Advances in Statistical Methods for Substance Abuse Prevention Research

The paper describes advances in statistical methods for prevention research with a particular focus on substance abuse prevention. Standard analysis methods are extended to the typical research designs and characteristics of the data collected in prevention research. Prevention research often includes longitudinal measurement, clustering of data in units such as schools or clinics, missing data, and categorical as well as continuous outcome variables. Statistical methods to handle these features of prevention data are outlined. Developments in mediation, moderation, and implementation analysis allow for the extraction of more detailed information from a prevention study. Advancements in the interpretation of prevention research results include more widespread calculation of effect size and statistical power, the use of confidence intervals as well as hypothesis testing, detailed causal analysis of research findings, and meta-analysis. The increased availability of statistical software has contributed greatly to the use of new methods in prevention research. It is likely that the Internet will continue to stimulate the development and application of new methods.     

Familias Unidas: The Efficacy of an Intervention to Promote Parental Investment in Hispanic Immigrant Families

This paper reports a test of the efficacy of Familias Unidas, a Hispanic-specific, ecologically focused, parent-centered preventive intervention, in promoting protection against and reducing risk for adolescent behavior problems. Specifically, the intervention was designed to foster parental investment, reduce adolescent behavior problems, and promote adolescent school bonding/academic achievement, all protective factors against drug abuse and delinquency. One-hundred sixty seven Hispanic families of 6th and 7th grade students from three South Florida public schools were stratified by grade within school and randomly assigned to intervention and no-intervention control conditions. Results indicated that Familias Unidas was efficacious in increasing parental investment and decreasing adolescent behavior problems, but that it did not significantly impact adolescent school bonding/academic achievement. Summer-vacation rates of adolescent behavior problems were six times higher in the control condition than in the intervention condition. Furthermore, change in parental investment during the intervention was predictive of subsequent levels of adolescent behavior problems. The findings suggest that Familias Unidas is efficacious in promoting protection and reducing risk for adolescent problem behaviors in poor immigrant Hispanic families.     

Obesity in youth and middle age and risk of colorectal cancer in men

To investigate an association between colon cancer and obesity during early adulthood—a potentially important period in the etiology of this disease—the authors assembled, by computer linkage, a population-based historical cohort of 52,539 men born between 1913 and 1927 residing in Hawaii (USA), for whom weight and height had been recorded in 1942–43 and 1972. Linkage of this cohort to the Hawaii Tumor Registry resulted in the identification of 737 incident cases of colorectal cancer for 1972–86. An average of 3.8 cancer-free controls were matched to each case on month and year of birth and ethnicity of the parents. A case-control analysis in each anatomic subsite of the large bowel revealed that both early and middle-age body mass increased the risk of sigmoid cancer in men in a dose-dependent fashion. The odds ratios (OR) for sigmoid cancer for the highest compared with the lowest tertiles of Quetelet index were: 2.1 (95 percent confidence interval [CI]=1.4–3.2) and 1.7 (CI=1.1–2.5), at ages 15–29 and in prediagnostic years, respectively. These associations were additive and idependent of socioeconomic status. Men who were above the median Quetelet index in 1942 and 1972 had an OR of 2.7 (CI=1.8–4.0), compared with those who were below the median in both periods. This study provides further evidence for an association of obesity with colon cancer in men and suggests that this association is limited to the sigmoid colon and may be related to both early and late events of colon carcinogenesis.The authors are with the Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii. Address correspondence to Dr Le Marchand, Epidemiology Program, Cancer Research Center of Hawaii, 1236 Lauhala Street, Suite 407, Honolulu, HI 96813, USA. This work was supported in part by Public Health Service grant 5-R29-CA44503 and contract NO1-CN-55424 from the National Cancer Institute, National Institutes of Health, Department of Health and Human Services.     

