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Background

Tobacco remains the world’s leading preventable cause of death, with the majority of tobacco-caused deaths occurring in low- and middle-income countries. The first global health treaty, the Framework Convention on Tobacco Control (FCTC), outlines a set of policy initiatives that have been demonstrated as effective in reducing tobacco use. Article 11 of the FCTC focuses on using the tobacco package to communicate tobacco-caused harms; it also seeks to restrict the delivery of misleading information about the product on the pack.

Objective

The objective of this study was to establish a surveillance system for tobacco packs in the 14 low- and middle-income countries with the greatest number of smokers. The Tobacco Pack Surveillance System (TPackSS) monitors whether required health warnings on tobacco packages are being implemented as intended, and identifies pack designs and appeals that might violate or detract from the communication of harm-related information and undermine the impact of a country’s tobacco packaging laws. The protocol outlined is intended to be applicable or adaptable for surveillance efforts in other countries.

Methods

Tobacco packs were collected in 14 countries during 2013. The intention was, to the extent possible, to construct a census of “unique” pack presentations available for purchase in each country. The TPackSS team partnered with in-country field staff to implement a standardized protocol for acquiring packs from 36 diverse neighborhoods across three cities in each country. At the time of purchase, data on price and place of acquisition of each pack was recorded. The field staff, according to a standardized protocol, then photographed packs before they were shipped to the United States for coding and archiving.

Results

Each pack was coded for compliance with the country-specific health warning label laws, as well as for key design features of the pack and appeals of the branding elements. The coding protocols were developed based upon prior research, expert opinion, and communication theories. Each pack was coded by two independent coders, with consistency of personnel across the project. We routinely measured intercoder reliability, and only retained variables for which a good level of reliability was achieved. Variables where reliability was too low were not included in final analyses, and any inconsistencies in coding were resolved on a daily basis.

Conclusions

Across the 14 countries, the TPackSS team collected 3307 tobacco packs. We have established a publicly accessible, Internet archive of these packs that is intended for use by the tobacco control policy advocacy and research community.  相似文献   
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Annals of Hematology - Despite the low risk of peripherally inserted central catheter (PICC) insertion-related bleeding, the practice of administering prophylactic platelets varies greatly....  相似文献   
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Folayan  Morenike Oluwatoyin  Ibigbami  Olanrewaju  Brown  Brandon  El Tantawi  Maha  Uzochukwu  Benjamin  Ezechi  Oliver C.  Aly  Nourhan M.  Abeldaño  Giuliana Florencia  Ara  Eshrat  Ayanore  Martin Amogre  Ayoola  Oluwagbemiga O.  Osamika  Bamidele Emmanuel  Ellakany  Passent  Gaffar  Balgis  Idigbe  Ifeoma  Ishabiyi  Anthonia Omotola  Jafer  Mohammed  Khan  Abeedha Tu-Allah  Khalid  Zumama  Lawal  Folake Barakat  Lusher  Joanne  Nzimande  Ntombifuthi P.  Popoola  Bamidele Olubukola  Quadri  Mir Faeq Ali  Rashwan  Maher  Roque  Mark  Shamala  Anas  Al-Tammemi  Ala’a B.  Yousaf  Muhammad Abrar  Abeldaño Zuñiga  Roberto Ariel  Okeibunor  Joseph Chukwudi  Nguyen  Annie Lu 《AIDS and behavior》2022,26(3):739-751
AIDS and Behavior - The aim of the study was to assess if there were significant differences in the adoption of COVID-19 risk preventive behaviors and experience of food insecurity by people living...  相似文献   
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Objectives

The purpose of this study was to describe patients with severe symptomatic aortic stenosis with normal flow and low gradients and determine whether they benefit from intervention.

Background

Severe symptomatic aortic stenosis is a progressive disease with high mortality. Although surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR) are indicated for patients with high gradients (>40 mm Hg) or low gradients due to low flow, the approach for patients with normal flow and low gradients is poorly defined.

Methods

Consecutive adult patients who underwent echocardiography between 2012 and 2015 at Tel-Aviv Medical Center and had an aortic valve area of ≤1.0 cm2, a mean gradient of <40 mm Hg, a stroke volume index of >35 ml/m2, and symptoms formed the study group. Patients designated for intervention (SAVR or TAVR) had their procedure within 6 months of the echocardiogram; the others were treated conservatively. The endpoints were all-cause mortality and cardiac-related mortality.

Results

During the study period, 1,358 patients with an aortic valve area of ≤1.0 cm2 and symptoms were identified; 34% of these had normal flow and low gradient aortic stenosis and 303 were included. After mean follow-up of 652 days, 60 patients (20%) had died, with overall mortality rates of 28%, 10%, and 12% for conservatively treated, TAVR, and SAVR patients, respectively (p < 0.001). Using Cox regression with adjustment for other variables, TAVR was associated with improved survival versus conservative treatment (hazard ratio [HR]: 0.49; 95% confidence interval [CI]: 0.26 to 0.93; p = 0.03), and lower cardiac mortality (HR: 0.30; 95% CI: 0.10 to 0.74; p = 0.007) with no significant difference for SAVR versus TAVR. After propensity score matching of TAVR and conservatively treated patients, 25 of 94 (28%) conservatively treated and 10 of 94 (12%) TAVR patients had died (p = 0.016). In the matched cohort, Cox regression showed that TAVR had a significant association with improved survival (HR: 0.42; 95% CI: 0.20 to 0.86; p = 0.03).

Conclusions

Symptomatic patients with an aortic valve area of ≤1.0 cm2, normal flow, and low gradient may benefit from intervention as opposed to conservative treatment.  相似文献   
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