Consumer health information services in the hospital setting

Before planning for provision of Consumer Health Information Services, the librarian and administration must anticipate the problems encountered in sharing funds, personnel, space, and materials with an existing medical or patient education library. Establishing new space within or outside the hospital, or participating in community projects which meet consumer health information needs, are important considerations for planners. This article sets forth the place of some CHI services in the hospital setting, and how they relate to other library services. Differences between hospital library support for Patient Education and for Consumer Health Information services are discussed.     

The birth plan revisited

In answer to a reader's question, the author of this column discusses moving birth plans beyond a check list of options to a plan of evolving confidence, support-building, and comfort.     

Really teaching lamaze: the power of pain

In response to a reader's question, this column discusses the benefits and uses of pain to facilitate childbirth. Childbirth educators are urged to help women understand pain, so that they may work with pain and appreciate the role it plays in providing them with the inner wisdom to give birth.     

Lamaze breathing: what every pregnant woman needs to know

Lamaze breathing historically is considered the hallmark of Lamaze preparation for childbirth. This column discusses breathing in the larger context of contemporary Lamaze. Controlled breathing enhances relaxation and decreases perception of pain. It is one of many comfort strategies taught in Lamaze classes. In restricted birthing environments, breathing may be the only nonpharmacological comfort strategy available to women. Conscious breathing and relaxation, especially in combination with a wide variety of comfort strategies, can help women avoid unnecessary medical intervention and have a safe, healthy birth.     

Relating deaf students' reading and language scores at college entry to their degree completion rates

Graduation patterns were examined for 905 deaf students (1990-1998) at the National Technical Institute for the Deaf. Students with higher reading and language skills had the best overall graduation percentage. Comparison of recipients of different degrees--bachelor of science (BS) versus fine arts (BFA); associate of applied science (AAS) versus occupational studies (AOS)--showed 92% of BS and 82% of AAS graduates reading at the 9th-grade level or above, versus 65% of BFA and 47% of AOS graduates. Interestingly, 80% of non-degree-earning students read at the 9th-12th grade levels; in absolute terms, they outnumbered graduates with similar reading skills in the AAS and BFA programs combined, and in the BS program. This indicates a need for improved counseling, placement, and retention strategies. Students performed similarly across degree categories, regardless of curriculum requirements and difficulty. Only non-degree-earning students had significantly lower grade averages.     

The lamaze certified childbirth educator: standards of practice

A student in a Lamaze Childbirth Educator Program expresses concern that some Lamaze Certified Childbirth Educators (LCCE educators) do not teach classes that reflect Lamaze standards. In this column, the ethical and professional standards of the LCCE educator and the challenges the childbirth educator experiences while practicing in the current maternity-care environment are presented and discussed. Lamaze International's Code of Ethics for Lamaze Certified Childbirth Educators provides guidance when dealing with these challenges.     

Teachers' education, classroom quality, and young children's academic skills: results from seven studies of preschool programs

In an effort to provide high-quality preschool education, policymakers are increasingly requiring public preschool teachers to have at least a Bachelor's degree, preferably in early childhood education. Seven major studies of early care and education were used to predict classroom quality and children's academic outcomes from the educational attainment and major of teachers of 4-year-olds. The findings indicate largely null or contradictory associations, indicating that policies focused solely on increasing teachers' education will not suffice for improving classroom quality or maximizing children's academic gains. Instead, raising the effectiveness of early childhood education likely will require a broad range of professional development activities and supports targeted toward teachers' interactions with children.     

Fetal heart rate and variability: stability and prediction to developmental outcomes in early childhood

Stability in cardiac indicators before birth and their utility in predicting variation in postnatal development were examined. Fetal heart rate and variability were measured longitudinally from 20 through 38 weeks gestation (n = 137) and again at age 2 (n = 79). Significant within-individual stability during the prenatal period and into childhood was demonstrated. Fetal heart rate variability at or after 28 weeks gestation and steeper developmental trajectories were significantly associated with mental and psychomotor development at 2 years (n = 82) and language ability at 2.5 years (n = 61). These data suggest that the foundations of individual differences in autonomic control originate during gestation and the developmental momentum of the fetal period continues after birth.     

Infant joint attention, temperament, and social competence in preschool children

Infant joint attention has been observed to be related to social-emotional outcomes in at-risk children. To address whether this relation is also evident in typically developing children, 52 children were tested at 12, 15, 24, and 30 months to examine associations between infant joint attention and social outcomes. Twelve-month initiating and responding to joint attention were related to 30-month social competence and externalizing behavior, even when accounting for 15-month temperament ratings, 24-month cognition and language, and demographic variables. These results suggest that, in addition to associations with language and cognition, infant joint attention reflects robust aspects of development that are related to individual differences in the emergence of social and behavioral competence in childhood.     

The mediating role of intention and stages of change in physical activity among adults with physical disabilities: an integrative framework

The study's purpose was to identify the mediating role of intention and the stages of change (SOC) in physical activity (PA) over a 6-month period using two models (theory of planned behavior [TPB] and TPB/SOC). Participants were 143 adults with physical disabilities (70.68% response rate; M age = 46.03). The TPB constructs, SOC (time 1), and PA (time 2) were assessed using standardized self-report questionnaires. Based on path analyses, attitude had the highest effect on intention and SOC followed by perceived behavioral control within both well-fit models. The variance in PA explained by the first (TPB) and second (TPB/SOC) models was 16% and 28% respectively. In the just identified model of TPB/SOC, the direct effect of SOC on physical activity remained strong (gamma(soc.pa) = .45) and SOC approached full mediation through attitude. Health promotion interventions need to include both intention and behavior elements (SOC) reinforcing increased PA value and barrier elimination.