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"Strong, David"
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أقوياء تحت المطر : كيف نجت اليابان من الزلازل، تسونامي، وكارثة فوكوشيما النووية
فى هذا الكتاب ... وفي يوم الخميس السابع عشر من آذار قررت كارين أنها مرت بما فيه الكفاية من الإجهاد العاطفي والضرر النفسي فالتوتر الذي كانت تمربه نتيجة الهزات الارتدادية كان يفوق قدرتها على التحمل، وكانت تشعر بأن شقتها في الطابق السادس تتحرك بشكل مستمر. لقد كانت معتادة على حدوث الزلازل لأنها عاشت في طوكيو لمدة طويلة، ولكن الهزات الارتدادية التي ألقت بها من فراشها أرضا عند الرابعة أو الخامسة من فجر ذلك اليوم قد قلبت الموازين توقعت كارين وجاك أن قوة هذه الهزات وصلت إلى 6 أو 7 درجات. ولو كان مركز الزلزال في طوكيو لكان الأمر كارثيا. فكانت النتيجة أن غادروا على متن رحلة جوية في منتصف تلك الليلة نحو كاليفورنيا ، وعند تلك المرحلة كانت أعصاب كارين قد أنهكت حيث تقول \" لقد كان خيار المغادرة متاحا لنا ولم تكن لدينا فكرة عن الفترة التي سيكون هذا الخيار متوفرا أمامنا. لقد كان قرار مغادرة أصدقائنا والبلاد التي كانت بمثابة وطننا قرارا تنفطر له القلوب، فقد كنا لا نعرف فيما إذا كنا سنعود أم لا، بناء على الظروف. ربما يكون حالنا تماما مثل شعور أجنبي في مدينة نيويورك يوم الحادي عشر من سبتمبر.
Book
Effectiveness of e-cigarettes as aids for smoking cessation: evidence from the PATH Study cohort, 2017–2019
ObjectiveTo assess the effectiveness of e-cigarettes in smoking cessation in the USA from 2017 to 2019, given the 2017 increase in high nicotine e-cigarette sales.MethodsIn 2017, the PATH Cohort Study included data on 3578 previous year smokers with a recent quit attempt and 1323 recent former smokers. Respondents reported e-cigarettes or other products used to quit cigarettes and many covariates associated with e-cigarette use. Study outcomes were 12+ months of cigarette abstinence and tobacco abstinence in 2019. We report weighted unadjusted estimates and use propensity score matched analyses with 1500 bootstrap samples to estimate adjusted risk differences (aRD).ResultsIn 2017, 12.6% (95% CI 11.3% to 13.9%) of recent quit attempters used e-cigarettes to help with their quit attempt, a decline from previous years. Cigarette abstinence for e-cigarette users (9.9%, 95% CI 6.6% to 13.2%) was lower than for no product use (18.6%, 95% CI 16.0% to 21.2%), and the aRD for e-cigarettes versus pharmaceutical aids was −7.3% (95% CI −14.4 to –0.4) and for e-cigarettes versus any other method was −7.7% (95% CI −12.2 to –3.2). Only 2.2% (95% CI 0.0% to 4.4%) of recent former smokers switched to a high nicotine e-cigarette. Subjects who switched to e-cigarettes appeared to have a higher relapse rate than those who did not switch to e-cigarettes or other tobacco, although the difference was not statistically significant.ConclusionsSales increases in high nicotine e-cigarettes in 2017 did not translate to more smokers using these e-cigarettes to quit smoking. On average, using e-cigarettes for cessation in 2017 did not improve successful quitting or prevent relapse.
Journal Article
Welcome to the punch
Three years ago, master criminal Jacob Sternwood escaped London during a daring robbery that left detective Max Lewinsky physically and emotionally scarred. When a failed heist puts Sternwood's son in a hospital, the fugitive is forced to come out of hiding, giving Max his second chance to get the one criminal who got away. But as Max returns to the pursuit of his arch-nemesis, he begins to uncover evidence of a vast conspiracy that may put him in even greater danger than his personal vendetta.
