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We describe a self-report measure of household smoking exposure and its relationship to ambient nicotine levels as measured by a passive nicotine monitor. Thirty-nine participants placed a passive nicotine monitor in their home for a 7-day period and completed a retrospective household smoking questionnaire. The composite index from the household smoking questionnaire was strongly correlated with air nicotine concentration (r = .74, p < .01). The household smoking questionnaire appears to be a convenient low-response cost method of assessing indoor smoke exposure.

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The combination of radon and smoking produces a synergistic risk of lung cancer. Lay understanding of this risk was examined from the perspectives of mental models theory, the psychometric approach to risk perception, and optimistic bias. As assessed by interview, participants (N = 50) had more extensive mental models for the risks of smoking than for the risks of radon or the combination of radon and smoking; 32% knew little or nothing about radon. Despite reading an informational brochure, their risk-perception ratings of the three hazards showed no perception of the synergy between smoking and radon risk, although the combined hazard was rated as less familiar but more controllable than the average of the single hazards (p < .01). No evidence of optimistic bias for the health consequences of radon, or the combination of radon and smoking was observed. Participants appeared to be combining the single-hazard risks subadditively to arrive at their combined-hazard risk perceptions. Further research on the integration of perceived risks would be beneficial for designing optimal communications about synergistic risk.

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The purpose of this study was to test whether older patients' personal models of diabetes predict their levels of self-management activities (dietary intake, physical activity, and blood glucose testing) and glycemic control. The Personal Models of Diabetes Interview (PMDI) was administered on two occasions to 78 patients (> or = 60 years) with non-insulin-dependent diabetes mellitus. Self-management behaviors, quality of life, and affect were assessed on the second occasion and at 4 months. Glycemic control was assessed at 4 months. Three constructs of the PMDI (cause, treatment effectiveness, and seriousness) were correlated significantly with several aspects of quality of life and with negative affect. Personal models, especially beliefs regarding treatment effectiveness, were predictive of dietary intake and physical activity but not blood glucose testing. Assessing patients' personal models is valuable for individualizing education and counseling for nutrition and physical activity, and selecting strategies consistent with patients' perspectives.

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This article describes the conceptual basis, design, and intervention approach for a worksite-based heart disease risk reduction project. Baseline characteristics of the 26 moderate size worksites participating in the Take Heart Project are also described. The trial is designed to produce changes at both the organization and employee level on tobacco use, dietary fat intake, and serum cholesterol. A key feature of the intervention is creation of employee steering committees to enhance ownership and involvement. From a menu of brief, low-intensity health education and environmental change activities, these committees select activities best suited to their worksite. The baseline characteristics of organizations randomized to intervention and control conditions were similar, and indicated a relatively high level of worksite activity related to cholesterol and smoking.

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The combination of prostate specific antigen (PSA) and transrectal ultrasonography was used to detect recurrent cancer in the prostatic fossa after radical prostatectomy. A total of 43 patients with persistently elevated PSA levels and negative bone scintigraphy following radical prostatectomy underwent digital rectal examination and transrectal ultrasonography. Ultrasound findings were considered suspicious if the scan showed any unusual hypoechoic tissue adjacent to the bladder neck, retro-trigone or peri-anastomotic site. Of 22 patients (51%) with biopsy proved cancer 21 (95%) had positive transrectal ultrasonography, while digital rectal examination was able to detect cancer in only 10 (45%). Among transrectal ultrasonography detected recurrences 15 (68%) were detected at the initial biopsy and 7 (32%) at repeat biopsies. Our study shows that the combination of PSA and transrectal ultrasonography provides a more effective method than digital rectal examination and PSA to detect biopsy proved cancer following radical prostatectomy.

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We evaluated preoperative and postoperative bladder function in 31 consecutive patients who underwent definitive operative correction of lipomyelomeningocele. Of 12 patients less than 1.5 years old at operation, bladder function was normal preoperatively and postoperatively in 5 (42%) and normalized postoperatively in 4 (33%). In 5 patients (42%) abnormal urodynamic findings were the only sign of neurological abnormality. Of the 19 patients older than 1.5 years at operation bladder function was normal preoperatively and postoperatively in only 4 (21%), and normalized postoperatively in none. We conclude that the majority of patients with lipomyelomeningocele have bladder dysfunction, and that in some cases this dysfunction can be prevented and/or reversed by early neurosurgical intervention. Urodynamic assessment is helpful as part of the neurological evaluation and in directing patient care.

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The restriction fragment length polymorphisms have been determined for six restriction enzymes (Bam HI, Bg1 II, Eco RI, Hinc II, Hind III, and Pvu II) and a DQ beta probe on 25 cell lines that are homozygous by consanguinuity at the MHC. These patterns reflect both DR haplotypes and DQ types of the cells tested. At least one non-polymorphic band is present in all the cell lines with every restriction enzyme except Hinc II. This band most probably represents DX beta hybridization. The polymorphic bands indicate that more polymorphism exists in the DQ subregion than is predicted serologically. Each DR haplotype is associated with a unique set of restriction fragments except for DR2 and DR6. The patterns are largely consistent within each DR haplotype. In addition, some bands reflect the established DQ specificities DQw1 and DQw2. Individual bands can be identified that are unique to the haplotypes DR1, DR4, DR5, and DR6 and the DQw1- and DQw2-associated haplotypes. Subdivisions of haplotypes can be identified with this probe. In particular, MVL (DR1), Akiba (DR2), QBL (DR3), FPF (DR5), and APD (DR6) have polymorphisms that distinguish them from other members of their DR haplotype.

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Lipomas are usually found in adipose tissue; however, on rare occasions, they are found in the hands or feet. The authors describe a lipoma in the lateral plantar aspect of the left heel of one of their patients. They describe the procedure used in surgical excision of lipomas and the possible complications.

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