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Article ; Online: A Stability Indicating HPLC Method to Determine Actual Content and Stability of Nicotine within Electronic Cigarette Liquids

Mahima Bansal / Manisha Sharma / Chris Bullen / Darren Svirskis

International Journal of Environmental Research and Public Health, Vol 15, Iss 8, p

2018 Volume 1737

Abstract: 1) Background: Despite the growing use of e-cigarettes, in most countries, there is no regulation covering manufacturing standards of the solution (‘e-liquid’), leading to concerns over the accuracy of labelling and stability of the products under a ... ...

Abstract	(1) Background: Despite the growing use of e-cigarettes, in most countries, there is no regulation covering manufacturing standards of the solution (‘e-liquid’), leading to concerns over the accuracy of labelling and stability of the products under a range of conditions. Following the United States (US) Food and Drug Administration (FDA) requirements for manufacture of e-liquids, we aimed to develop a simple high-performance liquid chromatography (HPLC) method to determine nicotine content in nicotine-containing e-liquids, even in the presence of degradation products; (2) Methods: We developed an HPLC method to quantify nicotine in the presence of the two major constituents of all e-liquids, glycerine and propylene glycol, and in the presence of degradation products; (3) Results: Our HPLC method performed strongly and was validated according to international guidelines. For the e-liquids tested, nicotine content levels were all higher than labelled (up to 117.9 ± 1.87% of the labelled content). While nicotine was shown to be unstable at 60 °C, it was stabilized at this temperature in the e-liquid formulations for up to 10 days; and (4) Conclusions: The HPLC method is suitable for adoption by laboratories to determine the actual content and stability of nicotine-containing products. The higher than labelled nicotine levels in e-liquids raises clinical and public health concerns.
Keywords	nicotine ; HPLC ; stability-indicating ; e-cigarettes ; e-liquids ; Medicine ; R
Subject code	540
Language	English
Publishing date	2018-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Comparative Health Risk Assessment of Electronic Cigarettes and Conventional Cigarettes

Jinsong Chen / Chris Bullen / Kim Dirks

International Journal of Environmental Research and Public Health, Vol 14, Iss 4, p

2017 Volume 382

Abstract: Background: Although some studies have identified hazardous substances in electronic cigarette (EC) liquids and emissions, there is limited information about the health risks of using ECs. Methods: In this study, the U.S. Environmental Protection Agency ( ...

Abstract	Background: Although some studies have identified hazardous substances in electronic cigarette (EC) liquids and emissions, there is limited information about the health risks of using ECs. Methods: In this study, the U.S. Environmental Protection Agency (EPA) health risk assessment model and findings of a literature review were used to determine and profile hazards. Focus was put on the toxicants reported in the literature on conventional cigarette (CC) smoke that most strongly associated with adverse health effects. To evaluate their health risks, dose-response relationships and standard-use conditions were used to estimate average hazard exposures and to calculate the overall health risks of ECs and CCs, benchmarked against international guideline levels for each hazard. Results: Four hazards (acrolein, diethylene glycol, propylene glycol and cadmium) reported in EC emissions and seven hazards (acetaldehyde, acrolein, formaldehyde, cadmium, CO, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), N′-nitrosonornicotine (NNN)) reported in CC emissions had maximum exposure levels higher than the guideline levels. Two hazards (acrolein, propylene glycol) in EC emissions and five hazards (acetaldehyde, acrolein, formaldehyde, cadmium, NNN) in CC emissions had average exposure levels higher than the guideline levels. Conclusions: Based on the conditions of use, ECs should be a safer nicotine-delivery product than CCs.
Keywords	tobacco control ; electronic cigarettes ; toxicology ; comparative risk ; risk assessment ; Medicine ; R
Subject code	910
Language	English
Publishing date	2017-04-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: See How They Grow

Gayl Humphrey / Rosie Dobson / Varsha Parag / Marion Hiemstra / Stephen Howie / Samantha Marsh / Susan Morton / Dylan Mordaunt / Angela Wadham / Chris Bullen

PLoS ONE, Vol 16, Iss 2, p e

Testing the feasibility of a mobile app to support parents' understanding of child growth charts.

