The introduction of midwifery in Ontario, Canada.

Midwives in Ontario, Canada, currently have no legal status. After an announcement in 1986 that the government would recognize them, an extensive planning period ensued. Groups of health care providers, consumers, and government representatives were active participants in formulating plans to integrate midwives into the centrally organized health care system in Ontario. Efforts to introduce legislation, establish a regulatory framework, and develop an educational program are well developed, but legalized practice must yet be realized.

Influences of the social network on choice and duration of breast-feeding in mothers of preterm infants.

A prospective analytic study was conducted to examine the influences of the social network on the choice and duration of breast-feeding among 125 mothers of preterm infants. The Influence of Specific Referents (ISR) Scale was used to measure mothers' perceptions of the wishes of seven social referents regarding feeding choice and to assess mothers' motivation to comply with their referents' wishes. Referents included family members, friends, and health care professionals. Mothers choosing to breast-feed reported greater influence from referents than those choosing to formula-feed. Among the 88 mothers who initiated breast-feeding or expression, the number of supports reported by mothers was the most influential factor on duration of lactation. Women with no source of support were six times more likely to cease lactation than women with six sources of support.

Disseminated aspergillosis in a patient with ocular reticulum cell sarcoma.

A 75-year-old healthy woman developed uveitis and chorioretinal infiltrates OD compatible with reticulum cell sarcoma. She was admitted to hospital 18 months later with somnolence and confusion. Examination revealed diffuse white matter hypodensity on computed tomography and a persistent cerebrospinal fluid pleocytosis. At necropsy reticulum cell sarcoma was found in the right globe and Aspergillus fumigatus was present in almost every other organ, including the brain.

Needle catheter duodenostomy: a technique for duodenal alimentation of birds.

A technique for duodenal alimentation (needle catheter duodenostomy) of birds was developed, using the domestic pigeon (Columba livia) as the experimental model. A needle catheter was inserted into the descending duodenum of 5 pigeons and was secured to the body wall and dorsum of each bird. A liquid diet was administered daily (in equal amounts of 0, 4, 8, 12, and 16 hours) for 14 days without adverse effects. On day 15, the catheters were removed, and the birds immediately resumed normal consumption of a pigeon ration and water diet. Although 4 of the 5 birds had minor weight loss, dietary alterations probably could be used on an individual basis to alleviate this problem. After oral alimentation was resumed, the 5 birds exceeded their initial body weight within 7 days. Four weeks after catheter removal, positive-contrast radiographic evaluations indicated that the duodenum of each pigeon appeared normal. Needle catheter duodenostomy was a viable method of alimentation in the domestic pigeon. This technique should be applicable for other avian species requiring bypass of the upper gastrointestinal tract proximal to the region of catheter insertion in the duodenum.

Inaccurate reaching associated with a superior parietal lobe tumor.

A man with a tumor in the right superior parietal lobule had difficulty reaching for visualized objects. There were no significant deficits in visual sensation, visual attention, somatosensory function, elementary motility, praxis, or visuospatial performance. If allowed to visually fixate the target before reaching, he misreached only with his left arm and only when he was not allowed to observe the reaching limb. If he was required to maintain central visual fixation while reaching into his peripheral visual fields, his left arm misreached into both visual hemifields but his right arm misreached only into the left visual hemifield. These results demonstrate abnormalities, referable to both the contralateral arm and the contralateral visual field, that can neither be reduced to elementary disturbances of visual or somatosensory function nor to an elementary disturbance of motility. This pattern of misreaching has not been previously reported in human subjects or in experimental animals, but this may be attributable to differences of methodology. The misreaching observed in this patient may correspond to loss of posterior parietal neurons serving a supramodal integrative function.