DVD
Effects of menthol use and transitions in use on short-term and long-term cessation from cigarettes among US smokers
ObjectivesTo estimate the effect of menthol use and transitions in use (switching to or from menthol) on short-term and long-term cessation from cigarette smoking and whether this differed across demographic groups (age, sex, race).MethodsWe compared the probability of 30+ day and 12-month abstinence from cigarette smoking by menthol use status using two cohorts of US adult cigarette smokers who attempted to quit smoking in the Population Assessment of Tobacco and Health (wave 1 to wave 3 and wave 2 to wave 4; n=5759), inverse probability of treatment weighting and adjusted risk ratios (aRRs).ResultsUsing menthol (vs non-menthol) prior to a quit attempt decreased the probability of 30+ day abstinence by 28% (aRR=0.78; 95% CI 0.67 to 0.91) and the probability of 12-month abstinence by 53% (aRR=0.65; 95% CI 0.47 to 0.88). Additionally, switching from menthol (vs maintaining menthol use) increased the probability of 30+ day abstinence by 58% (aRR=1.58; 95% CI 1.00 to 2.50) and the probability of 12-month abstinence by 97% (aRR=1.86; 95% CI 0.92 to 3.74). Switching to menthol (vs maintaining non-menthol use) was associated with a lower probability of 30+ day (aRR=0.70; 95% CI 0.42 to 1.16) and 12-month abstinence (aRR=0.64; 95% CI 0.30 to 1.36), but these associations were imprecise. The effects of menthol use on impaired quitting were slightly larger for non-Hispanic Black smokers, but not different for other demographic groups.ConclusionThese results demonstrate that menthol impaired menthol smokers’ attempts to quit smoking but switching from menthol improved success. This suggests that removing menthol may improve menthol smokers’ success during quit attempts.
Journal Article
Predictive Validity of the Expanded Susceptibility to Smoke Index
The susceptibility to smoking index can be improved as it only identifies one third of future adult smokers. Adding curiosity to this index may increase the identification of future smokers and improve the identification of effective prevention messages.
Analyses used data from the California Longitudinal Study of Smoking Transitions in Youth, for whom tobacco use behaviors, attitudes, and beliefs were assessed at 3 time points from age 12 through early adulthood. Logistic regressions were used to evaluate whether baseline curiosity about smoking was predictive of smoking during the 6-year follow-up period and whether curiosity about smoking provided evidence of incremental validity over existing measures of susceptibility to smoking.
Compared to those who were classified as definitely not curious about smoking, teens who were classified as probably not curious (OR adj = 1.90, 95% CI = 1.28-2.81) and those classified as definitely curious (OR adj = 2.38, 95% CI= 1.49-3.79) had an increase in the odds of becoming a young adult smoker. Adding curiosity to the original susceptibility to smoking index increased the sensitivity of the enhanced susceptibility index to 78.9% compared to 62.2% identified by the original susceptibility index. However, a loss of specificity meant there was no improvement in the positive predictive value.
The enhanced susceptibility index significantly improves identification of teens at risk for becoming young adult smokers. Thus, this enhanced index is preferred for identifying and testing potentially effective prevention messages.
