Trends in Labor Induction in the United States: Is It True That What Goes Up Must Come Down?

Commentary on: Zhang J, Yancey MK, Henderson CE. U.S. national trends in labor induction, 1989–1998. J Reprod Med 2002;47:120–124.
MacDorman MF, Mathews TJ, Martin JA, Malloy MH. Trends and characteristics of induced labour in the United States, 1989–98. Paediatr Perinat Epidemiol 2002;16:263–273.
Kozak LJ, Weeks JD. U.S. trends in obstetric procedures, 1990–2000. Birth 2002;29:157–161. Abstract: Three recent studies examined the national trend in labor induction in the United States. All show a doubling in the rate of induction during the 1990s, although vital statistics data show a consistently higher trend than that obtained from national hospital discharge data. Neither data source adequately documents the full range of indications for induction, its timing, hospital staffing considerations, and other factors that may play a role. Although rates of induction of labor may be leveling off, despite a lack of scientific evidence for its widespread use, rates are likely to remain at current levels for the next few years.     

The University Hospital Nurse Extender Model. Part I, An overview and conceptual framework

The University Hospital Nurse Extender Model using patient care technicians is a long-term strategy to maintain quality patient care. The authors present an overview and conceptual framework of the model. In future papers in this four-part series, the authors will discuss the implementation and evaluation of the model and describe six lessons learned during the implementation process. This information will be useful to any nursing administrator planning to implement a change in the way patient care is delivered.     

Serum lipids and blood pressure in relation to age and sexual maturity.

This study was designed to examine serum lipid profile and blood pressure in relation to age and sexual maturity. Written informed consent to participate was obtained from 42% of the eligible population of two Devon communities. The blood pressure of 343 boys and 336 girls, aged 11-16 years, was recorded and sufficient blood for analysis was obtained from 320 boys and 301 girls. Of these, sexual maturity of 221 boys and 209 girls was visually assessed using the indices developed by Tanner. In girls there was a significant (p less than 0.05) correlation between age and serum triglyceride level (r = 0.16) and in boys both serum cholesterol and HDL-cholesterol were significantly (p less than 0.01) and negatively correlated with age (r = -0.25 and -0.18 respectively). Girls had significantly higher (p less than 0.05) levels of HDL-cholesterol than boys but neither sex demonstrated significant changes (p greater than 0.05) in serum lipids or lipoproteins with sexual maturity. No significant differences (p greater than 0.05) were detected between the mean diastolic blood pressures of boys and girls but older boys had significantly higher (p less than 0.05) systolic blood pressures than similarly aged girls. Age was positively and significantly correlated (p less than 0.01) with blood pressure in both boys (systolic, r = 0.49; diastolic, r = 0.30) and girls (systolic, r = 0.28; diastolic, r = 0.29). More mature children were demonstrated to have both higher systolic and diastolic blood pressures than less mature children (p less than 0.05) but when allowance was made for school year group through analysis of co-variance the relationship for diastolic blood pressure in boys no longer remained significant. Blood pressures observed in this study do not raise general cause for concern but the data indicate that unfavourable serum lipid and lipoprotein profiles are common.