Two prenatal alcohol use screening instruments compared with a physiologic measure.

OBJECTIVE: To compare two prenatal alcohol use screening instruments with a physiologic measure of prenatal alcohol use. DESIGN: Retrospective comparison of the Prenatal Alcohol Use Interview (PAUI) and the ACOG Antepartum Record with CDTect. SETTING: An inner-city, high-volume, prenatal clinic. PARTICIPANTS: Fifty-six women selected and enrolled at their first prenatal visits. MAIN OUTCOME MEASURE: An assessment of relative sensitivity and specificity of two prenatal alcohol use screening instruments. RESULTS: Women identified as Drinkers by the CDTect were more likely to be identified as Drinkers by the PAUI (59%) than by the ACOG Antepartum Record (19%). Also, the PAUI had a lower false negative rate (41%) than the ACOG record (80%). That is, the PAUI was less likely to identify as Quitters women the CDTect identified as Drinkers than was the ACOG record. CONCLUSION: The PAUI is a more sensitive screen than the ACOG record and should be the instrument preferred for screening prenatal alcohol use.

The economics of electronic journals.

High print journal subscription costs, access to desktop publishing software, and awareness of Internet capability are among several reasons that interest in the electronic publishing of scholarly journals is increasing rapidly. The economic considerations of electronic publishing are not as familiar, however, although the fingertip accessibility of electronic journals, and in some cases, the lack of subscription charges gives the impression that electronic journal publishing is a much less costly means of publishing. Such an impression receives qualified confirmation in this article as an overview of the costs of scholarly publishing is provided, and the costs of print and electronic journals are compared. Also addressed are ways to recover costs of publishing electronic journals, and predictions for the future of such journals.

Psychometric analysis of the self-coherence survey.

Self-coherence, as measured by the Self-Coherence Survey, is an important determinant of psychosocial health in a variety of life circumstances. This report presents a psychometric analysis of the Self-Coherence Survey that resulted in three scales labelled Appraisal, Holism, and Introspection. The factorial structure, reliability, and validity of Self-Coherence was evaluated and replicated in two samples from the same community population (Phase I n = 433; Phase II n = 421). The three dimensions identified in the theoretical discussion of self-coherence published in this journal in 1993, were identified and replicated. Implications for further research and nursing practice are discussed.

Perinatal substance use: promoting abstinence in acute care settings.

All health-care providers need to understand the effects of alcohol, nicotine, and other drugs on the mother and developing fetus and the ways to promote abstinence or at least a decrease in use. The use of these substances may produce chronic and/or catastrophic effects that force the pregnant woman into contact with the health-care system. Such contact can produce a healthier outcome for both the mother and fetus if it includes identification of substance use and intervention to promote abstinence. In this article, the author describes the consequences of prenatal substance use for the mother and fetus, identifies techniques used to screen and assess prenatal substance use, and explains strategies used to intervene in prenatal substance use.

Self-coherence: theoretical considerations of a new concept.

The concept of self-coherence holds promise for nurse scholars interested in building psychosocial health theory. Self-coherence, a developmental personal resource that has been found to be related to psychosocial health, was conceptualized from a holistic health perspective. The assumption was made that humans, as open systems, continually strive toward order and self-differentiation by acquiring knowledge, structuring cognitive schemata, and choosing strategies to process environmental stimuli. Self-coherence was conceived of as a cognitive structure used during the process of perception or interaction with the environment. Should such interaction be stressful and tension creating, self-coherence would facilitate coping by bringing to the present experience self-awareness of one's responses to past experiences with the environment, and current motivations and goals, thereby reducing tension. The theoretical underpinnings of the concept are addressed including the genesis, the three conceptual domains, and the theoretical definition of self-coherence.