Biomedical subjects
Publications and source records attributed to S Sussman.
The authors report an adult patient with a symptomatic intracranial meningioma that was demonstrated by computerized tomography, angiography, and at surgery. The meningioma had occurred at a site where 19 years previously thorium dioxide had been injected into an abscess cavity. Pathological examination revealed the presence of thorium granules within the meningioma.
Abnormal tear calcium concentrations, which might be expected in ocular and systemic disorders,may be obscured if tear calcium concentration varies with flow rate. The results of the present study indicated that tear calcium concentration is independent of flow rate with rates faster than those which occur with stimulated overflow tearing (i.e., 2 mu1 per minute), but with slower flow rates such as would be encountered with basal, nonstimulated tear flow, tear calcium concentration increases as flow rate decreases. In addition, at given flow rates, tear calcium concentration is the same as that in at least two components of tears, i.e., lacrimal gland fluid, uncontaminated by fluid from the other orbital glands, and fluid from the other orbital glands, uncontaminated by lcarimal gland fluid. It is apparent that only if calcium concentration is correlated with fluid flow rate will determination of calcium in tears and in the components of tears produce valid information not only about tear calcium levels in the presence of ocular and systemic diseases but also about the mechanism of secretion of calcium by the orbital glands.
Between 1965 and 1972, 231 patients were admitted to St. Christopher's Hospital for Children in Philadelphia with the battered-child syndrome. The case records and reontgenograms of 217 patients were reviewed. About one-third of the patients repuired orthopaedic treatment. The purpose of this paper is to alert the orthopaedist to the existence and prevalence of the battered-child syndrome, to describe both the non-orthopaedic and the orthopaedic manifestations of this problem, and to delineate the orthopaedist's responsibility to the battered child and the child's family.
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OBJECTIVES: This paper presents the 1-year outcomes evaluation of Project Towards No Drug Abuse (Project TND), a large-scale indicated drug abuse prevention program in southern California applied to continuation high school youth, who are at high risk for drug abuse. METHODS: The efficacy of nine-lesson health motivation--social skills--decision-making curriculum was evaluated in a three-condition experimental design. Twenty-one schools were randomly assigned by block to one of three conditions--standard care (control), classroom program, and classroom program plus a semester-long school-as-community component. A pretest was followed by a 3-week-long drug abuse prevention program and then a posttest at 14 continuation high schools. The 7 standard care schools received only the pretest followed by the posttest (same time duration). Subjects were followed up 1 year later. RESULTS: Changes in use of cigarettes, alcohol, marijuana, and hard drugs were assessed in a pretest-1-year follow-up time interval. The follow-up rate was 67% (analysis n = 1,074). Indicated preventive effects were found on alcohol and hard drug use. No differences were found across the two program conditions. CONCLUSIONS: Project TND is the first program to demonstrate 1-year self-reported behavioral effects on alcohol use and hard drug use among older, high-risk youth by using a school-based, limited-session model.
OBJECTIVES: This paper reviews the literature regarding predictors of adolescent self-initiated smoking cessation and investigates self-initiated smoking cessation among a large sample of alternative high school youth in southern California. Youth transfer to alternative schools because of academic or behavioral problems, and they are at relatively high risk for cigarette smoking. METHODS: Several demographic (e.g., gender), behavioral (e.g., level of smoking), and psychosocial (e.g., risk-taking) predictors of adolescent smoking cessation were investigated. The alternative high school cohort provided a sufficient sample size of quitters (defined as no use in the past 30 days, measured after a 1-year period) to permit a prospective examination of adolescent smoking cessation. RESULTS: Although nine demographic, behavioral, or psychosocial variables discriminated among quitters and nonquitters in univariate analyses, only level of baseline smoking, smoking intention, and perceived stress were predictors in a final multivariable model. CONCLUSIONS: Based on the literature review and findings among the cohort, smoking cessation programs for adolescents should include counteraction of problem-prone attitudes, support of wellness attitudes, provision of motivation to quit strategies, and assistance with overcoming withdrawal symptoms.
