bluuebunny/crossref_metadata_2025 huggingface dataset:
Lability of Circadian Pacemaker Amplitude in Chick Pineal Cells: A Temperature-Dependent Process
Authors: Barrett R. Keith , Takahashi Joseph S.
Published: March 2007

Temperature is a major regulator of circadian rhythms. The authors report here three lines of evidence that temperature modulates the amplitude of the circadian pacemaker that drives rhythmic melatonin production in chick pineal cells. (1) The melatonin rhythm persists longer in constant conditions at 40°C than at 37°C. (2) The phase response curve to low-intensity (0.15 μW/cm 2) light pulses of 6-h duration has a higher amplitude at 37°C than at 40°C; a nonphotic stimulus, anisomycin, also causes larger shifts at 37°C than at 40°C. These results suggest a general increase in sensitivity to phase-shifting stimuli as temperature decreases. (3) The light intensity necessary for a critical pulse that causes arrhythmicity is lower at 37°C than at 40°C. All three of these effects of temperature can be explained in a unified manner by a limit cycle model in which temperature increases circadian pacemaker amplitude. The use of critical pulse experiments provides a novel method for estimating relative circadian pace maker amplitude under different conditions.
Hemodynamic Predictors for Weaning Patients from Ventricular Assist Devices (VADs)
Authors: Termuhlen David F. , Swartz Marc T. , Ruzevich Shelly A. , Reedy Jane E. , Pennington D. Glenn
Published: March 2007

In order to find hemodynamic parameters that can accurately predict whether patients can be successfully weaned from ventricular assist de vices (VADs), we studied data from 17 patients supported with Pierce-Donachy VADs [11 left VAD (LVAD); 6 right VAD (RVAD)] following cardiogenic shock for periods from 1.3 to 22 days (mean 5.4). Myocardial recovery was determined by daily measurements of "pump on pump off" parameters, and the data from the 8 LVAD patients and 3 RVAD patients whose hearts recovered were compared to the data from those whose did not.

In this study, daily pump on pump off hemodynamic measurements were found to be predictive of success for weaning patients from VADs. In particular, the most significant predictors were: increases in mixed venous oxygen satura tion, cardiac index, mean arterial pressure and ventricular ejection fraction, as well as decreases in atrial pressures. An index for measuring hemodynamic function with the VAD off is proposed, as are models of recovery. Seventy per cent of the patients weaned from VADs survived, indicating that patients ap propriately weaned from VAD support have a reasonable chance for survival.
What Have We Learned from Public Housing Resident Management?
Authors: Chandler Mittie Olion
Published: March 2007

This article reviews literature on the resident management of public housing that is synchronous with the attention it received in the late 1970s and 1980s. The earliest research emphasized the improvement of routine management functions and typically questioned the widespread feasibility of resident management. Objectives covered in later research included self-reliance, community and economic development, and homeownership. This literature proposes variables that affect the success or failure of resident management and other alternatives to conventional public housing management. Two major research needs remain: a framework to examine the interaction of factors that determine resident management outcomes and a comparative analysis of other options that address issues common to resident management.
Formulating the Right Planning Problem
Authors: George R. Varkki
Published: March 2007

As problem-solving activities, planning and public policymaking are susceptible to the Type III error: solving the wrong problem. Drawing on a diverse literature, this article describes methods-tools and procedures-that encourage deliberate problemformulation, thereby reducing the chances of such an error occurring. A number of problem formulation methods are described usingfictitious accounts of their application in a planning situation. To put them in context, these descriptions are preceded by a discussion of the occurrence of the Type III error in planning and responses to it, a brief review of the state of knowledge about problemformulation, and an overview of problem formulation methods.
Natural-Hazard Reduction and Sustainable Development: A Global Assessment
Authors: Berke Philip R.
Published: March 2007

This article reviews how the principles of sustainable development can be applied to natural-hazard reduction in developing countries. At issue is the extent to which sustainable development can be achieved through planning, and the role international aid plays in linking natural-hazard reduction to sustainable development. A conceptual framework is then offered for evaluating the impacts of outside aid on long-term hazard reduction efforts (and by implication, sustainable development). The consistent use of such framework would increase the validity of future studies of aid programs and improve the understanding about the adequacy of different institutional arrangements within the international aid delivery system.
Family Leave and Gender Justice
Authors: England Suzanne E.
Published: March 2007

The debate on whether employers should be mandated by law to provide unpaid leave for employees to care for dependent family members touches on conflicts between women's rights as citizens and their roles in the family. Because opponents have claimed that family leave is not good for business, proponents have been forced to defend the regulation of business. By reframing the issue in terms of gender justice, the discourse would be broadened to include the health and social policy context that leaves so many women with the stark choice of caregiving or employment .
Groups to Empower Battered Women
Authors: Wood Gale Goldberg , Middleman Ruth R.
Published: March 2007

