Prevalence of Cardiovascular Risk Factors in Rural Kenya-2023: Vihiga II.

BACKGROUND: The aim of this study was to estimate the prevalence of cardiovascular disease (CVD) risk factors among adults in Vihiga County, Western Kenya. METHODS: A cross-sectional population-based study was completed. Participants (n = 575) were selected at the household level using a systematic random sample, and sociodemographic, anthropometrical, clinical, and biochemical data were collected. RESULTS: The sample consisted of 71.8% women and 28.2% men. The prevalence of high blood pressure (BP) was 56.4%. A greater proportion of women (62.8%) had low levels of high-density lipoprotein (HDL) compared with men (44.7%) (odds ratio [OR], 2.99; 95% CI, 1.59-5.64). High triglyceride levels were more prevalent in men (16.4%) compared with women (15.4%) (OR, 0.37; 95% CI, 0.19-0.71). Based on average waist to hip ratio, abdominal obesity was significantly higher in women (55.4%) compared with men (27.6%) (OR, 2.62; 95% CI, 1.52-4.49). Low levels of physical inactivity were prevalent in women (36.3%) at significantly higher proportions compared with men (22.7%) (OR, 1.73; 95% CI, 1.02-2.92). Women used tobacco at significantly lower proportions (0.5%) compared with men (27.2%) (OR, 0.01; 95% CI, 0.00-0.06). A higher proportion of women (47.9%) rated their general health as poor compared with men (37.1%), a statistically significant difference (OR, 2.0; 95% CI, 1.23-3.28). CONCLUSION: The prevalence of CVD risk factors, such as hypertension, obesity, dyslipidemia, low physical activity, and tobacco use indicates the urgent need for comprehensive health promotion programs to improve public health in rural areas of Kenya.

The Role of the School Nurse in E-Cigarette Prevention and Cessation: A Scoping Review.

E-cigarettes have rapidly gained popularity among youth in recent years. This scoping review identifies opportunities for school nurses to incorporate e-cigarette prevention strategies into their practice and identifies gaps for future research in school nursing evidence-based practice. Using the methodological framework developed by Arksey and O'Malley and advanced by Levac et al., a literature review was conducted using PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), and Education Resources Information Center (ERIC) databases. A total of 15 articles were included in the final review. Articles for inclusion addressed interventions aimed at reducing e-cigarette use in K-12 schools. The results highlight two general types of school-based interventions: (1) universal e-cigarette prevention education and (2) targeted e-cigarette use-cessation programs. Each of these types of interventions presents a leadership opportunity for school nurses to engage within all domains of their scope of practice.

The Circassians and the Chechens in Jordan: results of a decade of epidemiological and genetic studies.

Circassians and Chechens in Jordan, both with Caucasian ancestry, are genetically isolated due to high rate of endogamous marriages. Recent interest in these populations has led to studies on their genetic similarities, differences, and epidemiological differences in various diseases. Research has explored their predisposition to conditions like diabetes, hypertension, and cancer. Moreover, pharmacogenetic (PGx) studies have also investigated medication response variations within these populations, and forensic studies have further contributed to understanding these populations. In this review article, we first discuss the background of these minority groups. We then show the results of a principle component analysis (PCA) to investigate the genetic relationships between Circassian and Chechen populations living in Jordan. We here present a summary of the findings from the 10 years of research conducted on them. The review article provides a comprehensive summary of research findings that are truly valuable for understanding the unique genetic characteristics, diseases' prevalence, and medication responses among Circassians and Chechens living in Jordan. We believe that gaining deeper comprehension of the root causes of various diseases and developing effective treatment methods that benefit the society as a whole are imperative to engaging a wide range of ethnic groups in genetic research.

Quit Happens: A community clinic-based, multitiered smoking cessation intervention.

OBJECTIVES: To evaluate the "Quit Happens" program launched to reduce tobacco use in low-income populations in a federally qualified nonprofit health center with clinics in Washington and Idaho. Quit Happens was implemented in 2015 and involved a public health nurse, patient, provider, clinic, health system, and community components. DESIGN AND SAMPLE: This smoking cessation program was assessed using a pre-post evaluation design. Nine clinics in a single system of federally qualified nonprofit health centers participated in this program. INTERVENTION: The Quit Happens program was implemented across nine clinics in Washington and Idaho. A specialized public health nurse led the tobacco cessation training of all clinic staff and assisted with development of the smoking cessation program. The 5A model was used as the framework for the training. MEASUREMENTS: The proportion of patients identifying as a current or former smoker was measured using data extracted from electronic health records. RESULTS: Declines in patient reports of currently smoking were observed between 2016 and 2018. The percent of current smokers identified in electronic health records decreased 18.7% and percent of former smokers doubled. CONCLUSION: This community-based tobacco cessation program had wide clinic and community support and self-reported smoking behavior declined over time. A public health nurse's leadership in offering training and program development around tobacco cessation to a local community organization can contribute to reductions in smoking rates.

