The Horizontal Myocutaneous Infrahyoid Island Flap for Soft-Tissue Head and Oral Reconstruction: Step-by-Step Video Description.

A clinical case is presented of a 70-year-old woman suffering from a right hemilingual epidermoid carcinoma. A step-by-step video description of the regional infrahyoid island flap is presented and narrated. Long-term results at 2 months in terms of aesthetics and function at the recipient and donor sites are excellent. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Evaluation of a direct mailing campaign to increase physician awareness and utilization of a quitline fax referral service.

Research has shown that fax referral services play an important role in linking people who are ready to quit tobacco use with effective cessation support provided through telephone-based quitlines. While many states have implemented fax referral services to assist health care providers in connecting their patients to quitlines, few published studies delineate optimum ways to promote this service to providers, particularly the role of direct mail educational campaigns. This is one of the first studies to evaluate the effectiveness of a small-scale educational and promotional campaign designed to increase health care providers' awareness and utilization of a state tobacco cessation quitline fax referral service. The campaign included a direct mailing to 6,197 health care providers in North Carolina. The mailing consisted of a large tube, in the shape of cigarette, with enclosed fax referral promotional materials. An 8-month follow-up survey was mailed to a 10% random sample of family physicians, pediatricians, dentists, and orthodontists who were sent the promotional tube mailing. Valid surveys were returned by 271 providers (response rate = 46%). Forty-four percent of respondents remembered receiving the tube mailing, and 40% reported familiarity with the fax referral service. While only 3.5% of respondents reported referring a patient to the quitline using the fax referral service in the previous 6 months, almost one-third reported an intention to use the fax referral service in the future. The pilot promotional campaign increased awareness of the fax referral service more than service utilization. While increased utilization of the service by health care providers appears promising, additional research is needed on how to maximize educational and promotional campaigns that influence clinician fax referral behaviors. The results of this study can help guide the development of future fax referral promotional campaigns to increase clinician access to and utilization of state quitlines.

Secondhand smoke policies at state and county fairs.

OBJECTIVES: We sought to assess the smoking policies at state and county fairs in North Carolina. METHODS: We contacted North Carolina fair managers by telephone to solicit participation in a survey that assessed the extent to which fairs have written policies about smoking and secondhand smoke (SHS) exposure, managers' beliefs concerning the health risks associated with SHS exposure, and specific reasons that might prompt managers to adopt smoke-free policies. RESULTS: Attempts were made to contact 47 fair managers, and 37 (66.0%) participated in the study. We found that although almost two-thirds of fairs prohibited smoking indoors, the vast majority (83.9%) had no limits on outdoor smoking. Most fair managers (84.6%) acknowledged that SHS may cause lung cancer, and a majority (51.6%) reported a belief that their patrons would largely be supportive of a more restrictive policy. LIMITATIONS: Fair managers' responses were primarily based on their own opinions, estimates, and attitudes. CONCLUSIONS: Because of the high number and density of fair patrons, unrestricted outdoor smoking likely exposes most patrons to SHS. Action to eliminate all exposure to SHS at state and county fairs is needed.

Business policies affecting secondhand smoke exposure.

BACKGROUND: Despite recent legislative and voluntary policy changes, a significant number of workplaces, recreational venues, and public facilities do not offer the public full protection from secondhand smoke exposure. The current study assessed smoking policies, attitudes toward smoke-free policies, and support for policy change among business owners and managers of businesses open to the public in North Carolina. METHODS: Business owners and managers were interviewed over the phone. Businesses included all airports, arcades, malls, bowling alleys, and arenas (seating more than 500) in the state as well as a random sample of grocery and convenience stores. RESULTS: A 100% smoke-free policy was reported in 53% of businesses, ranging from 12% in bowling alleys to 97% in arenas. A large majority of business owners and managers understand the health risks of secondhand smoke exposure (82%-89%) and support restrictions on smoking in their businesses (84%-91%). Barriers to voluntary policy change included the lack of legal requirement (39%) and fear of the loss of business (53%). LIMITATIONS: This study used self-report data from business owners and managers; the accuracy of the business smoking policy, customer and employee exposure time, and number of complaints may vary across respondents. It is also possible some participants were influenced by factors of social desirability of responses. CONCLUSIONS: Continued progress in establishing 100% smoke-free indoor environments may depend on successful advocacy in instituting legislation mandating the elimination of secondhand smoke in all public places. Advocacy efforts should include education around addressing economic concerns of businesses.