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H Morgenstern

Publications and source records attributed to H Morgenstern.

At least 163 records · Page 9Linked to original sources
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The expected impact of a smoking cessation program for pregnant women on infant mortality among Native Americans.

To quantify the expected impact of a smoking cessation program for pregnant women on infant mortality among Native Americans, we estimated the proportional reduction (impact fraction) and the absolute reduction (impact risk) in neonatal and postneonatal mortality as a result of the intervention program. The estimated attributable fraction due to maternal smoking was 16.6% of infant deaths in the Aberdeen Indian Health Service (IHS) Area, 16.2% in the Alaska IHS Area, and 5.2% in the Navajo IHS Area. Under the assumptions that 14% of the smokers participating in a smoking cessation program would quit and that the intervention would have 60% relative efficacy in preventing infant deaths attributable to smoking, the impact fraction was estimated to be 0.9% of all infant deaths in the Aberdeen Area, 1.0% in the Alaska Area, and 0.3% in the Navajo Area. Under the "best" model assumptions (28% cessation rate and 90% relative efficacy), 2.6% of all infant deaths, 3.7% of postneonatal deaths, and 1.2% of neonatal deaths would be prevented by a smoking cessation program in the Aberdeen Area. When applied to 1984-1986 infant mortality data, the impact risk per 100,000 live births under the "best" model assumptions was 10 neonatal deaths and 41 postneonatal deaths in the Aberdeen Area, 10 neonatal and 34 postneonatal deaths in Alaska, and 2 neonatal and 8 postneonatal deaths in the Navajo Area. This report points to the need to develop effective smoking cessation programs for Native Americans, targeted in particular to women of reproductive age.

Adult↗
PubMedDate not supplied

A prospective study of medical care utilization and morbidity in preschool children belonging to a prepaid group practice: background and methods.

The purpose of this paper is to describe the background and methods of a prospective study of medical care utilization and morbidity in a fixed cohort of over 500 preschool children whose families belonged to a prepaid group practice affiliated with Yale University. Following baseline interviews with their mothers, study children were followed for 12 months between 1981 and 1982. Information concerning the subjects' contacts with the health care facility serving members of the group practice was collected from accompanying adults, attending clinicians, and medical records. Using these data, we were able to identify episodes of care, linking all clinical visits and phone calls for single occurrences of an illness or injury. The major aim of the study is to identify psychosocial determinants of pediatric utilization (for both acute and preventive care) and of childhood morbidity. The possible predictors of principal interest are factors associated with the family environment, such as social stress and strain, family structure, and different aspects of the mother's social network. The dual emphasis on both illness and behavior outcomes is based on the important interrelationship between epidemiologic and health services research, especially when examining psychosocial effects.

Attitude to Health↗
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[Risk of bronchopulmonary cancer in patients with chronic obstructive bronchopneumopathy].

A total of 477 cases have been followed, presenting with chronic obstructive bronchopneumopathy, and another 151 cases with chronic bronchitis without obstructive syndrome, over a median duration of 5 years. In the first lot of patients 37 cases of bronchopulmonary cancer have been recorded over this period of time, of which 35 in 333 male patients (10.5%), and 2 in 144 women (1.4%). The annual rate of bronchopulmonary cancer was of 1.9% in males, and of 0.2% in females. In the group of patients with simple bronchitis only 3 cases of bronchopulmonary cancer have been recorded, with an annual rate of 0.4%. In male patients with chronic obstructive bronchopneumopathy the annual risk of bronchopulmonary cancer is of 1900 0/0000, 60 times greater than in the general population, where it is of 30 0/0000. A comparative analysis of the three groups: chronic simple bronchitis, chronic obstructive bronchopneumopathy and chronic obstructive bronchopneumopathy complicated with bronchopulmonary cancer shows that in the last group there are several outstanding features: a more advanced median age, intensive (heavy) smoking, a more advanced degree of chronic alcohol intoxication, frequent professional exposure, genetic deficiencies of I.A.T., prolonged corticoid therapy in the antecedents, and a higher proportion of associated diseases. In general this group is more exposed to risk factors, and has a higher risk of alteration of the defense mechanisms of the organism. However, a more detailed analysis is necessary for detecting the factors involved in the genesis of bronchopulmonary cancer in patients with chronic obstructive bronchopneumopathies.

Adult↗