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1 In RAW 264.7 murine macrophages and rat aortic smooth muscle (RASM) cells lipopolysaccharide (LPS) alone or in combination with interferon g (IFNg) or forskolin, respectively, stimulated the expression of the 130 kDa inducible isoform of nitric oxide synthase (iNOS) in both a time-and concentration-dependent manner. 2 Incubation with the direct activator of protein kinase C (PKC), phorbol 12-myristate 13-acetate (PMA) alone, did not result in detectable iNOS expression in either cell type. 3 Chronic PMA pretreatment resulted in signi®cant down-regulation of a, b and e isoforms of PKC in RAW 264.7 macrophages and corresponded to a 20 ± 30% reduction in LPS-induced iNOS expression. In contrast, IFNg alone or in combination with LPS stimulated an approximate 20% and 50% potentiation, respectively. 4 Pre-incubation with PKC inhibitors (calphostin C and H-7) showed similar eects upon stimulated induction of iNOS. 5 In RASM cells chronic PMA pretreatment resulted in down-regulation of a and e PKC isoforms and corresponded to potentiation of iNOS expression in response to LPS alone or in combination with forskolin. 6 Co-incubation of RASM cells in the presence of PMA, angiotensin II (AII) or foetal calf serum (FCS) resulted in the inhibition of iNOS expression in response to LPS alone or in combination with forskolin. 7 Dierential sensitivity to PKC inhibitors (calphostin C and H-7) was observed in RASM cells and exhibited both negative and positive modulation of stimulated induction. 8 In addition the PKC inhibitor compound Ro-31-8220 abolished stimulated induction in both cell types in response to all treatments. 9 These results suggest that PKC activation is required for induction of the 130 kDa isoform of NOS in both RAW 264.7 macrophages and RASM cells. However, individual PKC isoforms regulate iNOS expression in both a positive and negative manner.

We report the evidence base that supported the decision to implement the first campus-wide hospital smoking ban in the Republic of Ireland with effect from 1 January 2009. Three separate data sources are utilized; surveillance data collected from patients and staff in 8 surveys between 1997 and 2006, a 1-week observational study to assess smoker behaviour in designated smoking shelters and an attitudinal interview with 28 smoker patients and 30 staff on the implications of the 2004 indoors workplace smoking ban, conducted in 2005. The main outcome measures were trends in prevalence of smoking over time according to age, sex and occupational groups and attitudes to the 2004 ban and a projected outright campus ban. Smoking rates among patients remained steady, 24.2% in 1997/98 and 22.7% in 2006. Staff smoking rates declined from 27.4% to 17.8%, with a strong occupational gradient. Observational evidence suggested a majority of those using smoking shelters in 2005 were women and health-care workers rather than patients. Attitudes of patients and staff were positive towards the 2004 ban, but with some ambivalence on the effectiveness of current arrangements. Staff particularly were concerned with patient safety issues associated with smoking outdoors. The 2004 ban was supported by 87.6% of patients and 81.3% of staff in 2006 and a majority of 58.6% of patients and 52.4% of staff agreed with an outright campus ban being implemented. These findings were persuasive in instigating a process in 2007/08 to go totally smoke-free by 2009, the stages for which are discussed.

This commentary reports on the development and implementation of the competency-based IUHPE Health Promotion Accreditation System in the context of workforce capacity as a key activity of the International Union for Health Promotion and Education (IUHPE). The process of developing the System is described, including how it built on, and added to, international research and experience in competency-based approaches to health promotion. An overview of how the System works, its current status and future plans, is presented. Evidence of the positive impact of the System to date, in particular in the context of health promotion education, is considered.