Inducing Low Tar/Nicotine Cigarette Smoking in Women

Sixteen female smokers participated in a study of ‘safer cigarettes’ and bought their cigarettes from the experimenters at less than prevailing prices. Half received an economic incentive for purchasing cigarettes delivering progressively less tar and nicotine: the other half paid the same price regardless of brand purchased. Subjects were not required to change brands. Twelve of the sixteen subjects completed the twelve-week study. Significant reductions in tar and nicotine intake, which persisted for more than six months beyond the twelve-week study period, occurred in both groups. The differences between the two groups in tar and nicotine intake were not significant. A control group of seven female smokers showed little change in tar and nicotine intake over the same twelve-week period, and only modest changes in the subsequent six months. Neither the number of cigarettes smoked nor exhaled carbon monoxide levels (measured in a subsample of participants) increased as the subjects switched to lower nicotine levels.     

Disparities in Perinatal Quality Outcomes for Very Low Birth Weight Infants in Neonatal Intensive Care

ObjectiveTo determine if hospital-level disparities in very low birth weight (VLBW) infant outcomes are explained by poorer hospital nursing characteristics.ConclusionsPoorer nursing characteristics contribute to disparities in VLBW infant outcomes in two nurse-sensitive perinatal quality standards. Improvements in nursing have potential to improve the quality of care for seven out of ten black VLBW infants who are born in high-black hospitals in this country.     

Clinical factors predicting risk for aspiration and respiratory aspiration among patients with Stroke

Objective:

to investigate the association of risk factors with the Risk for aspiration nursing diagnosis and respiratory aspiration.

Method:

cross-sectional study assessing 105 patients with stroke. The instrument used to collect data addressing sociodemographic information, clinical variables and risk factors for Risk for aspiration. The clinical judgments of three expert RNs were used to establish the diagnosis. The relationship between variables and strength of association using Odds Ratio (OR) was verified both in regard to Risk for aspiration and respiratory aspiration.

Results:

risk for aspiration was present in 34.3% of the patients and aspiration in 30.5%. The following stood out among the risk factors: Dysphagia, Impaired or absent gag reflex, Neurological disorders, and Impaired physical mobility, all of which were statistically associated with Risk for aspiration. Note that patients who develop such a diagnosis were seven times more likely to develop respiratory aspiration.

Conclusion:

dysphagia, Impaired or absent gag reflex were the best predictors both for Risk for aspiration and respiratory aspiration.     

The McConnell Sign is Seen in Patients With Acute Chest Syndrome

Bedside ultrasound is often used as a part of the evaluation of patients who are critically ill. The McConnell sign is an important echocardiographic finding in some critically ill patients with pulmonary embolism and an acute right ventricular infarct. We present 3 critically ill patients with confirmed acute chest syndrome who showed the McConnell sign on echocardiography. In patients with sickle cell disease presenting with chest pain and shortness of breath, the presence of the McConnell sign does not narrow the differential diagnosis between pulmonary embolism, an acute right ventricular infarct, and acute chest syndrome.