Hepatitis B vaccination coverage of Vietnamese children in south-western Sydney

Vaccination coverage since the selective hepatitis B vaccination of neonates of high-risk group program introduced in 1987, was measured in 658 children from 301 Vietnamese families living in the south-western Sydney. The vaccination rate of children born after the introduction of the program was twice that of children born before its implementation (OR = 2.00, 95% CI 1.65-2.42). The shorter the mother's duration of residency in Australia, the more likely her children were to be fully vaccinated (OR = 2.49, 95% CI 2.43-2.62). A catch-up vaccination program of older siblings is required to assist the public health strategy to reduce the morbidity and mortality from hepatitis B viral infection.     

Postnatal depression and social supports in Vietnamese, Arabic and Anglo-Celtic mothers

Nitric oxide synthase III (NOS III) was identified in the guinea pig cochlea on an ultrastructural level using a post-embedding immunolabeling procedure. Ultrathin sections of London Resin (LR) White-embedded specimens were incubated with various concentrations of a commercially available antibody to NOS III and the immunoreactivity visualized by a gold-labeled secondary antibody. Analysis of ultrathin sections of the organ of Corti in the second turn of the cochlea showed that NOS III could be localized in the endothelial cells of the blood vessels under the basilar membrane, which was comparable to its location in similar cells types in various biological systems. Besides this, NOS III was also found in the cytoplasm and in the nuclei of inner and outer hair cells. Immunoreactivity was not distributed homogeneously within receptor cells. Numerous gold particles could be identified at the border of the cuticular plates, in the middle parts of the stereocilia and in the cytoplasm. Gold-labeled anti-NOS III antibodies in these sites were seen mostly on the cytoplasmic side of the submembranous cisterns in the vicinity of mitochondria and in the central parts of the hair cells, whereas the cisterns were nearly free from any immunoreactivity. NOS III was also detected in the efferent and afferent nerve endings that were located at the basal and basolateral side of the outer hair cells. Some immunoreactivity was visible in different nerve fibers of the inner and outer spiral tunnels. Besides this, gold-labeled antibodies were also present in the cuticular plate of inner and outer pillar cells, in the cytoskeletal elements located in the apical parts of Deiters cells, forming the lamina reticularis, and in the cytoskeletal-containing region of the cytoplasm of those Deiters cells located at the basal side of the outer hair cells. The role of the NOS III immunoreactivity identified in the organ of Corti was consistent with respect to hair cell and tissue modulation.     

Continuing evolution of the pattern of quinolone resistance in Neisseria gonorrhoeae isolated in Sydney, Australia

BACKGROUND AND OBJECTIVES: Multiple phenotypes of quinolone-resistant Neisseria gonorrhoeae isolated in Sydney since 1984 originated in Asia and increased in number and level of resistance in 1995. GOAL: To study the origins, characteristics, and infection pattern of quinolone-resistant Neisseria gonorrhoeae in Sydney from 1995 to 1997 and to compare these results with prior findings. STUDY DESIGN: Quinolone minimal inhibitory concentrations, phenotype, and geographic source of quinolone-resistant Neisseria gonorrhoeae isolated in Sydney from 1995 to 1997 were analyzed. RESULTS: Two hundred nineteen episodes of infection with quinolone-resistant Neisseria gonorrhoeae from 2,236 gonococcal isolates occurred during 1995 through 1997. The rate of isolation of quinolone-resistant Neisseria gonorrhoeae increased significantly at the end of 1996 and was maintained through 1997. The increase resulted from sustained domestic transmission of a limited number of phenotypes in heterosexual patients. CONCLUSION: The pattern of isolation of quinolone-resistant Neisseria gonorrhoeae in Sydney changed from the sporadic isolation of multiple phenotypes of imported quinolone-resistant Neisseria gonorrhoeae to a higher rate of endemic disease caused by a few subtypes. Alterations in antibiotic treatment regimens in the affected patient group were required.     

Experience of non-fatal overdose among heroin users in Adelaide, Australia: circumstances and risk perceptions

AIMS: To ascertain the prevalence and risk factors for non-fatal overdose among heroin users to assist in the development of an effective intervention. DESIGN: Cross-sectional design. SETTING: Community setting, principally metropolitan Adelaide. PARTICIPANTS: Current heroin users (used heroin in the previous six months). MEASUREMENTS: A structured questionnaire including the Severity of Dependence Scale. FINDING: Of 218 current South Australian heroin users interviewed in 1996, 48% had experienced at least one non-fatal overdose their life-time (median: two overdoses), and 11% had overdosed in the previous 6 months. At some time, 70% had been present at someone else's overdose (median: three overdoses). At the time of their own most recent overdose, 52% had been using central nervous system depressants in addition to heroin, principally benzodiazepines (33%) and/or alcohol (22%). The majority of overdoses occurred in a private home (81%) and in the presence of other people (88%). Unrealistic optimism regarding the risk of overdose was evident across the sample. Despite almost half the sample reporting having had an overdose, and the belief expressed by respondents that on average about 50% of regular heroin users would overdose during their life-time 73% had, during the previous 6 months, "rarely" or "never" worried about possibly overdosing. Optimism regarding the possibility of future overdose was reduced in those with recent experience of overdose in comparison to the rest of the sample. A targeted intervention aimed at the reduction of overdose among heroin users is outlined.     

