The Immediate Physiological Effects of E-Cigarette Use and Exposure to Secondhand E-Cigarette Vapor.

BACKGROUND: Vaping continues to grow as an alternative to smoking and as a recreational activity for people of all ages, including minors. The billion-dollar industry offers users a plethora of flavors, nicotine concentrations, e-juice combinations, and devices. While some studies suggest vaping is beneficial for certain ailments and as a smoking cessation tool, many studies report concerning health outcomes associated with vape use. Recent FDA regulations have banned certain vaping products following an increase of vaping-related lung injuries reported in 2019. Health care providers need to better understand the physiological effects of vaping-specific products and the impact of secondhand vapor. The specific aims of the present study were to understand the immediate effects on heart rate, breathing frequency, blood pressure, blood sugar, [Formula: see text], pulmonary function, and oral temperature following e-cigarette use and secondhand vapor exposure. METHODS: A total of 149 volunteers participated in this study; 76 subjects vaped mint-flavored e-cigarettes with 5% nicotine for 20 min while seated next to 73 nonvaping subjects who agreed to be exposed to the vapor. Health variables including heart rate, blood pressure, breathing frequency, blood glucose, FVC, [Formula: see text], and oral temperature were obtained prior to vaping or exposure to vapor and again after 20 min. RESULTS: Subjects who vaped had significantly higher heart rate, breathing frequency, and oral temperature, and significantly lower blood oxygenation levels (ie, [Formula: see text]) after vaping for 20 min. Nonvaping subjects exposed to vapor had significantly higher oral temperature after 20 min of exposure. Blood sugar and FVC were not significantly affected by vaping or exposure to vapor. CONCLUSIONS: Vaping with mint-flavored e-cigarettes with 5% nicotine for 20 min resulted in significant immediate physiological changes. Exposure to e-cigarette vapor significantly increased oral temperature within the same amount of time.

Identifying facial expressions in dogs: A replication and extension study.

This study replicated and extended previous research (Bloom & Friedman, 2013) indicating that humans can correctly identify emotional expressions in photographs of dog faces when tested with one breed (i.e., a Malinois). It examined the effect of dog facial morphology on accuracy of emotion identification by using images of a Malinois, as well as two-different breeds (Doberman and Rhodesian Ridgeback) expressing six-discrete emotions (happiness, sadness, anger, fear, disgust, surprise). Using a sample of 105-undergraduate students, participants were shown slides presenting four different expressive images of the same breed and asked to identify the image that best depicted one of the six emotions. Analyses indicated that participants were able to correctly identify all emotions across all dog breeds significantly better than chance, replicating the previous study for the Malinois, and extending its findings to additional breeds. Accuracy of emotion identification was predicted to be lower for the Doberman due to its darker coloration, possibly interfering with recognition of subtle emotional cues, but was found to be highest for the Malinois, followed by the Doberman, and then the Rhodesian Ridgeback.

A Mixed Methods Pilot Study on the Short-Term Physiological Effects of Vaping and Attitudes Regarding Its Use and Health Effects in Samples of Young Adults.

Vaping is a fairly new and legal way young people are inhaling substances into their lungs. Very little is currently known about the immediate physiological impact or the psychosocial reasons surrounding vape use. This study used a mixed methods approach to (a) understand the short-term physiological implications of vape use compared with people who do not vape and (b) investigate the reasons people choose to vape compared with those who choose not to vape. Twenty-four people participated in the study: 12 self-identified as nonvapers, and 12 self-identified as people who vape. All participants were between 18 and 24 years old. Qualitative analysis suggested people vape because they think it is cool, think it is less risky than smoking, and enjoy the social aspects of vaping. People who choose not to vape are concerned about the unknown health implications, think it is a waste of resources, and are apathetic toward it. Quantitative results revealed statistically significant increases in heart rate and decreases in the percentage of blood oxygenation after 20 minutes of vape use. Blood pressure, respiratory rate, and blood sugar scores did not significantly change after 20 minutes of vape use. Differences in the frequencies of men and women across the two groups were found. Significant differences found for systolic blood pressure, respiratory rate, and pulmonary function test became nonsignificant after controlling for gender. Both long- and short-term effects of vaping need to be further evaluated. The psychosocial reasons why certain people vape whereas others in the same peer group do not also need to be better understood.

Effects on vital signs after twenty minutes of vaping compared to people exposed to second-hand vapor.

