Birth Weight as a Risk Factor for Breast Cancer: a Meta-Analysis of 18 Epidemiologic Studies

Background: Birth weight has been identified as a birth-related factor associated with the risk of breast cancer. However, the evidence is inconsistent. Methods: To investigate the association between birth weight and breast cancer, we conducted a meta-analysis of published studies between 1996 and 2008. Eighteen studies encompassing 16,424 breast cancer cases were included in the meta-analysis. Data were combined using a fixed-effect or random-effect model depending on the heterogeneity across studies. Results: Women with their own birth weight \u3e4000 g or 8.5 lb had a higher risk for developing breast cancer than those with birth weight(OR¼1.20, 95% CI 1.08, 1.34). Findings were also consistent with a dose-response pattern effect. The summary effect estimate for breast cancer risk per 1 kg increase in birth weight was statistically significant (random effects OR¼1.07, 95% CI 1.02, 1.12). Conclusions: Although these results provided no evidence indicating whether birth weight is more strongly related to early-onset than to later-onset breast cancer, our findings suggest an association between birth weight and breast cancer. The underlying biological mechanism relating to this phenomenon needs additional study

Florida Public Health Association 2009 Survey of Academic Public Health Programs in Florida

Preparing the public health workforce is essential to the protection ofthe health and wellbeing ofthe state and the nation. Yet, a workforce shortage is looming. It is anticipated that by 2020, the nation will be facing a shortfall ofmore than a quarter of a million public health workers. To address this impeding shortage, the Association ofSchools ofPublic Health (ASPH) has stressed the need to build public health education capacity, with emphasis on competencies and curriculum in emerging diseases, with joint degrees, and with diverse approaches to education, including certificates and distance learning. To assess Florida’s available public health professional preparation programs in meeting workforce needs, the Academic Committee ofthe Florida Public Health Association (FPHA) undertook a survey of the nine public and private universities offering the MPH degree in the state

Translating research into MCH service: comparison of a pilot project and a large-scale resource mothers program.

This study examines the process and effect of translating a pilot research project into a large-scale service program. In a pilot resource mothers program for pregnant teenagers, participants had fewer low birth weight infants than teenagers in the comparison group. In the corresponding large-scale service program, a similarly positive effect on low birth weight was not seen. In an effort to understand how these differences occurred, the evaluation methodologies and key characteristics that describe the background, infrastructure, components, and service providers of the two projects were compared. Important differences between the pilot project and the service program were seen in funding stability, diversity of staff, community versus health department ownership of the program, caseloads, and levels of training and supervision. It seems probable that these differences brought about changes in the intensity and character of the intervention from the pilot to the service program, leading to a reduction of the intervention's efficacy in reducing the number of low birth weight infants. The implications of these findings for researchers and program planners are discussed

The management and use of data on maternal and child health and crippled children: a survey.

With the advent of the Maternal and Child Health Services Block Grant, both maternal and child health programs and crippled children's (CC) programs at the State level have assumed greater responsibility for identifying populations in need, planning appropriate services for them, and monitoring progress toward program objectives. To determine the capabilities of eight Southeastern States to produce and apply the data necessary to accomplish those tasks, a survey of data systems available to, and used by, perinatal and CC programs in the Southeast was undertaken. Findings of the survey suggested that the data available to perinatal programs were more useful for planning and evaluation than those available to CC programs, primarily due to the vital statistics data systems in each State. The major data management needs of the region include (a) measuring the health status of populations served by public perinatal programs, (b) measuring services received by population groups considered in need of public perinatal care, (c) estimating the incidence and prevalence of handicapping conditions among children, and (d) measuring the outcomes of CC programs. If these shortcomings are addressed, the programs will be in better positions for effective planning and evaluation. To improve data management and utilization capabilities, the programs may need to engage technical assistance and consultation from sources outside their service-oriented agencies

Florida Public Health Association 2009 Survey of Academic Public Health Programs in Florida

ABSTRAC

Why we know so little about prenatal care nationwide: an assessment of required methodology.

Policymakers, advocates, providers, recipients, and health services researchers all would agree that too little is known about the nature and effects of specific components of prenatal care. In the process of designing a national, longitudinal study of pregnancy and childbirth, we surfaced some methodological dilemmas that help to explain why so little is known. This article explores two of the major problems: (1) selecting a valid scientific sample of pregnant women and (2) collecting data from providers and women. From this analysis, seven methodological questions, which should be investigated through empirical field studies, are identified. Those field studies are essential if future research into the content of prenatal care is to achieve an acceptable level of methodological rigor

Translating research into MCH service: comparison of a pilot project and a large-scale resource mothers program.

This study examines the process and effect of translating a pilot research project into a large-scale service program. In a pilot resource mothers program for pregnant teenagers, participants had fewer low birth weight infants than teenagers in the comparison group. In the corresponding large-scale service program, a similarly positive effect on low birth weight was not seen. In an effort to understand how these differences occurred, the evaluation methodologies and key characteristics that describe the background, infrastructure, components, and service providers of the two projects were compared. Important differences between the pilot project and the service program were seen in funding stability, diversity of staff, community versus health department ownership of the program, caseloads, and levels of training and supervision. It seems probable that these differences brought about changes in the intensity and character of the intervention from the pilot to the service program, leading to a reduction of the intervention's efficacy in reducing the number of low birth weight infants. The implications of these findings for researchers and program planners are discussed