Smoke-free legislation and charitable gaming in Kentucky.

OBJECTIVE: To determine the effect of municipal smoke-free laws in Kentucky on gross and/or net revenues from charitable gaming activities. Between January 2000 and June 2007, 13 Kentucky communities implemented smoke-free legislation; only three specifically exempted charitable gaming facilities and compliance in several communities was not consistent. Kentucky is a tobacco-growing state that has the highest smoking rate in the United States. DESIGN: A fixed-effects time series design to estimate the impact of municipal smoke-free laws on charitable gaming. SETTING: 13 Kentucky counties that implemented smoke-free laws during the study period of January 2000 through June 2007. SUBJECTS: All charitable gaming facilities in 13 counties in which a smoke-free ordinance was enacted during the study period. MAIN OUTCOME MEASURES: Gross and net revenues from charitable gaming activities in each county for each quarter of the study period, obtained from the Kentucky Department of Charitable Gaming. RESULTS: When controlling for economic variables, county-specific effects and time trends using a robust statistical framework, there was no significant relation between smoke-free laws and charitable gaming revenues. Municipal smoke-free legislation had no effect on charitable gaming revenues. CONCLUSIONS: No significant harm to charitable gaming revenues was associated with the smoke-free legislation during the 7.5-year study period, despite the fact that Kentucky is a tobacco-producing state with higher-than-average smoking rates.

Application of bioreactor system for large-scale production of Eleutherococcus sessiliflorus somatic embryos in an air-lift bioreactor and production of eleutherosides.

Embryogenic callus was induced from leaf explants of Eleutherococcus sessiliflorus cultured on Murashige and Skoog (MS) basal medium supplemented with 1 mg l(-1) 2,4-dichlorophenoxyacetic acid (2,4-D), while no plant growth regulators were needed for embryo maturation. The addition of 1 mg l(-1) 2,4-D was needed to maintain the embryogenic culture by preventing embryo maturation. Optimal embryo germination and plantlet development was achieved on MS medium with 4 mg l(-1) gibberellic acid (GA(3)). Low-strength MS medium (1/2 and 1/3 strength) was more effective than full-strength MS for the production of normal plantlets with well-developed shoots and roots. The plants were successfully transferred to soil. Embryogenic callus was used to establish a suspension culture for subsequent production of somatic embryos in bioreactor. By inoculating 10 g of embryogenic cells (fresh weight) into a 3l balloon type bubble bioreactor (BTBB) containing 2l MS medium without plant growth regulators, 121.8 g mature somatic embryos at different developmental stages were harvested and could be separated by filtration. Cotyledonary somatic embryos were germinated, and these converted into plantlets following transfer to a 3l BTBB containing 2l MS medium with 4 mg l(-1) GA3. HPLC analysis revealed that the total eleutherosides were significantly higher in leaves of field grown plants as compared to different stages of somatic embryo. However, the content of eleutheroside B was highest in germinated embryos. Germinated embryos also had higher contents of eleutheroside E and eleutheroside E1 as compared to other developmental stages. This result indicates that an efficient protocol for the mass production of E. sessiliflorus biomass can be achieved by bioreactor culture of somatic embryos and can be used as a source of medicinal raw materials.

Methyl jasmonate elicitation enhanced synthesis of ginsenoside by cell suspension cultures of Panax ginseng in 5-l balloon type bubble bioreactors.

The effects of methyl jasmonate (MJ) elicitation on the cell growth and accumulation of ginsenoside in 5-l bioreactor suspension cultures of Panax ginseng were investigated. Ginsenoside accumulation was enhanced by elicitation by MJ (in the range 50-400 microM); however, fresh weight, dry weight and growth ratio of the cells was strongly inhibited by increasing MJ concentration. The highest ginsenoside yield was obtained at 200 microM MJ. In the second experiment, 200 microM MJ was added on day 15 during the cultivation. The ginsenoside, Rb group, and Rg group ginsenoside content increased 2.9, 3.7, and 1.6 times, respectively, after 8 days of MJ treatment. Rb group gisnsenosides accumulated more than Rg group ginsenosides. Among Rb group ginsenosides, Rb1 content increased significantly by four times but the contents of Rb2, Rc and Rd increased only slightly. Among Rg group ginsenosides, Rg1 and Re showed 2.3-fold and 3.0-fold increments, respectively, whereas there was only a slight increment in Rf group ginsenosides. These results suggest that MJ elicitation is beneficial for ginsenoside production using 5-l bioreactor cell suspension cultures.

