A perinatal intervention program for urban american indians part 1: design, implementation, and outcomes.

High infant mortality rates among American Indians are disproportionate to state statistics for other races and higher than the national average. These findings prompted a community health center in a large Midwestern city to create and provide an American Indian infant mortality reduction project in the early 1990s. Strategies for program implementation included networking with local organizations, communicating with reservation health clinics throughout the state, educating American Indian mothers and their community about factors contributing to American Indian infant mortality, and providing individual case management to American Indian women and infants. We offer this article for three reasons: This grant project was successful, disparity in rates of infant mortality among peoples of color continues, and a paucity of information exists about the health behaviors of American Indian women.

Caring together for elderly mothers: a qualitative study of relations between adult daughters and supportive home care workers.

This qualitative study examines relationships between adult daughters caring for elderly disabled mothers and the mothers' personal care workers (PCWs) paid directly by the Wisconsin Community Options Program (COP). A subset of a larger study, in these five cases PCWs provide substantial hands on care without substituting for the heavy care also provided by the daughters. Direct payment offers the daughters and workers freedom to schedule around their family obligations and other limits and tailor care to the abilities of all three participants. It also allows the daughter to be the paid provider when she chooses. Expansion of such supportive services could benefit many more low and middle income families.

Hypoxaemia and cirrhosis of the liver.

In order to determine the frequency of hypoxaemia and to evaluate the role of increased closing capacity in producing hypoxaemia in patients with cirrhosis of the liver, 13 patients with well-established cirrhosis were studied. Arterial blood gases, spirometry, lung volume, and closing capacity measurements were made with the patients in the seated and recumbent positions after exclusion of cardiopulmonary dysfunction. Four of 13 and six of 12 patients exhibited significant hypoxaemia in the seated and recumbent positions respectively. Five of 13 patients showed a closing capacity greater than predicted. This frequency of increased closing capacity was not higher than in a group of smokers of the same age. Unlike Ruff et al. (1971), we did not find a consistent relationship between hypoxaemia and closing capacity.