Smoking Behaviors and Abstinence in Low-Income Pregnant Women

Background: Despite efforts to educate individuals about the hazards of smoking, pregnant women continue to smoke. In the literature, there is less evidence about successful abstinence strategies for low-income women. The purpose of this pilot study was to assess smoking behaviors and factors that support smoking abstinence in low-income pregnant women. Methods: Using a longitudinal design, quantitative and qualitative data were collected from pregnant women at a low-income community prenatal clinic. Based on the Transtheoretical model, all subjects received information about the harmful effects of smoking and secondhand exposure, while current smokers were given a “quit kit” and contacted up to one year post-delivery to evaluate smoking behaviors. Results: All subjects (N = 135) ranged in age from 18 to 41; 75% were not married; 78% had household incomes \u3c $30,000; and the majority were African American (40%). Fifty-five (40.7%) never smoked while 77(57%) had a smoking history, of these 18(23%) were spontaneous quitters. Data indicated that 36% reported smoking during pregnancy, with the majority in pre-contemplation. After one year, 18% of current smokers quit. Conclusions: Without a specific plan, the majority were unable to successfully abstain. Rate of abstinence may have been further influenced because subjects began smoking at an early age and were unsuccessful at previous quit attempts. Providers must continue to educate pregnant women but also evaluate strategies that require few provider visits, are cost effective, focus on relapse prevention, and can successfully influence smoking abstinence in low-income pregnant women

Coverage of strategies for strengthening the basic health care

Objectives: Analyzing the coverage of strategies to strengthen Primary Care in the municipalities of the 4th Regional Health Management of Santa Catarina, Brazil. Method: A cross-sectional descriptive study conducted at the bank of indicators covering of Family Health teams (SF), Community Health Agents teams (ACS), National Programme for Improving Access and Quality of Primary Care (PMAQ) Professional Enhancement Program of AB (PROVAB), Psychosocial Care Centers (CAPS) and Stork Network of 25 municipalities. Results: 88% of the municipalities are suitable for the quantity of SF teams; 100% of the population is covered by ACS; 95,5% of SF teams joined the PMAQ; 48% did not join the PROVAB; 64% do not have CAPS; 32% did not join the Stork Network. Conclusion: These findings suggest the search for qualification and solving teams and health services, but show difficulties in expansion and articulation of actions

Coverage of strategies for strengthening the basic health care

Objetivos: analisar a cobertura das estratégias para fortalecimento da Atenção Básica nos municípios da 4a Gerência Regional de Saúde de Santa Catarina, Brasil. Métodos: estudo transversal, descritivo, realizado no banco de indicadores de cobertura de equipes de Saúde da Família (SF), equipes de Agentes Comunitários de Saúde (ACS), Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ), Programa de Valorização do Profissional da AB (PROVAB), Centros de Atenção Psicossocial (CAPS) e Rede Cegonha, de 25 municípios. Resultados: 88% dos municípios estão adequados em relação à quantidade de equipes de SF; 100% da população está coberta por ACS; 95,5% das equipes de SF aderiram ao PMAQ; 48% não aderiram ao PROVAB; 64% não possuem CAPS; 32% não aderiram à Rede Cegonha. Conclusão: os achados sinalizam a busca pela qualificação e resolubilidade das equipes e serviços de saúde, mas revelam dificuldades na expansão e articulação das ações.

Investigating the effectiveness and cost-effectiveness of FITNET-NHS (Fatigue In Teenagers on the interNET in the NHS) compared to activity management to treat paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME):amendment to the published protocol

The FITNET-NHS Trial is a UK, national, trial investigating whether an online cognitive behavioural therapy program (FITNET-NHS) for treating chronic fatigue syndrome/ME in adolescents is clinically effective and cost-effective in the NHS. At the time of writing (September 2019), the trial was recruiting participants. This article presents an update to the planned sample size and data collection duration previously published within the trial protocol. Trial registration: ISRCTN, ID: 18020851. Registered 8 April 2016

Impact of mental health problems on case fatality in male cancer patients

Background: Although mortality rates are elevated in psychiatric patients relative to their healthy counterparts, little is known about the impact of mental health on survival in people with cancer. / Methods and results: Among 16 498 Swedish men with cancer, survival was worse in those with a history of psychiatric hospital admissions: multiply-adjusted hazard ratio (95% confidence interval) comparing cancer mortality in men with and without psychiatric admissions: 1.59 (1.39, 1.83). / Conclusion: Survival in cancer patients is worse among those with a history of psychiatric disease. The mechanisms underlying this association should be further explored