Discordance of physiological and biochemical response to smoking and to psychological stress

Both smoking and psychological stress produce marked effects upon cardiovascular function, and several studies have demonstrated that in combination they produce additive or potentiating effects. More recently, it has been reported that individuals strongly reactive to psychological stress are also strongly reactive to nicotine. In an attempt to replicate and extend those findings, we examined reactivity to smoking and competitive mental arithmetic across several physiological and biochemical variables. Despite stable responding across mental arithmetic trials, we were unable to demonstrate significant correlations between reactivity to smoking and to a psychological stressor. We further observed that anxiety level, when low, was a poor predictor of desire to smoke and of withdrawal, whereas higher anxiety levels were more tightly linked to these measures. These findings have implications for the iDentification of individuals at risk of cardiovascular disease as well as for the design of smoking treatment and relapse prevention programs.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72030/1/j.1360-0443.1990.tb01607.x.pd

Effects of fluoxetine on weight gain and food intake in smokers who reduce nicotine intake

The effect of fluoxetine hydrochloride, a 5-HT uptake inhibitor (60 mg/day PO), in preventing weight gain associated with nicotine reduction was investigated in participants in a double-blind, placebo-controlled smoking-cessation trial. A lunch of cheese pizza and chocolate bars was offered, and caloric intake was monitored. The analysis focused on subjects (placebo: n=11; fluoxetine: n=10) who succeeded in reaching cotinine levels of less than 50% of their starting cotinine levels (signifying a stringent reduction in nicotine intake) and who participated in pre- and post-nicotine reduction lunch sessions 70 days apart. Subjects on placebo gained significantly more weight (mean+/-SEM = +3.3+/-0.7 kg) than subjects on fluoxetine (-0.6+/-1.2 kg). In fluoxetine-treated subjects, weight gain/loss was strongly correlated with initial body mass index, with higher BMI being associated with greater decreases in weight. A trend towards decreased caloric intake in the fluoxetine group was observed; the change in total calories at lunch was significantly correlated with weight change, an association accounted for principally by change in pizza intake. We conclude that fluoxetine treatment effectively prevents the weight gain that accompanies nicotine reduction and that this phenomenon is mediated, at least in part, by diminished caloric intake.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29620/1/0000709.pd

Pain in children with intellectual disabilities: a randomized controlled trial evaluating caregiver knowledge measures

Inadequate knowledge has contributed to inaccurate pain assessment and treatment for children with intellectual disabilities

Three-dimensional imaging and detection efficiency performance of orthogonal coplanar CZT strip detectors

We report on recent three-dimensional imaging performance and detection efficiency measurements obtained with 5 mm thick prototype CdZnTe detectors fabricated with orthogonal coplanar anode strips. In previous work, we have shown that detectors fabricated using this design achieve both very good energy resolution and sub-millimeter spatial resolution with fewer electronic channels than are required for pixel detectors. As electron-only devices, like pixel detectors, coplanar anode strip detectors can be fabricated in the thickness required to be effective imagers for photons with energies in excess of 500 keV. Unlike conventional double-sided strip detectors, the coplanar anode strip detectors require segmented contacts and signal processing electronics on only one surface. The signals can be processed to measure the total energy deposit and the photon interaction location in three dimensions. The measurements reported here provide a quantitative assessment of the detection capabilities of orthogonal coplanar anode strip detectors

Access to water in the countries of the former Soviet Union.

