBJECTS

287 female smokers who had quit smoking before but started again because of weight concerns.

INTERVENTION

Combination of a standard smoking cessation programme with nicotine gum and a behavioural weight control programme including a very low energy diet. A control group was treated with the identical programme but without the diet.

MAIN OUTCOME MEASURE

Sustained cessation of smoking.

RESULTS

After 16 weeks, 68/137 (50%) women had stopped smoking in the diet group versus 53/150 (35%) in the control group (P=0.01). Among these women, weight fell by mean 2.1 (95% confidence interval 2.9 to 1.3) kg in the diet group but increased by 1.6 (0.9 to 2.3) kg in the control group (P<0.001). After 1 year the success rates in the diet and control groups were 38/137 (28%) and 24/150 (16%) respectively (P<0.05), but there was no statistical difference in weight gain.

CONCLUSIONS

Combining the smoking cessation programme with an intervention to control weight helped women to stop smoking and control weight.

Nicotine nasal spray with nicotine patch for smoking cessation: randomised trial with six year follow up

OBJECTIVE

To evaluate the efficacy of using a nicotine patch for 5 months with a nicotine nasal spray for 1 year.

DESIGN

Placebo controlled, double blind trial.

SETTING

Reykjavik health centre.

SUBJECTS

237 smokers aged 22-66 years living in or around Reykjavik.

INTERVENTIONS

Nicotine patch for 5 months with nicotine nasal spray for 1 year (n=118) or nicotine patch with placebo spray (n=119). Treatment with patches included 15 mg of nicotine for 3 months, 10 mg for the fourth month, and 5 mg for the fifth month, whereas nicotine in the nasal spray was available for up to 1 year. Both groups received supportive treatment.

MAIN OUTCOME MEASURE

Sustained abstinence from smoking.

RESULTS

Sustained abstinence rates for the patch and nasal spray group and patch only group were 51% v 35% after 6 weeks (odds ratio 1.97, 95% confidence interval 1.17% to 3.32; P=0.011(chi2), 37% v 25% after 3 months (1.76, 1.01 to 3.08; P=0.045), 31% v 16% after 6 months (2.40, 1.27 to 4.50; P=0.005), 27% v 11% after 12 months (3.03, 1.50 to 6.14; P=0.001), and 16% v 9% after 6 years (2.09, 0.93 to 4.72; P=0.08) [corrected].

CONCLUSIONS

Short and long term abstinence rates show that the combination of using a nicotine patch for 5 months with a nicotine nasal spray for 1 year is a more effective method of stopping smoking than using a patch only. The low percentage of participants using the nasal spray at 1 year, and the few relapses during the second year, suggest that it is not cost effective to use a nasal spray for longer than 7 months after stopping a patch.

A double-blind randomized trial of nicotine nasal spray as an aid in smoking cessation

The objective of the study was to evaluate the therapeutic efficacy of nicotine nasal solution (NNS) for smoking cessation from the stopping day up to 3 months. We also followed the participants for 2 yrs after ceasing smoking to assess what happens after stopping using NNS. In a placebo-controlled, double-blind, 2 yr prospective study, 157 smokers were given either NNS, one dose containing 1 mg of nicotine per 100 microL (n=79), or placebo (n=78). Treatment was continued for up to 1 yr. One day after quitting smoking, the average number of daily doses was 11 in the group assigned NNS and 14 in the group assigned the placebo, and after 6 weeks, 14 and 6 doses, respectively, among abstinent participants still using spray. After 3 months, 65% of the abstainers in the nicotine group were still using the NNS. The abstinence rates were 51, 39 and 29% after 6 weeks, 3 and 6 months, respectively, as compared to 24, 19 and 18% in the placebo group (p=0.0003; p=0.003; p=0.050). The proportion abstinent at the 1 yr (25 vs 17%) and 2 yr follow-ups (19 vs 14%) was higher among those assigned to the nicotine than to the placebo group, but not significantly so for the numbers used in the study. In conclusion, the use of nicotine nasal spray significantly increased the abstinence rate during the first 6 months following the quitting day.

