bluuebunny/crossref_metadata_2025 huggingface dataset:
Sir Austin Bradford Hill: medical statistics and the quantitative approach to prevention of disease
Authors: WILKINSON LISE
Published: January 2006

Sir Austin Bradford Hill (1897‐1991), son of a prominent medical physiologist, was destined for the study of medicine when World War I intervened. He chose to enlist as a pilot in the Royal Navy Air Service. Having contracted tuberculosis on his way to the Dardanelles, Hill was ‘sent home to die’. In spite of the odds he recovered; but with no chance of working in physically taxing fields such as medicine or science. Advised and encouraged by Major Greenwood, he carved out for himself a career in medical statistics, first at the Medical Research Council and subsequently at the London School of Hygiene and Tropical Medicine, where his inspired leaching helped to shape the development of medical research in the second half of the twentieth century. He is particularly remembered for the way he made medical statistics an essential pan of modem epidemiology, a new phase in an epidemiology concerned with chronic as well as with infectious diseases. At the same time, he introduced randomization where therapies—beginning with streptomycin in tuberculosis—could be evaluated in large‐scale clinical trials. Perhaps his best known achievement is his design of the smoking and lung cancer trials, carried out with Richard Doll who later extended—and still extends—the trials which so convincingly have linked addiction to tobacco to patients' later problems with cancers and with coronary heart disease.
Use of the Nottingham Health Profile for measuring health status of patients in methadone maintenance treatment
Authors: TORRENS MARTA , SAN LUIS , MARTINEZ ALBA , CASTILLO CLAUDIO , DOMINGO‐SALVANY ANTONIA , ALONSO JORDI
Published: January 2006

This study was conducted to assess changes in health‐related quality of life over a 3‐year follow‐up period in a cohort of 135 opioid dependent patients using the Nottingham Health Profile (NHP) questionnaire. Data obtained at 12 months from 80 patients retained in the programme are presented. In summary, opioid addicts in a methadone maintenance programme for a 12‐month period experienced an early and substantial improvement in health‐related quality of life. The use of the NHP questionnaire to monitor changes in the subjective health of opioid‐dependent patients over time provides new insights in the assessment of treatment effectiveness of methadone maintenance programmes.
Nicotine withdrawal in women
Authors: MADDEN PAMELA A. F. , BUCHOLZ KATHLEEN K. , DINWIDDIE STEVEN H. , SLUTSKE WENDY S. , BIERUT LAURA J. , STATHAM DIXIE J. , DUNNE MICHAEL P. , MARTIN NICHOLAS G. , HEATH ANDREW C.
Published: January 2006

Associations between self‐report symptom profiles for nicotine withdrawal, personality (TPQ, EPQ‐R), life‐time history of psychopathology and smoking history were examined in data obtained from 553 female adult Australian twins (246 regular smokers), aged 32‐48 years, who had participated in a telephone interview survey that included life‐time assessments of smoking history, nicotine dependence and symptoms of withdrawal. Two hundred and two respondents were from high‐risk pairs where either the respondent or the respondent's co‐twin had reported a life‐time history of alcohol dependence; 351 were from control pairs. Latent class analysis was used to identify subtypes (‘classes’) of smokers reporting similar withdrawal symptom profiles. Three major classes were identified which appeared to represent a continuum from mild to severe nicotine withdrawal. Smokers from the severe withdrawal class were best characterized by hands shaking and by the prominence of depressive features. There mere marked increases in life‐time alcohol dependence rates as a function of severity class. In contrast, significantly elevated rates of major depression, conduct disorder and anxiety disorder were observed only among smokers from the most severe withdrawal class. Neuroticism was the only personality factor strongly associated with the development of withdrawal symptoms.
Smoking behaviour and personality: a population‐based study in Japan
Authors: ARAI YUMIKO , HOSOKAWA TORU , FUKAO AKIRA , IZUMI YOKO , HISAMICHI SHIGERU
Published: January 2006

Aims. The aim of our study was to determine whether the previously reported findings also apply to a general population in Japan and whether, among current smokers, such personality characteristics can be correlated with the age they stoned to smoke and their present daily consumption of cigarettes. Design. Cross‐sectional survey. Setting. Miyagi prefecture, in northern Japan. Participants. 20 538 residents in Miyagi, aged 40–64 years. Measurement. A self‐administered questionnaire involving smoking status (current, ex‐ and non‐smokers) and patterns and the Japanese version of the short‐form Eysenck Personality Questionnaire‐Revised (EPQ‐R). Findings. (I) Current and ex‐smokers were higher on Extraversion and Psychoticism than non‐smokers for both genders. (2) Heavy smokers were higher on Psychoticism than light smokers and those who started to smoke prior to the legally permitted age were higher on Psychoticism than those who did not. Conclusions. (1) Our study confirmed that the findings which had been previously reported in selected samples in western countries also apply to a general population in Japan; (2) current smokers were found to be heterogeneous in terms of Psychoticism when the age they started to smoke and their present daily consumption of cigarettes were taken into account.
Community prevention and alcohol retail access
Authors: REYNOLDS ROBERT I. , HOLDER HAROLD D. , GRUENEWALD PAUL J.
Published: January 2006