BACKGROUND: During the Soviet period, authorities in the USSR invested heavily in collective farming and modernization of living conditions in rural areas. However, many problems remained, including poor access to many basic amenities such as water. Since then, the situation is likely to have changed; economic decline has coincided with migration and widening social inequalities, potentially increasing disparities within and between countries. AIM: To examine access to water and sanitation and its determinants in urban and rural areas of eight former Soviet countries. METHODS: A series of nationally representative surveys in Armenia, Belarus, Georgia, Moldova, Kazakhstan, Kyrgyzstan, Russia and Ukraine was undertaken in 2001, covering 18,428 individuals (aged 18+ years). RESULTS: The percentage of respondents living in rural areas varied between 27 and 59% among countries. There are wide urban-rural differences in access to amenities. Even in urban areas, only about 90% of respondents had access to cold running water in their home (60% in Kyrgyzstan). In rural areas, less than one-third had cold running water in their homes (44% in Russia, under 10% in Kyrgyzstan and Moldova). Between one-third and one-half of rural respondents in some countries (such as Belarus, Kazakhstan and Moldova) obtained their water from wells and similar sources. Access to hot running water inside the homes was an exception in rural households, reflecting the lack of modern heating methods in villages. Similarly, indoor access to toilets is common in urban areas but rare in rural areas. Access to all amenities was better in Russia compared with elsewhere in the region. Indoor access to cold water was significantly more common among rural residents living in apartments, and in settlements served by asphalt roads rather than dirt roads. People with more assets or income and living with other people were significantly more likely to have water on tap. In addition, people who had moved in more recently were more likely to have an indoor water supply. CONCLUSIONS: This was the largest single study of its kind undertaken in this region, and demonstrates that a significant number of people living in rural parts of the former Soviet Union do not have indoor access to running water and sanitation. There are significant variations among countries, with the worse situation in central Asia and the Caucasus, and the best situation in Russia. Access to water strongly correlates with socio-economic characteristics. These findings suggest a need for sustained investment in rebuilding basic infrastructure in the region, and monitoring the impact of living conditions on health

Greater fruit selection following an appearance-based compared with a health-based health promotion poster

Background: This study investigated the impact of an appearance-based compared to a traditional health-based public health message for healthy eating. Methods: 166 British University students (41 male; aged 20.6±1.9 years) were randomized to view either an appearance-based (n=82) or a health-based (n=84) fruit promotion poster. Intentions to consume fruit and immediate fruit selection (laboratory observation) were assessed immediately after poster-viewing and subsequent self-report fruit consumption was assessed 3 days later. Results: Intentions to consume fruit were not predicted by poster type (β=0.03, p=0.74), but were associated with fruit-based liking, past consumption, attitudes, and social norms (smallest β=0.16, p=0.04). Immediate fruit selection was greater following the appearance-based compared to the health-based poster (β=-0.24, p<0.01), and this effect remained when controlling for participant characteristics (β=-0.21, p<0.01). Subsequent fruit consumption was greater following the appearance-based compared to the health-based poster (β=-0.22, p=0.03), but this effect became non-significant on consideration of participant characteristics (β=-0.15, p=0.13), and was instead associated with fruit-based liking and past consumption (smallest β=0.24, p=0.03). Conclusions: These findings demonstrate the clear value of an appearance-based compared to a health-based health promotion poster for increasing fruit selection. A distinction between outcome measures, and the value of a behavioural measure is also demonstrated

Reliability of the fagerstrom tolerance questionnaire and the fagerstrom test for nicotine dependence

The purpose of this study was to assess the test-retest stability of the Fagerstrom Tolerance Questionnaire (FTQ) in two samples: (a) paid subjects in an American laboratory; data were collected via telephone screen and subsequently via questions embedded in a written history; and (b) smokers hospitalized for depression in Paris; data were collected via a written questionnaire upon admission and again after 3 weeks of treatment for depression. Reliability data are also presented for a recently revised version of the FTQ, the Fagerstrom Test for Nicotine Dependence (FTND), and compared with FTQ data collected in a subsample of subjects in the American database who received both versions of the questionnaire. Both the FTQ (in both samples) and the FTND proved to be higly reliable. The validity of the scales, using cotinine, number of years smoked, and the "addictive" factor on the Classification of Smoking by Motives questionnaire as criterion variables, was also supported. No relationship between FTQ score and severity of depression was detected in either sample. Internal consistency was somewhat higher for the FTND than for the FTQ, replicating previous findings in the literature.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31860/1/0000810.pd

Controlled dosing of nicotine via an I ntranasal N icotine A erosol D elivery D evice (INADD)

