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PubMed1999

Births: final data for 1997.

OBJECTIVES: This report presents 1997 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant health characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown including teenage birth rates and total fertility rates, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 3.9 million births that occurred in 1997 are presented. RESULTS: Birth and fertility rates declined very slightly in 1997. Birth rates for teenagers fell 3 to 5 percent. Rates for women in their twenties changed very little, whereas rates for women in their thirties rose 2 percent. The number of births and the birth rate for unmarried women each declined slightly in 1997 while the percent of births that were to unmarried women was unchanged. Smoking by pregnant women overall dropped again in 1997, but continued to increase among teenagers. Improvements in prenatal care utilization continued. The cesarean delivery rate increased slightly after declining for 7 consecutive years. The proportion of multiple birth continued to rise; higher order multiple births (e.g., triplets, quadruplets) rose by 14 percent in 1997, following a 20 percent rise from 1995 to 1996. Key measures of birth outcome--the percents of low birthweight and preterm births--increased, with particularly large increases in the preterm rate. These changes are in large part the result of increases in multiple births.

Adolescent↗

PubMed2000

Births: final data for 1998.

OBJECTIVES: This report presents 1998 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant health characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown including teenage birth rates and total fertility rates, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 3.94 million births that occurred in 1998 are presented. RESULTS: Birth and fertility rates increased in 1998 by about 1 percent, the first increase since 1990. Birth rates for teenagers fell 2-5 percent. Rates for women in their twenties increased 1-2 percent each, whereas rates for women in their thirties rose 2-4 percent. All measures of childbearing by unmarried women increased in 1998; the number of births rose 3 percent, the birth rate increased about 1 percent while the percent of births that were to unmarried women rose to 32.8 percent. Smoking by pregnant women overall dropped again in 1998, but continued to increase among teenagers. Improvements in prenatal care utilization continued. The cesarean delivery rate increased for the second year after declining for 7 consecutive years. The proportion of multiple births continued to rise; higher order multiple births (e.g., triplets, quadruplets) rose by 13 percent in 1998, following a 14 percent rise from 1996 to 1997. Key measures of birth outcome--the percents of low birthweight and preterm births--increased. These changes are in large part the result of increases in multiple births.

Adolescent↗

PubMed2000

Components of social support among Japanese women with breast cancer.

PURPOSE/OBJECTIVES: To describe social support from the perspective of Japanese women with breast cancer. DESIGN: Qualitative, descriptive, and interpretive. SETTING: Outpatient breast clinic at a cancer center in a metropolitan area in Japan. SAMPLE: Sixteen Japanese women diagnosed with stage I and II breast cancer who underwent either modified radical or radical mastectomy and were receiving outpatient follow-up care. The majority were in their 50s, married, and employed. METHODS: Narrative data were collected through individual interviews using a semistructured interview guide. Responses were analyzed using qualitative, inductive content analysis. MAIN RESEARCH VARIABLE: Social support experiences. FINDINGS: "Simply Do It!," "Doing With/Being With," and "Doing For" were three situations in which Japanese women described social support. Doing For was the provision of instrumental aid and was most consistent with Western findings. Each of the three situations was perceived as emotional support. Cultural norms of reciprocity and social obligation entailed strong social imperatives that were sources of conflict. Verbalizations of personal feelings and emotions often did not occur, even among closest family and friends, but were communicated by behavior. CONCLUSIONS: The influence of Japanese culture on interpersonal relationships is strong and guided by cultural norms that include social obligation, maintaining harmonious relationships, and reciprocity. Provision of instrumental aid and areas of conflict were most consistent with Western findings, but differences in sources and forms of social support were pronounced. Continued exploration of social support in Japanese women with breast cancer is warranted. IMPLICATIONS FOR NURSING PRACTICE: Understanding and valuing cultural diversity is vital to developing more effective and individualized nursing care consonant with patients' and families' desires and comfort.

Adult↗

PubMed2001

[B-cell content after bone marrow transplantation--molecular basis of the limited antibody diversity].