Journal Article
E-Cigarette Use in the Past and Quitting Behavior in the Future: A Population-Based Study
Objectives. We examined whether smokers who used e-cigarettes are more likely to quit after 1 year than smokers who had never used e-cigarettes. Methods. We surveyed California smokers (n = 1000) at 2 time points 1 year apart. We conducted logistic regression analyses to determine whether history of e-cigarette use at baseline predicted quitting behavior at follow-up, adjusting for demographics and smoking behavior at baseline. We limited analyses to smokers who reported consistent e-cigarette behavior at baseline and follow-up. Results. Compared with smokers who never used e-cigarettes, smokers who ever used e-cigarettes were significantly less likely to decrease cigarette consumption (odds ratio [OR] = 0.51; 95% confidence interval [CI] = 0.30, 0.87), and significantly less likely to quit for 30 days or more at follow-up (OR = 0.41; 95% CI = 0.18, 0.93). Ever-users of e-cigarettes were more likely to report a quit attempt, although this was not statistically significant (OR = 1.15; 95% CI = 0.67, 1.97). Conclusions. Smokers who have used e-cigarettes may be at increased risk for not being able to quit smoking. These findings, which need to be confirmed by longer-term cohort studies, have important policy and regulation implications regarding the use of e-cigarettes among smokers.
Journal Article
Tobacco advertising, cross-over effects, and US adolescent progression from never to current tobacco use
Adolescent receptivity to tobacco advertising has been linked to increased tobacco initiation in longitudinal studies. However, not all ever users progress to daily use. We examined whether receptivity to tobacco advertising among adolescents was associated with product-specific use, including daily use, as an adult, and whether receptivity to one product had a cross-over effect and predicted use of a different product at follow-up.
In the US Population Assessment of Tobacco and Health (PATH) Study, 74.6% of adolescent never-tobacco-users at baseline (2013-14) reported receptivity to tobacco advertising (for cigarettes, e-cigarettes, cigars, smokeless tobacco) and were surveyed on current tobacco use (every day, some days in past 30 days) an median of 7 years later (n = 7506). Multivariable logistic regression analyses included 8 common covariates.
At follow-up, 20.1% were current tobacco users (15.4% e-cigarettes) and 8.4% were daily users (6.5% e-cigarettes). Receptivity to any advertising at baseline was associated with current use (AOR = 1.46, 95%CI: 1.29,1.66) as well as daily use (AOR = 1.41, 95%CI: 1.16,1.72). Product-specific advertising was associated with current use of each product at follow-up and there was a cross-over effect with receptivity to product advertising associated with current use of a different product. This cross-over effect on progression to daily use was only seen for e-cigarettes (e-cigarette receptivity: AOR = 1.48, 95%CI: 1.19,1.84; cross-over receptivity: AOR = 1.55, 95%CI: 1.16,2.06). The usual e-cigarette device for current vapers at follow-up included disposables (37.6%), refillable tanks (27.9%) and cartridges (26.4%). Fruit/candy and menthol flavors were used most. JUUL was the most common e-cigarette brand and 29% of JUUL users recently vaped fruit/candy flavors.
Among adolescents who were receptive to tobacco advertising but had never used tobacco at baseline, there was significant progression to current and daily tobacco use 6.6 years later. The cross-over advertising effect went beyond the particular advertised product and effectively promoted daily nicotine use, particularly among 12-14-year-old adolescents at baseline, with progression to e-cigarettes. Population increases in adolescent progression to daily nicotine use is a public health harm that needs public health action to counteract the effectiveness of e-cigarette marketing both in schools and at the community level.
Journal Article
Tobacco Consumption and Toxicant Exposure of Cigarette Smokers Using Electronic Cigarettes
Abstract
Background
There is considerable debate about the benefits and risks of electronic cigarettes (ECs). To better understand the risk–benefit ratio of ECs, more information is needed about net nicotine consumption and toxicant exposure of cigarette smokers switching to ECs.
Methods
Forty cigarette smokers (≥1 year of smoking) interested in switching to ECs but not necessarily quitting smoking were enrolled in a 4-week observational study and provided an e-Go C non-variable battery and refillable atomizers and choice of eight flavors in 12 or 24 mg nicotine dosage. Measurement of urinary cotinine (metabolite of nicotine), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL; a pulmonary carcinogen), and eight volatile organic compounds (VOCs) that are toxic tobacco smoke constituents was conducted at baseline and week 4.
