Adolescent Marijuana Use and Co-Occurrence with Tobacco Use: Implications for Tobacco Regulation

Background: Marijuana use among high school youth has been declining over the past two decades. However, there has been a notable shift in the national landscape with regards to social norms and marijuana legalization that could allow marijuana to become more available and may compete against prevention efforts among youth. Further, youth continue to utilize innovative ways to consume marijuana. There is a documented relationship between marijuana and tobacco use, particularly with the use of blunts. Despite the documented relationship between tobacco and marijuana use, little is known about the modes of marijuana use in relation to different tobacco products. With the recent FDA changes bringing cigars under the purview of the FDA Center for Tobacco Products (CTP), there may be an opportunity for CTP regulations of cigar products to impact youth use of both marijuana and tobacco. Methods: This study used data from the 2015 Cleveland Youth Risk Behavior Survey (n=6197) conducted as a census administration in 26 high schools; overall response rate was 66.5%. Youth were asked “During the past 30 days, how did you usually use marijuana?”. Responses were coded as a blunt; in a joint, bong, or pipe (JBP); or some other way. The standard CDC response categories for this item were altered to allow us to specifically examine blunt use. Analyses were restricted to those who smoked marijuana in the past 30 days and were conducted using SPSSv24. Demographic and tobacco use characteristics were examined for each mode of marijuana use. Result: Overall, 74.6% of past 30-day marijuana users reported usually smoking marijuana as a blunt, 15.1% smoked as a JBP, and 10.4% reported using in some other way. Females were more likely to smoke a blunt (79.5% v 71.1%) and less likely to use some other way (6.7% v 13.1%). Blacks were more likely to smoke a blunt compared to Whites and Hispanics (80.8% v 62.3% and 67.0% respectively); Whites were more likely to smoke a JBP compared to Black and Hispanics (33.8% v. 8.9% and 20.1% respectively). Past 30-day cigarette smokers were more likely to have smoked a JBP and less likely to have smoked a blunt compared to non-cigarette smokers. Conversely, past 30-day cigar smokers were more likely to have smoked a blunt and less likely to have smoked a JBP than non-cigar smokers. Youth who vaped in the past 30-days were more likely to use a JBP and use marijuana in some other way compared to youth who had not vaped. In a multivariable logistic regression predicting blunt use or JBP use, cigar product use increased odds of blunting (OR: 1.98) while hookah use was associated with increased odds of JBP. Conclusion: Cigar products are an easily accessible vehicle for smoking marijuana. Federal regulations to restrict youth access to cigar products could have significant impact on adolescent marijuana use, particularly among females and Black youth

The Theme of Religion in School Environment, Discussion with Teachers and Students

This article deals with the topic of school and religion, it opens a discussion on the presence of spirituality in the school environment and brings an analysis of a survey research. The research was aimed at the area of values, culture and religion in the school environment. The problem was explored through qualitative research strategy. The respondent group consisted of teachers and students who are familiar with the topic of values and spirituality in the school environment. Thus, the group of respondents is selected purposefully and a grounded theory a qualitative research method was chosen. Data gathering was done by focus group discussions (four focus groups) which were transcribed and analyzed by open coding. At the beginning of the analysis it was necessary to establish individual terms that emerged from the discussion. Also, a certain reflection has been made about those terms, how are they viewed and what is “behind them”. The goal of the survey was to acquire statements from teachers and students about the situation in the school environment regarding the topic of values and spirituality as a part of the culture of recognition in the school environment

Moving Towards Equity as a Driver of Health Behavior Research

For health behavior researchers, using a health equity lens requires us to more expressly consider multiple contexts in understanding and intervening to improve health-related behaviors and reduce disparities in outcomes. The results of such studies are critical to advancing our knowledge base, and for making meaningful progress toward optimal health and health equity. The selected papers serve as salient examples of how health equity perspectives could and should be integrated into all health behavior research

Use of Waste in the Removal of Oil Products

Předložený článek se zabývá problematikou odstraňování ropných látek z vodní hladiny a pevného povrchu za pomoci procesu adsorpce. Odpadu jako možné druhotné suroviny při odstraňování ropných produktů je používán k testování popel z tepláren, využívající rozličné druhy ohnišť. Při experimentech je sledována sorpční schopnost popelů jako sorbentů, při odstraňování všech tříd ropných látek (motorového oleje, motorové nafty, motorového benzínu a leteckého petroleje). Je provedeno matematické stanovení sorpční kapacity testovaných druhů popelů dle postupu normy ASTM F726-06 s ověřením a srovnáním sorpční kapacity daných popelů v laboratorních podmínkách a porovnání a stanovení spotřeby popelů při simulovaném úniku ropných produktů na pevném povrchu. Sorpční schopnost připravených sorbentů je porovnávána se sorpční schopností běžně používaného komerčního sorbentu na bázi rašeliny. Provedené experimenty prokázaly vhodnost využití testovaných druhotných surovin, což znamená pro instituce využívající sorpční přípravky snížení možných nákladů.The present article deals with the removal of oil products from the water and solid surface with the help of the adsorption process. Waste as possible secondary raw materials in removing petroleum products are used to test the ash from power stations, using different kinds of fi res. In experiments is observed sorption capacity ashes as sorbents, the removal of all classes of petroleum products (engine oil, diesel, petrol and kerosene). Mathematical determination is made sorption capacity ash species tested according to ASTM F726-06 process of verifying and comparing the sorption capacity of the ashes in the laboratory and compared and determine the consumption of ash simulated leak of petroleum products on a hard surface. Sorption capacity sorbents prepared is compared with the adsorption capacity of commonly used commercial peatbased sorbent. The experiments demonstrated the suitability of the use of secondary raw materials tested, which means for institutions using sorbent products reduce the potential costs