INTRODUCTION: Very little is known about the immediate physiological implications of vaping or inhaling second-hand vapor. This study used a quantitative approach to understand the short-term physiological implications of vape use and exposure to sec-ond-hand vapor for people who do not vape. MATERIAL AND METHODS: One hundred and forty-eight people participated in the study, 75 self-identified as non-vapers and 73 self-identified as people who vape. All participants were over the age of 18. Participants used or were exposed to non-flavored e-juice without nicotine in Sorin® vape devices. Heart rate, blood pressure, respiratory rate, blood oxygenation, blood glucose and pulmonary function tests were assessed. Physiological parameters were assessed prior to vape use or exposure to vapor and again after 20 minutes of vaping. RESULTS: Findings indicated there were no significant changes in most health parameters except blood pressure which was reduced in both groups. Heart rate was also significantly reduced for vaping participants. CONCLUSION: Vaping without flavorings or nicotine do not appear to have an immediate negative health impact on vital signs. The physiological effects of long-term exposure and/or vape use requires additional investigation. Information was established regarding the physiological effects of non-flavored, non-nicotine vaping so future studies can compare the effects of vaping with assorted flavors and nicotine concentrations to the effects of vaping only the base ingredients (vegetable glycerin and propylene glycol). New knowledge was gleaned relating to exposure to vapor, a phenomenon not previously examined but common espe-cially among non-vaping people who attend social events where people are vaping.

Exploring health economics course competencies' value for nurse administrators.

BACKGROUND: A survey of nursing administrators in the United States was conducted to solicit opinions about health economics (HE) course competencies for baccalaureate nursing programs. PURPOSE: To provide rationale for intensifying educational efforts to increase nurses' awareness about the value of HE skills in their everyday work. METHODS: Participants were asked to rate six HE competencies using a Likert scale. Paired-samples t tests, bivariate correlations, and standard multiple linear regressions were used to analyze survey results. DISCUSSION: A strong direct relationship exists between the amount of prior knowledge nursing administrators have about HE and the perceived level of usefulness of HE skills. CONCLUSION: Nurses' contributions to creating value in healthcare must be encouraged. Increasing the share and accessibility of the HE content in continuing education offerings could be one way to expand HE knowledge among practicing nurses and promote cost-effective delivery of healthcare in the United States.

Psychometric examination of a Brazilian adaptation of the Expressions of Spirituality Inventory - Revised / Exame das propriedades psicométricas de uma adaptação brasileira do Expressions of Spirituality Inventory - Revised / El examen de las propiedades psicométricas de una adaptación brasileña del Expressions of Spirituality Inventory - Revised

Using a sample of 493 adults, the present investigation examined the psychometric properties of a Brazilian adaptation of the Expressions of Spirituality Inventory- Revised (ESI-R; MacDonald 2000a), a measure of an empirically derived five dimensional model of spirituality which has been shown to have some promise for cross-cultural research. Reliability analysis indicated that the ESI-R dimensions produced satisfactory inter-item consistency coefficients. Exploratory factor analysis provided evidence generally supportive of the replicability of the five dimensions. Confirmatory factor analysis testing two competing factor models (four versus five factor) provided some support for both models. However, the five factor model emerged superior. Support for both convergent and discriminant validity of the ESI-R dimensions was also obtained. Overall, the findings of this study are consistent with those seen with samples from other cultures and suggest that the ESI-R holds promise for use in spirituality research in Brazil.

Utilizando uma amostra de 493 adultos, a presente investigação examinou as propriedades psicométricas de uma adaptação brasileira do Expressions of Spirituality Inventory- Revised (ESI-R; MacDonald 2000a), um teste empiricamente derivado de um modelo de espiritualidade de cinco fatores que tem se mostrado promissor para a pesquisa transcultural. Análises de fidedignidade indicaram que as dimensões do ESI-R produziram coeficientes satisfatórios de consistência inter-item. As análises fatoriais exploratórias apresentaram resultados gerais favoráveis à replicabilidade das cinco dimensões. As análises fatoriais confirmatórias, testando dois modelos fatoriais concorrentes (quatro versus cinco fatores), proveram algum suporte para ambos os modelos. Apesar disso, o modelo de cinco fatores emergiu como superior. Evidências para as validades convergente e discriminante do ESI-R também foram encontradas. No geral, os achados deste estudo são consistentes com aqueles observados em amostras de outras culturas e sugerem que o ESI-R se mostra promissor para o uso na pesquisa em espiritualidade no Brasil.