In vitro propagation of Dendrobium macrostachyum Lindl.--a threatened orchid.

In vitro propagation of Dendrobium macrostachyum, a threatened and endemic species was achieved through nodal explants. The nodal explants were cultured on Murashige and Skoog (MS) basal medium and MS medium supplemented with N6-benzyladenine (BA-2.22, 4.44 and 8.88 microM), Kinetin (KN-2.32, 4.65, and 9.29 microM) and Coconut water (CW, 5, 10 and 15%) individually or in combination with 2.69 microM alpha-naphthalene acetic acid (NAA). Axillary shoots were induced directly from nodal explants in medium containing BA, KN or CW. Optimal shoot induction (6 shoots/explant) was attained from nodal explants cultured on medium supplemented with 15% CW. Well developed shoots rooted at an average 5 roots per shoot in half strength MS medium devoid of any growth regulators.

Public opinion and legislators' views on tobacco policy.

We explored the relationship between public opinion and Kentucky state legislators' views on increasing the cigarette excise tax to curb smoking, local option to pass stricter youth access to tobacco laws, and smoking restrictions in public places. The relationship of gender, education, political party affiliation, tobacco use, and tobacco allotment ownership to public and legislators' opinions was examined using logistic regression. Data from the random, statewide University of Kentucky Public Opinion Poll (n = 628 Kentucky adults) and a Delphi study of Kentucky legislators (n = 116 members of the Kentucky General Assembly) were used in this study. Controlling for the demographic differences in gender, age, ethnicity, education, and tobacco allotment ownership between the public opinion and legislator samples, legislators were far less likely than the public to support workplace or restaurant smoking restrictions. Participants with a college education were twice as likely to favor cigarette tax hikes and four to five times more likely to favor workplace and restaurant smoking restrictions than were those without a college degree. Tobacco allotment owners and tobacco users were less likely to support raising cigarette taxes and local option to curb teen tobacco use compared to nonowners and nonusers. Findings of this study suggest that Kentucky legislators are not keeping up with public opinion about tobacco control, particularly in regard to smoking restrictions in workplaces and restaurants. Health professional organizations can play a role by educating both their membership and lawmakers about public support for tobacco control policy.

Kindergarten children's knowledge and perceptions of alcohol, tobacco, and other drugs.

Kindergarten children's knowledge and perceptions of alcohol, tobacco, and other drugs (ATODs) were assessed and the congruence between parent ATOD use and children's knowledge of ATODs was examined. Data were collected during the pre-intervention phase of an ATOD prevention trial with 5- and 6-year-old children and their parents. Three elementary schools were randomly selected from a population of 15 high-risk elementary schools in Lexington, Ky., (n = 126 parent-child dyads). Children were interviewed about their knowledge, feelings, and attitudes toward ATODs using the Child Drug Awareness Inventory. Parents self-reported ATOD use. Almost all (95%) kindergarten children recognized cigarettes; 56% correctly identified alcoholic beverages; and 17% recognized at least one illicit drug. Minority children were almost four times more likely to recognize illicit drugs than were non-minority children. Children's knowledge of ATODs was not correlated with the parents' reported drug use. ATOD prevention programs for young children merit greater emphasis.

Consensus for tobacco policy among former state legislators using the policy Delphi method.

OBJECTIVE: To test a novel approach for building consensus about tobacco control policies among legislators. DESIGN: A pilot study was conducted using a two-round, face-to-face policy Delphi method. PARTICIPANTS: Randomly selected sample of 30 former Kentucky legislators (60% participation rate). MAIN OUTCOME MEASURE: Consensus on tobacco control and tobacco farming policies. RESULTS: Former state legislators were more supportive of tobacco control policies than expected, and highly supportive of lessening the state's dependence on tobacco. Former state legislators were in agreement with 43% of the second-round items for which there was no agreement at the first round, demonstrating a striking increase in consensus. With new information from their colleagues, former lawmakers became more supportive of workplace smoking restrictions, limitations on tobacco promotional items, and modest excise tax increases. CONCLUSIONS: The policy Delphi method has the potential for building consensus for tobacco control and tobacco farming policies among state legislators. Tobacco control advocates in other states might consider using the policy Delphi method with policymakers in public and private sectors.

