Awareness of cancer-related programs and services among rural African Americans.

African Americans are at increased risk for cancer and represent an important target population for programs such as Healthy People 2000, the Cancer Information Service (CIS), and the 5 a Day for Better Health Initiative. Yet, awareness of such programs among rural blacks is unknown. This study assessed awareness of these programs and determined related knowledge and beliefs among rural African Americans. It was undertaken as part of the baseline survey for the Black Churches United for Better Health project, a National Cancer Institute-funded initiative. A minority of respondents (n = 3737) demonstrated name recognition of Healthy People 2000 (23.4%), the CIS (42.4%), and the 5 a Day Program (40.7%). Far fewer (7.4%) were able to correctly identify the recommended daily number of servings of fruits and vegetables. Reported family history of cancer was associated with a greater tendency believe that eating more fruits and vegetables can prevent disease. These findings underscore the need for efforts to reach the rural black community with culturally sensitive and stage appropriate cancer prevention messages. Knowledge of family history of cancer may play an important role in targeting subgroups and delivering effective cancer prevention messages.     

Reaching mothers of preschool-aged children with a targeted quit smoking intervention

Younger women smoke at disproportionately higher rates than other women and their smoking has a major impact on the health of their young children. To address this problem, a smoking cessation intervention combining minimal advice and assistance from a community health nurse and a tailored self-help guide was developed for low-income women with young children. The program evaluation results reported here were gathered from women using publicly funded pediatric services in four agencies with 32 clinic sites in central and eastern Pennsylvania. Unlike volunteers in formal cessation programs, the women varied widely in their readiness to quit smoking. Follow-up data were obtained from 1,230 female smokers, aged 18 to 39, after receiving brief, individualized smoking cessation advice and encouragement to read the self-help guide. One year later, 12.5 percent reported quitting smoking, and 20.2 percent reported having made a serious quit attempt that lasted at least 7 days. These results suggest that, even among smokers with low socioeconomic status and wide variation in their readiness to quit, minimal intervention programs requiring modest resources can promote cessation.This work was funded under contracts from the Cancer Control Program, Pennsylvania Department of Health (SPC-883141 and SPC-979425). The Quitting Times STOP IT quit smoking protocol was adapted from the Smoking Cessation Project, Maternal and Child Health, Massachusetts Department of Public Health. The authors also wish to express appreciation to the staff of the Division of Population Science, Fox Chase Cancer Center for their contributions to this project and especially those of Chris Jepson, Eunice King, C. Tracy Orleans, and Marjorie Utt.     

Breast screening practices among primary physicians: reality and potential

Increased use of regular screening mammograms and clinical breast examinations (CBE) among women aged 40 years and more could have a dramatic impact on mortality from breast cancer, but patient and physician barriers to mammography impede its acceptance. We conducted a survey of 300 primary care physicians to assess their knowledge, attitudes, beliefs, and breast screening practices. Our results show that only 71 percent of the respondents ordered mammograms for all women aged 50 to 75 years, which is the recommendation by the National Cancer Institute and American Cancer Society. Approximately 46 percent of respondents performed CBE on all women patients aged 50 to 75 years. Inadequate patient insurance coverage, equivocal radiology reports, patient reluctance or worry, and patient embarrassment all appear to be barriers to physicians' utilization of breast screening.     

Experimental infection of specific pathogen-free lambs with ovine adenovirus type 4.

Specific pathogen-free lambs were exposed to an aerosol of ovine adenovirus type 4 (OA4). The virus replicated both in the respiratory and the alimentary tracts, and was recovered from one lamb 80 days after inoculation. Although infection with OA4 did not produce clinical disease, it appeared to be associated with the development of pulmonary oedema in approximately half of the infected lambs. The oedema was mainly perivascular, but in severe cases was present in alveoli and bronchioles. Small accumulations of mononuclear cells were present around bronchioles and small blood vessels, but inclusion bodies were not detected.     

Identification and characterization of aquaporin-2 water channel mutations causing nephrogenic diabetes insipidus with partial vasopressin response

Congenital nephrogenic diabetes insipidus (NDI) is a rare disease caused most often by mutations in the vasopressin V2 receptor (AVPR2). We studied a family which included a female patient with NDI with symptoms dating from infancy. The patient responded to large doses of desmopressin (dDAVP) which decreased urine volume from 10 to 4 I/day. Neither the parents nor the three sisters were polyuric. The patient was found to be a compound heterozygote for two novel recessive point mutations in the aquaporin-2 (AQP2) gene: L22V in exon 1 and C181W in exon 3. Residue Cys181 in AQP2 is the site for inhibition of water permeation by mercurial compounds and is located near to the NPA motif conserved in all aquaporins. Osmotic water permeability (Pf) in Xenopus oocytes injected with cRNA encoding C181W-AQP2 was not increased over water control, while expression of L22V cRNA increased the Pf to approximately 60% of that for wild-type AQP2. Co-injection of the mutant cRNAs with the wild-type cRNA did not affect the function of the wild-type AQP2. Immunolocalization of AQP2-transfected CHO cells showed that the C181W mutant had an endoplasmic reticulum-like intracellular distribution, whereas L22V and wild-type AQP2 showed endosome and plasma membrane staining. Water permeability assays showed a high Pf in cells expressing wild-type and L22V AQP2. This study indicates that AQP2 mutations can confer partially responsive NDI.      

Methods and strategies to recruit African Americans into cancer prevention surveillance studies.

OBJECTIVE: Recruitment of African Americans into health research studies is a major challenge. This report describes a study of different methods and strategies to recruit African Americans into a population-based assessment of cancer behavioral risk factors. METHODS: African Americans ages 18 to 70 years in North Carolina (n = 5,000) were randomly selected from the Department of Motor Vehicle rosters and assigned at random to one of five different recruitment strategies based on variations of approach letters (generic versus culturally sensitive) and inclusion, exclusion, or promise of a small incentive. Prospective participants were sent an 11-page questionnaire by mail but could complete it by telephone or Internet as well as by mail. RESULTS: The overall response rate was 17.5% (747 completed surveys of 4,276 delivered): 655, 84, and 8 by mail, Internet, and telephone, respectively. Among eligible respondents, response was significantly higher for incentive-based than nonincentive strategies; 23.9% for the generic letter plus incentive compared with 15.8% for the generic letter only (P < 0.001). The culturally sensitive letter had little effect on participation (15.8% for both the generic and culturally sensitive letters). The mean age of eligible respondents was 43.9 years, 41% were male, 37% were college graduates, and 75% were overweight/obese. There were no differences in respondent characteristics by assigned recruitment strategy. CONCLUSIONS: Incentive-based strategies yielded the highest survey responses, whereas a culturally sensitive letter did not appreciably increase participation among African Americans in North Carolina. This study adds to what is known about culturally sensitive recruitment strategies for African Americans and challenges their usefulness in survey-based studies.