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Biomedical subjects

K M Cummings

Publications and source records attributed to K M Cummings.

At least 91 records · Page 5Linked to original sources

A discriminant function analysis of various interferon parameters among alcoholics and heavy smokers.

A three-group design of alcoholics, heavy smokers and controls was used to investigate the status of the interferon system, including natural killer cell activity. Group differences were indicated via discriminant function analysis which correctly classified 86% of subjects. Test-retest relations were investigated for 14 subjects following a 30-day alcoholic inpatient program. Whereas significant immune suppression was indicated at the time of detoxification, recovery was evident at the 30-day follow-up. Results are discussed in terms of the significance of alcohol abuse on immune system functioning with consequences for susceptibility to viruses, bacteria and medical illnesses.

Adult↗

Results of an antismoking media campaign utilizing the Cancer Information Service.

In this paper, results are presented on the response to an antismoking media campaign designed to encourage women cigarette smokers with young children to call for information on quitting. The intervention campaign used a mix of professionally produced broadcast and print materials that encouraged smokers to call the National Cancer Institute's Cancer Information Service (CIS) for information on quitting. The campaign was implemented in seven media markets in New York state, Pennsylvania, and Delaware; each of these markets was paired with a control market in one of the three states. Response to the campaign was gauged by monitoring calls to the New York and Pennsylvania area CIS offices from smokers residing in intervention and control media markets. Results from the 46-week campaign show that the number of calls for smoking-cessation information was five times greater from intervention markets than from control markets. The campaign also was successful in reaching the target audience of mothers of young children. Twenty-nine percent of calls received from intervention markets were from the target audience compared with 10% from the control markets. Forty-four percent of all calls received from intervention markets came during a 5-week period when time was purchased to air television spots.

Adult↗

Determinants of clean surgical wound infections for breast procedures at an oncology center.

OBJECTIVE: To determine the clean surgical wound infection rate for breast procedures and the risk factors predisposing patients to these infections. DESIGN: A survey study. SETTING: Oncology center. PATIENTS: A consecutive sample of adult female patients who underwent surgical breast procedures for suspected carcinoma of the breast. Patients undergoing excisional biopsy, lumpectomy, or mastectomy from January 1985 to January 1987 were included in the study. INTERVENTION: Clean surgical wound infection rates were derived overall and for each procedure type. The medical records of all patients were then reviewed to extract data on patient characteristics and operative information in order to assess the risk factors for infection. RESULTS: Among the breast procedures performed on 448 patients, the overall clean surgical wound infection rate was 8.7% (39/448). The clean surgical wound infection rate for each procedure type was as follows: biopsy 2.3%, lumpectomy 6.6%, and mastectomy 19%. In addition to the type of procedure, factors significantly (p less than .05) associated with the development of clean surgical wound infection in the univariate analysis included: presence of surgical drains (p less than .01); closed suction drainage (odds ratio [OR] = 16.5, 95% confidence interval [CI95] = 5.0-54.7); location of the drain (OR = 3.3, CI95 = 1.7-6.6); prolonged preoperative stay (OR = 1.2, CI95 = 1.0-1.5); length of surgery (OR = 2.2, CI95 = 1.7-3.0); and greater mean age (OR = 1.6, CI95 = 1.2-2.1). CONCLUSION: Clean surgical wound infections are not uncommon in patients undergoing breast procedures. Factors relating to both the patient and operative techniques contribute to the clean surgical wound infection rate. Further consideration should be given to perioperative antibiotic prophylaxis for selected breast procedures, and the role of surgical drains should be reassessed.

Biopsy↗

Using a low-cost, prize-drawing incentive to improve recruitment rate at a work-site smoking cessation clinic.

A major obstacle in promoting smoking cessation programs through work sites is recruiting adequate numbers of smokers. We used a quasi-experimental design to evaluate the effect of a low-cost incentive (a prize drawing) for attracting participants to a smoking cessation clinic offered at multiple work sites. Sixty-eight automobile dealerships were randomized to either a "prize" or control group. Smokers employed at work sites in the prize group were offered a chance to win a dinner for two for participating in a smoking cessation clinic. In November 1986, a questionnaire assessing tobacco use habits was sent to 3432 employees of the 68 work sites. A cohort of 844 smokers was identified from a total of 1986 employees who returned surveys. All smokers received registration materials to participate, free of charge, in one of three smoking cessation programs held in June 1987. The overall employee participation rate in the smoking cessation program was 6.6% (n = 56) with an overall work-site participation rate of 37.3% (n = 25). The rate was nearly identical in the "prize" and control groups (employee rate: 6.3% versus 6.7%; work-site rate: 39.4% versus 35.3%, respectively).

Adult↗

The impact of tailored self-help smoking cessation guides on young mothers.

