Keeneland Conference Plenary Sessions: Thomas R. Frieden

One of the leading challenges in public health today is moving forward as one whether we are part of academia, a clinical health setting, or a public health department, in order to improve health outcomes. Right now in the United States, the leading causes of death are caused from diseases that are preventable. We also face a steady rise in health inequalities among those citizens with a lower socioeconomic status. Director of the CDC, Thomas Friedan addressed the Keeneland conference audience on the impact that public health initiatives have had on the health of our nation. Public health interventions have a potential impact in all levels and the challenge is to identify areas where we can work systematically to improve health outcomes. Six key areas for potential impacts are smoking, obesity, health care associated infections, HIV, teen pregnancy, motor vehicle accidents. Major initiatives that need to be undertaken are heart attack and stroke prevention, electronic health records, and clinical innovations that involve improving quality of care and reducing prices. It is also vital that we come up with ways to bridge the gaps in program implementation

Effectiveness of a large-scale distribution programme of free nicotine patches: a prospective evaluation

Abstract BACKGROUND: After an increase in cigarette taxes and implementation of smoke-free workplace legislation, the New York City Department of Health and Mental Hygiene, the New York State Department of Health, and the Roswell Park Cancer Institute undertook large-scale distribution of free nicotine replacement therapy (NRT). We did a 6 month follow-up survey to assess the success of this programme in improving smoking cessation on a population basis. METHODS: 34,090 eligible smokers who phoned a toll-free quitline were sent a 6-week course of nicotine patches (2 weeks each of 21 mg, 14 mg, and 7 mg per day). Brief follow-up counselling calls were attempted. At 6 months after treatment, we assessed smoking status of 1305 randomly sampled NRT recipients and a non-randomly selected comparison group of eligible smokers who, because of mailing errors, did not receive the treatment. NRT recipients were compared with local survey-derived data for heavy smokers in New York City. FINDINGS: An estimated 5% of all adults in New York City who smoked ten cigarettes or more daily received NRT; most (64%) recipients were non-white, foreign-born, or resided in a low-income neighbourhood. Of individuals contacted at 6 months, more NRT recipients than comparison group members successfully quit smoking (33%vs 6%, p\u3c0.0001), and this difference remained significant after adjustment for demographic factors and amount smoked (odds ratio 8.8, 95% CI 4.4-17.8). Highest quit rates were associated with those who were foreign born (87 [39%]), older than 65 years (40 [47%]), and smoked less than 20 cigarettes per day (116 [35%]). Those who received a counselling call were more likely to stop smoking than those who did not (246 [38%] vs 189 [27%], p=0.001). With the conservative assumption that every 6-month follow-up survey non-respondent continued to smoke, the stop rate among NRT recipients was 20%. At least 6038 successful quits were attributable to NRT receipt, and cost was 464 US dollars per quit. INTERPRETATION: Easy access to cessation medication for diverse populations could help many more smokers to stop

Interaction in motion: designing truly mobile interaction

The use of technology while being mobile now takes place in many areas of people’s lives in a wide range of scenarios, for example users cycle, climb, run and even swim while interacting with devices. Conflict between locomotion and system use can reduce interaction performance and also the ability to safely move. We discuss the risks of such “interaction in motion”, which we argue make it desirable to design with locomotion in mind. To aid such design we present a taxonomy and framework based on two key dimensions: relation of interaction task to locomotion task, and the amount that a locomotion activity inhibits use of input and output interfaces. We accompany this with four strategies for interaction in motion. With this work, we ultimately aim to enhance our understanding of what being “mobile” actually means for interaction, and help practitioners design truly mobile interactions

Smoking Practices in New York City: The Use of a Population-Based Survey to Guide Policy-Making and Programming

No Abstract

The High Resolution IRAS Galaxy Atlas

An atlas of the Galactic plane (-4.7 deg < b < 4.7 deg) plus the molecular clouds in Orion, Rho Oph, and Taurus-Auriga has been produced at 60 and 100 micron from IRAS data. The Atlas consists of resolution-enhanced coadded images having 1 arcmin -- 2 arcmin resolution as well as coadded images at the native IRAS resolution. The IRAS Galaxy Atlas, together with the DRAO HI line / 21 cm continuum and FCRAO CO (1-0) line Galactic plane surveys, both with similar (approx. 1 arcmin) resolution, provide a powerful venue for studying the interstellar medium, star formation and large scale structure in our Galaxy. This paper documents the production and characteristics of the Atlas.Comment: To appear in Astrophysical Journal Supplement Series. Replaced June 2, 1997. Text unchanged. Missing tables added. Wrong figure sequence corrected. The Atlas images can now be accessed on line at http://crystal.ipac.caltech.edu:8001/applications/IGA

Gender-dependent differences in plasma matrix metalloproteinase-8 elevated in pulmonary tuberculosis.

Tuberculosis (TB) remains a global health pandemic and greater understanding of underlying pathogenesis is required to develop novel therapeutic and diagnostic approaches. Matrix metalloproteinases (MMPs) are emerging as key effectors of tissue destruction in TB but have not been comprehensively studied in plasma, nor have gender differences been investigated. We measured the plasma concentrations of MMPs in a carefully characterised, prospectively recruited clinical cohort of 380 individuals. The collagenases, MMP-1 and MMP-8, were elevated in plasma of patients with pulmonary TB relative to healthy controls, and MMP-7 (matrilysin) and MMP-9 (gelatinase B) were also increased. MMP-8 was TB-specific (p<0.001), not being elevated in symptomatic controls (symptoms suspicious of TB but active disease excluded). Plasma MMP-8 concentrations inversely correlated with body mass index. Plasma MMP-8 concentration was 1.51-fold higher in males than females with TB (p<0.05) and this difference was not due to greater disease severity in men. Gender-specific analysis of MMPs demonstrated consistent increase in MMP-1 and -8 in TB, but MMP-8 was a better discriminator for TB in men. Plasma collagenases are elevated in pulmonary TB and differ between men and women. Gender must be considered in investigation of TB immunopathology and development of novel diagnostic markers