\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

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

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

Poverty and Paternal Education Associated with Infant Safe Sleep Intentions in a Peri-Urban Community in Ecuador

Ecuador’s annual mortality rate from SIDS is 0.4 per 100 000 people, 4 times higher than neighboring countries Peru, Bolivia, and Brazil. Modifying the infant sleep environment toward safe practice has been demonstrated to be the most effective risk reduction strategy in reducing mortality from SIDS and little is known about sleep practices in Ecuador. The purpose of this study is to describe baseline infant sleep intentions of pregnant women in a peri-urban, low resource community in Ecuador. We also aim to identify demographic and psychosocial factors associated with suboptimal sleep practices in this context to develop long-term strategies to identify infants with high risk for SIDS/SUID. A cross-sectional study design was employed with 100 women in their third trimester of pregnancy. The majority of women were partnered (82%), both parents had approximately 8 years of education, and over half reported that their incomes met or exceeded their basic needs (55%). Significant predictors of safer sleep intention included years of paternal education (P = .019) and income meeting their basic needs (P = .0049). For each additional year of paternal education, families were 23% more likely to report safer intended infant sleep practices. Compared to those whose income did not allow for basic needs, those who had sufficient income to meet (or exceed) basic needs were 425% more likely to report safer intended sleep practices. Targeted interventions to high-risk populations may reduce the burden of SIDS/SUID in this community

Polytobacco Use Among College Students

INTRODUCTION: Use of more than one tobacco product among college students is increasing in popularity, leading to nicotine addiction and additional health risks. The study (1) examined polytobacco use patterns among college students who had ever used tobacco; and (2) assessed the sociodemographic and personal factors associated with current polytobacco use, compared to current single product use and former tobacco use among college students. METHODS: Of 10,000 randomly selected college students from a large public university in the Southeast, a sample of 1593 students age 18 or older completed an online survey assessing tobacco use and attitudes. Ever tobacco users were included in this study (n = 662, or 41.6% of survey completers). RESULTS: About 15% of ever users reported current polytobacco use, and more than 70% of polytobacco users smoked cigars, little cigars, or clove cigarettes in combination with one or more products. Cigarettes were the most commonly-used product among single users, followed by hookah. Males, underclassmen, and students with greater acceptance of cigarette use were more likely to be polytobacco users. Race/ethnicity was marginally related to polyuse status, with white/non-Hispanics 28% less likely to be polytobacco users versus single product users. CONCLUSIONS: Polytobacco users were more likely than single users to consume emerging tobacco products, (ie, hookah and electronic cigarettes). Males, underclassmen, and racial/ethnic minorities were more at risk for polytobacco use. As young people are particularly prone to nicotine addiction, there is a need to further investigate polytobacco use among college students