Early Brain Injury and Adaptive Functioning in Middle Childhood: The Mediating Role of Pragmatic Language.

OBJECTIVE: Traumatic brain injuries (TBIs) often adversely affect adaptive functioning (AF). However, the cognitive mechanisms by which AF is disrupted are not well understood in young children who sustain TBI. This study examined pragmatic language (PL) and executive functioning (EF) as potential mechanisms for AF disruption in children with early, predominantly mild-complicated, TBI. METHOD: The sample consisted of 76 children between the ages of 6 and 10 years old who sustained a TBI (n = 36) or orthopedic injury (OI; n = 40) before 6 years of age and at least 1 year prior to testing (M = 4.86 years, SD = 1.59). Children's performance on a PL and an expressive vocabulary task (which served as a control task), and parent report of child's EF and AF were examined at two time points 1 year apart (i.e., at age 8 and at age 9 years). RESULTS: Injury type (TBI vs. OI) significantly predicted child's social and conceptual, but not practical, AF. Results indicated that PL, and not expressive vocabulary or EF at time 1, mediated the relationship between injury type and both social and conceptual AF at time 2. CONCLUSIONS: A TBI during early childhood appears to subtly, but uniquely, disrupt complex language skills (i.e., PL), which in turn may disrupt subsequent social and conceptual AF in middle childhood. Additional longitudinal research that examines different aspects of PL and adaptive outcomes into adolescence is warranted.

Early Elementary School Outcome in Children With a History of Traumatic Brain Injury Before Age 6 Years.

OBJECTIVE: To describe elementary school outcomes for children who experienced a traumatic brain injury (TBI) before age 6 years compared with a control group of children with orthopedic injuries. PARTICIPANTS: Children ages 6 to 9 years recruited from community and trauma registries in a large southeastern state. DESIGN: Descriptive findings from the first year of a 3-year longitudinal study. MAIN MEASURES: Child assessment and parent report measures were administered to capture cognitive, language, reading, and behavior outcomes. Medical record review confirmed injuries and injury severity. RESULTS: The TBI group (n = 39) had a mean age of 7.55 years (standard deviation = 1.29) and was 5.15 (standard deviation = 1.56) years postinjury. The TBI group had primarily classified as mild complicated TBI (63%). On average, children in both groups performed within normal limits on most cognitive, language, and reading measures. Group differences were identified in verbal IQ, receptive language, and reading comprehension, with robust performance differences in pragmatic language, story retell and word fluency, and parent report of executive functions. CONCLUSIONS: Findings indicate the importance of in-depth follow-up specialist assessments (eg, neuropsychologist and speech and language pathologists) to identify potential nuanced difficulties in children with mild complicated TBI that may be missed by general evaluations.

Readiness for transition and health-care satisfaction in adolescents with complex medical conditions.

BACKGROUND: The purpose of this study is to examine contributions to patient perceptions of transition readiness and satisfaction with care amongst adolescents and young adults (AYAs) with complex health conditions engaging in paediatric care. METHODS: Participants included 94 patients aged 14-20 years (M = 16.41, SD = 1.56) with cystic fibrosis (n = 31), sickle cell disease (n = 27), and solid organ transplants (n = 36). Participants completed self-report questionnaires and medical providers completed measures of their medication regimen complexity. One-way analysis of variance compared differences between disease groups on study variables. Pearson product-moment correlation coefficients and linear regression models evaluated factors associated with AYA reported transition readiness and satisfaction with health care. RESULTS: There were no significant differences between disease groups on patient-reported transition readiness, barriers to medication adherence, health care self-management, or satisfaction. Patient age, self-reported health-care responsibility, medication barriers, and academic performance predicted a large portion of the variance in AYA perceptions of transition readiness (R2  = 0.27, F (4, 83) = 7.74, p < 0.001, Cohen's f2 = 0.37). Patient gender, self-reported health-care responsibility, and medication barriers predicted a medium portion of the variance in AYA satisfaction with health care (R2  = 0.23, F (3, 88) = 8.56, p < 0.001, Cohen's f2 = 0.30). CONCLUSIONS: Patient perceptions of health care self-management and barriers to medication adherence are important predictors of readiness for transition and satisfaction with care. Considering a holistic approach that includes these factors allows for improved understanding of individual needs for transition interventions that can improve adult outcomes for individuals with complex health conditions.

