Characterization of Patients With and Without Painful Peripheral Neuropathy After Receiving Neurotoxic Chemotherapy: Traditional Quantitative Sensory Testing vs C-Fiber and Aδ-Fiber Selective Diode Laser Stimulation.

Painful chemotherapy induced peripheral neuropathy (CIPN) is a common complication of chemotherapy with drugs such as taxanes and platinum compounds. Currently, no methods are available for early detection of sensory changes that are associated with painful CIPN, nor are there biomarkers that are specific to painful CIPN. This study aimed to compare Diode Laser fiber type-selective stimulator (DLss), a method to selectively stimulate cutaneous C and Aδ fibers, to traditional quantitative sensory testing (QST) in determining psychophysical differences between patients with painful CIPN and a control group. Sensory testing was performed on the dorsal mid-foot of 20 patients with painful neuropathy after taxane- or platinum-based chemotherapy, and 20 patients who received similar neurotoxic chemotherapy, without painful CIPN. In a multivariable analysis, C-fiber to Aδ fiber detection threshold ratio, measured by DLss, was significantly different between the groups (P <.05). While QST parameters such as warmth detection threshold were different between the groups in univariate analyses, these findings were likely attributable to group differences in patient age and cumulative chemotherapy dose. PERSPECTIVE: In this study, fiber-specific DLss test showed potential in identifying sensory changes that are specific for painful neuropathy, encouraging future testing of this approach as a biomarker for early detection of painful CIPN. TRIAL REGISTRATION: The study was approved by the Washington University Institutional Review Board (#201807162) and registered at ClinicalTrials.gov (NCT03687970).

Online smoking cessation program for Korean Americans: Randomized trial to test effects of incentives for program completion and interim surveys.

INTRODUCTION: Smoking is prevalent among Korean American men. Quitting is Winning, an Internet-based, cognitive-behavioral smoking cessation program, was developed using community-based participatory research principles. METHODS: A randomized controlled trial was used to evaluate whether participants were more likely to complete the program and quit smoking at 6-months of follow-up with additional reinforcement. The main outcomes were the proportion of participants who completed the online program and the proportion who quit smoking for at least 30days, 26weeks after enrollment, among those randomized into the high-reinforcement (HR) condition compared with those in the low-reinforcement (LR) condition. RESULTS: The study achieved a final enrollment of 403 participants including 56 women. Program completion was greater for the HR as compared to the LR condition (17% vs. 10%, p=.035). There was no significant difference in 30-day smoking cessation (intent-to-treat [ITT]) between the HR and LR conditions (9% vs. 8%, ns). Smoking cessation was greater among program completers as compared to those who did not complete the program (28% vs. 5%, p<.001). CONCLUSIONS: The addition of interim surveys and financial incentives for interim survey completion and program completion significantly increased the likelihood of program completion. Moreover, program completers were significantly more likely to quit smoking. Although smoking cessation rates did not significantly differ between the HR and LR conditions, the results suggest that future studies should explore the efficacy of larger financial incentives for program completion (Clinical Trial #NCT02584127).

An internet-based smoking cessation program for Korean Americans: results from a randomized controlled trial.

INTRODUCTION: Smoking is quite prevalent among Korean Americans (KAs). Quitting is Winning was developed using community-based participatory research principles as an online self-help smoking cessation program for KAs in response to feedback from our community partner who felt that most KAs prefer to quit "on their own." METHODS: A randomized controlled trial was used to evaluate this cognitive-behavioral program. The main outcome was the proportion of participants who had quit for at least 30 days, 50 weeks after enrollment, among those randomized into the Internet intervention compared with those receiving a similar program via booklet. The study had 11 online surveys administered every 5 weeks. RESULTS: The study took place between September 2005 and April 2009 and had a final enrollment of 1,112. Based on the outcome assessed at 50 weeks, there was no significant difference in 30-day smoking cessation between the Internet (11%) and booklet (13%) groups (intent-to-treat [ITT] difference = -2%, 95% CI = -6% to 2%). In post-hoc analysis, quitting was higher among participants in the Internet intervention (n = 562) who completed the online program: 26% quit compared with 10% who did not complete the program (ITT difference = 16%, 95% CI = 3%-29%). CONCLUSIONS: The Internet self-help smoking cessation program appears to help KA smokers quit, although not more than a similar program delivered via booklet. If we can get people engaged, online cessation programs have potential to reach smokers who would not or cannot participate in more traditional interventions.