2021 Volume 0246045

Abstract: Background Mobile devices provide new opportunities for the prevention of overweight and obesity in children. We aimed to co-create and test an app that offered comprehensible feedback to parents on their child's growth and delivered a suite of age- ... ...

Abstract	Background Mobile devices provide new opportunities for the prevention of overweight and obesity in children. We aimed to co-create and test an app that offered comprehensible feedback to parents on their child's growth and delivered a suite of age-specific information about nutrition and activity. Methods A two-phased approach was used to co-create the digital growth tool-See How They Grow-and test its feasibility. Phase one used focus groups (parents and professionals such as paediatricians and midwives) and a national on-line survey to gather requirements and build the app. Phase two involved testing the app over 12-weeks, with parents or carers of children aged ≤ 2-years. All research activities were undertaken exclusively through the app, and participants were recruited using social media and hard copy materials given to patents at a child health visit. Findings Four focus groups and 101 responses to the national survey informed the features and functions to include in the final app. Two hundred and twenty-five participants downloaded the app, resulting in 208 eligible participants. Non-Māori/Non-Pacific (78%) and Māori (14%) had the highest downloads. Fifty-four per cent of participants were parents of children under 6-months. These participants were more likely to regularly use the app than those with children older than 6-months (64% vs 36%, P = 0.011). Over half of the participants entered three measures (n = 101, 48%). Of those that completed the follow-up survey (n = 101, 48%), 72 reported that the app helped them better understand how to interpret growth charts. Conclusion The app was acceptable and with minor modifications, has the potential to be an effective tool to support parents understanding of growth trajectories for their children. A larger trial is needed to evaluate if the app can have a measurable impact on increasing knowledge and behaviour, and therefore on preventing childhood overweight and obesity.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prevalence of invasive cancer in a large general practice patient population in New Zealand

Ross Lawrenson / Chris Bullen / Fraser Hodgson / Chunhuan Lao / Rawiri Keenan / Lynne Chepulis / Dong Hyun Kim

Journal of Primary Health Care, Vol 12, Iss 3, Pp 215-

2020 Volume 224

Abstract: ABSTRACT INTRODUCTIONThe prevalence of cancer in the community is likely to be increasing due to an ageing population, implementation of cancer screening programmes and advances in cancer treatment. AIMTo determine the prevalence of primary invasive ... ...

Abstract	ABSTRACT INTRODUCTIONThe prevalence of cancer in the community is likely to be increasing due to an ageing population, implementation of cancer screening programmes and advances in cancer treatment. AIMTo determine the prevalence of primary invasive cancers in a large general practice patient population in New Zealand and to characterise the health-care status of these cancer patients. METHODSData were sourced from the patient management system of a large general practice (n=11,374 patients) in a medium-sized Waikato town and from the New Zealand Cancer Registry dataset to identify patients diagnosed with cancer between January 2009 and December 2018. RESULTSThere were 206 cancer diagnoses in 201 patients; 35 cancers were diagnosed in 1887 Māori patients (1.9%) and 171 in 9487 non-Māori patients (1.8%). The age-standardised prevalence was 3092/100,000 in Māori patients and 1971/100,000 in non-Māori patients. The most prevalent cancers were breast, male genital organ, digestive organ and skin cancers. In May 2019, 81 of 201 (40.8%) patients with cancer were receiving only usual care from their general practitioner, whereas 66 (32.8%) were having their cancer managed in secondary care. Comorbidities were common, including hypertension (38.8%), gastrointestinal disorders (29.9%) and mood disorders (24.4%). DISCUSSIONResults suggest that there may be disparities in cancer prevalence between Māori and non-Māori patients, although this needs to be confirmed in other general practices. Furthermore, primary care appears to be responsible for most of the care in this patient cohort and workloads should be planned accordingly, particularly with the high incidence of comorbidities.
Keywords	Cancer prevalence ; New Zealand ; cancer survivors ; primary health care ; registries ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	CSIRO Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Lower-Risk Cannabis Use Guidelines (LRCUG)

Benedikt Fischer / Dimitri Daldegan-Bueno / Ross Bell / Joseph M. Boden / Chris Bullen / Michael Farrell / Wayne Hall / David Newcombe

Public Health in Practice, Vol 1, Iss , Pp 100046- (2020)

A ready-made targeted prevention tool for cannabis in New Zealand

2020

Abstract: Cannabis use is common, especially among young people, and associated with risks for select acute and chronic adverse health and social outcomes. New Zealand features overall high cannabis use levels, yet may soon follow other jurisdictions and implement ...