Identification of botanicals with potential therapeutic use against methicillin-resistant Staphylococcus aureus (MRSA) infections.

Staphylococcus aureus is an opportunistic pathogen. Over- and improper-use of pharmaceuticals against S. aureus has led to the development of antibiotic resistance, including methicillin-resistant S. aureus (MRSA). This study examined the efficacy of botanical extracts as an alternative form of treatment to S. aureus and MRSA, including penicillin/methicillin-resistant S. aureus (PenR ), and multidrug resistant S. aureus (MDR). Initial screening of botanicals was done via a minimum inhibitory concentration procedure. In addition, a temporal growth curve was performed in order to quantify the growth of the bacteria in the presence of the extracts. Results demonstrated 13 botanicals that had varying activities against S. aureus, PenR , and MDR. These botanicals were separated into mild, moderate, and highly efficacious based on the concentration needed to inhibit bacterial growth. These results propose a comparison of botanical-derived antimicrobial extracts that may be utilized against S. aureus and different antibiotic resistant strains of MRSA.

Laryngeal papillomatosis associated dysplasia in the adult population: an update on prevalence and HPV subtyping.

OBJECTIVES: The objectives were to determine the prevalence of laryngeal dysplasia and associated human papilloma virus (HPV) subtypes in adult patients, 18 years or older, suffering from laryngeal papillomatosis at a tertiary care institution. STUDY DESIGN: Retrospective cohort study. METHODS: Patients with biopsy proven laryngeal papillomatosis were identified via chart review. All available pathology specimens were reviewed by a dedicated head and neck pathologist to confirm/refute the diagnosis of laryngeal dysplasia, and grade the level of dysplasia. Interrater agreement was compared using cross-tabulation methods. Specimens identified to be positive for dysplasia underwent further testing via in situ hybridization for low-risk (6/11) or high-risk (16/18) HPV subtypes. RESULTS: Of the 85 subjects identified to have laryngeal papillomatosis, 24(28%) demonstrated laryngeal dysplasia. There was good interrater agreement on the presence of dysplasia; however, there was only fair agreement on the grade of dysplasia. Of the pathology specimens tested for HPV subtype, the majority of patients (62%) were positive for HPV 6/11, including all high-grade dysplasia patients. Three (12%) dysplasia specimens were negative for both high- and low-risk HPV subtypes. CONCLUSIONS: We found a 28% prevalence of dysplasia in our patient population with the majority of patients positive for low-risk HPV subtypes indicating that high-risk HPV subtypes do not predispose laryngeal papilloma patients to dysplasia.

Voice outcomes from subligamentous cordectomy for early glottic cancer.

OBJECTIVES: We evaluated the voice and vocal fold pliability outcomes of European Laryngological Society (ELS) deep type I (subepithelial) and type II (subligamentous) cordectomies for early glottic cancer. METHODS: We reviewed the medical records of patients with glottic carcinoma at a tertiary care medical center between 2005 and 2011. Their procedures were stratified into ELS type I and ELS type II cordectomies. The data recorded included age, gender, tumor stage, recurrence, patient-assessed voice-related quality of life, perceptual voice evaluation, and stroboscopy. RESULTS: Four patients were identified as having subepithelial cordectomy, and 13 as having subligamentous cordectomy. The average preoperative and postoperative voice-related quality of life scores were 65 and 74 for the ELS I cohort and 64 and 95 for the ELS II group. The preoperative and postoperative perceptual voice evaluation scores were 56 and 35 for the ELS I cohort and 45 and 21 for the ELS II cohort. The ELS I cohort had a moderately to severely reduced mucosal wave, with 75% of patients demonstrating glottic insufficiency, whereas the ELS II cohort had a mildly to moderately reduced mucosal wave, with 8% of patients demonstrating glottic insufficiency. The survival outcomes were the same. CONCLUSIONS: Patients who underwent subligamentous excision of early glottic cancer had significantly improved postoperative voice and stroboscopy scores. This finding suggests that if tumor resection reaches the vocal ligament, and minimal superficial lamina propria can be preserved, subligamentous cordectomy should be performed.