The Cigarillo Purchase Task: A Qualitative Analysis

The cigarillo purchase task is a novel procedure modeled after the cigarette purchase task. This procedure can be used to assess the reinforcing value, or the positive behavioral response, to cigarillo products. Little research has used the cigarillo purchase task and the aim of the current study was to evaluate user’s understanding of and thoughts about a cigarillo purchase task. A convenience sample of young adults ages 21-28 were recruited online to participate in semi-structured interviews about cigarillo and e-cigarette use. The analysis included responses from participants who were current users of cigarillos (n=7) or cigarillos and e-cigarettes (n=8). Audio-recorded interviews conducted remotely were coded by two researchers and thematic analysis was implemented. Emergent themes were related to purchasing price, budget, normal cigarillo usage, cigarillo pack size, and time frame of use. Increased use was mentioned when products were free. When cigarillos were expensive, others introduced strategies to circumvent the 24-hour purchase period of the task. Comments were also made that budget is important and using a calculator during the task is helpful. Finally, some commented that selling in individual units wasn’t realistic and made it more difficult to purchase. Results suggest modifications to the task, including depiction of cigarillo pack size and use of a budget calculator. These enhancements support usability and replicability of results when implementing this purchase task in health behavior and tobacco control research

The Removal of Oil Substances Using of Laboratory Prepared Absorption Booms and Secondary Raw Materials

Předložený článek se zabývá problematikou odstraňování ropných látek z vodní hladiny a pevného povrchu za pomoci procesu adsorpce s využitím druhotných surovin – popelů po spalování biomasy rostlinného původu a laboratorně připraveného sorpčního hada, jehož obal, tj. povrch hada je tvořen hydrofobní polypropylenovou textilií, náplň hada tvoří hydrofobní popel po spalování biomasy rostlinného původu s polyuretanovou pěnou a hydrofobizačním činidlem. Při experimentech byla sledována sorpční schopnost při odstraňování motorového oleje, motorové nafty, motorového benzínu a leteckého petroleje v objemu 10 l, při kterém se nejlépe osvědčil popel I. se spotřebou 3,78-4,46 kg. Tato spotřeba byla shodná se spotřebou komerčního sorbentu, což znamená snížení možných nákladů pro instituce využívající sorpční přípravky.The paper deals with the removal of oil substances from water surface and solid surface by means of adsorption making use of secondary raw materials – ash from plant biomass combustion. The waste material is used as one component to make laboratory sorption booms, the surface of which is made of hydrophobic polypropylene fabric. The fi lling is a hydrophobic ash from combusting plant biomass, polyurethane foam and hydrophobic agent. The experiments focused on the booms' sorption capacities during the removal of different oil substances, such as engine oil, diesel oil, motor petrol and jet fuel, in the volume of 10 l. The best results were obtained with ash No I. with the consumption of 3.78-4.46 kg. The consumption was identical to the consumption of commercially available sorbent, which brings reduced costs for institutions using sorption agents

A bedside swallowing screen for the identification of post-extubation dysphagia on the intensive care unit – validation of the Gugging Swallowing Screen (GUSS)—ICU

Purpose Screening for dysphagia at the intensive care unit (ICU) soon after extubation can prevent aspiration, pneumonia, lower mortality, and shorten re‑feeding interval. This study aimed to modify the Gugging Swallowing Screen (GUSS), which was developed for acute stroke patients, and to validate it for extubated patients in the ICU. Methods In this prospective study, forty‑five patients who had been intubated for at least 24 h were recruited consecutively at the earliest 24 h after extubation. The modified GUSS‑ICU was performed twice by two speech and language therapists independently. Concurrently, gold standard the flexible endoscopic evaluation of swallowing (FEES) was performed by an otorhinolaryngologist. Measurements were conducted within a three‑hour period; all testers were blinded to each other’s results. Results According to FEES, 36 of 45 (80%) participants were diagnosed with dysphagia; 13 of those were severe, 12 moderate, and 11 mild. Compared to FEES, the GUSS‑ICU predicted dysphagia well (area under the curve for the initial rater pair: 0.923, 95% CI 0.832–1.000 and 0.923, 95% CI 0.836 ‑1.000 for the second rater pair). The sensitivity was 91.7% (95% CI 77.5–98.3%) and 94.4% (95% CI 81.3–99.3%); the specificity was 88.9% (51.8–99.7%) and 66.7% (29.9–92.5%); the positive predictive values were 97.1% (83.8–99.5%) and 91.9% (81.7–96.6%), and the negative predictive values were 72.7% (46.8–89%) and 75% (41.9–92.6%) for the first and second rater pairs, respectively. Dysphagia severity classification according to FEES and GUSS‑ICU correlated strongly (Spearman’s rho: 0.61 for rater 1 and 0.60 for rater 2, p < 0.001). Agreement by all testers was good (Krippendorffs Alpha: 0.73). The interrater reliability showed good agreement (Cohen`s Kappa: 0.84, p < 0.001). Conclusion The GUSS‑ICU is a simple, reliable, and valid multi‑consistency bedside swallowing screen to identify post‑extubation dysphagia at the ICU