Utilizando una muestra de 493 adultos, el presente estudio examinó las propiedades psicométricas de una adaptación brasileña de las expresiones del Expressions of Spirituality Inventory - Revised (ESI-R, MacDonald 2000a), una prueba derivada empíricamente de un modelo espiritual de cinco factores que han demostrado prometedor para la investigación transcultural. Análisis de confiabilidad indicaron que las dimensiones del ESI-R produjeron coeficientes satisfactorios de consistencia inter-ítem. El análisis factorial exploratorio mostró resultados favorables para la aplicación general de las cinco dimensiones. El análisis factorial confirmatorio proporcionaran algún apoyo para ambos modelos al probar dos modelos de factores concurrentes (cuatro a cinco factores). Sin embargo, el modelo de cinco factores era superior. También obtuvo evidencia de validez convergente y discriminante de las dimensiones ESI-R. En general, los resultados de este estudio son consistentes con los observados con muestras de otras culturas y sugieren que lo ESI-R se muestra prometedor para su uso en la espiritualidad de la investigación en Brasil.

The conceptualization and measurement of cognitive reserve using common proxy indicators: Testing some tenable reflective and formative models.

INTRODUCTION: The examination of cognitive reserve (CR) literature reveals a lack of consensus regarding conceptualization and pervasive problems with its measurement. This study aimed at examining the conceptual nature of CR through the analysis of reflective and formative models using eight proxies commonly employed in the CR literature. We hypothesized that all CR proxies would significantly contribute to a one-factor reflective model and that educational and occupational attainment would produce the strongest loadings on a single CR factor. METHOD: The sample consisted of 149 participants (82 male/67 female), with 18.1 average years of education and ages of 45-99 years. Participants were assessed for eight proxies of CR (parent socioeconomic status, intellectual functioning, level of education, health literacy, occupational prestige, life leisure activities, physical activities, and spiritual and religious activities). Primary statistical analyses consisted of confirmatory factor analysis (CFA) to test reflective models and structural equation modeling (SEM) to evaluate multiple indicators multiple causes (MIMIC) models. RESULTS: CFA did not produce compelling support for a unitary CR construct when using all eight of our CR proxy variables in a reflective model but fairly cogent evidence for a one-factor model with four variable proxies. A second three-factor reflective model based upon an exploratory principal components analysis of the eight proxies was tested using CFA. Though all eight indicators significantly loaded on their assigned factors, evidence in support of overall model fit was mixed. Based upon the results involving the three-factor reflective model, two alternative formative models were developed and evaluated. While some support was obtained for both, the model in which the formative influences were specified as latent variables appeared to best account for the contributions of all eight proxies to the CR construct. CONCLUSION: While the findings provide partial support for our hypothesis regarding CR as a one-dimensional reflective construct, the results strongly suggest that the construct is more complex than what can be captured in a reflective model alone. There is a need for theory to better identify and differentiate formative from reflective indicators and to articulate the mechanisms by which CR develops and operates.

More Questions than Answers: Continued Critical Reanalysis of Fredrickson et al.'s Studies of Genomics and Well-Being.

We critically re-examine Fredrickson et al.'s renewed claims concerning the differential relationship between hedonic and eudaimonic forms of well-being and gene expression, namely that people who experience a preponderance of eudaimonic well-being have gene expression profiles that are associated with more favorable health outcomes. By means of an extensive reanalysis of their data, we identify several discrepancies between what these authors claimed and what their data support; we further show that their different analysis models produce mutually contradictory results. We then show how Fredrickson et al.'s most recent article on this topic not only fails to adequately address our previously published concerns about their earlier related work, but also introduces significant further problems, including inconsistency in their hypotheses. Additionally, we demonstrate that regardless of which statistical model is used to analyze their data, Fredrickson et al.'s method can be highly sensitive to the inclusion (or exclusion) of data from a single subject. We reiterate our previous conclusions, namely that there is no evidence that Fredrickson et al. have established a reliable empirical distinction between their two delineated forms of well-being, nor that eudaimonic well-being provides any overall health benefits over hedonic well-being.

Aflibercept exhibits VEGF binding stoichiometry distinct from bevacizumab and does not support formation of immune-like complexes.