The Impact of Referral Source on Voice Therapy.

INTRODUCTION: Adherence to voice therapy is essential in achieving successful voice outcomes. Previous studies within the field of voice therapy have suggested that shorter wait times and utilization of an interprofessional practice (IPP) model of care have a positive effect on voice therapy completion rates. While the implementation of IPP has gained popularity, especially at academic voice centers, the majority of speech-language pathologists (SLP) practice in a traditional (T) setting where they are unaffiliated with the referring otolaryngologist. PURPOSE: This study aims to further examine how SLP practice models (interprofessional vs traditional) affect voice therapy initiation and completion rates. The secondary aim is to determine if voice therapy attendance rates have changed since the authors' initial investigations over 10 years ago. METHODS: A retrospective chart review of 452 patients was conducted. Data was collected on patient demographics (sex, age), diagnosis, severity of dysphonia (CAPE-V), quality of life impact (V-RQOL raw score), practice setting (IPP vs T), date of referral, date of voice therapy initial evaluation, number of therapy sessions completed, and attendance to therapy sessions defined as completion or dropout. RESULTS/CONCLUSIONS: Initiation of voice therapy treatment was the point in the referral process that was most impacted by practice model. Over half (53%) of referrals to voice therapy in a traditional practice model did not lead to initiation of treatment, while only 23% of the referrals taking place in an IPP model failed to initiate (P < 0.001). This study also demonstrated an improving, but continued rate of noninitiation and dropout from voice therapy when compared to data that was collected 10 years prior.

Effect of Omega-3 Supplementation in Patients With Smell Dysfunction Following Endoscopic Sellar and Parasellar Tumor Resection: A Multicenter Prospective Randomized Controlled Trial.

BACKGROUND: Endoscopic endonasal approaches pose the potential risk of olfactory loss. Loss of olfaction and potentially taste can be permanent and greatly affect patients' quality of life. Treatments for olfactory loss have had limited success. Omega-3 supplementation may be a therapeutic option with its effect on wound healing and nerve regeneration. OBJECTIVE: To evaluate the impact on olfaction in patients treated with omega-3 supplementation following endoscopic skull base tumor resection. METHODS: In this multi-institutional, prospective, randomized controlled trial, 110 patients with sellar or parasellar tumors undergoing endoscopic resection were randomized to nasal saline irrigations or nasal saline irrigations plus omega-3 supplementation. The University of Pennsylvania Smell Identification Test (UPSIT) was administered preoperatively and at 6 wk, 3 mo, and 6 mo postoperatively. RESULTS: Eighty-seven patients completed all 6 mo of follow-up (41 control arm, 46 omega-3 arm). At 6 wk postoperatively, 25% of patients in both groups experienced a clinically significant loss in olfaction. At 3 and 6 mo, patients receiving omega-3 demonstrated significantly less persistent olfactory loss compared to patients without supplementation (P = .02 and P = .01, respectively). After controlling for multiple confounding variables, omega-3 supplementation was found to be protective against olfactory loss (odds ratio [OR] 0.05, 95% CI 0.003-0.81, P = .03). Tumor functionality was a significant independent predictor for olfactory loss (OR 32.7, 95% CI 1.15-929.5, P = .04). CONCLUSION: Omega-3 supplementation appears to be protective for the olfactory system during the healing period in patients who undergo endoscopic resection of sellar and parasellar masses.