Despite B-cell counts and serum immunoglobulin levels usually normalized by one year, humoral immunity and the incidence of bacterial infections continue to be abnormal even after years following bone marrow transplantation. This immunodeficiency could be partially caused by B-cell repertoire restriction similar to that observed early in ontogeny. Immune reconstitution after haematopoietic stem cell transplantation really follows many established ontogenetic patterns relating to the appearance of particular membrane markers, immunoglobulin classes and subclasses, and onset of antigen receptor rearrangements. The sequence of events that occur during successful bone marrow transplantation can be regarded as a blueprint for immune reconstitution in other clinical settings as well. However, the repertoire does not resemble a fetal one, because it displays adult-size IgH CDR3s, adult-type immunoglobulin gene utilization and no evidence of bias towards any particular VH-gen family. Therefore, in the description and interpretation of these events, it is important to realize that immune reconstitution does not appear to recapitulate human fetal ontogeny. In terms of B lymphocyte diversity, the inadequacy of the recovering immune system is more likely to be explained by a combination of other factors--such as clonal dominance and the delayed occurrence of somatic hypermutation.

Adult↗

PubMed2001

Births: final data for 1999.

OBJECTIVES: This report presents 1999 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 3.96 million births that occurred in 1999 are presented. RESULTS: Overall birth and fertility rates changed less than 1 percent in 1999. Teenage birth rates fell 2 to 6 percent. The rate for women aged 20-24 years declined slightly, while rates for women in their late twenties and their thirties rose 2 to 3 percent each. The number of births to unmarried women, the birth rate, and the percent of births that were to unmarried women each rose 1 percent or less. Smoking by pregnant women overall dropped again, but rose among women aged 18-24 years. Improvements in prenatal care utilization continued. The cesarean delivery rate increased for the third year after declining for 7 consecutive years. The proportion of multiple births continued to rise; however, higher order multiple births (e.g., triplets, quadruplets) declined for the first time in over a decade, following increases of 13 percent per year during 1990-98. The percent low birthweight remained at 7.6 percent, while preterm births rose to 11.8 percent. These trends are in large part the result of increases in multiple births.

Adolescent↗

PubMed2002

Births: final data for 2000.

OBJECTIVES: This report presents 2000 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.059 million births that occurred in 2000 are presented. RESULTS: The number of births rose 3 percent in 2000; birth and fertility rates rose 1 to 2 percent. The total fertility rate was above "replacement" for the first time in almost 30 years. Teenage birth rates continued to fall while birth rates for women aged 20-24 years rose slightly, and rates for women in their late twenties and thirties rose 3 to 5 percent. Births to women in their forties and early fifties were also up for 2000. The number of births to unmarried women, the birth rate, and the percent of births that were to unmarried women rose 1 to 3 percent, but birth rates for unmarried teenagers declined. Smoking by pregnant women was down again. The cesarean delivery rate rose 4 percent to 22.9, the fourth consecutive increase; the primary cesarean rate was up and the rate of vaginal births after a previous cesarean was down. The number and rate of twin births continued to rise, but the triplet/+ birth rate declined for the second year in a row. For the first year in almost a decade the preterm birth rate declined (to 11.6 percent); the low birthweight rate, however, was unchanged at 7.6 percent.

Adolescent↗

PubMed2002

Births: final data for 2001.

OBJECTIVES: This report presents 2001 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco, and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.026 million births that occurred in 2001 are presented. Denominators for population-based rates are derived from the 1990 U.S. census. As a result, rates are generally larger than would be the case if 2000-based estimates were used. The magnitude of the overestimate will vary by population subgroup; overestimates are likely greatest for those of Hispanic origin. RESULTS: The number of births, the birth rate, fertility rate, and total fertility rates all declined 1 percent in 2001. The teenage birth rate reached another historic low. Birth rates for women in their twenties declined slightly, whereas rates for women aged 30 to 44 years continued to rise. Births to unmarried women changed very little. Smoking by pregnant women was down again. Women were more likely to begin care in the first trimester of pregnancy (83.4 percent). The cesarean delivery rate rose for the fifth consecutive year to 24.4 percent; the primary cesarean rate was up 5 percent and the rate of vaginal births after a previous cesarean fell 20 percent. Preterm and low birthweight levels both rose for 2001. The twin birth rate continued to climb, and following 2 years of decline, the rate of triplet/+ births also increased.

Adolescent↗

PubMed2003

Efficacy of telemedicine in the initial management of orthopedic trauma.

