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Biomedical subjects

J W Cullen

Publications and source records attributed to J W Cullen.

At least 37 records · Page 2Linked to original sources
PubMed1988

The National Cancer Institute's intervention trials.

The National Cancer Institute (NCI) has increased its emphasis in cancer prevention by undertaking a number of human intervention trials. Special emphasis is placed on chemoprevention, diet, and smoking and tobacco use. Some 24 clinical trials are ongoing in chemoprevention to assess the role of specific chemicals (natural and synthetic) in preventing, inhibiting, or reversing carcinogenesis. In diet and nutrition, several macronutrient trials are underway. The most significant of these is examining the relationship between dietary fat and breast cancer. In 1982, the NCI initiated a broad intervention research effort in smoking and tobacco use which has resulted in 46 prevention and clinical trials covering 25 states and more than 200 cities. More recently, a North American community-based intervention trial was begun to test cessation strategies for heavy smokers in 22 different sites. All of these intervention research efforts are testing strategies which later can be applied to large target population thereby supporting NCI's ambitious goal to reduce cancer mortality in this nation 50% by the year 2000.

Clinical Trials as Topic↗
PubMed1987

Quasi-experimental evaluation of the Los Angeles Know Your Body program: knowledge, beliefs, and self-reported behaviors.

In 1981-1982 the Division of Cancer Control (Jonsson Comprehensive Cancer Center, University of California, Los Angeles) implemented a Know Your Body program in the Los Angeles and Santa Monica Unified School Districts. The results from this evaluation are based on analyses of over 1,400 elementary school children (ages 9-11 years) from 18 schools who were assigned to one of four comparison groups: (a) Know Your Body curriculum and health screening (N = 688 students/seven schools), (b) Know Your Body health screening only (N = 333 students/three schools), (c) Know Your Body curriculum only (N = 253 students/five schools), and (d) the control group (N = 234 students/three schools). Standardized questionnaires concerning health knowledge, beliefs, and (self-reported) behaviors were group-administered by teachers in January 1981 (pretest) and then again in March 1982 (post-test). The group receiving both the Know Your Body curriculum and the clinical screening scored higher than the control group on four out of six post-test knowledge measures, one out of three belief scales, and one out of four behavioral measures. The curriculum-only group scored higher than the control group on five out of six post-test knowledge measures and on two of three belief scales. The screening-only group did not score significantly higher than the control group on any of the outcome measures. Among children identified during the clinical screening (at pretest) as being at higher risk of developing chronic disease (N = 543), students receiving both the screening and the curriculum (N = 401) scored higher on four out of six knowledge measures and reported significantly lower consumption of both dairy products and high-cholesterol foods than "high-risk" students receiving only the clinical screening (N = 142).

Attitude to Health↗
PubMed1987

What are the odds that smoking will kill you?

We calculated the long-term risks of death from smoking for individuals of various ages and smoking status in terms of the excess mortality contributed by smoking, over and above the baseline mortality from the same diseases caused by factors other than smoking using standard life table procedures. Since mortality data for specific smoking categories were available only from prospective studies in the late 1950s, we scaled these to the 1982 mortality levels. We assumed, for lung cancer, that the death rates for nonsmokers have not changed and, for other smoking-related diseases, that the risks of death for smokers relative to those for nonsmokers have not changed since the 1950s. Probabilities that result from alternative assumptions were also investigated and are presented. As many as one-third of heavy smokers age 35 will die before age 85 of diseases caused by their smoking. The probabilities of death from smoking when compared with other causes may be persuasive as public education tools. Their effective use for this purpose is affected not only by the deficiencies in the public's factual knowledge of the magnitude of the risks from smoking, but also by numerous apparent misconceptions relating to the interpretation of risk information. Risk data should be presented to the public in a manner that clarifies these misconceptions and facilitates their understanding of the overwhelming risk imposed by smoking.

Adult↗
PubMed1987

Cancer prevention and control: from research through applications.

As the understanding of the magnitude and social impact of cancer has advanced, three major forces have shaped the current state of the art in cancer prevention and control: the maturation of organization approaches to solving the cancer problem; the accumulation of scientific evidence that justified and illuminated the concept of cancer as a controllable disease; and, most recently, the development of a systematic cancer control research process that provides efficiency and clearer direction to the planning of a national cancer control program. The National Cancer Institute, recognizing the need for goal setting and scientific accountability in the conduct of cancer control research, has established quantified mortality reduction objectives for the year 2000 related to smoking cessation, diet changes, early detection, and state-of-the-art treatment. The cancer control research process and these objectives will guide the allocation of cancer control resources toward the application of effective health promotion strategies.

Goals↗
PubMed1986

A rationale for health promotion in cancer control.

