Effect of maternal weight status on the relationship between prenatal smoking and infant birth weight

The purpose of this study was to assess the effect of maternal pre-pregnancy weight status on the relationship between prenatal smoking and infant birth weight (IBW). Prenatal cigarette smoking and maternal weight exert opposing effects on IBW; smoking decreases birth weight while maternal pre-pregnancy weight is positively correlated with birth weight. As such, mutual effect modification may be sufficiently significant to alter the independent effects of these two birth weight correlates. Finding of such an effect has implications of prenatal smoking cessation education. Perception of risk is an important determinant of smoking cessation, and reduced or low birth weight (LBW) as a smoking-associated risk predominates prenatal smoking counseling and education. In a population such as the US, where obesity is becoming epidemic, particularly among minority and low-income groups, perception of risk may be lowered should increased maternal size attenuate the effect of smoking. Previous studies have not found a significant interaction effect of prenatal smoking and maternal pre-pregnancy weight on IBW; however, use of self-reported smoking status may have biased findings. Reliability of self-reported smoking status reported in the literature is variable, with deception rates ranging from a low of 5% to as high as 16%. This study, using data from a prenatal smoking cessation project, in which smoking status was validated by saliva cotinine, was an opportunity to assess effect modification of smoking and maternal weight using biochemically determined smoking status in lieu of self report. Stratified by saliva cotinine, 151 women from a prenatal smoking cessation cohort, who were 18 years and older and had full-term, singleton births, were included in this study. The effect of smoking in terms of mean birth weight across three levels of maternal pre-pregnancy weight was assessed by general linear modeling procedures, adjusting for other known correlates of IBW. Effect modification was marginally significant, p = .104, but only with control for differential effects among racial/ethnic groups. A smaller than planned sample of nonsmokers, or women who quit smoking during the pregnancy, prohibited rejection of the null hypothesis of no difference in the effect of smoking across levels of pre-pregnancy weight. ^

Effects of health disparities on Helicobacter pylori infection among children on the US-Mexico border

The objective of this study is to determine whether health disparities influence the odds of developing H. pylori infections among the children enrolled in the Pasitos Cohort Study on the US-Mexico border. The study variables were the number of prenatal care visits, ways of transportation, car in household, location of health services and insurance coverage. The study recruited eligible pregnant women to complete baseline questionnaires. Every six months after the birth of the child, infection status is measure by the 13-C urea breath test. Results indicate that having medical insurance consistently decreases the odds of being infected. Children with mothers who went to a private physician had decreased odds of infection compared to those utilizing public clinics, and having a car in the household increased the odds of infection. Limitations include bias due to loss to follow-up and the transient nature of the infection.^

Impact of real time polymerase chain reaction technology on the therapeutic approach to treatment of staphylococcal infections

Can the early identification of the species of staphylococcus responsible for infection by the use of Real Time PCR technology influence the approach to the treatment of these infections? ^ This study was a retrospective cohort study in which two groups of patients were compared. The first group, ‘Physician Aware’ consisted of patients in whom physicians were informed of specific staphylococcal species and antibiotic sensitivity (using RT-PCR) at the time of notification of the gram stain. The second group, ‘Physician Unaware’ consisted of patients in whom treating physicians received the same information 24–72 hours later as a result of blood culture and antibiotic sensitivity determination. ^ The approach to treatment was compared between ‘Physician Aware’ and ‘Physician Unaware’ groups for three different microbiological diagnoses—namely MRSA, MSSA and no-SA (or coagulase negative Staphylococcus). ^ For a diagnosis of MRSA, the mean time interval to the initiation of Vancomycin therapy was 1.08 hours in the ‘Physician Aware’ group as compared to 5.84 hours in the ‘Physician Unaware’ group (p=0.34). ^ For a diagnosis of MSSA, the mean time interval to the initiation of specific anti-MSSA therapy with Nafcillin was 5.18 hours in the ‘Physician Aware’ group as compared to 49.8 hours in the ‘Physician Unaware’ group (p=0.007). Also, for the same diagnosis, the mean duration of empiric therapy in the ‘Physician Aware’ group was 19.68 hours as compared to 80.75 hours in the ‘Physician Unaware’ group (p=0.003) ^ For a diagnosis of no-SA or coagulase negative staphylococcus, the mean duration of empiric therapy was 35.65 hours in the ‘Physician Aware’ group as compared to 44.38 hours in the ‘Physician Unaware’ group (p=0.07). However, when treatment was considered a categorical variable and after exclusion of all cases where anti-MRS therapy was used for unrelated conditions, only 20 of 72 cases in the ‘Physician Aware’ group received treatment as compared to 48 of 106 cases in the ‘Physician Unaware’ group. ^ Conclusions. Earlier diagnosis of MRSA may not alter final treatment outcomes. However, earlier identification may lead to the earlier institution of measures to limit the spread of infection. The early diagnosis of MSSA infection, does lead to treatment with specific antibiotic therapy at an earlier stage of treatment. Also, the duration of empiric therapy is greatly reduced by early diagnosis. The early diagnosis of coagulase negative staphylococcal infection leads to a lower rate of unnecessary treatment for these infections as they are commonly considered contaminants. ^

