A 33 year-old female at 38 weeks gestation with a history of Complex Regional Pain Syndrome (CRPS) Type 1 of the upper extremities, diagnosed 13 years prior to this admission, was scheduled for an elective cesarean section (C-Section). She refused neuraxial anesthesia and requested general anesthesia. This abstract discusses the general anesthesia steps taken to pre-empt recurrence of CRPS symptoms.
IMPORTANCE: Oklahoma has one of the highest rates of infant mortality and poor birth outcomes in the U.S., particularly among minority populations. OBJECTIVES: To describe the formation and implementation of a state-led infant mortality prevention program which sought to: educate minorities about their disproportionate risk for infant mortality; improve pregnancy, infancy, and early childhood outcomes; and prevent infant mortality. DESIGN, SETTING, AND PARTICIPANTS: Participants completed one of many community baby shower events and were evaluated pre- and post-shower on infant mortality and well-baby knowledge. INTERVENTION: The "A Healthy Baby Begins with You" program. Main outcomes and measures. Pre- and post-intervention questionnaires assessing participant knowledge about infant mortality and willingness to share learned knowledge with others in the community. RESULTS: Preliminary results suggest that community baby showers were well-received. Respondents tended to be American Indians, non-Hispanic Whites, or Blacks/African Americans, young adults (aged 20 to 29 years), pregnant women, and mothers of grandparents of young children. Showers were successful in increasing participant knowledge of infant mortality, although these results varied by respondent race and age. Most respondents reported intent to share knowledge acquired during community baby showers with others. CONCLUSIONS AND RELEVANCE: Preliminary findings suggest community baby showers may increase participant knowledge, although future studies are needed to ensure effectiveness across all participant subgroups. This study documents the feasibility and acceptability of a community-based educational program targeting dissemination of infant mortality and well-child information. Barriers and future directions for research and prevention are discussed.
CLINICAL QUESTION: In adults and adolescents using cigarettes and/or smokeless tobacco, is motivational interviewing (MI) more effective compared to counseling, medical therapies or no intervention for improving tobacco cessation? ANSWER: yes. Evidence is modest but conclusive that using MI alone or in conjunction with other therapies results in greater rates of tobacco cessation compared to interventions that did not include MI. LEVEL OF EVIDENCE OF THE ANSWER: A. DATE SEARCH WAS CONDUCTED: September 2015. LIMITS: Human, English, publication dates 2008 to present, meta-analyses, randomized-control trials, systematic reviews. INCLUSION CRITERIA: Meta-analyses, randomized-control trials, or systematic reviews published during or after 2008 comparing the use of MI to other therapies for tobacco cessation in humans. EXCLUSION CRITERIA: Studies published before 2008, MI used in other substance use disorders besides tobacco.
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