This paper describes the design, rationale and implementation of the Alcohol Access Component within the Community Trials Project of the Prevention Research Center. The Alcohol Access Component was to reduce the concentration or density of alcohol outlets in each experimental community by a combination of local zoning and land‐use planning approaches which was an effect to occur over several years. During the time of this trial, local regulations of alcohol outlets and public sites for drinking were changed in all three experimental communities. The amount of such alcohol policy change exceeded the goals for this component.
Solitary drinking: a risk factor for alcohol‐related problems?
Authors: BOURGAULT CHANTAL , DEMERS ANDRÉE
Published: January 2006

This paper investigates whether solitary drinking is a risk factor for alcohol‐related problems using data from a general population of drinkers in Montreal, Canada. Three indicators of solitary drinking mere used: (1) having had a drink alone; (2) frequency of solitary drinking; and (3) having had five drinks or more in a solitary setting. Among the 2015 respondent drinkers of a telephone survey, 31% reported drinking alone, of whom 27% did so more than once a week, and 17% had had five drinks or more alone at least once. Problems with family or social relationships, physical health, work, budget, physical security and happiness or view of life, self‐reported as being alcohol‐related, were measured by seven binary items. Strong positive associations were found at the univariate level between overall alcohol‐related problems and both solitary drinking and having had five or more drinks alone, whereas frequency of solitary drinking had no effect. Only the relationship with having five or more drinks alone remained statistically significant in logistic regressions controlling for potential confounders. No evidence mas found that solitary drinking per se is a risk factor for alcohol‐related problems unless large quantities of alcohol are involved.
Alcohol interventions: do the best things come in small packages?
Authors: DRUMMOND D. COLIN
Published: January 2006

Several extensive reviews have highlighted the effectiveness of brief alcohol interventions. The same reviews mere pessimistic about the role of more intensive, specialist treatments. It is argued here that the research evidence should be interpreted with caution. There are problems of generalizability of the research, and studies focusing on brief interventions in the primary health care field are largely not comparable with clinical trials conducted in the specialist setting. The efficacy of brief interventions as a routine mass intervention approach has been exaggerated. Even after extensive research, little is known of the effective ingredients and the most effective methods of delivery. Reviews of brief interventions have been overly selective, and meta analysis in this area is problematic. It is argued that such reviews lead to overgeneralization and turn attention away from promising specialist treatment approaches. More research is needed into identifying the target group most likely to benefit from brief interventions, cost effectiveness, and into shared care and stepped care approaches, before embarking on a major shift in treatment policy towards brief interventions.
Substance abuse and homelessness: social selection or social adaptation?
Authors: JOHNSON TIMOTHY P. , FREELS SALLY A. , PARSONS JENNIFER A. , VANGEEST JONATHAN B.
Published: January 2006

Although substance abuse has for many years been documented as a serious problem among homeless populations, there is as yet no clear understanding of the nature of the relationship between substance abuse and homelessness. We evaluate alternative social selection and social adaptation models of this process. Using data from a random probability sample, the substance abuse and homeless experiences of 303 homeless people and people at risk of homelessness in Cook County, Illinois, were investigated. Proportional hazards regression models were employed to assess both social selection and social adaptation models. Drug but not alcohol abuse was associated with first homeless episode. Prior homeless experiences were found to be predictive of first symptoms of both alcohol and drug abuse. Other variables, including the availability of social and economic resources, were also associated with each of these outcomes. Models of both selection and adaptation processes are necessary to account for the association between homelessness and substance abuse, indicating that a multi‐directional model is more appropriate. In addition findings suggest that, in recent years, drugs may have displaced alcohol as an important precursor of homelessness for many individuals.
A longitudinal study of social, psychological and behavioural factors associated with drunken driving and public drunkenness
Authors: KARLSSON GUNILLA , ROMELSjO ANDERS
Published: January 2006

Studies on psychosocial conditions in drunken drivers have generally been cross‐sectional and based on rather small selected samples. The objective of this study was to analyse, in a longitudinal perspective, the relationship, in young males, between social and psychological factors and indicators of alcohol abuse on one hand and the risk of subsequent drunken driving and public drunkenness on the other hand, in order to identify similarities and differences in risk factor patterns. Questionnaire information from 8122 military conscripts in 1969/70 was linked to data on drunken driving and public drunkenness for 495 males with offences registered up to 1977. Logistic regression analysis showed that the relative risk (RR) for high alcohol consumption, smoking, use of narcotics and sniffing of solvents had a statistically significant association to subsequent drunken driving and public drunkenness in univariate analyses. In multivariate logistic analyses, RR remained increased for those with fathers belonging to social class II and especially so for those coming from social class III. Smoking (RR 3.3, with a 95% confidence interval of 1.6–6.8) was significantly increased in drunken drivers with a blood alcohol concentration (BAC) of 0.15% or more at apprehension, as was truancy or contact with police or juvenile authorities in drunken drivers with a BAC of 0.05–0.15%, and illicit drug use, intoxication drinking, contact with police or juvenile authorities and hangover with public drunkenness. Thus, vie found that early social and behavioural factors, substance abuse and risky use of alcohol were predictors for both drunken driving and public drunkenness, with no marked differences in risk factor patterns.
Adult smokers who do not smoke daily
Authors: GILPIN ELIZABETH , GAVIN SHIRLEY W. , PIERCE JOHN P.
Published: January 2006

