Clinical analysis of subxiphoid vs. lateral approaches for treating early anterior mediastinal thymoma.

Objective: To investigate the clinical efficacy of the subxiphoid approach for early anterior mediastinal thymoma and evaluate its advantages over the lateral intercostal approach. Methods: A total of 345 patients with early anterior mediastinal thymoma were retrospectively analyzed from January 2016 to December 2020 in the First Affiliated Hospital of Soochow University. Out of these, 99 patients underwent subxiphoid video-assisted thoracoscopic thymectomy and 246 patients underwent transthoracic video-assisted thoracoscopic thymectomy. We compared the intraoperative conditions (such as operation time and intraoperative blood loss), postoperative conditions [such as postoperative pleural drainage volume, extubation time, postoperative hospital stay, and postoperative visual analogue scale (VAS) pain score], and postoperative complications (such as death, pneumonia, delayed wound healing, cardiac arrhythmia, and phrenic nerve injury) of the two groups and analyzed the clinical advantages of the subxiphoid approach for treating early anterior mediastinal thymoma. Results: There was no significant difference between the two groups in terms of general clinical features, operation time, and postoperative complications (P > 0.05).However, there was a significant difference in terms of intraoperative blood loss, postoperative pleural drainage volume, tube extubation time, postoperative hospital stay, postoperative VAS pain score, and postoperative analgesics (a significantly decreased flurbiprofen axetil amount) (P < 0.05). Conclusion: Compared with the lateral intercostal thoracic approach, the subxiphoid approach had advantages in terms of intraoperative blood loss, postoperative hospital stay, tube extubation time, postoperative pleural drainage volume, postoperative VAS pain score, and analgesics dosage. It could provide a better view of the bilateral pleural cavities and more thorough thymectomy and superior cosmesis, and it proved to be a safe and feasible minimally invasive surgical method.

Effectiveness of a brief condom promotion program in reducing risky sexual behaviours among African American men.

RATIONALE: The prevention of human immunodeficiency virus/sexually transmitted diseases remains a significant global public health issue, especially among vulnerable populations. AIMS AND OBJECTIVES: To promote condom use skills among young urban African American men. METHODS: As a pilot study, a randomized controlled trial was conducted among 136 African American men aged 18-24 years recruited from urban communities in Chicago. Participants assigned to the intervention received 45-60 minutes of a one-on-one single-session condom promotion program delivered by trained facilitators while those assigned to the attention-matched comparison condition received a general health program. Longitudinally, 115 (85%) and 120 (88%) participants completed the 3-month and 6-month follow-up surveys, respectively. RESULTS: Overall, the study results indicate that positive effects were observed from baseline to 6-month follow-up for intervention participants relative to comparison condition participants for prior condom use (1.23-1.82 versus 1.34-0.97); condom use intention (2.51-3.19 versus 2.69-2.21); perceived condom availability (3.44-3.72 versus 3.42-3.38); positive reasons to use condoms (2.82-3.08 versus 2.95-1.99); favourable condom use attitude (2.41-2.69 versus 2.49-1.95); barriers to condom use (1.33-0.79 versus 1.25-1.85); and negative condom use attitude (1.45-0.66 versus 1.33-1.39), respectively. CONCLUSIONS: We conclude that a brief single-session condom promotion program is effective in preventing high-risk sexual behaviours among urban young adult African American men.

Therapeutic community drug treatment success in Peru: a follow-up outcome study.

BACKGROUND: The purpose of this study was to assess the impact of drug abuse treatment in Peru that used the therapeutic community (TC) model. Program directors and several staff members from all study treatment facilities received two to eight weeks of in-country training on how to implement the TC treatment model prior to the follow-up study. METHODS: This outcome study involved 33 TC treatment facilities and 509 former clients in Lima and other cities in five providences across Peru. A retrospective pre-test (RPT) follow-up design was employed in which 30-day use of illegal drugs and alcohol to intoxication was measured at baseline retrospectively, at the same time of the six-month follow-up. In-person interview data were collected from directors of 73 percent of the eligible TC organizations in January and February 2003 and from former 58 percent of the eligible TC former clients between October 2003 and October 2004. Drug testing was conducted on a small sample of former clients to increase the accuracy of the self-reported drug use data. RESULTS: Medium to large positive treatment effects were found when comparing 30-day illegal drug and alcohol use to intoxication before and six months after receiving treatment. As a supplemental analysis, we assumed the 42 percent of the former clients who were not interviewed at the six month assessment had returned to drugs. These results showed medium treatment effects as well. Hierarchical Generalized Linear Modeling (HGLM) results showed higher implementation fidelity, less stigma after leaving treatment, and older clients, singly or in combination are key predictors of treatment success. CONCLUSION: This study found that former clients of drug and alcohol treatment in facilities using the TC model reported substantial positive change in use of illegal drugs and alcohol to intoxication at a six-month follow-up. The unique contribution of this study is that the results also suggest attention should be placed on the importance of implementing the TC drug abuse treatment model with fidelity. Further, the results strongly suggest that TC drug abuse treatment programs should incorporate follow-up activities that attempt to neutralize community negative reactions (perceived stigma) independent of other factors.

