Thermography in screening for breast cancer.

STUDY OBJECTIVE--The aim of the study was to determine whether thermography could be used to identify women with breast cancer or women at risk of developing the disease within five years. DESIGN--Women were screened for breast cancer and a documentary follow up was conducted five years later through general practitioner records. SETTING--The project involved Women resident in the Bath District Health Authority area, who were invited to attend a breast screening clinic. SUBJECTS--10,238 women aged between 40 and 65 were screened. Of these, 4284 accepted personal letters of invitation from their general practitioners and 5954 volunteered to take part in the project in response to publicity; 9819 (96.5%) were traced after five years. MEASUREMENTS AND MAIN RESULTS--All the women had a thermographic and clinical examination of their breasts. If either examination was abnormal they were referred for mammography. Sensitivity of thermography was found to be 61% and specificity 74%. A documentary follow up of each woman was conducted five years later, when it was found that 71.6% of the women who developed breast cancer had had a normal thermogram at the time of examination, as did 73% of those who did not. CONCLUSIONS--Thermography is not sufficiently sensitive to be used as a screening test for breast cancer, nor is it useful as an indicator of risk of developing the disease within five years.     

An Assessment of Hand Thermography in Vinyl Chloride Workers

Since Raynaud's phenomenon is an early and integral part ofthe condition of acro-osteolysis in vinyl chloride workers,a survey involving 143 workers and 56 controls was carried outto assess the feasibility of using hand thermography to detectchanges from the normal pattern of vascularity.From the almostidentical results between the control and the exposed subjects,and between groups within the exposed population, it appearsthat there is no detectable difference in thermographic appearances. Requests for reprints should be addressed to: Dr D. M. J. Williams, BP Chemicals International Ltd, Sully, Penarth, South Glamorgan CF6 2YU.     

糖尿病红外热像图处理方法研究

对红外热像图用于糖尿病诊断及其处理方法提出一些探索性的看法。     

Household smoking bans and adolescents' perceived prevalence of smoking and social acceptability of smoking

OBJECTIVES: Household smoking bans might decrease the visibility of cigarette smoking and communicate nonsmoking social norms and parental attitudes to youths, which may serve as mediators to reduce smoking initiation. Whether they have these effects even if parents smoke or do not otherwise communicate strong disapproval of smoking to their children is not clear. We tested these hypotheses in multi-level analyses. METHODS: A telephone survey of a random sample of 3831 Massachusetts adolescents (12-17 years) assessed respondents' perceptions of smoking prevalence and attitudes about the social acceptability of smoking in their community. The association of these outcomes with the presence of a smoking ban in the youths' home was tested in multivariate analyses that adjusted for town-level clustering and individual and environmental characteristics. RESULTS: A household smoking ban was reported by 71% of all youths and 49% of youths who lived with smokers. In multivariate models, youths who had a household smoking ban were more likely to perceive a lower adult smoking prevalence (OR 2.1; 95% CI 1.7-2.5; P < 0.001), greater adult disapproval of adult smoking (OR 2.0; 1.5-2.6; P < 0.001) and of teen smoking (OR 1.5; 95% CI 1.2-1.9; P = 0.001). CONCLUSIONS: Among adolescents, a household smoking ban was associated with a lower perceived prevalence of adult smoking in their communities and more negative attitudes about the social acceptability of smoking, two factors that affect the likelihood of smoking initiation. Household smoking bans had these effects even in the presence of two parental factors known to encourage adolescent smoking initiation (parental smoking and lack of perceived parental disapproval of youth tobacco use). This provides an additional rationale for promoting household smoking bans to parents.     

Household smoking restrictions and adolescent smoking

PURPOSE: To examine the association between household smoking restrictions and adolescent smoking, controlling for parental smoking, peer smoking, and tobacco marketing. DESIGN: Cross-sectional analysis of 1999 data from the Growing Up Today Study, a longitudinal cohort of adolescents. SETTING: Self-report questionnaire. SUBJECTS: 10,593 adolescents aged 12 to 18 years. MEASURES: The dependent variable was established smoking (smoking > or = 100 cigarettes). Variables of interest were household smoking restrictions, parental smoking, peer smoking, and tobacco promotional item (TPI) possession. RESULTS: Four percent of participants reported that their households permitted smoking. Parental smoking, peer smoking, and TPI possession were significantly associated with established smoking In logistic regression models adjusted for age, gender, peer smoking, and TPI possession, adolescent smoking was inversely related to the presence of a restrictive household policy (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.48-0.93); however, when parental smoking was added to this model, the association was attenuated (OR = 0.94, CI = 0.65-1.35). When only one parent in the household smoked, smoking restrictions were more common when this parent was the father. CONCLUSIONS: Although household smoking restrictions offer health benefits, they do not appear to be associated with adolescent smoking after accounting for other factors. Prior studies did not include parental smoking, peer smoking, and marketing influences. This analytic difference may explain apparent contradictions in the literature.     

Meanings of smoking and adolescent smoking across ethnicities.