The Role of Sex on Early Cochlear Implant Outcomes.

OBJECTIVE: To determine the presence of sex differences in cochlear implant outcomes. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS: Adult patients having undergone cochlear implantation from 2009 to 2017. INTERVENTION(S): Standard electrode length cochlear implantation. MAIN OUTCOME MEASURE(S): AzBio scores in quiet of the implanted ear at the 1 to 3 months and 6 to 9 months postoperative time points. RESULTS: Of 55 patients with complete demographic and speech recognition testing, 36.4% (n = 20) were men. The mean age at time of surgery was 59.81 ±â€Š16.54 years and the mean duration of hearing loss was 26.33 ±â€Š18.54 years; there was no significant difference between men and women. The mean preoperative AzBio score was 11 ±â€Š15.86% and there was no difference between men and women. Through 2 (sex) × 3 (time point) analysis of covariance (ANCOVA), there was no main effect of sex (F[1, 48] = 0.74, p = 0.39, η = 0.02) on postoperative AzBio scores, but there was a significant sex by time point interaction, (F[1.77, 85.03] = 4.23, p = 0.02, η = 0.08). At the 1 to 3 months postoperative time point, women exhibited higher relative improvement in AzBio scores than men (67 ±â€Š27% versus 55 ±â€Š31%). Further, this relative improvement increased and remained significant at the 6 to 9 months postoperative time point (women: 71 ±â€Š22% versus 58 ±â€Š30%). CONCLUSIONS: Sex may play a role in early speech recognition outcomes after adult cochlear implantation.

Proximal pharyngeal reflux correlates with increasing severity of lingual tonsil hypertrophy.

OBJECTIVE: To determine if degree of lingual tonsil hypertrophy (LTH) correlates with pharyngeal reflux. DESIGN: Prospective. METHODS: Patients with flexible laryngoscopic evidence of LTH were included. Degree of LTH was graded mild, moderate, or severe by two otolaryngologists blinded to pH study results. Three-sensor pH study results were correlated to LTH grade. RESULTS: Nineteen patients were included (five with mild LTH, eight with moderate LTH, and six with severe LTH). Nasopharyngeal reflux (NPR) events

Vocal outcome measures after bilateral posterior cricoarytenoid muscle botulinum toxin injections for abductor spasmodic dysphonia.

OBJECTIVE: To review vocal outcome measures, using the Voice Related Quality of Life (VRQOL) index, after simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injections. STUDY DESIGN: Case series. SETTING: Tertiary care academic clinic. SUBJECTS AND METHODS: Fourteen subjects with abductor spasmodic dysphonia received 37 simultaneous bilateral posterior cricoarytenoid muscle botulinum toxin injections for isolated abductor spasmodic dysphonia (ABSD) over a 16-month period. MAIN OUTCOME MEASURES: VRQOL index. RESULTS: Of the 37 injections, 33 of 37 (89%) resulted in improvement. Three injections resulted in no improvement, and one injection resulted in a worse VRQOL. The overall VRQOL mean improvement was 19.8 (range 5-53), with an average pre/postinjection VRQOL interval of 36 days (range 21-45 days). CONCLUSIONS: Simultaneous bilateral posterior cricoarytenoid muscle botulinum injections result in a statistically significant improvement in VRQOL index scores for a high percentage of ABSD patients, thus improving patient quality of life.

The relationship among receptive and expressive vocabulary, listening comprehension, pre-reading skills, word identification skills, and reading comprehension by children with reading disabilities.