Anti-vascular endothelial growth factor (VEGF) therapies have improved clinical outcomes for patients with cancers and retinal vascular diseases. Three anti-VEGF agents, pegaptanib, ranibizumab, and aflibercept, are approved for ophthalmic indications, while bevacizumab is approved to treat colorectal, lung, and renal cancers, but is also used off-label to treat ocular vascular diseases. The efficacy of bevacizumab relative to ranibizumab in treating neovascular age-related macular degeneration has been assessed in several trials. However, questions persist regarding its safety, as bevacizumab can form large complexes with dimeric VEGF165, resulting in multimerization of the Fc domain and platelet activation. Here, we compare binding stoichiometry, Fcγ receptor affinity, platelet activation, and binding to epithelial and endothelial cells in vitro for bevacizumab and aflibercept, in the absence or presence of VEGF. In contrast to bevacizumab, aflibercept forms a homogenous 1:1 complex with each VEGF dimer. Unlike multimeric bevacizumab:VEGF complexes, the monomeric aflibercept:VEGF complex does not exhibit increased affinity for low-affinity Fcγ receptors, does not activate platelets, nor does it bind to the surface of epithelial or endothelial cells to a greater degree than unbound aflibercept or control Fc. The latter finding reflects the fact that aflibercept binds VEGF in a unique manner, distinct from antibodies not only blocking the amino acids necessary for VEGFR1/R2 binding but also occluding the heparin-binding site on VEGF165.

Spirituality as a scientific construct: testing its universality across cultures and languages.

Using data obtained from 4004 participants across eight countries (Canada, India, Japan, Korea, Poland, Slovakia, Uganda, and the U.S.), the factorial reliability, validity and structural/measurement invariance of a 30-item version of Expressions of Spirituality Inventory (ESI-R) was evaluated. The ESI-R measures a five factor model of spirituality developed through the conjoint factor analysis of several extant measures of spiritual constructs. Exploratory factor analyses of pooled data provided evidence that the five ESI-R factors are reliable. Confirmatory analyses comparing four and five factor models revealed that the five dimensional model demonstrates superior goodness-of-fit with all cultural samples and suggest that the ESI-R may be viewed as structurally invariant. Measurement invariance, however, was not supported as manifested in significant differences in item and dimension scores and in significantly poorer fit when factor loadings were constrained to equality across all samples. Exploratory analyses with a second adjective measure of spirituality using American, Indian, and Ugandan samples identified three replicable factors which correlated with ESI-R dimensions in a manner supportive of convergent validity. The paper concludes with a discussion of the meaning of the findings and directions needed for future research.

A critical reanalysis of the relationship between genomics and well-being.

Fredrickson et al. [Fredrickson BL, et al. (2013) Proc Natl Acad Sci USA 110(33):13684-13689] claimed to have observed significant differences in gene expression related to hedonic and eudaimonic dimensions of well-being. Having closely examined both their claims and their data, we draw substantially different conclusions. After identifying some important conceptual and methodological flaws in their argument, we report the results of a series of reanalyses of their dataset. We first applied a variety of exploratory and confirmatory factor analysis techniques to their self-reported well-being data. A number of plausible factor solutions emerged, but none of these corresponded to Fredrickson et al.'s claimed hedonic and eudaimonic dimensions. We next examined the regression analyses that purportedly yielded distinct differential profiles of gene expression associated with the two well-being dimensions. Using the best-fitting two-factor solution that we identified, we obtained effects almost twice as large as those found by Fredrickson et al. using their questionable hedonic and eudaimonic factors. Next, we conducted regression analyses for all possible two-factor solutions of the psychometric data; we found that 69.2% of these gave statistically significant results for both factors, whereas only 0.25% would be expected to do so if the regression process was really able to identify independent differential gene expression effects. Finally, we replaced Fredrickson et al.'s psychometric data with random numbers and continued to find very large numbers of apparently statistically significant effects. We conclude that Fredrickson et al.'s widely publicized claims about the effects of different dimensions of well-being on health-related gene expression are merely artifacts of dubious analyses and erroneous methodology.

Childhood trauma and the development of paranormal beliefs.

Belief in the paranormal is fairly prevalent in the general population. Previous research has shown a link between several personological characteristics and paranormal beliefs. The current study attempted to further investigate this link by replicating previous models that have shown a link between childhood trauma, fantasy proneness, and paranormal beliefs. In addition, the study attempted to expand on this model by including other variables such as stigma, resiliency, and coping style. The study used a sample of 198 undergraduate students. A significant correlation between trauma and paranormal beliefs was found. Partial correlations and path analyses revealed that fantasy proneness and avoidant coping style fully mediate the relationship between trauma and paranormal beliefs. The results imply that researchers need to take into account how a person responds to trauma via the development of coping strategies to accurately understand any observed relationship between trauma and paranormal beliefs.

