Ultrasound in sialadenitis.

The salivary glands are located superficially and are therefore easily accessible to ultrasound (US) examination, particularly if a high-frequency probe designed for small parts is used. Hence, US examination of these organs is widely applied particularly in non-neoplastic pathologies. In this way, it is possible to obtain adequate images without the use of ionizing radiation or complex instrumentation such as magnetic resonance imaging. However, US examination requires an expert clinical knowledge and familiarity with the normal and pathological US anatomy of the area. Limitations and pitfalls linked to US examination of this area should also be kept in mind.

Gynecomastia in two young men with histories of prolonged use of anabolic androgenic steroids.

The aim of this report is to highlight the risk of anabolic androgenic steroid-induced gynecomastia in young men involved in nonagonistic sports and the role of ultrasonography in its diagnosis. The authors describe two cases of gynecomastia in nonprofessional weight lifters with histories of AAS use. In both cases, the diagnosis was based on patient history and clinical findings, but the sonographic examination confirmed the clinical suspicion and excluded the presence of other types of disease associated with mammary-gland enlargement in men.

Analysis of a multicomponent smoking cessation project: what worked and why.

BACKGROUND: Health promotion interventions often contain several, conceptually diverse elements. As a result, it is often difficult to determine why interventions succeed or fail as well as which components should be retained or eliminated. One method to examine the effectiveness of individual intervention elements is process analysis. METHODS: Kick It! is a multicomponent smoking cessation intervention developed for lower socioeconomic African Americans. The intervention includes several components, including a 24-page printed cessation manual, a staged-cessation video, a quit contract, two "Quit and Win" contests, and a single telephone booster call. Using data from a randomized intervention trial designed to test the efficacy of the Kick It! intervention, this article examines the use, impact, and interaction of the intervention's subcomponents as well as possible mediating variables related to successful quitting among intervention participants (n = 650). RESULTS: In univariate as well as multivariate analyses adjusting for age and stage of change, two of the five elements, watching the video and entering a Quit and Win contest, were significantly associated with 6-month point prevalence abstinence. Submitting a quit contract and receiving the booster call were significantly associated with quitting in univariate analyses, while reading the Kick It! guide was not significantly associated with quitting in either analysis. CONCLUSIONS: Despite the positive effects observed for individual elements, quitting was not significantly greater among intervention relative to comparison subjects. The primary reason for this appears to be the overall lack of intervention use. Additional research examining strategies to increase use of the Kick It! intervention components as well as the optimal sequencing and combination of components may be warranted.

A self-help smoking cessation program for inner-city African Americans: results from the Harlem Health Connection Project.

The authors develop and test a culturally sensitive, low-intensity smoking cessation intervention for low-socioeconomic African Americans. African American adult smokers were randomly assigned to receive either a multicomponent smoking cessation intervention comprising a printed guide, a video, and a telephone booster call or health education materials not directly addressing tobacco use. The results of the study were mixed. Although no significant effects were observed for the entire treatment cohort, the results of post hoc analyses suggest that culturally sensitive self-help smoking cessation materials plus a single phone contact can produce short-term cessation rates similar to those reported for majority populations. This conclusion should be tempered by the low completion rate for the booster call and several design limitations of the study.

Health promotion technology transfer: organizational perspectives.

This paper explores the relationship between organizational dynamics and program dissemination. Specifically, it is an analysis of factors affecting the directed diffusion of health promotion innovations which target schools and worksites as delivery channels. Technology transfer is the construct which is used to capture this notion of directed diffusion. The term is defined for the purposes of the paper as all strategically planned efforts to promote, influence, or accelerate the natural diffusion or dissemination processes. The paper has three main objectives: first to identify the theoretical perspectives which have influenced my thinking in the area of health promotion technology transfer; second, to describe an organizing framework for the study of health promotion technology transfer; and third, to recommend directions for health promotion planning efforts in the future and the role that research might play in that process.

Physician- and nurse-assisted smoking cessation in Harlem.

