bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation and ethical review of a tool to explore patient preferences for information and involvement in decision making
Authors: Murtagh F E M , Thorns A 
Published: May 2006

Aim:To improve clinical and ethical understanding of patient preferences for information and involvement in decision making.Objectives:To develop and evaluate a clinical tool to elicit these preferences and to consider the ethical issues raised.Design:A before and after study.Setting:Three UK hospices.Participants:Patients with advanced life-threatening illnesses and their doctors.Intervention:Questionnaire on information and decision-making preferences.Main outcome measures:Patient-based outcome measures were satisfaction with the amount of information given, with the way information was given, with family or carer information, and confidence about future decision making. Doctor-based outcome measures were confidence in matching information to patient preference, matching family or carer communication to patient preference, knowing patient preferences and matching future decision making with patient preference.Results:Of 336 admissions, 101 patients (mean age 67.3 years, 47.5% men) completed the study (control, n = 40; intervention, n = 61). Patient satisfaction with the way information was given (χ2 = 6.38, df = 2, p = 0.041) and family communication (χ2 = 14.65, df = 2, p<0.001) improved after introduction of the tool. Doctor confidence improved across all outcome measures (all p values<0.001).Conclusions:Patient satisfaction and doctor confidence were improved by administering the questionnaire, but complex ethical issues were raised by implementing and applying this research. The balance of ethical considerations were changed by advanced life-threatening illness, because there is increased risk of harm through delivery of information discordant with the patient’s own preferences. The importance of truly understanding patient preferences towards the end of life is highlighted by this study.
Dermal, inhalation, and internal exposure to 1,6-HDI and its oligomers in car body repair shop workers and industrial spray painters
Authors: Pronk A , Yu F , Vlaanderen J , Tielemans E , Preller L , Bobeldijk I , Deddens J A , Latza U , Baur X , Heederik D 
Published: May 2006

Objectives:To study inhalation and dermal exposure to hexamethylene diisocyanate (HDI) and its oligomers as well as personal protection equipment (PPE) use during task performance in conjunction with urinary hexamethylene diamine (HDA) in car body repair shop workers and industrial spray painters.Methods:Personal task based inhalation samples (n = 95) were collected from six car body repair shops and five industrial painting companies using impingers with di-n-butylamine (DBA) in toluene. In parallel, dermal exposure was assessed using nitril rubber gloves. Gloves were submerged into DBA in toluene after sampling. Analysis for HDI and its oligomers was performed by LC-MS/MS. Urine samples were collected from 55 workers (n = 291) and analysed for HDA by GC-MS.Results:Inhalation exposure was strongly associated with tasks during which aerosolisation occurs. Dermal exposure occurred during tasks that involve direct handling of paint. In car body repair shops associations were found between detectable dermal exposure and glove use (odds ratio (OR) 0.22, 95% confidence interval (CI) 0.09 to 0.57) and inhalation exposure level (OR 1.34, 95% CI 0.97 to 1.84 for a 10-fold increase). HDA in urine could be demonstrated in 36% and 10% of car body repair shop workers and industrial painting company workers respectively. In car body repair shops, the frequency of detectable HDA was significantly elevated at the end of the working day (OR 2.13, 95% CI 1.07 to 4.22 for 3–6 pmv0–8 am). In both branches HDA was detected in urine of ∼25% of the spray painters. In addition HDA was detected in urine of a large proportion of non-spray painters in car body repair shops.Conclusion:Although (spray) painting with lacquers containing isocyanate hardeners results in the highest external exposures to HDI and oligomers, workers that do not perform paint related tasks may also receive a considerable internal dose.
Incidence of dimethylacetamide induced hepatic injury among new employees in a cohort of elastane fibre workers
Authors: Lee C-Y , Jung S-J , Kim S-A , Park K-S , Ha B-G 
Published: May 2006

