Addiction Mindsets and Psychological Processes of Quitting Smoking

Background: Lay belief systems about the malleability of human attributes have been shown to impact behavior change in multiple domains. Addiction mindset—i.e., beliefs about the permanence (vs. malleability) of addiction — may affect cigarette smokers’ ability to quit, but this has never been examined. Objectives: The aims of the present research were to develop a measure of addiction mindset (study 1) and examine its associations with various psychological aspects of quitting smoking (study 2). Methods: In Study 1, using factor analysis of current smokers’ and nonsmokers’ (n?=?600) responses to 22 items designed to measure addiction mindset, we developed a reliable six-item Addiction Mindset Scale (AMS). In Study 2, adult smokers (n?=?200) completed the AMS, and measures of a number of psychological processes related to smoking. Results: Higher scores on the AMS, indicative of the belief that addiction is malleable (referred to as a growth mindset), were positively and significantly associated with greater motivation to quit, greater commitment to quitting, greater self-efficacy to abstain, less attribution of failure to lack of ability to change addiction, and fewer self-reported barriers to cessation (all p’s < .05). Conclusions: The results of this study show a relationship between the beliefs about the permanence of addiction and psychological processes relevant to quitting smoking. The findings underscore the potential of future research exploring how addiction mindsets relate to successful smoking cessation as well as other types of addictive behavior and how they can be applied to change people’s behavior.     

Nutrition and health education through I.C.D.S

Summary results and discussion were provided for an Integrated Child Development Service (ICDS) survey of 52 anganwadi community workers (AWWs) and 156 mothers of ICDS beneficiary children. The project was implemented in Nelamangala, Bangalore, India, in order to ascertain the practices of mothers in managing diarrhea and respiratory infections and nutrition. The results would be applied to improving health education and developing appropriate and effective communication about nutrition and health between the AWW and the mother. The results of the AWWs survey showed that the 96.16% of AWWs had education up to the high school level and 2 graduated from high school. 69.2% weighed children correctly and 53.84% plotted growth charts satisfactorily. 53.50% of the 2507 growth charts were satisfactorily graphed. 94% reported weighing all children every month, however, the work load made this activity very difficult. Only 5.7% plotted the growth chart immediately after weighing. 38.46% found the visual record of growth good tool of health and nutrition education. 86.92% correctly identified a flattened curve as an indicator of growth failure. 71.15% were aware that additional feeding was needed. 17.30% suggested treatment with tonics and 3.84% suggested treatment for worm infestations. The responses from the mothers indicated that 51.92% were illiterate, agricultural laborers. 92% of mothers had a per capita income of less than Rs. 300/month. 86.53% were aware of the growth monitoring of the AWWS and 61% knew it was conducted monthly. 20.53% had participated in weighing sessions and 42% reported that AWWs explained the meaning of growth monitoring and the importance of weighing procedures. 28.84% reported that AWWs showed comparisons of present and previous weights and explained the significance. 38.64% considered the information meaningful, but only 3.84% could correctly interpret a flattened curve. 63.43% were misinformed about diarrhea causes and treatment. The recommendation was for use of arm circumference tapes for measuring malnutrition, for better training of AWWs in promoting extra feeding for malnutrition, for promoting continued breast feeding during diarrhea bouts, and discouraging use of over-the-counter drugs for treatment of respiratory infections.     

The seroprevalence of Helicobacter pylori in a referral population of children in the United States

OBJECTIVES: The purpose of this study was to determine the prevalence of serum antibodies directed against Helicobacter pylori (H. pylori) in children referred to children's hospitals or medical centers throughout the United States. METHODS: This multisite cross-sectional prospective study involved 992 children from 12 states using a validated anti-H. pylori IgG enzyme immunoassay. The children were recruited into two groups: those without any GI complaints (non-GI referral, n = 619) and those who were referred for endoscopy because of abdominal pain (GI referral, n = 373). RESULTS: GI referral children had a higher rate of seropositivity (22.5%) than non-GI referral children (14.1%) from the same geographic regions. In both groups, older children were more likely to be seropositive for H. pylori, as were nonwhite children and those with lower socioeconomic status. H. pylori seropositivity rates were higher in GI referral children with four or more household members (relative risk [RR] = 1.47; CI 1.01-2.14). Multivariate analysis controlling for age, ethnicity, and household income, showed that presence of GI symptoms were associated with a nearly 2-fold risk for H. pylori seropositivity (odds ratio = 1.77, CI 1.27-2.47). Epigastric pain (RR = 2.21; CI = 1.33-3.66) and having three or more episodes of abdominal pain in the last 3 months (RR = 0.59, CI = 0.35-0.99) were the only specific symptoms significantly associated with H. pylori seropositivity. CONCLUSIONS: The H. pylori seropositivity rate of GI referral children with symptoms of abdominal pain was significantly higher. H. pylori infection in early childhood was found to be associated primarily with the child's household size and socioeconomic status.     

