Effect of lung cancer screening awareness on smoking cessation behavior.

BACKGROUND AND OBJECTIVES: Emphasizing the risk of lung cancer can encourage smoking cessation; however, computerized tomography (CT) scans reduced lung cancer mortality in a recent randomized screening trial. We postulated that awareness of lung cancer screening test will negatively impact smoking cessation behavior. METHODS: We identified 7,141 respondents who answered questions concerning their smoking-related behavior in the 2007 Health Information National Trends Survey (HINTS). We used survey weights in all analyses and used logistic regression models to assess the association of smoking status with awareness of lung cancer screening tests and evaluated smoking cessation behaviors. RESULTS: Overall, 2,183 (27.6%) of respondents had heard of a lung cancer screening test (26.9% among never smokers, 29.6% among former smokers, and 27.1% among current smokers). Smoking status was not associated with awareness of lung cancer screening tests. Among current smokers, awareness of lung cancer screening had no effect on quit attempts in the previous 12 months (OR=1.14, 95% CI=0.68-1.91) and consideration to quit in the next 6 months (OR=1.08; 95% CI=0.69-1.67). CONCLUSIONS: Smoking cessation should be recommended for all current smokers, and those with a history of smoking should be informed about lung cancer screening with CT scan.

Measuring student engagement among elementary students: pilot of the Student Engagement Instrument--Elementary Version.

Early school withdrawal, commonly referred to as dropout, is associated with a plethora of negative outcomes for students, schools, and society. Student engagement, however, presents as a promising theoretical model and cornerstone of school completion interventions. The purpose of the present study was to validate the Student Engagement Instrument-Elementary Version (SEI-E). The psychometric properties of this measure were assessed based on the responses of an ethnically diverse sample of 1,943 students from an urban locale. Exploratory and confirmatory factor analyses indicated that the 4-factor model of student engagement provided the best fit for the current data, which is divergent from previous SEI studies suggesting 5- and 6-factor models. Discussion and implications of these findings are presented in the context of student engagement and dropout prevention.

Mothers' physical abusiveness in a context of violence: effects on the mother-child relationship.

The purpose of this study was to investigate the effects of mothers' physical abusiveness on the quality of the mother-child relationship, and note how it further varied by their exposure to interparental violence (IPV). The sample consisted of 232 clinic-referred children, aged 2 to 7 years, and their biological mothers. Slightly more than a quarter of the children (N = 63, 27.2%) had been physically abused by their mothers; approximately half of these children also had a history of exposure to IPV (N = 34, 54%). Investigating effects of physical abuse in the context of IPV history on mothers' and children's emotional availability, we found that physically abused children with no IPV exposure appeared less optimally emotionally available than physically abused children with an IPV exposure. However, subsequent analyses showed that although dyads with dual-violence exposure showed emotional availability levels similar those of nonabusive dyads, they were more overresponsive and overinvolving, a kind of caregiving controllingness charasteric of children with disorganized attachment styles. These findings lend some support to the notion that the effects of abuse on the parent-child relationship are influenced by the context of family violence, although the effects appear to be complex.

Psoralen and ultraviolet A irradiation (PUVA) as therapy for steroid-resistant cutaneous acute graft-versus-host disease.

Psoralen plus ultraviolet A irradiation (PUVA) has immunomodulatory effects and is used to treat a variety of immune-mediated dermatologic diseases. We administered PUVA to 103 patients for treatment of steroid-resistant acute graft-versus-host disease (GVHD) of the skin. Twenty-nine patients had related donors (12 HLA-mismatched) and 74 had unrelated donors (23 HLA-mismatched). The median onset of GVHD was day 13 after transplantation, and the median onset of PUVA treatment was day 46. PUVA was administered as secondary therapy for 86 patients and tertiary therapy or greater for 17 patients. The median number of treatments was 16, and the mean cumulative exposure was 41 J/cm2. PUVA was generally well tolerated with 8 patients discontinuing therapy because of toxicity. At the start of PUVA treatment, 48 patients had rash affecting >50% of their body surface area (BSA), and 91 had rash involving >25% BSA. Of 65 patients who were evaluated after 6 weeks of PUVA treatment, 11 still had rash involving >50% BSA, 24 had rash involving >25% BSA, and 24 had no rash. The mean daily dose of prednisone at the start of PUVA therapy was 1.6 mg/kg compared to 0.7 mg/kg after 6 weeks of therapy. Fifty-nine patients (57%) did not require additional therapy for skin GVHD after starting PUVA. Ninety-two percent of patients developed chronic GVHD. Fifty-three patients (51%) remain alive at 129-1883 days after transplantation. These results suggest that PUVA can be an effective therapy for steroid-resistant acute GVHD of the skin.