Kentucky legislators' views on tobacco policy.

CONTEXT: Kentucky leads the nation in adult and teen smoking prevalence. Even though Kentucky is one of the most tobacco-dependent states, tobacco policy is subject to change in light of possible national tobacco legislation. OBJECTIVE: To describe the degree of agreement among Kentucky legislators regarding tobacco control and tobacco farming policy, and to discover whether use of the policy Delphi method produces a shift toward consensus on tobacco policy. DESIGN: A two-round policy Delphi study was conducted using in-person interviews. SETTING: Legislators' offices in Frankfort, Kentucky. PARTICIPANTS: Volunteer sample of 116 Kentucky legislators (84% response rate). MAIN OUTCOME MEASURES: Degree of agreement on tobacco control and tobacco farming policies. RESULTS: Lawmakers were highly supportive of policies to lessen the state's dependence on tobacco, and were favorable toward stronger tobacco control policies. There were discrepancies, however, between what policies legislators thought were desirable and what policies were realistic. Tobacco interests were identified as possible explanations for this disparity. Tobacco allotment ownership was associated with less support for tobacco control and tobacco farming policies. A shift toward consensus on tobacco policy was achieved in the second round for 45% of the interview items common to both rounds. CONCLUSIONS: Kentucky legislators were highly supportive of reducing the state's dependence on tobacco and more supportive of tobacco control policies than expected. The policy Delphi method has the potential for shifting opinions about tobacco policies among state legislators. The findings of this study identify opportunities for public health policy change in one of the most tobacco-dependent states in the United States.

Smoking cessation in drug treatment programs.

Substance abusers are more likely to smoke cigarettes than the general population. Yet, in most drug treatment programs smoking cessation receives little attention. The purposes of this study were to: (1) examine substance abuse counselors' attitudes toward and practices related to nicotine addiction and smoking cessation treatment; and (2) describe barriers to smoking cessation treatment and smoking policies in substance abuse treatment facilities. A total of 254 substance abuse counselors in Kentucky completed mailed questionnaires (53% response rate). Almost one-fourth were current smokers. Smoking and nonsmoking counselors differed in their attitudes toward nicotine addiction, barriers to treatment, and satisfaction with smoking cessation training. Few counselors routinely followed the clinical preventive guidelines with nicotine-dependent clients. However, they were receptive to providing smoking cessation treatment. Over half of the drug treatment programs banned indoor smoking, but permitted smoking on facility grounds. Implications for policy change by national addiction certification and licensing organizations and state accreditation authorities are discussed.

Entry into community-based nursing practice: perceptions of prospective employers.

To better prepare new graduates for entry-level positions in community settings, faculty of one college of nursing gathered information using focus groups of prospective employers. The groups were to identify the skills and qualities nurses need to practice in the community and ways to redesign nursing curricula to better prepare undergraduates for community-based practice. Data for this qualitative study were collected in five separate focus groups conducted with prospective employers (N = 18) from four major areas of Kentucky. By collaborating with prospective employers in the community, a partnership was established between nurse educators and community health leaders to improve the marketability of baccalaureate graduates. Assessment was the most frequently named skill essential to nursing practice in the community. Independence, critical thinking, collaboration, and confidence consistently emerged as important skills and qualities. Prospective employers were positive about developing partnerships to improve under-graduate nursing curricula. Recommendations for curricula to better prepare undergraduates for community-based practice are suggested.

Drug prevention with high risk families and young children.

The effects of a school and home-based drug prevention program on risk factors for subsequent alcohol, tobacco, and other drug (ATOD) use among children were studied. Data on parent and child risk factors for ATOD use were collected from fifty-six low-income parents and their children, ages four to six years, using a pretest-posttest design. The parent-child intervention was conducted over a two-month period. The intervention had no effect on parent or child risk factors. However, the program was favorably received by parents and children. Almost two-thirds of the parents at the experimental school were involved in the program. Almost half of the parents had high depressive symptoms. The high rates of ATOD use and depressive symptoms among these parents are cause for concern.

