Prevention of hepatitis B transmission in Indo-Chinese refugees with active and passive immunization.

Hepatitis B is a cause of disability and death worldwide, with high rates of perinatal transmission in third world countries, including those of Indochina. Prevention of transmission by active and passive immunization has been available since 1982. This study looked at the serological response of Indo-Chinese refugees to these products in an outpatient primary care clinic and at the compliance problems found in this setting. The carrier rate of all patients screened was 81/446 (18.5%), with 37/233 (15.8%) of prenatal patients as carriers. Newborns whose mothers were carriers were started on an immunization program. The combination of HBIG and vaccine was more than 90% effective in inducing immunity and preventing the carrier state; only two children of the 26 studied who received both active and passive immunization became carriers. Both failures were in children of HBeAg positive mothers. In contrast, those children exposed who had not received treatment (because of birth prior to 1982) had a 33% carrier rate. This success rate was found despite compliance problems in completing the immunizations on schedule. Only 23% of children received their vaccine within four weeks of the recommended schedule, with a mean delay of 1.3 months. Of the 79 children beginning immunizations, 11 moved before completion. All children remaining in San Diego completed the regimen. Thus, the benefits of giving the passive and active immunization to infants of hepatitis B carriers were clear. However, compliance problems jeopardize the effectiveness of a hepatitis B immunization program in this population.(ABSTRACT TRUNCATED AT 250 WORDS)     

Excretion of purine derivatives by ruminants: effect of exogenous nucleic acid supply on purine derivative excretion by sheep

The present study examined the relationship between the supply of exogenous nucleic acid (NA) purines and their recovery as the derivatives hypoxanthine, xanthine, uric acid and allantoin in urine. Six lambs, totally nourished by intragastric infusions of volatile fatty acids (VFA) and casein (i.e. no rumen fermentation), were given by abomasal infusion a microbial NA concentrate at six levels (from zero to 24.5 mmol purines/d). The true digestibility between the abomasum and terminal ileum of the NA purines was measured in a separate experiment using three lambs. The relative proportion of urinary allantoin increased, and that of other derivatives decreased, as the amount of NA infused was increased. The relationship between total excretion of purine derivatives (Y; mmol/d) and exogenous purines absorbed (X; mmol/d) was Y = 0.84X + 0.150W0.75 e-0.25X, where W is body-weight (kg). This implies that the endogenous contribution to the total excretion of derivative decreased as the supply of exogenous purines increased, with an associated progressive replacement of de novo synthesis by exogenous purines. The model also implies that 0.16 of the purines were eliminated through routes other than derivative excretion in urine. Once excretion exceeded 0.6 mmol/kg W0.75 per d, endogenous excretion was effectively zero and thus Y = 0.84 X. In normally fed sheep, derivative excretion should therefore relate to the microbial purines and, hence, microbial protein absorbed according to these models. The changing proportions of allantoin and other derivatives in urine were probably due to changes in the relative importance of endogenous and exogenous purines as precursors.     

