ABSTRACT
AIMS: To evaluate the effectiveness of a pharmacist-led multi-component smoking cessation programme (GIVE UP FOR GOOD) compared with usual care in hospitalized smokers. DESIGN: Randomized, assessor-blinded, parallel-group trial. SETTING: Three tertiary public hospitals in Australia. PARTICIPANTS: A total of 600 adult in-patient smokers [mean ± standard deviation (SD), age 51 ± 14 years; 64% male] available for 12 months follow-up. INTERVENTIONS: Multi-component hospital pharmacist-led behavioural counselling and/or pharmacotherapy provided during hospital stay, on discharge and 1 month post-discharge, with further support involving community health professionals (n = 300). Usual care comprised routine care provided by hospitals (n = 300). MEASUREMENTS: Two primary end-points were tested using intention-to-treat analysis: carbon monoxide (CO)-validated 1-month sustained abstinence at 6-month follow-up and verified 6-month sustained abstinence at 12-month follow-up. Smoking status and pharmacotherapy usage were assessed at baseline, discharge, 1, 6 and 12 months. FINDINGS: Sustained abstinence rates for intervention and control groups were not significantly different at both 6 months [11.6% (34 of 294) versus 12.6% (37 of 294); odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.55-1.50] and 12 months [11.6% (34 of 292) versus 11.2% (33 of 294); OR = 1.04, 95% CI = 0.63-1.73]. Secondary end-points, self-reported continuous abstinence at 6 and 12 months, also agreed with the primary end-points. Use of pharmacotherapy was higher in the intervention group, both during hospital stay [52.3% (157 of 300) versus 42.7% (128 of 300); P = 0.016] and after discharge [59.6% (174 of 292) versus 43.5% (128 of 294); P < 0.001]. CONCLUSIONS: A pharmacist-led multi-component smoking cessation intervention provided during hospital stay did not improve sustained abstinence rates at either 6 or 12 months compared with routine hospital care.
Subject(s)
Counseling , Inpatients , Smoking Cessation/statistics & numerical data , Tobacco Use Cessation Devices , Tobacco Use Disorder/therapy , Australia , Follow-Up Studies , Health Promotion/methods , Hospitals, Public , Humans , Program Evaluation , Single-Blind Method , Tertiary Care Centers , Tobacco Use Disorder/drug therapy , Treatment OutcomeABSTRACT
Ice-making machines have occasionally been implicated in nosocomial infection. We have examined the ice-making machines in our hospital both bacteriologically and for their general state of cleanliness and repair. Results were variable but, in most cases few organisms of significance were found. Some design features are considered and recommendations for the purchase, maintenance, cleaning and use of these machines are included.
Subject(s)
Equipment Contamination , Equipment and Supplies, Hospital , Ice , Water Microbiology , Cross Infection/etiology , England/epidemiology , Equipment Design , Humans , Maintenance and Engineering, Hospital , Water SupplyABSTRACT
This paper addresses the controversy in family therapy over basic philosophical issues in terms of a historical opposition between demonstrative and dialectical metatheories. It argues that advances in family therapy are indicative of the growing prominence of dialectical forms of understanding in the social sciences. Several family therapy concepts are explored as representative of the dialectical categories of motion, form, relationship, and transformation.
