Biodistribution Analysis of Peptide-Coated Magnetic Iron Nanoparticles: A Simple and Quantitative Method.

Biodistribution tracks compounds or molecules of interest in vivo to understand a compound's anticipated efficacy and safety. Nanoparticles deliver nucleic acid and drug payloads and enhance tumor permeability due to multiple properties such as high surface area to volume ratio, surface functionalization, and modifications. Studying the in vivo biodistribution of nanoparticles documents the effectiveness and safety of nanoparticles and facilitates a more application-driven approach for nanoparticle development that allows for more successful translation into clinical use. In this study, we present a relatively simple method to determine the biodistribution of magnetic iron nanoparticles in mice. In vitro, cells take up branched amphiphilic peptide-coated magnetic nanobeads (BAPc-MNBs) like their counterparts, i.e., branched amphiphilic peptide capsules (BAPCs) with a hollow water-filled core. Both BAPc-MNBs and BAPCs have widespread applications as a nanodelivery system. We evaluated the BAPc-MNBs tissue distribution in wild-type mice injected intravenously (i.v.), intraperitoneally (i.p.), or orally gavaged to understand the biological interactions and to further the development of branched amphiphilic peptide-based nanoparticles. The magnetic nanoparticles allowed collection of the BAPc-MNBs from multiple organs by magnetic bead sorting, followed by a high-throughput screening for iron content. When injected i.v., nanoparticles were distributed widely to various organs before elimination from the system via the intestines in feces. The spleen accumulated the highest amount of BAPc-MNBs in mice administered NPs via i.v. and i.p. but not via oral gavage. Taken together, these data demonstrate that the magnetic sorting not only allowed quantification of the BAPc-MNBs but also identified the distribution of BAPc-MNBs after distinct administration methods.

Broad-Scale Assessment of Methylmercury in Adult Amphibians.

Mercury (Hg) is a toxic contaminant that has been mobilized and distributed worldwide and is a threat to many wildlife species. Amphibians are facing unprecedented global declines due to many threats including contaminants. While the biphasic life history of many amphibians creates a potential nexus for methylmercury (MeHg) exposure in aquatic habitats and subsequent health effects, the broad-scale distribution of MeHg exposure in amphibians remains unknown. We used nonlethal sampling to assess MeHg bioaccumulation in 3,241 juvenile and adult amphibians during 2017-2021. We sampled 26 populations (14 species) across 11 states in the United States, including several imperiled species that could not have been sampled by traditional lethal methods. We examined whether life history traits of species and whether the concentration of total mercury in sediment or dragonflies could be used as indicators of MeHg bioaccumulation in amphibians. Methylmercury contamination was widespread, with a 33-fold difference in concentrations across sites. Variation among years and clustered subsites was less than variation across sites. Life history characteristics such as size, sex, and whether the amphibian was a frog, toad, newt, or other salamander were the factors most strongly associated with bioaccumulation. Total Hg in dragonflies was a reliable indicator of bioaccumulation of MeHg in amphibians (R2 ≥ 0.67), whereas total Hg in sediment was not (R2 ≤ 0.04). Our study, the largest broad-scale assessment of MeHg bioaccumulation in amphibians, highlights methodological advances that allow for nonlethal sampling of rare species and reveals immense variation among species, life histories, and sites. Our findings can help identify sensitive populations and provide environmentally relevant concentrations for future studies to better quantify the potential threats of MeHg to amphibians.

Statins for primary prevention in multimorbid patients: to prescribe or not to prescribe? A qualitative analysis of general practitioners' decision-making processes.

INTRODUCTION: A better understanding of the determinants involved in general practitioners' (GPs) decision-making processes when it comes to prescribing statins as primary prevention in patients with multimorbidity could provide insights for improving implementation of primary prevention guidelines. METHODS: We conducted a qualitative study using a deductive framework-based and inductive analysis of GPs' semi-structured interviews verbatim, from which expertise profiles of prescribers were also drawn. The analytical framework was built from a pragmatic synthesis of the evidence-based medicine, Modelling using Typified Objects (MOT) model of clinical reasoning processes, Theoretical Domains Framework, and shared decision-making frameworks. RESULTS: Fifteen GPs were interviewed between June 2019 and January 2020. Diabetes seemed to represent a specific motivation for deciding about statin prescription for primary prevention purposes; and in situations of multimorbidity, GPs differentiated between cardiovascular and non-cardiovascular multimorbidity. Expert prescribers seemed to have integrated the utilisation of cardiovascular risk calculation scores throughout their practice, whereas non-expert prescribers considered them difficult to interpret and preferred using more of a "rule of thumb" process. One interviewee used the risk calculation score as a support for discussing statin prescription with the patient. CONCLUSION: Our results shed light on the reasons why statins remain under-prescribed for primary prevention and why non-diabetic multimorbid patients have even lower odds of being prescribed a statin. They call for a change in the use of risk assessment scores, by placing them as decision aids, to support and improve personalised shared decision-making discussions as an efficient approach to improve the implementation of recommendations about statins for primary prevention.

