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Biomedical subjects

S Cummins

Publications and source records attributed to S Cummins.

8 recordsLinked to original sources
PubMed2006

Non-smokers seeking help for smokers: a preliminary study.

OBJECTIVES: To examine the phenomenon of non-smokers spontaneously taking action to seek help for smokers; to provide profiles of non-smoking helpers by language and ethnic groups. SETTING: A large, statewide tobacco quitline (California Smokers' Helpline) in operation since 1992 in California, providing free cessation services in English, Spanish, Mandarin, Cantonese, Korean, and Vietnamese. SUBJECTS: Callers between August 1992 and September 2005 who identified themselves as either white, black, Hispanic, American Indian, or Asian (n = 349,110). A subset of these were "proxies": callers seeking help for someone else. For more detailed analysis, n = 2143 non-smoking proxies calling from October 2004 through September 2005. MAIN OUTCOME MEASURES: Proportions of proxies among all callers in each of seven language/ethnic groups; demographics of proxies; and proxies' relationships to smokers on whose behalf they called. RESULTS: Over 22 000 non-smoking proxies called. Proportions differed dramatically across language/ethnic groups, from mean (+/-95% confidence interval) 2.7 (0.3)% among English-speaking American Indians through 9.3 (0.3)% among English-speaking Hispanics to 35.3 (0.7)% among Asian-speaking Asians. Beyond the differences in proportion, however, remarkable similarities emerged across all groups. Proxies were primarily women (79.2 (1.7)%), living in the same household as the smokers (65.0 (2.1)%), and having either explicit or implicit understandings with the smokers that calling on their behalf was acceptable (90.0 (1.3)%). CONCLUSIONS: The willingness of non-smokers to seek help for smokers holds promise for tobacco cessation and may help address ethnic and language disparities. Non-smoking women in smokers' households may be the first group to target.

Adolescent↗
PubMed2005

Natural experiments: an underused tool for public health?

Policymakers and public health researchers alike have demanded better evidence of the effects of interventions on health inequalities. These calls have been repeated most recently in the UK in the final Wanless report, which spoke of the "almost complete lack of an evidence base on the cost-effectiveness of public health interventions", and pointed more generally to the limited evidence base for public health policy and practice. Wanless and others have suggested that the gaps may be partially filled by exploiting the opportunities offered by "natural experiments", such as changes in employment opportunities, housing provision, or cigarette pricing. Natural experiments have an important contributions to make within the health inequalities agenda. First, they can play an important role in investigating the determinants of health inequalities. Second, they can assist in the identification of effective interventions, an area where it is widely acknowledged that the evidence-base is currently sparsely populated. This paper discusses some of the benefits and limitations of using this type of evidence, drawing on two ongoing quasi-experimental studies as examples.

Cost-Benefit Analysis↗
PubMed2005

Gender differences in the associations between health and neighbourhood environment.

Multiple deprivation indicators are frequently used to capture the characteristics of an area. This is a useful approach for identifying the most deprived areas, and summary indices are good predictors of mortality and morbidity, but it remains unclear which aspects of the residential environment are most salient for health. A further question is whether the most important aspects vary for different types of residents. This paper focuses on whether associations with neighbourhood characteristics are different for men and women. The sociopolitical and physical environment, amenities, and indicators of economic deprivation and affluence were measured in neighbourhoods in the UK, and their relationship with self-rated health was investigated using multilevel regression models. Each of these contextual domains was associated with self-rated health over and above individual socioeconomic characteristics. The magnitude of the association was larger for women in each case. Statistically significant interactions between gender and residential environment were found for trust, integration into wider society, left-wing political climate, physical quality of the residential environment, and unemployment rate. These findings add to the literature indicating greater effects of non-work-based stressors for women and highlight the influence of the residential environment on women's health.

Adult↗
PubMed1992

Response of fetal and newborn piglets to maternal protein restriction during early or late pregnancy.

Dietary protein restriction during pregnancy has an adverse effect on progeny development, although the importance of the time at which the nutritional insult occurs is unclear. The objective in our study was to test the hypothesis that severe protein restriction during the first trimester of swine pregnancy has a greater detrimental effect on fetal development than restriction in late pregnancy. On the day of mating, primiparous swine were assigned to control (C, 13% protein) or protein-restricted (PR, 0.5% protein) diets and fed in 4 regimens: 1) C diet throughout pregnancy (114 +/- 2 days) (n = 5), 2) PR diet to day 44, C diet to parturition (n = 6), 3) C diet to day 80, PR diet to parturition (n = 8), and 4) PR diet throughout pregnancy (n = 6). In addition, 6 pigs fed C and 7 pigs fed PR diets were killed at day 44 to assess placental and fetal development. Maternal diet had no effect on placental or fetal weight, crown-rump length, or heart girth circumference in 44-day fetuses. Mean birth weight of newborn piglets was 1462, 1291, 1262, and 1064 g for C, PR:C, C:PR, and PR groups, respectively (C greater than PR:C = C:PR greater than PR, p less than 0.01). Plasma total protein and albumin were less (p less than 0.01) in PR than in PR:C and C:PR; all three groups were less than C (p less than 0.01). Liver weight and total liver protein, RNA, and DNA followed the same pattern (C greater than PR:C = C:PR greater than PR, p less than 0.05). Longissimus muscle total protein, RNA, and DNA were greater in group C than in all other groups (p less than 0.01). Maternal protein restriction during early pregnancy produced less developmental impairment than restriction throughout pregnancy, but the magnitude of impairment was similar to that produced by restriction during only the third trimester. The effects of early restriction were manifested at birth, even though none of the indices of stunting were observed at 44 days when the maternal protein restriction was ended. Whether the effects of early versus late restriction show the same mechanism of action has not been determined.

Animals↗
PubMed1990

Prenatal and perinatal factors in the etiology of cerebral palsy.

Among 19,044 children born to mothers with monitored pregnancies and followed medically for at least 5 years, 41 (0.2%) had cerebral palsy that was not the result of a progressive disease or of a neural tube defect. All children without cerebral palsy were entered as controls subjects in the analysis. Significant prenatal or gestational predictors of cerebral palsy were a severe or nonsevere birth defect other than cerebral palsy or its sequelae, low birth weight, low placental weight, abnormal fetal position, and premature separation of the placenta. Maternal antecedents of cerebral palsy were unusually long or unusually short intervals between pregnancies and unusually long menstrual cycles. Perinatal risk factors were delayed crying as a measure of birth asphyxia and abnormal delivery. Children who had seizures within 48 hours of birth were at high risk for the development of cerebral palsy. Seventy-eight percent of children with cerebral palsy did not have birth asphyxia, and the 22% who did had other prenatal risk factors that may have compromised their recovery.

Birth Intervals↗