Family interactions of assaultive adolescents, stealers, and nondelinquents.

Eleven adolescent chronic offenders apprehended for assaultive crimes in the community were observed in their family homes. This group was matched with 11 adolescents apprehended for stealing and with 11 adolescents with no court contact. Assaultive adolescents, unlike their controls, ranked significantly higher among their own family members in terms of their total aversive behavior in the family home. The results support the notion that assaultive adolescents are more involved with fighting with their siblings in the family home and consequently have had more practice in fighting than their controls, thereby preparing them for assaultive behavior in the community. Assaultive adolescents had more female siblings than male siblings, whereas nondelinquent adolescents had more male than female siblings.

Failure of open radioactive 125iodine implantation to control localized prostate cancer: a study of 41 patients.

We studied 41 patients with localized prostate cancer who underwent bilateral pelvic lymphadenectomy with open insertion of radioactive 125iodine. Followup was a minimum of 5 years. Of the patients 13 died: 10 of recurrent prostatic adenocarcinoma (including 4 of 5 with pathological stage D1 cancer) and 3 of unrelated causes within 2 years of implantation without clinical evidence of prostate cancer. Of the 28 remaining patients 16 have known recurrence of cancer (positive bone scan and increasing prostate specific antigen (PSA) level or positive tissue biopsy]. Six patients have strong suspicion of local recurrence with elevated PSA levels (greater than 4.0 in 5) and increasing induration on digital rectal examination. Only 6 of the 41 patients (14.6%) are without evidence of disease. Openly implanted radioactive 125iodine does not appear to control effectively adenocarcinoma of the prostate.

Serum protein, enzyme and immunoglobulin responses following perineal cryosurgery for carcinoma of the prostate.

Alterations in serum proteins, enzymes and immunoglobulins were analyzed sequentially in 40 patients undergoing perineal cryosurgery for carcinoma of the prostate. A search was made for evidence of a tumor marker and for augmented host response attributable to an immune mechanism. The data showed little evidence to support a systemic immune response. A reliable tumor marker could not be identified when cryosurgery was used alone.

An in-depth analysis of male adolescent smokeless tobacco users: interviews with users and their fathers.

Male adolescent smokeless tobacco (ST) users (N = 191) were extensively interviewed, then followed over a 6-month period with monthly telephone interviews. In addition, their fathers (N = 137) were interviewed by telephone. Based on these data, ST use appears similar to cigarette smoking with respect to onset, patterns of use, social influences, attempts to quit, and indications of addiction. Onset and continued use of ST largely occur in a social context. Parents are reportedly aware (73%) of their sons' ST use but appear tolerant. The great majority of S's (92%) believe that there is some health risk associated with ST use. Over half report noticing ST-related changes in their oral cavities, although their dentists generally had not discussed ST use with them. Over one-third of the current users report unsuccessful quit attempts. ST use appears to be part of a more general pattern of substance use, including marijuana and alcohol.

How generalizable are the effects of smoking prevention programs? Refusal skills training and parent messages in a teacher-administered program.

This study investigated both substantive and methodological issues associated with school-based smoking prevention programs. Substantive issues included the efficacy of a refusal skills training curriculum and of parent messages mailed to students' homes. Methodological issues included the effects of assigning classrooms versus entire schools to experimental conditions and determination of the effects of attrition on internal and external validity. Results revealed differential impact for different subgroups of adolescents. The refusal skills program produced lower rates of smoking than the control condition for students who were smokers at the pretreatment assessment but may have produced detrimental effects among males who were nonsmokers at pretest. The provision of parent messages did not affect outcome. Method of assignment (schools versus classrooms) failed to produce significant effects, and attrition did not affect internal validity. However, the above differential findings, as well as the impact of attrition on external validity, raise questions concerning the generalizability of smoking prevention programs.

The efficacy of social-influence prevention programs versus "standard care": are new initiatives needed?

This study evaluates the effects of a school-based smoking prevention program after 1 year, using school (22 middle/elementary schools, 15 high schools) as both the unit of randomization and the unit of analysis. The multigrade level (grades 6 through 9) intervention was designed to address comprehensively the social influence factors that encourage smoking. Teacher survey data indicated that treatment schools had a median of 10 classroom sessions devoted to tobacco/drug use education, 5 of which were the sessions designed for this evaluation, and control schools had also dedicated a median of 10 classroom sessions to tobacco/drug education. Thus, the study evaluated the incremental effects of the social influence intervention compared to "standard-care" curricula. Among those who reported smoking one or more cigarettes in the month prior to the intervention, there was a significant treatment effect on rate of smoking at one year, but no grade level, gender, or interaction effects. The 1-year covariate-adjusted smoking rate among pretest smokers in the treatment schools was 76.6 cigarettes per month, compared to 111.6 cigarettes per month in control schools, a 31.4% difference. These effects were not accounted for by differential subject attrition. The analyses for nonsmokers, however, showed no significant effects, and the program did not affect self-reported alcohol or marijuana use. Taken together with the results of other prevention studies, these results point to the need for the development and evaluation of new initiatives to prevent substance use.