Surgical case volumes in non-university-affiliated cardiothoracic surgery training programs in the US have been extensively studied by the Residency Review Committee (RRC) for thoracic surgery. The RRC has established that these programs offer a broad experience in common cardiothoracic procedures such as myocardial revascularization, valvular surgery, and cardiopulmonary transplantation. However, resident exposure to other important but less common cardiac surgical conditions in these programs remains unanswered. To address this question, an institutional review board-approved retrospective review of the experience of thoracic surgery residents with one of the rarest of surgical conditions, cardiac tumors, was conducted at the Ochsner Clinic Foundation in New Orleans, Louisiana. A survey of existing private, non-university-affiliated US cardiothoracic surgery training programs was conducted to determine the extent of the cardiac tumor experience in these programs. The results were then compared with selected university programs.

Background Studies in areas with high levels of arsenic in drinking water have produced evidence of increased bladder cancer risks, but little information exists about risks at concentrations of around 100 μg/L or less. Ecological studies in Argentina have produced evidence of increased bladder cancer mortality in Córdoba Province, where some wells are contaminated with moderate arsenic concentrations. Methods This population-based bladder cancer case-control study, in Unión and Marcos Juárez counties, Córdoba, recruited 114 case-control pairs, matched on age, sex and county, during 1996–2000. Questionnaires were adminstered in face-to-face interviews and questions covered lifetime residential history, tap water and fluid consumption, education, and smoking and occupational histories. Water samples were obtained from drinking water sources at current and former residences, particularly from wells when they could be located. Water sample collection focused on the 40 years preceding interview. Exposure indices based on arsenic concentrations and tap water and fluid consumption patterns were constructed. Results Statistical analysis showed little evidence of an association between bladder cancer and exposure estimates based on measurements of arsenic concentrations in drinking water. However, using well water consumption per se as the index of exposure, time-window analyses suggested use of well water in the period more than 50 years before interview was associated with increased bladder cancer risk. This association was limited to ever smokers (e.g., odds ratio = 2.7, 95 percent confidence interval: 1.4, 5.1, for 51–60 years before interview). Conclusions Possible explanations for the unexpected results include exposure misclassification and a longer than expected latency for arsenic-induced cancers. However, similarity of the results with those from two other case-control studies suggests that arsenic may potentiate the effects of tobacco smoking in the causation of bladder cancer in humans. This may explain why it has been difficult to induce cancer with inorganic arsenic in laboratory studies.

Background The incidence of catracts is higher among women than men in developing countries. Risk factors for cataract include active cigarette smoking, exposure to intense sunlight, and severe diarrhea. Prior research suggests that exposure to smoke from household solid fuel may be a risk factor. Cooking and heating with solid fuels such as wood/wood-logs, dung-cake, coal and charcoal are predominant in developing countries where women are primary cooks. Methods An incidence-density casecontrol study was conducted to look at the relationship between exposure to smoke from household solid fuel and risk of cataracts among women visiting an eye hospital situated at the Nepal-India border. Cases (n = 206) were women patients, aged 35–65 years, who resided in neighboring districts in Nepal and India, and who visited the hospital for the first time with cataracts in one or both eyes. Controls (n = 203) were selected from among patients visiting the same hospital from same districts who had diagnoses of refractive error or astigmatism. Patients with a history of diabetes mellitus were excluded from both case and control groups. An interviewer-administered questionnaire included questions on education level, area of residence (urban v rural), cooking fuel, stove type, kitchen type and location, use of mosquito coil and incense, history of severe diarrhea, present food habits, smoking status, alcohol consumption, history of vitamin use, household crowding, time spent working outside in the sunlight, vaccination during childhood, house type, socio-economic status. Results Age was not a significant confounder because adjustment for age did not affect other relative risks in multivariate logistic models. In univariate analyses, the following variables were statistically significant as a risk factors for cataract: stove type (un-improved vs. improved: OR = 2.99, 95% CI: 1.93–4.63), fuel (solid vs. liquid: OR = 3.19, 95% CI: 1.99–5.1), education (illiterate vs. literate: OR =: 2.40, 95% CI: 1.44–4.00), area of residence (rural vs. urban: OR = 3.34, 95% CI: 1.76–6.25), kitchen location and ventilation (partially vs. fully: OR = 2.39 CI: 1.51–3.79), working in the sun (yes vs. no: OR = 1.51, 95% CI: 1.00–2.26). Variables such as smoking (ever vs. never: OR = 1.16, 95% CI: 0.73–1.85), history of severe diarrhea in the last five years (yes/sometime vs. no: OR = 1.22 CI: 0.81–1.82) were non-significant in the univariate analysis. In Multivariate logistic regression modeling, poor ventilation (OR: 1.89, 95% CI: 1.16–3.07), rural residency (OR: 2.15, 95% CI: 1.07–4.35), and solid fuel use with an unimproved stove (OR: 2.21, 95% CI: 1.29–3.82) were risk factors for cataracts. In our study 76% of cases and 79% of controls reportd that they did not smoke (p-value: 0.528) and only 3% of cases and controls reported that they were ex-smoker. Conclusions These preliminary analyses support the hypothesis that smokes from household solid fuel (wood, cow dung cake, crop residues, coal, coke, lignite), along with lack of ventilation in the kithcen, increases the risk of cataracts among women. In addition, rural residence seems to be a risk factor for cataracts.

O'Keefe's (1987) meta‐analysis concluded that the relative advantage for a high credible source was diminished when the identification of the source occurred after the message. Two replications using 1945 subjects and a total of 12 messages confirm this finding but provide a smaller estimate (r = .093 for this investigation while O'Keefe reports an average correlation of .352). Theoretically, the associationist position is not supported while a model suggesting a more sophisticated view of message processing is required. At a practical level, the findings suggest that highly credible message authors benefit from early identification whereas message authors evaluated as less credible benefit from delayed identification.