Activity of human leukocyte interferon in a human tumor cloning system.

Clinical trials using interferon to treat human malignancies are currently hampered by limited supplies of the compound. We have utilized a human tumor cloning system as an assay for the antitumor effects of human leukocyte interferon. Interferon was tested against 62 patients' tumors growing in this soft agar system. A dose-dependent cytotoxic effect of interferon was noted against only five of the patients' tumors. A greater than or equal to 70% decrease in tumor colony-forming units (TCFUs) was noted with one lymphosarcoma cell leukemia, one small cell lung cancer, one adenocarcinoma of the lung, one breast cancer, and a pancreatic cancer. One patient had his tumor cultured in vitro and had a clinical trial with interferon. This patient whose tumor demonstrated in vitro sensitivity had a clinical antitumor effect with interferon therapy. The in vitro results in this study suggest that the human leukocyte interferon currently available has a low level of activity in a human tumor cloning system. Additional testing is needed to determine whether the cloning system can identify the patient(s) who might have an antitumor effect from the interferon.

Maternal and child mortality along the U.S.-Mexico border.

This paper examines the maternal mortality and the age-specific mortality rates for the under 25 year olds in six border regions on the U.S. side of the U.S.-Mexico border and compares them with those of adjoining regions in Mexico. On the U.S. side of the border, the improvement in the general mortality status of maternal and child health from 1970 to 1980 was equal to or better than that of the nation as a whole. Despite this improvement, in 1980 five of the six border regions showed higher mortality rates due to external causes for the 1-4 age-group. On the Mexican side, maternal and child mortality was lower in the border region than in other parts of Mexico but much higher than in the United States. The 1-4 year olds in Mexico had the highest mortality rates among the three age-groups over 1 year of age.

California's use of health statistics in child health planning.

The California Health Plan for Children, 1979, compiled by the Committee on Health Planning of California, District IX of the American Academy of Pediatrics, is an extensive report on health problems unique to the children of California. Since its publication, many local and state health agencies have been using it as a guide and source of data in their planning efforts for child and youth health. The creation of the plan demonstrated a successful working relationship between health care practitioners and biostatisticians, the acceptance by health professionals of the use of health statistics in planning, the different uses of health statistics in formulating recommendations, and an approach to organizing and summarizing large bodies of data. Nevertheless, our experience indicates that although collection systems for data on population, mortality, natality, morbidity, and health services statistics abound, their use in community health planning for subpopulations is still limited by problems in the definition, validity, and completeness of the data elements. The establishment of an individualized data system for the entire population, to be developed, coordinated, and controlled by one central agency, could be a significant step toward solving these long-standing problems in our data systems.

A study of the quality of prescriptions issued in a busy pediatric emergency room.

An analysis of 2,213 prescriptions written by physicians in a busy, urban pediatric emergency room revealed that only 110 or 5 percent had no errors or omissions of specifications. The quality of the prescriptions was evaluated according to the standards of acceptable prescribing for the following specifications: quantity, dosage, time interval between doses or specific hours to be given, and specific instructions. The hospital pharmacists, also under pressure, generally failed to monitor the prescriptions adequately--either they did not rectify the physicians' errors or at times they made incorrect changes. To improve the quality of prescriptions issued under pressure in an emergency room, several courses of action are recommended: Pharmacology departments of medical schools should place more emphasis on teaching students the art of writing explicit, comprehensible prescriptions. The physician and pharmacist should work as a team in the interest of providing patients with accurate and detailed prescriptions; or both the physician and the pharmacist should delegate the composition of prescriptions to an automated computer system, thereby reducing human error in writing and monitoring prescriptions and allowing both professionals more time for direct contact with patients.

Eat for health: a nutrition and cancer control supermarket intervention.

