Nicotine absorption from e-cigarettes over 12 months

BackgroundResearch indicates that, over time, exclusive e-cigarette users (vapers) gradually reduce the nicotine concentration in their e-liquid and transition to more sophisticated devices. Alongside this, consumption of e-liquid increases and constant cotinine levels are maintained.AimsWe aimed to confirm these observations in 27 experienced vapers tested at baseline and 12 months later, by measuring nicotine absorption (via salivary levels of the nicotine metabolite cotinine; ng/mL), nicotine concentrations in e-liquid (mg/mL), volume of e-liquid consumed (mL per day), device types and flavours used, both at baseline and 12 months.ResultsVapers reduced both their nicotine concentrations in e-liquid over 12 months (from 13.83 mg/mL at baseline to 9.91 at follow up) but significantly increased their e-liquid consumption (from 4.44 to 6.84 mL). No significant changes in salivary cotinine concentrations (370.88 ng/mL at baseline and 415.78 ng/mL at follow up) were observed. There was an increase in sub-ohming (using an atomiser coil with resistance of <1 Ω with increased power) at 12 months, and in the use of fruit flavoured e-liquids.ConclusionsOur sample of experienced vapers reduced the concentration of nicotine in their e-liquid over time, but maintained their nicotine intake possibly through self-titration via more intensive puffing. Findings suggest there may be little benefit in reducing nicotine e-liquid concentration since this appears to result in higher e-liquid consumption which may incur both a financial and health cost. Gaining an understanding of underlying reasons for lowering e-liquid concentration would be a useful line of empirical enquiry.     

Efficacy of Kinesio Taping and Postural Correction Exercises on Levator Scapula Electromyographic Activities in Mechanical Cervical Dysfunction: A Randomized Blinded Clinical Trial

ObjectiveMechanical neck dysfunction (MND) is a major health burden. Although postural correction exercises (PCEs) are commonly used for its treatment, efficacy of Kinesio Taping (KT) has received considerable attention. This study was conducted to determine the effect of KT and PCEs on levator scapula (LS) electromyography.MethodsNinety-one patients with MND were randomly assigned into 1 of 3 groups that received 4 weeks’ treatment: group A, KT; group B, PCE; and group C, both interventions. Neck pain, LS root mean square (RMS), and median frequency (MDF) were measured pretreatment and post-treatment with the Numerical Pain Rating Scale and surface electromyography, respectively, by an assessor blinded to the patients’ allocation.ResultsMultivariate analysis of variance indicates a statistically significant group-by-time interaction (P = .000). Pain intensity was significantly reduced in group C more than in group B (P = .001). Mean values of RMS were significantly reduced in group C compared to both group A (P = .001) and group B (P = .022), whereas MDF was significantly increased in group C compared to either group A (P = .00) or group B (P = .026), and in group B compared to group A (P = 0.26). A paired t test revealed that there was a significant decrease in pain and RMS, and a significant increase in MDF in all groups (P < .01).ConclusionApplication of both KT and PCE combined can significantly reduce neck pain and normalize LS activities in patients with MND more than the application of either intervention.     

A Large-Scale Comparison of Canadian Sexual/Gender Minority and Heterosexual,Cisgender Adolescents’ Pornography Use Characteristics

BackgroundThe ease of access to pornography has made its use common among adolescents. Although sexual and gender minority (SGM) (eg, gay, transgender) adolescents may be more prone to use pornography owing to sexual orientation–related information seeking and/or scarcity of potential romantic or sexual partners, relatively little attention has been paid to their pornography use and to the quantitative examination of the similarities and differences between heterosexual, cisgender (HC) and SGM adolescents’ pornography use characteristics.AimThe aim of the present study was to compare SGM and HC adolescents’ pornography use considering potential sex differences.MethodsWe used a sample of 2,846 adolescents (52.5% girls; M_age = 14.5 years, SD = 0.6), which was collected as part of an ongoing longitudinal study on adolescents’ sexual health. Data were analyzed with 5 groups: HC boys; HC girls; SGM boys; SGM girls; and SGM non-binary individuals.OutcomesAdolescents completed a self-report questionnaire about sexual and gender minority status and pornography use (ie, lifetime use, age at first exposure, and frequency of use in the past 3 months.)ResultsResults indicated significant differences between all groups: 88.2% of HC boys, 78.2% of SGM boys, 54.2% of SGM girls, 39.4% of HC girls, and 29.4% of SGM non-binary individuals reported having ever viewed pornography by the age of 14 years. SGM girls indicated a significantly younger age at first pornography use than HC girls, but this difference was not significant among boys. SGM boys reported the highest (median: many times per week), whereas HC girls reported the lowest (median: less than once a month) frequency of pornography use.Clinical TranslationResults suggest that SGM and HC boys' pornography use characteristics are rather similar, whereas SGM and HC girls’ pornography use patterns may be considered different presumably because of the varying underlying motivations (eg, using pornography to confirm sexual orientation).Strengths & LimitationsSelf-report measures and cross-sectional designs have potential biases that should be considered. However, the present study involved a large sample of adolescents including SGM adolescents, a population group that is understudied.ConclusionApproximately two-thirds of teenagers had gained their first experience with pornography in the present sample, and 52.2% reported using it once a week or more often in the past 3 months, indicating that pornography use may play an important role in both HC and SGM adolescents’ sexual development. Gender-based differences concerning pornography use seem to be robust regardless of SGM status.Bőthe B, Vaillancourt-Morel, MP, Girouard A, et al. A Large-Scale Comparison of Canadian Sexual/Gender Minority and Heterosexual, Cisgender Adolescents’ Pornography Use Characteristics. J Sex Med 2020;17:1156–1167.     