食管内支架置入术并发症分析及防治

目的：分析食管内钛镍记忆合金支架置入术并发症的可能原因及防治方法。方法：共52例病人，食管癌、贲门癌29例，食管胃吻合口狭窄21例，自发性食管破裂2例，共置入各种钛镍记忆合金支架54枚。随访观察3～36个月。结果：内支架置入全部成功，术后患吞咽困难症状均改善。术后出现的并发症包括支架移位3例，支架堵塞9例。吸入性肺炎3例，呕血7例，残余漏2例，疼痛和异物感24例，严重返流症状5例。经过相应的治疗，除2例大呕血患外，其余并发症均得到纠正。结论：虽然食管内钛镍记忆合金支架置入术后有不可忽视的并发症，但经过相应治疗，一般均可纠正，它是治疗食管恶性狭窄和自发性食管破裂有效的方法。     

医源性子宫内膜异位症的治疗进展

医源性子宫内膜异位症是指由于医学检查或治疗的影响而使子宫内膜异位种植，存活或已有的内膜异位灶进一步发展，近年发病率逐渐上升，原因主要与各种妇产科操作的增多有关，现就医源性子宫内膜异位症的治疗进展作一综述。     

Industrial back belts and low back pain: Mechanisms and outcomes

The recent increased utilization of industrial back belts as personal protective equipment in the workplace has generated considerable controversy among occupational health and safety professionals in the United States. The purpose of this article is to review the literature regarding proposed mechanisms of action of these devices and studies related to outcome of belt utilization in the prevention of low back pain and disability in the workplace. At the present time, neither the suspected mechanisms of action nor the efficacy of these devices in the primary, secondary, and tertiary prevention of work-related low back pain has been adequately demonstrated in clinical trials. As a result, generally accepted guidelines regarding the safe use of belts in the occupational setting have not been established. Based on this review it is recommended that further well-controlled, prospective, randomized clinical trials are necessary to evaluate the effectiveness of these devices as personal protective equipment. During the interim, the decision to prescribe belts to employees in the workplace should be at the discretion of an adequately trained occupational health care provider. These devices should not be provided as an alternative to appropriate administrative and/or engineering controls.     

农村教师艾滋病防治知识、态度、行为和效能调查分析

目的了解农村教师艾滋病防治知识、态度、行为和效能情况,为开展艾滋病防治的信息、教育、沟通(IEC)技能训练提供科学依据。方法对1200名农村教师进行《艾滋病防治问卷》调查。结果农村教师艾滋病防治知识比较欠缺,相关态度和行为有待改善,艾滋病防治上的自我效能感亟待提高。结论对农村教师开展艾滋病防治知识的健康教育十分必要。     

防治生殖道感染的实施策略

本文运用有关调查资料及数据表明，妇女生殖道感染具有患病率高、无症状比例高、不求医比例高、得不到正确诊断和治疗的比例高的特点；防治生殖道感染，应首先防止新感染的发生，发现和治疗无症状的病例，改善患者的求医行为，正确诊断和治疗现患病例，有效降低生殖道感染的发病率。     

拉米夫定阻断乙型肝炎病毒宫内传播的临床探讨

【目的】研究拉米夫定对HBsAg阳性孕妇的乙肝病毒 (HBV)宫内阻断作用。【方法】拉米夫定组 43例 ,孕 2 8周起口服拉米夫定 ,每天 10 0mg至产后 30d。对照组 5 2例 ,未予用药。两组孕妇均于孕 2 8周、分娩前 ,其新生儿于生后 2 4h内免疫接种前抽静脉血检测HBsAg、HBeAg及HBV的定量。【结果】拉米夫定组孕妇HBV的DNA水平显著下降 (P <0 0 5 ) ,其新生儿宫内感染率 (16 3% )明显低于对照组 (32 7% ) ,P <0 0 5。两组孕妇及其新生儿未发现有不良反应。【结论】携带HBV孕妇产前服用拉米夫定可有效减少HBV宫内感染发生率。     

40例痔患者的辨证施护体会

目的：总结了痔患者的辨证施护体会，为临床护理工作提供参考。方法：回顾分析了自2001年以来收治的40例痔患者的临床资料。护理诊断及相应措施。结果：本组40例患者，痊愈者28例，好转者10例，病情稳定出院者2例。结论：树立以病人为中心的整体观。实施相应的辨证护理，贯彻以预防为主的方针，可提高痔的治愈率。