The Impact of Tobacco Control Program Expenditures on Aggregate Cigarette Sales: 1981-1998

Since the 1998 Master Settlement Agreement between states and the tobacco industry, states have unprecedented resources for programs to reduce tobacco use. Decisions concerning the use of these funds will, in part, be based on the experiences of states with existing programs. We review the experiences of several states that have adopted comprehensive tobacco control programs. We also report estimates from econometric analyses of the impact of tobacco control expenditures on aggregate tobacco use in all states and in selected states with comprehensive programs for the period from 1981 through 1998. Our analyses clearly show that increases in funding for state tobacco control programs reduce tobacco use.

Trap-Assisted Tunneling in the Schottky Barrier

The paper presents a new way how to calculate the currents in a Schottky barrier. The novel phenomeno-logical model extends the Shockley-Read-Hall recombi-nation-generation theory of trap-assisted tunneling. The proposed approach explains the occurrence of large leakage currents in Schottky structures on wide band semi-conductors with a high Schottky barrier (above 1 eV) and with a high density of traps. Under certain conditions, trap-assisted tunneling (TAT) plays a more important role than direct tunneling

Intracranial Pressure Modulates Distortion Product Otoacoustic Emissions: A Proof-of-Principle Study

BACKGROUND: There is an important need to develop a noninvasive method for assessing intracranial pressure (ICP). We report a novel approach for monitoring ICP using cochlear-derived distortion product otoacoustic emissions (DPOAEs), which are affected by ICP. OBJECTIVE: We hypothesized that changes in ICP may be reflected by altered DPOAE responses via an associated change in perilymphatic pressure. METHODS: We measured the ICP and DPOAEs (magnitude and phase angle) during opening and closing in 20 patients undergoing lumbar puncture. RESULTS: We collected data on 18 patients and grouped them based on small (Hg), medium (5-11 mm Hg), or large (≥15 mm Hg) ICP changes. A permutation test was applied in each group to determine whether changes in DPOAEs differed from zero when ICP changed. We report significant changes in the DPOAE magnitudes and angles, respectively, for the group with the largest ICP changes and no changes for the group with the smallest changes; the group with medium changes had variable DPOAE changes. CONCLUSION: We report, for the first time, systematic changes in DPOAE magnitudes and phase in response to acute ICP changes. Future studies are warranted to further develop this new approach

Transforming global leadership skills in graduate nursing programs using an intercultural setting and a case study on refugees.

Transformation of our world to a more just and equitable system will require a fundamental shift from a domination approach to a partnership-based approach. In nursing and health care, this shift will require a global perspective with culturally humble providers and systems. In this article we share the experience of our international course Leadership in Nursing – a Global Approach, a joint project of the University of Iceland Faculty of Nursing and the University of Minnesota School of Nursing. This collaborative immersion course offers a model of global partnership-based health-care education. International partnership-based collaboration in nursing and health-care education prepares students and faculty to take an active role in transforming global systems. Keywords: cultural humility; global leadership; nursing; partnershipPeer reviewe

Racial and Ethnic Differences in Serum Cotinine Levels of Cigarette Smokers Third National Health and Nutrition Examination Survey, 1988-1991

Context.— Cotinine, a metabolite of nicotine, is a marker of exposure to tobacco smoke. Previous studies suggest that non-Hispanic blacks have higher levels of serum cotinine than non-Hispanic whites who report similar levels of cigarette smoking. Objective.— To investigate differences in levels of serum cotinine in black, white, and Mexican American cigarette smokers in the US adult population. Design.— Third National Health and Nutrition Examination Survey, 1988-1991. Participants.— A nationally representative sample of persons aged 17 years or older who participated in the survey. Outcome Measures.— Serum cotinine levels by reported number of cigarettes smoked per day and by race and ethnicity. Results.— A total of 7182 subjects were involved in the study; 2136 subjects reported smoking at least 1 cigarette in the last 5 days. Black smokers had cotinine concentrations substantially higher at all levels of cigarette smoking than did white or Mexican American smokers (P\u3c.001). Serum cotinine levels for blacks were 125 nmol/L (22 ng/mL) (95% confidence interval [CI], 79-176 nmol/L [14-31 ng/mL]) to 539 nmol/L (95 ng/mL) (95% CI, 289-630 nmol/L [51-111 ng/mL]) higher than for whites and 136 nmol/L (24 ng/mL) (95% CI, 85-182 nmol/L [15-32 ng/mL]) to 641 nmol/L (113 ng/mL) (95% CI, 386-897 nmol/L [68-158 ng/mL]) higher than for Mexican Americans. These differences do not appear to be attributable to differences in environmental tobacco smoke exposure or in number of cigarettes smoked. Conclusions.— To our knowledge, this study provides the first evidence from a national study that serum cotinine levels are higher among black smokers than among white or Mexican American smokers. If higher cotinine levels among blacks indicate higher nicotine intake or differential pharmacokinetics and possibly serve as a marker of higher exposure to cigarette carcinogenic components, they may help explain why blacks find it harder to quit and are more likely to experience higher rates of lung cancer than white smokers