Physical symptoms, distress, and breast cancer risk perceptions in women with benign breast problems.

Physical symptoms, general and breast cancer-specific distress, and perceived breast cancer risk were assessed in 66 women with benign breast problems (BBP) and 66 age-matched healthy comparison (HC) women. BBP women reported significantly greater worry about breast cancer than HC women. Breast symptom incidence and breast cancer risk perceptions were found to mediate group differences in breast cancer worry. Hierarchical regression analyses indicated that perceptions of control over a potential breast cancer prognosis moderate the impact of breast symptoms on reports of breast cancer worry. Implications for risk counseling with BBP women are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The prevalence of breast feeding in Calgary, 1979-1980

The breastfeeding practices of infants in Calgary, Alberta in 1979 and 1980 were studied using annual cohorts. Approximately 63% of infants were breastfed during the 1st week and the proportion did not change significantly during the 1st month. This proportion is higher than in an earlier study in Calgary and surveys in Canada several years ago. Most infants not breastfed during the 1st month were given commercially available infants' formula, and only a small percentage of infants were given cow's milk. The proportion of breastfed infants fell significantly after 3 months, suggesting that encouragement of breast feeding should continue for several months after delivery.     

Study of neonatal immunological function in breast feeding and formula feeding

OBJECTIVE: To determine 4 immunoglobulins and soluble interleukin-2 receptor (sIL-2R) in maternal and neonatal serum, in order to study the immunological functions in the neonates. METHODS: 80 cases were divided into three groups: (1) breast feeding group (30 cases), (2) formula feeding group (20 cases), and (3) mixed feeding group (30 cases). Maternal serum was collected prior to delivery and on the sixth day after delivery. Neonatal serum was collected on the third and sixth day after delivery. Umbilical blood at birth was obtained also. Secretory immunoglobulin A (SIgA), IgA, IgG, IgM and sIL-2R levels in the sera were determined by radioimmunoassay and enzyme-linked immunosorbent assay. RESULTS: The SIgA, IgA, IgG, IgM and sIL-2R levels in maternal serum were not significantly different among 3 groups, while neonatal serum SIgA, IgA, IgG, IgM and sIL-2R levels on the sixth day after delivery in the breast feeding group were significantly higher than those in the formula breeding group (P < 0.001, P < 0.001, P < 0.05, P < 0.05). CONCLUSION: Breast feeding may improve neonatal humoral and cellular immunity.     

Psychopharmacotherapy in pregnancy and breast feeding

The primary purpose of this article is to review critically the literature on the use of psychotropic medications in pregnancy and during breast feeding in order to suggest strategies for the clinical management of these periods. Use of psychotropic medications during pregnancy may cause three complications: 1. teratogenicity, 2. perinatal syndromes (neonatal toxicity), and 3. postnatal behavioural sequelae (behavioural toxicity). The literature features few well-controlled studies concerning these points, so that the available information allows only few conclusions. Exposure to certain psychotropic drugs in utero may increase the risk for some specific congenital anomalies; there is mostly no strong evidence for behavioural toxicity in children exposed to psychotropic medications. Use of psychotropic drugs during pregnancy and breast feeding may be appropriate in many clinical situations and should include thoughtful weighing of risk of pre- and postnatal exposure versus risk of relapse following drug discontinuation. The authors try to present disorder-based guidelines for psychotropic drug use during pregnancy and breast feeding and for psychiatrically ill women who wish to conceive.     

Maternal feeding practices and childhood obesity: a focus group study of low-income mothers

OBJECTIVE: To identify maternal beliefs and practices about child feeding that are associated with the development of childhood obesity. DESIGN: Four focus groups. One group of dietitians from the Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the Northern Kentucky Health District and 3 groups of mothers with children enrolled in WIC. SETTING: The WIC program in the Northern Kentucky Health District. PARTICIPANTS: Fifteen WIC dietitians and 14 mothers (14 to 34 years of age) with young children (12 to 36 months of age) enrolled in WIC. RESULTS: The mothers in this study (1) believed that it was better to have a heavy infant because infant weight was the best marker of child health and successful parenting, (2) feared that their infants were not getting enough to eat, which led them to introduce rice cereal and other solid food to the diets before the recommended ages, and (3) used food to shape their children's behaviors (eg, to reward good behavior or to calm fussiness). The mothers acknowledged that some of their child-feeding practices went against the advice of their WIC nutritionists and physicians. Instead, the participants relied on their mothers as their main source of information about child feeding. CONCLUSIONS: Physicians and allied health professionals discussing childhood growth with mothers should avoid implying that infant weight is necessarily a measure of child health or parental competence. Parents who use food to satisfy their children's emotional needs or to promote good behavior in their children may promote obesity by interfering with their children's ability to regulate their own food intake. Interventions to alter child-feeding practices should include education of grandmothers.     