PURPOSE: Some researchers (F. R. Vellutino, F. M. Scanlon, & M. S. Tanzman, 1994) have argued that the different domains comprising language (e.g., phonology, semantics, and grammar) may influence reading development in a differential manner and at different developmental periods. The purpose of this study was to examine proposed causal relationships among different linguistic subsystems and different measures of reading achievement in a group of children with reading disabilities. METHODS: Participants were 279 students in 2nd to 3rd grade who met research criteria for reading disability. Of those students, 108 were girls and 171 were boys. In terms of heritage, 135 were African and 144 were Caucasian. Measures assessing pre-reading skills, word identification, reading comprehension, and general oral language skills were administered. RESULTS: Structural equation modeling analyses indicated receptive and expressive vocabulary knowledge was independently related to pre-reading skills. Additionally, expressive vocabulary knowledge and listening comprehension skills were found to be independently related to word identification abilities. CONCLUSION: Results are consistent with previous research indicating that oral language skills are related to reading achievement (e.g., A. Olofsson & J. Niedersoe, 1999; H. S. Scarborough, 1990). Results from this study suggest that receptive and expressive vocabulary knowledge influence pre-reading skills in differential ways. Further, results suggest that expressive vocabulary knowledge and listening comprehension skills facilitate word identification skills.

SUBRETINAL CANNULATION AS A COMPLICATION OF SUTURE TRABECULOTOMY SURGERY IN A PEDIATRIC PATIENT.

PURPOSE: To report a case of inadvertent subretinal cannulation of ab externo suture trabeculotomy surgery associated with serous macular detachment. METHODS: Retrospective case report. Ophthalmic examination and portable spectral domain optical coherence tomography (Envisu C2300; Bioptogen, Morrisville, NC) were performed under general anesthesia. RESULTS: A 5-year-old girl with uveitis secondary to oligoarticular juvenile idiopathic arthritis underwent trabeculotomy surgery of the left eye for steroid-induced glaucoma refractory to medical management. The surgery was complicated by inadvertent subretinal cannulation with the prolene suture. Multiple, arcuate, hypopigmented subretinal tracks, originating from the ora serrata, were observed. Spectral domain optical coherence tomography images through the macula revealed subretinal fluid overlying funduscopically visible tracks, defects in photoreceptor outer segments overlying the tracks, and normal choroidal anatomy. The serous macular detachment resolved spontaneously after 4 months and visual acuity returned to baseline 20/25 in the left eye, consistent with reversible localized damage to the outer retina and retinal pigment epithelium. CONCLUSION: We report a case of inadvertent subretinal cannulation during suture trabeculotomy surgery that resulted in serous macular detachment which resolved spontaneously. The inadvertent complication demonstrated a pathway for administration of therapeutics to the subretinal space.

Gastroesophageal reflux and laryngopharyngeal reflux in patients with sleep-disordered breathing.

OBJECTIVE: To assess the relationship of gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR) with obstructive sleep apnea (OSA). PATIENTS AND METHODS: Thirty-seven sleep-disordered breathing (SDB) patients underwent polysomnography (PSG) and dual-channel pH probe testing. LPR was defined as greater than 6.9 proximal reflux episodes or reflux area index (RAI) greater than 6.3. GER was defined as greater than 4% of time below pH 4.0. RESULTS: OSA was present in 28 patients. Twenty-three patients had LPR (66.7% of snorers, 60.7% of OSA patients). Twenty-one patients had GER (33.3% of snorers, 64.3% of OSA patients). Body mass index (BMI) correlated positively with respiratory disturbance index (RDI) (r = 0.67, P < 0.001). BMI did not correlate with pH probe parameters. OSA presence/severity did not correlate with LPR or GER. Supine LPR and GER events did not correlate with OSA presence/severity. CONCLUSION: Gastric acid reflux is prevalent in SDB patients. Direct correlations between reflux and PSG parameters were not identified. EBM RATING: B-2b.

The woodcock reading mastery test: impact of normative changes.

This study examined the magnitude of differences in standard scores, convergent validity, and concurrent validity when an individual's performance was gauged using the revised and the normative update (Woodcock, 1998) editions of the Woodcock Reading Mastery Test in which the actual test items remained identical but norms have been updated. From three metropolitan areas, 899 first to third grade students referred by their teachers for a reading intervention program participated. Results showed the inverse Flynn effect, indicating systematic inflation averaging 5 to 9 standard score points, regardless of gender, IQ, city site, or ethnicity, when calculated using the updated norms. Inflation was greater at lower raw score levels. Implications for using the updated norms for identifying children with reading disabilities and changing norms during an ongoing study are discussed.