The growing evidence linking dietary patterns to the incidence and prevention of chronic disease has prompted a number of prominent health and scientific agencies to publish dietary guidelines for the public. Some dietary guidelines address specific diseases, such as cancer or heart disease; others focus on overall health promotion. This situation has created a demand for nutrition education and information programs for the public. Increasingly, supermarkets are seen as potential sites for effective consumer education. Eat for Health is a joint research study by the National Cancer Institute (NCI) and Giant Food Inc., a regional supermarket chain in the Washington-Baltimore area. The study's goal was to test the feasibility of supermarkets as a site for consumer nutrition education. Eat for Health's educational focus was diet and cancer control issues in the context of dietary patterns that promote health. Particular attention was paid to reduction of fat intake and increases in consumption of dietary fiber from grains, vegetables, and fruits. Analysis of program results is currently underway; data should be available in early 1990.

Evaluation of statistical packages for suitability for use by clinical investigators in medicine.

With the increased availability of personal computers and statistical software packages, it is inevitable that there will be increasing attempts by clinical investigators to perform data management and statistical analysis. Reviews of statistical packages are abundant in computer and statistical journals. However the majority of them were not written for clinical investigators in medicine. This paper presents an analytic approach to evaluate the suitability of statistical packages for use by clinical investigators for data-management and preliminary statistical-analysis purposes. The evaluation scheme addresses five areas of concern: availability of data-management features; availability of basic statistical-analysis features; ease of use; documentation; and quality of programs. Among six statistical packages reviewed by this process, CRISP is recommended as the most suitable package for clinical investigators to use for data-management and preliminary statistical-analysis purposes.

Risk reduction through comprehensive cancer education: the American Cancer Society Plan for Youth Education.

The American Cancer Society (ACS) Plan for Youth Education for the Year 2000 is discussed in consideration of other health initiatives such as the U.S. Dept. of Health and Human Services' Objectives for the Nation and the National Cancer Institutes' Cancer Control Objectives for the Year 2000. Objectives of the ACS Plan are detailed with corresponding data sources to monitor progress. The Plan is designed to serve as a framework for ACS program planning, implementation, and evaluation in substance use, nutrition and eating patterns, cancer-early detection, cancer-the disease, and the environment. Justification for selecting the priority program areas also is described.

Diffusion of cancer education into schools.

Though implementing health education in schools has numerous advantages, many barriers impede adoption of effective curricula. Diffusion theory provides a framework for understanding why some school systems do not implement comprehensive, sequential, and behaviorally oriented curricula. Reasons for failure to provide optimal health education include competition for time, unawareness of resources and research results, political considerations, long-range planning difficulties, lack of teacher training, lack of testing, other academic priorities, uncertainty about responsibility for health education, and costs. Health educators can overcome such difficulties by working within existing curricular agendas, political interests, and budgets, and by organizing interventions through school health councils, while recognizing local programs, conditions, and resources.

Cancer knowledge and related practices: results from the National Adolescent Student Health Survey.

The National Adolescent Student Health Survey (NASHS) provides information on student knowledge, attitudes, and self-reported practices of eighth and 10th grade students in eight health areas. Data from the NASHS were reviewed relative to cancer risk factors, specifically, smoking, smokeless tobacco use, and nutrition. About 21% of 10th grade students reported smoking and a large percentage of both eighth and 10th grade students reported eating foods high in fat. The data indicate youth may be at increased risk for cancer and that much of that risk can be reduced by eliminating smoking and lowering dietary fat.

Respiratory tract illness in meat wrappers.

A questionnaire survey was done in 152 Houston supermarkets to assess the prevalence of respiratory tract symptoms in meat wrappers exposed to the thermal decomposition fumes of polyvinyl chloride (PVC) film wrap and in two supermarket control groups (checkers and meat cutters). Meat wrappers had increased respiratory tract symptoms; 12% of meat wrappers who smoked (vs 6% and 2% of controls) and 5% of meat wrappers who did not smoke (vs 0% and 0% of controls) had multiple respiratory tract symptoms. It is probable that a large number of meat wrappers have mild symptoms with some progressing to more severe respiratory impairment or clinical asthma.