A randomized clinical trial to evaluate the efficacy of contingency management for treatment of waterpipe tobacco addiction.

BACKGROUND AND OBJECTIVES: Unlike cigarette smoking cessation, waterpipe tobacco smoking cessation is relatively understudied. The objective of this randomized clinical trial was to examine the efficacy of contingency management (CM) for promoting initial waterpipe smoking abstinence. METHODS: The study used a two-group, repeated measures design. Participants attended 10 visits (two visits per week, on Mondays and Thursdays) across 5 weeks. Thirty-nine adult waterpipe tobacco users who did not smoke cigarettes and were not planning on quitting waterpipe tobacco smoking were randomly assigned to either the contingent (n = 19) or non-contingent (n = 20) groups. Contingent group received monetary rewards based on negative salivary cotinine results. Earning rewards started at $14 and increased by $.50 with each subsequent negative sample for a maximum $192.50. Non-contingent group earned rewards independent of salivary cotinine results. Prolonged abstinence was defined as having negative salivary cotinine results for eight or more visits (two lapses were allowed); and 7-day point prevalence was defined as having negative salivary cotinine results at visit 9 and 10 (final week). RESULTS: The prolonged abstinence rate in the contingent and non-contingent groups were 42.1% and 5.0%, respectively, (p = .008). The 7-day point prevalence in the contingent and non-contingent were 47.4% and 5.0%, respectively, (p = .003). DISCUSSION AND CONCLUSIONS: Rewards contingent on biochemically verified abstinence promote initial waterpipe tobacco cessation. This is useful information for consideration in future cessation programs for waterpipe smokers. SCIENTIFIC SIGNIFICANCE: CM strategy may have potential benefit in addressing waterpipe tobacco smoking in non-treatment seeking adults. (Am J Addict 2018;27:202-209).

Young adult waterpipe smokers: Smoking behaviors and associated subjective and physiological effects.

INTRODUCTION: The purpose of this pilot study was to investigate smoking behaviors and subjective and physiological effects of nicotine on young adult occasional waterpipe smokers. METHODS: This study utilized a repeated-measures design that included one repeated factor for condition (nicotine and non-nicotine). For each participant, the sequencing of the repeated factor was assigned using random allocation. The two nicotine conditions were nicotine (0.75 g) and non-nicotine (0 g placebo) tobacco. Over the course of two weeks, twenty-two participants completed subjective (Acute Subjective Effects of Nicotine) and physiological (blood pressure, heart rate, and CO level) measures. Additional measures (QSU and MNWS-R) were used to assess for withdrawal symptoms. SAMPLE: The participants (n=22) were young adults (23 ± 3.1years); 71% smoked waterpipe once a month in the past year and 29% smoked waterpipe 1-2 times per week. In addition, 60% reported sharing their waterpipe with friends while smoking. None of the participants reported using any other forms of tobacco products. RESULTS: Under the nicotine condition, participants tended to smoke longer (i.e. smoking duration, p=0.004), take more puffs (p=0.03), take shorter puffs (p=0.03), and inhale less volume with each puff (p=0.02). The repeated measures analysis of the factor headrush revealed an effect of the nicotine condition (F=9.69, p<0.001, partial η(2)=0.31) and time (F=8.17, p=0.02, partial η(2)=0.30). Heart rate increased significantly across the nicotine condition (F=7.92, p=0.01, partial η(2)=0.31) and over time (F=12.64, p=0.01, partial η(2)=0.41). CONCLUSIONS: This study demonstrates how differences between nicotine and non-nicotine waterpipe smoking are associated with changes in smoking behaviors, experiencing a headrush and an increase in heart rate.

Improving nursing students' knowledge using online education and simulation to help smokers quit.

UNLABELLED: The purpose of this study was to examine an evidence-based smoking cessation education program effect on nursing students' perceptions and self-confidence to help smokers quit smoking. METHOD: Upon completion of an on-line educational program students were provided opportunities to practice through simulation. Data were collected by pre and post assessment tools for the online-education and by a post assessment tool for the simulation. RESULTS: 110 senior nursing students participated in this study. Students' confidence in their overall ability to assist smokers to quit smoking was statistically significant compared to baseline (t=4.09, p<.001). Students self-rated higher levels of smoking cessation skills on Advising, Assessing, Assisting, and Arranging compared to baseline (p<0.00). CONCLUSION: Integration of evidence-based didactic and practical smoking cessation program into curricula improves nursing students' clinical skills in helping smokers to quit.

Hookah use: going down in smoke.

This article provides a review of tobacco smoking using a hookah, an emerging threat to public health, especially among young adults. Knowledge deficits persist in regards to this form of smoking, because many perceive it as less harmful than cigarette smoking and little research is available. Knowledge about hookah smoking can be instrumental in guiding health professionals to address this practice with their clients and in their communities. A failure to address all tobacco products as unique, individual entities undermines any success in public policy efforts to control tobacco use.

The global burden of cardiovascular disease.

