THE USE OF IMPROVED TECHNOLOGY AND MARKET-BASED INCENTIVES TO INCREASE FOREST RESOURCE AND BIODIVERSITY CONSERVATION IN RWANDA

This study evaluated the effectiveness of two distinct approaches to ecosystem conservation in Rwanda’s Nyungwe National Park: cookstove technology adoption and market-based policy instruments. A June 2014 survey of 250 households revealed that use of improved cookstove technology dramatically decreased fuelwood consumption for households in rural Rwanda, but that design, engineering and conflicting policy issues can hamper the widespread use of energy-efficient cooking technology. The second component of this research used the analytic hierarchy process (AHP) within a multi-criteria analysis (MCA) framework to explore the options for designing and implementing market-based instruments around the country’s conservation targets, particularly the highly biodiverse Nyungwe National Park. A series of workshops, held in June, October and November of 2014, were conducted at the local level (with regional farmers and agricultural cooperatives) and the national level (with representatives from conservation organizations and government). Focus group participants identified criteria for evaluating MBIs, and then ranked the priority of these criteria. Finally, national-level experts ranked how well distinct MBIs could achieve conservation goals. This paper summarizes the focus group findings and provides a recommendation for the design and implementation for market-based conservation instruments in Rwanda

Associations of Demographic Factors and Tobacco Use With Progesterone and Estradiol During Pregnancy

Objective: To evaluate the association of biochemically validated prenatal tobacco use with serum progesterone and estradiol in the second trimester of pregnancy, controlling for demographic and personal factors. Study design: This secondary analysis of a multicenter longitudinal study included 114 women with singleton pregnancies. Multiple regression analysis assessed whether prenatal tobacco use was related to hormone levels during the second trimester, controlling for covariates (age, body mass index, and race or ethnicity, with gestational age added to subsequent models). Result: In the initial regressions, tobacco users had significantly lower progesterone level compared with nonsmokers (p = .037), while estradiol was unrelated to prenatal tobacco use. Women with greater body mass index also had significantly lower progesterone (p = .028), but body mass index was unrelated to estradiol. With gestational age as an additional covariate, prenatal tobacco use was no longer a significant predictor of progesterone, but both body mass index and gestational age were significant (F = 10.6, p \u3c .001, R2 = 0.35). For estradiol, the overall regression of estradiol on age, body mass index, and race or ethnicity was not significant (F = 1.2, p = .31). With gestational age added to the model, the overall model was significant (F = 7.2, p \u3c .001, R2 = 0.27). Conclusion: This study provides additional evidence that prenatal tobacco use may influence lower serum progesterone during the second trimester. This is of particular concern given the link between depressed progesterone activity and risk for preterm birth

Advertising Exposure and Use of E-Cigarettes Among Female Current and Former Tobacco Users of Childbearing Age

Objective: The study examined the relationship between exposure to e‐cigarette advertising and e‐cigarette use by pregnancy status, including use of flavored e‐cigarette products, among women of childbearing age. Design: A cross‐sectional, correlational design was used. Subjects: Female current or former tobacco users in Central and Eastern Kentucky, 18–45 years old (N = 194, 52% pregnant). Measures: Demographics, pregnancy status, cigarette and e‐cigarette use, and exposure to e‐cigarette advertising. Results: Younger age, white non‐Hispanic race, and greater exposure to e‐cigarette advertising were associated with a higher likelihood of ever using e‐cigarettes (p \u3c .05 for each variable). Pregnancy was not associated with ever use (p = .11). Younger age was associated with use of flavored e‐cigarettes (p = .0027). Among e‐cigarette users, those who used flavored products were more likely to have seen advertisements or information about e‐cigarettes on social media, compared to those who used unflavored e‐cigarettes only (p = .016). Conclusion: There is a link between advertising exposure and ever use of e‐cigarettes. Pregnancy status is not significantly associated with ever use. Use of flavored e‐cigarettes is associated with younger age. E‐cigarette users with greater exposure to advertising on social media were more likely to use flavored products

\u3cem\u3eLas Dos Cosas\u3c/em\u3e versus Exclusive Breastfeeding: A Culturally and Linguistically Exploratory Intervention Study in Hispanic Mothers Living in Kentucky

INTRODUCTION: Formula supplementation among infants of breastfeeding Hispanic immigrants is common practice known as las dos cosas. The purpose of this study was to assess the feasibility, effectiveness, and acceptability of a culturally and linguistically diverse intervention to promote exclusive breastfeeding (EBF) for the first 6 months. METHODS: A sample of 39 Hispanic pregnant women was recruited and randomly assigned to intervention (n = 20) and control groups (n = 19). The intervention included a peer counselor and professional support, and mothers were followed from pregnancy to 6 months after birth. RESULTS: After the study, women assigned to the intervention group were over three times more likely to EBF their baby through all four postpartum assessed time points (odds ratio = 3.1, 95% confidence interval: 1.1-8.7). DISCUSSION: This culturally and linguistically diverse intervention contributed to increased EBF duration and decreased formula supplementation in Hispanic mothers up to 6 months postpartum