Requiring active consent from parents leads to different self-reports by adolescents than when it is not required. The present study compares self-reported demographic, psychosocial, and behavior variables between those students from whom active consent was and was not obtained. As found in previous studies, fewer minorities, fewer persons who were dissatisfied with school, fewer persons whose parents were of lower educational levels, and fewer cigarette smokers were represented in the sample recruited by active parental consent. Extending on previous work, we found those students whose parents failed to respond to the consent procedure were less likely to live with both parents, were more likely to be latch-key children, placed a lower priority on health, and were higher in risk-taking, lower in self-esteem, and lower in assertiveness than those whose parents had responded. These data further support the suggestion that those children who are omitted from a research study because of lack of action on the part of the parent are at higher risk for a number of health and social problems. These children need to be included in evaluation samples in order to accurately assess the effectiveness of prevention programming. Future studies should employ a passive consent procedure as a means of recruiting a representative subject pool in school-based prevention research.
Past studies which examined correlates of smokeless tobacco or cigarette use have investigated use of one tobacco product regardless of use of the other product. Thus, the etiology of exclusive use of the two tobacco products is not clear. The present study investigated the relationship of problem-prone-related variables to exclusive versus overlapping use of smokeless tobacco and cigarettes. Two samples of southern California male students (eighth-grade and high school) were divided into groups according to their tobacco use status: neither product, cigarettes only, smokeless tobacco only, or both tobacco products. Generally, triers and monthly users of both tobacco products reported a higher risk-taking preference, greater susceptibility to peer social influence to use tobacco products, and greater likelihood to have tried marijuana and alcohol than did subjects who were not users of either tobacco product. Adolescents who used either product, but not both, reported similar scores on most of the variables examined, which fell in between combined or nonuse categories. These results suggest that the number of tobacco products used, not the specific product, is associated with problem-prone attributes.
Differences in demographic and smoking-related characteristics were examined among an ethnically heterogeneous sample of participants and nonparticipants of a self-help media-enhanced smoking cessation program which had been aired in seven cities in California. Subjects had been prompted or not prompted to view the mass media smoking cessation broadcast as an experimental manipulation. Written self-help smoking cessation materials were provided as supplements in local Sunday newspapers. Predictors of viewing the smoking cessation broadcasts and reading the self-help manual were examined separately. Across conditions, more smokers read the manual than viewed the broadcast. Nonredundant predictors of viewing the smoking cessation broadcasts included being prompted to view the broadcast, and self-reports of a tendency to read or listen to self-help material. Nonredundant predictors of reading the self-help smoking cessation manual included city of residence, older age, being a heavier smoker, planning to quit in the next 3 months, and receiving a newspaper at home (in which the self-help material appeared). Apparently, a televised cessation program can reach smokers who vary widely in characteristics. Prompting viewing increases participation, but only to a limited extent. Distribution of a written cessation manual in Sunday newspapers tends to be utilized by a relatively larger population, but especially by those persons who are motivated to quit.
This one-year prospective study provides an extension of a previous cross-sectional investigation. The previous study found that the number of tobacco products used (i.e., smokeless tobacco, cigarettes), not type of tobacco product, was associated with higher scores on problem-prone variables. In the present study, a sample of 842 southern California seventh-grade adolescents who had not tried either cigarettes or smokeless tobacco were identified and surveyed one year later. Onset of tobacco use was examined as an outcome variable predicted by scores on four psychosocial and two alcohol use variables in seventh grade. Unlike the previous study, females were included in the current study, and the potential moderating effect of gender on the pattern of predictors was examined. Overall, these findings indicate that onset of cigarette smoking or use of both tobacco products is associated with alcohol use, risk taking, and low self-esteem. This study provides modest support for the previous investigation. In addition, two of the predictor variables were found to interact with gender. Risk-taking was found to have a stronger association with initiation of tobacco use for females than males. Susceptibility to social influence to use tobacco was found to be associated with initiation of tobacco use for males only.
Although much is known about the characteristics of employees who smoke cigarettes, very little is known about workers who use smokeless tobacco. The current study was designed to understand the characteristics of smokeless tobacco users in relation to their performance at work and compare them with smokers and former tobacco users. Data were collected via interviews and questionnaires from a random sample of employees working at Pacific Lumber Company (N = 146), the largest single-site lumber mill in California. A total of 63 smokeless tobacco users (21 of whom also smoked cigarettes), 43 cigarette smokers, and 40 employees who had successfully quit using tobacco (34 of whom previously used cigarettes only) provided information about their health behavior, quality of work life, and performance at work. Analyses revealed that smokeless tobacco users reported less healthful sleep patterns, drank alcohol more often, were intoxicated more often, reported less job satisfaction and organizational commitment, and reported that both chewers and smokers do not work as hard and take more breaks than do tobacco-free employees (quitters). Specific differences among chewers-only, smokers-only, smokers-and-chewers, and quitters are presented. Results suggest the organizational value of developing worksite cessation programs for smokeless tobacco users.
