New approach to the consultant contract.
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Biomedical subjects
Publications and source records attributed to J Riordan.
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The authors tested the validity of the LATCH breastfeeding assessment tool, controlling for intervening variables in 133 dyads. LATCH scores, mother's evaluation of an index feed, and intended duration of breastfeeding were assessed postpartum and followed 6 weeks. Women breastfeeding at 6 weeks postpartum had higher LATCH scores (mean +/- SD = 9.3 +/- 0.9) than those who weaned (mean +/- SD = 8.7 +/- 1.0), due to only one measure, breast/nipple comfort. Women who weaned before 6 weeks reported lower breast/nipple comfort (1.5 +/- 0.5) than those who were still breastfeeding at 6 weeks (1.7 +/- 0.5, P < .05). Total LATCH scores accounted for 7.3% of variance in breastfeeding duration. Total LATCH scores positively correlated with duration of breastfeeding (n = 128; r = .26, P = .003) and to mothers' scores (n = 132; r = .58, P = .001). Correlations among LATCH measures ranged from .02 to .51. The LATCH tool is a useful identifies the need for follow-up with breastfeeding mothers at risk for early weaning because of sore nipples.
We examined the relationship of labor pain relief medications with neonatal suckling and breastfeeding duration in 129 mothers delivering vaginally. Suckling was measured using the Infant Breastfeeding Assessment Tool (IBFAT). Controlling for infant age, birthweight, and gender, infants of unmedicated mothers had higher IBFAT suckling scores than those of medicated mothers (x = 11.1 vs. x = 8.2 respectively, P = .001). IBFAT suckling scores for intravenous and epidural groups were similar (x = 8.5) while those who received a combination of both intravenous and epidural medications were lower (x = 6.4 +/- 2.96, P = .001). Mothers evaluated their breastfeeding similarly to nurse evaluators (Z = 9.39, P = .001). Breastfeeding duration did not differ between unmedicated and medicated groups; however, dyads with low IBFAT scores weaned earlier than those with medium or high scores. Labor pain relief medications diminish early suckling but are not associated with duration of breastfeeding through 6 weeks postpartum.
Teaching breastfeeding on the Internet breaks down geographic barriers and draws students from all over the globe for a rich learning experience. This article describes the development and teaching strategies of a successful university-based graduate breastfeeding Internet course. A discussion forum, electronic visiting professors, case studies, and online exams enhance this global learning experience. The drawbacks of online learning are also presented.
The risk of death among elderly patients moved out of long-stay psychiatric hospitals can be minimised with careful preparation. A specialist team working with residents before the move, and visiting them for three months afterwards, helps provide continuity. In this group of 14 patients, aged 70 to 96, there were no deaths in the six months following the transition.
The study investigated psychosocial factors associated with the use/non-use of services by primary carers of people with dementia (caring for relative/friend with dementia). The factors considered were individual differences, health, stress, family/social support, years of caring, age of carers/person with dementia, gender and level of behavioural disturbance presented by the person with dementia. The participants were referred to the study by health services, social services representatives and GPs. The carers (N = 50) were divided into two groups (service user/non-user). The findings indicated that primary carers in the non-user service group scored significantly higher on a measure (sense of coherence; SOC) estimating an individual's ability to deal with stressful situations. The individual's ability to deal with caring responsibilities was associated with a reduction in the level of diagnosable psychiatric disorder or 'caseness' and the non-use of services. None of the other factors considered were found to be significantly different between the two career groups. However, a significant inverse association between health, stress and individual ability to deal with stressful situations was found when the two career groups were combined.
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Cognitive deficits in schizophrenia are reported to be more consistent with a static encephalopathy than a dementing disorder. This study investigates memory and intellectual decline in 62 chronic schizophrenic subjects using the Wechsler Adult Intelligence Scale-Revised (WAIS-R), the Rivermead Behavioural Memory Test and the National Adult Reading Test (NART) in a cross-sectional study using five age cohorts (18-29, 30-39, 40-49, 50-59 and 60-69 years of age) and then by two cohorts (young: 18-39; older: 40-69). A second method of investigating intellectual decline was implemented by estimating the discrepancy score between WAIS-R (current IQ) and NART (premorbid IQ) for each subject. No significant differences were found in WAIS-R Full Scale. Verbal and Performance IQ and memory functioning across the five age cohorts (and when using two age groups). A significant difference in test scores was found using the Picture Completion and Digit Symbol subtests of the WAIS-R. The differences were not related to age or duration of illness. No significant difference in scores were evident in the remaining WAIS-R subtests. These results support previous findings that schizophrenia is more consistent with a static encephalopathy than a dementing disorder and that intellectual and memory function does not markedly decline with age.
The ability of the National Adult Reading Test (NART; Nelson & Willison, 1991) and the revised NART (NART-R; Crawford, 1990) to estimate IQ was examined in a healthy sample (N = 47) using the Wechsler Adult Intelligence Scale-Revised (WAIS-R) scores as the criterion. Mean estimated IQs from the NART-R were not significantly different from the WAIS-R Full Scale and Performance IQ, but the NART-R significantly overestimated Verbal IQ by 2.5 points. Nelson & Willison's (1991) NART equations significantly overestimated Full Scale and Verbal IQ by 5.3 and 5.5 IQ points respectively. The NART-R had significantly higher correlations with Full Scale and Verbal IQ than the NART.
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The continuation of breastfeeding during a hospital stay is not only possible, it can be beneficial for both the mother and the infant. The ill mother avoids breast engorgement and possible mastitis; the infant of an ill mother continues to receive, in breast milk, antibodies to the mother's illness. Through breast milk, an ill infant receives antibodies to his illness, liquids, and an easily digested, nourishing food. In addition, the physical and emotional comfort the mother and infant give each other eases the job of the nurse who cares for them. Hospital policies that take a woman's lactational status into account and encourage breastfeeding should be the accepted standard.
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By examining and predicting dimensions of job satisfaction of community-based nurses, this study sought to provide information for recruiting and retaining community nurses. Data were collected from a sample of 104 community health, school health, and home health nurses. Prestige had the highest positive correlation with and was the single significant predictor of job satisfaction. Three other subscales, autonomy, social interaction, and organizational requirements, correlated with job satisfaction as moderately positive. Weak positive relationships were found with years of work, years on the job, age, and years of education. Pay was not associated with job satisfaction for these nurses.
Competitive recruitment of nursing school applicants requires a thorough understanding of why they pick a particular school. By applying marketing techniques, nursing schools can identify their institutions' perceived strengths and tailor their recruitment efforts to applicants' needs. Students and alumni (n = 228) responding to a mail survey indicated that their awareness of the nursing program was primarily through personal contacts and direct mail. Other marketing media were perceived as ineffective. Several market segments were identified through canonical correlation analysis: traditional and nontraditional students. Traditional students (under age 25, unmarried, local, in the baccalaureate program) chose the program due to quality of clinical instruction and financial aid. Nontraditional students (age 25 or older, married, returning LPN or RN, transfer, in generic BSN or associate programs) decided to attend based on convenience. The research resulted in the development of recruiting materials emphasizing the unique strengths of the nursing program.