Assessing Workplace Tobacco Policies: A Community-Academic Partnership

Purpose Describe the number and type of tobacco policies in manufacturing facilities Assess the resources for tobacco education and cessation Identify factors related to tobacco policies and practices within manufacturing facilitie

Predictors of Depression for Low-Income African American Single Mothers

Purpose: To test a model of predictors of depression in low-income single African American mothers. Design: Secondary analysis of existing data collected as part of a study of women at risk for clinical depression. Methods: Cross sectional secondary data analysis of a study of low-income African American single mothers with children ages 2-6. Path analysis was used to test a model of the potential mediating role of negative thinking. It was hypothesized that negative thinking mediates the effects of chronic stressors, general health status, and self-esteem on depressive symptoms Finding: Negative thinking mediated the relationships of chronic stressors and self-esteem with depressive symptoms. Conclusions: These findings supported the proposed model with one exception: negative thinking did not mediate the effects of physical health on depressive symptoms. Physical health also had no direct effect on depressive symptoms. Negative thinking may play a pivotal role in the development of depression for these at risk women. Self-esteem, chronic stressors and negative thinking should be important considerations in designing interventions to improve the mental health of at-risk African American women

Exposure to Secondhand Smoke and Nicotine Dependence

Background Nicotine dependence (ND) : “the smoking behavior accompanied by a reluctance to quit (Khurana, Batra, Patkar, & Leone, 2003). The US Public Health Service Clinical Practice Guideline ‘Treating Tobacco Use and Dependence’: A chronic condition that often requires repeated interventions (Office of the Surgeon General, 2000). Secondhand Smoke (SHS) is a potential source of exposure to high levels of nicotine. (Dimich-Ward, Gee, Brauer, Leung,1997) No current studies addressing the contribution of SHS to Nicotine Dependence (ND) or smoking behavior

Projected Smoking-Related Deaths Among U.S. Youth: A 2000 Update

This paper projects the long term consequences of the rise in youth smoking in the 1990s by updating the state estimates for projected smoking-related deaths among youth in the U.S. using information from the Behavioral Risk Factor Surveillance System (BRFSS) 2000 and the U.S. Census 2000. This analysis is similar to that from an earlier study published by the Centers for Disease Control and Prevention (CDC), Office on Smoking and Health (MMWR, 45[44], November 8, 1996). The 1996 analysis used young adult smoking prevalence data from 1994 and 1995; whereas, the analysis presented here represents smoking prevalence data from 2000. The overall number of potential future smoking-attributable deaths among persons aged 0-17 years in 2000 was 6,407,119 for the U.S., up from an estimated 5 million in 1995. Compared with the 1995 estimates, every state except Arizona shows increases in projected smoking-related deaths among youth for 2000. This upsurge is attributable to both increases in smoking prevalence among young adults and population aged 0-17 years from 1995 to 2000. The increase in smoking prevalence among young adults was statistically significant in nine states including Alabama, District of Columbia, Iowa, Kentucky, Nevada, North Dakota, South Carolina, South Dakota, and Vermont. With increasing attention and funding for comprehensive, research-based tobacco control programs in the U.S., one would expect smoking rates to decline over time, resulting in a reduction in projected smoking-related deaths among youth. The analysis reported here does not yet reflect this trend. This study clearly demonstrates that based on recent smoking patterns, there will continue to be a huge public health toll from tobacco. The results from this new analysis will be useful to states as they determine the overall public health benefits from increasing the state excise tax and consider funding for comprehensive tobacco control programs

Advanced Practice Nursing Roles, Regulation, Education, and Practice: A Global Study

Background and Objectives: Several subgroups of the International Council of Nurses Nurse Practitioner/Advanced Practice Nurse Network (ICN NP/APNN) have periodically analyzed APN (nurse practitioner and clinical nurse specialist) development around the world. The primary objective of this study was to describe the global status of APN practice regarding scope of practice, education, regulation, and practice climate. An additional objective was to look for gaps in these same areas of role development in order to recommend future initiatives. Methods: An online survey was developed by the research team, and included questions on APN practice roles, education, regulation/credentialing, and practice climate. The study was launched in August 2018 at the 10(th) Annual ICN NP/APNN Conference in Rotterdam, Netherlands. Links to the survey were provided there and via multiple platforms over the next year. Results: Survey results from 325 respondents, representing 26 countries, were analyzed through descriptive techniques. Although progress was reported, particularly in education, results indicated the APN profession around the world continues to struggle over titling, title protection, regulation development, credentialing, and barriers to practice. Conclusions and Practice/Policy Relevance: APNs have the potential to help the world reach the Sustainable Development Goal of universal health coverage. Several recommendations are provided to help ensure APNs achieve these goals