Aiding reduction of smoking with nicotine replacement medications: hope for the recalcitrant smoker?

OBJECTIVE

To assess the effect of the various nicotine replacement therapies (NRT) on smoking reduction.

DESIGN

During an initial sampling week, the subjects familiarised themselves with nicotine gum, patch, nasal spray, vaporiser (vapour inhaler) and sublingual tablet. A crossover design was used during the next four study weeks; during two of these weeks the subjects could select one nicotine replacement product of their choice to use, whereas during the other two they were randomly assigned a product to use.

SUBJECTS

143 men and women smoking an average of 22.6 (SD 7.0) cigarettes per day and exhibiting a Fagerström Tolerance Questionnaire (FTQ) score of 7.0 (SD 1.9).

INTERVENTIONS

Subjects were asked to use as much NRT as they wished, yet to smoke enough to feel comfortable.

MAIN OUTCOME MEASURES

Self-reported cigarette consumption, exhaled carbon monoxide (CO), withdrawal symptom score, cotinine plasma levels and motivation to quit were monitored over a period of five weeks.

RESULTS

Self-reported smoking declined steadily over the five weeks, from 22.6 (SD 7.0) to 10.4 (SD 1.0) (P<0.001) cigarettes daily (54% decrease), with the biggest drop (37%) during the first product-sampling week. Smoking reduction was greater on average during the weeks when the subjects could choose their nicotine product than when products were assigned. CO readings decreased from 22.7 (SD 8.5) to 14.8 (SD 8.4) ppm (P<0.001) confirming a reduction in smoking (35% decrease), although cotinine levels remained steady, suggesting that subjects were titrating nicotine to their original levels. Withdrawal scores decreased over time (32% decrease, P<0.001), showing that there was no discomfort associated with the smoking reduction, and motivation to quit was enhanced by the treatment in most subjects (93%).

CONCLUSIONS

NRT for aiding smoking reduction appeared to be safe, was associated with a clinically significant reduction in smoke exposure over a five-week follow up, and increased motivation to stop smoking. A smoking reduction procedure may help the very recalcitrant smoker gain confidence and increase the control over his/her smoking behaviour. More controlled research is needed to follow up these promising results.

Effect of nicotine nasal spray on smoking cessation. A randomized, placebo-controlled, double-blind study

BACKGROUND

Nicotine replacement therapies have proved to be of value in smoking cessation. However, not all smokers can use the nicotine gum or nicotine patch owing to side effects. In addition, the absorption of nicotine from these formulas is slow compared with smoking. A nicotine nasal spray delivers nicotine more rapidly. The objective of this study was to evaluate the efficacy and safety of the nicotine nasal spray for smoking cessation.

METHODS

Subjects were recruited through advertisements in newspapers and among patients referred to the smoking cessation clinic at Sahlgren's Hospital, Göteborg, Sweden. Two hundred forty-eight smokers were treated in small groups with eight counseling sessions over 6 weeks. At their first group session, subjects were randomized to a group receiving nicotine spray (n = 125), 0.5 mg of nicotine per single spray, or to a placebo group (n = 123). The procedure was double blind. Success rates were measured up to 12 months. The nonsmoking status was verified by expired carbon monoxide less than 10 ppm.

RESULTS

Significantly more subjects in the nicotine group were continuously abstinent for 12 months than in the placebo group (27% vs 15%; odds ratio, 2.16; 95% confidence interval, 1.15 to 4.12). Ten of the 34 abstinent subjects in the nicotine group used the spray for 1 year. Mild or moderate side effects were rather frequent for both sprays, but they were significantly more for the nicotine spray. Subjects with high scores (> 7) on Fagerström's tolerance questionnaire had a significantly lower success rate with placebo than with the nicotine spray. For subjects with low scores, there was no difference.

CONCLUSION

Nicotine nasal spray in combination with group treatment is an effective aid to smoking cessation.