Serving alcohol at home: what do most people do? Findings from a 2001 ontario adult survey

In Ontario, some court cases have involved attempts to sue social hosts for damage caused by the behaviour of drunken guests. Such legal actions give rise to the question of risks and responsibilities accruing to social hosts who serve alcohol. Using a sample of 1395 male and female adult residents of Ontario, the authors present self-report survey data concerning frequency of serving alcohol to guests, methods of handling guests who have too much to drink, prevention of drunk driving, service of alcohol to underage persons, and offering food and non-alcoholic drinks when serving alcohol at home. The results show high levels of intended safe practices overall, along with some areas for concern. Notably, about one-third of the total sample had had guests judged to be too drunk to drive home safely. A multivariate analysis confirmed significant differences associated with sex and age. The authors recommend the creation and evaluation of programmes to upgrade home-hosting skills as an adjunct to systemic alcohol control policies.     

Differential otomanometry

Management of otitis media, both acute and chronic, is one of the most common problems in clinical medicine. Among the many unresolved issues in otitis media research is accurate diagnosis which, in turn, depends heavily on valid otoscopic observation. Yet even today clinical otoscopy remains more of an art than a science. Because precise therapy is predicated on precise diagnosis, efforts to improve the validity and reliability of otoscopic techniques are warranted. Of great importance to the otoscopist is the visual estimate of tympanic membrane mobility secondary to hand-generated pneumatic pressure (pneumotoscopy). The degree of motion is usually graded in relative terms. In addition to pneumotoscopy, tympanometry is also used to assess the status of the middle ear. This is done indirectly through the plot of induced pressure versus acoustic immitance (tympanogram). Thus, both procedures depend on the differential application of induced pneumatic pressure on the tympanic membrane. If the middle ear is air-containing and the tympanic membrane is normal, even a slight pressure rise in the ear canal will displace the membrane. If the middle ear is fluid-filled, even large amounts of pressure produce no motion of the tympanic membrane. The pressure gradients, normal threshold, and optimal frequency of application for pneumotoscopy have not been studied previously in humans. Data are presented to compare the sensitivity, specificity, and predictive value of pneumotoscopy and tympanometry in the detection of effusion due to chronic secretory otitis media. In addition, preliminary data obtained by a new procedure, quantitative pneumotoscopy, are discussed.     

Low-risk gestational trophoblastic neoplasia: evaluating the need for initial inpatient treatment during low-dose methotrexate chemotherapy

OBJECTIVE: To evaluate the need for initial inpatient treatment for patients being treated with low-dose intramuscular methotrexate for low-risk gestational trophoblastic neoplasia (GTN). STUDY DESIGN: Clinical notes of all patients treated with low-dose intramuscular methotrexate for low-risk GTN were analyzed and side effects noted. RESULTS: There were no episodes of increased uterine bleeding requiring extra medical intervention. There were 7 cases of chest pain; none required a change from methotrexate chemotherapy. CONCLUSION: Patients being treated with low-dose intramuscular methotrexate for low-risk GTN do not need to be treated routinely in the hospital for their first treatment cycle.     

Continuity in self-report measures of maternal anxiety, stress, and depressive symptoms from pregnancy through two years postpartum

This study examined stability and change in maternal anxiety, stress and depression both during the second half of pregnancy and from pregnancy to six weeks and two years postpartum. Self-report measures included those designed to measure mood and state as well as more persistent attributes. Longitudinal data were collected from 137 women during pregnancy, 120 at six weeks, and 97 at two years. There was significant individual stability in scores on specific measures during pregnancy (range in Pearson rs=0.30-0.86) and from pregnancy through two years postpartum (rs=0.30-0.74). Comparable levels of convergence among measures of different constructs both within pregnancy and over time were also demonstrated, suggesting lack of precision in measurement instruments designed for specific constructs. Despite intra-individual stability, changes in mean levels were also observed over time with somewhat different patters for each variable. However, maternal parity was an important contributor to both level and trajectory. A summary composite score showed an elevated level of psychological distress during pregnancy in multiparous women, followed by a decline through two years postpartum; primiparous women displayed a gradual increase in distress [main effect F (1,87)=3.97, p < 0.05; time interaction F (2,174)= 7.15, p < 0.001] to multiparous levels by two years. Results are discussed in terms of a "motherhood" effect on psychological distress.     

Predictors of women's perceptions of the childbirth experience

OBJECTIVE: To determine the factors that predict women's perceptions of the childbirth experience and to examine whether these vary with the type of birth a woman experiences. DESIGN: Prospective cohort study. SETTING: The postpartum units of two eastern Canadian hospitals. PARTICIPANTS: Six hundred fifty two women and their newborns. DATA COLLECTION: Data were collected in hospital at 12 to 48 hours postpartum using self-report questionnaires and chart review. MAIN OUTCOME MEASURE: Perception of the childbirth experience was measured for women having a vaginal and emergency cesarean birth using the Questionnaire Measuring Attitudes About Labor and Delivery and planned cesarean birth using the Modified Questionnaire Measuring Attitudes About Labor and Delivery. RESULTS: Of the 20 predictors of women's childbirth perceptions, the strongest were type of birth; degree of awareness, relaxation, and control; helpfulness of partner support; and being together with the infant following birth. CONCLUSIONS: Of the predictors of a quality birth experience, most were amenable to nursing interventions: enhancement of patient awareness, relaxation, and control; promotion of partner support; and provision of immediate opportunities for women to be with their babies.