Alcohol consumption among low-income pregnant Latinas

BACKGROUND: Due to changing cultural norms, Latinas of childbearing age residing in the U.S. may be at increasing risk of drinking harmful levels of alcohol during pregnancy, and may also be unaware of the risks for Fetal Alcohol Spectrum Disorders associated with this behavior. We assessed the prevalence of alcohol consumption in a sample of low-income pregnant Latinas and examined risk factors for alcohol use in the periconceptional period. METHODS: As part of a larger intervention trial, a cross-sectional in-home interview study was conducted among a sample of 100 pregnant low-income Latinas receiving services from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in San Diego County, California. RESULTS: Fifty-seven percent of respondents indicated they were either life-time abstainers or had not consumed any alcohol in the periconceptional period. Forty-three percent reported some alcohol use in the three months prior to recognition of the current pregnancy, and 20% reported at least one binge episode of four or more standard drinks during that time frame. Five percent reported drinking seven or more drinks per week, and 8% continued drinking alcohol after recognition of pregnancy. Significant predictors of any alcohol use in the periconceptional period included English language/higher level of acculturation, younger maternal age, lower parity, higher level of education, younger age at first drink, and having ever smoked. Women who were aware of alcohol warning messages and /or had more knowledge of the Fetal Alcohol Syndrome (FAS) were significantly more likely to have consumed alcohol in the periconceptional period. Frequency of periconceptional use of alcohol did not differ between women who planned or did not plan the pregnancy. CONCLUSION: The prevalence and pattern of early pregnancy alcohol consumption in this sample of Latinas is similar to patterns noted in other race/ethnic groups in the U.S. Level of knowledge about FAS and awareness of warning messages was not protective for early pregnancy alcohol consumption, suggesting that specific knowledge was insufficient to prevent exposure or that other factors reinforce maintenance of alcohol consumption in early pregnancy. Selective interventions in low-income Latinas are warranted, and should be focused on women of reproductive age who are binge or frequent drinkers and who are at risk of becoming pregnant.     

Tobacco use prevalence and correlates among adolescents in a clinician initiated tobacco prevention trial in California, USA.

OBJECTIVES: Baseline data for the clinician initiated, tobacco prevention trial, the first non-school based clinician mediated tobacco prevention study, were used to explore the degree to which young people receiving orthodontic treatment use tobacco and the differences in use rates between national, California, and patient samples. Correlates of tobacco use were identified and these correlates were contrasted with findings from the published reports. DESIGN AND SETTING: A 26 item telephone survey assessed demographic information, tobacco use, selected health related behaviours, and variables based on social learning theory. The study was conducted among 11 to 18 year old orthodontic patients from San Diego, Orange, Riverside, San Bernardino, and Los Angeles Counties, California, USA. PARTICIPANTS: Of the 17925 patients who were eligible, 16915 (> 94%) completed the survey. MEASUREMENTS AND MAIN RESULTS: Multivariate analyses were conducted using a logistic mixed effects model. Although the 30 day prevalence rate of tobacco use (6%, n = 1010) proved lower than California and national samples, the rates for the age, gender, and race ethnicity subgroups showed trends similar to those seen in California and national samples. Ten variables were significantly associated with tobacco use (p < 0.05), including 30 day alcohol use (OR = 7.88), age (OR = 1.32), and living with a tobacco user (OR = 1.72). CONCLUSIONS: Because 6% of orthodontic patients use tobacco, interventions are warranted to reach the health "Objectives for the Nation". Patterns of correlates of tobacco use were essentially the same for orthodontic patients, California, and national samples, suggesting that these associations are generalisable.     

Prevention of tobacco use among adolescents in public schools in San Diego County, U.S.A.

Summary Project S.H.O.U.T. (which stands for Students Helping Others Understand Tobacco) is a tobacco-use prevention project funded by the United States National Cancer Institute for preventing the use of cigarettes and smokeless tobacco (snuff and chewing tobacco) in public schools in San Diego County, California. Based on principles of behavior modification. Project S.H.O.U.T. teaches students how to anticipate and overcome negative peer pressure to use tobacco and reinforces them for having done so. Preliminary results indicate that the prevalence of tobacco use among students receiving peer pressure resistance skills training was somewhat but not statistically significantly lower than the control group after one year of intervention. In addition, students in a third lottery condition, who were reinforced for simply not using tobacco, showed lower prevalence rates compared to controls. Additional support for the efficacy of the intervention program was provided by the refusal skills assessment test, which indicated that students exposed to the intervention were able to refuse tobacco offers more effectively than the control students. Our results indicate that tobacco use prevention experts should do more than provide decision-making and behavioral skills for resisting tobacco use, but should also reinforce the non-use of tobacco.

