Strategies for addressing the public health problem of depressive symptoms in mid-pregnancy will benefit from a life course perspective.

This work focuses on an emerging concept in nursing ethics--moral distress. Unlike an ethical dilemma where one does not know the right thing to do, in contrast, moral distress occurs when one knows the right thing to do but is constrained by the institution or one's coworkers in doing it. Moral distress is a process that involves recognition that a decision is difficult to act upon; the experience of emotional distress inherent in that situation; choosing strategies; and then acting. Whistle blowing and collaborative practice models both provide strategies for moral action in moral distress situations. Less dramatic and quieter forms of moral action will also be examined. Finally, developing the strength to move from moral distress to moral action will be discussed, as well as research implications for this emerging ethical issue.

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Efforts to improve rates of breastfeeding in this country to meet year 2010 goals must consider the many contextual factors that influence feeding. Interventions to promote breastfeeding should exceed the individual level, and occur at many layers simultaneously. The ecological model provides direction for the multiple interventions needed to increase rates and duration of breastfeeding.