It has been suggested that tailoring self-help materials for specific target populations will increase their effectiveness. This study tested the value of a self-help guide tailored specifically for women with young children. These women were recruited through a media campaign that encouraged smokers to call the Cancer Information Service (CIS) for assistance in stopping smoking. Women smokers with young children (under the age of 6) who called the CIS were given telephone counseling on quitting and were mailed one of three stop smoking guides. One third of callers received Quitting Times, a guide written specifically for women with young children; one third received the American Lung Association guide, Freedom from Smoking for You and Your Family; and one third received Clearing the Air, a guide developed by the National Cancer Institute. Six months after calling the CIS, these women were contacted by telephone to assess changes in smoking behavior. Overall, 12.5% of the women reported not smoking for at least 1 week at the time of the 6-month follow-up interview. There were no significant differences between subjects in the three groups in use of the self-help guides, methods used to attempt quitting, and quitting behavior. Findings from this study do not support the hypothesis that using a tailored stop smoking guide increases the targeted audience's cessation rate or affects quitting-related behavior. However, it should be noted that the smokers who called were predominantly in the contemplation or action stages.

Adult↗

Economic interventions to discourage the illegal sale of cigarettes to minors in New York State.

In New York State it is illegal to sell tobacco products to persons under the age of 18 years. In most communities, compliance with this law is poor. This study provides estimates of teenage cigarette smoking and the illegal sale of cigarettes to minors in 1990 in each of New York's 57 counties and in New York City. Results show that in New York State, approximately 135,700 teens between the ages of 12 and 17 years are regular cigarette smokers. Data available on the cigarette consumption and purchasing habits of teenage smokers reveal that nearly 21.9 million packs of cigarettes were sold illegally to minors in 1991 in New York State. This finding underscores the fact that cigarette sales to underage youth in New York is big business, representing $39.5 million in sales annually. Government officials should consider levying an illegal drug profit tax on the cigarette industry to recover the millions in profits derived annually from the illegal sale of cigarettes to children.

Adolescent↗

Health and economic impact of cigarette smoking in New York State, 1987-1989.

This study provides estimates of deaths attributable to smoking, years of potential life lost (YPLL), and economic costs for each of New York's 57 counties and New York City for the period 1987 to 1989. Results show that in New York State, cigarette smoking was responsible for an average of 30,359 deaths, 409,129 YPLL, and nearly $4 billion in economic costs annually. Overall, smoking-attributable deaths comprised 17.7% of all deaths, or more than the combined total from accidents, AIDS, homicide, and suicide. Findings demonstrate the enormous health and economic burden caused by tobacco use and reinforce the need for policies that discourage smoking, such as increased cigarette taxes, limited smoking in public places, enforcement of youth tobacco access laws, and funding for tobacco education programs.

Adult↗

Predictors of attempting and succeeding at smoking cessation.

This paper presents results of a prospective study which examined factors influencing self-initiated smoking behavior change in a cohort of smokers followed over 17 months. Employees of a cancer hospital and research center were surveyed about smoking habits, health status, attitudes about smoking and social-environmental factors. Seventeen months later, employees identified as smokers were resurveyed about their current smoking status, recent attempts at cessation and use of cessation aids in these attempts. Overall, 47% of subjects had not tried to stop smoking (non-stoppers, NS), 38% had attempted to quit but returned to smoking (recidivists, R) and 15% had successfully quit (SQ). Predictors of attempting cessation (R and SQ versus NS) included smoking fewer cigarettes daily, starting smoking at a later age, previous attempts at quitting, lower nicotine dependence, greater pressure to stop smoking and an expectation to quit in the near future. Amount smoked daily was the strongest predictor of successful quitting (SQ versus R). Findings from this study suggest intention to stop smoking is the most important factor differentiating smokers who attempt cessation from those who do not. Strength of smoking habit appears to be the strongest factor associated with successful quitting.

Adult↗

Variation in sensitivity to environmental tobacco smoke among adult non-smokers.

This study evaluated the extent to which acute reactions to environmental tobacco smoke (ETS) among 723 adult non-smokers differ between those who report a medical history indicative of atopy and those with no such history. Study subjects were divided into three risk groups, based on their medical history: people who reported a doctor-confirmed diagnosis of asthma, hay fever, or allergic reactions to pollen, dust, or mites (n = 140); people not in Group I, who reported a doctor-confirmed history of chronic bronchitis, pneumonia, or sinus trouble (n = 246); and all other subjects (n = 337). Reactions to ETS were assessed by asking subjects to report how much it bothers them to be exposed to other people's tobacco smoke and to indicate whether they typically experience symptoms when exposed to ETS. Study findings support the concept that people with a history of atopy or respiratory illness are more sensitive to the acute irritating effects of ETS compared to people without such a medical history.

Acute Disease↗

The effect of indoor air pollutants on otitis media and asthma in children.

This case-control study investigated the possible association between home environmental air pollutants and their effect on otitis media and asthma in children. Patients with physician-diagnosed otitis (n = 125, 74% response), with asthma (n = 137, 80% response), and controls (n = 237, 72% response) from a private pediatric practice seen between October 1986 and May 1987 were studied. A questionnaire inquired about housing characteristics (i.e., age, insulation, heating system) and sources of indoor air pollution such as cigarette smoking, use of woodburning stoves, household pets, etc. Analysis of the responses confirmed previous findings of significant relationships between maternal smoking (P = .021), and the presence of pets (P = .034) and the occurrence of asthma. A newly reported relationship between exposure to woodburning stoves and the occurrence of otitis (P less than .05) was reported. This implicates yet another risk factor (wood burning) in the etiology of otitis media.