This study was designed to increase smoking cessation rates, quit attempts, and cutting down among low-income African Americans using brief clinician advice in conjunction with socioculturally appropriate self-help smoking cessation/relapse prevention materials. Physicians and nurses were instructed in the National Cancer Institute's smoking intervention at inservice sessions. Smokers interviewed in a Harlem, New York clinic waiting room were recontacted 7 months later by telephone or mail (77% response). Residents receiving the intervention reported a 21% cessation rate at follow-up. An additional 27% decreased cigarette intake by at least 50%. Those reporting follow-up abstinence were significantly more likely to designate a quit date at baseline. They were also more likely to be men, employed, and have a nonsmoking partner. Smokers who decreased their cigarette intake significantly were older, employed, less nicotine-dependent (eg, delayed their wake-up cigarette), and more likely to use project materials. Physician advice had a significant impact both on patients' cutting down at least 50% and patients' watching the project video. Designation of a quit date and using project materials had a significant impact on making serious quit attempts. Results corroborate large sample, randomized, controlled trials with noninner-city physicians. We conclude that clinician smoking advice for every patient is warranted.

Cholesterol screening in a community health promotion program: epidemiologic results from a biracial population.

The prevalence and interrelationship of high blood cholesterol levels with other cardiovascular disease risk factors were studied in a biracial suburb of New York City. Participants in community-based screenings to determine blood cholesterol levels have been predominantly white women in older age groups, highly educated and nonsmokers. To reach a more representative segment of a local population and promote healthy lifestyle behaviors, cholesterol screenings were conducted within an ongoing health promotion program in Mount Vernon, NY. Plasma cholesterol levels were determined for 5,011 participants, including 2,308 whites and 1,778 blacks. Of the men, 29 percent had high cholesterol levels; among women, it was 27 percent. Of the men with high levels, half had levels greater than 200 milligrams per deciliter, as did 55 percent of the women. After statistical adjustments were made for age and other risk factors for high blood cholesterol, mean cholesterol levels were higher for whites than blacks. The level for white men was 204 milligrams per deciliter; for women, 212. For black men, the level was 199 milligrams per deciliter; for women, 208, P < .10. Hispanic men had levels of 199, P < .10. The levels for Hispanic women (203 milligrams per deciliter) were significantly lower than that of white women. Among whites who smoked more than 1 pack of cigarettes per day, mean cholesterol levels were 11 milligrams per deciliter higher than for those who never smoked or were light smokers (0, 1-20 cigarettes per day, P < .10). There were too few who smoked more than 1 pack to test this association adequately among blacks. The mean cholesterol levels for hypertensive black men were 10 milligrams per deciliter greater than for black men with normal blood pressure (P<.10).

Smoking cessation factors among African Americans and whites. COMMIT Research Group.

OBJECTIVES: This study was undertaken to explore smoking patterns and attitudes that influence smoking cessation and relapse among African Americans. METHODS: Baseline data from eight Community Intervention Trial for Smoking Cessation (COMMIT) sites were analyzed. RESULTS: Compared with Whites, African Americans who smoke less than 25 cigarettes per day were 1.6 times more likely to smoke within 10 minutes of awakening (a behavioral indicator of nicotine dependence), adjusting for education, age, and gender (OR = 1.2 for heavier smokers). African Americans reported a stronger desire to quit smoking and reported serious quit attempts in the past year. African Americans favored tobacco restrictions (they were 1.8 times more likely than Whites to view smoking as a serious community problem, 1.7 times more likely to favor restrictions on cigarette vending machines, and 2.1 times more likely to prohibit smoking in their car). African Americans were lighter/moderate, menthol smokers. CONCLUSIONS: African Americans find smoking socially unacceptable and are strongly motivated to quit, but their "wake-up" smoking may indicate high nicotine dependence, making abstinence difficult even for lighter smokers.

The relationship between cognitive maturity and information about health problems among school age children.