The effect of various in-vitro and ex-vivo parameters on irrigant flow and apical pressure using manual syringe needle irrigation: Systematic review

BackgroundFluid dynamics is a majorly neglected aspect to be studied in root canal irrigation. The fundamental rule to understand mechanics is to observe patterns of flow during the process. Thus, this work is conducted to do a systemic assessment of the in-vitro and ex-vivo based studies to evaluate the effect of various parameters on the irrigant flow and apical pressure on using a manual syringe needle for root canal irrigation.MethodsThe literature search was conducted through libraries such as PubMed (Medline), CINAHL, Embase, Scopus and other hand literature from Google Scholar, the British medical library etc. The systematic review was reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. As they include studies that were in-vitro and ex-vivo based, the risk of bias of the selected articles was assessed using a customized tool based on the previous literature and parameters evaluated in the studies included.ResultsThe literature search resulted in 101 items of which 19 records were included in this review. Results reported that multiple factors and parameters were assessed to evaluate the flow and apical pressures on using manual syringe needle irrigation.ConclusionsPresent systematic review gives insights in-depth about the irrigation dynamics of manual syringe needle irrigation. Besides, it is inconclusive to compile a single factor or a single parameter contributing to the enhanced irrigant flow and least apical pressures.     

Developmental pharmacokinetics and pharmacodynamics of nizatidine

OBJECTIVES: To characterize the impact of development on the pharmacokinetics and pharmacodynamics of nizatidine. METHODS: Children (age range, 5 days-18 years) and adults (age range, 18-50 years) were enrolled in four open-label trials. Nizatidine formulation and dose were determined by age: infants received 2 or 4 mg/kg i.v., children 2.5 or 5 mg/kg in one of three oral liquid formulations, and adolescents and adults received a fixed 150-mg capsule. Nizatidine and N-desmethylnizatidine concentrations were measured in serial post-dose plasma samples by a high-performance liquid chromatographic assay with mass spectrometric detection. Intragastric pH was recorded during a 24-hour post-dose interval. RESULTS: Data on 93 subjects were combined with previous values from 36 individuals to cover an age group not adequately captured and to control for formulation effects. Dose-normalized exposure estimates revealed no apparent age dependence; however, maximum plasma concentration (298.5 +/- 100.7 v 552.8 +/- 152.4 ng/mL per mg/kg dose) and AUC0-infinity (954.4 +/- 379.8 v 1,573.0 +/- 347.4 ng*hour/mL per mg/kg dose) were reduced in extemporaneous formulations in apple juice. The apparent modest age dependence observed for total body clearance (Cl/F) (r = 0.365) and Vss/F (r = 0.221) reflected a formulation-dependent decrease in bioavailability rather than a true age effect. The age-associated changes in lambda z observed for nizatidine and its metabolite were predictable and consistent with developmental acquisition of renal function. Mean and median pH, as well as fraction of time that the dosing interval remained above target pH values, were significantly greater with administration of the drug than without. CONCLUSIONS: The biodisposition of nizatidine in children and adults is similar; however, response after a comparable weight-based dose is equal and potentially greater in children.     

Gastroesophageal reflux disease and dental erosion in children

Recurrent exposure to gastric acid as in children with bulimia and gastroesophageal reflux disease (GERD) may contribute to dental erosion. We performed a prospective study to evaluate the presence of GERD and dental erosions in children with primary and permanent dentition. Children undergoing elective endoscopy for possible GERD (n = 37) underwent evaluation of their teeth for the presence, severity, and pattern of erosion and stage of dentition: 24 patients had GERD. Dental erosions were identified in 20; all had GERD. Erosion patterns showed more involvement of the posterior teeth. Many affected patients had primary dentition.     

Biliary dyskinesia in children

Biliary dyskinesia (BD) is a well-recognized cause of chronic abdominal pain in adults, but is less common in children. We reviewed our experience with the diagnosis, treatment, and follow-up in a group of children treated with cholecystectomy from March 1995 to October 2000. We identified children with chronic upper abdominal pain, normal ultrasonography (US), and delayed cholecystokinin (CCK)-stimulated gallbladder emptying (<35%). All other diagnostic tests for their abdominal pain were reviewed. Their treatment, surgical intervention, and outcome were recorded. During the study period, 74 cholecystectomies were performed in our institution, 10 (13.5%) of them for BD. The duration of symptoms ranged between 1 and 60 months (mean 22). All patients had a normal plain abdominal radiograph, normal US, and delayed gallbladder ejection fraction (EF). All were treated by elective laparoscopic cholecystectomy. Symptoms were completely relieved in all patients during the follow-up period, which ranged between 9 and 24 months (mean 12.8). Cholecystectom should be considered in children with chronic upper-abdominal pain and delayed EF on CCK-HIDA scintigraphy. Laparoscopic cholecystectomy is the procedure of choice in these patients.     

