Violence during pregnancy.

Abuse of pregnant women is a solvable health problem. The social image of pregnancy as a time of nurturing, love, and caring must be re-examined, because the evidence sadly is present that for many women abuse characterizes their pregnancies. Routine assessment of abuse with a planned intervention for all women is essential to break the cycle of violence and must be standard care for all women regardless of whether the setting is primary or tertiary care.

Cognitive nursing interventions with long-term care residents: effects on neurocognitive dimensions.

We recently reported that cognitive nursing interventions--such as cognitive-behavioral group therapy and focused visual imagery group therapy--administered over time may produce significant and lasting improvements in overall cognitive status in nursing home residents with slight to moderate cognitive impairment, when compared with subjects participating in educational discussion groups. To further elucidate the cognitive gains made by subjects, we reanalyzed the data focusing on the 15 neurocognitive parameters tested by means of the Modified Mini-Mental State Examination. Main effects of intervention were noted on neurocognitive operations involving abstraction and conceptual thinking, concentration and linguistic manipulation, and execution of auditorily presented language skills. Main effects for time were observed on short and medium term recall, fluency of category retrieval, abstraction and conceptual thinking, concentration and linguistic manipulation, and execution of visually presented commands. Intervention and time were found to produce interaction effects on subjects' ability to visually and linguistically identify objects and their praxic ability to recognize and redraw simple but intersecting geometric figures. From a functional brain perspective, these effects involved brain functions at higher cortical and subcortical/limbic levels, and lower and more basic cortical functions were not affected. These findings underscore the role of psychogeriatric nursing in maintaining or restoring cognitive function in nursing home residents with mild to moderate cognitive impairment, not only for the sake of cognition itself but also for the (corollary) sake of promoting functional independence and self-care in a high-risk population.