Abstract	Cannabis use is common, especially among young people, and associated with risks for select acute and chronic adverse health and social outcomes. New Zealand features overall high cannabis use levels, yet may soon follow other jurisdictions and implement legalization of non-medical cannabis use and supply towards public health objectives. While existing cannabis-oriented interventions mainly focus on primary prevention and treatment (e.g., for dependence), key harms from use are crucially influenced by risk factors that can be modified by the user. On this basis, and similar to other health behavior-oriented interventions, ‘Lower-Risk Cannabis Use Guidelines’ (LRCUG), consisting of 10 recommendation clusters for lower-risk use, were systematically developed in Canada as an evidence-based, targeted prevention tool towards reducing adverse outcomes among cannabis users. We briefly summarize the concept of and experiences with implementation of the LRCUG elsewhere, and describe how their adoption as a population health intervention may serve public health goals of possible cannabis legalization in New Zealand and elsewhere.
Keywords	Cannabis ; Health behavior ; Legalization ; Prevention ; Public health ; Risk ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2020-11-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Socio-economic status and behavioural and cardiovascular risk factors in Papua New Guinea

Patricia Rarau / Justin Pulford / Hebe Gouda / Suparat Phuanukoonon / Chris Bullen / Robert Scragg / Bang Nguyen Pham / Barbara McPake / Brian Oldenburg

PLoS ONE, Vol 14, Iss 1, p e

A cross-sectional survey.

2019 Volume 0211068

Abstract: Background Risk factors for cardiovascular disease (CVD) are negatively correlated with socio-economic status (SES) in high-income countries (HIC) but there has been little research on their distribution by household SES within low-and middle-income ... ...

Abstract	Background Risk factors for cardiovascular disease (CVD) are negatively correlated with socio-economic status (SES) in high-income countries (HIC) but there has been little research on their distribution by household SES within low-and middle-income countries (LMICs). Considering the limited data from LMICs, this paper examines the association between behavioural and cardiovascular risk factors and household SES in Papua New Guinea (PNG). Methods Reported here are results of 671 participants from the 900 randomly selected adults aged 15-65 years. These adults were recruited from three socioeconomically and geographically diverse surveillance sites (peri-urban community, rural Highland and an Island community) in PNG in 2013-2014. We measured their CVD risk factors (behavioural and metabolic) using a modified WHO STEPS risk factor survey and analysis of blood samples. We assessed SES by education, occupation and creating a household wealth index based on household assets. We calculated risk ratios (RR) and their 95% confidence intervals (CI) using a generalized linear model to assess the associations between risks and SES. Findings Elevated CVD risk factors were common in all SES groups but the CVD metabolic risk factors were most prevalent among homemakers, peri-urban and rural highlands, and the highest (4th and 5th) wealth quintile population. Adults in the highest wealth quintile had high risks of obesity, elevated HbA1c and metabolic syndrome (MetS) that were greater than those in the lowest quintile although those in the highest wealth quintiles were less likely to smoke tobacco. Compared to people from the Island community, peri-urban residents had increased risks of increased waist circumference (WC) (RR: 1.67, 95%CI: 1.21-2.31), hypertension (RR: 2∙29, 95%CI: 1∙89-4.56), high cholesterol (RR: 2∙22, 95%CI: 1∙20-4∙10), high triglycerides (RR: 1∙49, 95%CI: 1∙17-1∙91), elevated HbA1c (RR: 5∙54, 95%CI: 1∙36-21∙56), and Metabolic syndrome (MetS) (RR: 2∙04, 95%CI: 1∙25-3∙32). Similarly, Rural Highland residents ...
Keywords	Medicine ; R ; Science ; Q
Subject code	910
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Correction

Patricia Rarau / Justin Pulford / Hebe Gouda / Suparat Phuanukoonnon / Chris Bullen / Robert Scragg / Bang Nguyen Pham / Barbara McPake / Brian Oldenburg

PLoS ONE, Vol 14, Iss 2, p e

Socio-economic status and behavioural and cardiovascular risk factors in Papua New Guinea: A cross-sectional survey.

