How first-time mothers cope with child care while still in the maternity ward

The aim of the study was to ascertain those factors that are related to the way first-time mothers assess themselves to be coping with child care when leaving the maternity hospital. The study is part of a wider longitudinal project that follows-up first-time mothers' growth into motherhood for a period of 8 months after the birth. Data collection was done using a questionnaire distributed between January and May 1995. The sample comprised 271 first time mothers. The mothers completed the questionnaire on average on the fifth day after childbirth. A stepwise regression analysis was applied. The mothers who assessed themselves to be coping better with child care were those who went home feeling rested and in a good frame of mind and who had positive experience of child care in the maternity ward. The more functional support the mother perceived herself to receive from members of her social network the better she assessed herself to be coping with child care. Those mothers who had previous experience of taking care of infants also assessed themselves to be coping better with child care. On the basis of the research findings it may be stated that the first-time mother needs support from both nursing professionals and close relatives in order to trust their own abilities to cope better with child care during early motherhood.     

Cytokine responses and myocardial injury in coronary artery bypass grafting

OBJECTIVE: Cardiopulmonary bypass is acknowledged to be one of the major causes of a complex systemic inflammatory response after cardiac surgery, and it may contribute to postoperative complications and even multiple organ dysfunction. We here compared the cytokine responses and the degree of myocardial injury after coronary artery bypass grafting with or without cardiopulmonary bypass. METHODS: Nine patients underwent off-pump revascularization and 13 with cardiopulmonary bypass. Plasma levels of tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, IL-8 and IL-10 were measured before anesthesia induction, and 5 min, 1, 4, and 20 h after reperfusion to the myocardium. Levels of the MB isoenzyme of creatine kinase (CK-MB) were also measured after the operation. RESULTS: Levels of TNF-alpha were low in both groups. A delayed elevation of IL-6 was noted in the off-pump group. IL-8 and IL-10 levels were significantly higher in the CPB than in the off-pump patients after reperfusion (p=0.006 and 0.001 respectively). Postoperative CK-MB levels were significantly higher in the CPB than in the off-pump group (p=0.001). Cytokine levels correlated with CK-MB values. CONCLUSION: The results indicated that off-pump revascularization was associated with reduced cytokine responses and less severe myocardial injury. The degree of myocardial injury, as defined by CK-MB release, correlated with cytokine release. Intervention designed to reduce cytokine responses in cardiac surgery may be advantageous for patients with severe comorbidity.     

Short latency somatosensory evoked potentials during active hand movements

This study was designed to investigate the effect of active movement on spinal and cortical evoked responses. During voluntary hand movements the cervical and cortical short latency somatosensory evoked potentials (SEP) elicited by stimulation of the median nerve at the wrist were studied in nine healthy subjects. The latencies of the SEPs were not affected by active movements whereas the peak to peak amplitudes of the main cervical (N13-P15) and the main cortical (N20-P25) deflections were significantly reduced. The cortical subcomponents (N16 and N17), probably reflecting thalamic and thalamocortical activity, were not significantly affected by movements. The amplitude reductions in the cervical and cortical recordings might be related to proprioceptive feedback from the muscle afferents.