Relationships between household smoking restrictions and intention to quit smoking among Korean American male smokers in California.

This cross-sectional study examined the relationships between household smoking restrictions and intentions to quit smoking among Korean American male smokers in California. We used data from the California Korean American Tobacco Use Survey (CKATUS), which was conducted in 2004 using computer-assisted telephone interviewing. Among the 2,545 respondents who participated in the CKATUS, the 387 male smokers who answered a question assessing their intention to quit smoking were included in the final analyses. In univariable analyses, smokers who reported having household smoking restrictions were more likely to intend to quit smoking as compared with those who did not (P<0.01). Other independent correlates of having an intention to quit smoking were being less than 50 yr of age, having spent more than 50% of one's life in the US, being assimilated, and having other smokers in the household. In a multiple logistic regression analysis, the significant correlates of having an intention to quit smoking were household smoking restrictions (complete or partial restriction vs. no restriction on smoking; odds ratio, 2.54; 95% confidence interval, 1.22-5.28) and absence of other smokers in the household. In conclusion, smoking restrictions in the household are associated with an intention to quit smoking among Korean American male smokers in California.

Mobile phone use and risk of tumors: a meta-analysis.

PURPOSE: Case-control studies have reported inconsistent findings regarding the association between mobile phone use and tumor risk. We investigated these associations using a meta-analysis. METHODS: We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library in August 2008. Two evaluators independently reviewed and selected articles based on predetermined selection criteria. RESULTS: Of 465 articles meeting our initial criteria, 23 case-control studies, which involved 37,916 participants (12,344 patient cases and 25,572 controls), were included in the final analyses. Compared with never or rarely having used a mobile phone, the odds ratio for overall use was 0.98 for malignant and benign tumors (95% CI, 0.89 to 1.07) in a random-effects meta-analysis of all 23 studies. However, a significant positive association (harmful effect) was observed in a random-effects meta-analysis of eight studies using blinding, whereas a significant negative association (protective effect) was observed in a fixed-effects meta-analysis of 15 studies not using blinding. Mobile phone use of 10 years or longer was associated with a risk of tumors in 13 studies reporting this association (odds ratio = 1.18; 95% CI, 1.04 to 1.34). Further, these findings were also observed in the subgroup analyses by methodologic quality of study. Blinding and methodologic quality of study were strongly associated with the research group. CONCLUSION: The current study found that there is possible evidence linking mobile phone use to an increased risk of tumors from a meta-analysis of low-biased case-control studies. Prospective cohort studies providing a higher level of evidence are needed.

Effects of Web- and computer-based smoking cessation programs: meta-analysis of randomized controlled trials.

BACKGROUND: The effects of Web- and computer-based smoking cessation programs are inconsistent in randomized controlled trials (RCTs). We evaluated those effects using a meta-analysis. METHODS: We searched MEDLINE (PubMed), EMBASE, and the Cochrane Review in August 2008. Two evaluators independently selected and reviewed eligible studies. RESULTS: Of 287 articles searched, 22 RCTs, which included 29 549 participants with 16 050 enrolled in Web- or computer-based smoking cessation program groups and 13 499 enrolled in control groups, were included in the final analyses. In a random-effects meta-analysis of all 22 trials, the intervention group had a significant effect on smoking cessation (relative risk [RR], 1.44; 95% confidence interval [CI], 1.27-1.64). Similar findings were observed in 9 trials using a Web-based intervention (RR, 1.40; 95% CI, 1.13-1.72) and in 13 trials using a computer-based intervention (RR, 1.48; 95% CI, 1.25-1.76). Subgroup analyses revealed similar findings for different levels of methodological rigor, stand-alone vs supplemental interventions, type of abstinence rates employed, and duration of follow-up period, but not for adolescent populations (RR, 1.08; 95% CI, 0.59-1.98). CONCLUSION: The meta-analysis of RCTs indicates that there is sufficient clinical evidence to support the use of Web- and computer-based smoking cessation programs for adult smokers.