Almost 20% of Californian smokers do not smoke daily. Although occasional (non‐daily) smoking occurs during uptake, a liable pattern of occasional smoking may imply a milder level of nicotine addiction. We use a longitudinal population sample of smokers interviewed in both 1990 and 1992 to evaluate the stability of occasional smoking. Further, we use 1992 data, including smokers only interviewed in 1992, to compare occasional smokers who have (ever‐daily) and have not (never‐daily) smoked daily for at least 6 months, and contrast them to daily smokers for key variables associated with addiction. All our analyses exclude uptake smokers. Two‐thirds of never‐daily occasional smokers in 1992 also smoked occasionally in 1990, compared to only about 40% of ever‐daily occasional smokers. Never‐daily occasional smokers smoke less than ever‐daily ones. They are more often under age 40 years, of Hispanic origin, and were more likely to begin regular smoking beyond their teen years. Demographically, ever‐daily occasional smokers were similar to daily smokers except for being more educated. However, both ever‐daily and never‐daily smokers differed from daily smokers with respect to long‐term quitting history, plans to quit, confidence they could quit, and belief they are addicted to cigarettes. Our findings suggest that occasional smoking can be a stable pattern for long periods. Occasional smokers, particularly never‐daily ones, appear to be much less addicted to nicotine than daily smokers.
Alcohol, Europe and the developing countries
Authors: SAXENA SHEKHAR
Published: January 2006

Although most of the developing countries currently have a lower overall per capita consumption of alcohol than the European countries, the rapid rate of increase in recent years is highly significant from a public health perspective. Excessive alcohol consumption in developing countries leads to substantial negative effects on the health and also on the quality of life of the drinking individuals and their families. It also causes massive direct and indirect costs to these countries that they can ill‐afford. Europe has played a major facilitatory role for alcohol consumption in the developing countries and its continues to have considerable influence directly and indirectly even now. Increased international cooperation on scientific as well as policy issues is likely to achieve the twin aims of limiting alcohol use and preventing alcohol‐related health and social problems not only in Europe but all over the world, including in the developing countries. Important initial steps in this direction may be increased exchange of information, developing compatible policies and evolving culturally relevant public health measures. In order to achieve any success in limiting alcohol related problems, the need to keep a global perspective on alcohol is paramount.
Lost productivity and costs to society
Authors: GODFREY CHRISTINE
Published: January 2006

Having a single monetary amount that provides an indicator of alcohol misuse can be a powerful instrument for those advocating policy action. Existing studies suggest that alcohol use in any year may yield costs that are equivalent to 2–5% of the gross national product. While useful, such figures do not indicate which combinations of policies could yield the greatest net benefits for their populations. There may also be interest in the effects of alcohol use on public finances or the fairness of both taxes and welfare payments across different groups of the population. Which items are identified as being relevant and how these effects are measured and valued will depend on which policy question is being addressed. There are, however, a number of common issues such as whether costing studies should be confined to the heaviest and problematic, how benefits of alcohol consumption should be measured, how future benefits in terms of health gains should be valued and whether the costs to the drinker are important or only those costs which are borne by third parties. There will not always be simple answers to these questions. However, even if costing studies are confined to third party effects and the most conservative assumptions are taken, it is clear that there is powerful evidence that many societies would be better off if action is taken to prevent alcohol problems. Research on the effects of alcohol use is becoming increasingly sophisticated and this will lead to improvements in costing studies. Productivity losses are likely to remain one of the most significant costs of alcohol misuse.
Alcohol policy and the public good
Authors: EDWARDS GRIFFITH
Published: January 2006

Despite a diversity of cultural, social and economic experiences with alcohol at national level, a broad unity of purpose is emerging within the alcohol problems perspective. The scientific basis for that perspective finds its support in a sustained international research effort. With the publication in 1994 of the WHO report “Alcohol Policy and the Public Good”, that perspective has been given persuasive empirical underpinning and a sharp focus. Essentially the problems perspective suggests that the target for public policy is the prevention or alleviation of population‐wide alcohol‐related problems, with problems broadly defined. The test for any policy within this arena is then whether it contributes to the achievement of that target. The perspective is thus rational, empirical, rooted in the traditions of public health, and readily intelligible to the ordinary citizen. Key conclusions emanating from “Alcohol Policy and the Public Good” are summarized. That text is rounded off by the challenging assertion that “Drinking problems are not carried by an uncontrollable tide. With public will, and on the evidence, they are capable of amelioration.” A positive response to that challenge by the nations of Europe is both necessary and feasible.
Alcohol use and a safe environment
Authors: HOLDER HAROLD D.
Published: January 2006

