Prevention of smoking behaviors in middle school students: student nurse interventions

This article examines the use of the Tar Wars curriculum with the public health problem of preteen smoking and outlines interventions with a middle school population by community health student nurses from a state university. Smoking is the single most preventable cause of death and disability. Three million people die worldwide each year as a result of smoking. Cigarette smoking has now been labeled a pediatric disease. Estimates are that 3,000 children will begin a lifelong addiction to cigarettes every day. They will face a life of poor quality based on the medical consequences of smoking cigarettes. Mortality from tobacco use is annually greater than that from drug abuse, AIDS, suicide, homicide, and motor vehicle accidents combined. Preteen and teenage smoking is now a public health problem, therefore implications for service learning, nursing advocacy, and interventions with this health problem are discussed.     

Smoking behaviour in young families: Do parents take practical measures to prevent passive smoking by the children?

Objective - To investigate smoking behaviour in young families.

Design - Cross-sectional study.

Setting - Mother and child health centres in Oslo, Norway.

Subjects - the families of 1046 children attending the health centres for 6-weeks-, 2- or 4- year well child visits.

Main outcome measures - Daily smoking, smoking quantity and practical measures taken by the parents to prevent passive smoking among the children as assessed by parental reports.

Results - in 48% of the families at least one adult was smoking. 33% of the smoking parents smoked more than ten cigarettes per day. 47% of the smoking families reported that they did not smoke indoors.

Conclusions - the parents were less likely to smoke if they were more than 35 years of age, had a child aged less than one year, had' a spouse/co-habitee or had a long education. Smoking parents smoked less if they had a spouse/co-habitee, had a child aged less than one year or had few children. Smoking parents were more often careful and did not smoke indoors if they had a child aged less than one year, had a spouse/co-habitee, did not have a smoking spouse/co-habitee or smoked a low number of cigarettes per day.     

The association between active and passive smoking and frequent pain in a general population

Background: It is controversial whether the association between back pain, and other types of chronic pain, and smoking is causal or not. Aim: To examine the relationship between frequent pain and smoking, and between frequent pain and exposure to environmental tobacco smoke (ETS) in smokers and non‐smokers. Methods: A randomised population‐based study, Inter99 (1999–2006), Denmark. Subjects in the intervention groups (N=6784; participation rate=52.5%) completed self‐report questionnaires. Cross‐sectional data from baseline were analysed in adjusted logistic regression analyses to investigate the relationship between active and passive smoking and frequent pain in the back, abdomen, joints and head. Results: Daily smokers reported significantly more frequent pain in every of the six locations, and in several, minimum three, locations (OR=1.98 (95%CI=1.6–2.4)) than never smokers. We found a dose–response relationship between frequent pain and intensity of both active and passive smoking (test‐for‐trend p<0.001). Those exposed to 5h or more of ETS reported significantly more frequent pain than those almost never exposed to ETS (non‐smokers: OR=1.46 (95%CI=1.2–1.8), and smokers: OR=2.04(95%CI=1.4–3.0)). Also, an earlier smoking debut and an increasing number of pack‐years increased the probability of frequent pain in daily smokers (test‐for‐trend p<0.05). Conclusion: We found significant association, dose–response and reversibility between active smoking and frequent pain in all six locations. Furthermore, we found that increasing intensity of ETS increased the probability of frequent pain in non‐smokers, which has not been shown before. In conclusion, several findings in this study indicate a causal link between tobacco smoke and pain, which is supported by recent prospective studies.     

New tobacco trends: Waterpipe (hookah) smoking and implications for healthcare providers

Purpose: To inform healthcare providers about waterpipe smoking, a new trend in tobacco use that is gaining popularity among adolescents and young adults.
Data sources: American Lung Association Tobacco Policy Alert on Waterpipe Smoking, World Health Organization Tobacco Regulation Advisory Note on Waterpipe Smoking, and pertinent publications available in the literature.
Conclusions: Waterpipe smoking is a new trend in tobacco use that is associated with multiple health problems, including addiction. Healthcare providers should be aware of new tobacco trends that may affect patients, such as waterpipe smoking, that are potential gateways to nicotine addiction.
Implications for practice: Tobacco comes in many forms, all of which are addicting. Healthcare providers must be knowledgeable about new forms of tobacco to address all types of tobacco use with patients. Healthcare providers also have a responsibility to educate patients about the health risks inherent in these products to help prevent the long-lasting problem of nicotine addiction.     

Anabolic steroids: implications for the nurse practitioner

Anabolic steroids are being used by athletes in a wide variety of sports in efforts to enhance their athletic performances. Steroid abuse is complex to evaluate due to the highly emotional subject matter and the limitations in researching anabolic steroids. This article has been written to heighten the practitioner's awareness of the problem of "sports doping" with anabolic steroids. It will provide practical information on possible consequences of steroid use and outline essential information to obtain through the history, physical exam and laboratory studies. Intervention strategies based on the three levels of prevention are described. With awareness of the problem of sports doping and knowledge of how to deal with it in primary care, the nurse practitioner can enhance the health care provided to aspiring athletes, athletes and retired athletes.     