Short-term effects of patellar kinesio taping on pain and hop function in patients with patellofemoral pain syndrome.

BACKGROUND: Patellofemoral pain syndrome (PFPS) is the most prevalent orthopaedic condition among physically active individuals, contributing to an estimated 30% to 40% of all sports medicine visits. Techniques using Kinesio Tape (KT) have become increasingly popular; however, there has been scant research supporting its use on patients with PFPS. HYPOTHESIS: The use of patellar KT to treat patients with PFPS will provide a statistically significant improvement in short-term pain and single-leg hop measures as compared with sham placement of KT. STUDY DESIGN: Nonrandomized controlled clinical trial with repeated-measures design. LEVEL OF EVIDENCE: Level 3. METHODS: Forty-nine subjects (41 females, 8 males) between the ages of 12 and 24 years with PFPS participated in this study. Each subject underwent patellar kinesio taping with both experimental and sham applications while completing 4 functional tasks and the single-leg triple jump test (STJT). The treatment outcome was analyzed using separate paired t tests to measure improvement on a numeric pain rating scale. A 2-way, 2 × 2 analysis of variance was used to analyze the relationship between taping condition (experimental vs sham) and side (involved vs uninvolved) for STJT scores. RESULTS: Separate paired t tests found step-up, step-down, and STJT pain improvement statistically significant between taping conditions. The 2-factor analysis of variance yielded a significant main effect for taping condition, but the main effect for side was not significant. The interaction between taping condition and side was significant. This showed there was little change in STJT distance between repeated measures performed on the untaped, noninvolved leg. However, subjects' STJT distances were significantly greater for the experimental KT application than the sham application for the involved side. CONCLUSION: Patellar kinesio taping provided an immediate and statistically significant improvement in pain and single-leg hop function in patients with PFPS when compared with a sham application. However, improvement in STJT scores did not surpass the minimally detectable change value, and therefore, the clinical effectiveness of KT for improving single-leg hop function was not established in the current study. CLINICAL RELEVANCE: Kinesio Tape provides a viable, short-term method to control pain.

Persisters and nonpersisters: Identifying the characteristics of who stays and who leaves from adult literacy interventions.

Adult literacy programs are characterized by high attrition rates. Rigorous exploration of student persistence in adult reading classes is lacking. This study was an attempt to understand the profiles of adults who completed reading classes compared to a group of adults who made it to the midpoint and a group of adults who did not make it to the midpoint. Students were offered 100 hours of instruction. Of the 395 students who attended the first day of class, only 198 completed the program. Results indicated that English language status, age, some reading related skills, class assignment, avoidance of reading, previous adult education experience, and Women, Infants, and Children (WIC) benefit receipt variables significantly predicted persistence. The significance of some of these predictors varied based on analyzing midpoint completion or full completion. To further explore the characteristics of the sample, the most representative participants were selected from the group that did not make it to midpoint and from the group that completed the program. Results indicated that the most representative members of these two groups differed in English language status, gender, age, some reading related skills, and information access.

Differences in head and neck cancer risk perception between smoking and nonsmoking NASCAR attendees.