Three areas are discussed which illustrate the potential for drinking to increase the threat to personal safety, i. e. family harm and disruption, violence and crime, and traffic safety. Such threats to safety are especially important in that they extend well beyond the individual drinker into the lives of family members, friends, work colleagues, and even strangers who can become injured or killed in a drinking and driving accident. Thus, alcohol policy is a concern for all citizens whose personal safety can be at risk. From this perspective, alcohol‐involved problems are public health and safety issues. Controlled evaluations of a number of strategies provide evidence of potential effectiveness to reduce problems related to safely.
The sanctuary of sobriety: the emergence of temperance as a feminine virtue in Tudor and Stuart England*
Authors: WARNER JESSICA
Published: January 2006

This study examines the reasons why temperance was viewed as an appropriate virtue for women in sixteenth‐and seventeenth‐century England. It makes use of contemporary literature to document shifts in attitudes toward women who drank in a public and conspicuous fashion, and examines the economic and cultural changes that contributed to those shifts. The literature consulted in this study would suggest that up until the first decades of the sixteenth century men and women both enjoyed considerable freedom as to where and when they might consume alcohol, and would further suggest that it was only during the economic and social crises of the early modern period that two distinct drinking cultures starred to emerge, one centred in the home and exclusive of men, the other centred outside the home and exclusive of women. The emergence of temperance as a virtue specific to women happened to occur at a time when real wages were in sharp decline, and effectively sanctioned the redistribution of household income in favour of men, whose right to drink was never seriously challenged. Criticism of women who drank in a public and conspicuous fashion also happened to coincide with the rediscovery of classical texts commending the supposed temperance of the women of early Rome.
Hepatitis C virus serology in parenteral drug users with chronic liver disease
Authors: NOVICK DAVID M. , REAGAN KEVIN J. , CROXSON T. SCOTT , GELB ALVIN M. , STENGER RICHARD J. , KREEK MARY JEANNE
Published: January 2006

Chronic liver disease is a common complication of parenteral drug use, and liver cirrhosis is frequently seen in users of both parenteral drugs and alcohol. In 1978‐83, we studied 88 parenteral drug users with sufficient evidence of chronic liver disease to warrant liver biopsy. Current alcohol abuse was noted in 63 (72%), and six (7%) were former alcohol abusers. Cirrhosis was found in 33 (38%). Hepatitis C antibody (anti‐HCV) was detected in 86 (98%). Also, 40 of the anti‐HCV positive sera were tested with recombinant immunoblot assay and all of these were reactive. All but one of the 31 patients with anti‐HCV and cirrhosis were alcohol abusers. We conclude that parenteral drug users with chronic liver disease almost always have evidence of HCV infection. By 1978‐83, HCV infection had become well established in an addict population.
An Australian profile on the use of cocaine
Authors: HANDO JULIE , FLAHERTY BRUCE , RUTTER SCOTT
Published: January 2006

Data collected on cocaine in Australia in the mid to late 1980s, when law enforcement and treatment centres were concerned with possible increases in cocaine use, indicated a low prevalence of use. This artick reports findings from the Australian component of the 1993–94 World Health Organization study entitled “Initiative on Cocaine”, which provides an updated analysis of cocaine use patterns and consequences. The two components of this study were a “country profile” which summarized existing health, law enforcement and survey data on cocaine use from national, regional and city level records, and a key informant study which consisted of interviews with people from Sydney and Melbourne who were familiar with cocaine use through personal, professional or observational experience. Findings show that the prevalence of cocaine use has remained low among the general population in Australia (around 2%), and few people present to treatment services with primary cocaine problems or are arrested. However, the use of cocaine seems to have increased among inner Sydney injecting drug users. There have also been indications of larger police seizures of cocaine, reflecting a possible increase in availability. Recommendations are made to provide relevant interventions and continually monitor patterns of cocaine use, particularly among at‐risk groups.
Subgroups of smokers with different success rates after use of transdermal nicotine
Authors: SWAN GARY E. , JACK LISA M. , WARD MARCIA M.
Published: January 2006

To identify subgroups of smokers with different success rates, we applied “tree‐structured survival analysis” (TSSA) to data from a previously published trial of transdermal nicotine. The subjects who received active treatment (14 mg patch, n = 275, or the 21 mg patch, n = 262) constituted the sample for this analysis. Using age, gender, the Fagerstrom Tolerance Questionnaire (FTQ), motivation to quit, number of cigarettes smoked at baseline, and body mass index (BMI) as classification variables, TSSA identified two subgroups within the 14 mg patch group and four subgroups of smokers within the 21 mg patch group. Among those receiving the 14 mg patch, individuals with a BMI greater than 26.4 kg/m2 relapsed sooner than did those with a BMI less than or equal to this value. Within the 21 mg patch group, the survival curve for males was significantly different from that observed in females, with males experiencing a longer time to relapse after treatment than did females. Among males, those who were less dependent relapsed significantly later than did those men who were more dependent. Among females, those with a higher motivation to quit relapsed more slowly than did those women with less motivation to quit. This information may be helpful to clinicians seeking to match specific patients to specific treatments with transdermal nicotine in order to maximize treatment outcomes.
Addiction, ethics and public policy
Authors: West Robert
Published: January 2006

