Teaching guatemala midwives about postpartum hemorrhage.

PURPOSE: To evaluate the effect of a culturally sensitive teaching unit on traditional midwives' knowledge of nursing interventions to prevent and treat postpartum hemorrhage (PPH). METHODS: Sixteen midwives participated in a 1-day training program at a Refuge International Health Clinic in the remote town of Sarstun, Guatemala. The quasi experimental study used a one-group, pretest-posttest design. Researchers used a PPH Behavioral Checklist from the American College of Nurse Midwives (ACNM) to assess and compare knowledge of PPH interventions before and after the PPH teaching. RESULTS: The final analysis included 13 traditional midwives as the subjects. The culturally sensitive teaching improved traditional midwives' knowledge and skills about nursing interventions to manage PPH (pretest M = 1.385/8, posttest M = 4.846/8). CONCLUSIONS: Results of this pilot project suggest a culturally sensitive oral teaching in the primary language of the participants positively affects traditional midwives' knowledge and skills to manage PPH. Future training should be presented in a similar format to meet the needs of illiterate audiences in resource-poor settings.

BMI and lipid levels in Mexican American children diagnosed with type 2 diabetes.

PURPOSE: The purpose of this study was to determine potential associations between obesity as measured by body mass index (BMI) and lipid values in Mexican American (MA) children diagnosed with type 2 diabetes. BACKGROUND: Obesity in children is considered to be an emerging epidemic that is accompanied by an increase in prevalence of type 2 diabetes. Literature shows that there is a direct and strong relationship between abnormal lipid levels and obesity in Caucasian and African American children without type 2 diabetes. However, it was unknown whether Mexican American children diagnosed with type 2 diabetes have abnormal lipid levels. METHOD: A retrospective medical-record review was conducted on paediatric patients who received medical care from a military medical centre in the Southwest region of the United States. A convenience sample of records was used to study the relationship between obesity as measured by BMI and lipid levels in 49 Mexican American children diagnosed with type 2 diabetes. Total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), and BMI were reviewed. Data were analysed using descriptive and logistic regression statistics. FINDINGS: Ninety percent of the sample was obese and 75% had two or more abnormal lipid values. Abnormal levels of total cholesterol, HDL, and triglycerides were found to be statistically significant. CONCLUSIONS: The main findings indicate that MA children diagnosed with type 2 diabetes had significant associations between obesity as measured by BMI and abnormal total cholesterol, HDL, and triglyceride levels. As the BMI increased, the probability of abnormal total cholesterol and triglyceride levels increased. Similarly, as the BMI increased, the probability of abnormal HDL values increased. Mexican American children in this study had obesity levels similar to those in a study by the National Center for Health Statistics. In this study a step has been taken toward understanding a physiologic marker for cardiovascular disease in children.