From Procurement to Consumption: A Model to Understand Nutrition Policy Implementation in Permanent Supportive Housing

Background: Food insecurity has become an increasingly complex public health issue across the United States, particularly among various people battling with current or previous homelessness. This project sought to understand the food system in permanent supportive housing sites (PSH) that serve formerly homeless individuals and to explore the use of nutrition standards, specifically the Food Service Guidelines for Federal Facilities (FSGFFs), in this context. Methods: Participants were members of the administrative staff involved in the food procurement process, food preparation, administrative tasks, and daily operations in a small-intensive program managed by a local nonprofit agency that serves 12 adults over the age of 18 who experience chronic homelessness and persistent mental illness, or substance use disorders, and a second PSH site that helps 41 low-income adults with health conditions experiencing homelessness. The PSH Inquiry Tool (PSH-IT) was developed to better understand the business operations at each site, and the PSH Audit (PSH-A) was created to assess the applicability of FSGFF at each site. Results: Findings suggest that funding mechanisms, staff training, staff capacity, and access to nutrition education were critical barriers to the successful development and implementation of nutrition standards in PSH sites. Furthermore, findings suggest that adaptations to FSGFFs are required before implementation at PSH sites. Conclusion: This report advocates for increased involvement of community stakeholders to support nutrition policy development and implementation, a nutrition policy that impacts all levels of the food system from procurement to consumption, and local, state, or federal policy changes to support improved nutrition in PSH

Evaluation of a Peer-to-Peer Approach to Improve the Reach of Farmers’ Markets among Low-income Populations

Farmers’ markets have been implemented to improve access to nutritious foods, yet use is low among people receiving Supplemental Nutrition Assistance Program (SNAP) benefits. This study’s objectives were to assess the feasibility of implementing the FreshLink Ambassador intervention to promote use of farmers’ markets located in high SNAP neighborhoods, describe information dissemination by Ambassadors, and evaluate intervention impact on SNAP use. The theory-based and data-driven intervention trained nine community residents as FreshLink Ambassadors in 2017; eight completed the study. Ambassadors conducted weekly outreach disseminating coupons to promote use of three intervention markets. Four comparison markets were selected to evaluate impact on SNAP use. SNAP sales from 2016 to 2017, standardized per vendor per market day open, were compared using paired and cluster-adjusted t-tests, p \u3c .05. FreshLink Ambassadors conducted 155 outreach events reaching 1,138 people through coupon dissemination. The coupon redemption rate was 13.9%; redemption was significantly higher for people 50+ years of age, without children in the household, not currently receiving SNAP benefits, and living in the zip code with an intervention market. Intervention versus comparison markets had greater improvements in standardized SNAP sales ($0.73 vs.$0.44). These changes were not statistically significant but may be practically significant for farmers’ market operations. Findings provide evidence that implementation of the peer-to-peer outreach approach was feasible and coupon redemption rates exceeded industry standards indicating the “product” promoted by FreshLink Ambassadors was considered advantageous. Future research is warranted to evaluate different strategies intended to promote social access to farmers’ markets within a broader agenda to advance health equity

Effectiveness of Health Education Teachers and School Nurses Teaching Sexually Transmitted Infections/ Human Immunodeficiency Virus Prevention Knowledge and Skills in High School

BACKGROUND- We examined the differential impact of a well-established human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) curriculum, Be Proud! Be Responsible!, when taught by school nurses and health education classroom teachers within a high school curricula. METHODS- Group-randomized intervention study of 1357 ninth and tenth grade students in 10 schools. Twenty-seven facilitators (6 nurses, 21 teachers) provided programming; nurse-led classrooms were randomly assigned. RESULTS- Students taught by teachers were more likely to report their instructor to be prepared, comfortable with the material, and challenged them to think about their health than students taught by a school nurse. Both groups reported significant improvements in HIV/STI/condom knowledge immediately following the intervention, compared to controls. Yet, those taught by school nurses reported significant and sustained changes (up to 12 months after intervention) in attitudes, beliefs, and efficacy, whereas those taught by health education teachers reported far fewer changes, with sustained improvement in condom knowledge only. CONCLUSIONS- Both classroom teachers and school nurses are effective in conveying reproductive health information to high school students; however, teaching the technical (eg, condom use) and interpersonal (eg, negotiation) skills needed to reduce high-risk sexual behavior may require a unique set of skills and experiences that health education teachers may not typically have