Comprehensive vaping bans are associated with lower odds of initiation into electronic nicotine delivery systems use among young people.

BACKGROUND AND AIMS: E-cigarette and other electronic nicotine delivery systems (ENDS) use has grown considerably over the past decade, with notable increases among young people. US state policy contexts for ENDS and tobacco may shape initiation into ENDS use among adolescents as they age into early adulthood. We aimed to determine whether state-level comprehensive vaping ban policies reduce the odds of youth initiation into ENDS use, net of additional state-level ENDS and tobacco policies, as well as the youth's cigarette smoking status. DESIGN: Longitudinal data from the Population Assessment of Tobacco and Health study were merged with a state-year database on tobacco and ENDS policies. Multivariable discrete-time event history models of ENDS initiation were estimated. SETTING: United States. PARTICIPANTS: Twenty thousand twelve youth assessed over six waves from 2013 to 2019 (n = 53 974 observations). MEASUREMENT: We examined comprehensive indoor vaping bans (i.e. 100% vape-free workplaces, restaurants and bars) as a key factor in initiation into ENDS use (i.e. first instance of vaping) from age 13 to 22. FINDINGS: Among young people, residing in a state with a comprehensive vaping ban was associated with 18% lower odds of ENDS initiation (odds ratio = 0.82; 95% confidence interval =[0.71, 0.94]), even after controlling for other state ENDS and tobacco policies, the youth's cigarette smoking and socio-demographic background and state-level covariates. CONCLUSIONS: In the United States, state-level vaping bans (i.e. 100% vape-free workplaces, restaurants and bars) are associated with reduced odds of youth initiation into electronic nicotine delivery systems use.

Tobacco Policy and ENDS Policy Influences on Adolescent Vaping Across the U.S. States.

INTRODUCTION: Although the use of tobacco has declined among youth, ENDS has the potential to disrupt or reverse these trends. Policies for tobacco and ENDS may have an impact on adolescent ENDS use. The impacts of state-level policies were examined for both tobacco and ENDS indoor use bans, excise taxes, and age-of-purchase laws on past-month adolescent ENDS use from 2013 to 2019. METHODS: This study used cohort data from the Population Assessment of Tobacco and Health study and policy data from the Americans for Nonsmokers' Rights Foundation repository-3 policies for ENDS and 2 policies for tobacco products. Policies included comprehensive indoor vaping/smoking bans, purchase-age restrictions, and excise taxes. Hybrid panel models were estimated in 2022 using data merged from the 2 longitudinal sources on past-month vaping. The analytic sample (observations=26,008) included adolescents aged 12-17 years, yielding a total of 72,684 observations. RESULTS: The odds of adolescent ENDS use were 21.4% lower when the state had an ENDS purchase-age restriction and 55.0% lower when the state had a comprehensive tobacco smoking ban than in the years when the state did not have the ban. CONCLUSIONS: During a period of significant growth in ENDS use among U.S. youth, ENDS purchase-age restrictions and smoking bans reduced the odds of past-month vaping among adolescents. Wider implementation of policies may help intervene in youth vaping.

Adolescent Cannabis Use During a Period of Rapid Policy Change: Evidence From the PATH Study.

PURPOSE: To determine whether shifts in various state-level cannabis policies are associated with individual-level changes in adolescent cannabis use following implementation. METHODS: We use the restricted-access youth cohort of the PATH Study, a recent, longitudinal, and nationally representative dataset, to assess whether changes in cannabis policy affect youth cannabis use. Data include respondents aged 12 to 17 years across up to six repeated observations (N = 26,673). Hybrid (between-person and within-person) panel models are used to examine adolescent past-month cannabis use. RESULTS: Within-person effects showed that the odds of past-month cannabis use are lower (odds ratio [OR] = 0.632; p < .05) in years when a respondent's state allowed only cannabidiol (CBD) compared to years when the state had legalized medical cannabis. The odds of past-month cannabis use are lower during years when a respondent's state had decriminalized (OR = 0.617; p < .01) or criminalized (OR = 0.648; p < .05) adult recreational cannabis possession compared to years when it was legalized. These effects were robust to numerous controls, including time and state fixed effects. By contrast, significant between-person effects became nonsignificant with state fixed effects included, implying that state-level average use distinguishes average differences between states rather than policy. DISCUSSION: Liberalized cannabis policy is significantly associated with recent adolescent cannabis use. The most consequential policy shift associated with adolescent use is from either criminalization or decriminalization of cannabis possession to legalization, such that states making these changes should consider additional prevention efforts.

Thelastoma vanwaerebekei n. sp. (Oxyurida: Thelastomatidae) a parasite of Gymnetis litigiosa (Coleoptera: Scarabaeidae) from Uruguay.

