Purpose Examine associations between interpregnancy BMI change and gestational diabetes mellitus (GDM), pre-eclampsia (PE), gestational hypertension (GHtn), primary cesarean delivery, and vaginal birth after cesarean delivery (VBAC). Methods Modified Poisson regression models estimated adjusted associations. Results Every one unit increase in interpregnancy BMI increased risks of GDM (RR: 1.09, 95%CI: 1.07–1.11), PE (RR: 1.06, 95%CI: 1.04–1.09), GHtn (RR: 1.08, 95%CI: 1.06–1.10), and primary cesarean delivery (RR: 1.03, 95%CI: 1.01–1.05) and decreased the risk of a successful VBAC (RR: 0.98, 95%CI: 0.97–0.997) in the second pregnancy. A BMI increase ≥3 units increased risks of GDM (RR: 1.71, 95%CI: 1.52–1.93), PE (RR: 1.60, 95%CI: 1.33–1.94), GHtn (RR: 1.66, 95%CI: 1.42–1.94), and primary cesarean delivery (RR: 1.29, 95%CI: 1.12–1.49) and decreased the risk of a successful VBAC (RR: 0.89, 95%CI: 0.80–0.99) compared to women with interpregnancy BMI change within −1 and +1 unit. GDM was also increased among women increasing their BMI by ≥2 but <3 units (RR: 1.40, 95%CI: 1.21–1.61) and among those gaining ≥ 1 but <2 units (RR: 1.23, 95%CI: 1.08–1.40). Conclusion An interpregnancy BMI increase ≥3 units is associated with an increased risk of all outcomes. These findings emphasize the importance of interpregnancy weight management.
Objectives Studies suggest that parents tend to misperceive their child's actual weight status and typically underestimate their child's weight. Since few studies examine the factors that influence parental misperception, this study aims to assess the influence of parent and child factors with parental misperception of their child's actual weight status who were either at their recommended weight or overweight/obese in South Carolina in 2013 and 2014. Methods Secondary data were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) and the Children's Health Assessment Survey (CHAS) in 2013 and 2014 in SC. Parental misperception of child's actual weight status was measured by comparing parental perception to their child's actual weightstatus measured via BMI. Logistic regression was conducted to assess the association between parental and child factors with parental misperception of child's weight status. Results In the adjusted multivariate analysis, only child's age was significantly and positively associated with parental misperception of their child's actual weight status. Conclusions for Practice This cross sectional analysis showed an association between child's age and parental misperception of child's actual weight status. It is essential to educate parents about their children's weight status, especially among young children.
The Bereavement Program at the National Institutes of Health (NIH) Clinical Center was established in 2005. The program makes contact with the next of kin on 4 occasions postnotification of death. The objective of this analysis was to evaluate program effectiveness for those individuals who we successfully made contact with on all 4 occasions (N = 39). At 12 months postnotification, the majority viewed the NIH as a source of support (56%), and the frequency of positive emotional ratings increased (59%). There are limitations to this analysis, and biases may be present. In sum, this analysis serves as an example of a successful hospital-based bereavement program that enrolls patients who have been treated at the institution in any capacity who are also patients enrolled in institutional review board-approved research protocols.
Per South Carolina (SC) Law §44-29-10, all blood lead test records are reportable. The SC Environmental Public Health Tracking (SC EPHT) program is directly involved in blood lead surveillance in SC, as it maintains the blood lead record database. Although Adult Blood Lead Epidemiology and Surveillance funding from the Centers for Disease Control and Prevention was discontinued in 2013, SC EPHT has continued to monitor and record adult blood lead test records.In 2012, SC EPHT signed a memorandum of understanding with the SC Occupational Safety and Health Administration (SC OSHA). Per this agreement, quarterly reports of elevated adult blood lead concentrations (≥25 μg/dL) are supplied to SC OSHA, along with North American Industry Classification System codes of employers. This information is used for industrial inspections, mitigation, and abatement related to lead. The SC EPHT program's collaboration with SC OSHA has resulted in a number of public health actions that have improved the health and well-being of workers in SC. Of the 3 nationally accepted SC public health actions related to occupational lead exposure, 2 detail investigations and citations by SC OSHA. The other describes internal analyses conducted by the SC EPHT program regarding elevated blood lead levels in adults and associations with specific North American Industry Classification System codes.In this review, we outlined the role of SC EPHT related to adult blood lead surveillance in SC, including implementation of the memorandum of understanding with SC OSHA. We also examined demographics of adult blood lead records in SC for 2010-2015 and summarized public health actions related to occupational lead exposure in SC. Since federal funding for the SC EPHT program was initiated in 2009, the program has played an important part in lead surveillance in SC. The resulting health benefits to those with the potential for occupational exposure to lead are extremely important.
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