The present report describes an I ntranasal N icotine A erosol D elivery D evice (INADD) employing an artist's airbrush as aerosolizer and precise, electromechanical control of spray duration. It was designed for the administration of controlled doses of nicotine in a laboratory setting and has been used successfully in over 30 smokers and nonsmokers of both genders. In the present study, nicotine was administered to 12 male smokers at three different doses (0.05 mg, 1.00 mg, and 2.00 mg), and at the same dose (1 mg) on three different occasions. The low dose produced a minimal change in plasma nicotine, while the high dose produced a peak increment of around 16 ng/ml. The medium dose reliably produced a peak increment of around 8–9 ng/ml on all three occasions. Nicotine in plasma showed a sharp rise followed by a slower decline, mimicking the pattern associated with cigarette smoking. Physiological and biochemical responses showed significant dose-response relationships. Subjective reports suggested that aerosol dosing was somewhat aversive, but it is unclear whether this effect is intrinsic to the method or due to other factors. The device described in this report answers the need for a safe and easy means of controlling nicotine dose. Moreover, since nicotine administration via aerosol is novel for both smokers and non-smokers, minimizing the contributions of behavioral tolerance and habituation to the dosing vehicle, it lends itself to the comparison of the pharmacological effects of nicotine between experienced and naive subjects.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46339/1/213_2005_Article_BF02247431.pd

Dietary beliefs in the Baltic republics.

OBJECTIVES: As beliefs and knowledge about the possible effects of foods on health can influence food behaviours, this study examined selected dietary beliefs in the Baltic countries and the association of beliefs related to salt intake and to types of fat with food behaviours. DESIGN: A cross-sectional study. SETTING: Data from three surveys conducted in Estonia, Latvia and Lithuania in the summer of 1997 were used to describe the prevalence of dietary beliefs in these countries and to investigate the association between beliefs and behaviours (using logistic regression). SUBJECTS: Representative national samples of adults were selected in each country (Estonia, n = 2018; Latvia, n = 2308; Lithuania, n = 2153). RESULTS: Misunderstood concepts (myths) related to dietary salt, types of fat, meat consumption and bread and potatoes were observed in high proportions of the population. Education level was an important correlate of beliefs related to salt intake and types of fat, people with a higher education level being more likely to be familiar with these issues. Correct beliefs were not consistently associated with healthier behaviours (e.g. less frequent use of salt at the table and use of non-animal fats for cooking), except for salt intake in Estonia. CONCLUSIONS: Several misunderstood dietary concepts (myths) are still prevalent in the Baltic countries. Correct beliefs related to salt intake and types of fat were not consistent predictors of healthier food behaviours. In-depth qualitative investigations are needed to better describe and understand dietary beliefs and attitudes in the Baltic countries, and to identify barriers to the adoption of healthy food habits

Depression, smoking abstinence and HPA function in women smokers

To determine whether smokers with a history of depression are differentially susceptible to smoking withdrawal, depressed mood induction and/or hypothalamic–pituitary–adrenal (HPA) axis dysregulation during smoking abstinence, 24 women smokers with and without such a history were studied. During one 5-day interval, participants smoked ad libitum ; during a second they abstained. On day 4, the participants were exposed to the Velten mood induction procedure (VMIP). Participants were then instructed to take 1 mg dexamethasone at 11 pm. At 4 pm on day 5, blood samples were withdrawn to determine the cortisol and ACTH response. Despite lower baseline cotinine levels, history-positive participants displayed more pronounced overall withdrawal distress than did history-negative participants, regardless of condition. The VMIP increased depression as well as negative responses on other profile of mood states subscales. Despite many overall group differences, no significant main effects for smoking condition nor interaction effects emerged. All participants evinced cortisol suppression in response to dexamethasone during both conditions, but the degree of suppression did not differ as a function of either abstinence or depression history. In history-positive smokers, however, ACTH levels trended toward overall elevation and showed almost no suppression during abstinence; thus exacerbation of HPA dysregulation in history-positive smokers during smoking abstinence cannot be ruled out. Copyright © 2004 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34962/1/623_ftp.pd