This study of urban, multi-ethnic children was undertaken to explore the relationships between age, cognitive developmental capability (termed 'cognitive maturity') and accuracy of information about health problems. A total of 299 children in the first, second and third grades from six public and one private school in New York City were individually interviewed using an open-ended set of questions. Findings indicated that having accurate health information is not the same as comprehending the abstract internal nature of the 'facts'. Results supported Piaget's levels of cognitive development applied to the area of health. Findings also showed that age is a better predictor of children's accuracy about health information than their cognitive maturity. The findings underscore the need for those providing health education to place emphasis on the cognitive abilities of children and not to mistake recitation of factual information for understanding of conceptual elements of a health problem.

Prediction of smoking behavior in Japanese young adults.

Eighty-eight second grade students of a senior high school in Saitama prefecture in Japan participated in a prospective study to predict cigarette smoking behavior 3.5 years later. Predictor variables include sex, knowledge, beliefs and attitudes toward smoking, previous smoking behavior, and smoking behavior of their families. Stepwise discriminant analyses revealed that 90% of the smokers and 65% of the non-smokers were correctly classified. In this model, previous smoking behavior proved to be the best predictor. Attitude toward adult male's smoking, sex and smoking behavior of subjects' families were also related. These four variables explained 35% of the variance in smoking behavior. As for stepwise discriminant analyses among those who had not smoked at baseline, 78% of the smokers and 76% of the non-smokers were correctly classified. Attitude toward adult male's smoking, sex, knowledge about long-term effects of cigarette smoking and smoking behavior of their families entered the model in this order. These four variables explained 37% of the variance. Implications of this study for smoking prevention programs in Japan are discussed.

Feasibility of interactive videodisc technology to teach minority youth about preventing HIV infection.

Hispanic and African American adolescents are more likely than white Anglo youth to harbor misconceptions about acquired immunodeficiency syndrome (AIDS) and are also more likely to engage in intravenous drug use and sexual intercourse. This paper describes the development of an AIDS prevention curriculum that uses an interactive videodisc program to teach skills for interventions. Focus group and expert panel studies yielded suggests for intervention vignettes and scenes relevant to Hispanic and African American adolescents. The authors then developed and produced a sample curriculum, specifically designed for Hispanic youth. Content was designed to build knowledge, attitudes, and skills in handling situations where young persons are at risk for human immunodeficiency virus (HIV) infection. The feasibility of the finished pilot product was tested with adolescents and with professionals who serve ethnic and racial minority youth. Adults and Hispanic adolescent viewers rated the videodisc as enjoyable, interesting, and likely to achieve positive effects with the intended target population. Findings suggest that the interactive videodisc is a useful way to interest and help Hispanic adolescents learn ways of reducing their risk of contracting and spreading HIV infection through lifestyle practices. This developmental research in the use of interactive videodisc also provides a basis for further investigation.

Sexual behavior, attitudes toward safer sex, and gender among a cohort of 244 recovering i.v. drug users.

Heterosexual contact with drug users is a major route of AIDS transmission. This study of 135 male and 109 female methadone maintenance patients described subjects' sexual behavior, preventive practices and attitudes toward safer sex; explored ethnic-racial differences in high risk sexual behavior and attitudes; and examined the relationship between attitudes toward safer sex and frequency of condom use for men and women. Reported condom use was low, and it correlated with attitudes toward safer sex. Men tended to report higher rates of sexual risk-taking, although women reported more frequent sex with IV drug users. Study findings have implications for developing intervention strategies to reduce risk behavior associated with HIV transmission.

Computer-assisted strategies for substance abuse prevention: opportunities and barriers.

This article presents an analysis of the potential role that computer-assisted strategies could play in substance abuse prevention efforts in the future. Four primary areas are addressed. First, substance abuse prevention is discussed within the context of adolescent development. Second, computer-assisted instruction (CAI) is defined in terms of the opportunities it represents for substance abuse prevention. Third, a variety of barriers are described that must be addressed if the potential of CAI for enhancing substance abuse prevention efforts is ever to be realized. Finally, recommendations are made for coordinating research and development efforts, now and in the future, so that the potential of new technology for improving substance abuse prevention efforts will be adequately evaluated.