In order to determine the clinical usefulness of teleradiology in the initial treatment of musculoskeletal injury, a panel of orthopedic trauma surgeons developed a survey that was presented to participants at the annual meeting of the Orthopedic Trauma Association. Selected orthopedic trauma cases from a level-1 trauma and a tertiary care center were presented orally (including a description and interpretation of the radiographic findings) to volunteer participants. Questions related to treatment and patient management were then asked prior to and following the participants' viewing of digital radiographic images. Overall, 90% of respondents found telemedicine useful. They disagreed with the verbal radiographic report 49% of the time. Respondents changed their mind with regard to the need for admission 17% of the time; surgical indications, 22% of the time; and need for more information, 30% of the time.

Decision Making↗

PubMed2003

Births: final data for 2002.

OBJECTIVES: This report presents 2002 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco, and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.022 million births that occurred in 2002 are presented. Denominators for population-based rates are derived from the 2000 U.S. census. Rates for 1991-2001 may differ from those published previously based on the 1990 U.S. census. RESULTS: There were 4,021,726 live births in 2002, essentially unchanged from 2001. The birth rate, fertility rate, and total fertility rates all declined 1 percent in 2002. The teenage birth rate dropped 5 percent, reaching another record low. The birth rates for women 20-24 years declined, whereas the rate for women 25-29 years was stable. The birth rate for women 30-34 years declined, but the rate for women 35-44 years continued to rise. Births to unmarried women changed very little. Smoking during pregnancy was down again. The timeliness of prenatal care continued to improve. The cesarean delivery rate climbed to the highest level ever reported in the United States (26.1 percent) and the rate of vaginal birth after previous cesarean plummeted 23 percent to 12.6 percent. Preterm and low birthweight levels both rose for 2002. The twin birth rate continued to climb, but the rate of triplet/+ births was down slightly.

Adolescent↗

PubMedDate not supplied

Factors influencing appraisal of upset in black caregivers of persons with Alzheimer disease and related dementias.

Black caregivers of persons with Alzheimer disease and related dementias (ADRD) have demonstrated significantly lower levels of stress and burden than white caregivers, as measured by instruments that assess caregiving burden and stressfulness of specific problem behaviors. However, the reasons for reported differences are unclear and cannot be attributed solely to race. This descriptive study used content analysis to compare black caregivers' descriptions and interpretations of responses to memory and behavioral issues of relatives with ADRD to 11 explanations for lower levels of upset proposed in the caregiving literature. Findings confirmed only two explanations from the literature, social support and religious orientation, as factors that influenced appraisal of upset. Two new themes emerged, categorized as Making Sense and Using Strategies, as explanatory frameworks. Findings extend current knowledge of black caregivers' emotional responses to caregiving and support the need for future study of the ways in which particular ethnic and racial groups experience caregiving. Understanding the meaning of appraisals may enable service providers and program developers to tailor services and interventions to support the efforts of black and other minority caregivers.

Adaptation, Psychological↗

PubMed2004

[Concepts that professors and students have about competency in nursing].

This is a qualitative, exploratory, descriptive and interpretative study. The objective of the study is to identify and contextualize the concepts that professors and students have about competency in nursing. The study was carried out at the Nursing School of the Federal University of Rio Grande do Sul. The information was collected in two stages. The first one through eight semi-structured individual interviews and the second one through two focus groups. One of them was formed by students and the other group was formed by professors. Content analysis was used as analysis methodology. As a result three categories were found: significance, attributions and dimensions of competency.

Clinical Competence↗

PubMed2005

Births: final data for 2003.

OBJECTIVES: This report presents 2003 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, and tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.09 million births that occurred in 2003 are presented. Denominators for population-based rates are derived from the U.S. 2000 census. RESULTS: In 2003 there were 4,089,950 live births reported in the United States, 2 percent more than the number in 2002. The crude birth rate (CBR) and general fertility rate (GFR) rose slightly. Childbearing among teenagers declined for the 12th straight year to another historic low. Birth rates for women aged 20-24 years also declined, whereas rates for women aged 25-44 years increased 2-6 percent, reaching highs not reported since the mid- to late 1960s. All measures of unmarried childbearing increased considerably in 2003, but smoking during pregnancy continued to decline. Timely initiation of prenatal care improved slightly. The cesarean delivery rate jumped another 5 percent to another all-time high, and the rate of vaginal birth after previous cesarean dropped 16 percent, an all-time low. Key measures of birth outcome-the percentages of preterm and low birthweight (LBW) births-rose. The twinning rate increased, but the rate of triplet and higher order multiple births was essentially stable.

Adolescent↗

PubMed2006

[Imported diseases in immigrants: myth and reality].

