Hypertension and pulmonary edema associated with subconjunctival phenylephrine in a 2-month-old child during cataract extraction

We have analysed trends in male:female ratios among newborns between 1950 and 1990 in 29 countries from five continents. The numbers of liveborn males and females over the period 1950-1994 were derived from the World Health Organization (WHO) database. Countries for which reliable data were available included 20 major European countries (excluding the former Soviet Union, Albania and a few small countries), Canada, the USA, selected countries of Central and South America, Japan, Australia and New Zealand. From the original numbers of males and females, we computed the proportion of males among liveborns for each country and for selected broader areas within Europe. In most countries the proportion of male liveborns was constant during the study period. In particular, the proportion of male newborns in the European Union was 0.515 in 1950-1954, 0.514 in 1970-1974 and 0.514 in 1990-1994. In the USA, corresponding values were 0.513, 0.513 and 0.512. In Japan the ratios were 0.513 in 1950-1954, 0.516 and 1970-1974 and 0.514 in 1990-1994. Decreasing ratios were observed in some northern and eastern European countries plus Greece and Portugal and, particularly, in Mexico. In contrast, the proportion of male liveborns tended to increase in southern Europe and Australia. Overall, among the 29 countries considered, the proportion of males declined in 16, increased in six, and remained stable in seven.     

Systolic blood pressure trends in US adults between 1960 and 1980: influence of antihypertensive drug therapy

Recent blood pressure trends reflect progress in hypertension control, but prevalent drug therapy precludes direct estimation of the component due to primary prevention. In data gathered on persons aged 35-74 years in three successive US health examination surveys (1960-1980), systolic blood pressure levels assuming no drug therapy were imputed by reassigning blood pressure to the upper end of the distribution for respondents reporting use of antihypertensive medication. Blood pressure was partitioned into four ordinal categories based on weighted percentiles of the 1960-1962 distributions for 35- to 44-year-old males and females who reported no use of antihypertensive medication. Cumulative logit models (alpha = 0.01) were used to estimate age- and sex-specific trends for blacks and whites within two strata (<25 or > or =25) of body mass index (BMI) (weight (kg)/height (m)2). Before imputation, systolic blood pressure decreased between 1960 and 1980; after imputation, significant decreases remained only in 35- to 44-year-olds. Strong associations of black race and BMI > or =25 with higher blood pressures were present in models with and without drug therapy. Thus, according to the models, there has been little progress in decreasing racial or BMI-related blood pressure differentials. Above the age of 44 years, blood pressure trends were largely attributable to medication use. In contrast, data for 35- to 44-year-olds suggest progress in primary prevention.     

Oncocytoma of the inferior turbinate

According to the World Health Organization more than 60% of European countries have achieved the goal of no more than 3 DMFT at the age of 12 years. The others, including the newly independent Baltic states, still have high caries levels. Data from recent studies show that mean caries prevalence among 12-year-olds in Latvia, Lithuania, and Estonia was 5.8, 4.9, and 4.6, respectively. Absence of caries was recorded in 5% of Latvian and Estonian and 12% of Lithuanian 12-year-olds. Fifteen-year-old Latvians and Lithuanians averaged 8.1 and 7.0 DMFT, which, owing to the absence of radiographic examination, may be a substantial underestimation of real caries levels. The possible adverse effects of the privatization of dental care and the benefits of increased access to fluoride dentifrice in these countries have not yet been evaluated. The extremely poor oral hygiene seen in epidemiologic surveys indicates that fluoride dentifrices may not be widely used. The caries levels in the Baltic states resemble those commonly encountered a couple of decades ago in the Nordic countries. Data from two follow-up studies in Iceland show 66% and 52% decline in caries prevalence for 12- and 15-year-old children, respectively, over a period of 7 years. However, the caries experience of the 15-year-olds in the latter study was similar to that of 12-year-olds 10 years earlier, both in mean caries score (DMFS 11.3 and 12.1) and frequency distribution. Nor has the proportion of occlusal and approximal DF values changed in spite of frequent use of fissure sealants. While caries has become mainly a pit and fissure phenomenon in 12-year-olds, 44.3% of Swedish 19-year-olds reportedly have approximal lesions, and, when enamel lesions are recorded, approximal caries dominates the DFS scores. Analyses of trends in Nordic countries show that, despite a substantial decline in caries prevalence, vigilance is required to prevent a delayed caries development in the future adult population.     

