[The home environment of families with children as address for a public health action for reduction of tobacco smoke]

AIM

There is limited research about the acceptance of population-based prevention activities, offered systematically and directly at home. Screening data about smoking behaviour in families with children younger than 3 years were used. We examined associations between family variables (education, employment, number of children in the household), the "proportion of persons on social welfare" (PPSW) in the population aged 15-65 years and the following dependent variables: participation rate in a systematic screening, proportion of smokers within the sample of screened families and participation rate in counselling.

METHODS

For postal and personal contacts reporting data of children aged < 3 years, resident in Stralsund (due date 01.06.2008, N=1 298) were used. A total number of 827 families participated in the screening. The counselling was offered if at least 1 adult had smoked at least 1 cigarette per day in the last 4 weeks. Associations between family variables, PPSW and dependent variables were analysed using multilevel statistics.

RESULTS

The higher the PPSP the lower is the probability for participation in the screening (odds ratio=0.982; 95% confidence interval=0.970-0.996). There was at least one adult smoker in 425 (51.4%) of these 827 families participating in the screening. The counselling was offered in 425 families, whereby 65.9% (280) participated. There was no association between family variables, PPSW and participation in the counselling.

CONCLUSION

Differences in participation in the screening procedure are low: a high proportion of families in districts with a high PPSW took part. Even in districts with a PPSW rate of more than 30%, 71.3% of the families were successfully contacted. There is the recommendation to offer prevention measures in social< deprived city areas in a more proactive way considering the association between the prevalence of smoking in families and the proportion of PPSW.

[Internet and mobile phone interventions to decrease alcohol consumption and to support smoking cessation in adolescents: a review]

OBJECTIVE

The aim of this study was to review the published literature on Internet and mobile phone interventions to decrease alcohol consumption and for smoking cessation in adolescents.

METHODS

Electronic searches of PubMed, MEDLINE, Web of Science, PsycINFO, ERIC, and the Cochrane Register of Controlled Trials were conducted in August 2009. Additionally, reference lists of previously published reviews and meta-analyses within this topic were checked. Studies, published in scientific journals, containing English abstracts, and reporting results about the effectiveness of an intervention were included into the review.

RESULTS

Initial searches in the literature databases identified 2 263 articles of which 31 were eligible for inclusion in this review: 19 articles address internet interventions to decrease alcohol consumption, 7 Internet interventions for smoking cessation, and 5 mobile phone text messaging interventions for smoking cessation. No articles concerning mobile phone interventions to decrease alcohol consumption in adolescents were identified. 16 out of the 19 studies that aimed at decreasing alcohol consumption by the use of the Internet were conducted in college or university students from the United States or New Zealand and the majority of these studies were based on the social norms approach. Good empirical evidence exists concerning the efficacy of web-based social norms interventions to decrease alcohol consumption in students. In the field of smoking cessation, Internet interventions are much more heterogeneous concerning the target group and the provided interventions. So far, 5 controlled studies concerning Internet interventions for smoking cessation in adolescents are available, 2 of these studies were effective in decreasing the smoking prevalence at the last follow-up. Interventions using mobile phone text messaging for smoking cessation were well accepted and promising; however, they were primarily tested within pilot studies and conclusions about their efficacy are not possible so far.

CONCLUSION

Suggestions for the implementation of certain intervention approaches in Germany could not be derived from the existing studies. For research in Germany, it is suggested to work on the following topics: (1) testing the efficacy of web-based social norms interventions to decrease alcohol consumption in student and non-student samples, (2) testing the efficacy of Internet interventions for smoking cessation, and (3) testing the efficacy of text messaging interventions for smoking cessation.

Regulation of liver metabolism by the hepatic nerves

In the isolated rat liver perfused as usual via the portal vein, joint electrical stimulation of the nerve fibers around the artery and the portal vein in the liver hilus increased glucose output, shifted lactate uptake to output, decreased urea and glutamine formation as well as ammonia uptake, reduced ketone body production, lowered oxygen uptake and reduced perfusion flow simultaneously changing the intrahepatic flow distribution; it was accompanied by an overflow of noradrenaline into the hepatic vein. All effects were mediated predominantly via alpha-receptors; they were dependent on extracellular calcium. In livers perfused both via the artery and the portal vein, separate stimulation of the plexus at the common hepatic artery or at the portal vein caused similar effects on glucose and lactate balance and on perfusion flow. Arterial stimulation caused the higher metabolic responses and alterations not only in arterial but also 'transhepaticly' in portal flow, and conversely, portal flow elicited the smaller metabolic responses and alterations in both portal and 'transhepaticly' arterial flow. If sympathetic nerve actions were blocked using alpha- and beta-antagonists, the resulting parasympathetic stimulation increased glucose uptake in the presence of insulin and antagonized the glucagon stimulated glucose release, both alone and more strongly in the presence of insulin. The sympathetic nerves may act directly at the parenchymal cells or indirectly via an overflow of neurotransmitter from the vasculature into the sinusoids or via hemodynamic changes. Experiments with the smooth muscle relaxant sodium nitroprusside and with retrograde flow indicate that neither hemodynamic changes nor noradrenaline overflow from the vasculature can play a major role in the mechanism of action of sympathetic liver nerves on glucose and lactate metabolism. Comparative studies with perfused livers of rats, guinea pigs and tupaias are in line with the view that in the rat the sympathetic nerves act via contacts with only a few periportal hepatocytes, from where the signal is propagated through gap junctions, while in guinea pig and tupaia the nerves act via contacts with almost all parenchymal cells. Sympathetic nerve stimulation of the perfused rat liver caused an increase in the activity of glycogen phosphorylase and a decrease of glycogen synthase, but left the activity of pyruvate kinase unaltered; fructose 2,6-bisphosphate and cAMP were only slightly enhanced.(ABSTRACT TRUNCATED AT 400 WORDS)

Control of glycogenolysis and hemodynamics in perfused rat liver by the sympathetic innervation. Dependence on stimulation frequency and duration

Perivascular stimulation of the hepatic nerves in the in situ perfused rat liver with a constant frequency of 20 Hz over a constant period of 5 min had previously been shown to cause an increase of glucose output, a shift from lactate uptake to release, a reduction in perfusion flow (Hartmann et al. (1982) Eur. J. Biochem. 123, 521-526) and an overflow of noradrenaline into the hepatic vein (Beckh et al. (1982) FEBS Lett. 149, 261-265). In the present study the dependence of the metabolic and hemodynamic effects on the frequency between 1 and 30 Hz and duration of stimulation between 0.5 and 5 min was investigated. Over a constant stimulation period of 5 min the alteration in glucose exchange was maximal with a frequency of 10 Hz and half-maximal with 4 Hz. The corresponding values for the exchange of lactate were 5 Hz and 2 Hz, respectively, and for the perfusion flow 2.5 Hz and 1.5 Hz, respectively. An increase of noradrenaline overflow was not observed with the lower frequencies of 1 and 2.5 Hz; it was maximal at 10 Hz and half-maximal at 6.5 Hz. At a constant frequency of 20 Hz the increase in glucose release was maximal with a total stimulation period of 1 min and half-maximal with a period of 0.4 min. An essentially maximal alteration of lactate exchange and perfusion flow as well as of noradrenaline overflow was also effected by a stimulation period of 1 min.(ABSTRACT TRUNCATED AT 250 WORDS)