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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EThis article highlights select advances in the management of cardiovascular disease risk. It discusses personalized medicine in the management of cardiovascular disease, the role of e-cigarettes in smoking cessation and reduction, and the Global Cardiovascular Nursing Leadership Forum in mobilizing nurse leaders to promote prevention of cardiovascular disease worldwide.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Ecardiovascular disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ee-cigarettes\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EGCNLF\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Enurses\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPCNA\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Epersonalized medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Esmoking\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Estroke\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Evaping\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Egenomics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Esmoking cessation\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EA panel of speakers discussed recent improvements and innovations that could advance the field of cardiovascular disease (CVD) prevention and significantly improve public health.\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EPersonalized Medicine in CVD\u003C\/h2\u003E\u003Cp id=\u0022p-3\u0022\u003EPersonalized medicine (PM) is about moving away from a \u201cone-size-fits-all\u201d approach to health care, said Mary Kerins, RGN, MSc, St James\u2019 Hospital, Dublin, Ireland. This form of medicine uses the science of genomics and proteomics and provides the means to predict, prevent, treat, and cure disease, as well as to enable targeted diagnoses, prognoses, and therapies to promote individual wellness and advance health care.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EDespite the significant progress of PM since its introduction in the late 1990s, including in the field of CVD, Kerins emphasized that CVD remains the leading cause of mortality in women, and it accounts for 30% of deaths globally and 40% of deaths in the European Union (EU). Although PM is playing a growing role in health care, she noted that it remains in development in the EU, and she highlighted key findings from a report released in 2012 from the European Hospital and Healthcare Federation (HOPE) and PricewaterhouseCoopers (PwC) that discussed movement toward PM in 6 European hospitals [HOPE, PwC. \u003Cem\u003EPersonalised Medicine in European Hospitals.\u003C\/em\u003E 2011].\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe report documented that most European hospitals focused on initiatives related to diagnostics and therapeutics. Wide use of genetic screening was found in cancer treatment. In contrast, however, stem cell programs were rarely used, and telemedicine is not yet fully implemented. In addition, most hospitals did not address disease prevention, and only a few focused on nutrition and exercise to encourage wellness and enhance patient treatment. The major barriers to implementation of PM were found to be a lack of the following:\u003C\/p\u003E\u003Cul class=\u0022list-unord \u0022 id=\u0022list-1\u0022\u003E\u003Cli id=\u0022list-item-1\u0022\u003E\u003Cp id=\u0022p-6\u0022\u003EResearch funding\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-2\u0022\u003E\u003Cp id=\u0022p-7\u0022\u003ERobust scientific evidence in some fields\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-3\u0022\u003E\u003Cp id=\u0022p-8\u0022\u003EDoctors\u2019 knowledge about PM\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-4\u0022\u003E\u003Cp id=\u0022p-9\u0022\u003EA clear reimbursement system for related services\u003C\/p\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-10\u0022\u003ENevertheless, these findings merely emphasize the opportunity for hospitals to adapt this novel model of health care to individual patient-targeted services, said Kerins. However, she stressed the need to design and implement PM according to an individual hospital\u2019s needs, organization, and operational pattern.\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EIn her closing remarks, Kerins noted that it takes about 17 years for clinical research findings to be implemented routinely into clinical practice, and she stressed the need for a multidisciplinary approach to PM, as well as more research and regulation in this area. Although medicine of the past focused on population medicine, medicine of the future will focus on an individual, she concluded.\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-3\u0022\u003E\u003Ch2 class=\u0022\u0022\u003Ee-Cigarettes: Harmful or Helpful?\u003C\/h2\u003E\u003Cp id=\u0022p-12\u0022\u003EAccording to Peter Hajek, MA, PhD, Queen Mary University of London, London, United Kingdom, e-cigarettes (ECs) could represent a revolutionary development to improve the health of smokers.\u003C\/p\u003E\u003Cp id=\u0022p-13\u0022\u003EHe noted that the main components of the liquid in ECs are propylene glycol, vegetable glycerol, nicotine, and flavorings. And, although they contain potential toxicants, the concentrations of these substances are much lower than in smoke (\u0026lt;\u20051%) and are unlikely to pose serious risks to health. In addition, passive exposure to ECs is unlikely to be harmful, he added.\u003C\/p\u003E\u003Cp id=\u0022p-14\u0022\u003ENevertheless, controversy has clouded the debate over ECs and tobacco control, in particular due to concern that they represent a gateway to smoking for children or nonsmokers. However, Prof Hajek stressed that research has shown that up to now, ECs have not been impeding the decline in smoking and may even be helping it. Vaping has also been estimated to carry \u0026lt;\u20055% of the risk of smoking. Consequently, there is a need to correct the public\u2019s misperceptions of the risks of ECs, he said.\u003C\/p\u003E\u003Cp id=\u0022p-15\u0022\u003EProf Hajek shared data from a Cochrane Review of studies involving ECs, emphasizing the absence of either serious adverse events or safety concerns associated with vaping over the short to medium term (up to 2 years) [McRobbie H et al. \u003Cem\u003ECochrane Database Syst Rev\u003C\/em\u003E. 2014].