Battering is part of a pattern of coercive tactics, including verbal, psychological, and sexual abuse, that a man uses to intimidate, undermine, and force his female partner to comply with his wishes. The experience can be likened to brainwashing. Three sets of ideas seem important for feminist social workers to consider in working with such women: (1) a structural approach to practice; (2) empowerment through recasting perceptions, raising consciousness, and increasing access to opportunities and resources; and (3) using the small group as a supportive agency.
Coping with Multiple Roles: Family Configuration and the Need for Workplace Services
Authors: Marlow Christine
Published: March 2007

The study reported here investigated the impact of family configura tion on women clerical workers'ability to cope with multiple roles and on their need for workplace services. The women with children had more problems coping with their work and family lives than did the childless women, but there were few differences between the single and married mothers' ability to cope and need for services or in the need for services expressed by women in all family configurations.
Contested Caring: Women's Roles in Foster Family Care
Authors: Finn Janet L.
Published: March 2007

The foster care system is a microcosm of the larger social welfare system in the United States and reflects the same gender, class, and racial inequities. Women, as key actors in the foster care system, struggle with conflicting expectations of mothering, representations of family, and definitions of expertise that are inherently disempowering. This article examines women's roles as birth mothers, foster mothers, and social workers; outlines a conceptual framework for analyzing the problems women confront; and proposes a reorientation of thinking and practice in foster family care from a feminist perspective.
From Surviving to Thriving: The Complex Experience of Living in Public Housing
Authors: O'Brien Patricia
Published: March 2007

Interviews with 12 African American women who were long-term residents of a public housing complex and were engaged in tenant management activities found that obstacles in the complex reinforced their resilience and that their roles as mothers and their adherence to spiritual beliefs gave their lives meaning. Although tenant manage ment has not yet brought about collective empowerment, it has pro vided a foundation for personal development. The implications of these findings for social work practice and policy are discussed.
Women of the Shadows: Appalachian Women's Participation in the Informal Economy
Authors: McInnis-Dittrich Kathleen
Published: March 2007

This qualitative study of 23 Appalachian women identified four patterns of participation in the informal economy. The unique needs of these women illustrate the necessity for differential approaches to welfare reform and the ethical dilemma of social workers who are caught between their knowledge that these women use illegal, unre ported income to supplement insufficient welfare benefits and the punitive social policies and poor employment prospects that give the women no choice.
The Prevalence of Military Sexual Assault Among Female Veterans' Administration Outpatients
Authors: SKINNER KATHERINE M. , KRESSIN NANCY , FRAYNE SUSAN , TRIPP TARA J. , HANKIN CHERYL S. , MILLER DONALD R. , SULLIVAN LISA M.
Published: March 2007

Considerable publicity has focused on sexual violence among military women. The authors report the prevalence of military sexual violence and make comparisons among women veterans who report they experienced sexual violence while in the military and those who did not. Data are from the Veterans' Administration (VA) Womens' Health Project, which was designed to assess the health status of women veterans receiving VA ambulatory care. The nationally representative sample (N = 3,632) consists of female veterans who had at least one ambulatory visit at a VA facility between July 1, 1994, and June 30, 1995. More than half (55%) of the women report they were sexually harassed while in the military, and almost one quarter (23%) report they were sexually assaulted. There are differences in sociodemographic characteristics, military experiences, and current health perceptions of women who reported sexual harassment or sexual assault while in the military as compared to those who did not. The prevalence of military sexual harassment and sexual assault is high and screening for sexual assault is important in all women patients given the differences between groups.
Mediators of Attachment Style, Social Support, and Sense of Belonging in Predicting Woman Abuse by African American Men
Authors: RANKIN LARRY B. , SAUNDERS DANIEL G. , WILLIAMS REG A.
Published: March 2007

Recent studies have focused on attachment and related variables to explain partner abuse. These studies have not included significant numbers of African American men. Path analysis was used to examine the relationship between interpersonal relatedness (i.e., attachment, social support, and sense of belonging) as mediated by affect (hopelessness and depression) to explain abusive behaviors in African American men arrested for partner abuse. Data were collected using self-administered questionnaires from a convenience sample of 69 African American men 18 to 69 years of age. The strongest effect was from sense of belonging in predicting severity-weighted frequency of physical, psychological, and sexual abuse. Preoccupation with closeness had a negative direct effect on severity-weighted frequency of sexual abuse. Hopelessness and depression did not act as mediators. Implications for further research are discussed.
Incest Offenders' Perceptions of Their Motives to Sexually Offend Within Their Past and Current Life Context
Authors: HARTLEY CAROLYN COPPS
Published: March 2007