Results
All participants with follow-up data (92.5%) reported using the study EC. Of the 40 smokers, 16 reported no cigarettes at week 2 (40%) and six continued to report no cigarettes at week 4 (15%). Change in nicotine intake over the 4 weeks was non-significant (p = .90). Carbon monoxide (p < .001), NNAL (p < .01) and metabolites of benzene (p < .01) and acrylonitrile (p = .001) were significantly decreased in the study sample. Smokers switching exclusively to ECs for at least half of the study period demonstrated significant reductions in metabolites of ethylene oxide (p = .03) and acrylamide (p < .01).
Conclusion
Smokers using ECs over 4 weeks maintained cotinine levels and experienced significant reductions in carbon monoxide, NNAL, and two out of eight measured VOC metabolites. Those who switched exclusively to ECs for at least half of the study period significantly reduced two additional VOCs.
Implications
This study extends current literature by measuring change in smoking dependence and disease-associated biomarkers, NNAL and a panel of eight common VOCs that are toxic tobacco smoke constituents in smokers who switch to ECs. The findings support the idea of harm reduction, however some levels of toxicant exposure are still of clinical concern, particularly for dual users. Extrapolation of these results must be careful to separate the different toxic exposure results for exclusive switchers versus dual cigarette + EC users, and not to equate harm reduction with the idea that using ECs is harmless.
Journal Article
Immune Mechanisms Responsible for Vaccination against and Clearance of Mucosal and Lymphatic Norovirus Infection
Two cardinal manifestations of viral immunity are efficient clearance of acute infection and the capacity to vaccinate against secondary viral exposure. For noroviruses, the contributions of T cells to viral clearance and vaccination have not been elucidated. We report here that both CD4 and CD8 T cells are required for efficient clearance of primary murine norovirus (MNV) infection from the intestine and intestinal lymph nodes. Further, long-lasting protective immunity was generated by oral live virus vaccination. Systemic vaccination with the MNV capsid protein also effectively protected against mucosal challenge, while vaccination with the capsid protein of the distantly related human Lordsdale virus provided partial protection. Fully effective vaccination required a broad immune response including CD4 T cells, CD8 T cells, and B cells, but the importance of specific immune cell types varied between the intestine and intestinal lymph nodes. Perforin, but not interferon gamma, was required for clearance of MNV infection by adoptively transferred T lymphocytes from vaccinated hosts. These studies prove the feasibility of both mucosal and systemic vaccination against mucosal norovirus infection, demonstrate tissue specificity of norovirus immune cells, and indicate that efficient vaccination strategies should induce potent CD4 and CD8 T cell responses.
Journal Article
Predictors of parent self-monitoring patterns in a family-based behavioral weight loss treatment program
Objective
Self-monitoring dietary intake is a critical component of family-based intensive health behavior and lifestyle treatment for pediatric obesity, but adherence rates are often low. This study identifies predictors of parent self-monitoring rates during treatment.
Methods
A secondary analysis of parent self-monitoring data from a randomized controlled trial involving 150 parent-child dyads. Patterns of self-monitoring were identified using a latent class mixed model approach. Logistic regression analyses evaluated predictors of self-monitoring patterns.
Results
Latent class models identified two trajectory groups: a high consistent self-monitoring group and a low-decreasing self-monitoring group. When compared to parents in the low group, parents in the high group lost more weight throughout treatment. Children in the high group had a similar trajectory for weight loss; however, the groups were not statistically different. Higher levels of family chaos and poorer family problem-solving skills were associated with higher odds of being in the low group.
Conclusion
This study identified two patterns of rates of parent self-monitoring, which were associated with parent weight loss and were differentiated by family chaos and poor problem-solving. These findings suggest that families with high levels of chaos and poor problem-solving could benefit from early intervention to improve outcomes in pediatric obesity treatment programs.
Trial Registration
Clinicaltrials.gov Identifier: NCT01197443.
Journal Article