Addiction affects the lives of all of human kind, either directly or indirectly. The cost to individuals and societies is immense and tackling the problem is as much one for policy makers as clinicians, counsellors and scientists. Ethical issues permeate much of the work of all these groups. The issue of what is right and wrong, morally defensible or morally unacceptable arises at both an individual and societal level. This special issue contains 21 commissioned articles from leading figures in addiction research. To set the scene for these in‐depth analyses, this article reports the results of an expert panel survey on addiction, ethics and public policy. A total of 199 people from 24 countries identified as first authors of research papers abstracted in Addiction Abstracts in 1994 and 1995 completed a postal questionnaire asking their views on a range of issues. They were asked to state their position on the issue and to identify what they considered to be the most important factors in the decision. Among the findings of interest were: a majority believed that possession of cannabis should be legal but that possession of 'hard drugs' should be illegal. An overwhelming majority believed that tobacco advertising should be banned, that smoking should be prohibited in public buildings and offices and that the legal age for tobacco sales should be 18 or more. A majority believed that researchers should not accept backing from tobacco companies; opinion on accepting backing from the alcohol industry was more evenly divided. An overwhelming majority believed that drug addicts should be able to attend treatment centres on demand and that some form of methadone maintenance should be available to addicts who want it. The survey should prove a useful resource when debating the issues in policy and research arenas.
The recent Australian debate about the prohibition on cannabis use
Authors: Hall Wayne
Published: January 2006

This paper outlines the ethical arguments used in the Australian debate about whether or not to relax the prohibition on cannabis use by adults. Over the past two decades a rising prevalence of cannabis use in the Australian population has led to proposals for the decriminalization of the personal use of cannabis. Three states and territories have removed criminal penalties for personal use while criminal penalties are rarely imposed in the remaining states. Libertarian arguments for legalization of cannabis use have attracted a great deal of media interest but very little public and political support. Other arguments in favour of decriminalization have attracted more support. One has been the utilitarian argument that prohibition has failed to deter cannabis use and the social costs of its continuation outweigh any benefits that it produces. Another has been the argument from hypocrisy that cannabis is less harmful than alcohol and so, on the grounds of consistency, if alcohol is legally available then so should cannabis. To date public opinion has not favoured legalization, although support for the decriminalization of personal cannabis use has increased. In the long term, the outcome of the debate may depend more upon trends in cannabis use and social attitudes among young adults than upon the persuasiveness of the arguments for a relaxation of the prohibition of cannabis.
The conflict between least harm and no‐use tobacco policy for youth: ethical and policy implications
Authors: Pentz Mary Ann , Sussman Steve , Newman Traci
Published: January 2006

This paper examines policy and ethical implementation issues associated with local drug policies that are aimed at producing a "least harm" approach toward youth, with particular application to tobacco policy as an example of a legal, but addictive drug. Research is reviewed which shows the inconsistencies between federally mandated enforcement of zero tobacco use, the Synar Amendment and local community and school policies which appear to relax enforcement of no‐use policies for the purpose of retaining youth in school. The inconsistencies are described from the perspective of a "least harm" approach, in that tobacco use may be considered less harmful than absence from school, or use of other substances. The conflict between law and intent to reduce harm is examined with implications for long‐term enforcement of federal policy, and for effectiveness of tobacco and other drug abuse prevention programs and other drug policies. Several strategies for reducing the conflict are recommended. These include provision of support‐orientated smoking cessation programs for youth on school campuses and in community organizations, and promoting consistent no‐use norms across all drugs and across multiple channels that affect youth‐mass media, school, point‐of‐purchase settings and public settings and events.
A meta‐analysis of voucher‐based reinforcement therapy for substance use disorders
Authors: Lussier Jennifer Plebani , Heil Sarah H. , Mongeon Joan A. , Badger Gary J. , Higgins Stephen T.
Published: January 2006

Aims  To systematically investigate the effectiveness of voucher‐based reinforcement therapy for the treatment of substance use disorders.

Methods  Effect sizes and 95% confidence intervals were calculated for studies published between January 1991 and March 2004 that utilized voucher‐based reinforcement therapy (VBRT) or related monetary‐based incentives to treat substance use disorders (SUDs).

Findings  Thirty studies involved interventions targeting abstinence from drug use using experimental designs where effects on treatment outcome could be attributed to the VBRT intervention. The estimated average effect size (r) for those studies was 0.32 (95% CI 0.26–0.38). Analyses of variables thought to moderate VBRT effect sizes revealed that more immediate voucher delivery and greater monetary value of the voucher were associated with larger effect sizes. Additional studies were identified wherein VBRT was used to target clinic attendance (n = 6) or medication compliance (n = 4). VBRT studies targeting attendance produced average effect sizes of 0.15 (95% CI 0.02–0.28), while those that targeted medication compliance produced an average effect of 0.32 (95% CI 0.15–0.47). No significant moderators were identified for these 10 studies.

