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Biomedical subjects

J E Roberts

Publications and source records attributed to J E Roberts.

140 records · Page 8Linked to original sources
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Early maternal attachment behaviors of adolescent and adult mothers.

This comparison of observed attachment behaviors of 184 medically indigent, low-risk, inner-city adolescent and adult mothers addresses three critical questions unanswered by current research regarding the maternal attachments behaviors of adolescents. The 69 mothers aged 14 to 17 and the 36 mothers aged 18 to 19 exhibited significantly fewer maternal attachment behaviors during in-hospital infant feedings than a control group of 79 mothers aged 20 to 24. Verbal reports of adolescent and adult mothers were not reliable indicators of actual attachment behaviors. Two-way analyses of variance, statistically controlling for other background factors and amount of infant contact, did not diminish the impact of maternal age. However, rooming-in and educational levels appropriate for age both had additional independent impacts on maternal attachment scores.

Adolescent↗
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Recent developments in professional midwifery education and credentialing.

The American College of Nurse-Midwives, (ACNM), as a membership organization, and the ACNM Certification Council (ACC), as a credentialing agency, pursue independent but allied missions of expanding access to education for the practice of midwifery, while adhering to established standard of quality for education and clinical practice. The following recent actions taken by these agencies are presented for the information of the membership. 1) The Assured Equivalency Option, a mechanism through which nurse-midwives educated in countries other than the United States can demonstrate their competency and, as needed, acquire additional requisite didactic knowledge or clinical skills, leading to eligibility for national certification examination, is detailed. 2) The rationale for adoption of the multiple-choice format for the criterion-referenced national certification examination in nurse-midwifery and the methods used to determine the validity and reliability of the examination are described. 3) The award of a time-limited credential to those newly certified is offered as a policy statement of the ACC. 4) Deliberations and decisions leading to development of guidelines for the accreditation of non-nurse-midwifery education programs and credentialing as a professional midwife are recounted.

Clinical Competence↗
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State regulation of midwives: issues and options.

In the United States, state governments play a central role in determining the extent to which midwives can provide care to women and babies. State laws and regulations establish midwives' scope of practice, set licensure requirements, and frequently determine their ability to get paid and obtain access to health care facilities. For certified nurse-midwives (CNMs), state regulation has evolved from a haphazard patchwork of highly variable regulatory models into a fairly uniform set of rules and requirements from one state to the next. For direct entry midwives (DEMs), there is much less uniformity, with some states outlawing practice by any midwife who is not a CNM, whereas other states have established rigorous standards and requirements for the licensure of DEMs. This article provides a broad overview of these state regulatory variables for both CNMs and DEMs, and explores issues and options that both state regulators and midwives should consider when developing or amending state laws and regulations governing their practice. In particular, the role of the state in regulating the practice of the certified midwife (CM) is examined in the context of existing regulatory frameworks for CNMs and DEMs.

Certification↗
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Parents' report of vocabulary and grammatical development of African American preschoolers: child and environmental associations.

This study examined how child and family factors affect individual differences in the language development of African American children between 18 and 30 months of age. Participants were 87 African American children, primarily from low-income families. Children's vocabulary and grammatical skills were assessed at 18, 24, and 30 months of age using the short form of the MacArthur Communicative Development Inventory (CDI), a standardized parent report tool. Standardized language tests were administered repeatedly between 1 and 3 years of age. Results showed that children's vocabulary and utterance length grew linearly over time between 18 and 30 months of age. Children from more stimulating and responsive homes were reported to have larger vocabularies, to use more irregular nouns and verbs, and to use longer utterances, in addition to having more rapid rates of acquisition of irregular forms and longer utterances over time. Girls used longer utterances than boys and more irregular forms. Girls also had larger vocabularies in a secondary analysis that eliminated children whose parent report of their vocabulary was substantially lower than children's scores on a standardized language test. There are indications that some parents may be under-reporting their children's early vocabulary and grammatical development, with a high proportion of the parents reporting their child's 30 month vocabulary and grammatical development as being at or below the 10th percentile according to the CDI norms.

Black or African American↗
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Relating quality of center-based child care to early cognitive and language development longitudinally.