OBJECTIVE: Although research has documented a difference in cancer risk perception between smokers and nonsmokers, this has not been specifically documented for head and neck cancer. The aim of this study was to determine differences in risk perception for head and neck cancer between smokers and nonsmokers in an at-risk population. STUDY DESIGN: A cross-sectional survey was administered. SETTING: Community-based head and neck cancer screenings. SUBJECTS AND METHODS: Participants completed a 28-item questionnaire assessing sociodemographic information, smoking status, and risk perception of head and neck cancer. RESULTS: In total, 507 participants completed the questionnaire. Multivariate analysis of variance (MANCOVA) using dependent variables related to risk perception of head and neck cancer evidenced a significant main effect that smokers (mean [SD], 1.10 [0.07]) worried about head and neck cancer significantly more than nonsmokers (0.64 [0.06]), F(1, 459) = 26.97, P < .001, η(2) = .06, and nonsmokers (2.70 [0.05]) believed head and neck cancer was significantly more dangerous than did smokers (2.53 [0.06]), F(1, 459) = 5.90, P = .015, η(2) = .01. CONCLUSION: Findings indicated differences in perception of risk for head and neck cancer between smokers and nonsmokers. By gaining a better understanding of the psychosocial factors related to perceived risk of head and neck cancer, otolaryngologists and health care providers may better tailor interventions aimed at increasing awareness of cancer risk and promoting cessation.

Results of a large-scale head and neck cancer screening of an at-risk population.

OBJECTIVE/HYPOTHESIS: To determine whether a community-based head and neck cancer screening could be an effective method to detect positive findings of head and neck cancer in at-risk populations. STUDY DESIGN: Survey-based study with a nonexperimental intervention component. METHODS: Five hundred sixty-eight adults were screened for oral and laryngeal cancers by otolaryngologists and oral and maxillofacial surgeons during three National Association of Stock Car Auto Racing race weekend events. A prescreening survey collected demographic information, relevant medical history, and information regarding risk factors for head and neck cancers, including current or past tobacco use, alcohol consumption, and chemical exposures. Signs and symptoms of head and neck cancer were documented during the screening. RESULTS: Forty-three percent of participants with a history of smoking had abnormal findings. A Pearson chi-square indicated that the proportion of males who evidenced positive findings was significantly (P<0.05) higher than the proportion of females who evidenced positive findings. For every pack of cigarettes smoked per day, an individual was 1.95 times more likely to evidence abnormal findings even after controlling for alcohol use, family history of cancer, personal history of head and neck cancers, sex, age, and occupation. CONCLUSIONS: This study is the first to document the results of a large-scale head and neck cancer screening of a population of people known to be at risk of head and neck cancers. The study demonstrates the feasibility of developing and implementing large-scale community-based head and neck cancer screenings, as are often seen in the early diagnosis and education of signs, symptoms, and risks for other cancers.

The impact of a community-based oral, head and neck cancer screening for reducing tobacco consumption.

OBJECTIVE: Examine the usefulness of large-scale community-based head and neck cancer screening for reducing tobacco use in an at-risk population. Questions answered: (1) Is participating in a community-based head and neck cancer screening related to a reduction in tobacco usage? (2) Do differing factors between participants predict behavior change? STUDY DESIGN: Survey based with a longitudinal follow-up component. SETTING: Atlanta Motor Speedway during a National Association of Stock Car Auto Racing (NASCAR) race event. SUBJECTS AND METHODS: Recruited NASCAR fans (n = 620). Initial screening and 11-question survey for 6-month telephone follow-up. RESULTS: One hundred fifty-six participants (25%) required medical follow-up. Chi-square analysis indicated a significantly higher proportion of smokers (13%) evidenced positive findings compared to nonsmokers (8%) or past smokers (6%). Kruskal-Wallis analysis followed by Dunn's multiple comparison post hoc test indicated smokers were from a significantly lower socioeconomic status background compared to nonsmokers. Analysis of variance indicated contacted participants reported smoking significantly fewer cigarettes per day 6 months postscreening compared to the number of cigarettes smoked at the baseline. Forty-four (59%) participants reported reducing the number of cigarettes smoked per day, and 11 participants reported quitting smoking. CONCLUSION: The authors have demonstrated that large-scale community-based head and neck cancer screenings can be effectively implemented in nonmedical venues. This study demonstrated that targeting education for reduction of risk factors in the NASCAR population positively affected tobacco cessation.