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Accutane-exposed pregnancies--California, 1999.

Accutane (Roche Laboratories, Nutley, New Jersey), known by the generic name "isotretinoin," is a prescription oral medication approved by the Food and Drug Administration (FDA) to treat severe, recalcitrant nodular acne. It is also a known human teratogen that can cause multiple major malformations. Embryopathy associated with the mother's exposure to isotretinoin during the first trimester of pregnancy includes craniofacial, cardiac, thymic, and central nervous system malformations . In response to FDA recommendations, the manufacturer began a pregnancy-prevention program (PPP) in 1988 that included educational materials for physicians and patients and offered women reimbursement for contraceptive counseling by a physician. The PPP coordinators asked reproductive-aged women being treated with isotretinoin to enroll voluntarily in the Boston University Accutane Survey (BUAS). The total number of reproductive-aged women taking isotretinoin in the United States is unknown; however, 454,273 women enrolled in the BUAS from 1989 to October 1999. BUAS has estimated that 38%-40% of reproductive-aged women taking isotretinoin chose to enroll in the survey (BUAS, unpublished data, 1999). Although isotretinoin is contraindicated in pregnancy and has a package label warning users to avoid pregnancy while taking it, exposed pregnancies occur. Approximately 900 pregnancies occurred among BUAS enrollees during 1989-1998 (BUAS, unpublished data, 1999). Roche Laboratories began direct-to-consumer print advertisements in 1996, added television and radio advertisements to selected cities in 1997, and expanded the campaign to the entire United States in 1998.

Abnormalities, Drug-Induced↗

Older, but not wiser: how men get information about AIDS and sexually transmitted diseases after high school.

CONTEXT: As they reach adulthood, young men are less likely to use condoms and are at increased risk for exposure to AIDS and other sexually transmitted diseases (STDs). Little is known about which prevention efforts reach men in their 20s. METHODS: Longitudinal data from the 1988, 1990-1991 and 1995 waves of the National Survey of Adolescent Males are used to identify sources of information about AIDS and STDs among 1,290 young men aged 22-26. Information receipt from four main sources, the topics covered by each source and the personal characteristics associated with getting more information are all explored. RESULTS: Twenty-two percent of men surveyed discussed disease prevention topics with a health provider in the last year, 48% attended a lecture or read a brochure, 51% spoke to a partner, friend or family member, and 96% heard about AIDS or STDs from the media (e.g., television advertisements, radio or magazine). Excluding media sources, 30% of young men reported getting no STD or AIDS prevention messages in the last year. Being black or Hispanic, having had a physical exam or an AIDS test in the last year, and having discussions about AIDS or STDs with parents or a health care provider in the past were associated with receiving more information. CONCLUSIONS: Although young men who are at higher risk for STD or HIV infection are more likely than other young men to get information about disease prevention, young adult men are much less likely than adolescents to receive AIDS or STD prevention education. More prevention efforts need to be aimed at young adults.

Acquired Immunodeficiency Syndrome↗

Awareness and health seeking behaviour of rural adolescent school girls on menstrual and reproductive health problems.

A study was conducted on 130 girl students aged 13-17 years in Haryana to assess their awareness and health seeking behaviour regarding menstrual and reproductive health. Mean age at menarche of the girls was 13.6 +/- 0.83 years. Awareness about the process of menstruation was poor. Commonest reported menstrual problem was dysmenorrhoea (40.7%) followed by irregular menses (2.3%) of which only 5.3% consulted a doctor and 22.4% took over the counter medications from the chemist shops. Knowledge about normal duration of pregnancy and need for extra food during pregnancy was poor. Most of the girls knew about importance, duration of child spacing and need for three medical examinations during pregnancy. Major sources of information were television (73.1%), radio (37.1%) and parents (36.1%). Girls preferred to consult parents (49.2%) and doctors (44.6%) for help at times of having reproductive health problems. This study highlights the need for educating school girls about adolescent health, pregnancy and reproductive health problems through schools and parents by the health professionals.

Adolescent↗

Misuse of organomercury fungicides in Brazil.

A methoxyethyl mercuric compound, licensed in Brazil as a fungicide for seed dressing, was widely used for spraying tomato and other vegetable crops in 1966 and 1967.Mercury residues ranging from 0.05 to 0.30 mg/kg were detected in 14% of the tomatoes, 13% of other vegetable samples, and 57% of the tomato paste batches.A wide campaign through newspapers, radio, and television was quickly established to educate farmers and the population in general on the hazards of ingestion of mercury-contaminated food.All samples of tomatoes and other vegetables positive for mercury (residues above 0.05 mg/kg) were destroyed. Inspection posts on the main roads and highways prevented the delivery of contaminated food to cities and food processing plants.The sale of organomercury fungicides is now controlled in Brazil; however, treated seeds which are not planted may be diverted to human or animal consumption. There is no official record of accidents, but occasional cases of poisoning are known.The mercury residue level in Brazilian fish is low, indicating that environmental pollution by mercury is not a big problem in the country. However, some fresh-water and estuarine fish may contain mercury residues ranging from 0.01 to 0.66 mg/kg.

Animals↗

Factors associated with seeking emergency treatment following suspected chemical contamination of a leisure pool.

