Grantham-McGregor, S. M., and Back, E. H. (1970). Archives of Disease in Childhood, 45, 404. Breast feeding in Kingston, Jamaica. A longitudinal study was carried out on 300 Kingston infants born at the University Hospital of the West Indies. The method of milk feeding and the reasons given by the mothers for beginning bottle feeding were recorded. Other factors influencing the incidence of breast feeding were examined. Complementing in hospital, maternal employment, improving socio-economic status, advertising, and general misinformation were considered important. A higher incidence of gastro-enteritis was found in the first 4 months of life among partly or wholly bottle-fed babies than among breast-fed babies. Weight increments were calculated for the first 3 months of life. A higher proportion of infants with increments in the lowest 25% were bottle fed than those infants with increments in the remaining 75%o.
SUMMARY
Some items of gross motor and language development behaviour were evaluated in 300 Kingston, Jamaica, infants of predominantly Negro extraction throughout the first year of life. They were found to be accelerated over the normal white child of the Gesell Developmental Schedules. Children of low birthweight were significantly slower than the remaining children in attaining several items but were equal to the normal white child of the Gesell Schedules. Sex and socio‐economic class made no difference to the age of walking, although high weight at 12 months had a beneficial effect.
Objectives: Primary care providers (PCPs) prescribe medication for opioid use disorder (MOUD), but patients may receive MOUD from a provider who only prescribes MOUD, and who does not provide routine medical care that would be expected from a PCP. The importance of receiving MOUD from one's own PCP versus another provider on patient MOUD retention is not known. Methods: All patients receiving MOUD from December 2016 through November 2019 within a rural, Federally Qualified Health Center were included. Patient sociodemographic, PCP-MOUD concordance, and retention time in MOUD were extracted from the electronic health record. Travel-time from patients' home to the clinic where MOUD was provided was calculated. The risk of premature discontinuation was estimated with Kaplan-Meier curves and with hazard ratios (HR) with 95% confidence intervals (CI). All analyses were performed using R version 3.4.4. Results: Among (n = 353) patients receiving MOUD from 2016 to 2019, n = 77 (21.8%) patients receivedMOUD from their PCP (PCP-MOUD concordance). PCP-MOUD concordance was associated with reduced risk of premature discontinuation (HR = 0.41, 95% CI = 0.18-0.95), however, after multivariable adjustment, PCP-MOUD concordance was not significant (HR = 0.45, 95% CI = 0.19-1.05). Conclusions: In this rural Federally Qualified Health Center, MOUD provision by a patient's own PCP, as compared to a separate provider, did not reach statistical significance for an association with improved retention in treatment. These findings are likely due to a small sample size, and support expanding buprenorphine access as part of comprehensive primary care to combat the opioid crisis, especially in rural areas.
and districts by 18 January. The reverse process for submitting comments began on 11 February to complete the cycle back to the RHA by 24 February. Three weeks to discuss such matters is utterly absurd and even dangerous. I am informed that other areas and districts have had even less time available than Kent.
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