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Prävention von Tabakgenuss bei Jugendlichen in öffentlichen Schulen San Diegos, USA

Zusammenfassung Das Projekt S.H.O.U.T. (Abkürzung für «Students Helping Others Understand Tobacco») ist eine Initiative zur Raucherprävention, die vom US-amerikanischen Krebsforschungsinstitut (National Cancer Institute) gefördert wird und die den Einstieg in das Rauchen von Zigaretten und andere Formen des Tabakgenusses (Schnupftabak und Kautabak) in öffentlichen Schulen des Bezirks San Diego, Kalifornien, verhindern soll. Gestützt auf die Grundsätze der Verhaltensmodifikation vermittelt das Projekt S.H.O.U.T. Schülern, wie sie einen sozialen Druck von Gleichaltrigen, der negative Folgen haben würde, erkennen, ihm ausweichen und wie sie ihre Widerstandshaltung stabilisieren können. Erste Ergebnisse lassen erkennen, dass nach einem Jahr der Intervention die Prävalenz des Tabakgenusses bei Schülern, die eine Unterweisung in Techniken des Widerstands gegen den sozialen Druck von Gleichaltrigen erhalten haben, etwas, aber nicht statistisch signifikant, niedriger als in der Kontrollgruppe war. Die Prävalenzrate (verstanden als Tabakgenuss in der vergangenen Woche) blieb in den Interventionsschulen stabil bei 7,3%. Die Prävalenzrate in den Kontrollschulen stieg von 3,5 auf 8,2 %. Ausserdem waren die Prävalenzraten von Schülern, die in ihrem Verhalten, auf den Genuss von Tabak einfach zu verzichten, bestätigt worden waren, niedriger als in den Kontrollgruppen. Diese Ergebnisse zeigen, dass Präventionsexperten sich nicht einfach mit der Vermittlung von Techniken der Entscheidung und des Verhaltens in bezug auf Tabakkonsum zufrieden geben und auch die Ablehnung jedes Tabakkonsums verstärken sollten. Die Wirksamkeit des Interventionsprogramms konnte ebenfalls durch einen Test zur Entwicklung von Ablehnungsverhalten erhöht werden, der erkennen liess, dass Schüler, die unmittelbar von der Intervention angesprochen wurden, erfolgreicher Aufforderungen zum Tabakkonsum ablehnen konnten als die Schüler in der Kontrollgruppe. Unsere Befunde zeigen auch, dass sowohl gegen Zigarettenrauchen als auch die «rauchfreien» Formen des Tabakgenusses in einem Programm erfolgreich angegangen werden kann.

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Prévention de la consommation de tabac chez des adolescents dans les écoles publiques du comté de San Diego, USA

Résumé Le projet S.H.O.U.T. («Students Helping Others Understand Tobacco») est un projet financé par l'Institut américain de recherche sur le cancer (United States National Cancer Institute) qui s'intéresse à la prévention, en milieu scolaire, de la consommation de tabac, sous forme de cigarettes mais aussi de tabac à priser et à mâcher. Ce projet se fonde sur l'apprentissage de comportements nouveaux: l'intervention consiste à apprendre aux enfants à anticiper et résister aux offres de tabac puis à les conforter dans cette attitude de résistance aux pressions du groupe social. Les résultats préliminaires montrent que, si l'on compare les enfants ayant subi cet entraînement à un groupe témoin, la prévalence de la consommation de tabac est, après une année, inférieure, mais pas statistiquement différente, pour ces premiers. De plus, les élèves d'un troisième groupe qui étaient simplement récompensés s'ils prouvaient leur abstinence, présentent une prévalence inférieure à celle du groupe témoin.Par ailleurs, tous les élèves ont subi un test qui mesure les capacités à refuser. Manifestement, les élèves du groupe d'intervention savent refuser de manière bien plus habile et done plus efficace que ceux du groupe contrôle.Nos résultats indiquent done qu'il est possible, grâce à de tels programmes d'intervention, de modifier le comportement des enfants et, ainsi, de les amener à restreindre leur consommation de tabac.