Search

Objective: This study characterized maternity hospital breastfeeding practices in New York., Methods: The New York State Department of Health Breastfeeding Survey was sent to 138 hospitals providing maternity services to assess breastfeeding and rooming-in policies, infant feeding practices, breastfeeding training, staff structure, and support mechanisms. Additionally, hospital-specific exclusive breastfeeding rates were obtained from Hospital Profile data., Results: The response rate was 100%. Ninety-three percent of the hospitals allowed 24-hour rooming-in, in all postpartum rooms. Eighty-six percent of hospitals employed a designated lactation coordinator. Less than 1.5% of hospitals routinely gave formula, pacifiers, or glucose water to a breastfed infant. These supplements are most commonly provided because of the mother's request. The largest reported barrier to initiating breastfeeding in the hospital was presenting mothers with mixed messages, whereas the largest patient barrier was identified as the mother's culture. All hospitals provided obstetric nursing staff with lactation education, whereas 46.4% trained physicians. Among healthy births, exclusive breastfeeding was statistically more likely to occur in hospitals offering only basic care (Level I) or subspecialty care (Level III), relative to Regional Perinatal Centers delivering the highest level of care, and was more likely with hospitals outside of New York City, relative to those within the city. After controlling for hospital location and level of care, exclusive breastfeeding was statistically more likely in hospitals that initiate breastfeeding immediately following an uncomplicated vaginal or cesarean birth., Conclusions: Mothers should be encouraged to initiate breastfeeding immediately after birth. Practices of Level I hospitals that lead to increased breastfeeding should be identified.

The effect of residential neighborhood characteristics on a child's risk of serious motor vehicle traffic occupant injuries was evaluated in New York State, USA, for the years 1993-2003, with particular focus on the effect of neighborhood walkability. Risk increased significantly (p < 0.0001) with decreasing street connectivity and as more workers commuted more than 30 min using means other than public transportation, along with more single-parent households and less college attainment in the neighborhood, regardless of whether New York City was in the study. After adjusting for age, gender and socio-economic community factors, the apparent loss of walkability in a child's neighborhood increases their risk of serious injury as an occupant of a motor vehicle., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The risk of becoming a West Nile virus case in New York State, excluding New York City, was evaluated for persons whose town of residence was proximal to spatial clusters of dead American crows (Corvus brachyrhynchos). Weekly clusters were delineated for June-October 2002 by using both the binomial spatial scan statistic and kernel density smoothing. The relative risk of a human case was estimated for different spatial-temporal exposure definitions after adjusting for population density and age distribution using Poisson regression, adjusting for week and geographic region, and conducting Cox proportional hazards modeling, where the week that a human case was identified was treated as the failure time and baseline hazard was stratified by region. The risk of becoming a West Nile virus case was positively associated with living in towns proximal to dead crow clusters. The highest risk was consistently for towns associated with a cluster in the current or prior 1-2 weeks. Weaker, but positive associations were found for towns associated with a cluster in just the 1-2 prior weeks, indicating an ability to predict onset in a timely fashion.