Practices and Policies in the Initiation of Breastfeeding

Despite increasing knowledge about factors affecting the initiation of breastfeeding, many mothers still encounter problems and discontinue breastfeeding earlier than desired. Many hospitals still have not implemented the practices that are known to be helpful in the establishment of breastfeeding. As a result, a study was conducted to examine the policies and practices affecting breastfeeding in hospitals in Alberta, Canada. A questionnaire-based survey of all Alberta hospitals (including directors of nursing and staff nurses) found that many practices were still relatively inflexible; did not always reflect accurate, research-based information; and were not geared to the needs of mothers and infants. The implications of these findings are discussed.     

Normal range of fetal transcutaneous carbon dioxide tension during labour

Summary. Fetal transcutaneous carbon dioxide tension (tc-Pco), was monitored during 122 deliveries, using an electrode temperature of 44°C in 80 cases and of 41°C in 42 cases. Significant correlations between tc- P co₂ and umbilical artery blood P co₂ were found using both electrode temperatures, but the regression lines indicated a larger and more inconstant CO₂-contribution from skin metabolism when the low electrode temperature was used. Normal range of tc- P co₂ was calculated at 41°C and 44°C electrode temperatures. Mean values of fetal tc- P co₂ were found to increase during normal labour, and especially in fetuses developing acidosis, but only four of six infants born with acidaemia had tc- P co₂ values exceeding the normal range.     

Learned Helplessness as a Framework for Practice in Long-Term Care Environments

This paper presents an overview of learned helplessness theory and uses the iatrogenic diseases of institutional life as a framework for describing long-term care environments. On the basis of the theory and the nature of the environments that offer residents little opportunity for choice and control over events in their daily lives, the author proposes some possible remedies to increase the quality of life among older people in long-term care.     

AN INVESTIGATION INTO THE PROBLEMS OF EASY CHAIRS USED BY THE ARTHRITIC AND THE ELDERLY

Groups such as the arthritic and the elderly are particularlysusceptible to seating problems. An extensive questionnaireto determine the nature and extent of seating difficulties wasgiven to patients at rheumatology clinics and members of daycentres for the elderly in Leeds. Forty-two per cent of subjectshad some degree of difficulty in rising from their easy chairat home and of these 18% either experienced great difficultyor could not rise unaided. Only 13% had chairs designed to aidrising (e.g. high chair) and 40% of subjects thought their chaircould be improved. Thirty-four per cent said that their easychair caused them pain or discomfort. Information about subjects'body dimensions and their easy chair dimensions was also collected.Further research based on the survey results is planned in orderto develop criteria for the design of easy chairs for the arthriticand the elderly. ^*Based on a paper presented at the Annual Provincial Meetingof the Royal Society of Medicine, Section of Rheumatology andRehabilitation, the British Association of Rheumatology andRehabilitation, Nottingham, 25 and 26 september 1980     

Estimation of the variance components for dermal ridge count

Refinements of the scoring algorithm to estimate variance components from pedigree data are developed. Subsequent to these modifications, heritability estimates were readily obtained from data for over 50 traits, including total finger ridge count reported here. A significant contribution to the total variance of ridge count could be attributed to the effects of dominance, a finding not previously reported for this dermatoglyphic trait.     

How does work work for people with bipolar affective disorder?

Despite modern treatments, bipolar disorder remains a chronic, relapsing disorder that leads to long-term psychosocial disability. A review of the literature suggests that while employment rates amongst individuals with bipolar disorder may improve over time, and are relatively better compared to some other chronic mental disorders, employment prospects do not match the high scholastic achievements seen amongst this group of people before the onset of their illness. For those with bipolar disorder, clinical recovery does not necessarily mean functional recovery, and the usual early age of onset may further reduce an individual's preparedness for employment. Two brief vignettes are used to discuss how occupational therapists can help their clients maintain their sense of hope in vocational recovery, gain better self-awareness and work with clients at various stages of recovery rather than waiting for full functional recovery. Further research is required to help identify specific factors that contribute to the success of employment integration amongst people with bipolar disorder.