\u003C\/p\u003E\u003Cp id=\u0022p-16\u0022\u003EIn fact, data from this review suggested that ECs help smokers to quit smoking (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). In those who do not quit, they may reduce the quantity of smoking. But Prof Hajek noted that the review was based on a small number of studies and that further studies are needed to confirm this finding.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28_suppl_1\/2\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022The Efficacy of e-Cigarettes on Smoking Cessationdf, degrees of freedom; EC, electronic cigarette; M-H, Mantel-Haenszel method for calculating risk ratio.Reprinted from McRobbie H et al, Electronic cigarettes for smoking cessation and reduction, Cochrane Database Syst Rev, Vol 12; CD010216, Copyright \u0026#xA9; (2014), with permission from The Cochrane Collaboration.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1681406216\u0022 data-figure-caption=\u0022The Efficacy of e-Cigarettes on Smoking Cessationdf, degrees of freedom; EC, electronic cigarette; M-H, Mantel-Haenszel method for calculating risk ratio.Reprinted from McRobbie H et al, Electronic cigarettes for smoking cessation and reduction, Cochrane Database Syst Rev, Vol 12; CD010216, Copyright \u0026#xA9; (2014), with permission from The Cochrane Collaboration.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28_suppl_1\/2\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28_suppl_1\/2\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/28_suppl_1\/2\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/17004\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \u003Cp id=\u0022p-17\u0022 class=\u0022first-child\u0022\u003EThe Efficacy of e-Cigarettes on Smoking Cessation\u003C\/p\u003E\u003Cp id=\u0022p-18\u0022\u003Edf, degrees of freedom; EC, electronic cigarette; M-H, Mantel-Haenszel method for calculating risk ratio.\u003C\/p\u003E\u003Cp id=\u0022p-19\u0022\u003EReprinted from McRobbie H et al, Electronic cigarettes for smoking cessation and reduction, Cochrane Database Syst Rev, Vol 12; CD010216, Copyright \u00a9 (2014), with permission from The Cochrane Collaboration.\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-20\u0022\u003EOverall, however, based on current evidence, smokers who switch to ECs reduce their health risks significantly. And there is no evidence that ECs are enticing children to start vaping or smoking, said Prof Hajek. Nevertheless, ongoing surveillance is important to monitor for potential emergence of new risks and enable regulations to be revised accordingly. Public health priorities should aim to encourage smokers to switch from smoking to vaping. Provided they are not impeded by excessive regulation, ECs could make smoking obsolete, concluded Prof Hajek.\u003C\/p\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-4\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EThe Global Cardiovascular Nursing Leadership Forum\u003C\/h2\u003E\u003Cp id=\u0022p-21\u0022\u003EBarbara J. Fletcher, RN, MN, University of North Florida and Mayo Clinic Florida, Jacksonville, Florida, USA, discussed the Global Cardiovascular Nursing Leadership Forum (GCNLF), a Preventive Cardiovascular Nurses Association\u2013initiated strategic plan.\u003C\/p\u003E\u003Cp id=\u0022p-22\u0022\u003EBecause 12 million nurses comprise the largest health care discipline managing CVD risk, Fletcher noted that the American Heart Association and World Health Organization recognize the pivotal role that nurses play in the goal to reduce CVD deaths by 25% by 2025 [Hayman LL et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E. 2015]. According to Fletcher, the mission of the GCNLF is to engage and mobilize an international community of nurse leaders to promote prevention of CVD and stroke worldwide.\u003C\/p\u003E\u003Cp id=\u0022p-23\u0022\u003EFollowing the inaugural meeting of the GCNLF in 2014, findings demonstrated\u003C\/p\u003E\u003Cul class=\u0022list-unord \u0022 id=\u0022list-2\u0022\u003E\u003Cli id=\u0022list-item-5\u0022\u003E\u003Cp id=\u0022p-24\u0022\u003EA lack of standardization of nursing curricula\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-6\u0022\u003E\u003Cp id=\u0022p-25\u0022\u003Elack of outcomes data demonstrating that nurses influence CVD care\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-7\u0022\u003E\u003Cp id=\u0022p-26\u0022\u003EA lack of reimbursement for nurse-based prevention\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-8\u0022\u003E\u003Cp id=\u0022p-27\u0022\u003EThe perception of CVD prevention as a nonpriority\u003C\/p\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-28\u0022\u003EIn addition, barriers to nurses\u2019 continuity of care included\u003C\/p\u003E\u003Cul class=\u0022list-unord \u0022 id=\u0022list-3\u0022\u003E\u003Cli id=\u0022list-item-9\u0022\u003E\u003Cp id=\u0022p-29\u0022\u003EShort patient hospital stays\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-10\u0022\u003E\u003Cp id=\u0022p-30\u0022\u003ENurses being too busy\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-11\u0022\u003E\u003Cp id=\u0022p-31\u0022\u003ENurses\u2019 lack of awareness about prevention\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-12\u0022\u003E\u003Cp id=\u0022p-32\u0022\u003ELack of follow-up\u003C\/p\u003E\u003C\/li\u003E\u003Cli id=\u0022list-item-13\u0022\u003E\u003Cp id=\u0022p-33\u0022\u003EVariation in technological support\u003C\/p\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-34\u0022\u003ESubstantial educational and clinical practice gaps in CVD prevention were also found, both between and within countries. Consequently, the GCNLF aims to address these findings, said Fletcher, and to promote collaboration with other health care providers and international organizations dedicated to the prevention of CVD and stroke. Its next steps involve development of a website with access to educational resources on CVD and evidence-based guidelines. The GCNLF is also compiling a plan for international nursing organizations to determine how nurses can be more effective in global CVD and stroke prevention, concluded Fletcher.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/28_suppl_1\/2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzlfg2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlfg2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}