Nursing care in common breast problems in early breast feeding]

We examined and contrasted morning reports at two hospitals, university and community, that have a pediatric residency program. Patient diagnoses assigned at morning report were compared with final diagnoses to assess disease categories discussed and the value of including outpatient follow-up in this educational forum. Data were obtained during morning reports for 6 months by chief residents at university and private community hospitals. Pertinent history, physical examination, and laboratory and radiologic findings were recorded and were assigned a tentative morning report diagnosis based on morning report discussion. Cases were then reviewed at discharge and at 6 months to determine final diagnoses. At the university hospital, 58% of the cases were undiagnosed before presentation at morning report. Of those cases, 23% were assigned a diagnosis at morning report that differed from the final diagnosis. Similarly, at the private community hospital, 28% of cases were undiagnosed before presentation at morning report. Of those cases, 73% were assigned a diagnosis that differed from the final diagnosis. We conclude that the provision of follow-up at morning report is important for maximizing resident education.     

Living with breast cancer: care givers'' perceptions in a surgical ward

OBJECTIVE: To investigate the development of illness concepts among healthy Icelandic children. METHODS: Participants were 68 schoolchildren, 6-7, 10-11, and 14-15 years of age, and their parents. Cognitive developmental level and understanding of physical illness were assessed within a Piagetian framework. In addition, illness experience and illness behaviors (Child Illness Behavior Questionnaire) were assessed. RESULTS: Results were consistent with previous studies in that the development of illness concepts among Icelandic children was consistent with Piaget's theory of cognitive development. No relation was found between illness experience and understanding of illness. A more mature understanding of illness was related to willingness to report the onset of illness. CONCLUSIONS: The results suggest that findings from previous studies may be generalized to a broader population.     

Fathers and breast feeding: a pilot observational study

A small pilot survey (n = 113) by questionnaire of the fathers of a sample of children under one year of age was undertaken in order to investigate the involvement of fathers with infant feeding and their attitudes to the method of feeding adopted. The response rate was 72% overall and 79% when the partners of 'single parent' mothers were excluded. Nearly 30% of respondents had not discussed the method of feeding with anyone, but over 60% had discussed it with their partner. 64% of fathers sometimes helped with feeding their child and 17% said that they always helped. The majority of fathers did not mind their partner breast feeding in front of friends or relatives but 42% did not like them feeding in front of strangers and over half did not like them breast feeding in a public place. From this study, based on relatively small numbers, we conclude that fathers may feel left out of infant feeding. They should be given more opportunity to become involved from an early stage and take part in the decision about the method of infant feeding to be adopted.     

Promotion of breast feeding: effect on neonates of change of feeding routine at a maternity unit

The effect on the health of neonates of a change in neonatal routine care, including general rooming-in, breast feeding on demand and avoidance of supplementary bottle feeding was studied in conjunction to a breast feeding campaign at a maternity unit. There was an accentuated weight loss in the neonatal period during ad libitum breast feeding. The mean serum bilirubin of clinically jaundiced infants was slightly higher on a 4-hourly feeding schedule with supplementary bottles than on the new regimen. There was a similar high (32-33%) incidence of bilirubin levels greater than 205 mumol/l (12 mg/100 ml) in both groups. The incidence of spontaneous hypoglycaemia did not differ in the two groups. The new feeding regimen was thus considered safe. Infants at risk for hypoglycaemia were given supplementary bottles and were excluded from the study.     

Nursing across cultures: the Vietnamese client

Asian Americans are the most rapidly growing immigrant group in the United States today. Home care nurses will be caring for increasing numbers of patients originating from the Southeast Asian peninsula in the countries of Vietnam, Cambodia, and Laos. A Vietnamese case study explores some of the beliefs, values, and practices held by this group of Asian Americans. The case study highlights the problems that can occur when a nurse is unaware of the impact that culture has on a client from a different ethnic and cultural background. Six steps to provide culturally competent care are outlined.     

Cross-Cultural Equivalence and Validity of the Vietnamese MMPI-2: Assessing Psychological Adjustment of Vietnamese Refugees.

The cross-cultural equivalence and validity of the Vietnamese translation of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were examined in a sample of 1st-generation Vietnamese refugees in the United States (N = 143). Respondents completed the Vietnamese MMPI-2, the Harvard Trauma Questionnaire, a measure of acculturation, and a demographic questionnaire. An inspection of MMPI-2 mean profiles and items showing extreme endorsement rates suggested that certain symptom tendencies and cultural values may be reflected in responses to some MMPI-2 items. Older age, lower acculturation, greater experienced premigration-postmigration traumas, and military veteran status were all associated with elevated MMPI-2 profiles, suggesting that the MMPI-2 functions in a reasonably equivalent and valid way in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)