2024-03-28T09:04:58Zhttp://open-archive.highwire.org/handler
oai:open-archive.highwire.org:amjepid:135/8/8392015-05-11HighWireOUPamjepid:135:8
Does Cigarette Smoking Make You Ugly and Old?
Grady, Deborah
Ernster, Virginia
REVIEWS AND COMMENTARY
During the last 20 years, at least five studies have examined the association between cigarette smoking and facial wrinkling. Although there are methodological concerns with each of these studies, the data are consistent with the conclusion that smoking causes skin wrinkling that could make smokers appear unattractive and prematurely old. Cigarette smoking has been shown to decrease capillary and arteriolar blood flow in the skin, perhaps damaging connective tissue components that are important to maintaining the integrity of the skin. Americans are highly motivated to avoid or eliminate facial wrinkles. The association of smoking and facial wrinkling may be important evidence to convince young persons not to begin smoking and older smokers to quit. <it>Am J Epidemiol</it> 1992;135:839–42.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/839
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/8432015-05-11HighWireOUPamjepid:135:8
Asbestos and Colon Cancer: Lack of Association in a Large Case-Control Study
Garabrant, David H.
Peters, Ruth K.
Homa, David M.
ORIGINAL CONTRIBUTIONS
Previous studies linking exposure to asbestos with human colon cancer have used mortality rather than incidence as their endpoint and have neither assessed nor controlled for confounding by diet, genetic factors, or other risk factors for colon cancer. A case-control study of 746 historically confirmed cases of colon cancer and 746 matched neighborhood controls was conducted in Los Angeles County, California. In univariate analyses of the 419 male pairs, a weak association was found between asbestos exposure and colon cancer (odds ratio (OR) = 1.16, 95% confidence interval (Cl) 0.80–1.69). When confounding by family history of large bowel cancer, diet, body weight, and physical activity was controlled, there was no association between colon cancer and exposure to asbestos among males (OR = 0.99, 95% Cl 0.66–1.50). When asbestos exposure was restricted to occurrences preceding diagnosis by more than 15 years, there was no clear association between such exposure and colon cancer, either before (OR = 1.14, 95% Cl 0.76–1.70) or after confounding was controlled (OR = 0.93, 95% Cl 0.60–1.44). Further analyses by frequency and duration of exposure failed to show any association between asbestos and risk of colon cancer, but did show a consistent pattern of confounding by nonoccupational factors that, when controlled, invariably produced a weak protective effect of asbestos exposure. Among the 327 female pairs, only 6 cases and 11 controls reported asbestos exposure (OR = 0.55, 95% Cl 0.20–1.48), and there was no evidence of risk increasing as the frequency or duration of exposure increased. This study suggests not only that occupational exposure to asbestos is not a risk factor for colon cancer in the general population of Los Angeles, but also that observed associations between asbestos and colon cancer should not be interpreted as causal unless confounding by nonoccupational factors has been evaluated and controlled. <it>Am J Epidemiol</it> 1992; 135:843–53.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/843
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/8542015-05-11HighWireOUPamjepid:135:8
Myocardial Infarction and Coronary Death among Women: Psychosocial Predictors from a 20-Year Follow-up of Women in the Framingham Study
Eaker, Elaine D.
Pinsky, Joan
Castelli, William P.
ORIGINAL CONTRIBUTIONS
This study investigates the relation of psychosocial variables to the 20-year incidence of myocardial infarction or coronary death among women in the Framingham Study In 1965–1967, a psychosocial interview was given along with the collection of other coronary risk factor data This study includes 749 women aged 45–64 years who were free of coronary disease at this baseline examination Demographic variables, psychosocial scales (such as tension and reactions of anger), and individual interview items (such as attitudes toward children, money, and religion) were measured When age, systolic blood pressure, the ratio of serum total cholesterol to high-density lipoprotein cholesterol, diabetes, cigarette smoking, and body mass index were controlled for in multivariate proportional hazards models, the predictors of the 20-year incidence of myocardial infarction or coronary death were as follows among employed women, perceived financial status only, among homemakers, symptoms of tension and anxiety, being lonely during the day, difficulty falling asleep, infrequent vacations, housework affecting health, and believing one is prone to heart disease (<it>p</it> < 0.05 for all variables), and among both groups of women combined, low educational level, tension, and lack of vacations These results are discussed in relation to previous findings from the Framingham Study. <it>Am J Epidemiol</it> 1992;135:854–64.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/854
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/8652015-05-11HighWireOUPamjepid:135:8
Nonparticipation as a Determinant of Adverse Health Outcomes in a Field Trial of Oral Cholera Vaccines
Clemens, John D.
van Loon, Frederik F. P. L.