Development and validation of a tool to measure incivility in clinical nursing education.

Although the literature suggests that incivility on the part of staff nurses toward student nurses in the clinical setting exists, no instrument was found that addressed this phenomenon. This article describes the development and validation of the uncivil behavior in clinical nursing education (UBCNE) tool to measure nursing students' experiences with incivility in the clinical learning environment. The 20-item UBCNE was administered to 118 nursing students at a midwestern school of nursing. Analyses included evaluation of interitem response consistency, internal structure via principal components analysis using both orthogonal and oblique rotation, and assessment of the association to demographic variables and stress while on placement as a criterion measure. Six items were dropped due to high loading on more than 1 component. This resulted in a 12-item test with 2 modified subscales-hostile/mean/dismissive and exclusionary behavior. The revised subscales and total test demonstrate good reliability, and both subscales are clearly represented in the separate components. The UBCNE is an easily administered tool with good internal consistency. Future studies with a larger sample and in different settings need to be conducted.

Clarifying the relation between spirituality and well-being.

Koenig (J Nerv Ment Dis 196:349-355, 2008) and others have asserted that measures of spirituality used to investigate its association with health seem to present a misleading picture of the relationship because of evidence suggesting that spirituality has become conceptually confounded with well-being. To evaluate this claim, the present study used a sample of 247 university students to explore the relation of a multidimensional model of spirituality with several different forms of well-being and the association of both with a two-factor model of social desirability. Correlational and regression analyses revealed that, although there is some evidence of an association, it is generally of low effect size and seems to differ as a function of how spirituality is defined. More importantly, however, there was the finding that existential well-being, a concept often incorporated into definitions of spirituality and a part of the measurement model used in this study, is virtually uncorrelated with explicitly spiritual and religious variables but shows a pattern of association with measures of well-being and social desirability, which suggests that it would be better conceptualized as a form of well-being and not spirituality. The article concludes with a discussion of the meaning of the findings for understanding the spirituality-health literature and suggestions for future research.

Evaluation of a social skills program based on social learning theory, implemented in a school setting.

Using a sample of 647 Canadian children in kindergarten to Grade 3 (325 boys, 322 girls), the present study evaluated the perceived effectiveness of Skillstreaming (McGinnis & Goldstein, 2003), a widely known social skills program implemented to target the development of four skill sets, i.e., listening, following directions, problem-solving, and knowing when to tell. Results indicated significant postprogram improvements in all skills as well as in ratings of overall prosociality obtained from both classroom teachers and mental health staff, with medium to large effect sizes obtained from teachers' and mental health professionals' ratings, respectively. Additional analyses yielded significant but weak moderator effects of grade and preprogram prosocial functioning for teacher ratings but no consistent moderator effects for children's sex or school location (i.e., urban versus rural) regardless of rater.

Examination of the psychometric properties of the Spiritual Fitness Assessment.

Using a sample of 196 undergraduate students, the present study investigated the psychometric properties of the Spiritual Fitness Assessment, a measure of spiritual fitness designed for use by health and fitness professionals. Examination of inter-item consistency produced satisfactory alpha coefficients for the total test and its three subscales. Correlations of the SFA with measures of spirituality and spiritual well-being provide support for convergent validity. Significant positive correlations with a measure of self-esteem suggest that the test has satisfactory criterion validity. Correlations with age, sex, and a measure of social desirability indicate that the SFA is significantly, though only moderately, affected by demographic variables and motivated response tendencies. Factor analysis of the SFA items indicate that the test is factorially complex and subscales may need to be refined to better measure their intended constructs. Overall, the results of the study suggest that the test may be useful for evaluations of spiritual fitness. Further research with samples drawn from different populations is needed on the test to better establish its reliability and validity.

Measures of spiritual and transpersonal constructs for use in yoga research.

This article presents information on standardized paper-and-pencil measures of spiritual and transpersonal constructs that hold promise for use in yoga research. Nine instruments are discussed at length including the Assessment Schedule for Altered States of Consciousness, Ego Grasping Orientation, Expressions of Spirituality Inventory, Hindu Religious Coping Scale, Measures of Hindu Pathways, Self-Expansiveness Level Form, Spiritual Orientation Inventory, Spiritual Transcendence Scale, and the Vedic Personality Inventory. As well, a listing of an additional 14 measures, along with primary citations, is provided. In conclusion, the authors proffer recommendations for the use of psychometric tests and provide a general proposal for programmatic research.