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Background:Whether women are more or equally susceptible to the carcinogenic effects of cigarette smoke on the lungs compared with men is a matter of controversy. Using a large French population-based case-control study, we compared the lung cancer risk associated with cigarette smoking by gender.Methods:The study included 2276 male and 650 female cases and 2780 male and 775 female controls. Lifetime smoking exposure was represented by the comprehensive smoking index (CSI), which combines the duration, intensity and time since cessation of smoking habits. The analysis was conducted among the ever smokers. All of the models were adjusted for age, department (a regional administrative unit), education and occupational exposures.Results:Overall, we found that the lung cancer risk was similar among men and women. However, we found that women had a two-fold greater risk associated with a one-unit increase in CSI than men of developing either small cell carcinoma (OR=15.9, 95% confidence interval (95% CI) 7.6, 33.3 and 6.6, 95% CI 5.1, 8.5, respectively; P<0.05) or squamous cell carcinoma (OR=13.1, 95% CI 6.3, 27.3 and 6.1, 95% CI 5.0, 7.3, respectively; P<0.05). The association was similar between men and women for adenocarcinoma.Conclusion:Our findings suggest that heavy smoking might confer to women a higher risk of lung cancer as compared with men. [ABSTRACT FROM AUTHOR]

Purpose: This study assesses physician assistant (PA) students' interest in international experiences. A white paper from the Physician Assistant Education Association (PAEA), formerly the Association of Physician Assistant Programs (APAP), 'A Report on the Findings of the Ad Hoc Committee on International Physician Assistant Education,' recommends that the profession 'explore the motivation for students' international experiences.' In partial fulfillment of that objective, we examined the association between first-year PA students' attitudes toward international experiences and student demographic characteristics, type of PA school attended, and prior student experiences. Methods: A convenience sample of 12 PA programs (one public and one private school in each of six US geographical regions) received surveys to distribute to their first-year students. Eleven programs returned 482 completed surveys. Results: A sizable majority of the students, 59.8%, indicated interest in international rotations. PA students with prior health care experience or prior international experience as a volunteer in missions work (faith-based or secular), or studying abroad were more likely to show interest in international rotations. Student interest in other languages and cultures, single marital status, and lack of dependents also correlates positively with increased interest in international experiences. Student self-perception of spirituality, valuing the humanitarian mission of the PA profession, and prior international military experience do not correlate with interest in international rotations. Conclusions: PA students' interest in and participation in international rotations may affect the rapidly evolving globalization of the PA professional model. [ABSTRACT FROM AUTHOR]

We investigated the time trends in social inequalities in breast cancer mortality with an analysis by age at death and birth cohort using a representative 1% sample of the French population and four subcohorts (1968-1974, 1975-1981, 1982-1988 and 1990-1996). Causes of death were obtained by direct linkage with the French national death registry. Education was measured at the beginning of each period, and educational disparities in breast cancer mortality were studied among women aged 35-74 at the beginning of each period. In the 1970s, higher breast cancer mortality was found among higher educated women. This positive association progressively weakened and no association remained in the 1990s although it disappeared earlier among younger women. In an analysis by birth cohort, the same pattern was found among women born before 1925, whereas no association between education and mortality was observed among women born after 1925. Educational disparities in breast cancer mortality are currently changing and the previously observed positive gradient has disappeared. An important question is whether these relations are indirect, and due to changes in the prevalence of risk factors associated with education, but which we could not study. [ABSTRACT FROM AUTHOR]

Our objective was to study the relations between the risk of lung cancer and dietary factors in New Caledonia, in the South Pacific. A population-based case-control study of respiratory cancers was conducted between 1993 and 1995 in New Caledonia; we analyzed data for 134 incident lung cancer cases (109 men and 25 women) and 295 controls (227 men and 68 women) who had completed a food frequency questionnaire. Odds ratios (ORs) associated with food and nutrient intakes were calculated with unconditional logistic regression, with adjustment for smoking, age, and ethnicity. Analyses were performed separately for men and women. Among men, no significant associations were observed with any foods, including vegetables and fruits. Nonetheless, high consumption of dark green leafy vegetables (highest vs. lowest tertile of intake) was associated with decreased risk (OR = 0.5, 95% confidence interval = 0.2-1.2, P for trend = 0.12), particularly among Melanesians (OR = 0.4, 95% confidence interval = 0.1-1.0, P for trend = 0.07). A similar protective effect was also suggested for high consumption of poultry (P for trend = 0.06) and fresh fish (P for trend = 0.08). No significant association was found with nutrients. Among women, the analyses concerned few subjects and were not informative. This study suggests that high consumption of dark green leafy vegetables may reduce the risk of lung cancer among men in this population. [ABSTRACT FROM AUTHOR]