Rao, Malla
Sack, David A.
Ahmed, Faruque
Chakraborty, J.
Khan, M. R.
Yunus, M.
Harris, Jeffrey R.
Svennerholm, A. M.
Holmgren, Jan
ORIGINAL CONTRIBUTIONS
The authors estimated the incidence rates of cholera and death between 1985 and 1988 for 32,642 age- and sex-eligible persons who did not participate in a randomized, placebo-controlled field trial of killed oral cholera vaccines in rural Bangladesh. As compared with 20,744 placebo recipients, the relative risk of cholera for all nonparticipants, adjusted for potentially confounding demographic variables, was 1.20 (95% confidence interval (Cl) 1.03–1.41); this adjusted relative risk reflected elevated adjusted relative risks in nonparticipants who were medically ineligible (RR = 1.65; 95% Cl 1.22–2.22) or refused to participate (RR = 1.19; 95% Cl 1.01–1.41), but not in persons absent at the time of vaccination (RR = 1.00; 95% Cl 0.78–1 28) The adjusted relative risk of death was also elevated in nonparticipants as compared with placebo recipients (RR = 1.28; 95% Cl 1.10–1.48), with the same pattern of adjusted relative risks for different categories of nonparticipants: for ineligible subjects, 2.64 (95% Cl 2.12–3.29); for refusers, 1.20 (95% Cl 1.02–1.41); and for absentees, 0.95 (95% Cl 0.75–1.22). The authors concluded that nonparticipation was associated with clinically cogent adverse health outcomes, but that the magnitude of these associations varied according to the reason for nonparticipation. These findings underscore the caution required in assessing vaccine efficacy with controls who are not vaccinated because of choices made by patients or vaccinators. <it>Am J Epidemiol</it> 1992;135:865–74.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/865
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/8752015-05-11HighWireOUPamjepid:135:8
Epidemiology of Taeniasis and Cysticercosis in a Peruvian Village
Diaz, F.
Garcia, H. H.
Gilman, R. H.
Gonzales, A. E.
Castro, M.
Tsang, V. C. W.
Pilcher, J. B.
Vasquez, L. E.
Lescano, M.
Carcamo, C.
Madico, G.
Miranda, E.
The Cysticercosis Working Group in Peru,
ORIGINAL CONTRIBUTIONS
To determine the prevalence of cysticercosis in a rural area where the disease is endemic, the authors studied the seroepidemiology of human and porcine cysticercosis in a Peruvian jungle community (Maceda, Peru) in 1988 using an enzyme-linked immunoelectrotransfer blot (EITB) assay. Of the 371 sampled inhabitants, 30 (8%) were seropositive, most of whom were asymptomatic. After niclosamide therapy, four Taenia species worms were identified in the seropositive group, compared with one in the control group (<it>p</it> = 0.06). Pigs were frequently infected: 44 of 133 (33%) were found positive for Taenia by tongue examination and 57 of 133 (43%) were positive by EITB. In 69% of the sampled households that had pigs, there was at least one seropositive pig. The number of pigs diagnosed positive by the tongue examination was significantly greater in households that had latrines than in those that did not. Cysticercosis is a common but usually asymptomatic infection that affects both humans and pigs in the high jungle areas of Peru. <it>Am J Epidemiol</it> 1992;135:875–82.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/875
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/8832015-05-11HighWireOUPamjepid:135:8
Sexual Behavior and Status for Human Immunodeficiency Virus Type 1 among Homosexual and Bisexual Males in Mexico City
Hernandez, M.
Uribe, P.
Gortmaker, S.
Avila, C.
De Caso, L. Elena
Mueller, N.
Sepulveda, J.
ORIGINAL CONTRIBUTIONS
The authors examined sexual behaviors, the seroprevalence of human immunodeficiency virus type 1 (HIV-1), and condom use among 2,314 homosexual and bisexual men tested during 1988-1989 at the AIDS (acquired immunodeficiency syndrome) National Center in Mexico City Bisexuals constituted 24% of the sample, the seroprevalence rate was lower for bisexuals than homosexuals (21 vs 34%) In logistic regressions, HIV-1 seropositivity was independently related to age, education, pattern of insertive/receptive behavior in anal sex, lifetime number of male sex partners, having sex with someone with AIDS, homosexual versus bisexual behavior, and a history of condyloma The same logistic regressions were found to fit bisexuals and homosexuals The rate of HIV-1 was reduced in individuals who indicated always requiring their partners to use a condom when practicing receptive anal sex (1% of the total) The most common practice for both homosexuals and bisexuals was “mixed” behavior (i.e., both insertive and receptive anal sex); this was also the practice with the highest risk Bisexuals practiced both vaginal and anal sex with women and reported little condom use The substantial seroprevalence among bisexuals, their frequent sexual contact with women, and their low rate of condom use imply a continuing role as a bridge of infection to females Whether this risk will lead to a sustained heterosexual epidemic remains to be determined. <it>Am J Epidemiol</it> 1992,135 883–94.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/883
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/8952015-05-11HighWireOUPamjepid:135:8
Cigarettes, Coffee, and Preterm Premature Rupture of the Membranes
Williams, Michelle A.
