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Biomedical subjects

W O Willis

Publications and source records attributed to W O Willis.

7 recordsLinked to original sources
PubMed1999

Culturally competent nursing care during the perinatal period.

Effective nursing interventions require culturally competent nursing practice. Nurses can develop the skill sets needed to provide culturally competent care. These skills derive from nursing principles and practice that support respect for individual dignity and self-determination. Sweeping changes in health care delivery have shortened the length of client exposure to nursing care, especially in perinatal nursing. Moreover, changes in the United States population challenge the nurse's ability to respond appropriately to the expectations, values, and beliefs of many diverse cultural groups. Nursing theoretical frameworks provide a basis for cultural competence in practice.

Adult↗
PubMed1994

Cholinesterase activity in pregnant women and newborns.

Plasma and red blood cell cholinesterase activity in blood samples from 259 pregnant women and cord blood from some of their newborn were compared with samples from 25 nonpregnant female volunteers and with laboratory norms (Ellman method). Plasma cholinesterase was significantly lower (p < 0.05) and red blood cell cholinesterase higher (p < 0.05) in pregnant women than in nonpregnant controls in a repeated measures analysis. By the sixth post-partum week, both plasma and red blood cell cholinesterase were similar to nonpregnant control activity. Fetal cord red blood cell cholinesterase activity was also lower than in nonpregnant women, but plasma levels were not significantly different. When compared with standard laboratory normal ranges, most (98-100%) plasma cholinesterase values in pregnant women and newborn were within range, whereas the majority (59-87%, depending on trimester) of red blood cell levels were above range in pregnancy and below range in 53% of newborns. A low red blood cell cholinesterase in pregnant women is more consistent with a possible overexposure to anticholinesterases than a low plasma cholinesterase. Periods of altered sensitivity to specific cholinesterase inhibiting drugs and environmental agents are suggested by these findings.

Adolescent↗
PubMed1993

Pregnancy outcome among women exposed to pesticides through work or residence in an agricultural area.

The study population consisted of women enrolled in a southern California community clinic perinatal program. All women entering the program between January 1987 and December 1989 were asked to participate, and a cohort of 535 women was included in the study. Primarily Hispanic, of low income and educational level, many had recently immigrated from Mexico. They were potentially exposed to pesticides and other agricultural chemicals occupationally and/or environmentally because agricultural production in San Diego County is among the highest in the state. Study methods consisted of biologic assay of maternal blood samples for determination of cholinesterase activity and concurrent patient interviews to determine exposure history by self report. These assessments were conducted on each participant approximately once each trimester. Self-report and blood assay data were analyzed using chi 2, the Mantel-Haenszel extension of chi 2, and risk ratios to determine the association between pesticide exposure and spontaneous abortion, preterm birth, low birth weight and toxemia. No difference between exposed and unexposed women was noted for risk of preterm birth or toxemia. Subjects who experienced spontaneous abortion were all unexposed, and the rate of spontaneous abortion was 2.1%, less than generally expected. A greater incidence of low birth weight among unexposed women indicates that exposure may have had a "protective" effect.

Abortion, Spontaneous↗
PubMedDate not supplied

Prevention of infant mortality. An agenda for nurse-midwifery.

A major health objective of the United States government and the World Health Organization is the reduction of infant mortality by the year 2000. Significant progress in the reduction of infant mortality has been made internationally simply as a consequence of general improvements in public health and nationally as a consequence of increased technological sophistication. Recently, however, there has been an attenuation in the rate of decline, and it becomes necessary to address the unsolved issues that continue to affect morbidity and mortality in the first year of life. Year 2000 objectives related to infant mortality include the reduction of low birth weight and increasing access to prenatal care. Socioeconomic, behavioral, medical, and obstetric factors associated with low birth weight and lack of prenatal care are cited. Personal and political agenda targeted to the achievement of the public health goals are proposed.

Health Services Accessibility↗
PubMedDate not supplied

Cholinesterase and self-reported pesticide exposure among pregnant women.

Ascertainment of exposure to cholinesterase-inhibiting pesticides in pregnant subjects is complicated by altered enzyme activity that results from metabolic changes associated with pregnancy. Nevertheless, this study found a high correlation (Pearson chi-square = 13.67, p = .008) between classification of pesticide exposure using self-reported interview information and plasma cholinesterase activity for 203 pregnant women for whom three trimester cholinesterase values were available. All plasma cholinesterase activity values were referenced, by trimester, to a larger sample of 1,050 plasma cholinesterase values from 535 pregnant women. Subjects who lived nearest to agricultural land and who reported that they worked with pesticides in agricultural and other occupations tended to have lower plasma cholinesterase activity than those who reported use of household pesticides only.

Adolescent↗
PubMedDate not supplied

Requiring formal training in preventive health practices for child day care providers.

The study was a test of the feasibility of mandating training in preventive health practices for child day care providers in California. Three approaches were taken to determining the feasibility of mandatory training. They were (a) to identify persons and groups with the capability to provide training, (b) to identify systems and networks for communication and collaboration on health issues related to day care at the local level, and (c) to determine the child day care providers' concerns, needs, and future interests regarding child health. Information was collected on relevant courses offered by universities, colleges, and adult education programs; on training offered by child health authorities; and on formal curriculums offered by local and national sources. Day care center and family day care home providers were surveyed to determine their knowledge of child health issues, their concerns, and their future needs. The providers surveyed cared for a total of 14,340 children. Information on local networks was obtained from the surveys, from interviews, and from a special task force that had been set up to advise the State legislature. Study results supported the conclusion that a coordinated system of State-wide training was feasible, given the existing networks of training and educational resources, the number of day care providers who had already been motivated to seek some training in child health practices, and the almost unanimous interest among day care providers in obtaining training. Mandating training in child health for day care providers will require a commitment in the form of new legislation outlining basic requirements and allocating funding. The implementation and costs of such a mandate at the State and local level are discussed.

Child Abuse↗