Perceived risk and outcome expectancy on the practice of home infusion technique in a hemophilia population

This study described home infusion techniques and practices, measured the perceived risk of HIV and hepatitis transmission to self and others, and measured the outcome expectancy of following risk reduction guidelines for 90 hemophilia patients and/or their infusion assistants. It also assessed general knowledge of HIV and hepatitis information for the same population.^ The study subjects were hemophilia patients or their infusion assistants from the Gulf States Hemophilia Center in Houston, the El Paso Satellite Hemophilia Clinic in El Paso, or Texas members of the Women Outreach Network of the National Hemophilia Foundation (WONN) group. Each subject was interviewed either by telephone or in person. The questionnaire used was developed for the study and consisted of 60 items. These items assessed general demographics for the patients and assistants, including questions about their training to do infusions as well as the actual practices, measured perceived personal risk for the transmission of HIV or hepatitis to the assistants, perceived risk of transmission of HIV or hepatitis to others for assistants and self-infusers, and the outcome expectancy for following recommended risk reduction guidelines also for both groups.^ The theoretical framework used assumed that perceived risk and outcome expectancy would be predictive of behavior. The findings did not support this theory. Instead, the findings suggest that infusion behavior is habitual in nature; most respondents perform exactly the same behavior for every infusion. Since none of the variables selected were predictive of the compliance behavior for home infusion the teaching method should be directed towards mastery learning, or learning that will incorporate the correct behavior into a habitual pattern of home infusion. ^

AN ANALYSIS OF THE RELATIVE INFLUENCE OF RACE, INCOME, EDUCATION, AND FOOD STAMP PROGRAM PARTICIPATION/NONPARTICIPATION ON THE FOOD AND NUTRIENT CONSUMPTION OF A NORTH FLORIDA URBAN CLINIC POPULATION IN CONJUNCTION WITH A SURVEY OF NUTRITION RELATED HABITS AND ATTITUDES

The relative influence of race, income, education, and Food Stamp Program participation/nonparticipation on the food and nutrient intake of 102 fecund women ages 18-45 years in a Florida urban clinic population was assessed using the technique of multiple regression analysis. Study subgroups were defined by race and Food Stamp Program participation status. Education was found to have the greatest influence on food and nutrient intake. Race was the next most influential factor followed in order by Food Stamp Program participation and income. The combined effect of the four independent variables explained no more than 19 percent of the variance for any of the food and nutrient intake variables. This would indicate that a more complex model of influences is needed if variations in food and nutrient intake are to be fully explained.^ A socioeconomic questionnaire was administered to investigate other factors of influence. The influence of the mother, frequency and type of restaurant dining, and perceptions of food intake and weight were found to be factors deserving further study.^ Dietary data were collected using the 24-hour recall and food frequency checklist. Descriptive dietary findings indicated that iron and calcium were nutrients where adequacy was of concern for all study subgroups. White Food Stamp Program participants had the greatest number of mean nutrient intake values falling below the 1980 Recommended Dietary Allowances (RDAs). When Food Stamp Program participants were contrasted to nonparticipants, mean intakes of six nutrients (kilocalories, calcium, iron, vitamin A, thiamin, and riboflavin) were below the 1980 RDA compared to five mean nutrient intakes (kilocalories, calcium, iron, thiamin and riboflavin) for the nonparticipants. Use of the Index of Nutritional Quality (INQ), however, revealed that the quality of the diet of Food Stamp Program participants per 1000 kilocalories was adequate with exception of calcium and iron. Intakes of these nutrients were also not adequate on a 1000 kilocalorie basis for the nonparticipant group. When mean nutrient intakes of the groups were compared using Student's t-test oleicacid intake was the only significant difference found. Being a nonparticipant in the Food Stamp Program was found to be associated with more frequent consumption of cookies, sweet rolls, doughnuts, and honey. The findings of this study contradict the negative image of the Food Stamp Program participant and emphasize the importance of education. ^

