Breast cancer treatment experiences of Latinas in Los Angeles County

OBJECTIVE: We examined breast cancer treatment experiences of and outcomes for Latinas in Los Angeles County. METHODS: We conducted a population-based survey of women who were diagnosed with breast cancer between December 2001 and November 2002 (n=910) to evaluate the types of treatments received, communication with clinicians, and satisfaction. RESULTS: About two thirds were non-Latina White, 18.8% were African American, and 18.9% were Latina (with 11.0% preferring English and 7.9% preferring Spanish). The rest indicated other ethnic groups. Latinas who preferred Spanish were more likely to experience a delay of 3 months or more from diagnosis to surgical treatment (36.4% vs 9.1% for non-Latina Whites, 18.6% for African Americans, and 12.7%, for other Latinas, P<.001). African Americans and Latinas who preferred Spanish had very low rates of reconstruction (13.8% and 9.2%, respectively, compared with 42.1% for Whites and 34.5% for Latinas who preferred English, P=.009). Latinas who preferred Spanish had the highest odds ratio for low satisfaction. CONCLUSION: Latinas who preferred Spanish received different treatments and perceived a different treatment experience than did other cultural groups.     

Family characteristics and smoking among urban and rural adolescents living in China

BACKGROUND: Adolescent smoking is a public health concern in China. Although the family is an important social influence in China, few associations among family characteristics and adolescent smoking have been examined using Chinese samples. METHODS: Survey data on psychosocial variables and smoking were collected from a sample of 3629 7th grade adolescents (46% female; 54% male; mean age 12.7 years) in Wuhan, China. For adolescents, past 30-day smoking, family relationships, parents' negative sanctioning of smoking, parents' agreement with smoking, and parents' smoking behaviors are assessed. To account for the clustered data structure, hierarchical logistic regression analyses controlling for demographics (urbanization, age) examined the independent and multivariate effects of family characteristics for each gender. RESULTS: Girls are less likely than boys to report smoking and are more likely to report positive family relationships, and having parents with negative attitudes toward them smoking. Positive family relationships and age were strongly associated with smoking for both genders. No significant differences exist by gender. CONCLUSION: These findings suggest that the quality of family relationships are important for adolescent female and male smoking in China.     

Smoking prevention for ethnically diverse adolescents: 2-year outcomes of a multicultural, school-based smoking prevention curriculum in Southern California

BACKGROUND: Effective school-based curricula are needed to prevent smoking among ethnically diverse adolescents. This study evaluated a multicultural smoking prevention curriculum in ethnically diverse Southern California middle schools. METHODS: Students in 24 middle schools (N = 3157 sixth graders) received the multicultural curriculum, a similar curriculum without references to cultural issues, or a control condition. Odds ratios for experimentation with smoking over a 2-year period were calculated. RESULTS: The multicultural program was associated with a lower risk of smoking between sixth and eighth grade, relative to the control group. Program effects varied according to the ethnic composition of the schools. In schools with predominantly Hispanic populations, the multicultural curriculum was more effective than the control, but the standard curriculum was not. In schools with predominantly Asian or multicultural populations, the standard curriculum was more effective than the control, but the multicultural curriculum was not. Analyses stratified by ethnicity within the schools revealed that the multicultural curriculum was effective among Hispanic students within predominantly Hispanic schools, but not among Hispanic students within predominantly Asian/multicultural schools. CONCLUSIONS: Smoking prevention for adolescents in culturally diverse school contexts is a challenge. In this study, a multicultural curriculum was most effective among Hispanic students in predominantly Hispanic schools. Further research is needed to determine the best ways to prevent smoking in predominantly Asian and multicultural schools.     

Comparison of hexaminolevulinate based flexible and rigid fluorescence cystoscopy with rigid white light cystoscopy in bladder cancer: results of a prospective Phase II study