A leisure pool was evacuated when children complained of breathing difficulties, cough, and eye irritation subsequently thought to be due to high chloramine levels. The duration of the suspected contamination before the evacuation was unknown: it was suggested that some subsequent attendances at accident and emergency (A&E) departments had been prompted by news reports of the incident. The extent and nature of symptoms, the cause of the incident, and the impact of media reporting were investigated with the help of a postal questionnaire. One hundred and thirty-seven people (all but six under 20 years of age) attended A&E departments after the incident, most commonly with sore eyes (79%), cough (76%), and sore throat (71%). The number of different symptoms was associated with the length of time spent at the pool, but not with being present at the time of the evacuation or with having heard about the incident on radio or television.

Adolescent↗

Connecticut Children's Medical Center multi-year branding campaign.

As the only children's hospital in the state, Connecticut Children's Medical Center was challenged by the inherent complacency of parents. It met the challenge through a multi-level marketing effort which included television and radio, community outreach and strong media relations. By emphasizing the unique nature of children, the campaign affirms the need for a specialized children's health center.

Child↗

Increased acceptance of HRT and improved level of information: a change in Norwegian women's opinion from 1990 to 1997.

AIM: To investigate the development in women's attitude to hormone replacement therapy, and the change in views concerning positive and negative effects. METHODS: National cohort study based on telephone interviews in 1990 and 1997, of women randomly sampled from the Norwegian telephone book (n=1019 and 1003). The same questions were asked in both studies. RESULTS: In 1997, more women stated radio and television, doctors, friends and relatives as sources of information. The general attitude to hormone replacement therapy had become significantly more positive, and the respondents reported a higher level of information than in 1990. However, some misunderstandings about estrogen therapy still remain; the proportion of women who believed that estrogen treatment reduced the risk for breast cancer increased from 4% in 1990 to 15% in 1997. About one third of women aged 60 or more are current or past users. More than 60% of the women in the youngest age group state that they will consider use of estrogen replacement therapy. About four-fifths of the women in 1997 stated their willingness to use long term estrogen therapy if osteoporosis could be prevented. CONCLUSIONS: Estrogen replacement therapy has become a part of the public debate. A high degree of willingness to use estrogen is demonstrated. The self reported level of information is higher and women are generally more correctly informed about positive and negative effects.

Adult↗

[Dehiberations over the semantics of mass communication media].

The radio, cinema and T.V. have developed their own idiolects and aesthetic standards. These in turn have influenced social relationships and education. Their effect is the reduction of society to a common mass, in which no attentuon is paid to individual motive forces.

Adolescent↗

Preparing the "Ground War" against tobacco among Chinese Americans in New York City: baseline data.

OBJECTIVES: The objective of this paper is to report on data on the perceptions regarding smoking and environmental tobacco smoke as well as the health communication patterns of a representative sample of 715 adult Chinese families with children under age 18 who had not banned smoking in the home. METHODS: We selected a representative sample of Chinese American families residing in New York's five boroughs: Brooklyn, Bronx, Manhattan, Queens, and Staten Island based on Chinese family surnames and interviewed them by telephone between December 2000-March 2001. All except 4% of the interviews were conducted in English; most respondents chose to speak Cantonese and lesser numbers chose Mandarin. FINDINGS: For the most part, respondents believed in the hazards of smoking, especially as it harms children living at home. To address smoking, respondents believed the physicians is the most trustworthy source of health information and the sources of health information consulted would be overwhelmingly the Chinese language newspaper, followed by Chinese language radio and television. CONCLUSIONS: This study represents the first systematic assessment of Chinese Americans in New York with regard to selected tobacco control issues. The findings provide the empirical base for developing potential messages using the source considered most trustworthy (the physician) and the vehicle most consulted (Chinese language media).

Adolescent↗

Recruiting and retaining minority women: findings from the Women on the Move study.

OBJECTIVES: To describe the recruitment, enrollment, and retention of women participating in the Women on the Move study, a physical activity validation study targeting urban minority women aged 40 to 70 years. DESIGN: The intensive 15-day validation protocol included ingestion of doubly labeled water (2H2 18O), collection of 9 urine samples, completion of multiple physical activity surveys, including selected questions from the BRFSS and NHANES III, wearing an accelerometer, and completing a detailed diary of physical activity for 7 days. The follow-up interview included completion of more questionnaires, followed by measurement of resting metabolic rate. In planning for recruitment, enrollment, and retention of participants, investigators consulted with a community advisory board and conducted focus groups with members of the target communities and with key community leaders. METHODS: Recruitment methods included print, television, and radio advertisements and presentations at community health fairs, churches, and health clinics. RESULTS: Of the 656 women who expressed interest in the study, 386 (59%) met eligibility criteria, and 260 were enrolled (130 Latina, 130 African-American). To retain participants in the study, investigators had intensive telephone contact with the participants, scheduled meetings at times and locations convenient for the participants, used bilingual and bicultural staff, and offered participants staged monetary payments. Of the women enrolled, the retention for the meetings that could happen at more convenient locations was 98.8% and for the required meeting at a central location it was 85.4%. CONCLUSION: Experience from the Women on the Move study suggests that by working with community members, Latina and African-American women can be successfully recruited and, through extensive contact, retained, even in research studies with demanding protocols.

Adult↗

People are the focus of Deaconess. Image campaign also aims at recruiting staff.

Deaconess Hospital in Evansville, Ind., is recruiting hospital personnel in a campaign that also addresses the general public. Started in March 2001, the campaign consists of outdoor billboards, print ads, and radio and TV spots. All emphasize Deaconess workers and their ability to make a difference.

Hospitals, Community↗