Mittendorf, Robert
Stubblefield, Phillip G
Lieberman, Ellice
Schoenbaum, Stephen C.
Monson, Richard R.
ORIGINAL CONTRIBUTIONS
Premature (prior to 37 completed weeks of gestation) rupture of the membranes (preterm PROM) is one of the most common underlying causes of preterm delivery. However, there have been few epidemiologic studies of this obstetric complication The authors studied the relation of maternal cigarette smoking and coffee consumption to both preterm PROM and spontaneous preterm labor not complicated by premature rupture of the membranes (preterm NONPROM) in a large cross-sectional data base. The 307 preterm PROM and 488 preterm NONPROM cases who delivered during 1977–1980 at the Boston Hospital for Women were compared with 2,252 randomly selected women who delivered at term at that institution. Multiple logistic regression techniques were used to derive maximum likelihood estimates of adjusted odds ratios (OR) and 95% confidence intervals (Cl). After confounders had been adjusted for, the relative risk of preterm PROM for women who reported ever having smoked during pregnancy, as compared with nonsmokers, was 1.6 (95% Cl 1.1–2.4). However, no gradient between the the number of cigarettes smoked per day and the risk of preterm PROM was observed Similar results were observed for preterm NONPROM. Women who consumed three or more cups of coffee daily during the first trimester had a 2.2-fold greater risk of preterm PROM than did women who drank two or fewer cups (95% Cl 1.5–3.3). Among coffee drinkers, there was some evidence of a linear trend in the risk of preterm PROM as coffee consumption increased Consumption of three or more cups of coffee per day was less strongly associated with the occurrence of preterm NONPROM (adjusted OR = 1.4, 95% Cl 1.0–1.9). <it>Am J Epidemiol</it> 1992,135;895–903.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/895
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/9042015-05-11HighWireOUPamjepid:135:8
The Mediating Effect of Maternal Nutrition Knowledge on the Association between Maternal Schooling and Child Nutritional Status in Lesotho
Ruel, Marie T.
Habicht, Jean-Pierre
Pinstrup-Andersen, Per
Gröhn, Yrjö
ORIGINAL CONTRIBUTIONS
The present study tested whether maternal nutrition knowledge was a mediating factor in the association between maternal schooling and child nutritional status, and whether the mechanism involved differed according to socioeconomic status. The data were collected in Lesotho on 921 mother-child pairs and included scores from a nutrition knowledge test, socioeconomic and demographic information, and the child's anthropometric data. A wealth factor derived from a factor analysis was used to stratify the sample into two socioeconomic groups. Two-stage least-squares estimation was used to test the mediating role of nutrition knowledge between maternal schooling and child weight-for-age. Results showed that both the importance of maternal schooling and the mechanism by which it affects the child's weight-for-age are contingent upon the family's socioeconomic status. While maternal schooling was positively associated with weight-for-age for both wealthier and poorer households, the size of the effect was much larger for the latter group. The effect of maternal schooling on weight-for-age was mediated by the mother's nutrition knowledge only among wealthier households. These results imply that, in Lesotho, nutrition education for mothers could contribute to improving children's growth, but only in households that have access to a minimum level of resources. For poorer households, nutrition education would not be sufficient. <it>Am J Epidemiol</it> 1992;135:904–14.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/904
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/9152015-05-11HighWireOUPamjepid:135:8
Time Trends in Physical Activity among College Alumni, 1962-1988
Lee, I-Min
Paffenbarger, Ralph Seal
Hsieh, Chung-Cheng
ORIGINAL CONTRIBUTIONS
Little direct evidence exists in the epidemic-logic literature to support the widely held belief that an individual's physical activity behavior varies over the years. To provide data, the authors prospectively studied patterns of physical activity among 6,092 Harvard College alumni (average age at the start of follow-up, 43 years) who responded to questionnaires in 1962 or 1966, 1977, and 1988, and who declared themselves free of cardiovascular disease and cancer throughout that period. The median energy expenditure increased between 1962 or 1966 and 1977, but stabilized between 1977 and 1988. However, rank correlation coefficients between estimates of energy expenditure in 1977 and 1988 ranged from 0.36 to 0.41 for the various age groups (compared with 0.81-0.84 for the Quetelet index, and 0.60–0.65 for the current number of cigarettes smoked per day), implying that physical activity at the individual level was not constant. For 4,238 alumni for whom data on collegiate sports participation were available, the rank correlation coefficients between collegiate activity and alumni activity 1-7 decades later were even lower, ranging from 0.05 to 0.17 (compared with 0.31–0.58 for the Quetelet index). Thus, physical activity assessed over a short time period in an individual may not be a valid proxy for activity over the long term. The characteristics that distinguished alumni who consistently expended <1,000 kcal/week (in climbing stairs, walking, and playing sports) in 1962 or 1966, 1977, and 1988 from those who consistently expended >2,500 kcal/week were as follows: at baseline, older age, overweight, and cigarette smoking; and during college, not having been a varsity athlete and fewer hours playing sports. <it>Am J Epidemiol</it> 1992;135:915–25.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/915
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/9262015-05-11HighWireOUPamjepid:135:8
Assessing the Direction of Causality in Cross-sectional Studies
Flanders, W. Dana
Lin, Lillian
Pirkle, James L.