Conclusions  Overall, VBRT generated significantly better outcomes than did control treatments. These results further support the efficacy of VBRT, quantify the magnitude of its effects, identify significant moderators and suggest potential directions for future research.
Prediction of adolescent smoking from family and social risk factors at 5 years, and maternal smoking in pregnancy and at 5 and 14 years
Authors: O'Callaghan Frances V. , O'Callaghan Michael , Najman Jake M. , Williams Gail M. , Bor William , Alati Rosa
Published: January 2006

Aims  This study examines associations between maternal smoking and family, social or child risk factors when the child is aged 5 and adolescent smoking. The influence of mothers who smoke in pregnancy or continue to smoke at 14 years was also examined.

Design  The Mater‐University of Queensland Study of Pregnancy is a prospective cohort study.

Participants  Participants included 8556 women enrolled between 1981 and 1984 at their first antenatal visit. Completed questionnaires were obtained for 7223 offspring, comprising the study birth cohort. Of the 7223 eligible children a total of 4541 had information on both maternal smoking when the child was aged 5 years and adolescent smoking at 14 years.

Measurements  Measures included maternal smoking during pregnancy and when the child was aged 5 and 14 years, child smoking at 14 years, maternal alcohol use, child behaviour problems and social and demographic variables.

Findings  Adolescent smoking was predicted by a risk score at 5 years involving maternal smoking and alcohol use, non‐married status, having a partner who had ever been arrested, having four or more children in the household, and child aggression at 5 years. Continued maternal smoking from 5 to 14 years was associated strongly with adolescent smoking. There was also evidence that smoking in late pregnancy may exert an independent effect on adolescent smoking.

Conclusions  The results suggest the possibility of a direct effect of prenatal smoking on adolescent smoking and highlight a set of environmental risk factors in the development of adolescent smoking. These risk factors may be used as early warning signs that intervention may be needed, and given the similarities with risk factors for other adverse childhood outcomes, the benefits of early intervention may extend beyond smoking to other problem behaviours. The possibility of being able to predict other disorders, because of these associations, also warrants further investigation.
The Toll-like receptor 4 (Asp299Gly) polymorphism is a risk factor for Gram-negative and haematogenous osteomyelitis
Authors: Montes A H , Asensi Victor , Alvarez Victoria , Valle Eulalia , Ocaña M G , Meana A , Carton J A , Paz Jose , Fierer J , Celada A
Published: January 2006

Osteomyelitis is a bone infection caused mostly by Staphylococcus aureus but also by Gram-negative bacteria. Toll-like receptors (TLRs), after recognizing microbial products, induce a signal in neutrophils, leading to NF-κB activation and transcription of pro-inflammatory genes. Polymorphisms in TLR2 (Arg753Gln) and TLR4 (Asp299Gly, Thr399Ile) genes are associated with bacterial infections, we therefore studied these polymorphisms in osteomyelitis patients. Homozygotes for the TLR4 (Asp299Gly) polymorphism were significantly more frequent among the 80 osteomyelitis patients than in the 155 healthy controls (3/80, 3·8%versus 0/155, 0%; P = 0·038). Carriers of one or two G alleles of this tlr4 polymorphism were more likely to have Gram-negative, haematogenous and/or chronic osteomyelitis than those without this mutation (P < 0·031). Patients with the TLR4 (Thr399Ile) mutant, which cosegregates with the TLR4 (Asp299Gly), were also carriers of this second polymorphism. No differences for the TLR2 (Arg753Gln) genotypes were found between patients and controls. Neutrophils of patients homozygous for the TLR4 (Asp299Gly) polymorphism showed lower LPS-induced apoptosis reduction, phosphorylation of the inhibitor of NF-κB, and lower IL-6 and TNF-α levels (P < 0·05). We report here for the first time an association between this TLR4 polymorphism and susceptibility to Gram-negative bacteria and haematogenous osteomyelitis.
Elevated levels of mannan-binding leptin (MBL) and eosinophilia in patients of bronchial asthma with allergic rhinitis and allergic bronchopulmonary aspergillosis associate with a novel intronic polymorphism in MBL
Authors: Kaur S , Gupta V K , Shah A , Thiel S , Sarma P U , Madan T
Published: January 2006

