Increasing your credibility with physicians: strategies for lactation consultants.
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Biomedical subjects
Publications and source records attributed to E L Williams.
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Influences on the decision to initiate breastfeeding among low income mothers served by a suburban medical center in northern California were explored. Sixty-four mothers of children 0-24 months of age were interviewed in English or Spanish regarding their infant feeding education, breastfeeding attitudes and behavior, and social support. Fifty-nine percent reported having discussed infant feeding with a physician; these mothers were more likely to attempt breastfeeding than those who did not. Fifty-nine percent of the entire study population initiated breastfeeding. Initiation rates were highest for the Asian American group (86 percent), and lowest for Latinas (48 percent). Further research is needed regarding modifiable influences on breastfeeding initiation, including physician encouragement to breastfeed, for various ethnic groups.
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The Stanford Five-City Project was initiated in 1978 to evaluate the effects of community-wide health education on coronary heart disease risk factors in two control (San Luis Obispo and Modesto) and two treatment (Monterey and Salinas) cities. This paper examines sex differences in the prevalence of smoking, hypercholesterolemia, and hypertension from the baseline survey in 1979-1980 through the conclusion of the intervention in 1985-1986. Four independent cross-sectional surveys (n = 1,713, 1,709, 1,848, and 1,768) and four repeated surveys of a cohort (n = 817) were conducted. This analysis presents findings separately for a younger age group (25-49 years) and an older age group (50-74 years). Smoking, hypercholesterolemia, and hypertension were more prevalent among younger men than younger women in both treatment and control cities. In general, this excess risk among younger men disappeared or reversed in the older age group. Over the 7-year study, the prevalence of hypertension and smoking decreased for both men and women in all surveys, the prevalence of hyper-cholesterolemia displayed no definite change, and male/female ratios of risk factor prevalence showed either no change or a slight decrease. This study confirms a higher prevalence of the three major risk factors for coronary heart disease among younger men, with the prevalence of hypercholesterolemia and, to a lesser extent, the prevalence of smoking becoming greater among women than men in the older age group and the prevalence of hypertension becoming equivalent.
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The advantages of the transbrachial intra-aortic balloon include preoperative control of hypotension with promptly improved coronary, cerebral, renal, lumbar and hepatic perfusion and control of blood pressure during the induction of anesthesia. The abdomen can then be entered without further hemodynamic decompensation. Careful dissection is facilitated by a drier field and palpation of the balloon in the aorta. These advantages were realized in this series of patients without delay in the operative procedure. The low incidence of organ failure in the three surviving patients, all of whom were in a high risk group, attest to the efficacy of the transbrachial balloon in correcting hypotension perioperatively.
Aqueous extraction of the red alga C. rubrum gave a galactan sulphate and, possibly, a separate glucan and xylan. The galactan sulphate has an alternating structure of the agar-type with D-galactose or 6-O-methyl-D-galactose as one alternating unit, and L-galactose, 3,6-anhydro-L-galactose, and their respective 2-methyl ethers as the other unit. Sulphate hemi-ester groups are present on position 6 of both D- and L-galactose residues, with smaller amounts on positions 2 and 4 of, probably, D-galactose residues. The polysaccharide differs from others previously examined in that most of the L-galactose residues are non-sulphated.
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