How quality of center-based child care relates to early cognitive and language development was examined longitudinally from 6 to 36 months of age in a sample of 89 African American children. Both structural and process measures of quality of child care were collected through observation of the infant classroom. Results indicated that higher quality child care was related to higher measures of cognitive development (Bayley Scales of Infant Development), language development (Sequenced Inventory of Communication Development), and communication skills (Communication and Symbolic Behavior Scales) across time, even after adjusting for selected child and family characteristics. In addition, classrooms that met professional recommendations regarding child:adult ratios tended to have children with better language skills. Classrooms that met recommendations regarding teacher education tended to have girls with better cognitive and receptive language skills. These findings, in conjunction with the growing child-care literature, provide further evidence that researchers and policymakers should strive to improve the quality of child care to enhance early development of such vulnerable children.

Age Factors↗
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Maternal positions for childbirth: a historical review of nursing care practices.

The basis of maternity care practices related to maternal position for childbirth is analyzed historically in a review of the American periodical nursing literature from the early 1900's to the present and of contemporary maternity nursing texts. The factors of 1) concomitant obstetrical practices, 2) the prerogative of the physician, and 3) the evolving and predominantly supportive role of the nurse are identified as the major influences on these nursing practices. Historical aspects of the development of the current role of the nurse in maternity care are identified. While nurses are currently questioning care practices related to the positions of women for childbirth and offering more explicit rationale, the need for research related to features of physical care and a more assertive professional role for nurses is emphasized.

Female↗
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Promoting informed consent of women in labor.

Laboring women are increasingly being asked to participate in perinatal research. These women should be considered captive or special subjects who deserve greater protection of their rights. Essential elements of informed consent are reviewed. Specific guidelines are suggested for promoting informed consent for women in labor participating in clinical research.

Disclosure↗
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A descriptive analysis of involuntary bearing-down efforts during the expulsive phase of labor.

A series of descriptive studies was carried out to characterize maternal respiration, type of bearing-down efforts, vocalization, and behavior; describe the obstetric conditions and intrauterine pressure associated with the bearing-down reflex; and describe the duration of second stage, fetal heart rate, and neonatal outcomes when women bear down spontaneously. Thirty-one healthy nulliparous women who had received no formal childbirth education were neither directed nor instructed to bear down with contractions. The women were supported in their involuntary bearing-down efforts throughout the second stage of their labors while the above features of their labor were recorded. The findings suggest that labor progress is adequate and fetal outcome is good when the management of the expulsion phase of labor encourages maternal pushing that is complementary with the involuntary bearing-down reflex rather than sustained breath-holding. These findings support the necessity for further research regarding the bearing-down techniques used during labor.

Adolescent↗
PubMedDate not supplied

Analysis of spectral changes in isotopically substituted porphyrins adsorbed on melanin surfaces by solid-state carbon-13 nuclear magnetic resonance spectroscopy.

Two synthetic, water-soluble porphyrins, tetra-4N-methyl-pyridyl porphyrin (T4NMPyP) and tetra-N,N,N-trimethylanilinium porphyrin (TMAnP), and their indium(III) complexes have been isotopically substituted for evaluation by solid-state NMR of their adsorption to melanin. Methyl carbons on the pyridyl and anilinium nitrogens on the periphery of the porphyrin are one site of substitution; the four equivalent meso carbons in the porphyrin ring are the second. Chemical shifts and line widths of the carbon resonances in the bulk porphyrins change after they are adsorbed on synthetic and natural melanins. These changes may be related to the predominant binding interactions involved in the adsorption process and suggest that chemisorption, involving strong interactions comparable to chemical bonds, occurs between charged groups in both ligand and substrate. Inhomogeneous line broadening of the resonances implies that variations in binding exist, which is in keeping with the known heterogeneous nature of the melanin polymer and the different steric demands of the porphyrin ligands. These solid-phase experiments illustrate the promise of NMR for elucidating information about the binding of soluble molecules to insoluble and structurally irregular biopolymers. Furthermore, they represent the first spectroscopic probe of the binding of cationic molecules to the biopolymer melanin in the solid state. Coupled with results from molecular modelling, they indicate that cationic porphyrins bind to melanin at similar sites.

Binding Sites↗
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Uncovering hidden caring.

The characteristics of caring nursing practice are often, by their very nature, hidden. If caring is to become a core value of the health care system, these caring characteristics need to be uncovered so that they can be taught, rewarded, and recognized as contributing to successful patient outcomes.

Delivery of Health Care↗