Journal of community health
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Pediatricians are a recognized primary resource and advocate for injury prevention. The purpose of this study was to examine pediatricians' knowledge, perceptions, and behaviors regarding car booster seats and their willingness to use resources for parent education. Investigators implemented an anonymous, mailed survey to a national random sample of 1,041 US office-based pediatricians with 464 respondents: 53% female, 63% Caucasian, 52% parents of children under 12 years, and 87% board-certified. ⋯ Significant relationships were found between responses to knowledge questions and suburban location, gender, race, length of time in pediatric practice. Many pediatricians are not counseling their patients' parents on booster seats but believe counseling is important; many are confident in their counseling but do not rely on AAP-recognized counseling resources. Education about state booster seat laws and AAP guidelines may be useful in increasing the cues to action pediatricians convey to parents regarding booster seat use.
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The State University of New York (SUNY), Downstate Medical Center initiated a Master of Public Health (MPH) degree program in July 2001 following planning efforts that began in 1995. Twelve students entered the program in June 2002, and currently some 110 MPH students and 12 Doctor of Public Health (DrPH) students are enrolled. This article describes the long and complex process of transforming the original MPH degree program, with its single focus on urban and immigrant health, with a student enrollment of 12 and 8 full-time faculty, into a school of public health with a large student enrollment of 122 students, 25 full-time faculty, five MPH degree tracks, and four DrPH degree tracks. ⋯ The SUNY Downstate School of Public Health is the first CEPH accredited school of public health in the history of Brooklyn, and only the second such school in New York City. It is also the first CEPH accredited school of public health at a publicly supported university in New York City. The school has already had a major impact on improving the health and well-being of the people of Brooklyn through its numerous collaborative community-based health promotion and disease prevention programs.
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We examined the impact of metropolitan racial residential segregation on stage at diagnosis and all-cause and breast cancer-specific survival between and within black and white women diagnosed with breast cancer in California between 1996 and 2004. We merged data from the California Cancer Registry with Census indices of five dimensions of racial residential segregation, quantifying segregation among Blacks relative to Whites; block group ("neighborhood") measures of the percentage of Blacks and a composite measure of socioeconomic status. We also examined simultaneous segregation on at least two measures ("hypersegregation"). ⋯ For all-cause and breast-cancer specific mortality, living in neighborhoods with more Blacks was associated with lower mortality among black women, but higher mortality among Whites. However, neighborhood racial composition and metropolitan segregation did not explain differences in stage or survival between Black and White women. Future research should identify mechanisms by which these measures impact breast cancer diagnosis and outcomes among Black women.
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We examined differences in receipt of diabetes care and selected outcomes between rural and urban persons living with diabetes, using nationally representative data from the 2006 Behavioral Risk Factor Surveillance System (BRFSS). "Rural" was defined as living in a non-metropolitan county. Diabetes care variables were physician visit, HbA1c testing, foot examination, and dilated eye examination. Outcome variables were presence of foot sores and diabetic retinopathy. ⋯ Rural residence was not associated with receipt of services after individual characteristics were taken into account in adjusted analysis, but remained associated with an increased risk for retinopathy (OR = 1.20, 95% CI = 1.02-1.42). Participation in Diabetes Self-Management Education (DSME) was positively associated with all measures of diabetes care included in the study. Availability of specialty services and travel considerations could explain some of these differences.
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Accurate assessment of New York City (NYC) pediatric intensive care unit (PICU) resources and the ability to surge them during a disaster has been recognized as an important citywide emergency preparedness activity. However, while NYC hospitals with PICUs may be expected to surge in a disaster, few of them have detailed surge capacity plans. This will likely make it difficult for them to realize their full surge capacity both on individual and regional levels. ⋯ This goal was demonstrated through two objectives. The first identified major factors to consider when designing a stratification system. The second devised a preliminary system of PICU stratification based on clinical criteria and resources.