Occupational therapy practitioners should consider screening their older adult clientele for fear of falling, anxiety, and depression because these states may lead to fall risk and activity restriction.

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Idiopathic apnea of prematurity remains a major clinical problem that requires treatment. For three decades, methylxanthines (caffeine and theophylline) have remained as the primary treatment choice. Several studies have shown the effectiveness of doxapram in reducing apnea refractory to methylxanthines, but numerous side effects have been reported, so that its use remains controversial. In this study, we examined a novel therapy in the form of olfactory stimulation in premature newborns suffering from apnea refractory to caffeine. Thirteen premature newborns born at 28 to 31 gestational weeks were exposed to a pleasant odor diffused during 24 hours in the incubator. A reduction of the number of apnea during the day with odorization compared to the day before (baseline) or the day after (recovery) occurred in all infants. In mean, the reduction reached 42%. Particularly, the apnea associated with episodes of bradycardia and hypoxemia decreased strongly (49%) and affected all the infants. Due to this reduction, no additional treatment with doxapram was necessary. Taken together, these data indicate that the introduction of a pleasant odor in the incubator is of therapeutic value in the treatment of apnea unresponsive to caffeine and give a new possibility to reduce the use of the controversial doxapram. Aims To evaluate maternal ethnicity as a factor reported to increase the risk of shoulder dystocia, and to evaluate its predictive value at a population level. Methods We conducted a retrospective cohort study of 252 singleton, vertex vaginal deliveries with diagnosed shoulder dystocia born at North Middlesex University Hospital in London, UK. Maternal ethnicity was examined along with maternal characteristics, induction and length of labour, operative vaginal delivery, epidural utilisation, and birth weight. These variables were analysed as factors affecting incidence of shoulder dystocia and subsequent neonatal injury. Results Among women who met study criteria, 252 (2.4%) experienced a shoulder dystocia. Women of black ethnic background (African and Afro-Carribean) had the highest percetage of shoulder dystocia (43.8%), compared with White background (39.5%) and the lowest was amongst women of Asian background (16.6%). Additionally, in the setting of a shoulder dystocia, a higher risk of brachial plexus injury was observed in neonates delivered by women of Black background taking in to account confounding factors such as birth weight, gestational diabetes and previous shoulder dystocia. Conclusions Overall women of black background have an increased risk of shoulder dystocia and their neonates are more likely to experience birth injury subsequently. Induction of labour and infant birth weight greater than 4000g have traditionally been identified as significant independent predictors of shoulder dystocia; however ethnicity should be taken into account when considering caesarean section as prophylaxis against shoulder dystocia and neonatal investigations for possible brachial plexus injuries post birth. THE RELAT...