Effectiveness of interprofessional teamwork interventions for improving occupational well-being among perioperative healthcare providers: a systematic review.

The occupational well-being of healthcare providers is crucial for safe and effective patient care, especially in the complex, high acuity operating room (OR) setting. There has been a recent proliferation of interventions to improve teamwork in the OR setting, but the impact of these interventions on clinician occupational well-being has yet to be systematically assessed. This systematic review aimed to summarize the impact of interprofessional teamwork interventions on occupational well-being among perioperative healthcare providers. We included all qualitative or quantitative peer-reviewed studies assessing a multidisciplinary teamwork intervention including members of at least two professions. We included seven studies which involved checklists (n = 2), simulation-based training (n = 2), and various teamwork development and training programs (n = 3). Five of the seven included studies reported no significant effect on job satisfaction, while one found a significant negative association between the intervention and job satisfaction (p < .0001), and another showed significant decrease in worker stress. Our findings highlight the gaps in our understanding of the impact of interprofessional teamwork interventions on healthcare worker well-being in the perioperative environment and the multi-level factors influencing OR teamwork, intervention implementation, and well-being across the different professions.

[Drugs: minors and harm reduction?] / Drogues : mineur-e-s et réduction des risques ?

The use of controlled substances (narcotics and psychotropic substances) poses increased risks for minors. However, minors are generally excluded from existing harm reduction services (e.g. drug consumption rooms, drug checking, exchange of consumption material). Based on public health considerations, the authors recommend the establishment of harm reduction services for minors.

La consommation de substances soumises à contrôle (stupéfiants et substances psychotropes) présente des risques accrus pour les mineur-e-s. Pourtant, ces derniers sont généralement exclus des offres existantes de réduction des risques et des méfaits (par exemple, locaux de consommation, drug checking, échange de matériel de consommation). Sur la base de considérations de santé publique, les auteurs recommandent la création de services de réduction des risques dédiés aux mineur-e-s.

Monitoring wetland water quality related to livestock grazing in amphibian habitats.

Land use alteration such as livestock grazing can affect water quality in habitats of at-risk wildlife species. Data from managed wetlands are needed to understand levels of exposure for aquatic life stages and monitor grazing-related changes afield. We quantified spatial and temporal variation in water quality in wetlands occupied by threatened Oregon spotted frog (Rana pretiosa) at Klamath Marsh National Wildlife Refuge in Oregon, United States (US). We used analyses for censored data to evaluate the importance of habitat type and grazing history in predicting concentrations of nutrients, turbidity, fecal indicator bacteria (FIB; total coliforms, Escherichia coli (E. coli), and enterococci), and estrogenicity, an indicator of estrogenic activity. Nutrients (orthophosphate and ammonia) and enterococci varied over time and space, while E. coli, total coliforms, turbidity, and estrogenicity were more strongly associated with local livestock grazing metrics. Turbidity was correlated with several grazing-related constituents and may be particularly useful for monitoring water quality in landscapes with livestock use. Concentrations of orthophosphate and estrogenicity were elevated at several sites relative to published health benchmarks, and their potential effects on Rana pretiosa warrant further investigation. Our data provided an initial assessment of potential exposure of amphibians to grazing-related constituents in western US wetlands. Increased monitoring of surface water quality and amphibian population status in combination with controlled laboratory toxicity studies could help inform future research and targeted management strategies for wetlands with both grazing and amphibians of conservation concern.

Eicosanoid production varies by sex in mesenteric ischemia reperfusion injury.

