Second-hand smoke and indoor air quality in public places in Gaza City.

Second-hand smoke is a major cause of preventable disease and death in the Eastern Mediterranean Region. To assess how second-hand smoke impacts air quality, respirable suspended particles (PM2.5) which are emitted during cigarette and waterpipe smoking, were measured inside and outside of 18 smoking and 5 nonsmoking public venues in Gaza city. Median PM2.5 level inside the smoking venues was 117 microg/m3, which exceeds the WHO guidelines for daily PM2.5 exposure (25 microg/m3) by more than 4-fold. The median level inside the smoking venues (117 microg/m3) was significantly higher than outside the venues (43 microg/m3), and significantly higher than the median level inside non-smoking venues (40 microg/m3). By contrast particulate levels outside non-smoking venues (35 microg/m3) did not differ from the corresponding levels inside (40 microg/m3). To protect employees and the public from second-hand smoke exposure, policies prohibiting sinoking in public niaces are needed in Gaza city.

Second-hand smoke and indoor air quality in public places in Gaza city

Second-hand smoke is a major cause of preventable disease and death in the Eastern Mediterranean Region. To assess how second-hand smoke impacts air quality, respirable suspended particles [PM[2.5]], which are emitted during cigarette and waterpipe smoking, were measured inside and outside of 18 smoking and 5 nonsmoking public venues in Gaza city. Median PM[2.5] level inside the smoking venues was 117 microg/m[3], which exceeds the WHO guidelines for daily PM[2.5] exposure [25 microg/m[3]] by more than 4-fold. The median level inside the smoking venues [117 microg/m[3]] was significantly higher than outside the venues [43 microg/m[3]], and significantly higher than the median level inside non-smoking venues [40 microg/m[3]]. By contrast, particulate levels outside non-smoking venues [35 microg/m[3]] did not differ from the corresponding levels inside [40 microg/m[3]]. To protect employees and the public from second-hand smoke exposure, policies prohibiting smoking in public places are needed in Gaza city

Effect of the New York State cigarette fire safety standard on ignition propensity, smoke constituents, and the consumer market.

OBJECTIVES: This study examines empirical evidence from the New York experience testing tobacco industry arguments made in opposition to fire safety standards for cigarettes. DESIGN: Percentages of cigarettes exhibiting full length burns (FLBs), cigarette sales before and following the implementation of the New York standards, a sample of retail cigarette prices, brand availability, and selected smoke constituent yields were compared between cigarettes sold in New York and two other states. Cigarette paper analysis was conducted on cigarettes sold in New York. RESULTS: New York cigarette brands averaged 10.0% FLBs as compared to 99.8% for California and Massachusetts brands. Reduced ignition propensity (RIP) appears to have been achieved by cigarette paper banding. Cigarette sales, prices, and brand availability do not appear to have been affected by the New York standards. Yields of the majority of smoke constituents tested did not differ substantially between RIP cigarettes sold in New York as compared to the same brands sold in Massachusetts. Average yields of tar, carbon monoxide, and two compounds were slightly higher, the yields of seven compounds were higher for one brand only, and nicotine was lower, among New York brands tested. CONCLUSIONS: RIP cigarette brands have been designed to meet the New York fire safety standards. Their introduction has not affected cigarette sales or prices in New York. There is no evidence that the small increases in smoke constituent yields affect the already highly toxic nature of cigarette smoke. Data on smoking caused fires, deaths, and injuries dating from after the change in law are not yet available. Such data will be able to address the question of whether the demonstrated reduced ignition standards are associated with reduced fires and injuries. Based on the New York experience, prior industry objections to producing RIP cigarettes are unfounded. Other states and nations should adopt similar standards.

Risk factors for HIV infection among sex workers in Johannesburg, South Africa.

Our objective was to determine the prevalence and risk factors for HIV infection among female sex workers in Johannesburg, South Africa. A cross-sectional survey of female sex workers was conducted using interviewer-administered questionnaires. Prevalent sexually transmitted infections including HIV were evaluated through standard laboratory testing. HIV infection was identified in 137 (46.4%) of 295 subjects tested. Increasing frequency of condom use was significantly negatively associated with HIV infection (odds ratio [OR] for moderate use = 0.21; 95% confidence interval [CI]: [0.09, 0.50]; OR for high use = 0.14; 95% CI: [0.06, 0.34]). Sex workers aged > or = 29 years reported significantly different patterns of behaviour than younger workers. Among women aged > or = 29, a negative association with HIV infection (OR = 0.16; 95% CI: [0.07, 0.38]) was found, but only among those not infected with Neisseria gonorrhoeae. Older women in the Johannesburg sex industry may have adaptive behavioural strategies besides condom usage which reduce their risk of acquiring HIV. However, older sex workers with gonorrhoea constitute a high-risk subgroup.

