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Childbirth-Related Injuries Decline, Linked With Use Of Instruments, AHRQ Report Finds
There were nearly 158,000 potentially avoidable childbirth-related injuries to women and their infants in 2006, a significant decline from 2000, according to a report by the Agency for Healthcare Research and Quality, HealthLeaders Media reports. The report used data submitted for 15 million discharges by 1,900 hospitals in 25 states, including the largest states -- California, New York, Florida and Texas. Between 2000 and 2006, the rate of potentially avoidable injuries during vaginal childbirth without the use of instruments, such as forceps, declined by 30%, according to the report. The injury rate declined by 21.3% for vaginal childbirth using instruments and by 16.7% for women undergoing caesarean sections. Report author Roxanne Andrews of AHRQ said that the report did not examine factors that might have contributed to the declining injury rates but added that it is an area for further study.The report found that rates of injury were higher when instruments were used during childbirth. For instance, trauma to the woman during vaginal delivery with the use of instruments occurred 160.5 times per 1,000 discharges, compared with 36.2 times when instruments were not used. The report said that the most common injuries to women were perineum tears, which are avoidable in many cases. Traumatic injury to infants during childbirth -- such as broken collarbones, head injuries and infections -- occurred 1.6 times per 1,000 discharges.The report also highlighted care disparities between women in low-income areas and those in high-income areas. Women giving birth in high-income areas had 44% more injuries during vaginal delivery than their counterparts in low-income areas. Black and Hispanic women experienced fewer injuries than white women, while Asian American and Pacific Islander women experienced the highest rate of injuries. The report found that women covered by Medicaid were less likely to be injured during childbirth -- 127 injuries per 1,000 deliveries -- compared with women with private insurance plans -- 185 injuries per 1,000 deliveries. However, the rate of injury for infants covered under Medicaid was higher -- 1.7 per 1,000 deliveries -- than those under private plans -- 1.5 per 1,000 deliveries.The report encouraged providers to evaluate their practices to better understand why such complications occur. According to the report, "Identifying which types of patient safety problems exist for different sub-groups of patients is an important first step in developing interventions to reduce disparities and achieve high quality of care for all patients" (Clark, HealthLeaders Media, 6/18).

UCB Launches Vimpat In The US For Add-On Treatment Of Epilepsy In Adults
UCB has announced that Vimpat® (lacosamide) C-V , a new antiepileptic drug (AED) is available in the U.S. as an add-on therapy for the treatment of partial-onset seizures in people with epilepsy who are 17 years and older. Vimpat® will be available in U.S. pharmacies by the first week of June 2009.
News of the day
Alzheimer's Disease Is The Focus Of TBSI Annual Neuroscience Symposium
Brazos Valley residents, neuroscience researchers, and interested clinicians will each have opportunities to hear from internationally recognized researchers on the topic of aging and Alzheimer"s Disease during the Texas Brain and Spine Institute"s Third Annual Neuroscience Symposium on September 3 and 4. This year"s symposium will consist of an evening of public presentations aimed at helping local residents, Alzheimer"s patients, and their family members better understand early signs of the disease and ways to reduce your risk. The Friday afternoon session will feature a clinical presentation for health providers and researchers.
Endocrinology

Home Smoking Rules Tend To Vary By Race

Prohibiting tobacco use at home could reduce adolescent smoking rates, but the practice might be less common in black families than in white ones, a new study found. "African-American homes have fewer full bans, and more people are allowed to smoke in those homes," said Jessica Muilenburg, Ph.D., an assistant professor in the department of health promotion and behavior at the University of Georgia. The study appears in the August issue of the journal Health Education & Behavior. Researchers led by Muilenburg surveyed 4,296 Mississippi high school students about their smoking habits and home smoking rules. About three quarters of the teens surveyed were African-American; nearly one quarter were white. Sixty-one percent of teens reported having smoking bans at home that disallowed any smoking; 32 percent of teens noted they were not allowed to smoke at home although adults were; and 7 percent of teens reported no restrictions on smoking at home. Students whose parents did not ban smoking were more likely to try smoking and smoke daily, and less likely to feel that smoking was dangerous to their health. Overall, about 66 percent of white parents banned smoking at home completely, compared with 60 percent of African American parents. "More people are allowed to smoke in those homes and, although it didn"t seem to translate into behavior, it did look like quitting and the attempts to quit smoking were not as high as in our white sample. So ultimately, even though they wanted to quit as much as whites, black teens were less likely to make an attempt," Muilenburg said. This finding represents a health disparity in that more African-Americans lack a home environment that is conducive to quitting or preventing smoking, the authors said in the study. "Not only do home smoking bans send the message that smoking is not acceptable, but they also prevent all household members from exposure to secondhand smoke," said Jennifer Unger, Ph.D., a professor of community and global health at Claremont Graduate University in California. Although African-American homes might be less likely to ban smoking at home, Unger said that African-American adolescents in general are much less likely to smoke than white teens, a finding supported by this study. "Some studies have shown that African-American parents impose stricter discipline on their children and make more absolute rules about substance use, whereas white parents are more likely to allow their children to experiment with smoking and make their own decisions," Unger said. "Different parenting styles work for different people, but this suggests that in the African-American cultural context, absolute rules about no smoking may be more effective than letting the children experiment." Health Education & Behavior, a peer-reviewed journal of the Society for Public Health Education (SOPHE), publishes research on critical health issues for professionals in the implementation and administration of public health information programs. For information, contact Laura Drouillard at (202) 408-9804. Muilenburg JL, et al. The home smoking environment: Influence on behaviors and attitudes in a racially diverse adolescent population. Health Education & Behavior, August 2009. Health Behavior News Service


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