Respiratory and Bronchitic Symptoms Predict Intention to Quit Smoking among Current Smokers with, and at Risk for, Chronic Obstructive Pulmonary Disease

Rationale: Smoking cessation is the most important intervention for patients with chronic obstructive pulmonary disease (COPD). What leads smokers with COPD to quit smoking remains unknown

“This choice does not just affect me.” Attitudes of pregnant women toward COVID-19 vaccines: a mixed-methods study

Public health experts agree that pregnant women who fall into priority groups may be offered a Coronavirus Disease 2019 (COVID-19) vaccine. However, little is known about attitudes of pregnant women toward COVID-19 vaccination. We surveyed 300 pregnant women during the roll out of the Pfizer-BioNTech vaccine in Ireland. Women rated likelihood of receipt of a vaccine during pregnancy, on a 1–10 scale (1 = very unlikely, 10 = very likely). One hundred and thirteen (38%) women responded with a score of ≥8, while a similar proportion (36%) selected a score of ≤2. Safety of their unborn infant was the primary driver of decision making among survey participants, but specific safety concerns differed according to likely acceptance of a vaccine. Communication about COVID-19 vaccines to pregnant women must explicitly address safety. Pregnant women and their health-care providers should be supported with accessible interpretations of data so that they can make the best choice for their individual risk profile

Chronic Obstructive Pulmonary Disease Outcomes at Veterans Affairs Versus Non-Veterans Affairs Hospitals

Plain language summary: The U.S. Centers for Medicare and Medicaid Services (CMS) and the Veterans Health Administration have both implemented policies intended to reduce readmissions in patients with COPD, but little is known about the relative performance of VA and non-VA hospitals on COPD readmissions and mortality in the ensuing years. Clinical trials of various interventions designed to reduce hospital readmissions in patients with COPD have demonstrated the potential to reduce readmissions but also to increase the risk of death. This study compared readmission and death rates at VA and non-VA hospitals using publicly available data from CMS Hospital Compare. We also measured the association between hospital-level readmission and death rates at VA and non-VA hospitals and across various hospital characteristics. From 2015 to 2018, VA hospitals had lower COPD readmission and death rates compared to non-VA hospitals. Readmission and death rates were not associated at VA hospitals. Among non-VA hospitals, higher readmission rates were associated with lower death rates. The inverse association between readmission and death rates at non-VA hospitals calls for re-examination of readmissions policies