Association of alcohol consumption with HIV sex- and drug-risk behaviors among drug users.

The relationship between alcohol use and HIV transmission is well recognized but not fully understood. In particular, the role of alcohol abuse as a mediator of HIV risk behavior among drug users is not well documented. We hypothesized that alcohol use in drug users will result in greater HIV risk-taking behavior. Participants were 354 drug users, of whom 105 were recent injection drug users. Multiple regression models were used to characterize whether measures of sexual and injection drug use HIV risk behavior were related to alcohol consumption, controlling for other potentially associated factors. We found that sexual HIV risk-taking behavior is associated with increased alcohol consumption among women (p = 0.02), with women having more risky sexual behavior than males. However, contrary to our hypothesis, there was no significant association of alcohol consumption with risky injection drug behavior. Addressing alcohol problems among drug users, particularly women, may be an important opportunity to reduce HIV sexual risk behavior among this high-risk population.

Acceptability of the female condom in different groups of women in South Africa--a multicentred study to inform the national female condom introductory strategy.

OBJECTIVES: To assess the acceptability of the female condom to different groups of women and their partners in South Africa. DESIGN: Descriptive, cross-sectional study. SETTING: Multicentre study conducted in five sites. SUBJECTS: The study recruited 678 women from five centres to an acceptability trial of the female condom. Acceptability and successful use varied between the centres. OUTCOME MEASURES: Factors affecting successful use and willingness and intention to use the method again. RESULTS: In total, 209 women used the condom at least once. Discontinuation rates were high, with partner reluctance to try the method as the main reason given for discontinuation at all sites. Women who had previous experience with the male condom or who received a more intensive training session generally found the device easier to use. The main issues concerning women were over-lubrication (27%) and concern that the device was too large (28%). The majority of women said that they would be interested in using the method again (86%) and would recommend it to friends (95%). CONCLUSIONS: Overcoming partner opposition is an important issue to address when introducing the method. The study was used to address the national introductory strategy of the female condom, which began in 1998.

Clinical profile of participants in a brief intervention program for cannabis use disorder.

The increasing demand for cannabis dependence treatment has led to the identification of significant gaps in the knowledge of effective interventions. A randomized controlled trial of brief cognitive-behavioral interventions (CBT) for cannabis dependence was undertaken to address this issue. A total of 229 participants were assessed and allocated to either a 6-session CBT program, a single-session brief intervention, or a delayed-treatment control group. This paper demonstrates that individuals with cannabis use disorder will present for a brief intervention program. While they report similar patterns of cannabis use to nontreatment samples, they report a range of serious health and psychosocial consequences. While they appear relatively socially stable, they typically demonstrated severe cannabis dependence and significantly elevated levels of psychological distress, with the most commonly cited reason for cannabis use being stress relief. There were clinically relevant gender differences among the sample. This study provides more evidence of the demand for, and nature of issues relevant to, interventions for cannabis use disorders, and supports the need for further research into how best to assist individuals with these disorders.

Longitudinal course of behavioral and emotional problems in Williams syndrome.

A follow-up study of behavior and emotional problems in a cohort of young people with Williams syndrome 5 years after first assessment is described. Using a between-/within-subjects factorial layout, we compared scores on the Developmental Behaviour Checklist between young people with Williams syndrome and a large epidemiological control sample of young people with mental retardation due to other causes from Time 1 (1990/1991) to Time 2 (1995/1996). Results showed substantial persistence of the overall level of behavior and emotional problems. However, there were changes in certain types of behavior. Participants with Williams syndrome had significantly higher overall behavioral and emotional problems, communication disturbance, and anxiety over the 5-year period. Further, 10 or 13 checklist items maintained significantly higher levels among the Williams syndrome sample.

Epilepsy and associated psychopathology in young people with intellectual disability.