Laboratory animal allergy

Since the second World War, excess mortality of males has been steadily growing in Poland. The aim of this paper was to analyze the basic relationships between excess male mortality and some social and economic factors, with special reference to both age and place of residence. Data published in Demographic Yearbooks and included in reports produced by the Government Population Council were used in the analysis. The excess male mortality is expressed in terms of male/female mortality ratio, and also in terms of the difference between the average female and male life expectancy. In the early 1990s the general male mortality rate in Poland was by 23% higher than the general female mortality rate, whereas in males at younger working age (20-44 years) mortality was three times higher, and in the older age (45-64 years) groups 2.7 times higher than the female mortality. Compared with the majority of European countries, Poland is characterised by high rates of excess male mortality, which points to a deteriorated health status of the population. At present, excess mortality of the working age males is much higher than in the 1960s and 1970s. Our analysis of the 1960-1994 trends revealed that the highest excess male mortality occurs in the 20-24 age group. Although recently a falling trend has been observed in the infant, juvenile and post working age groups, a continuous increase is noted in the working age population of Poland. Causes of death were also included in our analysis. Among circulatory diseases, the highest excess mortality was due to acute myocardial infarction (the risk of death from this disease was 8 times higher for males than for females). Accidents, injuries and poisoning constitute another leading group of causes responsible for excess mortality (6/1 male/female death risk ratio). The excess male mortality rates are higher in the rural than in the urban areas. The excess male mortality was also reflected in the indices of average life expectancy. In 1995, the average life expectancy was 67.6 years for males and 76.4 years for females. Thus, in Poland males live 8.6 years shorter than females on average. Increased excess mortality among the working age males, a considerable difference between male and female average life expectancy, disturbed demographic male/female balance, these are at least some of the reasons why further in depth studies of excess male mortality in Poland should continue.     

Intraindividual variability in positive and negative affect over 45 days: Do older adults fluctuate less than young adults?

Opposing scenarios about age-related increases and decreases in intraindividual variability are found in the literature: Whereas accumulating evidence indicates that cognitive functioning is characterized by an age-related increase of short-term variability, age-related decreases in variability could be expected in affective states on the basis of theories of emotion regulation and self development. We examined age differences in intraindividual variability of positive affect (PA) and negative affect (NA) and in contingencies among daily affect, daily stress, and daily events using up to 45 daily assessments of 18 young (20–30 years) and 19 older (70–80 years) adults. Whereas age groups differed little in average affect levels, older adults showed significantly less variability in PA and NA than young adults. Age differences accounted for greater variance in variability than personality factors. Multilevel modeling indicated that for young but not older adults, PA was higher (lower) on days with a positive (negative) event, and NA was lower on days with a positive event. There were no age differences in daily affect reactivity to appraised stress severity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thermal pain: A sensory decision theory analysis of the effect of age and sex on d', various response criteria, and 50% pain threshold.

Studied the reactions of 64 18-67 yr. Old male and female normal volunteers to 0-300 mcal/sec/cm2. Over almost all intensities older females showed a lower ability to discriminate among stimuli (d') (p     

The occurrence of musculoskeletal alterations in worker populations not exposed to repetitive tasks of the upper limbs

A total of 749 workers (males: 139 aged between 15 and 35 years, and 171 aged > 35 years; females: 176 aged between 15 and 35 years, and 263 aged > 35 years) performing tasks not at risk for work-related musculoskeletal disorders of the upper limbs (WMSDs) underwent a clinical examination using a standardized method. The 'anamnestic cases' were defined on the basis of pain or paraesthesia present for at least 1 week during the previous 12 months, or appearing at least once a month, and not subsequent to acute trauma. The anamnestic cases among the males amounted to 4.4% (age 15-35 years) and 12.3% (age > 35 years); among the females, 4.6% (age 15-35 years) and 14.2% (age > 35 years). Of the 1498 limbs examined, the prevalent diseases reported were: suspect narrow chest syndrome: 0.3% among the males > 35 years, 0.6% among the females aged 15-35 years, 1% among the females > 35 years; scapulo-humeral periarthritis: 0.3% among the males aged > 35 years, 0.3% among the females aged 15-35 years, 1.3% among the females aged > 35 years; lateral epicondylitis: 0.3% among the males aged > 35 years, 0.2% among the females aged > 35 years; trapeziometacarpal arthrosis: 0.8% among the females aged > 35 years; wrist-hand tendinitis: 0.9% among the males aged > 35 years, 0.9% among the females aged 15-35 years; carpal tunnel syndrome: 2.5% among the females aged > 35 years. No disorders were detected outside the age ranges indicated. Several workers reported more than one disorder. The number of workers with at least one WMSD was: males 0% in the 15-35 years age range, 3.5% in the > 35 years age range; females 2.3% in the 15-35 years age range, 7.2% in the > 35 year age range; 3.9% of the total sample population. The prevalences were on average quite low, particularly among the older workers, hence the authors recommend that even minimal prevalences detected in particular work environments should not be underestimated.     

