Search

Objective: To examine prescription stimulant use among college students, particularly use with versus without prescriptions or attention deficit hyperactive disorder (attention-deficit/hyperactivity disorder (ADHD)) diagnoses. Participants: Data were drawn from a diverse sample of college students from seven colleges/universities in Georgia participating. Methods: Measures assessed ADHD-specific factors, prescription stimulant use, access, motives, side effects, and covariates. Results: Of the 219 students reporting prescription stimulant use (average age 20.72 years, 54.8% female, 82.1% White), 45.7% did not have prescriptions or ADHD diagnoses. Correlates of use without prescriptions/diagnoses included lower parental education, attending private school, not having depression- or anxiety-related diagnoses, and past 30-day marijuana and tobacco use. Those without prescriptions/diagnoses were more likely to use to stay awake longer, to have more enjoyable time, and to party longer; they also reported fewer adverse side effects. Conclusions: Campuses should educate students about ADHD, facilitate screening and treatment, and emphasize adverse consequences of recreational use.

Introduction Youth in the United States are using electronic nicotine delivery systems (ENDS) at a high rate. Modifications to ENDS by youth can introduce additional health hazards which have not been previously considered. To better understand these risks, we need more information on what these modifications are, the motivations behind them, and the sources of information on modifications. Aims and Methods Utilizing a trained moderator, in 2020–2021, we conducted one-on-one interviews with 19 youth ENDS users aged 16–17 living in the United States and analyzed their responses using a qualitative description approach. Results The most prominent modification was to the e-liquid; youth indicated they mixed e-juices to create new flavors and added substances not intended for vaping, including illicit drugs such as cannabis and cocaine. Few youths from our sample were interested in achieving a specific nicotine level to vape, and modifications to the battery, coil and wick were less frequently mentioned. Some of these modifications were motivated by a desire to achieve specific experiences with their device. At other times, modifications were made due to necessity because of limited access to ENDS devices and supplies. YouTube and peers were the main sources of information about modifying. Conclusions Youth are making modifications that are both intended and unintended by the manufacturer. Adding illicit drugs and other substances not made for vaping is of particular concern. Understanding how youth modify ENDS and how that changes their use is important to guide regulatory policy intended to reduce harm to youth from ENDS use. Implications Youth from our study indicated that they make modifications to the ENDS devices, specifically to the e-liquid. These modifications are both intended by the manufacturer, such as changing the e-liquid and replacing coils, and unintended, such as adding substances not meant for vaping. Future policies aimed at reducing youth ENDS use should consider mandating better safeguards against modifications that appeal to youth. [ABSTRACT FROM AUTHOR]

E-cigarettes (electronic cigarettes) have been the most used tobacco product among US youth since 2014, reaching a plateau during the COVID-19 pandemic. Youth e-cigarette use is associated with negative health consequences such as impaired cognitive functioning. For many, the COVID-19 pandemic altered social interactions, harm perceptions, and product availability. This changed the frequency and locations in which youth use e-cigarettes. To better understand youth e-cigarette use, we need more information on factors that can alter e-cigarette use, specifically, how the pandemic changed e-cigarette use among youth. In 2020-2021, we conducted online, individual interviews with 19 youth (aged 13-17) e-cigarette users living in the US to explore how COVID-19 impacted their e-cigarette use. Youth described a progression of e-cigarette use from initial experimentation, regular social use, and ultimately to nicotine addiction demonstrated by individual use in isolation. Many youth initiated e-cigarette use due to influences by friends or family members. Youth discussed progression to social use, with social interactions as an important reason for use and an avenue for expanding one's knowledge of e-cigarettes. After a period of time, youth began to recognize that the social interactions mattered less, suggesting to them that they had become addicted. This realization became more apparent during COVID-19, which changed how youth used e-cigarettes, especially around where use was occurring, health concerns, and use behavior and frequency. In our interviews, youth trajectory began with an initiation with family and friends, progressed to social use, and eventually developed to addiction, at which point social use was no longer the primary motivation for e-cigarette use. Understanding the trajectory of e-cigarette use will allow for effective interventions that reduce harm to youth from e-cigarette use. [ABSTRACT FROM AUTHOR]

Introduction: Vape shops represent prominent, unique retailers, subject to Food and Drug Administration (FDA) regulation in the United States.Aims and Methods: This study assessed compliance of US vape shop retail marketing strategies with new regulations (eg, required age verification, prohibited free samples) and pre-implementation conditions for other regulations (eg, health warning labels on all nicotine products, required disclosures of e-liquid contents).Results: 95.0% of shops displayed minimum-age signage; however, mystery shoppers were asked for age verification at 35.6% upon entry and at 23.4% upon purchase. Although 85.5% of shops had some evidence of implementing FDA health warnings, 29.1% had signage indicating prohibited health claims, 16.3% offered free e-liquid samples, 27.4% had signage with cartoon imagery, and 33.3% were within two blocks of schools. All shops sold open-system devices, 64.8% sold closed-system devices, 68.2% sold their own brand of e-liquids, 42.5% sold e-liquids containing cannabidiol, 83.2% offered price promotions of some kind, and 89.9% had signage for product and price promotions.Conclusions: Results indicated that most shops complied with some implementation of FDA health warnings and with free sampling bans and minimum-age signage. Other findings indicated concerns related to underage access, health claims, promotional strategies, and cannabidiol product offerings, which call for further FDA and state regulatory/enforcement efforts. [ABSTRACT FROM AUTHOR]

Central line associated blood stream infections (CLABSIs) and catheter associated urinary tract infections (CAUTIs) are conditions acquired in the acute care facility that are preventable. Invasive devices are frequently left in place without a clear clinical indication, increasing the risk for infection. A line stewardship program was developed to decrease the number of unnecessary central venous catheters (CVCs), decrease the number of unnecessary urinary catheters (UCs), and increase provider acceptance rates of removal recommendations. The program was implemented from March to November 2022 in seven facilities within a large hospital system. An interdisciplinary team consisting of infection preventionists, and nurse leaders performed chart reviews of patients with CVCs and UCs to determine device necessity. If no clear clinical indications were identified, the primary nurse and physician were contacted, and removal was recommended. Run charts were used to identify trends throughout the implementation period. 3,492 patients were reviewed including 1,867 patients with CVCs and 1,625 with UCs. During this time, 370 UCs and 252 CVCs were removed per the team's recommendation. The median removal rate after the intervention was accepted was 85%. Initially we saw a decrease in provider acceptance rate of device removal as the program expanded and new facilities were added to the pilot; as the program became more established, we saw a rise in the provider acceptance rate. We also saw a decline in the percentage of devices recommended for removal from our baseline. This was anticipated as we hoped our program would have a larger impact on staff's attentiveness to line necessity prior to our team's intervention. The implementation of a line stewardship program helped to reduce the number of unnecessary CVCs and UCs despite variable provider acceptance of removal recommendations. It increased awareness of device duration and encouraged interdisciplinary communication regarding the plan of care. [ABSTRACT FROM AUTHOR]