Abstract Objective: Physical health problems are pervasive among patients with co-occurring substance use and mental disorders. Yet, drug treatment programs often ignore tobacco use and its association with health. Abstinence self-efficacy has been associated with improved outcomes for co-occurring disorders, which in turn may also impact physical health. This study had the goal of assessing whether abstinence self-efficacy for drugs and alcohol and availability and use of services would influence tobacco use and other health-related outcomes among 351 individuals with co-occurring disorders in residential drug treatment. Methods: Structural models tested the impact of baseline abstinence self-efficacy and treatment service characteristics on 6-month outcomes of health problems, functional limitations, health perceptions, and cigarette and heavy alcohol use. Demographics and baseline values for outcome variables were included as covariates. Results: Correlations within time for poor health, cigarette use, and heavy alcohol use were substantial. A longer time in drug treatment was associated with less cigarette and heavy alcohol use at a 6-month follow-up. Baseline health problems were associated with more cigarette use and functional limitations at 6-months. Abstinence self-efficacy did not predict less cigarette use but predicted less heavy alcohol use and fewer functional limitations. Availability of specialized dual diagnosis groups and more on-site psychological services were not directly associated with outcomes but had an impact through indirect effects on more psychological service utilization which predicted better subjective health. Conclusions: Improving overall treatment retention and services utilization among patients with co-occurring disorders may generalize to improved health perceptions, but specific health promotion and smoking-cessation interventions are warranted to improve health outcomes. Keywords: co-occurring disordershealthself-efficacycigarette usetreatment outcomes ACKNOWLEDGMENTS Support for this research was provided by grants R01-DA011966 (Grella) and P01- DA01070-38 (Zane, Stein) from the National Institute on Drug Abuse. The production assistance of Gisele Pham is gratefully acknowledged.
Monoclonal antibody BQ16, raised against UM-UC-9, a human bladder cancer cell line, exhibited strong reactivity with most bladder carcinoma tissue samples and cell lines. In normal urothelium, BQ16 stained only the basal surface of urothelial cells at the junction with the lamina propria. BQ16 immunoprecipitated two protein bands of approximately 140 and 180 kDa (under non-reducing conditions), while on Western blots, BQ16 identified only the 140 kDa protein indicating that BQ16 binds to one chain of a dimeric protein complex. The dimeric structure, molecular size, and basal orientation of the BQ16 antigen prompted a comparison with the alpha 6 beta 4 integrin identified by monoclonal antibody UM-A9. In most tissues BQ16 and UM-A9 produced identical staining patterns. However, normal lymphocytes and certain bladder cancer cell lines were BQ16 positive but failed to react with UM-A9, indicating that the BQ16 and UM-A9 epitopes can be expressed independently. Pulse-chase immunoprecipitation experiments showed that the alpha 6 subunit was more prominent in early BQ16 precipitates and the beta 4 subunit was more prominent in early UM-A9 precipitates. Furthermore, preclearing cell extracts with the anti-alpha 6 antibody GoH3 removed all BQ16 reactivity and in UM-A9-negative, BQ16-positive cells, BQ16 precipitated the alpha 6 beta 1 complex. We conclude that BQ16 identifies the alpha 6 integrin subunit and that alpha 6 beta 4 integrin is strongly expressed in most bladder cancers.
Key fi ndings• Many patients who receive regular medical care for HIV do not get the dental care they need.• Many of those reporting unmet need for dental care-including Medicaid recipients whose state Medicaid program does not provide dental coverage-lack dental insurance.• HIV-infected patients are more likely to get dental care when it's provided by the clinic where they get their medical care.
We examined HIV/AIDS risk behaviors among homeless youth in cross‐national data collected in Melbourne, Australia (n= 398), and Los Angeles, California (n= 498). Using structural equation modeling, we found that the Australian youth reported greater involvement in AIDS risk behaviors than the American youth and the Australian youth were more involved in intervening risk factors that promote risk behaviors and less involved with protective factors that reduce risk behaviors. Youth reporting the highest rates of delinquent behaviors also had peers engaging in delinquent acts, used alcohol and marijuana, and were more likely to utilize social services. These findings underscore the importance of having a service sector that is able to adequately address the needs of homeless youth .
The objective of this program was to increase mammography screening rates among Hispanic women through a series of targeted community-wide interventions. A diverse array of outreach efforts was offered by the program to increase awareness and use of screening mammography. Before the program, 12 percent of the Hispanic women surveyed in the intervention community had been screened, compared with 27 percent after the program. There was no change in screening among Hispanic women in the control community (23 percent before and 24 percent after the program). The program demonstrated that the awareness and behavior of "hard-to-reach" underscreened Hispanic women can be changed through intensive targeted outreach and that a church-based cancer control program can play an effective role in the process. This finding has national health policy implications.
The Vaccine Research Center has developed a number of vaccine candidates for different diseases/infectious agents (HIV-1, Severe Acute Respiratory Syndrome virus, West Nile virus, and Ebola virus, plus a plasmid cytokine adjuvant-IL-2/Ig) based on a DNA plasmid vaccine platform. To support the clinical development of each of these vaccine candidates, preclinical studies have been performed in mice or rabbits to determine where in the body these plasmid vaccines would biodistribute and how rapidly they would clear. In the course of these studies, it has been observed that regardless of the gene insert (expressing the vaccine immunogen or cytokine adjuvant) and regardless of the promoter used to drive expression of the gene insert in the plasmid backbone, the plasmid vaccines do not biodistribute widely and remain essentially in the site of injection, in the muscle and overlying subcutis. Even though approximately 10(14) molecules are inoculated in the studies in rabbits, by day 8 or 9 ( approximately 1 week postinoculation), already all but on the order of 10(4)-10(6) molecules per microgram of DNA extracted from tissue have been cleared at the injection site. Over the course of 2 months, the plasmid clears from the site of injection with only a small percentage of animals (generally 10-20%) retaining a small number of copies (generally around 100 copies) in the muscle at the injection site. This pattern of biodistribution (confined to the injection site) and clearance (within 2 months) is consistent regardless of differences in the promoter in the plasmid backbone or differences in the gene insert being expressed by the plasmid vaccine. In addition, integration has not been observed with plasmid vaccine candidates inoculated i.m. by Biojector 2000 or by needle and syringe. These data build on the repeated-dose toxicology studies performed (see companion article, Sheets et al., 2006) to demonstrate the safety and suitability for investigational human use of DNA plasmid vaccine candidates for a variety of infectious disease prevention indications.
We examined correlates and predictive associations of tattoos and body piercings among 1,462 Colorado students in grades 9 to 12. More boys (19%) than girls (17%) reported tattoos, but more girls (42%) than boys (16%) reported piercings (earlobes not included). Older students reported more body modification. Structural equation models showed that although girls generally reported less deviant behavior, the indirect effect of female gender mediated through piercings was toward greater deviance that was not an artifact of girls having more piercings. Pierced girls were less school oriented than girls without piercings; they reported more substance use than boys without piercings, and pierced girls did not differ from boys in weapons possession and delinquency. However, among pierced respondents, boys still reported a greater number of deviant behaviors than girls. Educators and other adults should become aware of the possible at-risk status of body-modified adolescents, especially among girls who have piercings.
