Studies of home birth have compared it with hospital birth, with a focus on perinatal outcomes. Although such studies have established the safety of midwife-attended home births, this narrow view does not include all of the concepts represented in a proposed midwifery care framework derived from the philosophy of the American College of Nurse-Midwives. In this essay, the authors recommend the employment of qualitative research with a feminist perspective as a method to elucidate other concepts in the midwifery care framework, and suggest that future home birth research should explore the recognition and validation of the woman and her experiences, appropriate use of technology, and the influences of the birth environment.

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[Prevalence of cardiovascular risk factors in the working population of Navarra].

A high prevalence of cardiovascular risk factors (RFs) has been reported in Spain. The aim of the study was to determine the prevalence of the principal RFs of coronary heart disease (hypercholesterolaemia, low HDL, smoking, arterial hypertension, hyperglycaemia, obesity and sedentary behaviour) in the working population of Navarra. The present study represents the first baseline evaluation of a randomised intervention of primary prevention. The sample under study consisted of 790 workers (742 men and 48 women). Information was gathered on each worker by means of a standardised questionnaire, by the company medical service, and a physical check up was carried out. Total cholesterol and HDL were measured in venous blood by enzymatic autoanalyser. A description was made of the data (percentages of the risk factors and estimation of means for continuous variables). 67.2% of the sample had total cholesterol values higher than 200 mg/dl and 26.3% had HDL levels below 35 mg/dl. 37.1% were regular smokers. The prevalence of high blood pressure was 7.6%. 72.1% reached a body mass index above 25 Kg/m2 and 20.6% classified themselves as sedentary as they did not participate in any physical activity during their leisure time. The prevalence of hyperglycaemia was 1.4%. Only 4.2% of the workers were free of the risk factors under study. A high prevalence of hypercholesterolaemia was detected, and overweight, which supports the pertinence of establishing intervention programs of primary prevention of cardiovascular diseases at the work-site.

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