Abstract:
INTRODUCTION:In Nunavut, 60-80% of pregnant women report smoking in pregnancy, a rate five times the Canadian average. Nunavut also has the highest rates of preterm birth and low birth weight infants in Canada. The present study assessed whether the number of cigarettes smoked per day, as recorded in the first trimester, influenced birth outcomes. METHODS:Maternal-newborn charts were reviewed for infants born between 1 January 2003 and 31 December 2005 to at least one Inuit parent in the Qikiqtaaluk (Baffin) region of Nunavut. Smoking data, as reported by the mother at an early prenatal visit, were extracted from the prenatal record. Birth outcomes including birth weights (for term births), low birth weight, small for gestational age births and rates of preterm birth, were analysed according to category of reported number of cigarettes smoked (0, 1-5, 6-10, and >10 per day). Maternal age, alcohol and street drug use were also assessed for each category of smokers. Statistical analysis among groups was carried out. RESULTS:Of 918 births meeting the study criteria, more than 80% of women reported smoking. For 80% of those, the amount smoked per day was available. Non-smokers and women smoking less than 5 cigarettes daily had perinatal outcomes equal to or better than Canadian averages for low birth weight, small for gestational age, and preterm birth. Furthermore, average birth weights at term significantly decreased from 3681 g for non smokers to 3310 g for those smoking more than 10 cigarettes per day. Compared with non-smokers, women in the highest smoking category (>10 cigarettes daily) had a six-fold increase in low birth weight infants (OR 6.7, 95% CI 2.3-19.6), almost a four-fold increase for small for gestational age births (OR 3.7, 95% CI 1.6-8.8) and twice the chance of a premature birth compared with non-smokers (OR 2.14, 95% CI 1.1-4.2). Those in the highest smoking category were also most likely to report alcohol and other substance use. CONCLUSIONS:Inuit women who reported not smoking, or smoking less than 5 cigarettes per day had birth outcomes equal or superior to average Canadian outcomes in each category evaluated. Those women reporting smoking more than 10 cigarettes daily had significantly increased risk for preterm birth, low birth weight and small for gestational age infants. Because those in the highest smoking category also reported the highest rates of alcohol and other substance use, it is likely that a combination of factors assessed in this study influenced the outcomes. Along with public health preventative measures to reduce smoking directed to this high risk group, other contributing factors for adverse birth outcomes need to be assessed more fully to understand the complex interactions that lead to increased smoking, substance use and, therefore, adverse birth outcomes. Furthermore, evidence from this study suggests that smoking more than 10 cigarettes per day, reported at first prenatal visit, may provide a marker for those women at highest risk of poor outcomes, which could provide direction for focused public health efforts.
journal_name
Rural Remote Healthjournal_title
Rural and remote healthauthors
Mehaffey K,Higginson A,Cowan J,Osborne GM,Arbour LTsubject
Has Abstractpub_date
2010-07-01 00:00:00pages
1484issue
3issn
1445-6354pii
1484journal_volume
10pub_type
杂志文章abstract:INTRODUCTION:Decreasing physical activity levels, particularly among youth, continue to be a prominent health concern in Canada, and youth living in rural areas may encounter unique facilitators and barriers to physical activity. In addition, current research suggests that overweight and obesity rates are higher for yo...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Mondana Clinic is a small rural clinic located in the Napo river region of the Amazon basin in Ecuador. Since its opening in 1997 the clinic has grown to be the primary health care facility for approximately 3000 individuals. METHODS:A retrospective study was performed tabulating the ambulatory diagnosis,...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:INTRODUCTION:Road traffic crashes constitute a considerable public health burden and represent the eighth leading cause of death and tenth leading cause of disability adjusted life years (DALYs) globally. However, very little is known about the extent, causes and impact of crashes in low- and middle-income countries in...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2015-07-01 00:00:00
abstract:INTRODUCTION:In mid-July 2010 flash flooding in Pakistan destroyed the basic water, environmental sanitation and livelihood infrastructures in 82 districts. Two months later, the local press of Swat (northern Pakistan) reported that several residents of Marghazar town became ill and were hospitalized after drinking con...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:This article describes the use and effectiveness of the participatory action research (PAR) framework to better understand community members' perceptions and risks of pandemic influenza. In 2009, the H1N1 influenza pandemic affected Indigenous populations more than non-Indigenous populations in Oceania and...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2015-07-01 00:00:00
abstract:INTRODUCTION:Smoke-free laws and the addition of graphic warning labels to cigarette packages represent public health policies that can potentially reduce smoking and smoking-related disease. The attitudes and beliefs relating to these policies were examined among residents of Ohio Appalachia, a mostly rural region wit...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Health professions students interested in future rural practice locations spend a week learning about and investigating all aspects of small town personal, professional and community life. This augments the mainly clinical experience provided by clinical rotations they complete as part of their professiona...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract::Domestic migrant workers were stranded far from home when India declared nationwide lockdown to combat the pandemic of novel coronavirus (COVID-19). A large number of these workers were left with no economic support, no food and in many cases nowhere to live. The pandemic posed a serious health threat to these people,...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH6186
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:Farm health and safety has historically focussed on strategies such as injury prevention, safety audits and fulfilling legislative responsibilities. However, farmer injuries mask deeper health issues including higher rates of cancer, suicides, cardiovascular disease and stress. The relationship between occ...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:One approach to facilitating student interactions with patient pathways at Keele University School of Medicine, England, is the placement of medical students for 25% of their clinical placement time in general practices. The largest component is a 15-week 'student attachment' in primary care during the fin...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2016-04-01 00:00:00
abstract:INTRODUCTION:Malnutrition is a serious public health problem, particularly in developing countries, linked to a substantial increase in the risk of mortality and morbidity. Women and young children are most often affected. Rural disadvantage is a known factor, but little attention has been paid to rural-urban disparity...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2008-04-01 00:00:00
