Nursing Interventions for the First Three Postpartum Months

The transition to parenthood has been viewed as a crisis, yet families often have little contact with health-care professionals during the early postpartum months. What factors influence adaptation to parenthood and what nursing interventions facilitate the transition? A selective literature review is presented of the more commonly recognized interventions, including home visits, group support, and telephone support. Recommendations follow.     

ASSESSMENT OF LACK OF FIT IN SIMPLE LINEAR REGRESSION: AN APPLICATION TO SEROLOGIC RESPONSE TO TREATMENT FOR SYPHILIS

A patient treated for infectious syphilis is cured when serologic tests become non-reactive, which may take years to achieve. Our objective is to develop a method to determine, within months, whether the patient has responded adequately to treatment. Previous research and our exploratory graphical analysis suggested that treatment response is linear when we applied logarithmic transformations of the axes. If the response to treatment is linear, titres recorded within the first few months of treatment will determine the slope of the line and one can develop an action line in future research. We used a non-parametric method to assess whether the logarithmic transformation improved the linearity and then we applied three different methods of testing lack of fit in linear regression. Based upon a sample size that reflects a clinically reasonable number of data points, the results of these tests provided no evidence against linearity. © 1997 by John Wiley & Sons, Ltd.     

Acute febrile neutrophilic dermatosis in childhood (Sweet''s syndrome)

We report a case of Sweet's syndrome in childhood. Our patients suffered from repeated fevers, chest infections and had characteristic erythematous plaques. The severity of his illness increased with age and warranted oral steroid treatment. We review 16 cases reported to date in the literature and comment on the management and prognosis of the disease in childhood.     

Food Sources and Dietary Intakes of Vitamin K-1 (Phylloquinone) in the American Diet: Data From the PDA Total Diet Study

Objective To identify important food sources and estimate dietary intake of vitamin K-1 (phylloquinone) in the American diet.Design Core foods from the US Food and Drug Administration (FDA) Total Diet Study (TDS), which was based on the 1987-88 Nationwide Food Consumption Survey (NFCS), were analyzed for vitamin K-1. These nutrient values were then applied to the FDA TDS consumption model.Subjects Of the NFCS participants within the 14 selected age-gender groups, 3,634 who had 3 days of dietary data were included in the FDA TDS consumption model.Main outcome measures Vitamin K-1 intakes were estimated for each of the age-gender groups; the percentage contribution of each food item to total intake of vitamin K-1 was calculated from the FDA TDS model.Results Of the 14 age-gender groups selected, the 25- to 30-year-old women and men consumed less than the current Recommended Dietary Allowance (RDA) for vitamin K. In contrast, formula-fed infants had estimated vitamin K-1 intakes six times greater than the RDA. All other groups consumed amounts within the recommended daily intakes but lower than 90 μg/day. The top contributors to total vitamin K-1 intake were dark-green vegetables, although the fats and oils added to mixed dishes and desserts were also important contributors. The proportion of vitamin K-1 obtained from vegetables increased with age.Applications The data identify important dietary sources of vitamin K-1 in the American diet. This knowledge can be used to develop dietary assessment instruments for use in epidemiologic studies. J Am Diet Assoc. 1996; 96:149-154.     

Circadian rhythms in human performance and mood under constant conditions

This study explored the relationship between circadian performance rhythms and rhythms in rectal temperature, plasma cortisol, plasma melatonin, subjective alertness and well-being. Seventeen healthy young adults were studied under 36 h of «unmasking» conditions (constant wakeful bedrest, temporal isolation, homogenized «meals») during which rectal temperatures were measured every minute, and plasma cortisol and plasma melatonin measured every 20 min. Hourly subjective ratings of global vigour (alertness) and affect (well-being) were obtained followed by one of two performance batteries. On odd-numbered hours performance (speed and accuracy) of serial search, verbal reasoning and manual dexterity tasks was assessed. On even-numbered hours, performance (% hits, response speed) was measured at a 25–30 min visual vigilance task. Performance of all tasks (except search accuracy) showed a significant time of day variation usually with a nocturnal trough close to the trough in rectal temperature. Performance rhythms appeared not to reliably differ with working memory load. Within subjects, predominantly positive correlations emerged between good performance and higher temperatures and better subjective alertness; predominantly negative correlations between good performance and higher plasma levels of cortisol and melatonin. Temperature and cortisol rhythms correlated with slightly more performance measures (5/7) than did melatonin rhythms (4/7). Global vigour correlated about as well with performance (5/7) as did temperature, and considerably better than global affect (1/7). In conclusion: (1) between-task heterogeneity in circadian performance rhythms appeared to be absent when the sleep/wake cycle was suspended; (2) temperature (positively), cortisol and melatonin (negatively) appeared equally good as circadian correlates of performance, and (3) subjective alertness correlated with performance rhythms as well as (but not better than) body temperature, suggesting that performance rhythms were not directly mediated by rhythms in subjective alertness.     

Distal urethral electrical conductance (DUEC)—a preliminary assessment of its role as a quick screening test for incontinent women

Summary. Measurement of distal urethral electrical conductance (DUEC) has been used to detect the movement of urine along the distal urethra. DUEC was used as a screening test in 100 women attending the urodynamic clinic with incontinence and in the 33 women who voided over 250 ml, the findings correlated well with subsequent urodynamic diagnosis of urethral sphincter incompetence and detrusor instability.