Serum 25-hydroxyvitamin-D and nonalcoholic fatty liver disease: Does race/ethnicity matter? Findings from the MESA cohort

Background and aimsLow serum 25-hydroxyvitamin D (25(OH)D) is associated with higher nonalcoholic fatty liver disease (NAFLD) risk in studies of mainly white participants. Significant racial/ethnic differences exist in serum 25(OH)D and NAFLD prevalence questioning extending this association to other racial/ethnic groups. We tested whether the association between serum 25(OH)D and NAFLD vary by race/ethnicity.Methods and resultsThis was a cross-sectional analysis from the Multi-Ethnic Study of Atherosclerosis (MESA) that included 3484 participants (44% male; 38.4% Whites, 27.8% African-Americans, 23.5% Hispanics, and 10.3% Chinese-Americans) who had serum 25(OH)D and upper abdominal CT images available at baseline. Serum 25(OH)D was measured by high-performance liquid chromatography–tandem mass spectrometry. NAFLD was identified if liver-to-spleen Hounsfield-Unit ratio was <1. Whites had the highest 25(OH)D level and African-Americans had the lowest level (mean ± SD: 29.5 ± 10.4 vs.19.9 ± 9.1, respectively). Six hundred and eleven (17.5%) participants had NAFLD; Hispanics had the highest prevalence (26.2%) followed by Chinese-Americans (19.8%), Whites (15.8%) and African-Americans (11.7%), P < 0.0001. In adjusted model, the association of 25(OH)D with NAFLD differed by race/ethnicity (P < 0.0001). Negative association was only evident in Causations (OR (95% CI):1.23 (1.03, 1.47) per 1 SD lower serum 25(OH)D). For other racial/ethnic groups, BMI, triglycerides, diabetic status and/or smoking, but not serum 25(OH)D, were common independent risk factors for NAFLD.ConclusionsThe negative association between serum 25(OH)D and NAFLD in Whites may not be broadly generalizable to other racial/ethnic groups. Modifiable risk factors including BMI, triglycerides, diabetic status and/or smoking associate with NAFLD risk in non-white racial/ethnic groups beyond 25(OH)D.     

Health promotion and health education: advancing the concepts

BACKGROUND: Health education and health promotion activities are a fundamental requirement for all health professionals. These two paradigms are closely related but are not inter-dependent. Despite this, it is known that many nurses confuse the terms and use them interchangeably. With this in mind, it is necessary to re-conceptualize the terms in an attempt to bring them to a current form of 'maturity'. AIM: The aim of the paper is to provide an up-to-date analysis of health promotion and health education that serves as a conceptual and operational foundation for clinicians and researchers. METHOD: A concept analysis following the criterion-based methods described by Morse and her colleagues was applied to the terms health education and health promotion, using generic and nursing-related literature. RESULTS: The conceptual literature on health education is consistent between generic and nursing-related sources. On the contrary, earlier nursing literature on health promotion is now at odds with more recent socio-political and community action models of health promotion, in that it focuses on individualistic and behavioural forms of 'health promotion'. A significant proportion of later nursing-related literature, however, suggests a maturing of the concept that brings it further in line with a socio-political health promotion agenda. CONCLUSION: While the theoretical and conceptual literature surrounding health education has remained relatively constant and unchanged over the last decade or so, the same cannot be said for the health promotion literature. The evolving dominance of socio-political action in health promotion has overtaken individualistic and behaviourally-related forms. While the recent nursing literature addresses and acknowledges the place of socio-political activity as the mainstay of health promotion interventions, this is largely from a theoretical stance and is not applied in practice.     

Playing the game: A grounded theory of the integration of international nurses

BackgroundMigration trends to Australia have seen an increase in international nurses, with twenty-nine percent of current registered nurses having received their first nursing qualification outside of Australia. The process international and local nurses navigate to enable successful integration into the Australian healthcare system is unclear.AimTo explore how international nurses and Australian nurses adapt to work together in the Australian healthcare system and to develop a theory that explains this process.MethodsGrounded theory methodology was used. Concurrent data collection/generation and analysis of online-survey data (n = 186) and in-depth interviews (n = 15) was undertaken. Storyline was used as a technique of analysis to develop, construct and present the theory. Focus groups (n = 9 + 7) were conducted to confirm the relevance of the theory.FindingsNurses work together to enable successful integration of international nurses. Four phases underpin this adaptation to the cultural norms of the workplace: (i) Joining the game; (ii) Learning the game, (iii) Playing by the rules, and (iv) The end game. These phases comprise the grounded theory Playing the game: Integration of internationally qualified registered nurses in the Australian healthcare system.DiscussionAdditional orientation programs and collegiate support for international nurses were significant factors influencing successful adaption to the cultural context of the work environment. Defining the role and scope of practice of the registered nurse in the Australian context provided challenges.ConclusionSupportive colleagues were critical to successful integration and retention of experienced nurses irrespective of where nurses obtain their nursing qualification. Additional orientation programs for international nurses could improve the experience of nurses migrating to work in Australia.