Cardiovascular disease (CVD) today is responsible for approximately one-third of deaths worldwide, and that figure will surely increase in both developing and developed countries as risk factors for the disease--primarily dyslipidemia, hypertension, obesity, diabetes, physical inactivity, poor diet, and smoking--continue to increase. Although these risk factors are modifiable, to date there is a relative paucity of measures to prevent or control them, particularly in developing countries. A population strategy combined with a high-risk strategy for CVD prevention could greatly reduce the burden of disease in the coming decades. Many initiatives are working, but many more are needed. This chapter provides background on the global burden of CVD and provides the context for the subsequent chapters addressing nurses' roles in reversing the bleak predictions for the ravages of CVD if risk factors are left unchecked in the coming decades.

The global burden of cardiovascular disease.

Cardiovascular disease (CVD) today is responsible for approximately one-third of deaths worldwide, and that figure will surely increase in both developing and developed countries as risk factors for the disease-primarily dyslipidemia, hypertension, obesity, diabetes, physical inactivity, poor diet, and smoking-continue to increase. Although these risk factors are modifiable, to date there is a relative paucity of measures to prevent or control them, particularly in developing countries. A population strategy combined with a high-risk strategy for CVD prevention could greatly reduce the burden of disease in the coming decades. Many initiatives are working, but many more are needed. This chapter provides background on the global burden of CVD and provides the context for the subsequent chapters addressing nurses' roles in reversing the bleak predictions for the ravages of CVD if risk factors are left unchecked in the coming decades.

Smoking patterns among Jordanian health professionals: a study about the impediments to tobacco control in Jordan.

BACKGROUND: Little is known about Arab health professionals' smoking practices. AIM: This is the first study to examine smoking practices among Arab health professionals. METHODS: Background: Little is known about Arab nurses and physicians' smoking patterns. AIM: This study aims to examine smoking patterns among Arab nurses and physicians. METHODS: A total of 918 nurses and physicians participated in this study. Data were collected using the Global Professional Health Survey. RESULTS: About 38.8% are current smokers. The smoking percentages for male nurses and male physicians were high (83.8%, 94.6% respectively) compared to female nurses and female physicians (16.2%, 5.4% respectively). Approximately 53.8% wanted to quit and 60.6% had made previous quit attempts that lasted for more than two days. About 64.1% believed that nurses and physicians who smoke were less likely to advise patients to stop smoking. The predictors of smoking were: age when tried first cigarettes OR=6.36, 95% CI=4.48, 9.04; father smokes OR=1.95, 95% CI=1.40, 2.72; mother smokes OR=1.99, 95% CI=1.18, 3.39; shift work OR=1.45, 95% CI=1.04, 2.03; and the interaction (gender and profession) OR=1.82, 95% CI=1.55, 2.14. DISCUSSION: Effective interventions often begin with and/or depend on nurses and physicians being committed to smoking cessation. Given the very high smoking rates among nurses and physicians a key priority must be to provide quit smoking programs and to enable them to become effective champions of smoking cessation nationwide.

Nursing interventions in tobacco-dependent patients with cardiovascular diseases.

Smoking is a well-established risk factor for cardiovascular disease (CVD). This chapter provides an overview of a program of nursing research relevant to tobacco use in patients with CVD. The Women's Initiative for Nonsmoking (WINS) provides a rich demonstration of a key randomized clinical trial (RCT) on the efficacy of smoking cessation in women. The National Institutes of Health priority for data mining of existing RCTs is demonstrated in the numerous presentations of findings from secondary papers from WINS that answer additional research questions relevant to smoking cessation, including the influence of depression on smoking, myths about and underuse of nicotine replacement therapy. The methodological and logistical challenges inherent in tobacco intervention studies are presented, including a discussion of research needed in the measurement of withdrawal symptoms. Additionally, the role and contributions of nurses serving on the federal guideline development process are highlighted. International research activities of the coauthors from Jordan and Korea are also presented, including a discussion of the need for research in waterpipe use.

Jordanian nurses' and physicians' learning needs for promoting smoking cessation.

Smoking causes many health problems, including myocardial infarction, stroke, and peripheral vascular disease, and has devastating effects on the cardiovascular system. This study was performed to assess: (1) the prevalence of smoking among Jordanian nurses and physicians, (2) the differences in prevalence of smoking by sex, and 3) nurses' and physicians' learning needs for promoting smoking cessation. A descriptive cross-sectional design was used. Five Jordanian hospitals were randomly selected; 164 nurses (65.3%) and 87 physicians (34.7%) participated in the study. Prevalence of smoking among nurses and physicians was 41.5% (n = 66) and 43.6% (n = 38), respectively, and significantly more men than women smoked (odds ratio, 5.45; confidence interval, 2.52-11.74 [P = .00]). Many Jordanian nurses and physicians do not recognize the addictive aspect of smoking, and health professionals receive no formal training in smoking cessation approaches to use with patients. Most nurses and physicians recognize that University curricula must include information about smoking cessation.