Thelastoma vanwaerebekei n. sp. was extracted from the hindgut of Gymnetis litigiosa. The new species is included in the group of species with females having the excretory pore at the same level as the pharyngeal basal bulb (or slightly anteriorly), long tail length (approximately 30% of total body length) and males without spicules. Females of T. vanwaerebekei n. sp. differ from those of T. madecassum in tail shape (filiform and conical, respectively). They differ from T. basiri, T. imphalensis and T. dessetae in the morphology of the anterior region. In females, pharyngeal length is shorter than in T. depressum. In males, T. vanwaerebekei n. sp. differs from T. blabericola in the tail length, and from T. raoi in the number of caudal papillae. The partial 18S SSU and 28S LSU rRNA gene regions were amplified.

[Primary healthcare and underreporting and (in)visibility of violence against women]. / Subnotificação e (in)visibilidade da violência contra mulheres na atenção primária à saúde.

This study aimed to map indicators of violence against women as recorded by primary healthcare services in Belo Horizonte, Minas Gerais State, Brazil, and to identify difficulties experienced by health professionals in reporting such violence. Epidemiological data on this type of notification were collected in the information system of the Municipal Health Department. Data were produced with a semi-structured questionnaire and three focus group sessions with participation by 270 primary care professionals. The data were submitted to content analysis and were coded, categorized, and discussed in light of a literature review. A central analytical axis was called (in)visibility of violence against women. The data revealed both the recognition of violence as a public health problem and the invisibility that prevents dealing with it properly. Notification of such violence is often viewed as a fuss or commotion, which hampers progress in discussing and acting on the problem.

Subnotificação e (in)visibilidade da violência contra mulheres na atenção primária à saúde / Primary healthcare and underreporting and (in)visibility of violence against women / Subnotificación e (in)visibilidad de la violencia contra las mujeres en la atención primaria a la salud

Esta pesquisa teve por objetivo mapear indicadores de violências contra mulheres em unidades básicas de saúde de Belo Horizonte, Minas Gerais, Brasil, e identificar as dificuldades experimentadas por profissionais de saúde na notificação de violências. Dados epidemiológicos sobre esse tipo de notificação foram levantados no sistema de informações da Secretaria Municipal de Saúde. Dados qualitativos foram produzidos com questionário semiestruturado e três sessões de grupos focais, com a participação de 270 profissionais da atenção primária à saúde. Os dados foram submetidos à análise de conteúdo, sendo codificados, categorizados e discutidos à luz da revisão de literatura. Um eixo analítico central foi denominado (in)visibilidade da violência contra mulheres. Emergem dos dados tanto o reconhecimento da violência como problema de saúde pública quanto a invisibilidade que impede o seu enfrentamento. Observa-se que a notificação é frequentemente tomada como denúncia, o que dificulta o avanço nas discussões e ações concernentes ao problema.

This study aimed to map indicators of violence against women as recorded by primary healthcare services in Belo Horizonte, Minas Gerais State, Brazil, and to identify difficulties experienced by health professionals in reporting such violence. Epidemiological data on this type of notification were collected in the information system of the Municipal Health Department. Data were produced with a semi-structured questionnaire and three focus group sessions with participation by 270 primary care professionals. The data were submitted to content analysis and were coded, categorized, and discussed in light of a literature review. A central analytical axis was called (in)visibility of violence against women. The data revealed both the recognition of violence as a public health problem and the invisibility that prevents dealing with it properly. Notification of such violence is often viewed as a fuss or commotion, which hampers progress in discussing and acting on the problem.

Esta investigación tiene como objetivo mapear indicadores de violencia contra las mujeres en las unidades básicas de Belo Horizonte, Minas Gerais, Brasil, e identificar las dificultades observadas por los profesionales de sanidad en la notificación de la violencia. Datos epidemiológicos sobre ese tipo de notificación fueron recogidos en el sistema de información de la Secretaría Municipal de Salud. Se consiguieron datos cualitativos mediante un cuestionario semiestructurado y tres sesiones de grupos focales, con la participación de 270 profesionales de atención primaria a la salud. Los datos fueron sometidos a un análisis de contenido, fueron codificados, categorizados y discutidos a la luz de la revisión de la literatura. Un eje analítico central fue denominado (in)visibilidad de la violencia contra las mujeres. Emergen dos datos, tanto el reconocimiento de la violencia como un problema de salud pública, como la invisibilidad que impide su enfrentamiento. Se observa que la notificación es frecuentemente entendida como denuncia, lo que dificulta el avance en las discusiones y acciones concernientes al problema.

Comparative study of the cutaneous sensation of leprosy-suspected lesions using Semmes-Weinstein monofilaments and quantitative thermal testing.