Adherence to Pap test guidelines: variation among Asians in California.

OBJECTIVES: To compare Pap screening in the previous 3 years among subgroups of Asian American women, aged 18 to 65 years. DESIGN: Analysis of data from the 2001 and 2003 California Health Interview Survey (CHIS), a cross-sectional population-based telephone survey. MAIN MEASURES: The survey elicited information from major Asian subgroups, including Chinese, Filipina, Japanese, Korean, South Asian, and Vietnamese. Surveys were administered in several languages, including Mandarin, Cantonese, Korean, and Vietnamese. Employing the Andersen behavioral model of health services utilization, this study fits logistic regression models to identify correlates of Pap screening within and across Asian American subgroups. These analyses use time living in the United States and English proficiency as acculturation measures. RESULTS: There were different independent correlates of Pap test receipt for the six Asian subgroups. English proficiency and income were independently associated with Pap screening among only one subgroup; education, time in the US, and insurance among three; and age and usual source of care among four subgroups. Unmarried women were more likely to report not having a Pap test in the past three years across all six subgroups. CONCLUSIONS: Based on these differences, programs and policies targeting the health of Asian American women should consider tailoring interventions to match the needs of different ethnic groups. Specifically, program materials should strive to be both culturally sensitive and linguistically appropriate for all target populations.

Cancer coverage in a mainstream and Korean American online newspaper: lessons for community intervention.

OBJECTIVE: Korean Americans have higher incidence of stomach, liver, and cervical cancer than most groups in CA, USA, and generally lower rates of cancer screening. To better target community interventions, we evaluated the cancer content in a leading Korean American newspaper, the Korea Daily, compared to a mainstream newspaper from the same metropolitan area, the Los Angeles (LA) Times. METHODS: Using the online versions of each newspaper for the year 2006, we counted articles mentioning cancer and evaluated the content in a random sample of 300 articles from each newspaper. Articles were categorized by relevance of cancer content and topic(s) covered. RESULTS: Although the LA Times had a higher proportion of articles mentioning cancer, the Korea Daily had more articles that primarily focused on cancer and addressed specific types of cancer. Articles in the Korea Daily were more likely to discuss prevention, while those in the LA Times more often focused on people, politics, or research. CONCLUSIONS: Smaller, ethnic newspapers may be more amenable to messages about prevention and appropriate places to target community-focused interventions. PRACTICE IMPLICATIONS: Health practitioners should consider submitting articles to ethnic newspapers and forming partnerships with journalists to cultivate this potential.

"Health is strength": a community health education program to improve breast and cervical cancer screening among Korean American Women in Alameda County, California.

BACKGROUND: A 48-month community intervention was conducted to improve breast and cervical cancer (BCC) screening among Korean American (KA) women in Alameda County (AL), California. KA women in Santa Clara (SC) County, California served as a comparison group. METHODS: Random samples of KA women from each county were surveyed by telephone in 1994 (n=818) and 2002 (n=1084). Propensity score analyses were used to estimate the difference between counties in changes over time in screening (Pap tests, breast self-examinations, clinical breast examinations, and mammography), and to estimate differences in screening between participants and non-participants in an educational workshop among women in AL in 2002. RESULTS: Mammography screening and clinical breast examinations increased over time in both counties. Pap tests increased in AL but not SC, and breast self-examinations did not change significantly in either county. None of the intervention-comparison group differences over time were significant. In 2002, compared to non-participants, women who attended a workshop were more likely to report a recent Pap test (P<.08). CONCLUSIONS: Although our overall intervention did not appear to enhance screening practices at the community-level, attendance at a women's health workshop appears to have increased cervical cancer screening.