We tested the hypothesis that an education program addressing breast cancer screening schedules and modalities coupled with a breast cancer risk assessment provided by community pharmacists can increase women's confidence in performing screening practices endorsed by the American Cancer Society (ACS). This randomized, paired, pre-post study was conducted in six community pharmacies and two health-screening fairs; subjects were 140 women over 18 years of age. The pharmacist-administered program used the Breast Cancer Risk-Assessment Tool (Gail model) software provided by the National Cancer Institute of the National Institutes of Health. In addition, pharmacists provided education and training on breast self-examination (BSE), clinical breast examination (CBE), and mammography. Adherence to ACS guidelines for monthly BSE increased from 31% to 56% (p<0.001) for all women 6 months after the program. Performance of monthly BSE by women considered at high risk for developing breast cancer increased from 20% to 60% (p<0.005). The mean number of BSEs performed over 6 months increased from 2.69 to 4.09 (p<0.001). Women's confidence performing correct BSE improved from 6.41 to 7.04 (p<0.001) on a scale of 0-10. Adherence to ACS guidelines for CBE and mammography did not reveal statistically significant improvements except for better adherence to CBE in women aged 40-49 years (81% to 97%, p<0.025). The strength of the pharmacists' intervention may not appear as manipulation of high-risk patients' behavior but as improvement of self-directed behaviors, such as BSE, across all age groups.

Experimental design is important when studying mixtures/combinations of chemicals. The traditional approach for studying mixtures/combinations of multiple chemicals involves response surface methodology, often supported by factorial designs. Although such an approach permits the investigation of both the effects of individual chemicals and their interactions, the number of design points needed to study the chemical mixtures becomes prohibitive when the number of compounds increases. Fixed ratio ray designs have been developed to reduce the amount of experimental effort when interest can be restricted to a specific ray. We focus on the design and analysis issues involved in studying mixtures/combinations of compounds along fixed ratio rays of the compounds. To obtain the inference regarding the interactions among the compounds, we show that the only data required are those along the fixed ratio ray.

Drug-exposed infants did not differ from nonexposed infants on Neonatal Behavioral Assessment Scale (NBAS) clusters or on birth characteristics. Infants (n = 137) born to three groups of low-income mothers--cocaine and poly-drug-using mothers in a drug user treatment group (n = 76) and in a treatment rejecter group (n = 18), and to a nonuser group (n = 43)--were examined at 2 days and 2-4 weeks. The motor cluster improved and regulation of state worsened from time 1 to 2. There were no interactions of group by time. Regression analyses were conducted to see whether group differences might either emerge or disappear after removing effects of competing variables, but they did not. Power analysis showed that sample size was sufficient to have detected group differences.