Snuff use and smoking among senior high school students: effects of a snuff sales ban

OBJECTIVES: The popularity of snuff especially among adolescents is rising. The association between long-term snuff use and oral cancer discovered in epidemiological studies has prompted a variety of preventive measures to be taken to reduce snuff use and prevent adoption of the habit. In this study, the effect of a recent (I March, 1995) snuff sales ban introduced in Finland was investigated. Further, the rates of smoking, snuff use, alcohol use and drug experimenting were investigated before the introduction of the ban to characterize the study population.
DESIGN AND SUBJECTS: Two questionnaire studies were carried out. The first was carried out 3 months prior to the ban in 1994 and the second 9 months after the ban in 1995 in a senior high school population in southwestern Finland. The participants were 793 students (aged 15–22 years) in the first survey and 545 students (aged 16–23) in the second. Associations between variables were analyzed using cross-tabulation and stepwise logistic regression. The effects of the ban were determined on the basis of direct questions in the second questionnaire relating to the snuff sales ban.
RESULTS: Snuff was used by 9% of the students participating in the first study. The results of the second questionnaire indicate that the implementation of the snuff sales ban reduced the rate of snuff use by 1% in the study population. The majority of the snuff users (76%) reported that they had maintained their snuff habit. Of those reporting that they were snuff users before implementation of the snuff sales ban, 12% had switched to smoking and 5% to drugs.
CONCLUSIONS: The results of the present study suggest that the snuff sales ban in this population with a high rate of snuff use had little effect on snuff use rates and may have some short-term negative consequences as some snuff users switch to other substitutes, such as smoking, with known adverse health effects.     

口服糖皮质激素大鼠皮肤组织形态学变化

目的:观察口服糖皮质激素大鼠皮肤形态学改变,为建立新的皮肤衰老动物模型提供形态学上的依据。方法:实验于2006-07/2007-02在广东医学院药理教研室组织药理实验室完成。①实验对象:20只SD雄性SPF级大鼠随机分为两组,糖皮质激素组和空白对照组,每组10只。②实验方法:糖皮质激素组每天口服灌胃糖皮质激素3.5mg/(kg·d),空白对照组每天口服灌胃同等剂量生理盐水,喂养100d后麻醉下处死大鼠,取背部正中1cm×1cm大小皮肤组织检测相关指标。③实验评估:常规苏木精-伊红染色、VanGieson染色法、Weigert-间苯二酚-碱性品红染色法观察皮肤组织形态改变,并用计算机图像分析系统定量分析表皮厚度和弹力纤维总面积。结果:纳入结果分析16只,其中空白对照组8只,糖皮质激素组8只。糖皮质激素组大鼠皮肤表皮变薄,弹力纤维面积减少,胶原纤维多断裂,排列疏松,糖皮质激素组大鼠表皮厚度(33.8±3.1)μm,弹力纤维总面积(3557.9±373.1)μm2,均小于对照组大鼠表皮厚度(63.7±7.4)μm,弹力纤维总面积(5049.0±497.5)μm2。结论:糖皮质激素3.5mg/(kg·d)口服灌胃100d可导致大鼠皮肤衰老样改变,与人类皮肤衰老有相似形态学表现。     

Effects of Short-Term Varenicline Administration on Emotional and Cognitive Processing in Healthy,Non-Smoking Adults: A Randomized,Double-Blind,Study

Varenicline is an effective and increasingly prescribed drug for smoking cessation, but has been associated with depressive symptoms and suicidal behavior. However, it remains unclear whether those changes in mood and behavior are directly related to varenicline use, or caused by smoking cessation itself or reflects depression and suicidality rates in smokers, independent of treatment. To investigate the influence of varenicline on mood and behavior independent of smoking and smoking cessation, we assessed the effects of varenicline on emotional processing (a biomarker of depressogenic effects), emotion-potentiated startle reactivity, impulsivity (linked with suicidal behavior), and cognitive performance in non-smoking subjects. We used a randomized, double-blind design, in which we administered varenicline or placebo to healthy subjects over 7 days (0.5 mg/day first 3 days, then 1 mg/day). Cognitive and emotional processing was assessed by a battery of computerized tasks and recording of emotion-potentiated startle response. A total of 41 subjects were randomized, with 38 subjects included in the analysis. The varenicline group did not differ from placebo in terms of negative biases in emotional processing or mood. However, compared with placebo, the varenicline group scored higher on working and declarative memory. In conclusion, short-term varenicline use did not influence negative biases in emotional processing or impulsivity in non-smoking subjects, thereby not supporting direct depressogenic or suicidal risk behavior-inducing effects. In contrast, varenicline may have cognitive-enhancing effects.     

Connecting food,well-being and environmental sustainability: towards an integrative public health nutrition

Modern society has no shortage of human nutrition science, nor interventions designed to improve the way we eat. Yet nutrition science, and the models, approaches and interventions derived from this, is apparently delivering diminishing returns in terms of population weight gain, unhealthy eating patterns and the obesity ‘epidemic’. We draw on a range of literature(s) to argue that public health nutritionists in affluent societies face an ingenuity gap – a series of complex and inter-connected challenges which are neither fully recognised nor easily amenable to resolution through conventional thinking and practice. Four such challenges are: nutritionism; economism; consumerism and individualism. We use an integrative framework to explain their significance for public health nutrition, where they exert a combined and compounding influence. In addition to these problems, insights from other disciplines show that ‘modern’ society and some of its key characteristics are linked to increasing environmental threats. The latter undermine food security and the sustainability of society itself, and possess global impact. For public health nutrition to be situated in and responsive to this broader context, the discipline will need a better understanding of the relationship between modern society, food choice and environmental sustainability. As ‘healthy eating’ may not be an achievable goal within the present social, economic and cultural system, public health nutrition has a unique and vital role to play in shaping change for the future.     

Midwives and Liability: Results from the 2009 Nationwide Survey of Certified Nurse‐Midwives and Certified Midwives in the United States

Introduction: In partnership with the American College of Nurse‐Midwives (ACNM), the authors conducted a survey of ACNM members to examine the incidence of lawsuit involvement, the outcomes of the litigation in which they were involved, and coping mechanisms among midwives who had been involved in a lawsuit. Methods: In the spring of 2009, a nationwide Web‐based survey was completed by ACNM members. In addition to using chi‐square tests and nonparametric testing in data analysis, a logistic regression model was used to evaluate predictors of lawsuit involvement. Results: Among 1340 midwives responding to the survey, 32% had been named in a lawsuit at least once. The median number of years in practice when the event leading to lawsuit occurred was 6. The majority of midwifery lawsuits involved hospital births and were settled prior to going to court. Three variables were statistically significant for involvement with litigation: the midwife's age, the number of births attended, and the ACNM region of practice in the United States. Discussion: Lawsuits among midwives were significantly related to exposure to births over time. Practice patterns and job security were not greatly affected by the experience of a lawsuit. Future cyclic surveys are needed to track the frequency of litigation and the outcomes that lead to lawsuits and to better define the relationships between midwifery practice and medical malpractice litigation.