As the result of a long struggle to conceptualize cancer control and to implement control measures, the scientific community recently has been able to identify the essential factors that must be the foundation of a systematically approached national cancer control program. This accomplishment is welcomed given the refractory nature of the health-research, health-care system in our country to apply what is already known for the benefit of the public health. It took the United States a decade and a half to act on knowledge that smoking causes cancer and a decade and a half more to realize that its efforts to control smoking and tobacco use are still small and are not commensurate with available knowledge from biomedical and behavioral research. In this article, these factors are reviewed in the historical context in which cancer control has been evolving and addressed in the light of health promotion issues.

Female↗
PubMed1986

International control of smoking and the US experience.

International data demonstrate convincingly that lung cancer death rates follow and parallel cigarette smoking prevalence rates in both men and women. Effective control of lung cancer and the many other diseases associated with smoking can be achieved only by continued reductions in smoking prevalence in developed countries and the arrestment of smoking in developing countries. Smoking control strategies can take the form of prevention programs, cessation programs, regulatory and legislative measures, and modifications in tobacco product composition. Because of uncertainties surrounding the efficacies of specific smoking control approaches, the National Cancer Institute recently initiated a major intervention research program to identify and assess the most promising strategies to reduce smoking prevalence in the general public and high-risk populations; heavy smokers, blacks, Hispanics, women, youth, and smokeless tobacco users. By 1990, trial results will be available to allow systematic application of smoking control strategies (demonstrations) using physicians and dentists, mass media, school programs, self-help materials, and the community as a laboratory. For a number of reasons, such approaches are strongly recommended over efforts to reduce cigarette tar and nicotine levels as the primary focus of lung cancer control.

Advertising↗
PubMed1986

Design of cancer prevention studies.

Cancer prevention in the past has referred principally to activities and studies identifying and describing the causes of and risk factors related to cancer. Although these efforts, excellent as they are, still require some fine tuning, the time has come to apply what we know to reduce cancer incidence and mortality worldwide. The National Cancer Institute has embarked on a national course of targeted intervention research and control aimed at reducing cancer mortality by 50% by the end of this century. A large proportion of that goal is to be achieved through cancer prevention research and applications. This paper will discuss the details of that plan with special emphasis paid to smoking and dietary interventions.

Diet↗
PubMed1984

The organization of community disease prevention services: approaches to preventing lung cancer in the Los Angeles Basin.

The UCLA Jonsson Comprehensive Cancer Center initiated a broadly based community program with the goal to reduce lung cancer incidence and mortality in the Los Angeles Basin (LAB). Representatives from the medical and science communities participated with representatives from the business, legal, and legislative sectors of LAB in a number of workshops over an 18-month period. The objectives of the workshops were to involve as many community interests as feasible to identify the issues related to the lung cancer problem and to mount a strategic and broadly based plan to achieve the stated goal. More than 70 individuals participated in this effort. The principal topics identified and developed related to "Smoking and Youth," "Smoking in High Risk Adults," "Smoking in the Workplace," and "Occupational Exposures." The results of this protracted interaction and planning effort are now in evidence in a variety of action programs and intervention research across this large geographic region.

California↗
PubMed1983

Baseline chronic disease risk factors in a racially heterogeneous elementary school population: The "Know Your Body" program, Los Angeles.

The Los Angeles "Know Your Body" (KYB) program is an organized health education activity for children designed to encourage positive health behavior and discourage or interrupt behavioral patterns that are linked to illness, injury, disability, or death. Components of KYB include a 20-week curriculum; a survey of health knowledge, attitudes, and behaviors; in-service training for elementary school teachers; and a clinical screening that provides feedback to students on selected indices. As part of a KYB field demonstration in Los Angeles conducted by the UCLA Division of Cancer Control, Jonsson Comprehensive Cancer Center, 1,503 Los Angeles and Santa Monica-Malibu children ages 9-11 in grades 4 and 5 underwent baseline health screening evaluations in March 1981, measuring height, weight, triceps skinfold thickness, serum cholesterol, pulse rate recovery following exercise, and blood pressure. The population mean for serum cholesterol was 182.6 mg/dl, with no significant racial/ethnic, sex, or age differences. Significant racial/ethnic differences were found in obesity, with Hispanics having the highest prevalence, Asians the lowest. Black students scored significantly higher in pulse rate recovery following exercise, suggesting better relative cardiovascular fitness, and Asians scored lowest. Blacks were more likely to exceed the 95th percentile in diastolic and systolic blood pressure. Overall, 48% of the children had one or more chronic disease risk factors.

Age Factors↗
PubMed1981

Cancer prevention activities in cancer centers.

The above comments only partially reflect current research and interventions in cancer prevention, but they do lead to at least two simple conclusions: first, we are at an embryonic stage in the development of cancer prevention activities. Although the reasons for this are somewhat arcane and complex, it is nevertheless disappointing. Second, there is a growing commitment to and enthusiasm for prevention activity, albeit it to differing degrees and at different levels. In many centers it appears that there is interest, and while ill-defined, there is evidence for the search for structure and function. This is even being reinforced with the allocation of resources. On the other hand, several centers have already made the commitment, and seemed to have gained the respect of the scientific community both intra and extramurally in their respective orientations.

Cancer Care Facilities↗