Cues to parent involvement in drug prevention and school activities.

This exploratory study used focus group methods to identify strategies that promote parent involvement with young children in an alcohol, tobacco, and other drug (ATOD) prevention program. The Health Belief Model (HBM) guided the interview process and data analysis. Five focus groups were conducted with low-income parents and school personnel from two urban elementary schools in Lexington, Kentucky. Cues to Action was the most frequent HBM construct expressed by both parents and school personnel in regard to ATOD prevention programs and general school activities. Enthusiasm for school activities expressed by children to their parents was identified as the core cue to parent involvement. Transportation, child care, and incentives were the basic requirements for parent involvement. Positive attitudes of school personnel, a combination of communication strategies, and multiple channels for involvement were major cues to parent involvement. Recommendations for involving parents in ATOD prevention and general school activities are suggested.

Policy research: lessons from the field.

Nursing's involvement in policy development has become a standard and expected part of nursing practice. One avenue of involvement, policy research, is clarified through description and case example. Policy research is described as context-driven, multimethodological, and time-sensitive. Considering these essential characteristics when planning and implementing policy research enhances nursing's ability to positively influence the policy process. A case example of policy research from the criminal justice system evaluated the effectiveness of a diversion program with alcohol and marijuana misdemeanants (N = 1,239). The purposes of the study were to describe the percentage of diversion participants with alcohol or marijuana-possession charges who were successful in completing the diversion program and to examine the incidence of subsequent arrests on alcohol or marijuana-possession charges among those who successfully completed the program. The case example demonstrates the intricate and unique relationship between research and the policy arena. Policy research can equip nursing to enter policy debates with data and to participate as a persuasive agent of social change.

Predicting Head Start parent involvement in an alcohol and other drug prevention program.

This study examined Health Belief Model predictors of parent involvement with preschool children in an alcohol and other drug (AOD) prevention program. Over 300 Head Start parents were invited to participate in BABES (Beginning Alcohol and Addictions Basic Education Studies) with their children once a week for 7 weeks. Two hundred parents completed self-report instruments prior to participation in BABES. Previous classroom involvement, barriers, county, and race predicted high attendance (3 to 7 lessons). AOD use severity, benefits, and role modeling predicted low attendance (1 to 2 lessons). Further research involving manipulation of external cues, parent involvement in nonclassroom settings, and race-homogeneous samples is recommended.

Parental alcohol and other drug (AOD) use and health beliefs about parent involvement in AOD prevention.

Because the family plays an important role in predicting alcohol and other drug (AOD) use among youth, prevention efforts must begin in early childhood and involve parents. The purpose of this study was to determine differences between parent AOD users and nonusers in relation to health beliefs about parent involvement in AOD prevention with preschool children. A convenience sample of 200 Head Start parents in East Central Indiana completed self-report instruments measuring Health Belief Model constructs. Almost half (45%) reported alcohol use, over half (54%) smoked cigarettes, and 11% admitted using illicit drugs. Compared to nonusers, illicit drug users were more likely to perceive their children as susceptible to future AOD use, but less likely to view AOD use by their children as serious. Compared with nonsmokers, tobacco users were more likely to perceive their children as susceptible to future AOD use and had less interest in maintaining health through early prevention activities.

Development of the PAAI as a measure of attitudes of parents with preschool children toward substance use and abuse.

Because parents have a major impact on their preschool children's development, the study of parental attitudes is crucial to understanding substance abuse behavior. This study examined the reliability of an instrument to measure attitudes of parents with preschool children regarding substance use and abuse. The sample consisted of a lower to middle socioeconomic, racially diverse population of 101 parents of preschool children. The Parent Attitude Assessment Instrument (PAAI) measured parents' attitudes toward substance use and abuse, parental role modeling, and substance abuse prevention with preschool children.

Lyme disease: an increasing health risk for school-age children.

Lyme disease, a bacterial infection with noticeable short-term and serious long-term consequences, is the most common tick-borne disease. First described in 1977, Lyme disease poses a significant health threat to school-age children exposed to the tick vector primarily in three specific regions of the United States. This article describes Lyme disease and its clinical signs and symptoms, and discusses the school nurse's role in identification, management, and prevention of this new health risk.