Objectives: A case-control study was conducted in France to assess possible associations between occupational exposures and squamous cell carcinomas of the larynx and hypopharynx.Methods: The study was restricted to men, and included 201 hypopharyngeal cancers, 296 laryngeal cancers, and 296 controls (patients with other tumour sites). Detailed information on smoking, alcohol consumption, and lifetime occupational history was collected. Occupational exposure to seven substances (formaldehyde, leather dust, wood dust, flour dust, coal dust, silica dust, and textile dust) was assessed with a job exposure matrix. Exposure variables used in the analysis were probability, duration, and cumulative level of exposure. Odds ratios (ORs) with their 95% confidence intervals (95% CIs) were estimated by unconditional logistic regression, and were adjusted for major confounding factors (age, smoking, alcohol, and when relevant other occupational exposures).Results: Hypopharyngeal cancer was found to be associated with exposure to coal dust (OR 2.31, 95% CI 1.21 to 4.40), with a significant rise in risk with probability (p<0.005 for trend) and level (p<0.007 for trend) of exposure. Exposure to coal dust was also associated with an increased risk of laryngeal cancer (OR 1.67, 95% CI 0.92 to 3.02), but no dose-response pattern was found. A significant relation, limited to hypopharyngeal cancer, was found with the probability of exposure to formaldehyde (p<0.005 for trend), with a fourfold risk for the highest category (OR 3.78, 95% CI 1.50 to 9.49). When subjects exposed to formaldehyde with a low probability were excluded, the risk also increased with duration (p<0.04) and cumulative level of exposure (p<0.14). No significant association was found for any other substance.Conclusion: These results indicate that exposure to formaldehyde and coal dust may increase the risk of hypopharyngeal cancer. [ABSTRACT FROM AUTHOR]

Objectives: Previous projections of mortality from mesothelioma among French men have used the age-generation method, based on the Poisson regression model. In this study an alternative method to model mortality from mesothelioma was used to predict its future trend: this method was based on the risk function that links this mortality to past exposure to asbestos, combined with population exposure data.Method: Data on past French asbestos imports were used to model the overall past exposure to asbestos in men and assess two extreme scenarios (optimistic and pessimistic) for its future trends. The number of male deaths occurring between the ages of 50 and 79, from 1997-2050, was then calculated with the risk function for mesothelioma.Results: The results showed that mortality from mesothelioma among French men aged 50-79 will continue to increase, reaching a peak averaging between 1140 (optimistic scenario) and 1300 deaths (pessimistic scenario) annually around the years 2030 and 2040, respectively. No preventive measures applied now will affect this trend before then. These results are similar to those of two other predictions of mortality from mesothelioma among French men: a peak around 2030 of 800-1600 deaths annually among men aged 25-89 years, and a peak around 2020 of 1550 deaths annually among men aged 40-84.Conclusions: Our results indicate that between 1997 and 2050, the most optimistic and pessimistic trends of future exposure will lead to the deaths from mesothelioma of between 44 480 and 57 020 men, with a corresponding loss of from 877 200 to 1 171 500 person-years of life. [ABSTRACT FROM AUTHOR]

Two methods used for retrospective evaluation of occupational exposures, a case by case assessment by expert and the application of a job exposure matrix (JEM), are compared using occupational histories collected for a case-control study on sinonasal cancer. The objective was to identify the main sources of discrepancies and to contribute to an optimal use of a JEM for population-based case-control studies. Comparisons were based on job periods, and were performed separately for two substances: formaldehyde and wood-dust. Job periods were classified according to the category of exposure assigned by the matrix, and to the probability and level of exposure assessed by the study expert. The sources of discrepancies were examined for job periods probably or definitely exposed according to the JEM and unexposed for the expert, or unexposed in the JEM and probably or definitely exposed to medium or high level for the expert. Such discrepancies were observed for 8% of the job periods for formaldehyde and 3% of the job periods for wood-dust. The agreement between the two approaches was better for wood-dust than for formaldehyde. The relative importance of different sources of discrepancies was not the same for formaldehyde and wood-dust. For formaldehyde a substantial part of the discrepancies was due to disagreements between the study expert and the matrix experts, which were mostly differences in threshold limits between 'not exposed' and 'definitely exposed at a low level'. Differences between experts' opinions did not explain the discordances observed for wood-dust. The presence of additional information in the questionnaire was an important source of discrepancy for the two substances.(ABSTRACT TRUNCATED AT 250 WORDS) [ABSTRACT FROM AUTHOR]