Coordinated multi-wavelength observations of Sgr A*

We report on recent near-infrared (NIR) and X-ray observations of Sagittarius A* (Sgr A*), the electromagnetic manifestation of the ~4x10^6 solar masses super-massive black hole (SMBH) at the Galactic Center. The goal of these coordinated multi-wavelength observations is to investigate the variable emission from Sgr A* in order to obtain a better understanding of the underlying physical processes in the accretion flow/outflow. The observations have been carried out using the NACO adaptive optics (AO) instrument at the European Southern Observatory's Very Large Telescope (July 2005, May 2007) and the ACIS-I instrument aboard the Chandra X-ray Observatory (July 2005). We report on a polarized NIR flare synchronous to a 8x1033 erg/s X-ray flare in July 2005, and a further flare in May 2007 that shows the highest sub-flare to flare contrast observed until now. The observations can be interpreted in the framework of a model involving a temporary disk with a short jet. In the disk component flux density variations can be explained due to hot spots on relativistic orbits around the central SMBH. The variations of the sub-structures of the May 2007 flare are interpreted as a variation of the hot spot structure due to differential rotation within the disk.Comment: 15 pages, 7 figures, contribution for the conference "The Universe under the Microscope" (AHAR 2008), to be published in Journal of Physics: Conference Series by Institute of Physics Publishin

Reductions in cardiovascular, cerebrovascular, and respiratory mortality following the national Irish smoking ban: Interrupted time-series analysis

Copyright @ 2013 Stallings-Smith et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.This article has been made available through the Brunel Open Access Publishing Fund.Background: Previous studies have shown decreases in cardiovascular mortality following the implementation of comprehensive smoking bans. It is not known whether cerebrovascular or respiratory mortality decreases post-ban. On March 29, 2004, the Republic of Ireland became the first country in the world to implement a national workplace smoking ban. The aim of this study was to assess the effect of this policy on all-cause and cause-specific, non-trauma mortality. Methods: A time-series epidemiologic assessment was conducted, utilizing Poisson regression to examine weekly age and gender-standardized rates for 215,878 non-trauma deaths in the Irish population, ages ≥35 years. The study period was from January 1, 2000, to December 31, 2007, with a post-ban follow-up of 3.75 years. All models were adjusted for time trend, season, influenza, and smoking prevalence. Results: Following ban implementation, an immediate 13% decrease in all-cause mortality (RR: 0.87; 95% CI: 0.76-0.99), a 26% reduction in ischemic heart disease (IHD) (RR: 0.74; 95% CI: 0.63-0.88), a 32% reduction in stroke (RR: 0.68; 95% CI: 0.54-0.85), and a 38% reduction in chronic obstructive pulmonary disease (COPD) (RR: 0.62; 95% CI: 0.46-0.83) mortality was observed. Post-ban reductions in IHD, stroke, and COPD mortalities were seen in ages ≥65 years, but not in ages 35-64 years. COPD mortality reductions were found only in females (RR: 0.47; 95% CI: 0.32-0.70). Post-ban annual trend reductions were not detected for any smoking-related causes of death. Unadjusted estimates indicate that 3,726 (95% CI: 2,305-4,629) smoking-related deaths were likely prevented post-ban. Mortality decreases were primarily due to reductions in passive smoking. Conclusions: The national Irish smoking ban was associated with immediate reductions in early mortality. Importantly, post-ban risk differences did not change with a longer follow-up period. This study corroborates previous evidence for cardiovascular causes, and is the first to demonstrate reductions in cerebrovascular and respiratory causes

Incidence of post myocardial infarction left ventricular thrombus formation in the era of primary percutaneous intervention and glycoprotein IIb/IIIa inhibitors. A prospective observational study

BACKGROUND: Before the widespread use of primary percutaneous coronary intervention (PCI) and glycoprotein IIb/IIIa inhibitors (GP IIb/IIIa) left ventricular (LV) thrombus formation had been reported to complicate up to 20% of acute myocardial infarctions (AMI). The incidence of LV thrombus formation with these treatment modalities is not well known. METHODS: 92 consecutive patients with ST-elevation AMI treated with PCI and GP IIb/IIIa inhibitors underwent 2-D echocardiograms, with and without echo contrast agent, within 24–72 hours. RESULTS: Only 4/92 (4.3%) had an LV thrombus, representing a significantly lower incidence than that reported in the pre-PCI era. Use of contrast agents did not improve detection of LV thrombi in our study. CONCLUSION: The incidence of LV thrombus formation after acute MI, in the current era of rapid reperfusion, is lower than what has been historically reported