E-cigarettes and Cessation: Asking Different Questions Requires Different Methods.
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ABSTRACT:
SUBMITTER: Glasser A
PROVIDER: S-EPMC8496581 | biostudies-literature | 2021 May
REPOSITORIES: biostudies-literature
Publications
E-cigarettes and Cessation: Asking Different Questions Requires Different Methods.
Glasser Allison A Giovenco Daniel P DP Levy David T DT Vojjala Mahathi M Cantrell Jennifer J Abrams David D Niaura Raymond R
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 20210501 5
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Project description:IntroductionDespite knowledge about major health effects of secondhand tobacco smoke (SHS) exposure, systematic incorporation of SHS screening and counseling in clinical settings has not occurred.MethodsA three-round modified Delphi Panel of tobacco control experts was convened to build consensus on the screening questions that should be asked and identify opportunities and barriers to SHS exposure screening and counseling. The panel considered four questions: (1) what questions should be asked about SHS exposure; (2) what are the top priorities to advance the goal of ensuring that these questions are asked; (3) what are the barriers to achieving these goals; and (4) how might these barriers be overcome. Each panel member submitted answers to the questions. Responses were summarized and successive rounds were reviewed by panel members for consolidation and prioritization.ResultsPanelists agreed that both adults and children should be screened during clinical encounters by asking if they are exposed or have ever been exposed to smoke from any tobacco products in their usual environment. The panel found that consistent clinician training, quality measurement or other accountability, and policy and electronic health records interventions were needed to successfully implement consistent screening.ConclusionsThe panel successfully generated screening questions and identified priorities to improve SHS exposure screening. Policy interventions and stakeholder engagement are needed to overcome barriers to implementing effective SHS screening.ImplicationsIn a modified Delphi panel, tobacco control and clinical prevention experts agreed that all adults and children should be screened during clinical encounters by asking if they are exposed or have ever been exposed to smoke from tobacco products. Consistent training, accountability, and policy and electronic health records interventions are needed to implement consistent screening. Increasing SHS screening will have a significant impact on public health and costs.
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Project description:Conservation increasingly seeks knowledge of human behaviour. However, securing reliable data can be challenging, particularly if the behaviour is illegal or otherwise sensitive. Specialised questioning methods such as Randomised Response Techniques (RRTs) are increasingly used in conservation to provide greater anonymity, increase response rates, and reduce bias. A rich RRT literature exists, but successfully navigating it can be challenging. To help conservationists access this literature, we summarise the various RRT designs available and conduct a systematic review of empirical applications of RRTs within (n = 32), and beyond conservation (n = 66). Our results show increased application of RRTs in conservation since 2000. We compare the performance of RRTs against known prevalence of the sensitive behaviour and relative to other questioning techniques to assess how successful RRTs are at reducing bias (indicated by securing higher estimates). Findings suggest that RRT applications in conservation were less likely than those in other disciplines to provide prevalence estimates equal to, or higher than those derived from direct questions. Across all disciplines, we found reports of non-compliance with RRT instructions were common, but rarely accounted for in study design or analysis. For the first time, we provide conservationists considering RRTs with evidence on what works, and provide guidance on how to develop robust designs suitable for conservation research contexts. We highlight when alternate methods should be used, how to increase design efficiency and improve compliance with RRT instructions. We conclude RRTs are a useful tool, but their performance depends on careful design and implementation.
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Project description:The cultural keystone species theory predicts plant species that are culturally important, play a role in resource acquisition, fulfil a psycho-socio-cultural function within a given culture, have high use-value, have an associated naming and terminology in a native language, and a high level of species irreplaceability qualify for cultural keystone species designation. This theory was proposed as a framework for understanding relationships between human societies and species that are integral to their culture. A greater understanding of the dynamic roles of cultural keystones in both ecosystem processes and cultural societies is a foundation for facilitating biocultural conservation. Given such important direct conservation implications of the cultural keystone species theory, we reviewed the use of this theoretical framework across the literature to identify new directions for research. Most studies often emphasized the role of cultural keystones species in human societies but failed to provide a robust and reproducible measure of cultural keystone species status or direct test of the predictions of the theory and underemphasized their potential roles in ecosystem processes. To date, no studies that mentioned cultural keystone species tested the predictions of the theory. Only 4.4% provided a measure for cultural keystone status and 47.4% have cited or applied keystone designation to a given species without providing a reproducible measure for cultural keystone species. Studies that provided a measure for cultural keystone species primarily occurred in North America while few of these studies occurred in Australia and Europe with none occurring in Africa. As such, most cultural keystone species have been designated as such qualitatively based on researcher subjectivity while other studies have designated keystone species with quantitative indices of cultural importance, often incorporating researcher biases or measuring a few of the cultural keystone status predictors rather than all of them, indicating a lack of consensus in identifying cultural keystone species. Thus, we pose the need for a paradigm shift toward the development of serious and systematic approaches for keystone designation.
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Project description:BackgroundMorning walk rounds have lost some of their engagement while remaining a useful and valued practice.AimWe created a pilot study to evaluate the impact on rounds of learning to asking a variety of different questions.SettingOne-hour intervention sessions were voluntarily offered to members of the Department of Medicine and taught by an expert in the question, listen, and respond method.ParticipantsParticipants included attendings and residents in Internal Medicine on medical teams.Program descriptionQuestionnaires were collected on six pre-intervention and six post-intervention days. Nine months later, an anonymous online survey was sent to participants asking about their use of a wider variety of questions.Program evaluationTwo hundred eight physicians (residents 175 (45.5%), attending physicians 25 (27.7%)) filled out pre-intervention surveys. One hundred eighty-one physicians (residents 155 (40.3%), attending physicians 18 (20%)) filled out post-intervention surveys. When survey responses from the attendings and residents on the medical teams were combined, post-intervention rounds were perceived as more worthwhile (1.99 pre-intervention and 1.55 post-intervention, [95% confidence interval 1.831-2.143]) (p < 0.001) and more engaging (1.68 pre-intervention and 1.30 post-intervention, [95% confidence interval 1.407-1.688]) (p < 0.001).Non-medical teams' survey responses did not change. Patient census data indicated no significant difference in the hospital's census on the pre- and post-intervention dates. Spontaneous suggestions for improving rounds came largely from the residents and included teaching points, clinical pearls, patient focus, more interactive, increased dedicated time for teaching, inclusive/multidisciplinary, questions, and evidence-based teaching. Of the participants who answered the online survey 9 months later, 75% (6/8) reported that they "actually asked a wider variety of types of questions."DiscussionThis pilot study indicates that the 1-h intervention of learning to ask a variety of different questions is associated with rounds that are rated as more worthwhile and engaging by the medical teams.
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