Laryngeal cancer represents an important cause of cancer in France, and the individual effects of alcohol and tobacco on this cancer site are well known. However the problem of the interaction between these agents is less extensively documented, and the role of the high consumptions of alcohol has not been studied frequently. A case-control analysis was undertaken to investigate the joint effect of alcohol and tobacco by comparing 197 glottic and 214 supraglottic cancer cases to 4135 controls representative of the French general population. Heavy drinkers were available from the two groups of cases, the highest alcohol category being equivalent to a consumption of more than 2 litres of wine per day. The relative risks estimated for heavy drinkers and smokers were high, and the results indicated an even stronger effect of alcohol drinking and tobacco smoking on the upper part of the laryngeal region. Additive and multiplicative models were fitted to the data. The multiplicative hypothesis was found to be the most appropriate, implying that the risks associated with alcohol and tobacco multiply when the exposures occur simultaneously. The public health implications of this result and the contribution of heavy drinkers and smokers to the frequency of upper respiratory and digestive tract cancers are discussed. [ABSTRACT FROM PUBLISHER]

Objectives: To ascertain whether certain occupations are associated with laryngeal or hypopharyngeal cancer.Methods: A hospital based case-control study was carried out in 15 hospitals in France. It included 528 male cases diagnosed between January 1989 and April 1991, and 305 male controls with various other types of cancer. Interviews were carried out to obtain lifetime job histories and information on potential confounders. Logistic regression was used to compute the odds ratios (OR) for each of about 80 occupations and industries.Results: There was an excess risk of laryngeal and hypopharyngeal cancer among service workers (OR 2.2, 95% confidence interval (95% CI) 1.3 to 3.9), agricultural and animal husbandry workers (OR 1.6, 95% CI 0.9 to 2.8), miners and quarrymen (OR 2.0, 95% CI 0.9 to 4.3), plumbers and pipe fitters (OR 2.6, 95% CI 0.8 to 8.1), glass formers and potters (OR 4.3, 95% CI 1.0 to 18) transport equipment operators (OR 1.5, 95% CI 1.0 to 2.5), and unskilled workers (OR 1.7, 95% CI 1.0 to 2.9). Analysis by industrial branch showed an excess risk for coal mining (OR 2.1, 95% CI 1.1 to 4.1), manufacture of metal products (OR 1.9, 95% CI 1.0 to 3.3), and administration and sanitary services (OR 1.7, 95% CI 1.1 to 2.5).Conclusion: These results suggest that occupational exposure might have a role in generating laryngeal and hypopharyngeal cancer, and indicate the need for further evaluation of these findings, an for the identification of the carcinogens which might account for the excess risks found for certain occupations. [ABSTRACT FROM AUTHOR]

Objective: After an inquiry from the employees of an offset printing plant, a historical cohort study was conducted to investigate cancer mortality among these workers.Methods: The cohort comprised 262 men, who contributed 2771 person-years of observation. 16 deaths were identified during the follow up period (1980-91). Expected numbers of deaths were derived from age specific regional rates. Standardised mortality ratios (SMR) and 95% confidence intervals (95% CIs) were calculated.Results: An increased cancer mortality was found after 10 years of employment (SMR 213, 95% CI 98 to 405, based on nine deaths), mainly due to a high mortality from lung cancer (SMR 381, 95% CI 104 to 975, four deaths), and from oesophageal cancer (SMR 1049, 95% CI 216 to 3065, three deaths). For workers with at least 20 years since the start of employment, the SMR was 262 (95% CI 105 to 540) for all cancer sites, 447 (95% CI 92 to 1306) for lung cancer, and 1094 (95% CI 132 to 3952) for oesophageal cancer. The increased cancer mortality was concentrated among pressmen.Conclusion: Although based on small numbers, the findings suggest an increased risk of cancer among these workers, which should be further investigated. [ABSTRACT FROM AUTHOR]

A case-control study on cancer of the nose and paranasal sinuses, and several risk factors including previous nasal diseases and symptoms, was performed in France from January 1986 through February 1988. The frequency of previous nasal diseases and symptoms was analyzed by histologic type of cancer. Different results were observed for squamous cell carcinomas and adenocarcinomas. In men, there were statistically significant associations between squamous cell carcinomas and sinusitis, bleeding from the nose, polyps, rhinitis, and trauma to the nose; and between adenocarcinomas, bleeding from the nose, and rhinitis. In women, there was an association between squamous cell carcinomas and nasal polyps. [ABSTRACT FROM AUTHOR]

An account is given of the usage of a new system of programs that enable the IBM 709/90 computer to generate control tapes for the Photon 5560 Unit. The input to the system may be Flexowriter material with interspersed control codes, or material that is provided on cards or tapes, or generated internally in certain other forms. [ABSTRACT FROM AUTHOR]

Reviews the Web site of Bible gateway started by Nick Hengeveld in 1993. Features of the site; Number of Bibles available on the site; Information on the search methods of the site.

The article reviews the Web site RIBApix, located at www.ribapix.com, from the Royal Institute of British Architects.

The article reviews the database web site Gale Virtual Reference Library, located at htp://gale.cengage.com.

The article reviews the website "The Unbound Bible," found at http://unbound.biola.edu.