Hookah smoking behavior initiation in the context of Millennials

OBJECTIVES

This study aims to examine current hookah users' perceptions, attitudes, and normative beliefs regarding hookah smoking to further elucidate the rise in hookah smoking prevalence among young adults (aged 18-24 years) and reveal why hookah smoking is perceived as less harmful than other forms of tobacco consumption.

STUDY DESIGN

Qualitative.

METHODS

Data from six focus group interviews with hookah smokers aged between 18 and 24 years were analyzed using a grounded theory approach. Focus groups were evenly split between frequent and infrequent hookah users, and were predominantly composed of college students, with two groups of hookah users consisting of 18-24 year olds of non-student status.

RESULTS

Hookah users shared a much larger set of positive hookah smoking behavioral beliefs as opposed to negative behavioral beliefs. Generational traits served as the overarching commonality among the behavior performance initiation determinants observed. The most notable generational trends observed were within the cultural category, which included the following millennial characteristics: autonomy, personalization, novelty appeal, convenience, globally oriented, entertainment, collaboration, health conscious, and valuing their social network.

CONCLUSIONS

Millennial hookah users revealed mindfulness regarding both potential negative and positive reasons stemming from continued hookah use; however, behavioral beliefs were primarily fixated on the perception that hookah smoking was a healthier alternative to cigarette smoking. Future implications for this study's findings include generating more positive ways to express these traits for young adults; policy implications include raising hookah bar age limits, implementing indoor smoking restrictions, and limiting the ease of accessibility for purchasing hookah supplies.

Poor health among smokers obtaining colonoscopy screening: making the case for cessation intervention

OBJECTIVES

Assess differences in perceived health status among individuals receiving colonoscopy screening based on smoking status.

STUDY DESIGN

Cross-sectional data were collected as part of a larger study investigating whether verbal and non-verbal communication and behaviors of gastroenterologists and nurses.

METHOD

Data for this study were collected between 2011 and 2013 among receiving colonoscopy screenings. Data were collected as part of a study assessing patients (n = 1785) undergoing colonoscopy screenings about their expectations, concerns, understanding of the procedure, and perceived health status. Differences between current, former and never smokers were analyzed using a one-way between subjects ANOVA, with a Scheffe post hoc.

RESULTS

Post hoc analyses revealed that current smokers were significantly different from former or never smokers on the following variables: days their physical health was not good, days their mental health was not good, days health influenced their activities, days pain influenced their ability to perform activities, perceived general health, and current anxiety.

CONCLUSION

This study looked at perceived health among individuals receiving colonoscopy screening by on smoking status, a relevant population based on the recent Surgeon Generals link. Former smokers reported similar health status across all variables as never smokers, suggesting the effect of quitting smoking on self-perceived health. With this link, tailored smoking cessation messages to smokers receiving colonoscopy screenings may be an excellent vantage point for a smoking cessation intervention.

The invaluable team member

This article was written specifically to encourage hospitals that are initiating total quality management to include physicians at the beginning stages of the process. Including physicians from the outset can benefit the entire organization. Physicians, by the nature of their profession, have an important role in the quality of the patient care process.

Treatment satisfaction with an asthma management program: a "five"-year retrospective assessment

The results of a five-year follow up of asthmatic children and parents who had completed a structured asthma management program are reported. The purpose of this project is (1) to assess treatment satisfaction, and (2) to identify which of the training components are considered most useful and/or which components are still being used by the participants. Eight families are interviewed. Results indicate that educational information and behavioral asthma management techniques are considered most useful. Improvement in asthma after program completion is reported and is attributed to the asthma management program, maturation, and medication.

Caustic ingestion: controversies in management. A review of 214 cases

Two hundred fourteen patients admitted with a history of caustic ingestion are reviewed. Sixty-five had mucosal penetrating burns. Children five years of age and under accounted for 39% of admissions, but only 8% of burns requiring treatment. Adults accounted for 48% of admissions and 81% of burns requiring treatment. Complications associated with mucosal penetrating burns occurred in 31 patients; all but one were due to lye or acids. A three year prospective study evaluating methylprednisolone in the management of caustic burns is reported. This included 24 patients with mucosal penetrating burns due to lye or acids. The results of this study, and this review as a whole, indicate that methylprednisolone is beneficial in moderately severe burns due to lye, but is not indicated for severe burns from liquid lye, or for acid burns.

Endotracheal tube perforation of the hypopharynx

Perforation of the hypopharynx or esophagus is a serious though not often reported complication of endotracheal intubation. Only 12 cases had been reported before the eight which are presented here to emphasize this hazard of intubation. The early symptoms of perforation, which occurred during insertion of the tube, were: subcutaneous emphysema (seven patients), mediastinal emphysema (six), pneumothorax (two), cardiac arrest (one). One patient had no recognized early signs of perforation, but presented with an abscess of the mediastinum six weeks later. The site of perforation, determined by endoscopy in six patients, was the lateral hypopharynx in four, and the vallecula in two. The outcome of the eight perforations was as follows: two patients recovered on conservative management; in two, abscesses of the neck and in one an abscess of the mediastinum developed. All three recovered after drainage of the abscesses. Three patients died. Two outstanding characteristics of these eight cases were that in all of them intubation was attempted by physicians relatively inexperienced in the technique, and in all but one it was done in emergency. Since the use of intubation in emergency situations is increasing, all physicians in training should receive formal instruction in technique.