Objective:To investigate the incidence ofN,N-dimethylacetamide (DMA) induced hepatic injury among new elastane fibre workers and to explore factors relating to DMA induced hepatic injury.Methods:Elastane fibre workers exposed to DMA were monitored for hepatic injury. Four hundred and forty new workers employed from 1 January 2002 to 31 July 2004 were included as study subjects. DMA exposure estimates were based on urinary N-methylacetamide (NMA) concentrations.Results:There were 28 cases of DMA induced hepatic injury. The overall incidence of DMA induced hepatic injury among new elastane fibre workers was 0.089/person-year. Incidence rates were 7–10 times higher in high exposure groups than in low exposure groups. Fewer DMA induced hepatic injuries occurred among workers employed for a longer period. Workers whose exposure duration was more than seven months showed no hepatic injury in either the high or low exposure groups. Exposure category and duration of employment were significant variables in the multiple logistic regression analysis.Conclusions:Results suggest the existence of dose dependent DMA induced hepatic injury. The inverse relation between the incidence of DMA induced hepatic injury and duration of employment may reflect a type of healthy survivor effect or tolerance to DMA induced hepatic injury.
Prevalence and risk factors for work related asthma in young adults
Authors: Caldeira R D , Bettiol H , Barbieri M A , Terra-Filho J , Garcia C A , Vianna E O 
Published: May 2006

Objectives:To investigate the prevalence and predictors of work related asthma in young adults from the general population.Methods:A total of 1922 subjects randomly selected from a birth cohort 1978/79 in Brazil, aged 23–25 years, completed a respiratory symptoms questionnaire based on the European Community Respiratory Health Survey, and underwent spirometry, bronchial challenge test with methacholine, and skin prick test. For subjects presenting with bronchial hyperresponsiveness, workplace exposure and its relationship with symptoms were assessed by a specific questionnaire and individualised job description to define cases of work related asthma.Results:The prevalence of work related asthma was 4.2% (81 cases): 1.5% (29 cases) were classified as aggravated asthma and 2.7% (52 cases) as occupational asthma. Work related asthma was associated with atopy and education. Lower educational level (1–8 years of schooling) was associated with work related asthma (odds ratio 7.06, 95% CI 3.25 to 15.33). There was no association between work related asthma and smoking, gender, or symptoms of rhinitis.Conclusion:The prevalence of work related asthma was high (4.2%), and was associated with low schooling, probably because of low socioeconomic level. The disease may therefore be a consequence of poverty.
Noise exposure and children’s blood pressure and heart rate: the RANCH project
Authors: van Kempen E , Van Kamp I , Fischer P , Davies H , Houthuijs D , Stellato R , Clark C , Stansfeld S 
Published: May 2006

Background:Conclusions that can be drawn from earlier studies on noise and children’s blood pressure are limited due to inconsistent results, methodological problems, and the focus on school noise exposure.Objectives:To investigate the effects of aircraft and road traffic noise exposure on children’s blood pressure and heart rate.Methods:Participants were 1283 children (age 9–11 years) attending 62 primary schools around two European airports. Data were pooled and analysed using multilevel modelling. Adjustments were made for a range of socioeconomic and lifestyle factors.Results:After pooling the data, aircraft noise exposure at school was related to a statistically non-significant increase in blood pressure and heart rate. Aircraft noise exposure at home was related to a statistically significant increase in blood pressure. Aircraft noise exposure during the night at home was positively and significantly associated with blood pressure. The findings differed between the Dutch and British samples. Negative associations were found between road traffic noise exposure and blood pressure, which cannot be explained.Conclusion:On the basis of this study and previous scientific literature, no unequivocal conclusions can be drawn about the relationship between community noise and children’s blood pressure.
The impact on relative risk estimates of inconsistencies between ICD-9 and ICD-10
Authors: Richardson D B 
Published: May 2006