INTRODUCTION AND OBJECTIVE: Several studies have shown that rigid fluorescence cystoscopy (RFC) with hexaminolevulinate (HAL) is superior to standard rigid white light (RWLC) cystoscopy in diagnosing bladder tumours, with a clinically relevant impact on the patient's management. These studies, however, have been done with rigid cystoscopes. We carried out a study to evaluate whether the technique of fluorescence cystoscopy with HAL was also feasible with a specially designed flexible fluorescence cystoscope (FFC). METHODS: 20 patients with known or suspected bladder cancer were included in a comparative within patient controlled Phase II study. All patients signed informed consent. All patients received 50 ml of HAL (Hexvix) 8 mM 1h prior to transurethral resection. Using a D-light-C system (Storz, Germany), FFC and RFC were performed followed by RWLC. All lesions visible during these three cystoscopies were mapped, taped and resected. RESULTS: In these 20 patients (mean age 71 years (49-89), 3 females) mean HAL instillation time was 81 min. Overall 27 histologically confirmed lesions were found in 19 patients. Detection rates in these 19 patients were 14 with FFC, 17 with RFC and 15 with RWLC. Of the 27 lesions 19 were detected with FFC, 23 with RFC and 20 with RWLC. Overall fluorescence intensity using the flexible system was 76% (30-147%) as compared to RFC using a visual analogue score. No side effects were noted which were attributable to HAL. CONCLUSION: The use of FFC is feasible and seems to be comparable to RWLC and slightly inferior to RFC. Larger studies should determine the role of flexible fluorescence cystoscopy.     

Genotype frequencies at codon 129 of the Prion Protein Gene in Brazil: implications in susceptibility to variant Creutzfeldt--Jakob disease compared to European and Asian populations

A polymorphism at codon 129 of the prion protein gene has been shown to confer genetic susceptibility to prion diseases, and to influence the epidemic course of variant Creutzfeldt--Jakob disease. We employed a PCR-endonuclease digestion-based assay to investigate this genetic trait in Brazil, and then compared our results to previously published data from several European and Asian countries.Financial Support: Fundacao de Amparo a Pesquisa do Estado de São Paulo -- FAPESP     

Detection and evaluation of endocrine-disruption activity in water samples from Portuguese rivers

Water samples (n = 183) from Portuguese rivers were tested for the presence of endocrine disruptors using the recombinant yeast assay (RYA) combined with chemical identification of compounds having endocrine-disruption properties by liquid chromatography coupled to mass spectrometry. Ten selected locations were sampled monthly for a period of 20 months, from April 2001 to December 2002. More than 90% of samples showed either no detectable or low levels of estrogenicity (<0.1 ng/L of estradiol equivalents). The remaining samples (17 in total, 9.3%) showed estrogenicity values ranging from 0.1 to 1.7 ng/L of estradiol equivalents; only two samples showed values greater than 1 ng/L of estradiol equivalents. Most highly estrogenic samples (13 of 17 samples) originated in five sampling sites clustered in two zones near Porto and Lisbon. Chemical analysis detected alkylphenolic compounds (octyl- and nonylphenol plus nonylphenol ethoxylates) in all samples, albeit at concentrations less than 1 microg/L for each compound in 80% of samples. Total analyte concentration exceeded 10 microg/L in only 10 samples, with all but one of those originating from only two sampling sites. In these two locations, a good correlation was observed between the concentrations of octylphenol, nonylphenol, and to a lesser extent, bisphenol A in the samples and their estrogenicity values as calculated by RYA. We conclude that estrogenic activity can be explained by alkylphenol contamination in only these sites; for the remainder, we propose that pesticides and urban waste may be the main factors responsible for estrogenic contamination.     

Integrating hepatitis, STD, and HIV services into a drug rehabilitation program

BACKGROUND: Considering the difficulties in providing screening and vaccination services for inmates in short-stay incarceration facilities, an evaluation was conducted of the integration of prevention services in an alternative sentencing drug rehabilitation program (alternative to incarceration) in San Diego CA. METHODS: During the period April 1999 to December 2002, clients were asked to complete a brief risk-assessment questionnaire, and were offered hepatitis B virus (HBV) vaccination, HBV and hepatitis C virus (HCV) serologic testing, STD screening, and HIV counseling and testing. RESULTS: Of the estimated 1125 rehabilitation program enrollees, 930 (83%) participated in the integration program services. Most clients were male (64%), were aged >30 years (64%), and few (7%) reported previous HBV vaccination. Of the 854 clients eligible for hepatitis B vaccination, 98% received the first dose, 69% the second dose, and 42% completed the series. Eleven percent of clients had prior HBV infection, and 14.7% had HCV infection, with positivity rates being highest among those with a history of injection drug use-HBV, 19%, and HCV, 36%. HIV infection was rare (prevalence, 0.3%), and STDs were uncommon (chlamydia prevalence, 2%, and gonorrhea prevalence, 0.6%). Total annual cost of integration services (excluding HIV testing) was dollar 31,994 equating to dollar 122 per client served. CONCLUSIONS: Alternative sentencing drug rehabilitation programs provide a venue to efficiently deliver integrated hepatitis and other prevention services. Considering the vast number of high-risk persons in drug rehabilitation, probation, parole, and inmate release programs, an opportunity exists to greatly expand hepatitis services.