Changes across 3 years in self-reported awareness of product warning messages in a Hispanic community. (73/22632)

This study investigated the self-reported awareness of product warning messages among independent random samples of Hispanics in San Francisco surveyed from 1989 through 1992. Messages tested were primarily related to cigarette smoking and the consumption of alcoholic beverages. In general, respondents reported low levels of awareness of product warning messages with the exception of those messages dealing with the consumption of alcohol or cigarettes during pregnancy. Nevertheless, there were increases in awareness across years for the alcohol-related warning messages and for one of the cigarette messages, indicating that continued exposure increases awareness of the message. A notable proportion of the respondents reported being aware of a bogus message implying the presence of socially desirable responses in self-reports of message awareness. Gender, education, age and acculturation level of the respondents also showed effects on reported awareness of specific messages. Continued exposure to product warning messages seems useful in producing health-enhancing behaviors among Hispanics.  (+info)

Provocative appeals in anti-smoking mass media campaigns targeting adolescents--the accumulated effect of multiple exposures. (74/22632)

This paper reports findings from a longitudinal study that evaluated the accumulated effect of three consecutive mass media campaigns using provocative and dissonance arousing appeals to prevent cigarette smoking by adolescents. In the spring of 1992, all eligible adolescents aged 14 and 15 in one intervention county (N = 4898) and one control county (N = 5439) in Norway were included in the study, and were followed until they were 17 and 18 years of age in 1995. Only students who completed questionnaires both in 1992 and 1995 were included in the analyses. Among the non-smokers at baseline, a significantly lower proportion of adolescents of both genders had started to smoke in the intervention county compared to the proportion in the control county. Among those who were smokers at baseline, significantly more girls in the intervention county had stopped smoking than in the control county, while no significant difference between the counties was detected among boys. Our findings suggest that provocative and dissonance arousing appeals that create affective reactions and lead to interpersonal communication should be given more attention in campaigns designed to influence adolescent smoking. However, such appeals may easily produce negative reactions and the normative context should be thoroughly considered when using such appeals in future interventions.  (+info)

Women's smoking behaviour--caught by a cigarette diary. (75/22632)

This study explores women's smoking behaviour in relation to mood, activity and social context. A particular aim was to design a 'cigarette diary', useful for research as well as for practical purposes. Fifty male nurses and secretaries kept a diary for one to three typical work days. Diaries consisted of a set of identical sheets, each of which related to one cigarette. Pre-smoking mood and the context of smoking were carefully noted. It was hypothesized that smoking is positively related to perceived stress. Results partly supported this hypothesis, but they also showed that a majority of the cigarettes were smoked in a state of happiness and relaxation.  (+info)

A multiple case study of implementation in 10 local Project ASSIST coalitions in North Carolina. (76/22632)

Community health promotion relies heavily on coalitions to address a multitude of public health issues. In spite of their widespread use, there have been very few studies of coalitions at various stages of coalition development. The purpose of this study was to identify factors that facilitated or impeded coalition effectiveness in the implementation stage of coalition development. The research design was a multiple case study with cross-case comparisons. Each of the 10 local North Carolina Project ASSIST coalitions constituted a case. Data collection included: semi-structured interviews, observation, document review, and surveys of members and staff. Some of the major factors that facilitated implementation included: the ability of the coalition to provide its own vision, staff with the skills and time to work with the coalition, frequent and productive communication, cohesion or a sense of belonging on the coalition, and complexity of the coalition structure during the intervention phase. Barriers to effective implementation included: staff turnover and staff lacking community organization skills, dependence on the state-level staff during the planning phase and lack of member input into the action plan. Conflict contributed to staff turnover, reluctance to conduct certain activities and difficulty in recruiting members, all of which had implications for implementation.  (+info)

Carotid plaque, intima media thickness, cardiovascular risk factors, and prevalent cardiovascular disease in men and women: the British Regional Heart Study. (77/22632)