Brief discussion groups were completed with 211 predominantly African American and Latino seventh graders to investigate reasons for adolescent smoking and perceived efficacious smoking prevention program strategies. Study data consisted of audiotaped group discussions, which were content-coded, and open-ended posttest responses. The results indicated that, through use of relatively nondirected methods, reasons for smoking and smoking prevention methods generated by African American and Latino youth were similar to those popularly endorsed by white youths in previous research. Perhaps, optimal program contents are similar across ethnic groups. Still, one may speculate that identification with and diffusion of prevention messages may be maximized if they demonstrate cultural relevancy.
Correlates of drug use were examined in a continuation high school sample (n = 1.315), using canonical correlation analysis. Fourteen demographic, attitudes/belief, and psychosocial pressure/ anxiety-type variables were included as concurrent predictors. Eight drug-use-related measures were also placed into the analysis as outcome variables. Two factors were revealed. White ethnicity, not being Latino, all attitude/belief measures, and family conflict and depression showed relatively high loadings on the first predictor factor, and were associated with all drug-use measures. Latino ethnicity and being relatively unacculturated (i.e., tending to speak Spanish), most of the attitude/belief measures (but not sensation seeking or spirituality), and perceived peer approval to use drugs, trait anxiety, and depression showed relatively high loadings on the second predictor factor, and were associated with the hard-drug-use measures. These results suggest that there is a subgroup of unacculturated Latino youth who are anxious, who perceive they will achieve peer approval by using drugs, and who tend to use hard drugs. Indicated drug abuse prevention strategies may need to be tailored to this subgroup when developing and implementing programming.
Project EX is an eight-session teen school-based clinic tobacco use cessation program that involves the inclusion of enjoyable, motivating activities ("games," "talk show," and alternative medicine-type) to try to enhance quit rates among youth. This clinic program was tested in a three-group experimental design: clinic-only, clinic plus a school-as-community (SAC) component, and standard care control. Eighteen schools were assigned to the three conditions using a randomized block design. A total of 335 smokers participated in the study, making this the largest controlled teen smoking cessation field trial conducted to date. Seventeen percent of the smokers enrolled in the clinics had reports of having quit smoking for at least the last 30 days at 3-month follow-up (5 months after the program quit day), compared to only 8% of the control condition smokers over than same time period. The Project EX clinic component appears to be an effective means of tobacco use cessation among teens.
The present study tested whether smokeless tobacco (ST) fits a unidimensional model of drug involvement and tried to locate ST along the dimension that underlies drug use. The latent trait analysis was employed to quantify drug involvement in a sample of high school students. Analyses showed that although ST use fits the unidimensional model of drug involvement, the place of ST use along the continuum of drug involvement is not stable and differs by gender and ethnicity. Particularly for males, ST use is likely to be preceded by soft drug use and followed by hard drug use; for females, however, ST use is closely associated with hard drug use. The analyses also revealed that the fit of the unidimensional model and the location of ST use along the dimension vary with different ethnic groups.
The present study provides a detailed multiple-choice self-report analysis of home, school, and other public locations where youth report using drugs. In addition, these settings were examined as a function of gender, ethnicity, type of drug used, and drug abuse status. The participants for the present study are 413 continuation high school youth, who are at relatively high risk for substance abuse. The single most frequent location of use was the participants' bedroom with a small group of friends. However, heavier users used different drugs across a greater variety of locations. Not surprisingly, drugs were used least at school. Interestingly, the prototypical party drug use situation is not a popular situation for drug use, at least among these high-risk youth.
This article reports a large-scale study of the prediction of marijuana use cessation among adolescents who were regular users at baseline. Social, attitude, intrapersonal, violence-related, drug-use-related, and demographic baseline measures served as predictors of whether or not 566 current marijuana users reported having quit use 1 year later. Quitting was defined as having not used marijuana in the last 30 days and having no intention to use marijuana in the future (31% of the baseline users). Those who were slightly older, who reported receiving relatively less approval for using drugs, who held relatively unfavorable attitudes about the acceptability of drug use, and who reported relatively less victimization in the last year were relatively likely to quit. Implications of these results include the need to increase unacceptability of marijuana use to help increase efforts at self-initiated quitting.