The objective of the present study was to compare the warm cold perception thresholds (WPT), cold perception thresholds (CPT) and the warm and cold perception interval (WCPI) determined in our previous study with the touch-pressure thresholds, in leprosy-suspected skin lesions ('patch'). Thermal testing was conducted using a thermal sensory analyser TSA-2001 (Medoc Ltd., Israel) and the method of levels. The touch-pressure thresholds were measured using Semmes-Weinstein monofilament (SWM) of 0-05 g, 0.2 g, 2 g, 4 g, 10 g and 300 g. A cross-sectional study of 112 patients presenting with leprosy-suspected skin lesions, with no clinical evidence of peripheral nerve damage, was conducted. Leprosy diagnoses were based on clinical dermato-neurological examinations. One-hundred-and-eight subjects (45 males, 63 females; average age 37.7 years) completed the tests: 82 were positively diagnosed with leprosy and 26 with diseases of different aetiologies. The SWM test showed a sensitivity of 81.7% and a specificity of 96.1%, while the warm and cold perception thresholds presented sensitivity of 90.2% and 92-2%, respectively (both with 100% specificity). In leprosy patients, lesions that exhibited pressure thresholds of 0.05 g typically showed significantly different WPT, CPT and WCPI values when compared with skin lesions of different aetiologies. Within the leprosy group, the mean values of WPT, CPT and WCPI increased according to the increase in touch-pressure thresholds. Some of the patients exhibiting leprosy lesions with touch-pressure thresholds of 0-05 and 0-2 g presented normal WPT or CPT values. However, all patients with SWM equal or above 2.0 g presented altered WPT and CPT. All patients with leprosy, including those that exhibited pressure thresholds of 0.05 g, presented altered WCPI in the skin lesions. Despite a higher sensitivity to thermal tests, the SWM has adequate validity as a screening tool in the diagnosis of cutaneous forms of leprosy and in the selection of patients who should be submitted to a more detailed examination.

Impaired warm and cold perception thresholds in leprosy skin lesions.

The aim of the present study was to determine the frequency of alteration in warm perception thresholds (WPT), cold perception thresholds (CPT) and the warm and cold perception interval (WCPI) in leprosy-suspected skin lesions, and to determine if these tests could assist in the diagnosis of leprosy. Tests were conducted using a thermal sensory analyser TSA-2001 (Medoc Ltd, Israel) and the method of levels. A cross-sectional study of 112 patients presenting leprosy-suspected skin lesions ('patch'), with no clinical evidence of peripheral nerve damage, was conducted. Leprosy diagnosis was based on clinical dermato-neurological examinations and complementary tests. One hundred and eight subjects (45 males, 63 females; average age 37.7 years) completed the tests: 82 were positively diagnosed with leprosy and 26 with diseases of different etiologies. The mean values of WPT (45-63 +/- 5.59), CPT (9.64 +/- 11.34) and WCPI 36.01 +/- 15.58) registered in leprosy-skin lesions were significantly different (P < 0.001) from lesions of diverse aetiologies and skin area without lesions. The cut-off point for WPT as determined from the ROC curve (receiver operating characteristic) was 35-10 degrees C, with a sensitivity of 90.2% and a specificity of 100%, and the corresponding cut-off point for CPT was 28.95 degrees C, with a sensitivity of 92.7% and a specificity of 100%. Nevertheless, all patients with leprosy presented a WCPI greater than 6.10 degrees C (ROC curve) in skin lesions. Increase in the thermal thresholds indicated warm hypoaesthesia, cold hypoaesthesia or both. The WCPI, which embraces both warm and cold perception thresholds, was the best indicator of thermal sensation, a term used in literature as a non-specific expression that does not describe warm and cold stimuli explicitly in terms of units of temperature.

Quality of life in post-menopausal osteoporosis.

BACKGROUND: To evaluate the impact of osteoporosis on the patients' quality of life, particularly in the absence of fractures. METHODS: 100 post-menopausal women (age 50-85)--62 with uncomplicated primary osteoporosis and 38 with primary osteoporosis complicated by vertebral fractures; all already treated--were studied using two validated questionnaires: Qualeffo-41 for quality of life in osteoporosis, and Zung for depression. Data were compared to those of 35 controls of comparable age, affected by a different chronic disease (hypothyroidism). RESULTS: Family history of osteoporosis and T-score of spine were similar in the two subgroups of osteoporotic women. Body mass index, age at menopause and education level were similar in the two subgroups of osteoporotic women and in the control group. The patients affected by osteoporosis perceived it as a disease affecting their personal life with undesirable consequences: chronic pain (66% of women with fractures and 40% of women without fractures), impaired physical ability, reduced social activity, poor well-being (21% of women without fractures) and depressed mood (42% of women irrespective of fractures). Overall, 41% of the women showed a reduced quality of life. On the contrary, in the control group only 11% reported a reduced quality of life. CONCLUSION: The quality of life of osteoporotic patients should be investigated even before fractures, in order to develop appropriate counselling, support and care interventions to help patients develop efficient strategies for accepting the disease and coping with it.

Multidrug-resistant Salmonella Typhimurium infection from milk contaminated after pasteurization.

An outbreak of multidrug-resistant Salmonella enterica serotype Typhimurium infections occurred in Pennsylvania and New Jersey. A case-control study implicated pasteurized milk from a dairy, and an inspection indicated the potential for contamination after pasteurization. Dairy cattle are the likely reservoir, and milk may be an important vehicle of Salmonella transmission to humans.