Combination Treatment With Varenicline and Nicotine Patch on Smoking Cessation Outcomes in Heavy Drinkers at 26-Week Follow-up.

PURPOSE/BACKGROUND: People who smoke cigarettes and drink alcohol heavily are less likely to quit smoking compared with those who do not drink heavily. The current study examined the effects of a 12-week treatment phase of combination varenicline and nicotine patch compared with placebo and nicotine patch on smoking cessation (primary outcome) and alcohol consumption (secondary outcome) in heavy drinking smokers at 26-week follow-up. METHODS/PROCEDURES: Participants were daily smokers who met heavy drinking criteria. They were randomly assigned to receive either varenicline and nicotine patch (n = 61) or placebo and nicotine patch (n = 61) for 12 weeks. At week 26, self-reports of point prevalence cigarette abstinence were biochemically confirmed, and past-month alcohol drinking days and heavy drinking days were assessed. FINDINGS/RESULTS: At week 26, smoking quit rates did not differ by treatment group (25% varenicline and 26% placebo). Relative to week 12 outcomes, week 26 quit rates significantly dropped off in the varenicline group but not in the placebo group. Alcohol drinking reductions for the whole sample that were previously observed from baseline to week 12 were sustained at week 26, although they did not differ between treatment groups. IMPLICATIONS/CONCLUSIONS: In heavy drinking smokers, smoking cessation success was evident in a quarter of the total sample at 3 months postmedication discontinuation. At this time, quit rates were the same between those who received varenicline and nicotine patch and those who received nicotine patch alone. Future research is warranted to examine what may aid in longer-term smoking quit rates in heavy drinking smokers.

The use of innovative approaches to strengthen health system resilience during the COVID-19 pandemic: case studies from selected Commonwealth countries.

This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. The COVID-19 pandemic has exposed the vulnerabilities and limitations of many health systems and underscored the need for strengthening health system resilience to make and sustain progress toward Universal Health Coverage (UHC), global health security and healthier populations in tandem. In response to the COVID-19 pandemic, Commonwealth countries have been practicing a combination of innovative integrated approaches and actions to build health systems resilience. This includes utilizing digital tools, improvements in all-hazard emergency risk management, developing multisectoral partnerships, strengthening surveillance and community engagement. These interventions have been instrumental in strengthening national COVID-19 responses and can contribute to the evidence-base for increasing country investment into health systems resilience, particularly as we look toward COVID-19 recovery. This paper gives perspectives of five Commonwealth countries and their overall responses to the pandemic, highlighting practical firsthand experiences in the field. The countries included in this paper are Guyana, Malawi, Rwanda, Sri Lanka, and Tanzania. Given the diversity within the Commonwealth both in terms of geographical location and state of development, this publication can serve as a useful reference for countries as they prepare their health systems to better absorb the shocks that may emerge in future emergencies.

Ethanol induces a dose-dependent conditioned place preference and conditioned place aversion in Japanese quail.

The conditioned place preference (CPP) paradigm is commonly used to investigate the motivational properties of drugs of abuse. Cues in the environment may become paired with these motivational properties and later result in drug seeking. Because many of these alcohol-paired cues are visual, Japanese quail may be a beneficial model to examine visual cue-induced alcohol seeking behavior. The aim of the present study was to examine the motivational properties of ethanol using a visual CPP model. During CPP, quail were given an initial preference test to determine their initially preferred chamber, during which time they could explore the entire chamber for 15 min. Following the initial preference test, quail were gavaged with their assigned treatment (water or 0.75 or 2.0 g/kg of ethanol) and were confined to their initially least preferred chamber every other conditioning day for 30 min. On alternate days, they were gavaged with water and confined to the preferred chamber for 30 min. After the 8th day of conditioning, a final preference test was given. Locomotor activity was also measured during conditioning. The findings indicated that quail that received the 0.75 g/kg ethanol developed a place preference to the ethanol-paired chamber, and that quail treated with 2 g/kg ethanol developed a place aversion to the ethanol-paired chamber. Additionally, locomotor activity was reduced in quail that received the high dose of ethanol. The findings suggest that both the rewarding and aversive properties of ethanol may be observable in this visual cue CPP model. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Investigating the Developmental Trajectory of Long-term Oral Feeding Problems in 'Healthy' Preterm Infants.

PURPOSE: To investigate the occurrence of oral feeding problems in preterm infants up to one year after hospital discharge. METHODS: Thirty-six infants born <34 weeks gestation were enrolled in a prospective exploratory longitudinal pilot study prior to hospital discharge. Parents of eligible infants completed telephone questionnaires at 3, 6, and 12 months corrected gestational age. The occurrence and type of feeding problems; medical problems; and rehabilitation services received were collected. RESULTS: A total of 26 (72.2%) parents responded, with 11 (42%) identifying feeding problems that developed within the first year of life. Avoidant behavior (including crying, agitated/fussy, and refusing to eat) was the most common feeding problem that occurred. CONCLUSION: Feeding problems in 'healthy' preterm infants may occur at any point in development within the first year of life. Increased screening after hospitalization is needed for early identification and to make appropriate referrals in a timely manner to prevent and/or reduce the severity of long-term feeding problems.