OBJECTIVE: This study aimed to investigate the role of epilepsy in psychopathology among an epidemiological sample of young people with intellectual disability (ID). The study also compared behavioural and emotional problems in young people on medication to control their epilepsy with those not on medication, and young people with epilepsy who were having current seizure activity with those with no current seizure activity. METHODOLOGY: An epidemiological cohort of 392 participants, representative of the general Australian population of young people with ID, were used in the study. One hundred and fifteen individuals from this cohort were identified as suffering from epilepsy. The Developmental Behaviour Checklist was used to measure symptoms of behavioural and emotional disturbance. RESULTS: Results confirmed that young people with ID and epilepsy did not differ from controls without epilepsy on measures of psychopathology. Furthermore, those with epilepsy on medication had no difference in levels of problem behaviours than epileptics not on medication. CONCLUSIONS: The results suggest that epilepsy has little or no influence on problem behaviours for young people with ID. Our attempt to understand the pathogenesis of behaviour problems in persons with ID may be better directed towards understanding genetic mechanisms than epilepsy pathologies.

Language laterality in English/Welsh bilinguals: language-acquisitional and language-specific factors in the development of lateralisation.

In order to test the hypothesis that monolinguals differ from bilinguals in their pattern of language lateralisation and to examine the relative merits of language-acquisitional versus language-specific factors, two experiments involving divided screen presentation of two languages were conducted using Welsh/English speaking participants. In the first experiment 80 monolingual teenagers were compared to 80 bilingual teenagers on a tachistoscopic "visual half-field" test of Welsh and English nouns and verbs. ANOVA revealed a greater left hemisphere advantage for Welsh-English bilinguals as compared to English monolinguals. Thus, in contrast to previous studies, in our bilinguals there was evidence of greater left hemisphere involvement in the processing of language. In the second experiment, four separate groups of 40 teenagers, varying in the age and manner of acquisition of their languages, were compared on the same test of Welsh and English words. These groups can be viewed as graded from the early to late bilinguals. ANOVA revealed a greater left hemisphere advantage when processing Welsh as compared to English words for all four groups. However no significant difference was observed between the four groups in respect of laterality for Welsh and English, indicating an equally greater left hemisphere bias for all four groups when processing Welsh words. We discuss these results in terms of a language-specific effect and suggest the specific orthography of the Welsh language (for individually presented nouns and verbs) promotes a left hemisphere advantage over and above language-acquisitional factors.

Compliance and use behaviour, an issue in injectable as well as oral contraceptive use? A study of injectable and oral contraceptive use in Johannesburg.

This study examines the compliance, use behaviour and knowledge of method of women using injectable and oral contraceptives in two clinic sites in the Johannesburg area, South Africa. An interviewer administered questionnaire was used to collect information in the clients' home language. A total of 400 women were interviewed in the clinics. The mean age of clients was 26.2 years (range 13 to 43 years). Of the clients not wanting to get pregnant, 30.4 per cent of injectable users and 18.4 per cent of oral contraceptive (OC) users had stopped using their method temporarily before returning to the same method (called the nonuse segment) and had not used any other form of contraception during this time. Almost one third of injectable users (31.2 per cent) had been late for their next injection at least once. Although nearly all women using injectables had experienced some menstrual disturbances, over one third (38.5 per cent) had not been informed by the providers about the possibility of these changes. Many women gave the disruption of their menstrual cycle as the reason for the nonuse segment. The majority of OC users lacked information on how to use their method correctly. Nearly all women expressed an interest in obtaining more information on their current method and other available methods. This study shows that compliance is an issue in injectable as well as OC users.

PIP: Interviews conducted at two South African family planning clinics (urban Johannesburg and the Orange Farm settlement) assessed method compliance in 400 current users of oral contraceptives (OCs) or injectables. The mean age of study respondents was 26 years in the inner city clinic and 25 years in the informal settlement. The median duration of use was 24 months for injectables and 21 months among OC users. 31.2% of injectable users had either forgotten or been unable to return to the clinic for their next injection on at least one occasion. Among women not wanting to become pregnant, 30.4% of injectable users and 18.4% of OC users had stopped using their method temporarily and had not used any other contraceptive method during this time. Disruption of the menstrual cycle was a major contributing factor to segments of nonuse. Although almost all injectable users experienced some menstrual disturbances, 38.5% had not been informed by a provider about the likelihood of such changes. 26.6% of OC users reported a change in their normal menstrual cycle, but 86% were not told the pill might affect their period. Moreover, 79.5% of OC users had not been counseled about what to do if they missed a pill. Overall, these findings suggest that South African women are not being given adequate information on what to expect from and how to use their method correctly--a lack that may have serious implications for contraceptive compliance.