A Smoking Warning Ignored

Despite a plethora of campaigns to persuade women who smoke not to do so while they are pregnant, a new study finds that the message still has not sunk in among younger, less-educated women. In fact, between 1967 and 1980, the proportion of white women under 20 who smoked during their pregnancies actually went up.

The finding, said a team of researchers from the government’s National Center for Health Statistics, has disturbing implications for the fight against rates of low weight at birth--a key factor that has stalled attempts to reduce U.S. infant mortality. During the 13 years in question, government researchers found the smoking rate during pregnancy among whites under 20 rose from 36% to 39%. The rate stayed the same--27%--among young blacks. Smoking rates were highest for women who had fewer than 12 years of education--though the overall rate for that category of schooling dropped slightly, from 48% to 43%. The results were published in the American Journal of Public Health.

“These results emphasize the need to develop effective smoking-cessation programs, especially for individuals with low educational attainment,” the study said.

But in view of the failure of programs aimed at the pregnant smoker, the team added that “the most effective strategies for convincing pregnant women to stop smoking are not clear.”

Mourning a Pet

Veterinarians are being spurred to greater sensitivity in a de facto but vital grief-counseling role necessary after the death of a pet that has assumed--in a real sense--the role of a family member.

Specifically, veterinarians have been urged, in a commentary in a leading journal, to studiously avoid describing getting another pet after one has died as finding a “replacement.” By using this terminology, veterinarian Jacob Antelyes argues, vets may denigrate the significant family role played by a deceased pet and unnecessarily worsen grief that is, in many ways, as complex after the death of an animal as after that of a human.

“If the pet is truly a family member, as has been demonstrated millions of times,” Antelyes contended in the Journal of the American Veterinary Medical Assn., “the next logical question is: Can we ‘replace’ a father, a mother, sister or spouse, for that matter? If the pet is a genuine family member, no one should be so crude as to suggest that it could be replaced. Apparently, few others have learned, however, not to equate a lost pet with the replacement of a 100-watt light bulb.”

In all, Antelyes argued that talking about “replacing” a lost pet is an “odious” and even emotionally destructive habit. Though the choice of words is a subtle one, he contended, discussing “the new pet” instead of the “replacement” may help.

Paramedic Study

Though overtaxed paramedic services in Southern California and in many other parts of the country have come under increasing criticism for mishandled and botched patient care, a new Los Angeles study, which may be the first systematic attempt to determine how well hospital paramedic base stations function, finds surprisingly few errors.

The new study, done by emergency medicine researchers at Martin Luther King Medical Center in Watts, found that physicians who gave radio directions to paramedics ordered the correct treatment 97% of the time. The result, said Dr. Jonathan Wasserberger, “actually indicates the system is running very well,” given the pressures of time and the difficulties of dealing with unseen patients in field situations.

The study focused on 5,994 paramedic runs processed by radio at King between Jan. 1, 1981, and Jan. 31, 1984. Wasserberger, who headed the study, said analysis of another 2,000 cases handled since the end of the study--and not included in the report, published in the journal Annals of Emergency Medicine--indicates the medical judgment error rate is little changed.

However, the study still found doctors mishandled 65 cases in which lidocaine, a drug commonly used in possible heart attack victims to prevent dangerous changes in the heart’s rhythm, should have been administered but was not. King doctors issuing radio orders also failed, on 31 occasions, to order paramedics to immobilize the necks of patients they encountered who may have had head injuries.

In a telephone interview, Wasserberger said the results were, in the main, highly encouraging--especially in light of the sometimes overwhelming pressures on the local paramedic system. While the new study focused only on King, he said he believes other large paramedic base stations are now offering care as good as what the study found.