Little insight is available in the literature on how best to assist the pregnant smoker in public health maternity clinics to quit during pregnancy. A randomized pretest/posttest experiment was used to evaluate the effectiveness of two different self-help cessation methods. Three hundred and nine pregnant women from three public health maternity clinics were assigned randomly to one of three groups with one-third assigned to each: a control group; a group receiving the American Lung Association's Freedom From Smoking Manual; and those receiving A Pregnant Woman's Self-Help Guide to Quit Smoking. Using a saliva thiocyanate (SCN) and behavioral report at mid-pregnancy and end of pregnancy to confirm cessation

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We randomized 135 adult asthma patients to a control group, and 132 patients to an experimental group which received a special health education intervention. Four adherence measures were documented at baseline and 12-month follow-up: correct inhaler use, inhaler adherence, medication adherence, and total adherence rating. Costs to routinely deliver the intervention were $32.03/patient. Experimental group patients exhibited a significantly higher level of improvement in adherence (44 percent) than control group patients (2 percent).

Several states have enacted legislation restricting undocumented immigrants' access to publicly funded health benefits not protected by federal law. Using electronic health records from 140,856 county health department visits, we assessed the monthly change in Latino patients' visits compared to non-Latinos 12 months before and after implementation of Alabama's immigration law. We used ICD-9 diagnosis codes to determine whether visits included services exempt under the law: immunizations, testing and treatment for sexually transmitted infections (STIs) and communicable diseases, and family planning. Differences between groups in the mean percent change were assessed with t-tests. Among children younger than 18 years, there were no significant differences by ethnicity. Visits among Latino adults decreased by 28% for communicable diseases, 25% for STIs, and 13% for family planning; this was significantly different from changes among non-Latino adults (p <.05). State-level legislation may reduce immigrants' access to protected benefits, which could adversely affect the broader public's health.

Background: Pediatric cardiopulmonary arrests are rare. Mock codes were instituted to bridge the gap between opportunity and reality. Aim: The goal was to improve medical caregivers' skills in pediatric resuscitation. Methods: All pediatric and internal medicine/pediatric (med/peds) residents were anonymously surveyed pre-and postintervention about confidence level about codes and code skills. Twenty mock codes were conducted during the 1 year intervention period. Statistical comparisons were made between each resident pre-and post-survey, graduating third-year residents (PGY3s) prior to intervention versus PGY3s with mock codes and pediatric versus med/peds residents. Results: All residents significantly improved in their perception of overall skill level during the study ( p < 0.0001). PGY3s were significantly more confident in their skills than PGY2s or PGY1s and PGY2s were significantly more confident than PGY1s both pre-and post-mock codes ( p < 0.0001). Med/peds residents were significantly more confident in their skills than pediatric residents both pre-( p ¼ 0.041) and post-intervention ( p ¼ 0.016). The two skills with the lowest score post-intervention were the ability to place an interosseous line and the ability to manage cardiac dysrhythmias. Conclusions: Pediatric mock codes can improve resident confidence and self-assessment of their resuscitation skills. Data from surveys such as this can be used to design future skill-based educational initiatives.

The development and analysis of an instrument to evaluate the use of metered dose inhalers by patients in the University of Alabama at Birmingham (UAB) Asthma Program is presented. A total of 238 adult asthma patients demonstrated use of the metered dose inhaler for this analysis. Patient skill in using the inhaler was recorded using the instrument, Inhaler-Use Checklist, developed at UAB. The study found that most patients use metered dose inhalers incorrectly, despite training received from their physicians on proper use of inhalers.

Introduction: Childhood obesity affects ~20% of children in the United States. Environmental influences, such as parks, are linked with increased physical activity (PA). Objective: To examine whether changes in Body Mass Index (BMI) z-score were associated with construction of a new park. Methods: A quasi-experimental design was used to determine whether living in proximity of a park was associated with a reduction in BMI z-score. Children were selected from health clinics within an 11 mile radius of the park. A repeated-measure ANOVA was employed for analysis of the relationship between exposure (new park) and BMI z-score. Results: Participants were 1443 (median age 10.3 range (2–17.9 years), BMI: z-score 0.84 ± 1.09) African American (77.4%) adolescents. Change in BMI z-score was not statistically different for children living at different distances from the park after controlling for age, gender, race, ethnicity, or payer type (p = 0.4482). We did observe a small 0.03 increase in BMI z-score from pre- to post-park (p = 0.0007). There was a significant positive association between child’s baseline age and BMI z-score (p < 0.001). Conclusions: This study found proximity to a park was not associated with reductions in BMI z-score. Additional efforts to understand the complex relationship between park proximity, access, and PA are warranted.