This study explored incest offenders' motives for engaging in a sexual offense. Connections that offenders drew between their motives and past and current life contexts are also examined. A series of qualitative interviews with eight Caucasian male incest offenders currently receiving treatment was used to gather their perceptions of motives. A perceived need for sexual gratification, seeking an outlet from present dissatisfaction, an expression of anger, and the inappropriate display of affection or love were the primary motives described. Early life context of offenders was characterized by physical and emotional abuse and a perception of rejection by one or both parents. Conflict in the marital relationship was the most frequently reported difficulty in their current life related to motives to offend. Offenders drew more connections between motives and life context at the time of the offense than they did to past life context. Implications for treatment are discussed.
The Perception of Relationship Violence in the Lyrics of a Song
Authors: MAXWELL JENNIFER P.
Published: March 2007

This article uses Q methodology, respondent questionnaires, and qualitative interviews to examine the relationship between the experience of victimization and how respondents interpret musical lyrics. Two factors representing different perspectives on the song, “I May Know the Word,” were identified in a prior Q study. Factor A interpreted the song as a literal representation of rape, battering, and sexual assault; Factor B viewed it as a more abstract conflict over decision making. Data from the current study show a significant correlation between Factor A and the number of specific abuse behaviors individuals had experienced. However, although individuals subjected to multiple types of abuse were more likely to interpret the song in a literal manner, they did not necessarily name their experiences as rape or violence. The literature on the effects of traumatic experience is explored to explain this apparent contradiction.
Preventing the “Second Rape”
Authors: CAMPBELL REBECCA , WASCO SHARON M. , AHRENS COURTNEY E. , SEFL TRACY , BARNES HOLLY E.
Published: March 2007

Although prevention efforts aimed at eliminating the occurrence of sexual assault are clearly needed, it is also important to consider how we can prevent further trauma among those already victimized. Prior research suggests that rape survivors may experience victim-blaming treatment from system personnel ( termed secondary victimization or the second rape). This research examined how postassault contact with community systems exacerbated rape victims' psychological and physical health distress. Findings revealed that the majority of rape survivors who reported their assault to the legal or medical system did not receive needed services. These difficulties with service delivery were associated with both perceived and objective measures of negative health outcomes. Contact with the mental health system, rape crisis centers, or religious communities was generally perceived by victims as beneficial. This study suggests that the trauma of rape extends far beyond the assault itself, as negative community responses can significantly elevate distress.
A Coping Model for Adult Survivors of Childhood Sexual Abuse
Authors: DRAUCKER CLAIRE BURKE
Published: March 2007

A causal model that identifies relationships among sexual abuse situation characteristics, based on Finkelhor and Browne's traumagenic model of childhood sexual abuse; the accomplishment of cognitive coping tasks, based on Taylor's theory of cognitive adaptation; and long-term effects was tested in a group of 149 adult survivors of childhood sexual abuse. Structural equation modeling was used to test the proposed paths and the goodness of fit of the model. Results indicated that the model did not fit the data, but conclusions related to the explanatory power of the model could not be drawn because of the low reliabilities of several of the scales. However, five of the hypothesized direct relationships and one of the hypothesized indirect relationships were significant. A revised model is proposed and examined.
Long-Term Psychological and Social Impact of Witnessing Physical Conflict Between Parents
Authors: HENNING KRIS , LEITENBERG HAROLD , COFFEY PATRICIA , TURNER TONIA , BENNETT ROBERT T.
Published: March 2007

A community sample of 617 adult women completed a questionnaire about witnessing interparental physical conflicts before the age of 16. One hundred and twenty-three (20%) of the respondents reported witnessing some type of physical conflict between their parents. The mean age when physical conflict was first observed was 8. Women who had witnessed parental physical conflict exhibited higher levels of current psychological distress on the General Severity Index of the Brief Symptom Inventory and lower levels of social adjustment as measured by the Social Provisions Scale. The differences in adult psychological and social adjustment between the witness and nonwitness groups persisted even after individually covarying for the influence of witnessing parental verbal conflict, childhood physical abuse, and perceived parental caring. Conceptual and methodological difficulties involved in trying to isolate the effects of witnessing parental physical conflicts from the effects of multiple overlapping family risk factors are discussed.
Family Functioning as Predictors of Distress in Revictimized Sexual Abuse Survivors
Authors: KOVEROLA CATHERINE , PROULX JOCELYN , BATTLE PAULA , HANNA CINDY
Published: March 2007

The present study examines the distress symptomatology and family functioning in female undergraduate students who had been sexually victimized in childhood and revictimized in adulthood. This group was contrasted with a child sexual abuse group, peer sexual abuse group, and a no sexual trauma group. Findings indicated that the revictimized group reported the most severe forms of sexual assault relative to other victimized groups. The victimized groups were all significantly more distressed than the nonabused control group with the revictimized group reporting significantly more PTSD symptomatology than other victimization groups. The victimization groups differed significantly from the nonabused group on dimensions of family functioning, but they did not differ significantly from each other. Multiple stepwise regression analysis indicated that conflict and control were significant predictors of distress in the victimization group. Cohesion was a significant predictor of distress in the nonabused group. The clinical implications of the findings are discussed.
A Typology of Interpersonal Stalking
Authors: WRIGHT JAMES A. , BURGESS ALLEN G. , BURGESS ANN W. , LASZLO ANNA T. , McCRARY GREGG O. , DOUGLAS JOHN E.
Published: March 2007