Multilevel analysis of individual and community predictors of smoking prevalence and frequency in China: 1991-2004.

This study uses a series of nationally representative samples from China. We studied more than 4,000 households to explore factors associated with both the prevalence and the frequency of cigarette smoking over 13 years between 1991 and 2004. By introducing variables at both the individual and the community level, we found that some key variables are consistent predictors of smoking measures over time, thus they should be the targets of future intervention/prevention programs.

Hierarchical linear modelling of smoking prevalence and frequency in China between 1991 and 2004.

This study uses the hierarchical linear modelling (HLM) growth curve technique to explore predictors of the change in the prevalence and frequency of cigarette smoking in China between 1991 and 2004. Using nationally representative data, the study introduces a number of previously unanalysed variables at both the individual and the community level. The findings show that a number of factors are associated with the change in both the prevalence and frequency of smoking in China. In addition, there is a trend of decreasing prevalence of smoking in China after the effects of other covariates are adjusted. Finally, the free market cigarette price has an inconsistent relationship with the change in the prevalence and frequency of smoking, which further reveals the daunting task of tobacco control for public health scholars and policymakers in China.

Individual and contextual predictors of inhalant use among 8th graders: a multilevel analysis.

Few studies of inhalant use have examined a large number of predictors at the individual level, including risk and protective factors and delinquent behavior, while also taking into account contextual variables (such as school size and poverty rates). This exploratory study uses 8th grade data from a large-scale survey of students in Kentucky to examine individual and contextual predictors of prevalence of inhalant use, and compares the predictors of inhalant use with factors predicting the use of marijuana and other drug use. Hierarchical Generalized Linear Modeling results using a logit link function suggest that the relationships between inhalant use and some of these factors are different than the relationships between the factors and both marijuana and other drug use. Implications for prevention of inhalant use are discussed.

A quantitative study on the condom-use behaviors of eighteen- to twenty-four-year-old urban African American males.

This research study sought to develop, pilot test, and assess a brief male-centered condom promotion program for urban young adult African American males. For study implementation, both qualitative and quantitative research methods were used, and the project was guided by tenets of two common but integrated theoretical frameworks in HIV/sexually transmitted disease (STD) prevention research: the social cognitive theory and the stages of change model. The purpose of the qualitative component was to identify and explore condom-use barriers and facilitators while that of the quantitative component was to identify the prevalence of condom-related behaviors and the feasibility of program administration. After recruitment of study participants from hang-out spots and street intercepts, study participants were self-administered a baseline survey regarding their perceived condom-use behaviors prior to random assignment to program conditions (a condom promotion program and an attention-matched comparison condition). In this paper, we report the findings from the analyses of the quantitative baseline survey data. While the occurrence of HIV/STD-related risk behavIors were highly prevalent among this population; importantly, regression analyses revealed that sexual debut, favorable attitudes toward condom use, social or personal connectedness to HIV/STDs, health beliefs, perceived susceptibility, unprotected sexual encounters, and refusal skills were predictive of retrospective (i.e., prior 30 days) condom use while positive reasons (pros) to use condoms, condom-use beliefs, condom-carrying, health belief, unprotected sexual encounters and refusal skills were also predictive of prospective (i.e., future 30 days) condom-use intentions. The implications and limitations of this study are described and recommendations provided for program development.

Socioeconomic predictors of smoking and smoking frequency in urban China: evidence of smoking as a social function.

A number of previous studies have documented the worsening smoking problems in China. This paper identifies several key socioeconomic variables associated with smoking among urban working adults and calls researchers' attention to the important function of cigarette smoking as a social connection builder in China. This study argues that a smoking prevention and education program should place more emphasis on making smoking socially unnecessary and/or unacceptable because of the continuing increase in the number of smokers and the low desire to quit among smokers. The findings also suggest that while socioeconomic characteristics are excellent in predicting whether a person smokes or not, they are dismal in predicting smoking frequency among working adults.