Log in
  • Home
  • News & Publications
  • News & Views
  • View December 13: CDC Tracks Smoking in Middle and High School Students; Optimal dose of mobilization therapy in the ICU: a prospective cohort study.

View December 13: CDC Tracks Smoking in Middle and High School Students; Optimal dose of mobilization therapy in the ICU: a prospective cohort study.

13 Dec 2023 9:39 AM | Anonymous

CDC Tracks Smoking in Middle and High School Students
Submitted by: Linda Baas

The National Youth Tobacco Survey (NYTS) is an annual survey of middle and high school students designed to track the type and frequency of tobacco use among US youths.1 The survey is across-sectional, school-based, self-administered survey with 3 levels of clustering devised to obtain a representative sample of US students in private and public schools. Respondents are queried on ever use or current use. Different products were surveyed and included cigarettes, cigars, hookah, nicotine patches, and e-cigarettes.

Initial view showed a statistically significant overall drop in high school students’ current use of tobacco from 14.1 to 10%; females used tobacco products more than males (11.2% vs 8.9%). While it is positive to see this drop in older students’ use of tobacco, the use among middle school students increased from 4.6 to 6% (p< .05). The report includes racial differences as well as the manufactures of e-cigarettes and types of flavors vaped.

There is much to ponder about this report, but it is important to note the trends from year to year. The CDC emphasizes that the use of any form of tobacco product is not safe. E-cigarettes are the most common form of tobacco use with 25% report daily use and 89% used flavored vapes.

The CDC calls for “sustained public health monitoring with implementation of evidence-based tobacco control strategies, including effective youth intervention, media campaigns, Food and Drug Administration regulations, and other proven tobacco prevention policies might further reduce youth tobacco product use.1(p.1182)

References:

Birdsey, J et al. Tobacco Product use among US middle and high school students: National Youth Tobaco Survey 2023. CDC MMWR Weekly (Nov ember 3, 2023) 72(44.)1173-1182

Optimal dose of mobilization therapy in the ICU: a prospective cohort study.
Submitted by: Linda Baas

Patients in an intensive care unit (ICU) suffer a life-threatening illness that is the first hurdle they must face. But in addition, there are psychological threats that result from witnessing harrowing sights and sounds, sleep deprivation, and fear. Finally, there is the ICU induced weakness from bed rest and muscle loss that contributes to long term frailty or physical impairment.

Early mobilization is a goal of nursing care to prevent the harmful effects of deconditioning. This has been a focus of care in hospitalized patients for decades. In recent years, this has been instituted earlier and can safely begin in the ICU. Results have included shorter length of ICU stay, earlier hospital discharge, and increased functional level. Research has supported the initiation of mobilization by 72 hours from admission to the ICU, and this is an accepted goal in German hospitals. Exercise prescription usually consists of frequency, duration, and intensity. This study was undertaken to determine the duration of mobilization exercise delivered to ICU patients at a German Hospital.

The intervention was delivered by physical therapists or nurses and consisted of rehabilitation exercise and/or ambulation per day. Patients were assessed at ICU transfer and at hospital discharge. The Barthel Index score on the Transfer and Ambulation Scales were summed and could range from 0 completely dependent on staff to 30 completely independent. To obtain a prehospital score, patients or family members were asked to provide a retrospective assessment.

Forty minutes or more of the mobilization intervention resulted in higher levels of the Bartels Index at ICU transfer and at hospital discharge. The authors note that organizational culture and adequate staffing is important to implement this strategy to minimize deconditioning. 

References:

Lorenz, M et al. Optimal dose of mobilization therapy in the ICU: a prospective cohort study. Journal of Intensive Care 2023 11:56




Powered by Wild Apricot Membership Software