Intestinal ischemia/reperfusion (I/R)-induced injury is an inflammatory response with significant morbidity and mortality. The early inflammatory response includes neutrophil infiltration. However, the majority of rodent studies utilize male mice despite a sexual dimorphism in intestinal I/R-related diseases. We hypothesized that sex may alter inflammation by changing neutrophil infiltration and eicosanoid production. To test this hypothesis, male and female C57Bl/6 mice were subjected to sham treatment or 30 min intestinal ischemia followed by a time course of reperfusion. We demonstrate that compared to male mice, females sustain significantly less intestinal I/R-induced tissue damage and produced significant LTB4 concentrations. Male mice release PGE2. Finally, treatment with a COX-2 specific inhibitor, NS-398, attenuated I/R-induced injury, total peroxidase level, and PGE2 production in males, but not in similarly treated female mice. Thus, I/R-induced eicosanoid production and neutrophil infiltration varies between sexes suggesting that distinct therapeutic intervention may be needed in clinical ischemic diseases.

The Influence of Neonatal Nursery Design on Mothers' Interactions in the Nursery.

UNLABELLED: This study examined the influence of neonatal nursery design on interactions between nurses and mothers of infants in the nursery. DESIGN AND METHODS: We used a natural quasi-experimental design, using semi-structured interviews and a structured measure of mothers' and nurses' perceptions of nursing care, to compare mothers (n=26 and n=40) and nurses (n=22 and n=29) in an open-bay (OB) nursery and a single family room (SFR) nursery. Thematic analysis was used to generate key themes from the interviews. RESULTS: Mothers and nurses in both nursery designs talked about Valuing interactions; the importance of interactions between mothers and nurses. Mothers and nurses described SFRs as providing a space, My/their room, which enhanced mothers' sense of control and connection with the infant. SFRs were also associated with Changing the norms of interactions with nurses and other mothers, which created challenges in the desired quantity and quality of interactions for mothers and nurses. Nurses in the SFR nursery also reported Enhanced interactions, including improved confidentiality and personalized communication. Mothers in the OB nursery reported more supportive mothering actions from nurses than mothers in the SFR nursery. Both mothers and nurses in the OB nursery also talked about Our nursery community, which captured the value of having other nurses and mothers in the rooms. CONCLUSION: Mothers and nurses perceived that the SFR nursery enhanced privacy and maternal closeness for mothers compared to the OB nursery. However, the SFR nursery design presented challenges to some interactions of value to nurses and mothers.

Excessive substance use among young people consulting family doctors: a cross-sectional study.

BACKGROUND: Family doctors can only play a role in the prevention of excessive substance use in young people if those affected are seen in the practice. OBJECTIVE: To describe the prevalence of excessive substance use among young people consulting family doctors in a European context. METHODS: As part of a trial of an intervention addressing substance use we collected data from young people consulting 32 family doctors in the French-speaking part of Switzerland. Before the consultation, consecutive patients aged 15-24 years completed a self-administered questionnaire on their general health and substance use. Outcomes were excessive alcohol (defined as ≥1 episode of binge drinking), excessive cannabis (use ≥1/week), regular tobacco (≥1 cigarettes a day) and/or any other substance use in the past 30 days. Prevalence data were computed with 95% confidence intervals (CIs) adjusted for clustering within practices, stratified by age and gender. RESULTS: Between February 2009 and November 2010, 636 patients were eligible. Participation rate was 93.4% (n=594, 53% female). The prevalence of excessive use in the past 30 days was alcohol 44.9% (95% CI: 37.8-52.1), cannabis 11.1% (95% CI: 8.0-14.1), tobacco 23.4% (95% CI: 19.0-28.1) and any other drug 2.6 (95% CI: 1.4-4.2). Excessive use was higher in males than in females. Except for tobacco prevalence of excessive use was only slightly higher in young adults compared to adolescents. CONCLUSION: Excessive substance use is frequent among young people consulting family doctors in a European context. Future research should provide guidance about how to best seize this window of opportunity for prevention and early intervention.

Australian midwives' interpretation of the re-registration, recency of practice standard.

OBJECTIVE: The aim ofthe present study was to investigate how midwives are responding to the changed re-registration requirements; specifically the Recency of Practice (RoP) Standard. METHODS: A qualitative longitudinal case study used conversational interviews conducted annually at two time phases after the introduction of national registration. RESULTS: Findings reveal that confusion has created challenges in demonstration of the RoP standard. This confusion was evident at individual and organisational levels. CONCLUSIONS: Professional bodies need to support staff in this transition by providing clearer guidance that exemplifies the Nursing and Midwifery Board of Australia expectations.

Non-family support for breastfeeding maintenance among career women in Taiwan: a qualitative study.

