Midwives' experiences of encountering women seeking an abortion

In order to gain knowledge about midwives' clinical and emotional experiences of working with termination of pregnancy (TOP) and their perception of women's motives for having an abortion questionnaires were mailed to a representative sample of Swedish midwives (n = 258), and 84% responded. Responses to 17 statements were studied and interpreted. It was found that every third midwife had not at all worked with TOP, and every fifth had not done so in the preceding two years. Among those who had experienced this work, few midwives had considered changing their job or had had misgivings or feelings of inadequacy caused by encountering women seeking an abortion. Both working currently with TOP and for a longer period of time were found to evoke positive experiences in every other midwife. Midwives' perception of motives for abortion corresponded very well to motives provided by women themselves. Half the midwives had had misgivings concerning late abortions and somewhat fewer regarding surgical abortions. In general, religious belief did not influence midwives' views of TOP. Those midwives who had themselves had an abortion reported fewer misgivings about late abortions than those without personal experience of TOP.     

Originalpräparate und Ersatzmittel

Ohne Zusammenfassung     

Beiträge zu Einer Physiologischen und Pathologischen Chemie der Haut

Zusammenfassung Die Quaddelprobe nachMc Clure undAldrich ist nicht imstande, die chemische Bestimmung des Wassergehaltes intravital entnommener Haut zu ersetzen. Dies ergibt sich aus der Tatsache, daß eine Kongruenz zwischen hohem Wassergehalt der Cutis und verkürzter QRZ. nur in ungefähr der Hälfte der untersuchten Fälle vorhanden ist, während der Rest ein wechselndes Verhalten zeigt. Ein Drittel dieses Restes weist sogarverlängerte QRZ, bei gleichzeitig erhöhtem H₂O-Gehalt der Cutis auf.Während wir die Quaddelprobe als Ersatz für die chemische Ermittelung des H₂O-Wertes der Cutis, d. h. also für die Bestimmung desaktuellen Wassergehaltes der Haut ablehnen, kommt ihr für die Frage, ob eine normale oder pathologisch veränderteWasserresorptionsfähigkeit der Cutis vorliegt, eine gewisse Bedeutung zu. Dies zeigt sich besonders deutlich im gegensätzlichen Verhalten des H₂O-Gehaltes und der QRZ. bei der senilen Haut, bei einzelnen Fällen von Adipositas, der Pemphigusgruppe usw.Die Wasserresorptionsfähigkeit der Cutis, ausgedrückt durch das Verhalten der QRZ., scheint weniger vomaktuellen Wassergehalt der Haut abzuhängen, als vielmehr von lokalen, wahrscheinlich physikalisch-chemisch bedingtengewebsstrukturellen Verhältnissen.Der Wassergehalt der Haut ist bei Adipösen in ungefähr zwei Drittel unseres Materiales erhöht, und zwar wie wir feststellten, fast ausnahmslos in der Cutis und nicht im subcutanen Fettgewebe; damit fällt die oftmals geäußerte Annahme, daß bei Adipositas das subcutane Fettgewebe das Wasserspeicherorgan darstellt. Auch bei Fettleibigen geht die QRZ. mit dem Wassergehalt der Cutis nicht ausnahmslos parallel, im Gegenteil, es fanden sich auch hier nicht so selten verlängerte QRZ. bei hohem H₂O-Gehalt der Cutis.     

Vitamin D Status among Women in a Rural District of Nepal: Determinants and Association with Metabolic Profile—A Population-Based Study

Hypovitaminosis D is prevalent worldwide, and especially in South-Asia. According to the Institute of Medicine (IOM), 25(OH)D levels below 30 nmol/L are defined as vitamin D deficiency (VDD) and levels between 30–50 nmol/L as insufficiency (VDI). Besides its role in calcium homeostasis, it has been postulated that vitamin D is involved in metabolic syndrome. Given the scarcity of data on vitamin D status in Nepal, we aimed to examine the prevalence of VDD and VDI, as well as the determinants and association with metabolic parameters (lipids, HbA1c), in a cohort of women in rural Nepal. Altogether, 733 women 48.5 ± 11.7 years of age were included. VDD and VDI were observed in 6.3 and 42.4% of the participants, respectively, and the prevalence increased by age. Women reporting intake of milk and eggs > 2 times weekly had higher 25(OH)D levels than those reporting intake < 2 times weekly. Women with vitamin D levels < 50 nmol/L displayed higher levels of cholesterol, LDL-cholesterol, triglycerides, and HbA1c. Additionally, a regression analysis showed a significant association between hypovitaminosis D, dyslipidemia, and HbA1c elevation. In conclusion, VDI was prevalent and increased with age. Milk and egg intake > 2 times weekly seemed to decrease the risk of VDI. Moreover, hypovitaminosis D was associated with an adverse metabolic profile.     

The 2001 Bethesda System: terminology for reporting results of cervical cytology

Diane Solomon, MD; Diane Davey, MD; Robert Kurman, MD; Ann Moriarty, MD; Dennis O'Connor, MD; Marianne Prey, MD; Stephen Raab, MD; Mark Sherman, MD; David Wilbur, MD; Thomas Wright, Jr, MD; Nancy Young, MD; for the Forum Group Members and the Bethesda 2001 Workshop

JAMA. 2002;287:2114-2119.

Objectives  The Bethesda 2001 Workshop was convened to evaluate and update the 1991 Bethesda System terminology for reporting the results of cervical cytology. A primary objective was to develop a new approach to broaden participation in the consensus process.

Participants  Forum groups composed of 6 to 10 individuals were responsible for developing recommendations for discussion at the workshop. Each forum group included at least 1 cytopathologist, cytotechnologist, clinician, and international representative to ensure a broad range of views and interests. More than 400 cytopathologists, cytotechnologists, histopathologists, family practitioners, gynecologists, public health physicians, epidemiologists, patient advocates, and attorneys participated in the workshop, which was convened by the National Cancer Institute and cosponsored by 44 professional societies. More than 20 countries were represented.

Evidence  Literature review, expert opinion, and input from an Internet bulletin board were all considered in developing recommendations. The strength of evidence of the scientific data was considered of paramount importance.

Consensus Process  Bethesda 2001 was a year-long iterative review process. An Internet bulletin board was used for discussion of issues and drafts of recommendations. More than 1000 comments were posted to the bulletin board over the course of 6 months. The Bethesda Workshop, held April 30-May 2, 2001, was open to the public. Postworkshop recommendations were posted on the bulletin board for a last round of critical review prior to finalizing the terminology.

Conclusions  Bethesda 2001 was developed with broad participation in the consensus process. The 2001 Bethesda System terminology reflects important advances in biological understanding of cervical neoplasia and cervical screening technology.