This article offers a structure for trying to distinguish between different types of stalking and for assessing the outcome of these different types of incidents. Using a law enforcement experiential paradigm, 10 stalking victims pilot-tested a questionnaire of 148 items. Revisions provided a 46-item checklist. In addition, 30 cases were used to pilot-test a typology of stalking based on the nature of the relationship—nondomestic or domestic; the content of communication—nondelusional or delusional; level of aggression—low, medium, or high; level of victim risk; motive of stalker; and outcome of case. Clinicians, investigators, judicial, and policy staff can utilize data from the Stalking Incident Checklist in their respective roles to provide for safety and protection of the victim and treatment and containment of the stalker.
An Examination of the Reliability of Sexual Assault Reports
Authors: SCOTT KATHRYN D. , ANESHENSEL CAROL S.
Published: March 2007

This article examines the extent to which individuals are consistent in their survey interview reports of sexual assaults over time and the impact of consistency on prevalence and risk factor estimates for sexual assaults. Specifically, persons whose sexual assault reports are consistent over time (positive on two occasions or negative on two occasions) are compared to individuals whose reports are inconsistent over time (positive on one occasion and negative on the other). Data are from a longitudinal mental health survey of a large (N = 3,132), gender- and ethnically diverse, community-based sample, interviewed twice over a 1-year interval. Results reveal that consistency is a function of the individual's position in society. Also, prevalence estimates, which appear stable over time, are based on positive reports by differing groups of respondents.
Criminal Victimization and Its Effect on Fear of Crime and Justice Attitudes
Authors: DULL R. THOMAS , WINT ARTHUR V. N.
Published: March 2007

This study explores the relationship between criminal victimization of a college student cohort and the impact of this victimization on their fear of crime and attitudes related to the justice system. The subgroups of victims and nonvictims were used to examine the change of attitude between their first and fourth years of college. Those who had been victims of crime had significantly greater fear of becoming future victims of property crime but no significant change in their fear of personal crimes. Nonvictims showed no increase in fear of property victimization but significant increase of fear for some personal crimes. Regarding the relationship between victimization and attitudes about the justice system, we could generalize that nonvictims showed significantly greater change in attitudes toward police, victims greater change in attitudes toward courts, and little change (none significant) for either victims or nonvictims in their attitudes toward the use of the death penalty.
Psychometric Evaluation of the Risk Appraisal Guide (RAG)
Authors: LOZA WAGDY , DHALIWAL GURMEET K.
Published: March 2007

The Risk Appraisal Guide (RAG) is a recently developed assessment instrument for predicting violent behavior of mentally disordered male offenders. The aim of this research was to investigate some of the psychometric properties of the RAG with a nonmentally disordered offender population. Subjects consisted of 136 federally sentenced Canadian male offenders who had not been diagnosed with a mental disorder. The results indicated the reliability and the concurrent validity of the RAG for assessing violent behavior of federally incarcerated, non-mentally disordered male offenders. Further research requires a determination of the predictive validity of the RAG with these offenders.
Factors Influencing Sexual Victimization and Revictimization in a Sample of Adolescent Mothers
Authors: COLLINS MARY ELIZABETH
Published: March 2007

This study involved secondary analysis of an existing longitudinal data set of a survey of adolescent mothers (N = 315). Using multivariate logistic regression analysis, data from Time 1 were used to predict victimization reported in the year between Time 1 and Time 2. Three factors—any sexual victimization reported at Time 1, previous victimization involving rape using force, and ever having been hit by a partner—increased the likelihood of reported sexual victimization at Time 2. Three other factors were found to reduce the risk of victimization: having been victimized more than 1 year prior to the first survey; being pregnant at Time 1; and reporting satisfaction with social relationships. Additional analyses were used to investigate risk factors for revictimization.
Self-Mutilating Behavior of Sexually Abused Female Adults in Turkey
Authors: BARAL IŞIN , KORA KAAN , YÜKSEL ŞAHİKA , SEZGİN UFUK
Published: March 2007

The authors' study included 42 female adult patients. All the patients had been sexually abused by family members. The participants were grouped into two groups: those with self-mutilating behavior (SMB) and those without such behavior. They were evaluated for history of physical and sexual trauma, suicide attempts, eating habits, and SMB. The ratio of SMB in the sample was 33.3%. Our findings support that SMB and sexual abuse are closely related to eating disorders, particularly anorexia. The relationship between SMB and suicide attempts was found statistically significant. Childhood abuse, especially sexual abuse, is a largely ignored psychosocial problem in Turkey. SMB and sexual abuse are highly correlated, and therefore SMB might be considered as an important signal for the presence of sexual abuse.
Alcohol and Sexual Assault in a National Sample of College Women
Authors: ULLMAN SARAH E. , KARABATSOS GEORGE , KOSS MARY P.
Published: March 2007