BACKGROUND AND PURPOSE: B-mode ultrasound is a noninvasive method of examining the walls of peripheral arteries and provides measures of the intima-media thickness (IMT) at various sites (common carotid artery, bifurcation, internal carotid artery) and of plaques that may indicate early presymptomatic disease. The reported associations between cardiovascular risk factors, clinical disease, IMT, and plaques are inconsistent. We sought to clarify these relationships in a large, representative sample of men and women living in 2 British towns. METHODS: The study was performed during 1996 in 2 towns (Dewsbury and Maidstone) of the British Regional Heart Study that have an approximately 2-fold difference in coronary heart disease risk. The male participants were drawn from the British Regional Heart Study and were recruited in 1978-1980 and form part of a national cohort study of 7735 men. A random sample of women of similar age to the men (55 to 77 years) was also selected from the age-sex register of the general practices used in the original survey. A wide range of data on social, lifestyle, and physiological factors, cardiovascular disease symptoms, and diagnoses was collected. Measures of right and left common carotid IMT (IMTcca) and bifurcation IMT (IMTbif) were made, and the arteries were examined for plaques 1.5 cm above and below the flow divider. RESULTS: Totals of 425 men and 375 women were surveyed (mean age, 66 years; range, 56 to 77 years). The mean (SD) IMTcca observed were 0. 84 (0.21) and 0.75 (0.16) mm for men and women, respectively. The mean (SD) IMTbif were 1.69 (0.61) and 1.50 (0.77) mm for men and women, respectively. The correlation between IMTcca and IMTbif was similar in men (r=0.36) and women (r=0.38). There were no differences in mean IMTcca or IMTbif between the 2 towns. Carotid plaques were very common, affecting 57% (n=239) of men and 58% (n=211) of women. Severe carotid plaques with flow disturbance were rare, affecting 9 men (2%) and 6 women (1.6%). Plaques increased in prevalence with age, affecting 49% men and 39% of women aged <60 years and 65% and 75% of men and women, respectively, aged >70 years. Plaques were most common among men in Dewsbury (79% affected) and least common among men in Maidstone (34% affected). IMTcca showed a different pattern of association with cardiovascular risk factors from IMTbif and was associated with age, SBP, and FEV1 but not with social, lifestyle, or other physiological risk factors. IMTbif and carotid plaques were associated with smoking, manual social class, and plasma fibrinogen. IMTbif and carotid plaques were associated with symptoms and diagnoses of cardiovascular diseases. IMTbif associations with cardiovascular risk factors and prevalent cardiovascular disease appeared to be explained by the presence of plaques in regression models and in analyses stratified by plaque status. CONCLUSIONS: IMTcca, IMTbif, and plaque are correlated with each other but show differing patterns of association with risk factors and prevalent disease. IMTcca is strongly associated with risk factors for stroke and with prevalent stroke, whereas IMTbif and plaque are more directly associated with ischemic heart disease risk factors and prevalent ischemic heart disease. Our analyses suggest that presence of plaque, rather than the thickness of IMTbif, appears to be the major criterion of high risk of disease, but confirmation of these findings in other populations and in prospective studies is required. The association of fibrinogen with plaque appears to be similar to its association with incident cardiovascular disease. Further work elucidating the composition of plaques using ultrasound imaging would be helpful, and more data, analyzed to distinguish plaque from IMTbif and IMTcca, are required to understand the significance of thicker IMT in the absence of plaque.  (+info)

Hprt mutant frequency and aromatic DNA adduct level in non-smoking and smoking lung cancer patients and population controls. (78/22632)

