Impact of Traditional and New Media on Smoking Intentions and Behaviors: Secondary Analysis of Tasmania's Tobacco Control Mass Media Campaign Program, 2019-2021.

BACKGROUND: Tasmania, the smallest state by population in Australia, has a comprehensive tobacco control mass media campaign program that includes traditional (eg, television) and "new" channels (eg, social media), run by Quit Tasmania. The campaign targets adult smokers, in particular men aged 18-44 years, and people from low socioeconomic areas. OBJECTIVE: This study assesses the impact of the 2019-2021 campaign program on smokers' awareness of the campaign program, use of Quitline, and smoking-related intentions and behaviors. METHODS: We used a tracking survey (conducted 8 times per year, immediately following a burst of campaign activity) to assess campaign recall and recognition, intentions to quit, and behavioral actions taken in response to the campaigns. The sample size was approximately 125 participants at each survey wave, giving a total sample size of 2000 participants over the 2 years. We merged these data with metrics including television target audience rating points, digital and Facebook (Meta) analytics, and Quitline activity data, and conducted regression and time-series modeling. RESULTS: Over the evaluation period, unprompted recall of any Quit Tasmania campaign was 18%, while prompted recognition of the most recent campaign was 50%. Over half (52%) of those who recognized a Quit Tasmania campaign reported that they had performed or considered a quitting-related behavioral action in response to the campaign. In the regression analyses, we found having different creatives within a single campaign burst was associated with higher campaign recall and recognition and an increase in the strength of behavioral actions taken. Higher target audience rating points were associated with higher campaign recall (but not recognition) and an increase in quit intentions, but not an increase in behavioral actions taken. Higher Facebook advertisement reach was associated with lower recall among survey participants, but recognition was higher when digital channels were used. The time-series analyses showed no systematic trends in Quitline activity over the evaluation period, but Quitline activity was higher when Facebook reach and advertisement spending were higher. CONCLUSIONS: Our evaluation suggests that a variety of creatives should be used simultaneously and supports the continued use of traditional broadcast channels, including television. However, the impact of television on awareness and behavior may be weakening. Future campaign evaluations should closely monitor the effectiveness of television as a result. We are also one of the first studies to explicitly examine the impact of digital and social media, finding some evidence that they influence quitting-related outcomes. While this evidence is promising for campaign implementation, future evaluations should consider adopting rigorous methods to further investigate this relationship.

Problem-solving training: assessing the feasibility and acceptability of delivering and evaluating a problem-solving training model for front-line prison staff and prisoners who self-harm.

OBJECTIVES: Problem-solving skills training is adaptable, inexpensive and simple to deliver. However, its application with prisoners who self-harm is unknown. The study assessed the feasibility and acceptability of a problem-solving training (PST) intervention for prison staff and prisoners who self-harm, to inform the design of a large-scale study. DESIGN AND SETTING: A mixed-methods design used routinely collected data, individual outcome measures, an economic protocol and qualitative interviews at four prisons in Yorkshire and Humber, UK. PARTICIPANTS: (i) Front-line prison staff, (ii) male and female prisoners with an episode of self-harm in the previous 2 weeks. INTERVENTION: The intervention comprised a 1 hour staff training session and a 30 min prisoner session using adapted workbooks and case studies. OUTCOMES: We assessed the study processes-coverage of training; recruitment and retention rates and adequacy of intervention delivery-and available data (completeness of outcome data, integrity of routinely collected data and access to the National Health Service (NHS) resource information). Prisoner outcomes assessed incidence of self-harm, quality of life and depression at baseline and at follow-up. Qualitative findings are presented elsewhere. RESULTS: Recruitment was higher than anticipated for staff n=280, but lower for prisoners, n=48. Retention was good with 43/48 (89%) prisoners completing the intervention, at follow-up we collected individual outcome data for 34/48 (71%) of prisoners. Access to routinely collected data was inconsistent. Prisoners were frequent users of NHS healthcare. The additional cost of training and intervention delivery was deemed minimal in comparison to 'treatment as usual'. Outcome measures of self-harm, quality of life and depression were found to be acceptable. CONCLUSIONS: The intervention proved feasible to adapt. Staff training was delivered but on the whole it was not deemed feasible for staff to deliver the intervention. A large-scale study is warranted, but modifications to the implementation of the intervention are required.

Marine Mammal Lung Dynamics when Exposed to Underwater Explosion Impulse.

