Knowledge and attitudes of adults towards smoking in pregnancy: results from the HealthStyles© 2008 survey.

Smoking during pregnancy is causally associated with many adverse health outcomes. Quitting smoking, even late in pregnancy, improves some outcomes. Among adults in general and reproductive-aged women, we sought to understand knowledge and attitudes towards prenatal smoking and its effects on pregnancy outcomes. Using data from the 2008 HealthStyles© survey, we assessed knowledge and attitudes about prenatal smoking and smoking cessation. We classified respondents as having high knowledge if they gave ≥ 5 correct responses to six knowledge questions regarding the health effects of prenatal smoking. We calculated frequencies of correct responses to assess knowledge about prenatal smoking and estimated relative risk to examine knowledge by demographic and lifestyle factors. Only 15 % of all respondents and 23 % of reproductive-aged women had high knowledge of the adverse effects of prenatal smoking on pregnancy outcomes. Preterm birth and low birth weight were most often recognized as adverse outcomes associated with prenatal smoking. Nearly 70 % of reproductive-aged women smokers reported they would quit smoking if they became pregnant without any specific reasons from their doctor. Few respondents recognized the benefits of quitting smoking after the first trimester of pregnancy. Our results suggest that many women lack knowledge regarding the increased risks for adverse outcomes associated with prenatal smoking. Healthcare providers should follow the recommendations provided by the American Congress of Obstetricians and Gynecologists, which include educating women about the health risks of prenatal smoking and the benefits of quitting. Healthcare providers should emphasize quitting smoking even after the first trimester of pregnancy.

HIV viral load levels and CD4+ cell counts of youth in 14 cities.

OBJECTIVES: To describe the HIV viral load and CD4 cell counts of youth (12-24 years) in 14 cities from March 2010 through November 2011. METHODS: Baseline HIV viral load and CD4 cell count data were electronically abstracted in a central location and in an anonymous manner through a random computer-generated coding system without any ability to link codes to individual cases. RESULTS: Among 1409 HIV reported cases, 852 participants had data on both viral load and CD4 cell counts. Of these youth, 34% had CD4 cell counts of 350 or less, 27% had cell counts from 351 to 500, and 39% had CD4 cell counts greater than 500. Youth whose transmission risk was male-to-male sexual contact had higher viral loads compared with youth whose transmission risk was perinatal or heterosexual contact. Greater than 30% of those who reported male-to-male sexual contact had viral loads greater than 50 000 copies, whereas less than 20% of heterosexual contact youth had viral loads greater than 50 000 copies. There were no differences noted in viral load by type of testing site. CONCLUSION: Most HIV-infected youth have CD4 cell counts and viral load levels associated with high rates of sexual transmission. Untreated, these youth may directly contribute to high rates of ongoing transmission. It is essential that any public health test and treat strategy place a strong emphasis on youth, particularly young MSM.

Preexposure prophylaxis for adolescents and young adults at risk for HIV infection: is an ounce of prevention worth a pound of cure?

An alarming proportion of incident human immunodeficiency virus (HIV) infections worldwide occur in youth. In the United States, 69% of all new infections among youth occurred in young men who have sex with men (YMSM). Recent studies show the promise of preexposure prophylaxis (PrEP) for preventing HIV infection, but research efforts suffer from disproportionately low representation of the youth who are most at risk. Youth-focused research is critical and should include behavioral, community, and biomedical interventions to create a comprehensive HIV prevention package. The many ethical, legal, and regulatory considerations in conducting HIV research among, and in providing care services to, youth must be addressed so that those at high risk and most likely to benefit can have unfettered access to safe and effective health-promoting interventions. YMSM and minority youth are at substantial HIV risk and urgently need effective HIV prevention tools for which the short and long-term benefits and risks have been carefully considered.

