ABSTRACT
OBJECTIVE: To assess the characteristics of heat-related deaths in Wisconsin during the summer of 1999. METHODS: Review of death certificates indicating heat as an underlying or contributing cause of death. RESULTS: Heat-related illness led to 21 deaths during the summer of 1999 in Wisconsin. The rate of death was highest in the elderly, particularly those aged 65-84 years (2.2/100,000). Heat was the underlying cause for 12 of the 21 deaths. Cardiovascular conditions were the underlying cause in 8 of the deaths, and a contributing cause for another 7. CONCLUSIONS: The elderly, persons taking psychotropic medications, and persons with chronic diseases, particularly cardiovascular conditions, are at increased risk of death from heat during heat waves. Prevention messages and weather advisories during heat emergencies must target these groups. Care givers and medical personnel must be on heightened awareness for the signs and symptoms of heat exhaustion and heat stroke during these periods.
Subject(s)
Heat Stress Disorders/mortality , Age Factors , Aged , Aged, 80 and over , Female , Heat Stress Disorders/diagnosis , Heat Stress Disorders/therapy , Humans , Male , Middle Aged , Risk Factors , Wisconsin/epidemiologyABSTRACT
The Abbott LCx Neisseria gonorrhoeae assay (Abbott Laboratories, Abbott Park, Ill.) uses a ligase chain reaction (LCR) amplification in the LCx probe system for detection of a specific nucleotide sequence in the Opa-encoding gene of N. gonorrhoeae. We evaluated the LCx assay in a comparison with conventional culture employing modified Thayer-Martin media for the detection of N. gonorrhoeae from female endocervical specimens obtained from patients attending a sexually transmitted disease clinic. Discordantly LCR-positive and culture-negative specimens were further evaluated by testing with another LCR assay which used an N. gonorrhoeae-specific pilin probe. Specimens positive by both LCR assays were considered confirmed LCx-positive specimens. A specimen was considered to contain N. gonorrhoeae when it was either culture positive or culture negative and confirmed LCx positive. A total of 403 female endocervical specimens were evaluated. The prevalence of N. gonorrhoeae in this population was 8.7%. The sensitivity and specificity of the LCx assay were 94.3 and 99.4%, and those of culture were 77.1 and 100%, respectively. The Abbott LCx assay is a rapid, sensitive method for detection of N. gonorrhoeae in female endocervical specimens.
Subject(s)
Cervix Uteri/microbiology , Neisseria gonorrhoeae/isolation & purification , Female , Humans , Sensitivity and SpecificitySubject(s)
Clinical Clerkship , Pediatrics/education , Public Health/education , Ambulatory Care , Child , Curriculum , Humans , WisconsinABSTRACT
BACKGROUND: Although the concept of community-oriented primary care (COPC) has generally been favorably viewed, it does not appear to have been widely applied. Further development of COPC will depend on data regarding the extent of knowledge about COPC, of COPC application and training, and of perceived obstacles to its use. METHODS: Surveys of 200 randomly selected board-certified family physicians and 120 randomly selected family practice residency programs were conducted to determine the state of knowledge and use of COPC. RESULTS: Sixty percent of the physicians and 81% of the training programs responded. Approximately 75% of the responding physicians and 25% of the program directors had not heard of COPC. Despite this, COPC is viewed positively, and some elements of a COPC approach are part of many practice and training sites. Respondents identified several needs for information on COPC, including more information about COPC, practical models of its use, improved methodology of its application, and demonstrations of its efficacy. CONCLUSIONS: COPC is seen as an attractive theoretical model. However, more extensive application of this approach will require more familiarity with the concept, the development of practical methodology and models for its use, and demonstrations of its efficacy.
Subject(s)
Community Medicine/education , Family Practice/education , Internship and Residency , Physicians, Family , Primary Health Care , Adult , Attitude of Health Personnel , Data Collection , Humans , Models, Theoretical , United StatesABSTRACT
Continuity of nursing care between the preoperative and postoperative phases of the patient with congenital heart disease is the goal of the perioperative nurse. Good assessment and planning are essential to efficient participation in the various stages of the operative course, from premedication to transport to the ICU.
