Maternal transmission of nicotine dependence: psychiatric, neurocognitive and prenatal factors.

This paper reviews the literature on maternal influences on smoking behaviors of offspring from the perspective of neuropsychiatric deficits that may be transmitted from mother to child. In particular, we review what is known regarding associations between: (1) in-utero exposure to smoking, (2) adolescent neurocognitive functioning and psychiatric comorbidity, and (3) the patterns of smoking and progression of nicotine dependence. Furthering our knowledge of these differences in susceptibility to nicotine dependence among youth will provide additional avenues for prevention and intervention efforts targeted toward those at high risk for dependence.

The prevalence of risk factors among women in the United States by race and age, 1992-1994: opportunities for primary and secondary prevention.

OBJECTIVE: To analyze the prevalence of 11 modifiable behavioral risk factors, including multiple risk factors, among white, black, Asian and Pacific Islander, American Indian, and Hispanic women in the United States. DESIGN: We used Behavioral Risk Factor Surveillance System (BRFSS) data for 1992 to 1994 to examine risk factors (smoking; obesity; diabetes; heavy alcohol consumption; sedentary lifestyle; and inadequate use of seat belts, pap smears, consumption of fruits or vegetables, mammography and colorectal screening, and immunization), among women age 18 to 49, 50 to 64, and 65 and older. We also conducted a multiple regression analysis, comparing the odds of having either 1-2 versus 0 or 3 or more versus 0 risk factors among racial/ethnic groups, controlling for education and family income, to see if racial/ethnic differences can be attributed to socioeconomic differences. RESULTS: US women engage in a variety of behaviors that place them at risk for many causes of morbidity and mortality. Risk profiles vary substantially among racial/ethnic populations: Pacific Islanders have relatively low prevalences of most major risk factors, while blacks and American Indians have relatively high prevalences of many major risk factors. Prevalence differences among racial/ethnic populations are diminished but not eliminated when socioeconomic factors are accounted for. CONCLUSIONS: Appropriately designed programs to help women reduce their behavioral risk factors are needed. Action by health care providers, communities, and policy makers can substantially improve the health of women in the United States.

Moderate leisure-time physical activity: who is meeting the public health recommendations? A national cross-sectional study.

We identified the prevalence of adults who met the 1993 Centers for Disease Control and Prevention and the American College of Sports Medicine moderate physical activity recommendation and the 1996 Surgeon General's Report on Physical Activity and Health energy expenditure guideline for leading a moderately active lifestyle. Participants were 16,890 women and 12,272 men at least 18 years old who were asked in the 1990 National Health Interview Survey about their leisure-time physical activities. About one third of US adults met either recommendation for moderate activity; 32% met the Centers for Disease Control and Prevention and the American Association of Sports Medicine recommendation and 38% met the surgeon general's guideline. Women, ethnic minorities, adults with lower educational attainment, and older adults were least active. Public health efforts are needed to address the issues related to physical inactivity and to provide organized programs to increase moderate physical activity levels in US adults.

Human granulocytic ehrlichiosis in New York.

BACKGROUND: Human granulocytic ehrlichiosis (HGE), a potentially fatal tick-borne disease, was first described in the upper Midwest in 1994. Following reports of suspected cases of ehrlichiosis from New York physicians, descriptive and case-control studies were conducted to characterize the epidemiology and risk factors for HGE in New York residents. METHODS: Descriptive data were gathered from surveillance and laboratory reports and hospital records. A confirmed case was defined as either (1) a 4-fold change in total antibody titer to Ehrlichia equi by indirect immunofluorescence or (2) a polymerase chain reaction assay positive for Ehrlichia phagocytophila/E equi group DNA. A probable case was defined as an acute febrile illness and either (1) a single E equi titer greater than or equal to 80 or (2) morulae on a peripheral blood smear. The case-control study included patients with confirmed HGE 18 years of age or older with the onset of disease in 1995 and 2 to 3 neighborhood-matched controls. RESULTS: During 1994 and 1995, the New York State Department of Health, Albany, received reports of 241 residents who were tested for HGE; 30 met the confirmed case definition and 34 met the probable case definition. The median age of patients was 46 years (age range, 9-90 years), 35 (55%) were male, and 25 (45%) were hospitalized. Fever, headache, malaise, and myalgia were the most frequently reported symptoms. Fifty-six (88%) of the 64 patients resided in areas in which Lyme disease is hyperendemic. In the case-control analysis, cases were more likely than controls to have sustained a tick bite during 1995 (matched odds ratio, 5.0; 95% confidence interval, 0.9-49.8). Cases and controls did not differ by occupational exposure to ticks, underlying chronic diseases, or measures taken to prevent tick bites. CONCLUSIONS: This study, which, to our knowledge, is the first population-based study of HGE, demonstrates the recent recognition of HGE in the state of New York. Control measures should be integrated with those for Lyme disease and should focus on minimizing contact with ticks and obtaining early treatment for infection.

Development and testing of computer software for nursing assessment and care planning at a spinal cord injury center.

This paper describes a pilot project using a Macintosh personal computer and customized software to computerize nursing admission assessment and care planning data. The project setting is a 47-bed Spinal Cord Injury Center with two inpatient units and an outpatient department serving approximately 1,000 patients with spinal cord injury at a Department of Veterans Affairs Medical Center in northern California. The computer software development, implementation, and evaluation are described. This software (MacNursing) was found to be a low cost, customized approach to computerizing spinal cord injury admission assessment data and care planning which reduces repetitive writing and facilitates continuity of care. Personal computers and this software have provided the mechanism for establishing a spinal cord injury patient database.

Vacuum tumescence: an option for spinal cord injured males with erectile dysfunction.

Vacuum tumescence with constriction/retention bands is an option for management of male erectile dysfunction. The appropriateness of this system for individuals with spinal cord injury was evaluated at the Palo Alto, California, Veterans Administration Medical Center, Spinal Cord Injury Center. Following a structured educational program and use of the system for at least 2 months, 13 male subjects and 9 female partners responded to a questionnaire evaluating their satisfaction and the safety of the device. Findings indicate an increase in frequency of intercourse and increased sexual satisfaction with use of the device without occurrence of significant physical problems for the subjects or their partners.