Mortality from airways disorders in Alberta, 1927-1987: an expanding epidemic of COPD, but asthma shows little change

Mortality from asthma has been reported to be increasing in recent years in many countries, including Canada. Alberta, and the prairie provinces generally, appear to have an excess of deaths from asthma compared to other provinces. We studied mortality from asthma and from chronic obstructive pulmonary disease (COPD) generally in Alberta between 1927 and 1987 using a data set compiled and recorded from Alberta Vital Statistics to describe birth cohorts' age-specific mortality rates. We also present the distribution of deaths in the years since 1987. There was a clear and sustained increase in mortality from COPD since 1950 after age 40 but no evidence to support the proposition that deaths from asthma were increasing in recent years; more recent data from Alberta Vital Statistics show no sustained increase since 1987, either. There was great variability from year to year and sporadically increased rates in a given year that were not sustained. These transient increases were observed particularly among females aged 10-14, 15-19, and 25-29 and among males aged 15-19, 25-29, and 80-84; however, there were also comparable decreases in asthma mortality of similar magnitude during the same time period in different age groups or in the other sex in the age group 10-14. We conclude that there is no excess of deaths from asthma over those expected by historical trends in Alberta at the present time but that the smoking-related epidemic of deaths from COPD continues unabated. The "smoothness" and consistency of the mortality trends suggest that physicians certifying deaths from these causes are using implicit diagnostic criteria that have not changed abruptly.     

Differential features of motor neuron disease mortality in Spain

BACKGROUND: The objective of this study was to describe the temporal and spatial patterns of motor neuron disease (MND) in Spain. METHODS: We studied data where MND was stated as the principal cause of death in official statistics from Spain. Time trends were analysed for age-, sex-specific and age-adjusted rates for the period 1951-1990. Age-adjusted mortality and relative risk, obtained by Poisson regression adjusting for age, were calculated for each province from deaths during the period 1975-1988. Maps were constructed using log transformed rates. Statistical significance of spatial aggregation was assessed using the Ohno et al. test. RESULTS: The 1951-1990 mortality rate, age- and sex-adjusted to the European population, for the population aged > or = 40 years was 1.49 per 100,000; 1.90 and 1.21 for males and females respectively. In general, mortality increased with age. Age-adjusted rates rose until 1960, dropped by 70% during the 1960s and declined slightly over the 1951-1990 period as a whole. From 1970 onwards MND mortality rose evenly, particularly in the 60-69 age group. A North-South gradient was suggested for both sexes with statistically significant clustering in the Northern coastal regions and--for males alone--in the Midwest provinces. CONCLUSIONS: Mortality from MND in Spain displayed a magnitude and recently rising temporal trend similar to that described in several other countries. Specific traits were: a decrease during the 1960s, which has been described for Japan only, as well as spatial heterogeneity and a predominant recent increase among the 60-69 age group. The determinants of these unusual MND mortality patterns are unknown.     