Alcohol is associated with risk of sexual assault among women and with increased risk of experiencing completed rape once attacked. In particular, alcohol use prior to sexual assault by both offenders and victims may affect the severity of sexual victimization experienced by women. Little research has explored the mechanisms (e.g., social context, behavior) through which alcohol may affect outcomes of sexual attacks using multivariate analysis. This study analyzed the role of alcohol in sexual assaults experienced by a national sample of female college students. A hierarchical multivariate regression showed that victim alcohol abuse propensity and both victim and offender alcohol use prior to attack were directly associated with more severe sexual victimization to women as measured by the Sexual Experiences Survey. This study suggests that alcohol use plays both direct and indirect roles in the outcomes of sexual assaults. Rape and alcohol abuse prevention efforts can benefit from incorporating information about alcohol's role in different assault contexts.
Children's Witnessing of Adult Domestic Violence
Authors: EDLESON JEFFREY L.
Published: March 2007

Social service professionals are more frequently identifying children who witness adult domestic violence as victims of that abuse. This article expands common definitions of how children witness adult domestic violence. A total of 31 research articles that met established quality criteria were included in this review. A variety of behavioral, emotional, and cognitive-functioning problems among children were found to be associated with exposure to domestic violence. Factors that appear to moderate the impact of witnessing violence—such as whether the child was also abused, child gender and age, and the time since last exposure to violence—were identified. Concerns about research methodology used in this area of research and the application of this knowledge also are raised.
Traps for the Unwary in Administration of Employee Benefit Plans
Authors: Vater Joseph A.
Published: March 2007

Plan sponsors historically have had few limitations under the Employee Retirement Income Security Act or the Internal Revenue Code on the types of benefits or the level of benefits provided through a health plan. However, recently, the Equal Employment Opportunity Commission has increased its enforcement of claims against employers under various federal discrimination statutes. In addition, counsel for participants are using these discrimination statutes to challenge claim denials that are based on exclusions in the plan. As a result, benefit professionals should be reviewing plan benefits to determine whether potential discrimination issues exist. In addition, in considering whether to terminate an employee, employers should review whether the employee is about to vest in one of the employer’s plans or whether the employee has received benefits from one of the employer’s plans. Section 510 of ERISA prohibits an employer from dis- criminating against an employee for exercising a right under a plan or to interfere with the attaining of a right under a plan.
Changing the CPI: What Effect would it have on Employee Benefits?
Authors: Siegler Ira , Funari Mary
Published: March 2007

Economists in and out of government generally agree that the Consumer Price Index (CPI) overstates the true annual inflation rate by as much as 1%. While proposals for a readjustment of the index are stalled for now, the cry for a downward revision of the CPI is likely to be revived since it would affect a wide range of government and private-sector payments. Thus, the impact on employers of a downward revision in the future is worth examining. Obviously, a change in CPI measurement would have a direct impact on retirement plan sponsors' costs; however, the authors point out that a modest change would be a non-event with regard to the initial benefit workers would receive upon retirement. And a downward adjustment of the CPI would lower the cost to employers of providing certain healthcare benefits.
Social Security Reform: Another Look at the Facts
Authors: Abdnor Leanne J.
Published: March 2007

Facing an unfunded liability of approximately $9 trillion dollars within the next 75 years, "our beloved Social Security system is an unfunded Ponzi scheme in which the government has promised future benefits that it cannot pay with the current structure," says the author. While the system has been financially good for those who have already retired, the author says it is quickly becoming a very bad deal for today's young workers. She maintains that raising taxes and cutting benefits are not viable options by themselves for resolving Social Security's future problems. The author cites Personal Retirement Accounts (PRA) as one of the strongest proposals for workers to create economic wealth because it will allow workers to: 1) own the funds in their accounts; 2) invest in capital markets; and 3) use these assets for their retirement, or pass some of them on to their children. The author acknowledges however, that switching to PRAs involves the obstacles of managing the transition and the ensuing issues inherent in setting up and administering the accounts. "The largest issue surrounding the debate of investing Social Security funds in the marketplace is: who should do the investing, individuals or the federal government?"
The Effect of Victim Participation on Parole Decisions: Results From a Southeastern State
Authors: Smith Brent L. , Watkins Erin , Morgan Kathryn
Published: March 2007