Air Pollutants↗

What scientists funded by the tobacco industry believe about the hazards of cigarette smoking.

Despite overwhelming evidence documenting the hazards of cigarette smoking, the tobacco industry denies that smoking has been proven to cause disease. The industry professes a desire to clear up the smoking and health "question" and often points to its support of the Council for Tobacco Research (CTR) as evidence of its interest in investigating the health dangers of smoking. This paper presents results of a survey of CTR-funded scientists regarding their beliefs about the health dangers posed by smoking cigarettes. The vast majority of scientists funded by the CTR believe that cigarette smoking is an addiction that causes a wide range of serious, often fatal, diseases. This result suggests that the tobacco industry is unwilling to accept even the opinions of scientists it has deemed worthy of funding. Scientists should consider the ethical implications of accepting funds from the CTR and other tobacco industry-supported institutions.

Advertising↗

Massive screening for colorectal cancer. A single institution's public commitment.

Data from three massive screening programs for the detection of colorectal cancer and adenomatous polyps were reproducible through the collaboration of several departments at Roswell Park Memorial Institute, Buffalo, NY. The majority of carcinomas detected had demonstrated no lymph node metastases. The percentage of screenees with positive stool occult blood tests discovered to have colorectal cancer and adenomatous polyps was 19%, 24%, and 21% in 1982, 1984, and 1987, respectively. The cost-effectiveness of this large-scale screening effort by centers such as Roswell Park Memorial Institute has been demonstrated in accordance with high public acceptance and the high incidence of colorectal cancer.

Colitis, Ulcerative↗

An intervention to reduce the sale of cigarettes to minors.

This study reports the results of an intervention to stop the illegal sale of cigarettes to minors. Sixty-two of 120 stores in Erie County, New York, were randomly selected to receive in the mail an informational packet requesting their help in stopping the illegal sale of tobacco to minors. The packet included a letter to the store manager citing the law prohibiting the sale of tobacco products to minors and requesting their assistance in observing the law; a supply of warning signs; and a tip sheet designed to assist store managers in educating their employees about the law. Two weeks after the mailing, stores in the study were visited by study teenagers aged 14 to 16 who attempted to purchase cigarettes. The intervention resulted in an increased number of stores posting warning signs, but had no effect on deterring the sale of cigarettes to minors. Minors purchased cigarettes in 77% of stores that received the special mailing and in 86% of nonintervention stores. Warning signs were visible in 40% of stores that received the special mailing and in none of the nonintervention stores. The findings from this study suggest that a merchant education program to increase awareness of the law and posting of warning signs is not sufficient to discourage the sale of tobacco products to minors.

Adolescent↗

The public health benefit of increasing tobacco taxes in New York State.

The 1989-1990 New York State budget increased the tax on a package of cigarettes from 21 to 33 cents. In this paper we estimate the impact of this tax increase on smoking prevalence and smoking-induced deaths in New York State. Findings show that 115,967 New Yorkers will be encouraged to quit or not start smoking as a result of the increased cigarette tax. The reduced prevalence of smoking attributed to the tax will result in the avoidance of approximately 28,992 premature smoking-induced deaths over the next generation.

Adolescent↗

Cancer mortality in a northeastern native American population.

This study compared cancer mortality among the Seneca Nation of Indians (SNI) between 1955 and 1984 with cancer patterns exhibited by the general population of New York State (NYS), exclusive of New York City. Cancer mortality among the SNI was compared with cancer mortality in NYS using age and sex standardized mortality ratios (SMR). Deficits in overall cancer mortality were noted among both SNI males (SMR = 78) and females (SMR = 73). Results from this investigation will contribute to the understanding of patterns of malignant disease mortality among native peoples and may be of benefit for monitoring the impact of cancer mortality among the SNI and other Native American groups.

Adolescent↗

Cancer surveillance in a northeastern native American population.

This study compares cancer incidence among the Seneca Nation of Indians (SNI) between 1955 and 1984 with cancer incidence patterns exhibited by the general population of New York State (NYS), exclusive of New York City. The cohort for this study consisted of all members of the SNI enrolled on January 1, 1955 and residing in NYS (N = 3262). Cancer incidence among the SNI is compared with cancer incidence patterns in NYS using age and sex standardized incidence ratios (SIR). Decreased cancer incidence was observed for all sites combined with SNI males exhibiting 64% of expected incidence and females exhibiting 53% of expected incidence. Although incidence deficits were observed for several sites, cancer incidence was not significantly elevated for any cancer site. Results from this investigation will contribute to the understanding of patterns of malignant disease among native peoples and aid in directing cancer control programs and services available to native groups.

Adolescent↗