Comprender las actitudes de los médicos hacia las personas con síndrome de Down / No disponible

Es importante comprender las actitudes de los médicos hacia las personas con síndrome de Down a causa de la influencia que los médicos tienen sobre el futuro de estas personas. Sin embargo pocos estudios han valorado dichas actitudes. Utilizando los datos de la encuesta 2008 DocStyles©, una encuesta anual on line que se realiza en Estados Unidos, evaluamos estas actitudes mediante una encuesta que incluyó preguntas sobre opiniones relacionadas con situaciones educativas y laborales de carácter inclusivo, relaciones previas con individuos con síndrome de Down, y sentimiento de comodidad al prestarles la atención médica. Aproximadamente el 20% de los participantes coincidieron en que los escolares con síndrome de Down deberían ir a escuelas especiales, y casi la cuarta parte afirmaba que incluir a escolares con síndrome de Down en clases ordinarias suponía un factor de distracción. Mientras que el 76% se sentían cómodos al atender médicamente a sus pacientes con síndrome de Down, el 9,8% se sentía incómodo, y el 14,3% mostraban un sentimiento neutro. Los resultados mostraron que las actitudes que apoyaban la inclusión y el sentimiento de confort al ofrecer atención médica fueron más frecuentes en médicos de raza blanca, no hispanos, en los que habían tenido previamente relaciones con personas con síndrome de Down, en los pediatras, y en los médicos que trabajaban en un grupo o entorno hospitalario. Estos datos ayudan a dirigir el desarrollo de los currículos y del material de adiestramiento para futuros profesionales de la salud, en relación con el síndrome de Down

No disponible

Down syndrome: national conference on patient registries, research databases, and biobanks.

A December 2010 meeting, "Down Syndrome: National Conference on Patient Registries, Research Databases, and Biobanks," was jointly sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH) in Bethesda, MD, and the Global Down Syndrome Foundation (GDSF)/Linda Crnic Institute for Down Syndrome based in Denver, CO. Approximately 70 attendees and organizers from various advocacy groups, federal agencies (Centers for Disease Control and Prevention, and various NIH Institutes, Centers, and Offices), members of industry, clinicians, and researchers from various academic institutions were greeted by Drs. Yvonne Maddox, Deputy Director of NICHD, and Edward McCabe, Executive Director of the Linda Crnic Institute for Down Syndrome. They charged the participants to focus on the separate issues of contact registries, research databases, and biobanks through both podium presentations and breakout session discussions. Among the breakout groups for each of the major sessions, participants were asked to generate responses to questions posed by the organizers concerning these three research resources as they related to Down syndrome and then to report back to the group at large with a summary of their discussions. This report represents a synthesis of the discussions and suggested approaches formulated by the group as a whole.

Understanding physicians' attitudes toward people with Down syndrome.

Understanding attitudes of physicians toward people with Down syndrome is important because of the influence physicians have on the future of individuals with Down syndrome. However, few previous studies have assessed these attitudes. Using data from the 2008 DocStyles(©) survey, an annual online survey conducted in the United States, we assessed attitudes of physicians toward people with Down syndrome using a survey that included questions about opinions toward inclusive educational settings and workplaces, previous relationships with people with Down syndrome, and comfort in providing them with medical care. Approximately 20% of participants agreed that students with Down syndrome should go to special schools, and nearly a quarter agreed that including students with Down syndrome in regular classrooms is distracting. While 76.0% of respondents felt comfortable providing medical care to people with Down syndrome, 9.8% reported feeling uncomfortable, and 14.3% reported feeling neutral. Results showed that attitudes that supported inclusion and comfort with providing medical care were more commonly reported among non-Hispanic white physicians, those who had previous relationships with people with Down syndrome, pediatricians, and physicians working in a group or hospital setting. These data are helpful to guide the development of training materials and curricula for healthcare providers regarding Down syndrome.

Understanding attitudes toward people with Down syndrome.

Understanding attitudes of the public toward people with Down syndrome is important because negative attitudes might create barriers to social integration, which can affect their success and quality of life. We used data from two 2008 U.S. surveys (HealthStyles(c) survey of adults 18 years or older and YouthStyles(c) survey of youth ages 9-18) that asked about attitudes toward people with Down syndrome, including attitudes toward educational and occupational inclusion and toward willingness to interact with people with Down syndrome. Results showed that many adults continue to hold negative attitudes toward people with Down syndrome: A quarter of respondents agreed that students with Down syndrome should go to special schools, nearly 30% agreed that including students with Down syndrome in typical educational settings is distracting, and 18% agreed that persons with Down syndrome in the workplace increase the chance for accidents. Negative attitudes were also held by many youth: 30% agreed that students with Down syndrome should go to separate schools, 27% were not willing to work with a student with Down syndrome on a class project, and nearly 40% indicated they would not be willing to spend time with a student with Down syndrome outside of school. Among both adult and youth, female sex and respondents with previous relationships with people with Down syndrome were consistently associated with more positive attitudes. These results may be helpful in the development of educational materials about Down syndrome and in guiding policies on educational and occupational inclusion.