Advances in victims' rights in many states have generated numerous changes which potentially affect offenders' dispositions. One of the most pro found of these changes in the last two decades has been the right of victims to either allocute (make an oral statement) or have their voices heard through vic tim impact statements, normally presented as part of the presentence report. Offender dispositions may be affected at two points in justice processing as a result of these changes: at sentencing and/or at parole hearings. Despite these legislative changes, most research has indicated that victim participation has had little impact on sentence outcomes. The current study examined parole hearings in one southeastern state to determine if, and how, victim participa tion is related to parole decision making. Results indicate that victim and offender participation are significantly related to parole decisions. The study identifies the relative importance of types of participatory involvement as well as thresholds at which participation begins to affect decision making.
Engineering in the Age of Innocence: a Genealogy of Discourse Inside the Czechoslovak Writers' Union, 1949-67
Authors: Shore Marci
Published: March 2007

And so it happened that in February 1948 the Communists took power not in bloodshed and violence, but to the cheers of about half the population. And please note: the half that cheered was the more dynamic, the more intelligent, the better half.

Milan Kundera
The Commodification of Otherness and the Ethnic Unit in the Balkans: How to Think about Albanians
Authors: Blumi Isa
Published: March 2007

L'Albanie... toutes la nature s'y montre âpre, sauvage et les habitants sont d'un aspect et d'un caratère dignes de cette nature, beaux, grands, robustes, belliqueux, féroces.
Dependency by Way of Rejection
Authors: Földényi László
Published: March 2007

Let us not speak ill of Nationalism. Without the nationalist virulence, a technical, rational, uniform imperium would rule over Europe and the world... Nationalism was the final tension of the individual in the face of the gray death, which awaited his own.

And yet:

The rise of nationalism in every nation points to the fact that its originality is about to expire.

Nicolás Gómez Dávila
Working Women, Maternity Entitlements, and Breastfeeding: A Report from Bangladesh
Authors: Haider Rukhsana , Begum Syeeda
Published: March 2007

Early infant feeding practices and facilities available for supporting breastfeeding in workplaces in Dhaka, Bangladesh were studied through interviews with working women (n=238) with children younger than 30 months of age. Of the women interviewed, 20 percent were aware of the benefits of, and had exclusively breastfed in the first month, 13 percent in the second month, and two percent in the fifth month of employment. The median age of starting complementary feeds was 41 days (range, 1210) preparatory to resuming work. Total duration of breastfeeding was significantly shorter in mothers who had started these feeds before 41 days of age as compared to those who started later (meanSD) 275 216 days versus 361 223 days (p=0.003). Ninetynine percent of the mothers were unaware of their maternity entitlements, and only 20 percent had taken breaks for breastfeeding, those breaks being treated as "unofficial."

Working women should be informed through health personnel and communication media, about the benefits of exclusive breastfeeding and about maternity entitlements. Provision of facilities to support breastfeeding in the workplace must also be encouraged so that maternal employment does not hamper breastfeeding.
Nurses' Attitudes and Behaviors that Promote Breastfeeding
Authors: Patton Carla B. , Beaman Margaret , Csar Norma , Lewinski Charlotte
Published: March 2007

This descriptive correlation study determined the attitudes and behaviors of obstetrics nurses toward breastfeeding and early lactation. Maternity nursing staff at 20 Midwestern hospitals, representing all levels of prenatal care in urban and rural settings, voluntarily answered a 19-item questionnaire. A total of 230 anonymous responses were received. Sixty-four percent of the nurses would recommend or actively encourage breastfeeding and were very interested in helping a woman learn how to breastfeed. Time factors, including shortened length of stay, and lack of knowledge were perceived to be the primary barriers for nurses in assisting mothers to breastfeed. Nurses who cited length of stay as a barrier had more years in obstetric nursing (p<.05). Level of nurses' education correlated positively to active encouragement and support of breastfeeding (p=.024), as well as personal breastfeeding experience (p=.02). The average discharge breastfeeding rate at the study hospitals was 40 percent, well below the national average of 56 percent. Both education and personal experience influence the nurse's attitudes and behaviors in the promotion ofbreastfeeding. These nurses perceived breastfeeding support as too time-consuming, which suggests that they have not fully adapted to shorter obstetric stays. Nurses need support and continuing education to identify personal bias and knowledge deficits which hinder breastfeeding promotion.
Supporting A Preterm Infant's Behaviour During Breastfeeding: A Case Report
Authors: Nyqvist Kerstin Hedberg , Ewald Uwe , Sjödén Per-Olow
Published: March 2007

Preterm infants present a special challenge to lactation consultants because of their high reactivity to stimuli from their physical and social environment, low muscle tone, and limited extent of awake, alert behavior. In a descriptive case report, a girl at an age corresponding to a gestational age of 29 weeks was observed during a breastfeeding session according to the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Recommendations, based on her behavioral responses, were given to her mother. In an observation two days later, she showed more wakefulness and more efficient sucking. General recommendations are offered for support of preterm infants' behavior during breastfeeding. The NIDCAP structure is advocated as a mental checklist for breastfeeding assessment and advice.
Clinical Use of Silicone Nipple Shields
Authors: Wilson-Clay Barbara
Published: March 2007