Cancer mortality in Italy, 1994, and an overview of trends from 1955 to 1994

BACKGROUND: Data and statistics are presented on cancer death certification in Italy, updating previous publications covering the period 1955-1993. METHODS: Data for 1994 and the quinquennium 1990-94 subdivided into 30 cancer sites are presented in 8 tables, including age- and sex-specific absolute and percentage frequencies of cancer deaths, and crude, age-specific and age-standardized rates, at all ages and truncated for the 35-64 year age group. Trends in age-standardized rates for major cancer sites are plotted from 1955 to 1994. RESULTS: The age-standardized (world standard) death certification rates from all neoplasms steadily declined from the peak of 199.2/100,000 males in 1988 to 186.3 in 1994, and in females from 102.5 in 1989 to 98.6 in 1994. Ever larger was the decline in truncated rates, for males from the peak of 275.1/100,000 in 1983 to 223.2 (-19%) in 1994, and for females from 151.6/100,000 in 1987 to 136.4 (-10%). A major component of the favourable cancer mortality trends in males was lung cancer (accounting for 31,000 deaths in both sexes combined in 1994), whose overall age-standardized rates declined from 60.3 in 1987-89 to 54.6/100,000 males in 1994 (-9%), and from the peak of 96.7 in 1983 at ages 35 to 64 to 72.7 in 1994 (-25%). In contrast, female lung cancer rates have remained stable from 1992 onwards, but have increased from 7.2 to 7.7 at all ages and from 10.6 to 11.0 at age 35-64 between 1985-89 and 1990-94. These different trends in the two sexes reflect the patterns and trends in smoking among Italian males and females. CONCLUSIONS: Cancer mortality trends in Italy over the period 1990-94 were relatively favourable, mainly reflecting the decline in lung cancer rates in males, together with the persistent declines in gastric cancer in both sexes and in cervix uteri for women. Continuous advancements were registered for neoplasms amenable to treatment, essentially testicular cancer, Hodgkin's disease and childhood leukaemias. The major unfavourable trends were observed for non Hodgkin's lymphomas, and require therefore further monitoring, besides a clearer understanding of their determinants. Italy maintains an intermediate level of cancer mortality on a European scale, suggesting that further progress is possible, mostly for tobacco-related neoplasms in males.     

Physicochemical, molecular-orbital and electronic properties of acephate and methamidophos

The genus Leishmania can be taxonomically separated into three main groups: the Old World subgenus L. (Leishmania), the New World subgenus L. (Leishmania) and the New World subgenus L. (Viannia). The haploid genome of Old World Leishmania species has been shown to contain 36 chromosomes defined as physical linkage groups; the latter were found entirely conserved across species. In the present study, we tried to verify whether this conservation of the genome structure extends to the New World species of Leishmania. 300 loci were explored by hybridization on optimized pulsed field gel electrophoresis separations of the chromosomes of polymorphic strains of the six main pathogenic Leishmania species of the New World. When comparing these New World karyotypes with their Old World counterparts, 32 out of 36 linkage groups were found conserved among all species. Four chromosomal rearrangements were found. All species belonging to the L. (Viannia) subgenus were characterized by the presence (i) of a short sequence exchange between chromosomes 26 and 35, and (ii) more importantly, of a fused version of chromosomes 20 and 34 which are separated in all Old World species. 69 additional markers were isolated from a plasmid library specifically constructed from the rearranged chromosomes 20+34 in an attempt to detect mechanisms other than a fusion or breakage: only two markers out of 40 did not belong to the linkage groups 20 and 34. On the other hand, all strains belonging to the New World subgenus L. (Leishmania) were characterized by two different chromosomal rearrangements of the same type (fusion/breakage) as above as compared with Old World species: chromosomes 8+29 and 20+36. Consequently, these two groups of species have 35 and 34 heterologous chromosomes, respectively. Overall, these results show that large-scale chromosomal rearrangements occurred during the evolution of the genus Leishmania, and that the three main groups of pathogenic species are characterized by different chromosome numbers. Nevertheless, translocations seem particularly rare, and the conservation of the major linkage groups should be an essential feature for the compared genetics between species of this parasite.     

Monoclonal antibody against pIII of filamentous phage: an immunological tool to study pIII fusion protein expression in phage display systems

Voided urine samples from 575 young Japanese under 20 years of age (297 males and 278 females including infants) and from 380 subjects (20-29 years old, 193 males and 187 females) were analyzed for levels of creatinine, selenium, zinc, cadmium and mercury. This investigation presents data regarding the normal urinary levels of these substances in age groups of 0-4, 5-9, 10-14, 15-19, and 20-29 years. Urinary levels of creatinine and cadmium showed remarkable increases with the age of the subjects, whereas that of selenium was constant at all ages under 20. Urinary concentrations of heavy metals were represented by creatinine and selenium ratios. Comparisons between these ratios revealed that selenium is an excellent index for representing the levels of the substances contained in a voided urine sample. Creatinine was not useful as an index for younger subjects, because the urinary concentration of this compound increased almost threefold as the subjects became older, up to 15 years of age.     

