The contribution of twins to perinatal mortality in Jamaica

Summary. The Jamaican Perinatal Mortality Survey collected data that have been used in this paper to estimate: (1) the rate of multiple deliveries on the island; (2) the way in which this varies with demographic features; and (3) the causes of perinatal mortality among twins on the island.
The survey consisted of two phases: a study of all births in the months of September and October 1986 (the cohort months) and a study of all perinatal deaths in the 12 months from 1 September 1986 to 31 August 1987.
Among the 10408 pregnancies in the cohort months, 99(1.0%) were multiple pregnancies. The twinning rate showed statistically significant trends with maternal age and parity but no association with social factors.
Among the 2020 perinatal deaths occurring in the 12-month period, 173 (8.6%) were twins, with particularly high contribution to the Wigglesworth group 'deaths from immaturity'. Mortality rate of twins was significantly lower if mothers resided in areas where there were good obstetric and paediatric facilities.     

Prevalence and Predictors of Adolescent Dating Violence

This study of 561 rural North Carolina adolescents examined relationships among race, parental educational level, family structure, parental discipline, family violence exposure, and dating violence experiences. The sample was predominantly female (77%), with 40% black and 58% white. The subjects ranged in age from 15 to 20 years; 80% of the adolescents were 16–18. Dating violence experiences were assessed by a researcher-constructed instrument measuring warning signs of potential violence and actual violent experiences. The results suggested that recognition of abusive relationships is difficult, with many adolescents denying such a relationship but actually reporting numerous abusive events. Sixty percent had experienced violent acts during dating relationships; 24% reported extreme violence (episodes of rape, use of weapons). More than 20% of the adolescents reported family violence and 2.2% reported family sexual abuse. The study suggests new avenues for research in adolescent date violence, and for interventions with high risk groups.     

The relationship among receptive and expressive vocabulary, listening comprehension, pre-reading skills, word identification skills, and reading comprehension by children with reading disabilities.

PURPOSE: Some researchers (F. R. Vellutino, F. M. Scanlon, & M. S. Tanzman, 1994) have argued that the different domains comprising language (e.g., phonology, semantics, and grammar) may influence reading development in a differential manner and at different developmental periods. The purpose of this study was to examine proposed causal relationships among different linguistic subsystems and different measures of reading achievement in a group of children with reading disabilities. METHODS: Participants were 279 students in 2nd to 3rd grade who met research criteria for reading disability. Of those students, 108 were girls and 171 were boys. In terms of heritage, 135 were African and 144 were Caucasian. Measures assessing pre-reading skills, word identification, reading comprehension, and general oral language skills were administered. RESULTS: Structural equation modeling analyses indicated receptive and expressive vocabulary knowledge was independently related to pre-reading skills. Additionally, expressive vocabulary knowledge and listening comprehension skills were found to be independently related to word identification abilities. CONCLUSION: Results are consistent with previous research indicating that oral language skills are related to reading achievement (e.g., A. Olofsson & J. Niedersoe, 1999; H. S. Scarborough, 1990). Results from this study suggest that receptive and expressive vocabulary knowledge influence pre-reading skills in differential ways. Further, results suggest that expressive vocabulary knowledge and listening comprehension skills facilitate word identification skills.     

The ethical use of fetal tissue for transplantation and research

The exercise of organ and tissue transplantation is a common occurrence in our society Expectations of future advances in this arena are raising many ethical, moral and public-policy questions The scientific data base supporting the usefulness of fetal tissue to repair or reverse disease is modest, and uses are speculative Should fetal tissue transplantation research proceed and, if so, under what conditions? This paper examines the issues related to the use and procurement of fetal tissue for research and transplantation     

Identification of Risk Factors for Postoperative Nausea and Vomiting in the Perianesthesia Adult Patient

Postoperative nausea and vomiting (PONV) is a common and potentially debilitating complication of surgery. The preoperative assessment of PONV using established risk assessment tools enables the identification of patients at risk and potentially decreases the incidence of PONV in adult surgical patients. The identification of risk factors associated with PONV and the factors that are independent predictors of PONV preoperatively can facilitate the effective prophylactic treatment and management of PONV in adult surgical patients.     

Pregnant Adolescents With Addictions

Adolescence is the most formative time in the lives of women. During this time girls are making choices that have implications for the rest of their lives. Adolescence also can be a time when the negative impact of sexual and physical abuse from childhood begins to take its toll, contributing to adolescent pregnancy and substance abuse. In the last decade the incidences of pregnancy and drug use in the adolescent population have increased, with 80% of teenagers reported being sexually active by the age of 19 years and 80% of high school seniors reporting use of alcohol; 64% reporting smoking; and 41 % reporting marijuana use in 1995. Nurses working with pregnant adolescents must screen for substance abuse problems and physical abuse. If problems are identified, the nurse should refer the adolescent for counseling.     

Addressing Couples' Sexuality Concerns During the Childbearing Period: Use of the PLISSIT Model

During pregnancy, a couple may benefit from discussing sexuality concerns with a nurse. Couples indicate they do not receive this support, and frequently nurses state they do not have the knowledge, time, or skills to provide patient education regarding sexuality. The PLISSIT model provides a framework for developing and implementing interventions to assist clients in maintaining their sexual relationship throughout the childbearing experience.