T cell cloning and 32P-post-labelling methods were used to study the mutant frequency (MF) at the hypoxanthine-guanine phosphoribosyl transferase (hprt) locus and the aromatic DNA adduct level (AL) in peripheral lymphocytes of newly diagnosed lung cancer patients (92 ever-smokers and 87 never-smokers) and matched population controls (82 ever-smokers and 79 never-smokers). Overall, the MF (total mean 20.6 x 10(-6)) and AL (4.1 x 10(-8)) were similar in cases and controls with the same smoking status, indicating that the disease has limited effect on the two endpoints. When cases and controls were combined, the AL was significantly higher in current smokers than in former or never-smokers (P = 0.0003) and the MF was significantly higher in ever-smokers than in never-smokers (P = 0.004). Age affected the MF significantly in ever-smokers (1.6%/year, 95% CI 0.6-2.5, adjusted for pack-years and years since last smoking), especially among cases (2.1%/year, 95% CI 0.5-3.7). An increase of AL with age was observed in currently smoking cases only (2.3%/year, 95% CI 0.3-4.2, adjusted for smoking dose). For currently smoking cases, there was also a more pronounced effect of smoking dose on both endpoints and a significant correlation between AL and MF (r = 0.52, P = 0.04) was observed among those with the highest dose. Our data also provide additional evidence for the different turnover times of smoking-induced DNA adducts and hprt mutations. The stronger increase of MF and AL with age and dose in currently smoking patients compared with controls is consistent with an interaction between smoking and genetic host factors.  (+info)

Can autologous bone culture predict spinal fusion capacity? (79/22632)

The capacity of the individual patient to initiate osteoblast proliferation as a predictor for successful lumbar spinal fusion has not yet been reported. The objectives of this study were, first, to analyze the relationship between in vitro osteoblast proliferation and clinical bony fusion in the individual patient in order to predict the fusion outcome and, second, to measure the effect of preoperative tobacco smoking on osteoblast proliferation. Sixty-one patients (mean age 46 years) underwent posterolateral lumbar fusion in the period 1994-1995. Thirty-eight patients received CD pedicle screw implants and 23 received posterolateral fusions alone. During surgery, autogenous iliac bone was harvested and 1 g of trabecular bone without blood or bone marrow was then isolated for cell culturing. The cultures were classified as excellent (confluence within 4 weeks), good (confluence between 4 and 6 weeks) and poor (no or poor growth). Spine fusion was evaluated by two independent observers from plain anterior-posterior, lateral, and flexion/extension radiographs taken 1 year postoperatively, and the functional outcome was measured by the Dallas Pain Questionnaire (DPQ). Twenty-three patients had excellent, 19 good, and 19 poor in vitro osteoblast proliferation. Bony fusion was obtained in 77% of patients: 83% in the CD instrumentation group and 70% in the non-instrumentation group (NS). There was no significant correlation between osteoblast proliferation and spinal fusion or functional outcomes when analyzing the CD instrumentation and non-instrumentation groups together or separately. Elderly patients had a significantly poorer osteoblast proliferation than younger patients (P < 0.008). Preoperative tobacco consumption had no discernible effect on osteoblast proliferation, and no correlation between smoking and fusion was found. Further refinement of autologous osteoblast culturing may provide a biological tool for selection of patients who require biological enhancement of their bone fusion capacity. The poorer osteoblast proliferation related to advanced age supports the important negative biological influence of age on bony fusion. However, with more sensitive testing and better discrimination, other results are possible - or can in any event not be excluded.  (+info)

Explaining educational differences in mortality: the role of behavioral and material factors. (80/22632)

OBJECTIVES: This study examined the role of behavioral and material factors in explaining educational differences in all-cause mortality, taking into account the overlap between both types of factors. METHODS: Prospective data were used on 15,451 participants in a Dutch longitudinal study. Relative hazards of all-cause mortality by educational level were calculated before and after adjustment for behavioral factors (alcohol intake, smoking, body mass index, physical activity, dietary habits) and material factors (financial problems, neighborhood conditions, housing conditions, crowding, employment status, a proxy of income). RESULTS: Mortality was higher in lower educational groups. Four behavioral factors (alcohol, smoking, body mass index, physical activity) and 3 material factors (financial problems, employment status, income proxy) explained part of the educational differences in mortality. With the overlap between both types of factors accounted for, material factors were more important than behavioral factors in explaining mortality differences by educational level. CONCLUSIONS: The association between educational level and mortality can be largely explained by material factors. Thus, improving the material situation of people might substantially reduce educational differences in mortality.  (+info)