Improving referral rates for smoking cessation: A multifaceted intervention aimed at radiation oncologists.

Objective: Continuation of smoking after a cancer diagnosis increases the burdensome side effects from cancer treatment, and decreases the chances of cure. Smoking cessation may improve oncological outcomes in cancer patients. This study aims to evaluate if radiation oncologists can be motivated by a smoking cessation awareness intervention to discuss smoking status more frequently and increase the referral rate for smoking cessation-support.Study design and Setting:A multifaceted approach was used to improve awareness: First, current practice was evaluated by a retrospective chart review of 282 patients referred for radiotherapy to ascertain smoking status, discussion of smoking cessation support and referral rates. Secondly, radiation oncologists were interviewed about their motives and barriers to discuss smoking status and smoking cessation support. The results were fed back in a teaching lecture to the doctors involved. Finally, the effect of this smoking cessation awareness intervention was prospectively evaluated in 100 patients. Results: After the smoking cessation awareness intervention, smoking cessation was more frequently discussed compared to baseline (77% (10/13)) and 39.5% (17/43) respectively. The referral rate for smoking cessation increased from 2.3% (1/43) to 69.2% (9/13). Conclusion: Without an active smoking prevention awareness policy, referral for smoking cessation support for cancer patients by radiation oncologists is low. A relatively short and simple smoking awareness intervention for radiation oncologist may result in a more frequent discussion with patients about smoking cessation and an even larger increase in referrals for smoking cessation support.

The effectiveness of smoking cessation interventions after cancer diagnosis: A systematic review and meta-analysis.

OBJECTIVES: patients with cancer who smoke have more side effects during and after treatment, and a lower survival rate than patients with cancer who quit smoking. Supporting patients with cancer to quit smoking should be standard care. The aim of this systematic review was to determine the most effective smoking cessation method for patients diagnosed with cancer. METHODS: PubMed, Embase, Web of Science and Google Scholar were systematically searched. Included were randomized controlled trials and observational studies published after January 2000 with any smoking cessation intervention in patients with any type of cancer. Result of these studies were evaluated in a meta-analysis. RESULTS: A total of 18,780 papers were retrieved. After duplicate removal and exclusion based on title and abstract, 72 publications were left. After full text screening, 19 (randomized) controlled trials and 20 observational studies were included. The overall methodological quality of the included studies, rated by GRADE criteria, was very low. Two out of 21 combined intervention trials showed a statistical significant effect. Meta-analysis of 18 RCTs and 3 observational studies showed a significant benefit of combined modality interventions (OR 1.67, 95% C.I.: 1.24-2.26, p = 0.0008) and behavioural interventions (OR 1.33, 95% C.I.: 1.02 - 1.74, p = 0.03), but not for single modality pharmacological interventions (OR 1.11; 95% C.I.: 0.69-1.78, p = 0.66). CONCLUSION: A combination of pharmacological and behavioural interventions may be the most effective intervention for smoking cessation in patients with cancer.

The effectiveness of inter-municipal cooperation for integrated sustainable waste management: A case study in Ecuador.

There is an increasing awareness that effective waste management is essential for transitioning towards a circular economy and achieving sustainable development goals. Scholars have studied inter-municipal cooperation (IMC) as a governance solution with the potential to generate economies of scale and reduce financial costs in waste management. However, previous research has not yet focused on measuring the effectiveness of different types of cooperation on social and environmental outcomes. We analyse the effect of different types of IMC, ranging from indirect to collaborative, on Integrated Solid Waste Management (ISWM) indicators. Our embedded qualitative case study in the emerging metropolitan region of Cuenca-Azogues (Ecuador) found that municipalities that invested in more complex cooperation types achieved better integrated waste management performance, particularly on final disposal, citizen participation, inclusion of recyclers and environmental sustainability.

Where I Belong: Identification Processes of Young Volunteers in Super-Diverse Cities.

In the context of super-diverse cities, scholars and policy makers are increasingly interested in the potential of volunteering to establish identification for newcomers and locals alike. In this paper, we address the question of how young volunteers in Rotterdam and Vienna negotiate belonging within their super-diverse surroundings. Our exploratory study builds on a cross-national research project in which we collected qualitative interview data from volunteering youth. We follow a weak-theory approach and conceptualise belonging as emotional, procedural, and relational. We trace identification processes of newcomers and locals in terms of belonging through volunteering in urban contexts of super-diversity. Our paper demonstrates that volunteering serves as a vehicle for feelings of belonging and inclusion for young volunteers, specifically addressing the urban super-diversity of Vienna and Rotterdam. Our research also indicates the partiality and temporality of volunteering as a source of belonging and the function of volunteering as a structure of inclusion, not necessarily enabling structural inclusion.

Tendoscopic treatment of recurrent peroneal tendon dislocation.

PURPOSE: To study the possibility of tendoscopic treatment of recurrent peroneal tendon dislocation. METHODS: The case of one patient is described including the tendoscopic technique to deepen the fibular groove. RESULTS: In this single case, there were no complications, recovery time was short, and there was no recurrence of peroneal tendon dislocation. CONCLUSION: Though it seems possible to deepen the fibular groove tendoscopically, further studies are necessary to determine the role of tendoscopy in recurrent peroneal tendon dislocation.

Combined posterior and anterior ankle arthroscopy.

Treatment of combined anterior and posterior ankle pathology usually consists of either combined anterior and posterior arthrotomies or anterior ankle arthroscopy with an additional posterolateral portal. The first technique bears the risk of complications associated with the extensive exposure, the latter technique provides limited access to the posterior ankle joint. A case is described of combined anterior and posterior arthroscopy, with the patient lying prone and then turned supine, addressing both anterior and posterior ankle pathologies in one tempo. This minimally invasive combined approach allows quick recovery and early return to work and sports activities.

Tendoscopy of the peroneal tendons.

Tendoscopy of the peroneal tendons is a useful tool to diagnose and treat peroneal tendon disorders. Endoscopic ankle surgery is followed by a functional postoperative treatment and offers the advantages of less morbidity, reduction of postoperative pain, and outpatient surgery. The article describes the technique and results of peroneal tendoscopy performed in 23 patients between 1995 and 2000.

Endoscopic calcaneoplasty.

This article describes the technique of endoscopic calcaneoplasty and the results of a consecutive group of patients that was treated in the prone position in the authors' hospital.

Measuring alignment of the hindfoot.

In subtalar arthrodesis operations, correction of the hindfoot alignment is performed in about half of the cases. To improve the quality of the operation, a measurement system was developed which reliably measures the hindfoot angle pre-, per-, and postoperatively. This device was evaluated by measuring subjects in standing weightbearing position and in prone nonweightbearing position. The results were compared with hindfoot angles constructed on posterior photographic images. The results are similar to other studies (all maximum values): intratester accuracy 1.4 degrees, intertester accuracy 2.2 degrees, intratester reliability 0.9, and intertester reliability 0.74. The proposed device will improve the quality of correction, because it enables peroperative measurement of hindfoot alignment.

Treatment of a large intraosseous talar ganglion by means of hindfoot endoscopy.

We report on 2 patients with a large intraosseous ganglion of the talus who were treated by means of a 2-portal endoscopic approach of the hindfoot with the patient in the prone position. By means of this approach, it is possible to visualize, debride, and graft a large intraosseous talar lesion. In both patients, the lesions were treated successfully, with no recurrence at follow up.