Background:The 10th revision of the International Classification of Diseases (ICD) represents a major change in the ICD system. This paper investigates the impact on relative risk estimates of inconsistencies in outcome classification between ICD-9 and ICD-10, including scenarios in which occupational exposure levels are correlated with year of death (and therefore with the ICD revision in effect at death). The setting of interest is a cohort mortality study in which follow up spans the periods during which ICD-9 and ICD-10 were in effect. The relative risk estimate obtained when death certificates are coded to the ICD revision in effect at time of death is compared to the relative risk estimate that would be obtained if all death certificates were coded to a consistent ICD revision (that is, ICD-10). The ratio of these relative risks is referred to as the coefficient of bias.Methods:Simple equations relate the coefficient of bias to the sensitivity and specificity of the classification of decedents into categories of cause of death via ICD-9 (treating classifications based upon ICD-10 as the standard). Bridge coded mortality data for 2 296 922 decedents (that is, death certificates coded to ICD-9 and ICD-10) are used to derive estimates of sensitivity and specificity by category of cause of death. Numerical examples illustrate the application of these equations.Results:Estimates of the sensitivity of classification of decedents into categories of death defined by ICD-9 ranged from 0.26–1.00. Specificity was above 0.98 for all categories of cause of death. Numerical examples illustrate that inconsistencies in outcome classification between ICD-9 and ICD-10 may have substantial impact on relative risk estimates if there is a strong relation between exposure status and the proportion of deaths coded to a given ICD revision.Conclusions:For analyses of mortality outcomes that exhibit poor comparability between ICD-9 and -10, it may be prudent to recode cause of death information to a standard ICD revision in order to avoid bias that can occur when exposures are correlated with the proportion of deaths coded to a given ICD revision.
Cost-effectiveness of pharmacotherapies for nicotine dependence in primary care settings: a multinational comparison
Authors: Cornuz J , Gilbert A , Pinget C , McDonald P , Slama K , Salto E , Paccaud F 
Published: May 2006

Objective:To estimate the incremental cost-effectiveness of the first-line pharmacotherapies (nicotine gum, patch, spray, inhaler, and bupropion) for smoking cessation across six Western countries—Canada, France, Spain, Switzerland, the United States, and the United Kingdom.Design and study population:A Markov-chain cohort model to simulate two cohorts of smokers: (1) a reference cohort given brief cessation counselling by a general practitioner (GP); (2) a treatment cohort given counselling plus pharmacotherapy. Effectiveness expressed as odds ratios for quitting associated with pharmacotherapies. Costs based on the additional physician time required and retail prices of the medications.Interventions:Addition of each first-line pharmacotherapy to GP cessation counselling.Main outcome measures:Cost per life-year saved associated with pharmacotherapies.Results:The cost per life-year saved for counselling only ranged from US$190 in Spain to $773 in the UK for men, and from $288 in Spain to $1168 in the UK for women. The incremental cost per life-year saved for gum ranged from $2230 for men in Spain to $7643 for women in the US; for patch from $1758 for men in Spain to $5131 for women in the UK; for spray from $1935 for men in Spain to $7969 for women in the US; for inhaler from $3480 for men in Switzerland to $8700 for women in France; and for bupropion from $792 for men in Canada to $2922 for women in the US. In sensitivity analysis, changes in discount rate, treatment effectiveness, and natural quit rate had the strongest influences on cost-effectiveness.Conclusions:The cost-effectiveness of the pharmacotherapies varied significantly across the six study countries, however, in each case, the results would be considered favourable as compared to other common preventive pharmacotherapies.
Smokeless tobacco use 1992–2002: trends and measurement in the Current Population Survey-Tobacco Use Supplements
Authors: Mumford E A , Levy D T , Gitchell J G , Blackman K O 
Published: May 2006