HEAD OF HOUSEHOLD STRUCTURE: ITS INFLUENCE ON THE DIETARY QUALITY OF U.S. HOUSEHOLDS, 1977-78 (UNITED STATES, NATIONWIDE FOOD CONSUMPTION SURVEY)

Using analysis of variance, household data collected in the Spring portion of the 1977-78 Nationwide Food Consumption Survey conducted by the United States Department of Agriculture were analyzed to examine the relationship between household characteristics and dietary quality of the household food supply. Results indicated that head of household structure was a statistically significant variable, with female headed households having higher dietary quality.^ Further analysis indicated that neither race, degree of urbanization, regional location, the education level of the female head, nor her employment status were significant variables in influencing dietary quality. The influence of head of household structure remained significant when these variables were controlled. However, income, household size, and family life cycle stage had statistically significant effects on dietary quality, and when individually controlled, the influence of head of household structure disappeared. ^

The risk prediction for SPM and its impact on the survival in patients with head and neck squamous cell carcinoma

Head and Neck Squamous Cell Carcinoma (HNSCC) is the sixth common malignancy in the world, with high rates of developing second primary malignancy (SPM) and moderately low survival rates. This disease has become an enormous challenge in the cancer research and treatments. For HNSCC patients, a highly significant cause of post-treatment mortality and morbidity is the development of SPM. Hence, assessment of predicting the risk for the development of SPM would be very helpful for patients, clinicians and policy makers to estimate the survival of patients with HNSCC. In this study, we built a prognostic model to predict the risk of developing SPM in patients with newly diagnosed HNSCC. The dataset used in this research was obtained from The University of Texas MD Anderson Cancer Center. For the first aim, we used stepwise logistic regression to identify the prognostic factors for the development of SPM. Our final model contained cancer site and overall cancer stage as our risk factors for SPM. The Hosmer-Lemeshow test (p-value= 0.15>0.05) showed the final prognostic model fit the data well. The area under the ROC curve was 0.72 that suggested the discrimination ability of our model was acceptable. The internal validation confirmed the prognostic model was a good fit and the final prognostic model would not over optimistically predict the risk of SPM. This model needs external validation by using large data sample size before it can be generalized to predict SPM risk for other HNSCC patients. For the second aim, we utilized a multistate survival analysis approach to estimate the probability of death for HNSCC patients taking into consideration of the possibility of SPM. Patients without SPM were associated with longer survival. These findings suggest that the development of SPM could be a predictor of survival rates among the patients with HNSCC.^

Social integration, health behaviors and health status among Mexican-American women in the *southwestern United States