The purpose of the study was to describe the influence of non-family-based support on breastfeeding practices among career women in Taiwan during the first four postnatal months. A qualitative, case study approach was used to investigate the phenomenon. A purposive sample of 14 women was recruited and took part in two to three in-depth interviews. The data were transcribed and analysed using descriptive content analysis. It was found that non-family supports had significant influence on their efforts to maintain breastfeeding. Women faced a number of challenges to breastfeeding. The services provided by in-centre care organizations, the resources and organizations accessed through the Internet, and the support provided by colleagues in their workplaces supported women's efforts to maintain breastfeeding. Given the low breastfeeding maintenance rates in Taiwan and the changing societal structure where fewer families rely on family support, the findings highlight the resources, programmes and nursing practice which might support women's needs and promote breastfeeding among career women.

An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers' Knowledge, Confidence, and Attitudes.

OBJECTIVES: The goal of this implementation study was to describe the implementation and evaluation of the impact of an online pediatric palliative care training program in Nepal, using the Project ECHO model. METHODS: The study used mixed methods, including a program case study describing the online learning program and before-and-after surveys of program participants, assessing learning through changes in knowledge, comfort, and attitudes. An end-of-program survey was used to evaluate participants' overall experiences with the learning program and use of the learning resources. RESULTS: A literature review, stakeholder surveys, and expert input informed the design of the intervention. The course used the Project ECHO model of online education, with modifications based on the leadership team's previous ECHO experiences and local stakeholder input. The intervention occurred over 9 months, with 22 online teaching sessions. Each session consisted of a didactic lecture, case presentation, and interactive discussion with expert clinical teachers. Fifty-five clinicians in Nepal participated, including physicians (47%), nurses (44%), and psychotherapists (5%). Clinicians reported improvements in knowledge, skills, and attitudes after program participation. Program acceptability scores were high, with 93% of participants reporting that the course provided effective learning. CONCLUSIONS: Project ECHO can be successfully implemented to deliver continuing professional development in Nepal. Delivering palliative care education online using the Project ECHO model, leads to improved knowledge, skills, and attitudes for clinicians. Project ECHO suggests an innovative solution which can provide training and support to clinicians in settings where educational opportunities in palliative care are limited.

[Empowering yourself to better participate in feedback: a new cognitive-behavioural model for medical learners]. / S'outiller pour mieux participer à la rétroaction : Un nouveau modèle cognitivo-comportemental destiné aux apprenants en médecine.

Sharing formative feedback is inherent in the supervision process and the acceptance of feedback by learners is an essential step in learning. However, receiving feedback from the supervisor evokes emotions and accepting it is not easy. Several recommendations guide preceptors on how to share feedback with learners and all emphasize the importance of encouraging the learner to actively interact in the feedback process. Although studies point to the positive effect of informing and training learners about feedback, few focus on their responsiveness to feedback. Under the rubric of developing a personal skill to better accept feedback, we propose a new behavioral model, called H.O.S.T., which aims to guide learners to approach feedback with a personal growth mindset associated with the learning position. Specifically, the model presents an interdependent set of attitudes and behaviors that aim to facilitate emotional management and engagement in the feedback process, in order to initiate the reflective process necessary for learning and to enable the acquisition of targeted skills. The acronym H.O.S.T. reminds students of the four essential elements of the behavioral model: humility, openness, shared explicitness and tenacity. Based on the positive psychology movement, each element is defined and justified by known theoretical concepts. In order to better assimilate the components of the model, the use of internal dialogue is adopted to facilitate the training and adoption of behaviors. The essence of the model is discussed in light of the feedback literacy dedicated to learners.

Biodistribution Analysis of Peptide-Coated Magnetic Iron Nanoparticles: A Simple and Quantitative Method.

Biodistribution is the tracking of compounds or molecules of interest in the subject which is integral to understanding their anticipated efficacy and safety. Nanoparticles are highly desirable delivery systems which have the ability to deliver higher nucleic acid and drug payloads and they have enhanced tumor permeability due to their unique properties such as high surface area to volume ratio. Studying the biodistribution of nanoparticles is crucial to understand their effectiveness and safety in vivo, facilitate a more application driven approach for nanoparticle development which will lead to their successful translation into clinical use. In this study, we present a relatively simple method to determine the biodistribution of magnetic iron nanoparticles in mice. Branched Amphiphilic Peptide coated Magnetic Nanobeads BAPc-MNBs like their counterpart i.e., Branched Amphiphilic Peptide capsules (BAPCs) with a hollow water-filled core, are readily taken up by cells in vitro and have widespread application as a nanodelivery systems. We evaluated the BAPc-MNBs tissue distribution in wildtype mice injected intravenously (i.v.), intraperitoneally (i.p.) or orally gavaged to understand the biological interactions of the peptide nanoparticles and to further the development of branched amphiphilic peptides-based nanoparticles. BAPc-MNBs were distributed widely to various organs when injected i.v. and were eliminated from the system via the intestines in feces. The spleen was found to accumulate the highest amount of BAPc-MNBs in mice administered the NPs i.v. and i.p. while they were not absorbed into the system via oral gavage. This study not only presents a relatively simple quantification method to determine in vivo biodistribution of magnetic iron nanoparticles that can be widely applied but also demonstrates the potential of Branched Amphiphilic Peptides in the form of BAPCs or BAPc-MNBs as a delivery system.