A Meta-Analysis of Primate Hand Preferences, Particularly for Reaching.

P. F. MacNeilage, M. G. Studdert-Kennedy, and B. Lindblom (1987) proposed a progression for handedness in primates that was supposed to account for the evolution of a right bias in human handedness. To test this proposal, the authors performed meta-analyses on 62 studies that provided individual data (representing 31 species: 9 prosimians, 6 New World monkeys, 10 Old World monkeys, 2 lesser apes, and 4 greater apes), of the 118 studies of primate handedness published since 1987. Although evidence of a population-level left-handed bias for prosimians and Old World monkeys supports P. F. MacNeilage et al., the data from apes, New World monkeys, and individual species of prosimians and New World monkeys do not. Something other than primate handedness may have been the evolutionary precursor of the right bias in hand-use distribution among hominids. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The epidemiology of osteoporotic fractures in a Mediterranean country

A population study was carried out over a period of 3 years (1987-1989) to determine the incidence of osteoporotic fractures. Fractures diagnosed in the two acute hospitals of the Maltese Islands were collected and classified according to the fracture site, age, sex, and patient's residence. Fractures in the Maltese Islands can only be diagnosed and adequately treated in these two general hospitals. A total of 8780 fractures were examined. Fracture of the neck of the femur was the most common fracture for which patients were admitted to the hospital. There were twice (1.96) as many females as males hospitalized for this fracture, giving an annual incidence of 262/100,000 females to 134/100,000 males over the age of 45. The fracture incidence was 2-3 times less than that found in North European countries, but was similar to the fracture rates obtained in Mediterranean studies. Fracture radius was the most frequent fracture treated on an outpatients basis. In over 45-year-olds, the female predominance persisted, giving a ratio of 3.65:1. This gave an annual incidence of 452/100,000 females to 150/100,000 males. Again, the fracture incidence obtained was significantly lower than that of Northern European countries. Other long bones showed a similar female to male (F:M) ratio in the cohort over 45 years of age. The bones showing this F:M ratio were the humerus (3.9:1), fibula (1.89:1), and tibia (1.6:1). Below 45 years of age males had more fractures than females for any bone studied.(ABSTRACT TRUNCATED AT 250 WORDS)     

Computerized quality-of-life screening in an oncology clinic

A 3-year prospective cohort study was conducted to estimate the life expectancy free of dementia (dementia-free life expectancy) in a representative sample of older persons living in an urban Japanese community. For the persons aged 65 years and older, who were not demented at the baseline survey in 1988, mortality and incidence rates of dementia were calculated. At the age of 65 years, males showed a total life expectancy of 18 years, including 16 years free of dementia, and females showed a total life expectancy of 23 years, including 18 years without dementia. At 65 years, the dementia-free life expectancy represented 89% of the total life expectancy for males and 79% for females. Total life expectancy and dementia-free life expectancy were longer among females than among males. However, the life-years with dementia were longer among females. This result would be attributable to a higher incidence of dementia and a lower mortality among females.     

Normal values of some parameters determining congruency of the hip in the radiographic image]

OBJECTIVE: To determine the seroprevalence of Helicobacter pylori (H. pylori) in a subset of a birth cohort of New Zealanders at age 21 and examine the association with risk factors and digestion-related symptoms. DESIGN: Assay of serum collected from members of a longitudinal study during 1993-94 and a survey of risk factors and digestion-related symptoms by interview and questionnaire. METHODS: Serum from 785 sample members (413 males, 372 females) of the 950 participating in the Dunedin Multidisciplinary Health and Development Study (DMHDS) at age 21 was analysed for H. pylori antibodies. Serum samples (n = 579) from the cohort at age 11 collected in 1983 were analysed for those who were seropositive at age 21. RESULTS: The seroprevalence of H. pylori at age 21 was 4.1% (32/785), with proportionally more males in the seropositive group (chi 2 = 6.7, P < 0.01). Serum samples taken at age 11 were available for 19 of the seropositive group and 74% of these (11 males, three females) were seropositive. The seropositive group at age 21 was no different in the size of their families, but at age 5 contained proportionally more individuals from families of low socioeconomic status (SES) (chi 2 = 6.1, P < 0.05). There was no difference between the two groups in terms of upper gastrointestinal tract symptoms, recent use of medications, smoking or alcohol consumption. CONCLUSION: The seroprevalence of H. pylori among a birth cohort of 21-year-old New Zealanders is significantly lower than among most populations of about the same age in other countries. Seropositivity is higher in males and among families of lower SES, and is not associated with digestion-related symptoms. The seroconversion rate after age 11 appears to be low.     