abstract:INTRODUCTION:Irukandji syndrome, a potentially life-threatening condition that follows the sting of small carybdeid jellyfish, occurs along the northern Australian coastline from Broome, Western Australia in the west to Rockhampton, Queensland in the east. Much of this area is classified rural or remote. Because correc...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2005-07-01 00:00:00
abstract:CONTEXT:The World Health Organization's World report on disability calls upon all nations to 'remove the barriers which prevent [people with disabilities] from participating in their communities; getting a quality education, finding decent work, and having their voices heard' (p. 5). People with communication disabilit...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2015-07-01 00:00:00
abstract:INTRODUCTION:There is evidence in the literature that rural background significantly encourages eventual rural practice. Given the shortage of healthcare providers in rural areas, we need to explore ways of ensuring throughput and success of rural-origin students in health sciences. It is therefore important to underst...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:A lack of education capacity to support the development of medical supply management competency is a major issue affecting Pacific Islands countries (PICs). Limited human resources and underdeveloped medicines supply management competency are two significant impediments to reaching the health-related Mille...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract:INTRODUCTION:Rates of mental health issues are increasing, coupled with insufficient resources to provide appropriate support. This is a particular challenge for rural areas in Australia that face significant social inequities including a scarcity of health resources. E-health initiatives are often proposed to maximise...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH5103
更新日期:2019-08-01 00:00:00
abstract:INTRODUCTION:Indigenous children in Australia have higher dental caries levels than their non-Indigenous counterparts. Indigenous communities in South Australia's mid-north region have identified dental health as one of their top health priorities. In response to this, an oral health program based at the Pika Wiya Heal...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2007-04-01 00:00:00
abstract:INTRODUCTION:Iran has a major land mine injury problem in its border areas. Mine injuries have a high mortality and morbidity, and the injuries generally occur in remote areas. Iran has a well developed system of rural health workers and clinics, covering most border areas. These have mainly had prevention, immunizatio...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2008-10-01 00:00:00
abstract::The provision of health services to rural and remote communities has been the source of much concern and debate in recent times. One aspect of this is the universal problem of insufficient medical practitioners in rural areas and the associated issues of recruitment and retention. Rural communities can play an importa...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2004-04-01 00:00:00
abstract:INTRODUCTION:Early postgraduate, or junior doctors, are still required to practise in rural and remote communities, and they continue to face numerous issues and difficulties. Within the hospital setting, exposure to rural practice appears to be very limited during internship, and also to some extent, during the second...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2005-10-01 00:00:00
abstract:INTRODUCTION:Much of regional Australia continues to face challenges in recruitment and retention of medical practitioners, despite the apparently successful rural medical education initiatives funded by the Commonwealth Government. International fee-paying (IFP) medical students are a significant component of Australi...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH4292
更新日期:2017-07-01 00:00:00
abstract:INTRODUCTION:Chronic conditions are a growing healthcare concern. People living in rural regions are particularly affected because many barriers exist to accessing services and supports. Peer support for chronic condition self-management, where people living with chronic conditions learn about how to care for themselve...
journal_title:Rural and remote health
pub_type: 杂志文章,评审
doi:
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:Atrial fibrillation (AF) is a major risk factor for ischaemic stroke and a common presentation in general practice. Scoring systems to guide antithrombotic treatment have been available since 1996, with the CHA2DS2-VASC in current use; however, little is known about adherence to guidelines in rural general...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH4342
更新日期:2019-03-01 00:00:00
abstract:INTRODUCTION:Flinders University in Australia has had a rural longitudinal integrated clerkship for selected medical students, the Parallel Rural Community Curriculum, since 1997. The Northern Ontario School of Medicine (NOSM) in Canada introduced a similar clerkship for all NOSM students in 2007. An external evaluatio...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:The WHO has estimated that 1% of the world's population need a wheelchair, but few have access. Access to wheelchairs for most of the South African poor population is through accessing rehabilitation services at public health facilities. This study explored access to wheelchair services from the perspectiv...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH5855
更新日期:2021-01-01 00:00:00
abstract:INTRODUCTION:Nurses in rural settings are often the first to assess and interpret the patient's clinical presentations. Therefore, an understanding of how nurses experience decision-making is important in terms of educational preparation, resource allocation to rural areas, institutional cultures, and patient outcomes....
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00
abstract::Prostate cancer mortality worldwide has recently decreased by 6% after peaking in the 1990s. Based on the recently published results of the European Randomised Study for Screening of Prostate Cancer (which showed a relative prostate cancer mortality reduction of at least 20% by PSA-based population screening) it could...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2009-04-01 00:00:00
abstract:CONTEXT:This article explores the relevance of the body of military psychology knowledge to the management and support of those living and working in rural/remote industries and locations, particularly within Australia. ISSUES:For those who live and work in rural/remote settings, there are social, occupational, health...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2016-10-01 00:00:00
abstract:INTRODUCTION:Breastfeeding provides health benefits to infants and mothers, yet many women decide against breastfeeding. This study examined differences in the prevalence of breastfeeding among national, urban, rural, and Appalachian regions of the USA. METHODS:Secondary data analysis of the US 2007 National Survey of...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:The Indian Ocean Territories (IOT) comprising Christmas and Cocos (Keeling) Islands are situated over 2500 km from Perth, Australia, and are accessible by commercial aircraft only twice a week. The IOT Health Service (IOTHS) is administered from the Department of Transport and Regional Services in Canberra...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2007-04-01 00:00:00