Background:As smoking prevalence declines in the United States, it is important to understand if smokeless tobacco (SLT) use is also changing and if so, among what groups.Methods:We examine the prevalence of SLT use and smoking, 1992–2002, using the Current Population Survey-Tobacco Use Supplements (CPS-TUS), which used US nationally representative samples based on stratified clusters of households.Results:Consistent with declines in smoking, the prevalence of current SLT use declined over the period 1992–2002 for males and females ages 18 and older. The overall separate declines in SLT use and in smoking are mirrored by a decline in concurrent use of SLT and cigarettes. SLT use is becoming more associated with white males, but use is declining faster among the youngest males.Conclusions:The findings indicate that relative reductions in smoking prevalence are exceeded by relative reductions in SLT use, with sizeable reductions in concurrent use. These results suggest that the stricter cigarette policies of recent years may not only reduce cigarette use, but also the use of alternative tobacco products. In light of potential policy implications of SLT use as a potential reduced exposure product (PREP), current survey methods require more careful measurement of SLT use in terms of initiation, duration, quantity, and cessation.
Adolescent smoking behaviour and cigarette brand preference in Japan
Authors: Osaki Y , Tanihata T , Ohida T , Minowa M , Wada K , Suzuki K , Kaetsu A , Okamoto M , Kishimoto T 
Published: May 2006

Objectives:As part of efforts to develop a smoking control strategy for Japanese adolescents, the results of two nationwide surveys on adolescent smoking behaviour were compared.Design:Descriptive study on smoking behaviour among high school students was conducted. Self-reporting anonymous questionnaires were administered to 115 814 students in 1996 and 106 297 in 2000 through randomly sampled junior and senior high schools throughout Japan.Main outcome measures:Smoking prevalence, proportion of smokers by usual sources of cigarettes, national estimated cigarettes consumed by minors, share of cigarette brands smoked by high school students.Results:The experiment rate among junior high school boys decreased in 2000 compared with that in 1996, whereas current and daily smoking rates did not. Although prevalence among Japanese girls was much lower than that among boys, prevalence among girls increased in 2000. The main source of cigarettes among high school smokers was vending machines. The proportion of smokers who usually purchased cigarettes from vending machines increased in 2000, in spite of the 1998 introduction of restrictions on night-time operations. Japanese adolescents were more likely than adults to smoke American cigarette brands, and the adolescent market share of American brands has increased rapidly, especially for menthol brands.Conclusions:This survey revealed the seriousness of the problem of smoking behaviour among Japanese high school students, and suggested that this behaviour may be influenced by social environmental factors, including the marketing strategies of the tobacco industry. Action should be taken to reduce the prevalence and impact of pro-tobacco marketing messages and to abolish cigarette vending machines.
The fraction of ischaemic heart disease and stroke attributable to smoking in the WHO Western Pacific and South-East Asian regions
Authors: Martiniuk A L C , Lee C M Y , Lam T H , Huxley R , Suh I , Jamrozik K , Gu D F , Woodward M 
Published: May 2006

Background:Tobacco will soon be the biggest cause of death worldwide, with the greatest burden being borne by low and middle-income countries where 8/10 smokers now live.Objective:This study aimed to quantify the direct burden of smoking for cardiovascular diseases (CVD) by calculating the population attributable fractions (PAF) for fatal ischaemic heart disease (IHD) and stroke (haemorrhagic and ischaemic) for all 38 countries in the World Health Organization Western Pacific and South East Asian regions.Design and subjects:Sex-specific prevalence of smoking was obtained from existing data. Estimates of the hazard ratio (HR) for IHD and stroke with smoking as an independent risk factor were obtained from the ∼600 000 adult subjects in the Asia Pacific Cohort Studies Collaboration (APCSC). HR estimates and prevalence were then used to calculate sex-specific PAF for IHD and stroke by country.Results:The prevalence of smoking in the 33 countries, for which relevant data could be obtained, ranged from 28–82% in males and from 1–65% in females. The fraction of IHD attributable to smoking ranged from 13–33% in males and from <1–28% in females. The percentage of haemorrhagic stroke attributable to smoking ranged from 4–12% in males and from <1–9% in females. Corresponding figures for ischaemic stroke were 11–27% in males and <1–22% in females.Conclusions:Up to 30% of some cardiovascular fatalities can be attributed to smoking. This is likely an underestimate of the current burden of smoking on CVD, given that the smoking epidemic has developed further since many of the studies were conducted.
Philip Morris’s Project Sunrise: weakening tobacco control by working with it: Table 1
Authors: McDaniel P A , Smith E A , Malone R E 
Published: May 2006