Analysis of immunoglobulin genes in splenic marginal zone lymphoma suggests ongoing mutation

BACKGROUND: The incidence of venous thromboembolism has not been well described, and there are no studies of long-term trends in the incidence of venous thromboembolism. OBJECTIVES: To estimate the incidence of deep vein thrombosis and pulmonary embolism and to describe trends in incidence. METHODS: We performed a retrospective review of the complete medical records from a population-based inception cohort of 2218 patients who resided within Olmsted County, Minnesota, and had an incident deep vein thrombosis or pulmonary embolism during the 25-year period from 1966 through 1990. RESULTS: The overall average age- and sex-adjusted annual incidence of venous thromboembolism was 117 per 100000 (deep vein thrombosis, 48 per 100000; pulmonary embolism, 69 per 100000), with higher age-adjusted rates among males than females (130 vs 110 per 100000, respectively). The incidence of venous thromboembolism rose markedly with increasing age for both sexes, with pulmonary embolism accounting for most of the increase. The incidence of pulmonary embolism was approximately 45% lower during the last 15 years of the study for both sexes and all age strata, while the incidence of deep vein thrombosis remained constant for males across all age strata, decreased for females younger than 55 years, and increased for women older than 60 years. CONCLUSIONS: Venous thromboembolism is a major national health problem, especially among the elderly. While the incidence of pulmonary embolism has decreased over time, the incidence of deep vein thrombosis remains unchanged for men and is increasing for older women. These findings emphasize the need for more accurate identification of patients at risk for venous thromboembolism, as well as a safe and effective prophylaxis.     

An epidemiological assessment of ischemic heart disease and mortality in men over 70 in the population of Saint Petersburg

AIM: To analyze prevalence of ischemic heart disease (IHD), main IHD risk factors and mortality in the population of males aged 70-79 and over 80 years. MATERIALS AND METHODS: The study included 209 males aged 70-79 years and 96 males over 80. All the males were examined for IHD and 3 main risk factors: blood hypertension, hyperlipidemia and smoking. RESULTS: Incidence of IHD was about similar in both age groups. For 3.5 years of follow-up in the group of 80-year-olds mortality was 2 times that of the group of 70-79-year-olds. The presence of IHD in the groups was directly related to the presence of 2 or 3 risk factors, especially in the group aged 70-79 years. In the group of 80-year-olds and older combination of IHD with affection of cerebral vessels was a poor prognosis sign. CONCLUSION: Factors deteriorating prognosis in males over 70 were: macrofocal myocardial infarction in anamnesis, atherosclerosis of the coronary and cerebral arteries.     

Hormonal events during female puberty in relation to breast cancer risk

Cigarette smoking among adolescents continues to be a major public health problem in the United States. Smoking trends from 1976-1977 to 1992-1994 were examined in the Bogalusa Heart Study, an investigation of cardiovascular disease risk factors among black and white, male and female adolescents in a semirural town in the southern United States. Age-race-sex specific chi 2 tests for trends over five survey periods were conducted. In almost every age group, black boys and girls were less likely to be current smokers or to have ever smoked or tried cigarettes, as compared with white boys and girls, respectively (P < 0.01). Within age groups, few significant trends in smoking status from 1976-1977 through 1992-1994 were observed among white boys and girls. Among black males and females, however, sharp decreases were observed among all age groups in the prevalence of having ever smoked or tried cigarettes (P = 0.0001) and among the older age groups in the prevalence of being a current smoker (P = 0.0001). Thus, substantial declines in the prevalence of smoking were observed among black children but not among white children. Further research is required to understand why these ethnic differences in smoking occurred so that public health programs may target further the smoking behaviors in children.