2019 Volume 0212894

Abstract: This corrects the article DOI:10.1371/journal.pone.0211068.]. ...

Abstract	[This corrects the article DOI:10.1371/journal.pone.0211068.].
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The effectiveness and safety of combining varenicline with nicotine e-cigarettes for smoking cessation in people with mental illnesses and addictions

Chris Bullen / Marjolein Verbiest / Susanna Galea-Singer / Tomasz Kurdziel / George Laking / David Newcombe / Varsha Parag / Natalie Walker

BMC Public Health, Vol 18, Iss 1, Pp 1-

study protocol for a randomised-controlled trial

2018 Volume 11

Abstract: Abstract Background Smoking rates are higher in New Zealand (NZ) adults with mental illnesses and alcohol and other drug (AOD) addictions, compared to the overall population. Quit attempts using “gold standard” smoking cessation treatments often fail in ... ...

Abstract	Abstract Background Smoking rates are higher in New Zealand (NZ) adults with mental illnesses and alcohol and other drug (AOD) addictions, compared to the overall population. Quit attempts using “gold standard” smoking cessation treatments often fail in people with these conditions, so more flexible treatment regimens that adapt to a person’s responsiveness to treatment are worth investigating. The STATUS trial aims to evaluate the effectiveness and safety of combining varenicline with nicotine e-cigarettes for smoking cessation among varenicline non-responders in treatment for mental health illnesses and/or AOD addictions. Methods This is a pragmatic two-arm, open-label, randomised trial. Participants will be daily smokers using mental health and/or addiction services in Auckland, aged ≥18 years, motivated to quit smoking, and eligible to access varenicline through the NZ special authority process. After 2 weeks of using varenicline plus behavioural support, participants who have not reduced their daily smoking by ≥50% will be randomised (1:1) to either 10 weeks of continued varenicline use or 10 weeks of varenicline plus an 18 mg/mL nicotine e-cigarette. All participants will receive weekly withdrawal-orientated behavioural support calls for 6 weeks post-randomisation. The primary outcome is self-reported biochemically-verified (exhaled carbon monoxide) continuous abstinence at 24 weeks post-randomisation. Secondary outcomes, measured at six, 12 and 24 weeks post-randomisation include: self-reported continuous abstinence, 7-day point prevalence abstinence, smoking reduction, time to relapse, cross-over, use of other smoking cessation support, serious adverse events, treatment adherence, compliance, acceptability, dual use, continuation of treatment use, mental illness symptoms and AOD use, health-related quality of life, and cost-analysis. A sample size of 338 will confer 80% power (p = 0.05) to detect a 15% absolute difference between the varenicline alone and varenicline plus e-cigarette groups. Discussion ...
Keywords	Varenicline ; Electronic cigarettes ; E-cigarettes ; Smoking cessation ; Effectiveness ; Safety ; Public aspects of medicine ; RA1-1270
Subject code	150
Language	English
Publishing date	2018-05-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Evaluation of MyTeen – a SMS-based mobile intervention for parents of adolescents

Joanna Ting Wai Chu / Robyn Whittaker / Yannan Jiang / Angela Wadham / Karolina Stasiak / Matthew Shepherd / Chris Bullen

BMC Public Health, Vol 18, Iss 1, Pp 1-

a randomised controlled trial protocol

2018 Volume 8

Abstract: Abstract Background Parents play an important role in the lives of adolescents and efforts aimed at strengthening parenting skills and increasing knowledge on adolescent development hold much promise to prevent and mitigate adolescent mental health ... ...