Caught in the middle: experiences of tobacco-dependent nurse practitioners

PURPOSE: To explore how tobacco-dependent nurse practitioners (NPs) describe their experiences with health promotion and disease prevention practices with patients who smoke. DATA SOURCES: Twelve NPs who completed a graduate level NP program of study participated in face-to-face interviews and/or online chat room interviews. CONCLUSIONS: Participants' responses revealed three themes relevant to their experience as tobacco-dependent clinicians with health promotion responsibilities. These themes centered around (a) living as an insider in the world of tobacco addiction, (b) having the outside-in view of living with a tobacco addiction, and (c) being caught in the middle of a tobacco addiction. IMPLICATIONS FOR PRACTICE: All of the tobacco-dependent participants described limited smoking-cessation interventions with their patients. A barrier to implementation of more aggressive interventions, perhaps, is the provider's own tobacco addiction. With increasing evidence that tobacco-dependent health care professionals are not adequately intervening with tobacco-dependent patients, effective strategies are needed to assist and/or support not only tobacco-dependent patients but providers as well.     

Effect of parental hypertension and/or parental diabetes on hypertension in Taiwanese diabetic patients

BACKGROUND: Both type 2 diabetes mellitus (T2DM) and hypertension aggregate in families. It is a common thought that diabetic patients with parental diabetes and/or parental hypertension are more likely to develop hypertension. This study evaluated the separate and joint effects of parental hypertension and parental diabetes on the prevalence of hypertension in patients with T2DM. MATERIALS AND METHODS: A total of 89 956 patients from a national cohort were interviewed by telephone. Information about age, sex, onset age of diabetes, body height, body weight, systolic (SBP) and diastolic blood pressure (DBP), smoking, hypertension, and paternal and maternal history of diabetes and hypertension were obtained. Hypertension was defined in two ways: (1) a positive history; or (2) a positive history or a reported SBP > or = 140 mmHg and/or DBP > or = 90 mmHg in patients without a hypertension history. RESULTS: While analysed separately in logistic models, both parental diabetes and parental hypertension were positively associated with hypertension. However, when both were analysed together, only parental hypertension was positively associated with hypertension, with paternal and maternal hypertension exerting a similar effect of an approximately 2.5-fold higher risk. While considering the effect of parental hypertension, both paternal and maternal diabetes was significantly associated with a lower risk of hypertension with odds ratios of approximately 0.8. Parental hypertension was also significantly associated with increased SBP and DBP; and parental diabetes with lower values in multiple linear regression. CONCLUSIONS: Parental hypertension is strongly associated with hypertension. However, parental diabetes may be protective if the effect of parental hypertension is considered.     

英国开业护士概况及启示

在英国,开业护士参与了社区诊所、急诊、儿科等领域的卫生服务。开业护士拥有处方权,提高了服务效率,改善了医疗服务效果,节约了社会成本。该文对英国开业护士的历史、现状、培养及能力要求、管理、优势评价方面进行介绍,建议我国应探索开业护士参与卫生服务模式,建立完善培养体系,制订明确的管理体制,扩充开业护士人力资源。     

加拿大开业护士概况及启示

在加拿大的初级诊疗和慢病管理等方面,开业护士的服务质量、安全性、患者满意度及成本效益均体现出了优势。该文通过对加拿大开业护士的历史发展、工作内容、认证及培养和作用评价等方面进行概述,分析了我国社区护理人员可以借鉴的内容,为我国开业护士的培养提供一定参考。     

Nurses, smoking, and the workplace

The purpose of this study was to examine attitudes and experiences of nurses regarding smoking and smoking cessation in the workplace. Eight focus groups were conducted with current or former smokers (n = 60). A questionnaire provided information about smoking history. Content analysis revealed six themes: taking breaks, stress and smoking, social support from colleagues, hiding smoking from patients and their families, impact of workplace smoking restrictions, and challenges to smoking cessation in the workplace. Nurses who smoke were perceived as taking more breaks and spending less time with patients than those who do not smoke. These findings document the impact of smoking among nurses in the workplace. Strategies are needed to support smoking cessation efforts of nurses as an important occupational health issue.     

Attention-deficit disorder in children: the role of the nurse practitioner

Attention-deficit disorder is a relatively common syndrome; it is probably the behavior disorder of childhood that primary care practitioners most frequently see. This article describes 1) the clinical picture, subtypes and possible etiologic factors involved in the disorder; 2) the diagnostic evaluation of the child who presents with symptoms suggestive of this syndrome; 3) the natural history of the disorder and its relationship to other disorders of childhood, adolescence and adult life; and 4) the management of the disorder. The nurse practitioner can play a major role in evaluating these children, in designing a proper multimodality treatment program, in making referrals for appropriate types of intervention and in monitoring the results of this multimodality therapeutic program over time.     

Generic professional behaviors: implications for the clinical nurse specialist role

The clinical nurse specialist (CNS) as an advanced practitioner contributes significantly to the provision of comprehensive and sophisticated patient care services. If the CNS is to remain a dominant clinical force in these days of cost consciousness in the health care system, however, clinicians and administrators must justify and define this important clinical role. This article offers a framework for describing the role of the CNS from a pragmatic but conceptually based perspective. A professional practice model is examined and discussed in relation to the authority base for practice, the legal definition of nursing. Issues of social relevance and the tradition of sexism are explored as important factors to consider when validating the CNS role. If the CNS is to have the opportunity to make a difference in the practice setting, the position must survive the budgetary process. Clear explanations of the value of basic and advanced nursing practice in our current health care system are critical.     

Tobacco and media exposure in poor neighbourhoods: implications for the incidence of smoking among community residents

It is an accepted truth that tobacco, as well as second-hand smoke, causes lung and other cancers. This health policy fact sheet examines the need and implications for tobacco control legislation in the United States. Major stakeholders and special interest groups influence whether or not further tobacco control legislation can be passed and who it affects. This paper will review not only the ethical implications, such as the ethical theory, ethical principles and ethical rules of conduct that support tobacco control legislation, but also its legal and economic implications as well as media influences. This paper concludes with the authors' assessment that the United States is in fact in need of more tobacco control legislation.