While the effects of active smoking and second-hand smoke (SHS) are well documented, the concept of third-hand smoke (THS) is a relatively new phenomenon in the environmental and public health field. This notion was coined in 2009 (Winickoff et al. in Pediatrics 123(1):e74-e79, 2009) but was not really brought to light until the New York Times published an article on the topic (Rabin in A new cigarette hazard: 'third-hand smoke'. The New York Times, http://www.nytimes.com/2009/01/03/health/research/03smoke.html?_r=0 , 2009). Research on THS is fairly new and currently only limited animal studies have been performed that explore the health impacts associated with an individual THS-specific component. The public at large has a limited understanding of this new concept. As such, attitudes and beliefs surrounding THS exposure are still immature. Future research must be conducted to facilitate hazard identification, exposure and risk assessment to address its health impact on susceptible populations and to differentiate THS versus active smoking and SHS. In addition, policies and laws concerning tobacco smoke will need to be reviewed, possibly revised with the role of THS considered as an indispensable component of a broader tobacco control strategy.
The contributions of the American Psychological Association (APA) to the public interest are assessed. APA has taken an effective leadership role on issues involving justice to the disadvantaged categories of its own membership. On other issues, which have been more controversial, APA has been less effective, partly because APA participates in our culture of self-interest and individualism, and partly because identifying the public interest is inherently political. Psychologists are urged to look beyond self and group interests toward the urgent issues of our time concerning survival and justice. All the same, how APA pursues the guild interests of psychology as a science and as a profession impinges strongly on the public interest in any plausible sense and requires close scrutiny. Because the public interest can only be determined by a political process, open advocacy on public interest issues within APA governance structure is appropriate.
Background and Purpose-The utility and safety of brain biopsy for suspected primary angiitis of the central nervous system (PACNS) are uncertain. Factors predictive of a positive biopsy have not been well described. Our aim was to evaluate the diagnostic yield and safety of brain biopsy in suspected PACNS and determine whether any prebiopsy variables are associated with a positive biopsy. Methods-This is a retrospective study of consecutive patients who underwent diagnostic brain biopsy for PACNS at a single institution. The relationship between biopsy yield and patient demographics, surgical technique, laboratory testing, neuroimaging, biopsy characteristics, and prebiopsy immunosuppressive therapy were examined. Results-PACNS was confirmed in 9 of 79 patients (11%). Biopsy identified alternative diagnoses in 24 patients (30%), with cerebral amyloid angiopathy (8 patients), encephalitis (5 patients), demyelination (3 patients), and CNS lymphoma (3 patients) most commonly found. There was no correlation between a positive biopsy and cerebrospinal fluid results, neuroimaging, surgical technique, biopsy characteristics, or preoperative immunosuppressive therapy. Smaller biopsies (P=0.02) and closed procedures (P=0.013) were less likely to yield a diagnosis. Postoperative complications occurred in 13 patients (16%), 3 (4%) of which were serious. Conclusions-Brain biopsy leads to pathological confirmation of vasculitis in a minority of suspected PACNS cases but alternative diagnoses are often identified. Importantly, rare but meaningful complications may occur. (Stroke.
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