Emergency health surveillance after severe flooding in Louisiana, 1995.

INTRODUCTION: In disaster situations, timely surveillance systems that provide illness, injury, and mortality information to public health officials and hospitals are essential for planning and evaluating interventions. OBJECTIVES: To describe flood surveillance methodology, the impact of the event on hospitals, and the number of daily patient visits due to selected illnesses and injuries before, during, and after severe flooding in southeastern Louisiana in May 1995. METHODS: Survey of disaster-area hospitals regarding flood impact. Emergency department surveillance of injuries and illnesses for the week before, the two days during, and the week after the flood. RESULTS: There occurred an increase in the number of persons who drowned or were injured that presented to the moderately affected hospitals during the storm, but there was no increase in visits for gastroenteritis to any group of hospitals. Services were disrupted in more than half of hospitals. The severely affected hospitals had the least variation in the average number of daily visits. None of the drownings were reported by those hospitals that reported severe service disruption. CONCLUSIONS: Data should be collected from all hospitals in or near disaster areas, even if they were not directly affected by the disaster. Public education about the danger of drowning during flash flooding must be improved. The Louisiana experience emphasizes the need for a disaster-preparedness plan for rapid surveillance of illnesses and injuries.

Effectiveness of primiparae and multiparae at soothing their newborn infants.

To examine the effectiveness of new parents at soothing their infants, the authors filmed primiparae (20 mothers, 20 fathers) and, for comparison, multiparae (25 mothers, 25 fathers) during an interaction with their crying 2- to 3-day-old infants. Data were derived from loudness ratings of the infants' distress signals and by measuring the time it took parents to quiet their infants. In addition, specific parental behaviors were coded by microanalysis. From these data, measures of soothing effectiveness and behavioral profiles were derived. Data analyses showed that most primiparae were effective at soothing their infants' cries and that there were no parity effects on measures of soothing effectiveness. However, mothers, regardless of parity, were more effective at quieting their infants than were fathers, and there were significant differences in mothers' and fathers' caregiving behaviors. These data suggest that primiparae are effective at quickly soothing their newborns and that their skill, as measured, does not depend on parenting experience. Moreover, the data point to significant differences in mothers' and fathers' competence at quieting their newborns whether or not they are experienced at parenting.

Migration of di-(2-ethylhexyl) phthalate from PVC child articles into saliva and saliva simulant.

A simple migration test and a more complicated simulation of children's sucking and biting was used to establish migration of DEHP from PVC child-use articles into saliva and compared to a mimic test. The static migration test of a film containing approximately 30% DEHP with saliva simulant gave the lowest values of DEHP; simple shaking increased the amounts of DEHP from 25 +/- 8 to 499 +/- 153 micrograms/g film. The more complicated arrangements to simulate sucking and biting are not so suitable for standard applications. When comparing the in vitro migration tests with the mimic test the factors were 25 and 29 for the static tests (3 and 6 hours) and 1.4 for the shaking test.

Revising nursing documentation to meet patient outcomes.

Often, complex documentation forms place unnecessary burdens on nurses. A change in one hospital's patient care forms contributes to positive outcomes. With the revised documentation, nurses spend more time caring for patients while still meeting the Joint Commission on Accreditation of Healthcare Organizations' requirements.

Patients', nurses', and physicians' perceptions of nurses' caring behaviors.

The purpose of this study was to identify how patients, nurses and physicians in a coronary care setting rank the importance of different nurse behaviors related to caring. The study was descriptive and used Q Methodology characterized by a forced choice format and priority rankings. Analysis of the mean scores for each subset of subjects revealed two items within the top five for all three subgroups. Comparison of this studies findings with previous studies showed similarities among patient rankings but little agreement among nurses regarding what constitutes caring behavior. Implications for practice, administration, research and education are identified.

Controversy in the management of optic pathway gliomas. 29 patients treated with radiation therapy at Baylor College of Medicine from 1967 through 1987.

The optic gliomas of 29 patients, including 14 with von Recklinghausen neurofibromatosis (NF-1), were subjected to X-ray therapy. The data indicate a projected 20-year survival rate of 92% for all 29 patients. Moreover, among the NF-1 patients, 86% were stabilized or improved, while among non-NF-1 patients, only 47% stabilized or were improved. Thus, these data suggest that there are differences in the biophysiological behavior of optic nerve gliomas in patients with NF-1, and, as well, that there is a salutary response to radiation treatment as measured by improvement or stabilization of vision, with and without radiologic evidence of concomitant tumor regression.