Objective:To analyse the implications of Philip Morris USA’s (PM’s) overtures toward tobacco control and other public health organisations, 1995–2006.Data sources:Internal PM documents made available through multi-state US attorneys general lawsuits and other cases, and newspaper sources.Methods:Documents were retrieved from several industry documents websites and analysed using a case study approach.Results:PM’s Project Sunrise, initiated in 1995 and proposed to continue through 2006, was a long-term plan to address tobacco industry delegitimisation and ensure the social acceptability of smoking and of the company itself. Project Sunrise laid out an explicit divide-and-conquer strategy against the tobacco control movement, proposing the establishment of relationships with PM-identified “moderate” tobacco control individuals and organisations and the marginalisation of others. PM planned to use “carefully orchestrated efforts” to exploit existing differences of opinion within tobacco control, weakening its opponents by working with them. PM also planned to thwart tobacco industry delegitimisation by repositioning itself as “responsible”. We present evidence that these plans were implemented.Conclusion:Sunrise exposes differences within the tobacco control movement that should be further discussed. The goal should not be consensus, but a better understanding of tensions within the movement. As the successes of the last 25 years embolden advocates to think beyond passage of the next clean indoor air policy or funding of the next cessation programme, movement philosophical differences may become more important. If tobacco control advocates are not ready to address them, Project Sunrise suggests that Philip Morris is ready to exploit them.
Eliminating child labour in Malawi: a British American Tobacco corporate responsibility project to sidestep tobacco labour exploitation
Authors: Otañez M G , Muggli M E , Hurt R D , Glantz S A 
Published: May 2006

Objectives:To examine British American Tobacco and other tobacco industry support of the Eliminating Child Labour in Tobacco Growing Foundation.Design:Analyses of internal tobacco industry documents and ethnographic data.Results:British American Tobacco co-founded the Eliminating Child Labour in Tobacco Growing Foundation (ECLT) in October 2000 and launched its pilot project in Malawi. ECLT’s initial projects were budgeted at US$2.3 million over four years. Labour unions and leaf dealers, through ECLT funds, have undertook modest efforts such as building schools, planting trees, and constructing shallow wells to address the use of child labour in tobacco farming. In stark contrast, the tobacco companies receive nearly US$40 million over four years in economic benefit through the use of unpaid child labour in Malawi during the same time. BAT’s efforts to combat child labour in Malawi through ECLT was developed to support the company’s “corporate social responsibility agenda” rather than accepting responsibility for taking meaningful steps to eradicate child labour in the Malawi tobacco sector.Conclusion:In Malawi, transnational tobacco companies are using child labour projects to enhance corporate reputations and distract public attention from how they profit from low wages and cheap tobacco.
The Tobacco Control Scale: a new scale to measure country activity
Authors: Joossens L , Raw M 
Published: May 2006

Objectives:To quantify the implementation of tobacco control policies at country level using a new Tobacco Control Scale and to report initial results using the scale.Method:A questionnaire sent to correspondents in 30 European countries, using a scoring system designed with the help of a panel of international tobacco control experts.Results:The 30 countries are ranked by their total score on the scale out of a maximum possible score of 100. Only four countries (Ireland, United Kingdom, Norway, Iceland) scored 70 or more, with an eight point gap (most differences in scores are small) to the fifth country, Malta, on 62. Only 13 countries scored above 50, 11 of them from the European Union (EU), and the second largest points gap occurs between Denmark on 45 and Portugal on 39, splitting the table into three groups: 70 and above, 45 to 62, 39 and below. Ireland had the highest overall score, 74 out of 100, and Luxembourg was bottom with 26 points. However even Ireland, much praised for their ban on smoking in public places, did not increase tobacco taxes in 2005, for the first time since 1995.Conclusions:Although the Tobacco Control Scale has limitations, this is the first time such a scale has been developed and applied to so many countries. We hope it will be useful in encouraging countries to strengthen currently weak areas of their tobacco control policy.