Interviews with caregivers during acute asthma hospitalisations.

Objective: Childhood asthma is complex and poor management of childhood asthma is the leading health reason for pediatric emergency department visits, hospitalizations and missed school days for school-aged children. The purpose of this study was to explore caregiver perceptions of home management of childhood asthma in school-aged children who have been hospitalized for asthma. Methods: Using qualitative descriptive design with in-depth interviews, we aimed to explore family caregiver perceptions of managing asthma in school-aged children between 5 and 12 years of age. Results: Data were collected from 17 participants; however, two transcripts were incomplete due to interruption in interview from medical team. The sample consisted of 15 families with child age mean of 8 years, and diagnosed with asthma at 2 years and 8 months. Four experts with asthma and research design analyzed all transcripts and six clear themes emerged. These themes included family or caregiver burden, care coordination, certainty or uncertainty continuum, effort to control, sign or symptom recognition, and trigger recognition. In this article, we defined each theme and identify specific statements from families on daily life when affected by childhood asthma. Conclusions: The findings of this study confirm and extend results from other studies of caregivers who have school-aged children diagnosed with asthma. This study found that families play a vital role in management of asthma on a daily basis and families often assess the overall management of asthma by all child relations throughout the day. Clinical implications are highlighted within each theme.

An Analysis of Associations Between Electronic Nicotine Delivery System Users.

BACKGROUND: Electronic nicotine-delivery systems have been increasing in prevalence among young adults. Although these devices are marketed to aid in quit smoking, young adults who do not smoke traditional cigarettes are using these devices. This study explored associations between individuals' quit type (ie, no plans to quit, plans to quit, or quit > 6 months ago) and perceived health status, perception of harm compared to cigarettes, perception of secondhand vapor harm, and reasons for first use. METHODS: We utilized a cross-sectional study design using a 33-item electronic survey questionnaire. The total sample size was 2,792. Out of these the ENDS users were 1,217. The survey was distributed to university students in 5 areas in 3 countries: the United States (ie, Florida, Alabama, and Illinois), Germany (ie, Hamburg) and South Africa (ie, Potchefstroom). RESULTS: Quantitative data analysis indicated that, regardless of quit status, there was a general lack of knowledge regarding secondhand vapor effects. Additionally, young adults are utilizing these products primarily due to peer influence and stress relief. Harm perception may factor into quit attempts using electronic nicotine-delivery systems. CONCLUSIONS: Education provided by respiratory therapists (and to respiratory therapy students) would be valuable as they inform patients and communities of the scholarly literature on vaping devices.

Prevalence of and beliefs about electronic cigarettes and hookah among high school students with asthma.

PURPOSE: To assess current cigarette, hookah, and electronic cigarette (e-cigarette) use among high school students with and without asthma. Beliefs and use of tobacco products by a household member were also examined. METHODS: The 2014 Florida Youth Tobacco Survey was administered to high school students to assess current use of cigarettes, hookah, and e-cigarettes (i.e., within past 30 days). Student's home exposure and beliefs about cigarettes, hookah, and e-cigarettes were also assessed. Students were randomly selected using a two-stage cluster probability design. RESULTS: Adolescents with asthma had a higher prevalence of current hookah (14.0%) and e-cigarette use (12.4%) compared with their peers (10.9%, 10.2%, respectively). Adolescents with asthma were also at increased risk for current use of cigarettes (adjusted odds ratio [AOR]: 1.24), hookah (AOR: 1.32), and e-cigarettes (AOR: 1.34). Adolescents with asthma reported positive beliefs about tobacco products and were more likely to report living with individuals who used cigarettes (31.5%), hookah (12.1%), and e-cigarettes (15.5%) compared with their peers (26.5%, 8.5%, 12.5%, respectively). CONCLUSIONS: Adolescents with asthma reported tobacco product use, positive beliefs about tobacco products, and high potential home exposure to tobacco products. There is a pressing need for education regarding potential harm of alternative tobacco products among adolescents with asthma.

Waterpipe tobacco smoking impact on public health: implications for policy.

BACKGROUND: Given the increasing evidence of its negative health effects, including contributions to both infectious and chronic diseases, waterpipe tobacco smoking raises public health concerns beyond even those presented by traditional smoking. METHODS: Identification of Clean Indoor Air Acts (CIAAs) from each of the 50 United States and District of Columbia were retrieved and examined for inclusion of regulatory measures where waterpipe tobacco smoking is concerned. Several instances of exemption to current CIAAs policies were identified. The cumulative policy lens is presented in this study. RESULTS: States vary in their inclusion of explicit wording regarding CIAAs to the point where waterpipe tobacco smoking, unlike traditional smoking products, is excluded from some legislation, thereby limiting authorities' ability to carry out enforcement. CONCLUSION: Consistent, comprehensive, and unambiguous legislative language is necessary to prevent establishments where waterpipe tobacco smoking occurs from skirting legislation and other forms of regulatory control. Stricter laws are needed due to the increasing negative health impact on both the smoker and the bystander. Actions at both the federal and state levels may be needed to control health risks, particularly among youth and young adult populations.