ABSTRACT
Millions of American girls and women have been drawn to smoking by an industry that has been clearly and systematically targeting women of all ages and life circumstances. Tobacco marketing strategies skillfully link cigarette use to typical female values. Biologically speaking, women are especially vulnerable to the legion of health problems of tobacco use. Smoking is a critical hazard for women in their reproductive years, particularly when they are pregnant.
Subject(s)
Mass Media , Tobacco Use Disorder/etiology , Women's Health , Female , Humans , Infant, Newborn , Pregnancy , Smoking Cessation , Tobacco Use Disorder/complications , Tobacco Use Disorder/epidemiologyABSTRACT
OBJECTIVE: To demonstrate the effectiveness of a comprehensive, multispecialty, interdisciplinary team approach to prenatal and obstetric care for previously medically underserved patients. STUDY DESIGN: A retrospective chart review analysis was performed on a total of 1,800 charts pertaining to 600 patients divided evenly between a publicly funded, comprehensive prenatal care program and that same institution's private faculty practice. For each of the 600 patients data were extracted from prenatal, intrapartum and postpartum records. Data were analyzed using Fisher's exact test, the chi2 test and the Mann-Whitney test. In addition, for certain parameters, the data from the publicly funded program were compared to national data. RESULTS: In the publicly funded group, more patients initiated prenatal care at a later date (p < 0.0001), had a significantly higher rate of illegal substance use (p < 0.0007), utilized home care services more frequently (p < 0.0001) and averaged a somewhat longer hospital stay for mother and neonate (p < 0.0019, p < 0.0001, respectively). However, there was no significant difference between the 2 groups or between the publicly funded group and the national averages for most antepartum, intrapartum and postpartum complications or for maternal or fetal morbidity or mortality. The publicly funded group averaged a higher rate of breast-feeding. CONCLUSION: Despite belonging to a higher risk population, there were no statistically significant differences in maternal or neonatal outcomes between the publicly funded group and the private faculty practice group or between the publicly funded group and national data. This suggests that a comprehensive, multispecialty, interdisciplinary team approach to prenatal and obstetric care is an effective program to provide to patients who have previously been medically underserved.
Subject(s)
Comprehensive Health Care/economics , Financing, Government , Obstetrics/economics , Outcome Assessment, Health Care/statistics & numerical data , Patient Care Team/economics , Prenatal Care/economics , Adult , Female , Humans , Medically Underserved Area , New York/epidemiology , Obstetric Labor Complications/economics , Obstetric Labor Complications/epidemiology , Pregnancy , Pregnancy Complications/economics , Pregnancy Complications/epidemiology , Program Evaluation , Retrospective Studies , Risk FactorsABSTRACT
OBJECTIVE: To determine whether our health care employees were undergoing mammography screening according to American Cancer Society guidelines and to determine whether aggressive outreach, education and streamlining of mammography scheduling could improve compliance. STUDY DESIGN: All female employees at North Shore University Hospital (NSUH) and several other health system facilities (SF) were sent mailings to their homes that included breast health education and mammography screening guidelines, a questionnaire regarding their own mammography screening history and the opportunity to have their mammography screening scheduled by the Mammography Screening Employee Inreach Program (MSEIP) coordinator. RESULTS: Of the approximately 2,700 female employees aged 40 and over at NSUH and SF, 2,235 (82.7%) responded to the questionnaire, and 1,455 had a mammogram done via the MSEIP. Of the 1,455, 43% either were overdue for a mammogram or had never had one. During a second year of the MSEIP at NSUH and SF, an additional 1,706 mammograms were done. CONCLUSION: People employed in health care jobs do not necessarily avail themselves of appropriate health care screening. An aggressive program that utilized education, outreach and assistance with scheduling was effective in increasing compliance with mammography screening.
Subject(s)
Breast Neoplasms/psychology , Health Education , Health Promotion , Mammography/statistics & numerical data , Occupational Health Services , Patient Acceptance of Health Care , Adult , Breast Neoplasms/diagnosis , Female , Health Care Surveys , Humans , Program EvaluationABSTRACT
Millions of American girls and women have been drawn to smoking by an industry that has been clearly and systematically targeting women of all ages and life circumstances. Tobacco marketing strategies skillfully link cigarette use to typical female values. Biologically speaking, women are especially vulnerable to the legion of health problems of tobacco use. Smoking is a critical hazard for women in their reproductive years, particularly when they are pregnant.
Subject(s)
Smoking/adverse effects , Women/psychology , Cardiovascular Diseases/etiology , Child , Female , Humans , Infant , Infertility/etiology , Male , Neoplasms/etiology , Osteoporosis/etiology , Pregnancy , Pregnancy Complications/etiology , Sex Factors , Smoking/psychology , Smoking Cessation/psychology , Tobacco Smoke Pollution/adverse effectsABSTRACT
Breast cancer is reported to occur in from 1 in 3000 to 1 in 10,000 pregnancies worldwide. In the United States, 10% to 20% of breast cancers occur in women of childbearing age. Diagnosis and treatment of breast cancer during pregnancy present many additional challenges.