Using the Hispanic Health and Nutrition Examination Survey (HHANES), this research examined several health behaviors and the health status of Mexican American women. This study focused on determining the relative impact of social contextual factors: age, socioeconomic status, quality of life indicators, and urban/rural residence on (a) health behaviors (smoking, obesity and alcohol use) and (b) health status (physician's assessment of health status, subject's assessment of health status and blood pressure levels). In addition, social integration was analyzed. The social integration indicators relate to an individual's degree of integration within his/her social group: marital status, level of acculturation (a continuum of traditional Mexican ways to dominant U.S. cultural ways), status congruency, and employment status. Lastly, the social contextual factors and social integration indicators were examined to identify those factors that contribute most to understanding health behaviors and health status among Mexican American women.^ The study found that the social contextual factors and social integration indicators proved to be important concepts in understanding the health behaviors. Social integration, however, did not predict health status except in the case of the subject's assessment of health status. Age and obesity were the strongest predictors of blood pressure. The social contextual factors and obesity were significant predictors of the physician's assessment of health status while acculturation, education, alcohol use and obesity were significant predictors of the subject's assessment of health status. ^

Quaternary oxygen isotope record of planktonic foraminifera from ODP Site 805 on the Ontong Java Plateau

The oxygen isotope records of G. sacculifer and Pulleniatina in the uppermost three cores at Ocean Drilling Program Hole 805C span the last 1.6 m.y., an estimate based on Fourier stratigraphy. The last 700,000 yr are dominated by both eccentricity and obliquity-related orbital fluctuations. The range of variation of delta18O values is about 1.5?, of which ca. 75% may be assigned to global ice-volume effect. The remainder of the range is shared by the effects of surface temperature variation, thermocline depth change (in the case of Pulleniatina, especially), and differential dissolution. Before 1 Ma, obliquity-related fluctuations dominate. The transition between obliquity- and eccentricity-dominated time occurs between ca. 1 and 0.7 Ma. It is marked by irregularities in phase relationships, the source of which is not clear. The age of the Brunhes/Matuyama boundary is determined as 794,000 yr by obliquity counting. However, an age of 830,000 yr also is compatible with the counts of both eccentricity and obliquity cycles. In the first case, Stage 19 (which contains the boundary) is coincident with the crest of the 19th obliquity cycle, setting the first crest downcore equal to zero, and counting backward (o19). In the second, Stage 19 coincides with o20. No evidence was found for fluctuations related to precession (23 and 19 k.y.) rising above the noise level, using plain Fourier expansion on the age model of the entire series. Detailed stratigraphic comparison with the Quaternary record of Hole 806B allows the recognition of major dissolution events (which increase the difference in delta18O values of G. sacculifer at the two sites). These occur at Stages 11-13, 16-17, and near 1.5 Ma (below o33).

Tab. 2: Grain-sizes of cobble on the surface of sanderwurzel

yResults of 13 field investigations between 1966 and 1990 of the southwestern to eastern margin of Kötlujökull and its proglacial area are summarized with respect to sandar and their formation. Generally, the results are based on sedimentological examinations in the field and laboratory, on analyses of aerial photographs, and investigations of the glacier slope. The methods permitted a more detailed reconstruction of sandar evolution in the proglacial area of Kötlujökull since 1945, of tendencies in development and of single data going back until the last decades of the 19th century. Accordingly, there existed special periods of "flachsander"-formations with raised coarsegrained "sanderwurzels" resultant from the outbreak of subglacial meltwater tunneloutlets and other periods with "hochsander-"formations by supraglacial drainage. At present the belts of hochsanders in front of the glacier come up to more than 4 m in thickness and 1000 m in width, therefore containing perhaps more sediment direct in front of Kötlujökull than the old belts of flachsanderwurzels. In one case the explosion-like subglacial meltwater outburst combined with the genesis of a sanderwurzel could be observed for a time and is thoroughly discussed. The event is referred to the outburst of a sub- to inglacial meltwater body being under extreme hydrostatic press ures which is combined with the genesis of a new subglacial tunneloutlet as a new flachsander. Often these outbursts led to the destruction of a morainic belt more than 1000 m in width. Presumably the whole event was finished in not more than a few days. In addition to a characteristic pear-shaped form and water-moved stones up to diameters of 1 m the wurzels possess a single "main-channel" with rectangular cross-sections as far as 4 m deep and 50 m wide just as small flat channels resembling fish bones in connection with the main channel. Presumably, they have been active only in the last stage of wurzel formation. With regard to the subglacial tunnel gates long-living L-meltwater outlets are distinguished from short-living K-meltwater outlets. These are always combined with a raised coarse-grained sanderwurzel, but its meltwater discharge is generally decreasing and ceases after some years, whereas the discharge of L-meltwater outlets continues unchanged for long times (except seasonal differences). The material of flachsanders is preponderantly composed of mugearitic and andesitic cobble extending at least for some kilometres from the glacier margin, whereas the hochsanders correspond to medium to coarse sands without clay and without alternations into the direction of flow. The hochsander fans are covered with small braidet channels. Their sedimentary structures are determined by the short time changing of supraglacial meltwater discharge and the upper flow regime combined with the development of antidunes, which rule the channel-flows during the main activity periods in summer. Unlike the subglacial drainage the supraglacial drainage led to only weak effects of erosion on the glacier foreland. So the hochsanders refilled depressions of morainic areas or grew up on older flachsanderwurzels. Whereas all large flachsanders developed in front of approximate stationary glacier margins, the evolution of coherent belts of hochsanders were combined with progressive glacier fronts. On the other hand, there was obviously no evolution at all of large sandar in front of back-melting margins of Kötlujökull. Based on examinations of the glacier surface and on analyses of aerial photographs the different types of sandar are referred to different structures of the glacier snout. Finally chances of surviving of sandar in the proglacial area of Kötlujökull are shortly discussed just as the possibility of an application of the Islandic research results on Pleistocene sandar in northern Germany.