Use of nipple shields is controversial. However, when weaning is imminent, they may enable breast-refusing infants to transfer back to the breast. A chart review of 248 clients seen during a 13-month period in a private lactation clinic revealed 32 women who received thin, silicone nipple shields. Among this group, the most common presenting problems were breast refusal (69 percent) and difficulty with latch (25 percent). Bottles had been introduced in 75 percent of these cases. Thirty-eight percent of the mothers using nipple shields weaned their infants during the initial crisis period; 56 percent continued to breastfeed for at least six weeks postpartum. Two ill infants continued to receive human milk by bottle for four and 12 months respectively. Parity appeared to correspond inversely with success of the shield intervention. The presence of flat or inverted nipples appeared to contribute to the phenomenon described as "nipple confusion."
Mothers' Reports of the Outcome of Nipple Shield Use
Authors: Brigham Merilee
Published: March 2007

Although nipple shields have undergone significant design improvements in recent years, many lactation consultants are reluctant to use them to assist with breastfeeding challenges. This article shares the experience of lactation consultants and their clients in the Breastfeeding Center at Evergreen Hospital with the use of ultra-thin, silicone nipple shields. Fifty-one clients who used ultra-thin nipple shields were interviewed by telephone to determine patterns of use and client satisfaction. Eighty-six percent of the respondents reported that the ultra-thin nipple shield helped them continue to breastfeed. Our positive experiences, along with those of our clients, suggest that ultra-thin nipple shields can be a useful lactation tool in maintaining the breastfeeding relationship until problems are resolved.
A Comparison of Two U.S. Surveys of Infant Feeding
Authors: Kennedy Kathy I. , Visness Cynthia M.
Published: March 2007

This study compares the 1988 National Maternal and Infant Health Survey (NMIHS) and the 1989 Ross Laboratories Mothers Survey with respect to sample characteristics and proportions of women who breastfed. Weighted proportions of women included in the two surveys were compared according to various characteristics to see how well they represented U.S. childbearing women. A z-statistic was produced to test for significant differences in the proportions who breastfed. In 1988-89, 52.2% of American women breastfed according to the Ross survey and 53.4% according to the NMIHS. Despite differences in sample size, sampling technique and the application of sample weights, the difference between the surveys was only 1 percentage point, and most levels of most variables examined were comparable. The Ross survey is a valuable source of data because it is ongoing, and it is generally corroborated by the NMIHS. The NMIHS is probably more representative of the U.S. population of childbearing women, and is a reliable source of data for setting U.S. objectives concerning infant feeding, and for the study of other issues vis-a-vis breastfeeding.
Breast Milk Composition After Exercise of Different Intensities
Authors: Carey Gale B. , Quinn Timothy J. , Goodwin Susan E.
Published: March 2007

The purpose of this study was to determine if breast milk composition changed significantly following exercise conducted at different intensities. Nine postpartum women exercised on a treadmill up to maximal oxygen uptake (100% of VO2max) on the first laboratory visit, for 30 minutes on two subsequent occasions (50% and 75% of VO2max) and also performed a nonexercise control session. Blood and breast milk were collected prior to exercise, immediately after exercise, and at 30, 60, and 90 minutes postexercise. Blood samples were analyzed for lactic acid (LA) while milk samples were analyzed for LA, pH, lipid, ammonium, and urea. Milk LA after the 100% intensity session was significantly elevated through 90 minutes postexercise, while there was no significant increase in milk LA at any collection time after the 50% or 75% intensity sessions. There were no significant uifferences in milk pH, lipid, ammonium, or urea measurements after any of the exercise sessions. These data show that unlike maximum intensity exercise, moderate intensity exercise does not increase breast milk LA content.
Breastfeeding After Strenuous Aerobic Exercise: A Case Report
Authors: Duffy Lynn
Published: March 2007

There are no documented adverse effects of breastfeeding after long distance running. This case describes an exclusively breastfed baby who cried after being breastfed about 1--2 hours following his mother's 5-mile run. When artificial baby milk was substituted for the postrun feeding only, the inconsolable crying did not occur. Testing the mother's breast milk before and after running showed a similar level of lactic acid; no other component was tested. Further research is needed in this area.
Comparing Breastfeeding and Breast Pumps Using a Computer Model
Authors: Zoppou Christopher , Barry Steven I. , Mercer Geoffry N.
Published: March 2007