Safety of therapeutic beta-blockade in patients with coexisting bronchospastic airway disease and coronary artery disease

Atherosclerotic coronary artery disease and bronchospastic airway disease frequently coexist in older patients. There are substantial data suggesting reduced mortality with the use of beta-adrenergic blocking drugs in patients with symptomatic coronary artery disease, especially patients who have postmyocardial infarction and/or severe coronary artery disease associated with left ventricular dysfunction. Conversely, the use of beta-adrenergic blocking drugs (even selective beta(1)-adrenergic blocking drugs) has the potential of exacerbating bronchospasm. This prospective registry evaluates the safety of use of selective beta(1)-adrenergic blocking drugs in patients with symptomatic coronary artery disease and bronchospastic airway disease. A total of 835 consecutive patients with symptomatic coronary artery disease were prospectively evaluated for coexisting coronary and bronchospastic airway disease. Of these, 30 patients (mean age: 61 +/- 14 years) met the qualifying inclusion criteria. All these study patients except 1 (29/30 [96%]) reached therapeutic beta-blockade (resting heart rate <70 beats per minute). The 1 patient who discontinued use of beta-adrenergic blocking drugs as a result of lifestyle-limiting bronchospasm had no serious adverse outcome. No hospitalizations were required because of worsening bronchospasm. Ten percent of patients reported increased requirement of inhaled beta(2)-agonist use. The patients were followed for 15 +/- 9 months. One patient died of stroke at 22 weeks of follow-up. In conclusion, use of selective beta(1)-adrenergic blocking drugs at a therapeutic dose is safe (as long as careful clinical follow-up is available) and should be considered in all patients with coexisting symptomatic coronary artery disease and bronchospastic airway disease.     

Acute and long-term results after intra-arterial thrombolysis of occluded lower extremity bypass grafts using recombinant tissue plasminogen activator for acute limb-threatening ischemia

Occlusion of lower extremity vascular bypass grafts results in acute limb-threatening ischemia. The underlying cause of graft failure generally is distal anastomosis stenosis, and relief of culprit stenosis is a required to maintain long-term patency. Of the three thrombolytic agents used for prolonged infusion to accomplish fibrinolysis, streptokinase was the first to be used and is limited owing to the antigenicity that precludes repeated use. Urokinase had been the mainstay of thrombolytic therapy until it was withdrawn by the U.S. Food and Drug Administration in 1999 because of the potential of transmission of infectious agents during its manufacturing process. Recombinant tissue plasminogen activator (rt-PA) has not been studied adequately to assess safety and efficacy, and there are no standardized dosing guidelines. We report our experience with six patients presenting with acute limb-threatening ischemia attributable to thrombosis of synthetic lower extremity bypass grafts. After thrombolysis using rt-PA (mean bolus dose, 12.2 +/- 3.6 mg; range, 6-15 mg administered over 5 minutes followed by infusion at 2 mg/h for 15.6 +/- 6.4 hours; total dose, 51 +/- 16 mg), successful thrombolysis was achieved in 84% of the patients. The primary patency rate was 75% and the secondary patency rate 100% at 16 weeks. One patient underwent amputation owing to unsuccessful thrombolysis. No major bleeding or vascular complications occurred. We conclude that intra-arterial thrombolysis using rt-PA is a safe and effective therapy for patients with thrombotic occlusion of synthetic lower extremity bypass grafts presenting with acute limb-threatening ischemia and allows a high rate of secondary patency, avoiding amputation.     

Analysis of the vacA,cagA, cagE,iceA, and babA2 genes in Helicobacter pylori from sixty-one pediatric patients from the Midwestern United States

This study was designed to characterize H. pylori from pediatric gastric biopsy specimens in terms of several genes (vacA, cagA, cagE, iceA1, iceA2, and babA2) proposed to be involved in the pathogenesis of this organism. Many of these genes have been studied in adult H. pylori isolates, however, these genes have not been well characterized in H. pylori from children. Using PCR we observed that 44% of the H. pylori in our biopsies shared two common genotypes (vacA s1b m1, cagA, cagE, iceA2 +/- babA2). While 26% of the H. pylori had unique genotypes. The cag pathogenicity island associated genes, cagA and cagE, were found together in 64% or our H. pylori, while 84% were iceA2 positive. The presence of the babA2 gene has been proposed to be associated with a higher risk of H. pylori related diseases, however, we found that only 36% of our H. pylori contained this gene.