Vocational and occupational counsseling: a strategy of preventive intervention directed to Young men and women from the interior of the province of Buenos Aires

This work belongs to one of the activities that are carried out in the Vocational and Occupational Guidance Center (V.O.G.C.) of the Faculty of Humanities and Educational Sciences at the L.P.N.U. In the year 1994 the Vocational/Occupational Guidance Programme for Municipalities was created, destined for work with adolescents who are attending their last year at secondary schools in the interior of the Province of Buenos Aires . The Programme aims at fostering the development of spaces for reflection related to the educational/working projects of the adolescents who are close to entering university. The proposal is based on the methodology of work groups, in the journeys preoccupations are sheared, the worries and fears experienced by the students are shared with their hosts, possibilities are used as ground for construction, dealing both with aspects of their current situation and their future possibilities. From the analysis of the group productions collected throughout these years, we have developed a student's profile that - although it resembles the one obtained from local adolescents- adds new questions and points of view, thus increasing the complexity of the balance of forces related to the question of having to make a choice.

Vocational and occupational counsseling: a strategy of preventive intervention directed to Young men and women from the interior of the province of Buenos Aires

This work belongs to one of the activities that are carried out in the Vocational and Occupational Guidance Center (V.O.G.C.) of the Faculty of Humanities and Educational Sciences at the L.P.N.U. In the year 1994 the Vocational/Occupational Guidance Programme for Municipalities was created, destined for work with adolescents who are attending their last year at secondary schools in the interior of the Province of Buenos Aires . The Programme aims at fostering the development of spaces for reflection related to the educational/working projects of the adolescents who are close to entering university. The proposal is based on the methodology of work groups, in the journeys preoccupations are sheared, the worries and fears experienced by the students are shared with their hosts, possibilities are used as ground for construction, dealing both with aspects of their current situation and their future possibilities. From the analysis of the group productions collected throughout these years, we have developed a student's profile that - although it resembles the one obtained from local adolescents- adds new questions and points of view, thus increasing the complexity of the balance of forces related to the question of having to make a choice.

Vocational and occupational counsseling: a strategy of preventive intervention directed to Young men and women from the interior of the province of Buenos Aires

This work belongs to one of the activities that are carried out in the Vocational and Occupational Guidance Center (V.O.G.C.) of the Faculty of Humanities and Educational Sciences at the L.P.N.U. In the year 1994 the Vocational/Occupational Guidance Programme for Municipalities was created, destined for work with adolescents who are attending their last year at secondary schools in the interior of the Province of Buenos Aires . The Programme aims at fostering the development of spaces for reflection related to the educational/working projects of the adolescents who are close to entering university. The proposal is based on the methodology of work groups, in the journeys preoccupations are sheared, the worries and fears experienced by the students are shared with their hosts, possibilities are used as ground for construction, dealing both with aspects of their current situation and their future possibilities. From the analysis of the group productions collected throughout these years, we have developed a student's profile that - although it resembles the one obtained from local adolescents- adds new questions and points of view, thus increasing the complexity of the balance of forces related to the question of having to make a choice.