Mannan-binding lectin (MBL), an important component of innate immunity, binds to a range of foreign antigens and initiates the lectin complement pathway. Earlier studies have reported high plasma MBL levels in allergic patients in comparison to healthy controls. In view of varied plasma MBL levels being determined by genetic polymorphisms in its collagen region, we investigated the association of single nucleotide polymorphisms (SNPs) in the collagen region of human MBL with respiratory allergic diseases. The study groups comprised patients of bronchial asthma with allergic rhinitis (n = 49) and allergic bronchopulmonary aspergillosis (APBA) (n = 11) and unrelated age-matched healthy controls of Indian origin (n = 84). A novel intronic SNP, G1011A of MBL, showed a significant association with both the patient groups in comparison to the controls (P < 0·01). Patients homozygous for the 1011A allele showed significantly higher plasma MBL levels and activity than those homozygous for the 1011G allele (P < 0·05). The 1011A allele also showed a significant correlation with high peripheral blood eosinophilia (P < 0·05) and low forced expiratory volume in 1 s (FEV1) (P < 0·05) of the patients. We conclude that the 1011A allele of MBL may contribute to elevated plasma MBL levels and activity and to increased severity of the disease markers in patients of bronchial asthma with allergic rhinitis and ABPA.
Historical biogeography of amphibian parasites, genus Polystoma (Monogenea: Polystomatidae)
Authors: Bentz Sophie , Sinnappah‐Kang Neeta D. , Lim Lee‐Hong Susan , Lebedev Boris , Combes Claude , Verneau Olivier
Published: January 2006

Aim  The present‐day geographical distribution of parasites with a direct biological life cycle is guided mostly by the past dispersal and vicariance events that have affected their hosts. The Amphibia–Polystoma association (which satisfies these criteria) also exhibits original traits, such as host specificity and world‐wide distribution. This biological model was thus chosen to investigate the common historical biogeography of its widespread representatives.

Location  North and South America, Eurasia and Africa.

Methods  We investigated the phylogeny of 12 species of neobatrachian parasites sampled from North and South America, Eurasia and Africa. Hosts belonged mostly to hyloids and ranoids of families Bufonidae, Hylidae, Leptodactylidae, Ranidae and Hyperoliidae. Phylogenetic reconstructions were inferred from maximum likelihood and maximum parsimony analyses from complete ITS1 sequences.

Results  The group of American species appeared paraphyletic with one species at the base of a Eurafrican clade, within which two lineages were seen: one composed of only Eurasian species, and the other of European and African species, with the two European species basal to an African clade.

Main conclusions  The route of Polystoma evolution is deduced from the phylogenetic tree and discussed in the light of host evolution. We conclude that Polystoma originated in South America on hyloids, after the separation of South America from Africa. The genus must have colonized North America in Palaeocene times and Eurasia by the mid‐Cainozoic, taking advantage of the dispersal of either ancestral bufonids or hylids. Africa, however, appears to have been colonized more recently, during the Messinian period.
Hepatitis B virus genotypes and G1896A precore mutation in 486 Spanish patients with acute and chronic HBV infection
Authors: Rodriguez‐Frias F. , Jardi R. , Buti M. , Schaper M. , Hermosilla E. , Valdes A. , Allende H. , Martell M. , Esteban R. , Guardia J.
Published: January 2006

Summary.  This study aims to determine the prevalence of hepatitis B virus (HBV) genotypes (A–F) and their association with the G1896A precore mutation in 486 patients positive for HBV surface antigen. Genotypes were determined by RFLP and precore mutation by real‐time PCR. Genotypes D (48.1%) and A (39.5%) were the most common, followed by F (4.1%) and B, C and E (<1%). The A to D ratio (A:D) was 1.4 in HBeAg+ chronic hepatitis B (CHB), 0.6 in HBeAg− CHB and 1.4 in HBeAg− inactive carriers. Distribution of these genotypes was different between HBeAg+ CHB and HBeAg− CHB (P = 0.02), and between HBeAg− CHB and HBeAg− inactive carriers (P = 0.009). Genotype A was the most prevalent in HBeAg+ CHB with elevated alanine aminotransferase (ALT) (68.6%) and genotype D in HBeAg+ CHB with fluctuating ALT (60.7%). There was a difference in genotype prevalence between chronic and acute infection (P = 0.03). The precore mutant correlated with high levels of HBV‐DNA in genotype d HBeAg− CHB. Genotype D is not as highly prevalent in Spanish patients as would be expected in a Mediterranean area. The unequal prevalence of genotypes between acute and chronic infection suggests that genotype A is associated with a higher tendency to cause chronic infection.
The development of picture cards and their use in ascertaining characteristics of Chinese surgical patients’ decision‐making preferences
Authors: Henderson Amanda , Shum David , Chien Wai‐Tong
Published: January 2006

Aim  This exploratory pilot study developed and tested the validity of picture cards as a strategy to ascertain patients’ desired participation in decision making. These were then used to ascertain characteristics of Hong Kong Chinese patients’ decision‐making preferences for surgery.

Validation of tool  Two sets of analyses tested the validity of picture cards in an Australian and Hong Kong Chinese population. First, the ratings of the two groups of participants using the picture cards for three scenarios (severe, moderate and mild medical conditions) were correlated with mean ratings of three decision‐making subscales of a self‐report questionnaire for the three scenarios. Second, a 3 (Scenario) × 2 (Ethnic Group) mixed anova examined whether the picture cards are sensitive to differences relating to severity of medical conditions and ethnicity.

