Background Although preterm birth less than 37 weeks gestation is the leading cause of neonatal morbidity and mortality in the United States, the majority of data regarding preterm neonatal outcomes come from older studies, and many reports have been limited to only very preterm neonates. Delineation of neonatal outcomes by delivery gestational age is needed to further clarify the continuum of mortality and morbidity frequencies among preterm neonates. Objective We sought to describe the contemporary frequencies of neonatal death, neonatal morbidities, and neonatal length of stay across the spectrum of preterm gestational ages. Study Design Secondary analysis of an obstetric cohort of 115,502 women and their neonates who were born in 25 hospitals nationwide, 2008–2011. All live born non-anomalous singleton preterm (23.0–36.9 weeks of gestation) neonates were included in this analysis. The frequency of neonatal death, major neonatal morbidity (intraventricular hemorrhage grade III/IV, seizures, hypoxic-ischemic encephalopathy, necrotizing enterocolitis stage II/III, bronchopulmonary dysplasia, persistent pulmonary hypertension), and minor neonatal morbidity (hypotension requiring treatment, intraventricular hemorrhage grade 1/2, necrotizing enterocolitis stage 1, respiratory distress syndrome, hyperbilirubinemia requiring treatment) were calculated by delivery gestational age; each neonate was classified once by the worst outcome they met criteria for. Results 8,334 deliveries met inclusion criteria. There were 119 neonatal deaths (1.4%). 657 (7.9%) neonates had major morbidity, 3,136 (37.6%) had minor morbidity, and 4,422 (53.1%) survived without any of the studied morbidities. Deaths declined rapidly with each advancing week of gestation. This decline in death was accompanied by an increase in major neonatal morbidity, which peaked at 54.8% at 25 weeks of gestation. As frequencies of death, and major neonatal morbidity fell, minor neonatal morbidity increased, peaking at 81.7% at 31 weeks of gestation. The frequency of all morbidities fell beyond 32 weeks. Neonatal length of hospital stay decreased significantly with each additional completed week of pregnancy; among babies delivered from 26 to 32 weeks of gestation, each additional week in utero reduced the subsequent length of neonatal hospitalization by a minimum of 8 days. The median post-menstrual age at discharge nadired at 35.7 weeks post-menstrual age for babies born at 32–33 weeks of gestation. Conclusions Our data show that there is a continuum of outcomes, with each additional week for gestation conferring survival benefit while reducing the length of initial hospitalization. These contemporary data can be useful for patient counseling regarding preterm outcomes.

OBJECTIVES. The purpose of the present study was to examine the role of self-exempting or cognitive dissonance-reducing beliefs about smoking and health. Such beliefs may hold important implications for the content and targeting of health promotion campaigns. METHODS. A survey of smokers and ex-smokers was conducted in western Sydney, Australia. Six hypotheses were tested. RESULTS. The principal findings were (1) that 27.9% of smokers and 42.1% of ex-smokers agreed that smokers were more likely than non-smokers to get five smoking-related diseases; (2) that for 11 of 14 beliefs tested, more smokers than ex-smokers agreed to a statistically significant degree; (3) that the median number of such beliefs agreed to by smokers was five, compared with three for ex-smokers; (4) that for only 5 of 14 beliefs was agreement expressed by more precontemplative smokers than smokers contemplating or taking action to quit; (5) that more than one in four smokers, despite agreeing that smokers are more likely than non-smokers to get five diseases, nonetheless maintain a set of self-exempting beliefs. CONCLUSIONS. Fewer smokers than ex-smokers accept that smoking causes disease, and smokers also maintain more self-exempting beliefs. Becoming an ex-smoker appears to involve shedding such beliefs in addition to accepting information about the diseases caused by smoking.

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The Bangladesh Acute Nerve Damage Study (BANDS) is a prospective cohort study designed to investigate epidemiological, diagnostic, therapeutic and operational aspects of acute nerve function impairment in leprosy. The study is based at a single centre in Bangladesh, in an area with a high prevalence of leprosy. The centre, Danish Bangladesh Leprosy Mission, has a well-established vertical leprosy control programme. In this paper, the study design and methodology are described, together with definitions of nerve function impairment (NFl) used in this and subsequent papers. The study recruited 2664 new leprosy cases in a 12-month period. The male:femaJe ratio is 1•25: I, and 17•61 % of the cohort are under 15 years of age. In all, 83•33% of the cohort are paucibacillary (PB), and 16•67% multibacillary (MB). However, the MB rate amongst males is 19•72%, and amongst females is 12•85%, despite an equal period of delay to diagnosis. 55% of patients presented for treatment within 12 months of developing symptoms. 6• 12% of the total number of cases were smear positive, and 36•71% of the MB cases were smear positive. 9•61% of the total number of cases were graded as having World Health Organisation (WHO) disability grade I, and 5•97% had grade 2. Amongst MB cases, 27-48% had WHO grade 1 disability present, and 18•24% had grade 2 present, compared with 6•04% and 3 •5 1 %, respectively, amongst PB cases. A total of 11•90% of the cohort had sensory NFl of any kind, and 7•39% had motor NFL Ninety patients presented with NFl needing treatment (3•38%), and of these, 61 (67•78%) had silent NFL MB patients had a prevalence of reactionlNFI needing treatment nearly 7 times higher than PB cases (15•32% amongst MB; 2•30% amongst PB), and males nearly double that of females (5•67% amongst males, 2•96% amongst females). The most

This systematic review assesses the long-term effectiveness of weight loss on all cause mortality in overweight/obese people. Medline, Embase and Cinahl were searched (1966-2005). Cohort studies and trials on participants with body mass index > or =25 kg m(-2), with weight change and mortality with > or =2-year follow-up, were included finally identifying 11 papers based on eight studies. There may be gender differences in the benefits for all cause mortality. The impact of weight loss in men on mortality was not clear with some studies indicating weight loss to be detrimental, while a recent cohort study showed benefits, if it were a personal decision. Other studies with no gender separation had similarly mixed results. However, one study indicated that overweight/obese women with obesity-related illness, who lost weight intentionally within 1 year, had significantly reduced mortality rates of 19-25%. In contrast, studies of overweight/obese diabetics irrespective of gender showed significant benefit of intentional weight loss on mortality in a meta-analysis, hazard ratios = 0.75 (0.67-0.83). There is some evidence that intentional weight loss has long-term benefits on all cause mortality for women and more so for diabetics. Long-term effects especially for men are not clear and need further investigation.