In recent years, with the growth of immigration from low income countries, in certain health spheres and in civil society itself through the mass media, there has been speculation about the risk to the health of the receptor community brought by immigration. This article attempts to conceptualise the terminology that is used to deal with the diseases of immigrants, to serve as a common denominator in the description and interpretation of the data provided by the medical journals, avoiding the confusions that arise in non-specialised health settings or in those that are remote from this. It aims to reflect on the reality of these diseases, both those that are imported and those that are transmissible, and to clarify the risks for the receptor community and their determinants.

Communicable Diseases↗

PubMed2006

Births: final data for 2004.

OBJECTIVES: This report presents 2004 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.1 million births that occurred in 2004 are presented. Denominators for population-based rates are post-censal estimates derived from the U.S. 2000 census. RESULTS: In 2004, 4,112,052 births were registered in the United States, less than 1 percent more than the number in 2003. The crude birth rate declined slightly; the general fertility rate increased by less than 1 percent. Childbearing among teenagers and women aged 20-24 years declined to record lows. Rates for women aged 25-34 and 45-49 years were unchanged, whereas rates for women aged 35-44 years increased. All measures of unmarried childbearing rose in 2004. Smoking during pregnancy continued to decline. No improvement was seen in the timely initiation of prenatal care. The cesarean delivery rate jumped 6 percent to another all-time high, whereas the rate of vaginal birth after previous cesarean fell by 13 percent. Preterm and low birthweight rates continued their steady rise. The twinning rate increased, but the rate of triplet and higher order multiple births was down slightly.

Adolescent↗

PubMed1986

[Ethological methods exemplified by early childhood autism].

When humans are primarily impaired or overtaxed in their more elaborate abilities of coping with the social environment they seem to fall back on more primitive coping behaviours known from other mammals in severe conflict situations. This seems true for some behaviours in early childhood autism. Ethology has specialized in analyzing such non-verbal behaviour. Ethological motivation analysis, the study of context dependence and of the development of such behaviours in the individual patient should be exploited for their interpretation. Mere description of behaviour is not likely to contribute much. Psychiatric thinking on the interaction of genetic and environmental factors does not fully agree with ethological and biological views.

Adaptation, Psychological↗

PubMed1989

[Is circumoral cyanosis a sign of peripheral or of central cyanosis?].

Two hundred Dutch paediatricians were invited to give their description and interpretation of the concept of 'circumoral cyanosis'. Analysis of the results shows great inter-doctor variability: 63% considered the circumoral cyanosis as a pathologic sign and 70% as an expression of central cyanosis, although in textbooks and publications this sign is defined as an expression of peripheral cyanosis and is not considered to be pathological.

Cyanosis↗

PubMed1980

[Role of the lymphocytes in the inhibition of tumor growth in various forms of thyroid cancer].

The paper deals with the description and interpretation of contacts between the lymphocytes infiltrating the tumor and tumor cells found in electron microscopic examinations of papillary carcinoma of the thyroid. It is suggested that lymphocytes exert a cytotoxic effect on the tumor cells the machanism of which is similar to that of the cytotoxic effect of lymphocyte killers on target cells in vitro. In the author's opinion, this process results in the damage and necrosis of the tumor and its replacement with connective tissue. The author believes this to be the mechanism of self-limitation of the sclerosing microcarcinoma of the thyroid which is known to be relatively benign and in some cases may be an occasional finding at operations for struma or at autopsies.

Antibody-Dependent Cell Cytotoxicity↗

PubMed1993

The experience of dyspnea in late-stage cancer. Patients' and nurses' perspectives.

We examined the phenomenon of dyspnea during the last weeks of life as it is experienced by patients with cancer and understood by the nurses providing their care. The literature on late-stage cancer suggests a discrepancy between the prevalence of this symptom and the degree to which it is considered clinically significant. Using a range of descriptive and interpretive approaches, we sought to interpret that discrepancy through an understanding of how patients and nurses interpret the nature and meaning of this serious and distressing symptom. Data sources included a pencil-and-paper survey of late-stage cancer patients, chart audit of a population of late-stage cancer patients in a metropolitan home-care hospice program, and intensive interviews with selected patients and nurses. The findings showed that although dyspnea seems to be a significant clinical problem for patients in late-stage cancer, and although effective intervention and management strategies are available, dyspnea often goes unreported by patients and unnoticed by healthcare professionals.

Activities of Daily Living↗