Abstract	Abstract Background Parents play an important role in the lives of adolescents and efforts aimed at strengthening parenting skills and increasing knowledge on adolescent development hold much promise to prevent and mitigate adolescent mental health problems. Innovative interventions that make use of technology-based platforms might be an effective and efficient way to deliver such support to parents. This protocol presents the design of a randomised controlled trial to investigate the effectiveness of a SMS-based mobile intervention (MyTeen) for parents of adolescents on promoting parental competence and mental health literacy. Methods A parallel two-arm randomised controlled trial will be conducted in New Zealand, aiming to recruit 214 parents or primary caregivers of adolescents aged 10–15 years via community outreach and social media. Eligible participants will be allocated 1:1 into the control or the intervention group, stratified by ethnicity. The intervention group will receive a tailored programme of text messages aimed at improving their parental competence and mental health literacy, over 4 weeks. The control group (care-as-usual) will receive no intervention from the research team, but can access alternative services if they wish, and will be offered the intervention programme upon completion of a 3-month post-randomisation follow-up assessment. Data will be obtained at baseline, post intervention (1-month), and 3-month follow up. The primary outcome is parental competence assessed by the Parental Sense of Competence Scale at 1-month follow up. Secondary outcomes include: mental health literacy; knowledge of help-seeking; parental distress; parent-adolescent communication; and programme satisfaction. Discussion To our knowledge this is the first randomised controlled trial on the effectiveness of delivering a parenting support intervention for parents of adolescents solely via a SMS-based mobile intervention. If effective, it could have great potential to reach and support parents of adolescents. Trial ...
Keywords	Parenting intervention ; MHealth ; Adolescent ; Mental health ; Prevention ; Public aspects of medicine ; RA1-1270
Subject code	796
Language	English
Publishing date	2018-10-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Manaaki – a cognitive behavioral therapy mobile health app to support people experiencing gambling problems

Gayl Humphrey / Joanna Chu / Nicki Dowling / Simone Rodda / Stephanie Merkouris / Varsha Parag / David Newcombe / Elsie Ho / Vili Nosa / Rebecca Ruwhui-Collins / Robyn Whittaker / Chris Bullen

BMC Public Health, Vol 20, Iss 1, Pp 1-

a randomized control trial protocol

2020 Volume 11

Abstract: Abstract Background The low utilisation of current treatment services by people with gambling problems highlights the need to explore new modalities of delivering treatment interventions. This protocol presents the design of a pragmatic randomized ... ...

Abstract	Abstract Background The low utilisation of current treatment services by people with gambling problems highlights the need to explore new modalities of delivering treatment interventions. This protocol presents the design of a pragmatic randomized control trial aimed at assessing the effectiveness and acceptability of cognitive behavioral therapy (CBT) delivered via a mobile app for people with self-reported gambling problems. Methods An innovative CBT mobile app, based on Deakin University’s GamblingLess online program, has been adapted with end-users (Manaaki). Six intervention modules have been created. These are interwoven with visual themes to represent a journey of recovery and include attributes such as avatars, videos, and animations to support end-user engagement. An audio facility is used throughout the app to cater for different learning styles. Personalizing the app has been accomplished by using greetings in the participant’s language and their name (e.g. Kia ora Tāne) and by creating personalized feedback. A pragmatic, randomized control two-arm single-blind trial, will be conducted in New Zealand. We aim to recruit 284 individuals. Eligible participants are ≥18 years old, seeking help for their gambling, have access to a smartphone capable of downloading an app, able to understand the English language and are willing to provide follow-up information at scheduled time points. Allocation is 1:1, stratified by ethnicity, gender, and gambling symptom severity based on the Gambling Symptom Assessment Scale (G-SAS). The intervention group will receive the full mobile cognitive behavioural programme and the waitlist group will receive a simple app that counts down the time left before they have access to the full app and the links to the data collection tools. Data collection for both groups are: baseline, 4-, 8-, and 12-weeks post-randomisation. The primary outcome is a change in G-SAS scores. Secondary measures include changes in gambling urges, frequency, expenditure, and readiness to change. Indices of app engagement, utilisation and acceptability will be collected throughout the delivery of the intervention. Discussion If effective, this study will contribute to the improvement of health outcomes for people experiencing gambling problems and have great potential to reach population groups who do not readily engage with current treatment services. Ethics approval NZ Health and Disability Ethics Committee (Ref: 19/STH/204) Trial registration Australian New Zealand Clinical Trial Registry (ANZCTRN 12619001605189) Registered 1 November 2019.
Keywords	Problem gambling ; mHealth ; CBT ; App ; Smartphone ; Self-directed ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2020-02-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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