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PubMedDate not supplied

Effectiveness of a large-scale distribution programme of free nicotine patches: a prospective evaluation.

BACKGROUND: After an increase in cigarette taxes and implementation of smoke-free workplace legislation, the New York City Department of Health and Mental Hygiene, the New York State Department of Health, and the Roswell Park Cancer Institute undertook large-scale distribution of free nicotine replacement therapy (NRT). We did a 6 month follow-up survey to assess the success of this programme in improving smoking cessation on a population basis. METHODS: 34,090 eligible smokers who phoned a toll-free quitline were sent a 6-week course of nicotine patches (2 weeks each of 21 mg, 14 mg, and 7 mg per day). Brief follow-up counselling calls were attempted. At 6 months after treatment, we assessed smoking status of 1305 randomly sampled NRT recipients and a non-randomly selected comparison group of eligible smokers who, because of mailing errors, did not receive the treatment. NRT recipients were compared with local survey-derived data for heavy smokers in New York City. FINDINGS: An estimated 5% of all adults in New York City who smoked ten cigarettes or more daily received NRT; most (64%) recipients were non-white, foreign-born, or resided in a low-income neighbourhood. Of individuals contacted at 6 months, more NRT recipients than comparison group members successfully quit smoking (33%vs 6%, p<0.0001), and this difference remained significant after adjustment for demographic factors and amount smoked (odds ratio 8.8, 95% CI 4.4-17.8). Highest quit rates were associated with those who were foreign born (87 [39%]), older than 65 years (40 [47%]), and smoked less than 20 cigarettes per day (116 [35%]). Those who received a counselling call were more likely to stop smoking than those who did not (246 [38%] vs 189 [27%], p=0.001). With the conservative assumption that every 6-month follow-up survey non-respondent continued to smoke, the stop rate among NRT recipients was 20%. At least 6038 successful quits were attributable to NRT receipt, and cost was 464 US dollars per quit. INTERPRETATION: Easy access to cessation medication for diverse populations could help many more smokers to stop.

Administration, Cutaneous↗
PubMed2000

Global health policy.

Explore the source record for details and available documents.

Communicable Disease Control↗
PubMed1999

Affirmative action.

Explore the source record for details and available documents.

Cultural Diversity↗
PubMed1998

A mass outbreak of gastroenteritis associated with group C rotaviral infection in schoolchildren.

In 1988, a mass outbreak of epidemic diarrhea, i.e., consisting of 296 cases, occurred in Fukuoka Prefecture. Fecal samples from patients of the outbreak were cultured for bacteria, but all samples were negative. Although direct electron microscopy (DEM) revealed the existence of rotavirus-like particles (diam. 60-70 nm) in the fecal samples, serological studies could not detect any antigenic relation to the ordinary rotaviruses by the reverse passive hemagglutination (RPHA) and enzyme-linked immunosorbent assay (ELISA) tests or immune electron microscopy (IEM) examination. The outbreak appeared to be caused by group C rotaviruses, based on the pattern of electrophoretic migration of RNA genome segments in polyacrylamide gel electrophoresis (PAGE). Furthermore, IEM examination showed large aggregates of virus particles and antibodies when the virus particles were incubated with a reference serum specific for group C rotaviruses.

Acute Disease↗
PubMed1999

The role of cultural and social factors in the cause of addictive disorders.

For many centuries, generations of young people were protected from the early onset of addictive disorders. Although addiction to drugs and alcohol had been well known for centuries, widespread addiction has occurred only in recent centuries. Because the human gene pool or human biochemistry did not likely change suddenly to produce this result, social and cultural factors likely have produced widespread addiction. From another perspective, the sociocultural factors that once protected our societies against widespread addiction may have become weakened or inoperative. Our social institutions--our families, schools, religions, neighborhoods, and governments--no longer protect us and our young from addiction as they once did. The failure of traditional social institutions to protect us from addiction does not mean that we must seek drug panaceas only in nonsocietal venues, such as medications and psychotherapies. Rather, we should look to those elements of our institutions that have failed us and seek to bolster them. A gradually evolving body of literature on this topic demonstrates that institutional changes can serve to reduce widespread addiction among us. Moreover, these changes can be implemented at many levels: within our families, schools, friendship groups, workplaces, churches, neighborhoods, and legislatures.

Adolescent↗
PubMed1999

Addictive disorders in adolescents.

Physicians should recognize the importance of individual differences in the etiologic pathway to drug abuse. Drug use in most adolescents subsides or stops by adulthood; however, adolescents with behavioral or affective dysregulation, poor social skills, a limited social network, and substance abuse during late adolescence are at increased risk for substance dependence in adulthood. Research is needed, however, to clarify the developmental emergence and interaction between individual and contextual risk factors. Understanding person-environment processes within a developmental perspective not only yields a better understanding of the causes but also informs about taxonomy, prevention, and readiness to change and compliance in treatment and after-care. Treatment outcome research suggests that (1) relapse is likely to occur within the first 3 months after treatment completion and, to a lesser extent, over the year following treatment completion; (2) relapse is more likely in adolescents who have comorbid psychiatric disorders and other problems, such as high stress, low social skills, lack of involvement in productive activities or active leisure, and no follow-up intervention; (3) continued after-care treatment may maintain treatment gains; (4) the effectiveness of treatment and aftercare is likely to vary by the amount, mode, and the consistency with which it is delivered; (5) gender differences might have an impact on treatment outcome; and (6) adolescents presenting for treatment are likely to respond well to interventions based on family therapy and CBT approaches.

Adolescent↗
PubMedDate not supplied

[Control of Chagas' disease in Guarani communities: knowledge and hygiene habits within the Project to Improve Living Conditions in Bolivia].

The aim of this study was to identify knowledge and control of vectorial transmission (Triatoma infestans, known as vinchuca) of Chagas' disease in Guaraní Communities in Bolivia. We performed a descriptive study of a series of 98 individuals through a semi-structured questionnaire. Interviewees were asked about their familiarity with vinchuca, whether they thought vinchuca produced disease, the name of the disease and its consequences, as well as behavior related to eliminating the domestic insect vectors, such as cleaning of the home, backyard and corral.The insect vector was sufficiently well known (98%), although the name of the disease was identified by only 14.3% of the interviewees. Although the dwellings favored insect proliferation, they were not frequently cleaned: 28.6% cleaned their homes while and 42.9% cleaned the backyard and 7.1% cleaned the corral. Gender differences were found in the division of labor: women cleaned the homes and backyards, while men clean the corral. Experience has shown that the usefulness of projects for building healthy living areas and for health education depends on the value given to these projects by the community. Women are probably the best target group, because they perform a greater number of preventive tasks and seldom leave the community for extended periods of time.

Adolescent↗
PubMed2002

A critical comparison of the cost-effectiveness of domestic radon remediation programmes in three counties of England.

Radon remediation programmes in domestic dwellings were carried out in five areas, from three counties of England, and the total costs obtained. A single company, which abided by the Code of Practice of the Radon Council of Great Britain, carried out the remediation. The dose savings from the programmes were calculated and used to estimate the number of lung cancers averted. The data obtained allowed the cost-effectiveness of the remediation programmes in each area to be calculated. The remediation programmes in three areas (Northants 2, 3 and North Oxfordshire) were cost-effective whereas those in two areas (Northants 1 and North Somerset) were not. To be cost-effective, the Northants I and North Somerset areas would need to increase the number of householders that carried out remediation, if they were over the UK Action Level. Health policy makers should concentrate their resources on communities in areas where there is a significant proportion of dwellings above the UK Action Level and where the number of properties being remediated is low.

Air Pollution, Indoor↗