PURPOSE: To develop insight into population-specific meanings of smoking in our highly multicultural middle schools in order to provide effective and appropriate tools for smoking prevention efforts. METHODS: We used focus group interviews to develop the Meanings of Smoking Index (MSI), a nine-item scale that uses a "mark all that apply" strategy to assess what smoking means to children who have tried smoking as well as to those who are susceptible to smoking. In 24 public and parochial middle schools in the greater Los Angeles area, 2336 7th graders (1483 Latino, 565 Asian/ Pacific Islander and 288 white, 55.2% of the sample was female) completed the MSI as part of a school-based trial of culturally-targeted smoking prevention strategies. Items were rank ordered according to salience (rate of endorsement) and relevance (strength of relationship with lifetime smoking) across the entire sample and separately for Hispanic/Latino, Asian/Asian-American and white respondents. Spearman correlation coefficient was used to compare results between ethnicities. RESULTS: The most frequently endorsed meanings were similar across ethnicities. Magnitude of associations between smoking behaviors and meanings were dissimilar across ethnicities. The meaning with the strongest relationship to lifetime smoking for whites and Latinos was "it helps me study" (OR 3.4 and 2.6 respectively), and for Asians was "don't want to make another smoke alone" (OR 5.4). CONCLUSIONS: We have shown previously that interventions on meanings of eating behaviors changed dietary behaviors in adolescents. The present findings suggest that meanings are powerful determinants of adolescent smoking in culturally diverse populations and could offer powerful intervention tools to prevent adolescent smoking.     

Association of smoking status, cumulative smoking, duration of smoking cessation, age of starting smoking, and depression in Korean adults

ABSTRACT: BACKGROUND: Many previous studies did not sufficiently control for several confounding factors that may affect the association between smoking and depression, such as socioeconomic status. We investigated the association between depression and smoking status, smoking exposure, duration of smoking cessation, and age of starting smoking while controlling for socioeconomic factors. METHODS: This study was based on a community health survey performed in Jeollanam-do, South Korea, between September and November 2009. In total, 20,084 subjects (9,128 males and 10,966 females) were included in the analysis. Information on smoking characteristics, such as smoking status, pack-years of smoking, and age of starting smoking, was collected using a standardized questionnaire. Depression was defined using the Korean CES-D score. RESULTS: The odds ratios (ORs) of depression were 1.35 (0.92-1.98) for former smokers and 1.77 (1.27-2.48) for current-smokers among males, and 2.67 (1.38-5.16) for former smokers and 3.72 (2.11-6.54) for current-smokers among females, after adjusting for other confounding factors. Compared to light smoking, heavy smoking was significantly associated with depression in males [OR = 3.97, 95% confidence interval (CI) = 1.42-11.14], but not in females (OR = 1.24, 95% CI = 0.73-2.09). No significant associations between depression and age of starting smoking and duration of smoking cessation were observed among former smokers. CONCLUSIONS: Our data demonstrate that smoking is strongly associated with depression, particularly among females. These findings suggest that depression prevention may need to be combined with smoking prevention and that different strategies may be needed for males and females.     

Predicting adult smoking: the influence of smoking during adolescence and smoking among friends and family

The aim of the study was to predict smoking from early adolescenceto adulthood by using longitudinal data. The data was gatheredin connection with the North Karelia Youth Project. The projectwas started in 1978 with students in the seventh grade of juniorhigh school (aged 13 years) and finished in 1980 when the studentsreached the ninth grade. The follow-up study included four additionalsurveys over 15 years, the last being in 1993–94. Theresults show that two-thirds of the smokers in the ninth gradeof junior high school (aged 15 years) were still smoking atthe age of 28. About half of the smokers at the age of 28 weresmokers in the ninth grade and the other half had started afterthat. Previous smoking status and smoking by friends were themost important predictors of smoking. The continuity of smokingand non-smoking from adolescence to adulthood supports the importanceof prevention programs in junior high school. On the other hand,about half of the smoking adults had started smoking after that.This indicates that the prevention programs should continueafter junior high school.     

拒烟自我效能在吸烟危害认知对戒烟成功影响的中介效应分析

目的 分析拒烟自我效能在吸烟危害认知对戒烟成功影响的中介效应。方法 采用以社区人群为基础的病例对照研究设计,以642例男性自发性戒烟成功者为病例组,700例男性自发性戒烟失败者为对照组。吸烟危害认知水平由12个评分项目的总分评估,拒烟自我效能由拒烟自我效能问卷评估。总效应被分解为直接效应和间接效应,通过基于KHB法的logistic回归分析探讨各效应。结果 调整潜在混杂因素(包括年龄、开始吸烟年龄、职业、教育水平、婚姻状况)后,拒烟自我效能的中介效应仅占吸烟危害认知对戒烟成功影响总效应的6.03%,吸烟危害认知对戒烟成功影响的直接效应占总效应的93.97%;在3种拒烟自我效能情境(包括积极、消极、习惯情境)下的中介效应占吸烟危害认知对戒烟成功总效应的比例分别为6.80%、3.08%和2.32%。结论 拒烟自我效能在吸烟危害认知对戒烟成功的影响具有部分中介效应。提高吸烟者的危害认知水平可直接促使其戒烟成功,并可通过增大拒烟自我效能促使其成功戒烟。     

Excessive smoking

Ohne Zusammenfassung

---

«La fumée du tabac en dose exagérée»

     

Adolescent smoking

Most smokers start experimenting with cigarettes in early adolescence. This paper describes the factors which influence the development of the smoking habit. Methods of intervention, both in and out of the classroom, are discussed. Recommendations for further legislation and increased taxation on tobacco are supported.