Caudill, Samuel P.
ORIGINAL CONTRIBUTIONS
Interpretation of observational studies is difficult, particularly in cross-sectional studies, because the direction of cause and effect may be difficult to assess Did the “outcome” affect the measured exposure level, or did the exposure affect the outcome? In this paper, the authors describe a pattern, the “checkmark pattern,” which can arise in cross-sectional studies. This pattern is characterized by higher levels of the outcome in an unexposed comparison group than in some subgroups of the exposed. The pattern, if seen in certain types of observational studies, suggests that the “outcome” variable may have affected the measured exposure level. Recognition of the pattern may help the epidemiologist to decipher the causal sequence Two examples illustrate the issues involved. <it>Am J Epidemiol</it> 1992;135:926–35.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/926
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/9362015-05-11HighWireOUPamjepid:135:8
The Circadian Rhythm of the Perinatal Mortality Rate in Switzerland
Ruffieux, Christiane
Marazzi, Alfio
Paccaud, Fred
ORIGINAL CONTRIBUTIONS
The authors examine the relation between the perinatal mortality rate (PMR), birth weight in four categories, and hour of birth throughout the week in Switzerland, using data on 672,013 births and 5,764 perinatal deaths recorded between 1979 and 1987. From Monday to Friday, the PMR follows a circadian rhythm with a regular increase from early morning to evening, with a peak for babies born between 7 and 8pm. This pattern of variation has two main components. The circadian rhythms for the proportion of births in the four weight categories and the PMR circadian rhythm for babies weighing more than 2.5 kg According to a cosinor model, which describes about 40% of the total variation in the PMR, the most important determinants are changes in the proportions of births Low birth weight increases toward the afternoon and night Mechanisms underlying the weight-specific timing of birth are discussed, including time selection of birth according to obstetric risks, the direct effect of neonatal and obstetric care, and chronobiologic behavior. <it>Am J Epidemiol</it> 1992;135:936–52.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/936
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/9532015-05-11HighWireOUPamjepid:135:8
BOOK REVIEWS
Waters, W. E.
BOOK REVIEWS
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/953
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/9552015-05-11HighWireOUPamjepid:135:8
BOOK REVIEWS
Sandler, Robert S.
BOOK REVIEWS
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/955
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/956-a2015-05-11HighWireOUPamjepid:135:8
ERRATUM
ERRATUM
The Journal Editorial Office has noted a typographical error in the Instructions to Authors published in our January 1, 1992 issue. This occurs under “Typescript Requirements and Number of Copies,” where we specify the maximum number of words for an Original Contribution and a Brief Original Contribution. Please note that the correct wording should be that the maximum number of words for an Original Contribution is 4,000 words, while the maximum number of words for a Brief Original Contribution is 1,500 words. These maximum lengths are exclusive of tables, figures, references, and abstract.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/956-a
en
Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/8/9562015-05-11HighWireOUPamjepid:135:8
ERRATUM
ERRATUM
Dr. Nancy Krieger has notified the <it>Journal</it> that her name is misspelled on the cover of the March 15, 1992, issue (Volume 135, Number 6). Dr. Krieger wishes to point out that she is <it>not</it> Dr. Nancy Kreiger of Canada. The <it>Journal</it> regrets the error.
Oxford University Press
1992-04-15 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/135/8/956
en
Copyright (C) 1992, Oxford University Press