Lacking willpower?: A latent class analysis of healthcare providers' perceptions of smokers' responsibility for smoking

Objective: Healthcare providers' (HCPs) perceptions of smokers' responsibility for smoking may affect implementation of smoking cessation care (SCC), but are understudied. This study examined Dutch HCPs' perceptions of smokers' responsibility for smoking, and how many and which subgroups exist with regard to these perceptions.Methods: Observational cross-sectional study among physicians and other HCPs (N = 570). Latent class analysis was used to analyse data.Results: Results showed two latent classes of HCPs: a majority (77 %) that appeared to hold smokers themselves more accountable for their smoking, and a minority (23 %) that seemed more inclined to believe that people smoked as a consequence of factors such as addiction, and smoking initiation when people were young and could not foresee consequences. The two-class model showed excellent certainty in classification. Class membership was associated with age, working experience, and smoking status. The majority class experienced more barriers to SCC than the minority class and provided SCC tasks to fewer patients.Conclusions: HCPs' perceptions of smokers' responsibility for smoking relate to HCP background characteristics, barriers to SCC and implementation of SCC.Practice Implications: New approaches to improving SCC might be needed that take HCP's perceptions of smokers' responsibility into account. (C) 2020 The Author(s). Published by Elsevier B.V.Prevention, Population and Disease management (PrePoD)Public Health and primary car

Breaking the silence of the 500-year-old smiling garden of everlasting flowers: The En Tibi book herbarium

We reveal the enigmatic origin of one of the earliest surviving botanical collections. The 16th-century Italian En Tibi herbarium is a large, luxurious book with c. 500 dried plants, made in the Renaissance scholarly circles that developed botany as a distinct discipline. Its Latin inscription, translated as “Here for you a smiling garden of everlasting flowers”, suggests that this herbarium was a gift for a patron of the emerging botanical science. We follow an integrative approach that includes a botanical similarity estimation of the En Tibi with contemporary herbaria (Aldrovandi, Cesalpino, “Cibo”, Merini, Estense) and analysis of the book’s watermark, paper, binding, handwriting, Latin inscription and the morphology and DNA of hairs mounted under specimens. Rejecting the previous origin hypothesis (Ferrara, 1542–1544), we show that the En Tibi was made in Bologna around 1558. We attribute the En Tibi herbarium to Francesco Petrollini, a neglected 16th-century botanist, to whom also belongs, as clarified herein, the controversial “Erbario Cibo” kept in Rome. The En Tibi was probably a work on commission for Petrollini, who provided the plant material for the book. Other people were apparently involved in the compilation and offering of this precious gift to a yet unknown person, possibly the Habsburg Emperor Ferdinand I. The En Tibi herbarium is a Renaissance masterpiece of art and science, representing the quest for truth in herbal medicine and botany. Our multidisciplinary approach can serve as a guideline for deciphering other anonymous herbaria, kept safely “hidden” in treasure rooms of universities, libraries and museums

Isotopic analysis of Solenopsis geminata diets in invaded Indonesian savanna.

OBJECTIVE: To examine the extent to which smokers express negative statements about quitting and the extent to which these statements influence general practitioners' (GPs') and practice nurses' (PNs') (dis)continuation of guideline-recommended smoking cessation care. METHODS: Fifty-two video-consultations were observed (GP-consultations: 2007-2008; PN-consultations: 2010-2011). Dialogues were transcribed verbatim and professionals' and patients' speech units were coded and analysed using sequential analyses (n=1424 speech units). RESULTS: GPs focused on asking about smoking (GPs: 42.4% versus PNs: 26.2%, p=0.011) and advising them to quit (GPs: 15.3% versus PNs: 3.5%, p<0.001), whereas PNs focused on assisting them with quitting (GPs: 25.4% versus PNs: 55.2%, p<0.001). Overall, patients expressed more negative statements about quitting than positive statements (negative: 25.3% versus positive: 11.9%, p<0.001), especially when PNs assessed their willingness to quit (OR 3.61, 95% CI 1.44-9.01) or assisted them with quitting (OR 2.23, 95% CI 1.43-3.48). PRACTICE IMPLICATIONS: An alternative approach to smoking cessation care is proposed in which GPs' tasks are limited to asking, advising, and arranging follow-up. This approach seems the least likely to evoke negative statements of patients about quitting during dialogues with GPs and is compatible with the tasks and skills of PNs who could, subsequently, assist smokers with quitting

eHealth for the prevention of healthcare-associated infections: a scoping review

Background: The increase in smartphone use and mobile health applications (apps) holds potential to use apps to reduce and detect healthcare-associated infections (HAIs) in clinical practice. Aim: To obtain an overview of available apps for HAI prevention, by selecting the clinically relevant apps and scoring functionality, quality and usefulness. Methods: This scoping review of available apps in the iOS and Android app stores uses an in-house-developed tool (scraper https://holtder.github.io/talos) to systematically aggregate available apps relevant for HAI prevention. The apps are evaluated on functionality, assessed on quality using the 'Mobile Application Rating Scale' (MARS), and assessed on potential use in clinical infection prevention. Findings: Using the scraper with CDC HAI topics through 146 search terms resulted in 92,726 potentially relevant apps, of which 28 apps met the inclusion criteria. The majority of these apps have the functionality to inform (27 of 28 apps) or to instruct (20/28). MARS scores for the 28 apps were high in the following domains: functionality (4.19/5), aesthetics (3.49/5), and information (3.74/5), with relatively low scores in engagement (2.97/5), resulting in a good average score (3.57/5). Conclusion: Low engagement scores restrict apps that intend to inform or instruct, possibly explained by the often-academic nature of the development of these apps. Although the number of HAI prevention apps increased by 60% in 5 years, the proportion of clinically relevant apps is limited. The variation in HAI app quality and lack of user engagement, could be improved by co-creation and development in the clinical setting. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Medical Microbiolog

Optimizing smoking cessation guideline implementation using text-messages and summary-sheets: A mixed-method evaluation

Public Health and primary carePrevention, Population and Disease management (PrePoD

National guidelines for smoking cessation in primary care: a literature review and evidence analysis

National guidelines for smoking cessation in primary care can be effective in improving clinical practice. This study assessed which parties are involved in the development of such guidelines worldwide, which national guidelines address primary care, what recommendations are made for primary care settings, and how these recommendations correlate with each other and with current evidence. We identified national guidelines using an online resource. Only the most recent version of a guideline was included. If an English version was not available, we requested a translation or summary of the recommendations from the authors. Two researchers independently extracted data on funding sources, development methodologies, involved parties, and recommendations made within the guidelines. These recommendations were categorised using the pile-sort method. Each recommendation was cross-checked with the latest evidence and was awarded an evidence-rating. We identified 43 guidelines from 39 countries and after exclusion, we analysed 26 guidelines (22 targeting general population, 4 targeted subpopulations). Twelve categories of recommendations for primary care were identified. There was almost universal agreement regarding the need to identify smokers, advice them to quit and offer behavioural and pharmacological quit smoking support. Discrepancies were greatest for specific recommendations regarding behavioural and pharmacological support, which are likely to be due to different interpretations of evidence and/or differences in contextual health environments. Based on these findings, we developed a universal checklist of guideline recommendations as a practice tool for primary care professionals and future guideline developers

Effect of a workplace-based group training programme combined with financial incentives on smoking cessation:a cluster-randomised controlled trial

Prevention, Population and Disease management (PrePoD)Public Health and primary car