Very little is known about marine mammal susceptibility to primary blast injury (PBI) except in rare cases of opportunistic studies. As a result, traditional analysis techniques relied on methods developed more than 30 years ago using terrestrial mammals as surrogates. Modeling tools available today have the computing power to vastly improve calculation of safe ranges and injury zones from underwater explosions (UNDEX) employing morphologically accurate proxies with material properties similar to marine mammal tissues. The Dynamic System Mechanics Advanced Simulation (DYSMAS) fluid-structure interaction (FSI) software is being used to simulate the complex phenomena of UNDEX, shock wave, and bubble pulse propagation through the water and transmission of energy to a cetacean focusing on the dynamic response of the thoracic cavity and air-filled lungs to a shock wave. The approach integrates fluid and structural analyses with the material properties of blubber, bone, and muscle using marine mammal morphometrics to eliminate unnecessary assumptions made during more traditional approaches to analysis developed before these types of data and computational power were available. DYSMAS analyses of a 1D gas bubble surrounded by water was found to closely match the classical bubble dynamics models. Further, DYSMAS models of a spherical gas bubble surrounded by tissue and rib structure demonstrate a global radial oscillation of the gas bubble, but also show significant local deflection and material strain in response to the UNDEX loading. The intended result of the investigation is an improved and scientifically defensible understanding of the effects of UNDEX on marine mammals. Anat Rec, 2018. © 2018 Wiley Periodicals, Inc. Anat Rec, 302:718-734, 2019. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Assessing attitudinal barriers toward end-of-life care.

Due to the rapid influx of Palliative care and Hospice services over the last decade, there has been an increase in the number of medical professionals interacting with terminal patients. One of the challenges with this growth becomes how to integrate these services into already busy practices along with providing physicians the education and tools they need to provide quality care. While there is no shortage of articles focusing on the educational needs of physicians related to end of life care, less is known about the level of anxiety physicians feel about interacting with dying patients and their families.

Public health in an industrial community: Port Kembla, 1907-2007.

This paper considers how various health agencies in New South Wales have responded to the issue of air pollution, particularly in Port Kembla since the end of World War II when levels rose dramatically and residents began calling for something to be done. Several shortcomings surrounding the production of the report of the NSW government-appointed Smoke Abatement Committee in the 1950s created the foundation for a tradition of inadequate research into the effects of industrial contamination on public health, and of legislation which sought to address environmental amenity rather than risks to public health. The reopening of a copper smelter in Port Kembla in 1997 demonstrated a continued policy to relegate the impacts on public health to a low priority consideration and is a damning reflection on more than fifty years of inquiry.

The relative benefits and cost of medicaid home- and community-based services in Florida.

PURPOSE: We compared inpatient days, nursing home days, and total Medicaid claims for five Medicaid-funded home- and community-based services (HCBS) programs for in-home and assisted living services in Florida. DESIGN AND METHODS: We studied a single cohort of Medicaid enrollees in Florida aged 60 and older, who were enrolled for the first time in any of five Medicaid HCBS programs and who had at least one assessment (N=6,014). In this 3-year longitudinal study, we used a two-stage probit regression and ordinary least squares regression in order to test the independent effects of explanatory variables on outcomes and cost. RESULTS: After controlling for differences in frailty, chronic health conditions, presence of dementia, and available caregiver, we found that Medicaid HCBS programs had a differential effect on hospital and nursing home utilization and cost. IMPLICATIONS: Medicaid HCBS programs serve very impaired populations at a wide range of costs to Medicaid. The rates for Medicaid HCBS programs could be adjusted upward or downward in order to better reflect the level of need in each program. At the same time, providers could use titration techniques based on the relative costs of these needs in order to budget for the costs of meeting the needs of particular elders.

An empirical comparison of record linkage procedures.

We consider the problem of record linkage in the situation where we have only non-unique identifiers, like names, sex, race etc., as common identifiers in databases to be linked. For such situations much work on probabilistic methods of record linkage can be found in the statistical literature. However, although many groups undoubtedly still use deterministic procedures, not much literature is available on deterministic strategies. Furthermore, there appears to exist almost no documentation on the comparison of results for the two strategies. In this work we compare a stepwise deterministic linkage strategy with a probabilistic strategy, as implemented in AUTOMATCH, for a situation in which the truth is known. The comparison was carried out on a linkage between medical records from the Regional Perinatal Intensive Care Centers database and educational records from the Florida Department of Education. Social security numbers, available in both databases, were used to decide the true status of each record pair after matching. Match rates and error rates for the two strategies are compared and a discussion of their similarities and differences, strengths and weaknesses is presented.