Setting and participants  A convenience sample of initially 35 Hong Kong and 24 Australian patients was used to validate the picture card tool. A convenience sample of a further 186 Hong Kong Chinese surgical inpatients used the tool.

Design  Participants selected the picture card that best represented their decision‐making preference.

Main variables  Demographic factors, prior knowledge, nature of surgery and preference for participation in decision making.

Results  Significant correlations were made between the questionnaire and the picture card tool. Using the tool, a significant difference was found between males’ and females’ decision‐making preference, yet, no significant difference was found with respect to type or previous surgical operation.

Conclusion  Results indicate that demographic variables do have an effect, however undergoing previous surgery or type of surgery does not affect decision‐making preference.
Perceptions of communication between people with communication disability and general practice staff
Authors: Murphy Joan
Published: January 2006

Objective  To explore consultation between people with communication disability and General Practice (GP) staff from the perspectives of both patients and staff.

Background  Communication disability causes a particular problem in primary care. This issue has not yet been investigated from the perspective of both patients and GP staff.

Design  Eight focus groups were held – four with GP practices, two with people with intellectual disability and two with people who had had a stroke. Picture symbols and Talking Mats®, a visual communication framework, were used to assist the participants with communication disability. Discussions were audio recorded and analysed thematically.

Participants  Twenty GP staff, 12 people with aphasia and six people with learning disability were interviewed.

Results  GP staff expressed frustration with not being understood and not understanding but there was a lack of awareness of the reasons behind these difficulties. They all said they mainly relied on carers. They recognized the significance of poor communication in terms of access to health services and agreed that the extent of the problem was greater than they had previously believed. People with communication disability described significant problems before, during and after the consultation. Although some acknowledged that they needed help from their carer, most objected to staff speaking to the carer and not to them.

Conclusions  The main priorities for GP staff were the need for relevant training and simple resources. The main priorities for people with communication difficulty were continuity of staff, trust, better GP staff communication skills, and less reliance on carers.
Acute digoxin loading reduces ABCA8A mRNA expression in the mouse liver
Authors: Wakaumi Michi , Ishibashi Kenichi , Ando Hitoshi , Kasanuki Hiroshi , Tsuruoka Shuichi
Published: January 2006

1. Human ABCA8, a new member of the ATP binding cassette (ABC) transporter family, transports certain lipophilic drugs, such as digoxin. To investigate the roles of this transporter, we cloned a mouse homologue of ABCA8, from a mouse heart cDNA library, named ABCA8a.

2. The deduced mouse ABCA8a protein is 66% identical with that of human ABCA8 and possesses features common to the ABC superfamily. It was found that ABCA8a was mainly expressed in the liver and heart, similar to human ABCA8.

3. We further evaluated the effect of acute digoxin (a substrate for ABCA8) intoxication on the mRNA expression of ABCA8 using northern blotting with a 3′ non‐coding region as a probe to avoid cross‐hybridization with other ABCA genes.

4. Following acute digoxin infusion, the mRNA expression of ABCA8 was significantly reduced in the liver 12–24 h after injection (14.7% of vehicle treatment), but not in the heart and kidney.

5. Real‐time quantitative polymerase chain reaction analysis confirmed the reduction in ABCA8a mRNA. Similar reductions in ABCA5, ABCA7, ABCA8b and ABCA9 mRNA were also observed. A comparable amount of digitoxin did not affect ABCA8a mRNA expression in the liver.

6. The results suggest that ABCA8 may play a role in digoxin metabolism in the liver.
Feitai, a Chinese herbal medicine, reduces transforming growth factor‐β1 and monocyte chemoattractant protein‐1 expression in bleomycin‐induced lung fibrosis in mice
Authors: Shen Yun , Zhao Hao‐Long , Du Juan , Li Yu‐Ting , Tan Fang , Huang Cheng‐Gang , Pei Gang
Published: January 2006

1. Feitai, a Chinese medicine formulation, has been shown to protect against lung fibrosis induced by bleomycin (BLM). In the present study, we investigated the effect ofFeitaion transforming growth factor (TGF)‐β1 and monocyte chemoattractant protein‐1 (MCP‐1), which play important roles in the pathogenesis of BLM‐induced lung fibrosis.

2. The results demonstrated thatFeitaicould significantly attenuate BLM‐induced acute lung inflammation and subsequent lung fibrosis. Meanwhile, the expression of MCP‐1 and TGF‐β1mRNA in the lungs increased in the BLM‐treated group compared with the saline‐instilled control group andFeitaitreatment significantly decreased cytokine expression in BLM‐treated mice. In addition,Feitaidiminished the accumulation of MCP‐1‐ and TGF‐β1‐positive cells in lung tissues at the time of peak mRNA levels.

3. In summary, the results of the present study indicate that treatment withFeitaiameliorates BLM‐induced lung fibrosis, at least in part via the inhibition of MCP‐1 and TGF‐β1expression.