Study of the electrostatic effects of mutations on the surface of dehaloperoxidase-hemoglobin A.

Point mutations of dehaloperoxidase-hemoglobin A (DHP A) that affect the surface charge have been prepared to study the interaction between DHP A with its substrate 2,4,6-trichlorophenol (TCP). Kinetic studies of these surface mutations showed a correlation, in which the more positively charged mutants have increased catalytic efficiency compared with wild type DHP A. As a result, the hypothesis of this study is that there is a global electrostatic interaction between DHP A and TCP. The electrostatic nature of substrate binding was further confirmed by the result that kinetic assays of DHP A were affected by ionic strength. Furthermore, isoelectric focusing (IEF) gel study showed that the pI-6.8 for DHP A, which indicates that DHP A has a slight negative charge pH 7, consistent with the kinetic observations.

Investigating patients' experiences: methodological usefulness of interpretive interactionism.

AIM: To demonstrate the methodological usefulness of interpretive interactionism by applying it to the example of a study investigating healthcare experiences of women affected by domestic violence. BACKGROUND: Understanding patients' experiences of health, illness and health care is important to nurses. For many years, biomedical discourse has prevailed in healthcare language and research, and has influenced healthcare responses. Contemporary nursing scholarship can be developed by engaging with new ways of understanding therapeutic interactions with patients. Research that uses qualitative methods of inquiry is an important paradigm for nurses who seek to explain and understand or describe experiences rather than predict outcomes. DISCUSSION: Interpretive interactionism is an interpretive form of inquiry for conducting studies of social or personal problems that have healthcare policy implications. It puts the patient at the centre of the research process and makes visible the experiences of patients as they interact with the healthcare and social systems that surround them. Interpretive interactionism draws on concepts of symbolic interactionism, phenomenology and hermeneutics. CONCLUSION: Interpretive interactionism is a patient-centred methodology that provides an alternative way of understanding patients' experiences. It can contribute to policy and practice development by drawing on the perspectives and experiences of patients, who are central to the research process. It also allows research findings to be situated in and linked to healthcare policy, professional ethics and organisational approaches to care. IMPLICATIONS FOR RESEARCH/PRACTICE: Interpretive interactionism has methodological utility because it can contribute to policy and practice development by drawing on the perspectives and experiences of patients who are central to the research process. Interpretive interactionism allows research findings to be situated in and linked to health policy, professional ethics and organisational approaches to caring.

Reconceptualising health and health care for women affected by domestic violence.

Domestic violence is a major public health issue that influences all aspects of affected women's lives (World Health Organisation, 2010). Women who are subjected to domestic violence seek help from a wide range of professionals within health and social care sectors, and evidence suggests that their experiences tend to be negative. We argue that current approaches are based on responses that are medically informed and provide an alternate lens from which to view women's health care needs. This paper reports on the findings of the second phase of a two-phase study. The first phase of the study reported on women's emerging health needs, efforts to seek help and experiences of seeking healthcare. The second phase examined how nurses constructed the health and health issues of women affected by domestic violence when women presented for health care. This paper brings together the findings of both phases to argue there is a disconnection in women's experiences and needs and how nurses construct needs and deliver care. Biographical disruption is a new lens from which to view women's experiences and is a framework which highlights how women experience significant dislocation of their sense of self as a result of domestic violence.

Effect of proton pump inhibitors and other commonly prescribed drugs on rescanning of patients undergoing myocardial perfusion imaging: a case-control study.