There is a role for computer models in increasing the understanding of milk extraction from the human teat. A computer model can be used to investigate aspects of extracting milk from the human teat which are not feasible using clinical experiments. In this paper, the behavior of the human teat during an infant suckling and with the use of a breast pump is modeled. The model is used to (1) identify the role of suction and the peristaltic motion of the tongue during suckling and (2) compare the volume of milk extracted by an infant breastfeeding with that obtained using a breast pump. Infants use a peristaltic motion of the tongue, along with some suction, to extract milk. Breast pumps use a cyclic pattern of suction only. In the model, the human teat is represented as a cylindrical porous elastic material saturated with fluid. We mimic an infant suckling by imposing both suction and a peristaltic force in the computer model of the human teat. This is compared to the effect of suction only, which models the action of breast pumps. The results demonstrate that there is an optimal time to apply the peristaltic force during the suction cycle which will increase the milk volume. The model and results may be of use in the future design of effective breast pumps.
Do Consumer Infant Feeding Publications and Products Available in Physicians' Offices Protect, Promote, and Support Breastfeeding?
Authors: Valaitis Ruta K. , Sheesl-ka Judy D. , O'Brien Mary Fodor
Published: March 2007

The purpose of this study was to determine if consumer infant feeding publications and products distributed by physicians' offices protect, promote, and support breastfeeding. A total of 127 physician office practices completed a mailed questionnaire that measured the types of print and nonprint materials available and policies and practices regarding these resources. Commerciaily produced pamphlets were available in 114 (90%) of the offices surveyed, and were twice as likely to be routinely distributed as pamphlets from nonprofit agencies and government. Many publications contained outdated recommendations about breastfeeding; the most accurate publications were available in only 29 (23%) of practices surveyed. Magazines contravening the WHO Code were widely available (91 offices; 72%) and routinely distributed (58 offices; 46%). One hundred one offices (80%) accepted frec formula and 43 (38%) routinely distributed it. Few offices had a policy (n=25; 20%) or criteria (n=17; 13%) for selecting infant feeding resources. Those with policies were less likely to distribute commercial pamphlets. In the majority of offices surveyed, physicians' offices accepted and routinely distributed publications and products which do not "protect, promote, and support" breastfeeding. Offices are encouraged to have policies guiding the distribution of infant feeding materials.
Human Milk: An Invisible Food Resource
Authors: Hatloy Anne , Oshaug Arne
Published: March 2007

Human milk is an invaluable food resource for infants and young children in Sub-Saharan Africa. Statistics on production of human milk at local and national levels are lacking. In this article, estimates of the quantity of human milk production in Mali, Senegal, Nigeria, and Zimbabwe were calculated. Annual production in the urban and rural areas in Mali was 13 and 17 kg per capita, respectively. National annual median production ranged from 93,000 (Zimbabwe) to 1.3 million metric tons (Nigeria), and from 9 (Zimbabwe) to 15 kg per capita (Mali). Given a value of (US)$1 per liter, inclusion of human milk in calculations of the gross national product (GNP) for these countries would increase this value by more than 5% for Mali, and nearly 2% for Senegal. Human milk is a significant food source to children in this region and should be included in national food statistics due to its nutritional and economic importance.
WIC-Based Interventions to Promote Breastfeeding Among African-American Women in Baltimore: Effects on Breastfeeding Initiation and Continuation
Authors: Caulfield Laura E. , Gross Susan M. , Bentley Margaret E. , Bronner Yvonne , Kessler Lisa , Jensen Joan , Weathers Benita , Paige David M.
Published: March 2007

We evaluated the single and combined effects of introducing a motivational video and peer counseling into four matched WIC clinics on breastfeeding initiation and continuation at 7-10 days among African-American WIC participants. Of the 242 women with complete data, 48% initiated breastfeeding, but only 31% were still breastfeeding at 7-10 days. Initiation was associated with cesarean delivery, infant feeding instruction, no artificial milk discharge pack, attending the peer counselor only-intervention site, and intention to breastfeed. Continuation was influenced by infant feeding instruction, no artificial milk discharge pack, and intention to breastfeed. Overall, trends toward a positive impact of the breastfeeding promotion activities were evident but weak, and largely gone by 7-10 days postpartum.
Staff Support for Mothers to Provide Breast Milk in Pediatric Hospitals and Neonatal Units
Authors: Pantazi Marie , Jaeger Marie Christine , Lawson Margaret
Published: March 2007

This paper reports on two surveys of nurses and midwives working in a large pediatric hospital and three neonatal units in London, England, regarding support for mothers to provide breast milk. One hundred and twenty-two pediatric staff and 55 neonatal staff returned the questionnaires. Fifty-three percent of pediatric staff had received no training in breastfeeding during or after nursing school. Twenty-two percent of neonatal staff had no relevant training, yet they frequently were asked to help mothers in providing breast milk for their infant. Some respondents demonstrated lack of relevant knowledge including the importance of breast milk, ideal frequencies for milk expression, and the potential to establish lactation at any time. There was a wide range of comments on the barriers in providing breast milk. These results illustrate the need for appropriate breastfeeding policies and staff training. There is a particular lack of studies based in the United Kingdom on breastfeeding in pediatric units. It is hoped that this article will generate discussion among staff about the breastfeeding support they offer and ways to strengthen it.