X-ray fluorescence scanning of discrete samples on the Schwalbenberg II loess-paleosol sequence, raw data, magnetic susceptibility, organic carbon and U-ratio as grainsize index

The Schwalbenberg II loess-paleosol sequence (LPS) denotes a key site for Marine Isotope Stage (MIS 3) in Western Europe owing to eight succeeding cambisols, which primarily constitute the Ahrgau Subformation. Therefore, this LPS qualifies as a test candidate for the potential of temporal high-resolution geochemical data obtained X-ray fluorescence (XRF) scanning of discrete samplesproviding a fast and non-destructive tool for determining the element composition. The geochemical data is first contextualized to existing proxy data such as magnetic susceptibility (MS) and organic carbon (Corg) and then aggregated to element log ratios characteristic for weathering intensity [LOG (Ca/Sr), LOG (Rb/Sr), LOG (Ba/Sr), LOG (Rb/K)] and dust provenance [LOG (Ti/Zr), LOG (Ti/Al), LOG (Si/Al)]. Generally, an interpretation of rock magnetic particles is challenged in western Europe, where not only magnetic enhancement but also depletion plays a role. Our data indicates leaching and top-soil erosion induced MS depletion at the Schwalbenberg II LPS. Besides weathering, LOG (Ca/Sr) is susceptible for secondary calcification. Thus, also LOG (Rb/Sr) and LOG (Ba/Sr) are shown to be influenced by calcification dynamics. Consequently, LOG (Rb/K) seems to be the most suitable weathering index identifying the Sinzig Soils S1 and S2 as the most pronounced paleosols for this site. Sinzig Soil S3 is enclosed by gelic gleysols and in contrast to S1 and S2 only initially weathered pointing to colder climate conditions. Also the Remagen Soils are characterized by subtle to moderate positive excursions in the weathering indices. Comparing the Schwalbenberg II LPS with the nearby Eifel Lake Sediment Archive (ELSA) and other more distant German, Austrian and Czech LPS while discussing time and climate as limiting factors for pedogenesis, we suggest that the lithologically determined paleosols are in-situ soil formations. The provenance indices document a Zr-enrichment at the transition from the Ahrgau to the Hesbaye Subformation. This is explained by a conceptual model incorporating multiple sediment recycling and sorting effects in eolian and fluvial domains.

Geochemistry of Albian to Santonian black shale sequences on the Demerara Rise, South American margin

Ocean Drilling Program Leg 207 recovered thick sequences of Albian to Santonian organic-carbon-rich claystones at five drill-sites on the Demerara Rise in the western equatorial Atlantic Ocean. Dark-colored, finely laminated, Cenomanian-Santonian black shale sequences contain between 2% and 15% organic carbon and encompass Oceanic Anoxic Events 2 and 3. High Rock-Eval hydrogen indices signify that the bulk of the organic matter in these sequences is marine in origin. However, d13Corg values lie mostly between -30 per mil and -27 per mil, and TOC/TN ratios range from 15 to 42, which both mimic the source signatures of modern C3 land plants. The contradictions in organic matter source indicators provide important implications about the depositional conditions leading to the black shale accumulations. The low d13Corg values, which are actually common in mid-Cretaceous marine organic matter, are consequences of the greenhouse climate prevailing at that time and an associated accelerated hydrologic cycle. The elevated C/N ratios, which are also typical of black shales, indicate depressed organic matter degradation associated with low-oxygen conditions in the water column that favored preservation of carbon-rich forms of marine organic matter over nitrogen-rich components. Underlying the laminated Cenomanian-Santonian sequences are homogeneous, dark-colored, lower to middle Albian siltstones that contain between 0.2% and 9% organic carbon. The organic matter in these rocks is mostly marine in origin, but it occasionally includes large proportions of land-derived material.