OBJECTIVES: Proton pump inhibitor use is associated with increased gastric wall activity on myocardial perfusion imaging; however, the clinical impact is unknown. We sought to determine the association of the use of proton pump inhibitors and nine other commonly prescribed classes of medications on the risk of rescanning patients undergoing myocardial perfusion imaging. METHODS: A matched case-control study was performed including 337 rescanned cases and 337 same-day controls from a total of 5432 patients undergoing myocardial perfusion imaging (MPI) over a 4-year period. RESULTS: The odds of rescanning was higher in patients taking a proton pump inhibitor than those not [adjusted odds ratio (OR), 1.6; 95% confidence interval (CI), 1.1-2.2] and in those taking an angiotensin-converting enzyme inhibitor than those not (adjusted OR, 1.5; 95% CI, 1.0-2.2) adjusted for age, sex and BMI category. Eight other commonly prescribed medications showed no associations with rescanning. Among the cases of rescanning, the culprit organ site of extracardiac activity was the left lobe of the liver, 48%; gastric wall, 31%; gastric lumen, 12%; spleen, 7% and bowel <1%. Proton pump inhibitor use was strongly associated with rescanning due to gastric wall uptake (adjusted OR, 6.3; 95% CI, 2.8-14.1) but not the other causes of rescanning. CONCLUSIONS: Proton pump inhibitor use and angiotensin-converting enzyme inhibitor use are associated with an increased risk of rescanning of patients undergoing MPI. Gastric wall activity is likely to account for the excess cases of rescanning in those taking a proton pump inhibitor.

Heterogeneity of definitions and measurements of binge drinking in research on adolescents and young adults.

INTRODUCTION: Binge drinking is a widespread health compromising behaviour among adolescents and young adults and is one of the leading causes of mortality and injuries among this population. The definitions and measurement methods of binge drinking are heterogeneous but constitute a crucial component in the literature on associated factors related to binge drinking. This study focused on how binge drinking is defined and measured in the literature exploring its associated risk factors among adolescents and young adults. METHODS: The databases PubMed, Embase, PsycINFO and Social Care were searched for articles published between 1 January 2006 and 30 April 2020 using 3 concepts: binge drinking; risk or protective factors; and adolescents/young adults with respective key words. Data were extracted on the main characteristics of studies and the parameters of binge drinking measurements. RESULTS: 173 studies were included, mostly cross-sectional (61 %) and longitudinal (38 %). Only 23 % of the studies explicitly referred to a standardised definition of binge drinking even though 76 % of the studies used a consensual threshold of 5 drinks or more for men. A lower threshold for women was applied in 26 % of the studies. Recall periods ranged between 2 weeks and 1 year in 85 % of the studies and only 16 % presented binge drinking in terms of frequency and/or quantity of drinks. CONCLUSION: Our results highlight the heterogeneity in the definitions and measurements of binge drinking, raising concerns for meaningful comparisons between studies focused on factors associated with the behaviour. The scientific community needs to be aware of these variations and address the gap of poor stratification and inconsistencies in binge drinking reporting.

Multimorbidity and statin prescription for primary prevention of cardiovascular diseases: A cross-sectional study in general practice in France.

Background: Statins are a first line, evidence-based yet underprescribed treatment for cardiovascular primary prevention. In primary care settings, multimorbidity is a complex situation which makes it difficult to apply prevention guidelines. Aim: To assess the associations between multimorbidity and prescription of statins in accordance with the 2016 ESC recommendations ("appropriate prescription"), and to identify the factors and conditions associated with these prescriptions. Design and setting: Cross-sectional prospective study in the French region of Rhône-Alpes among 40 general practitioners and their patients. Methods: We examined the association between appropriate statin prescription and several patient characteristics, including multimorbidity, using multivariate logistic regression models. Results: Between August 2017 and February 2019, 327 patients were included in the study. Seventy-four (22.6%) were on statin medication and 199 (60.9%) exhibited multimorbidity, defined as ≥2 diseases. Only 22.5% of eligible patients were prescribed statins for primary prevention. Diabetes was most strongly associated with appropriate statin prescription (aOR 8.10, CI 95: 3.81-17.80). Multimorbidity was not associated with appropriate statin prescription (aOR 1.31, CI 95: 0.54-3.26), except in the presence of diabetes which defined diabetic multimorbidity (aOR 10.46, CI 95: 4.87-23.35). Conversely, non-diabetic multimorbidity was associated with lower odds of being appropriately prescribed a statin (aOR 0.26, CI 95: 0.12-0.56). Conclusion: Multimorbidity, in itself, does not seem to be a determinant factor for appropriate statin prescription. The latter appears to be determined by a patient's type of multimorbidity, especially the presence or not of diabetes. Differentiating between diabetic and non-diabetic multimorbidity may be a pragmatic way for GPs to improve primary prevention in a patient-centered and shared decision-making approach.