Baseline prevalence of heart diseases, hypertension, diabetes, and obesity in persons with acute traumatic spinal cord injury: potential threats in the recovery trajectory.

BACKGROUND: Chronic diseases impede the recovery trajectory of acutely injured persons with traumatic spinal cord injury (TSCI). This study compares the odds of prevalent heart disease, hypertension, diabetes mellitus, and obesity between persons with TSCI and persons with lower extremity fractures (LEF) who were discharged from acute care facilities. METHODS: 1,776 patients with acute TSCI (cases) and 1,780 randomly selected patients with LEF (controls) discharged from January 1, 1998, through December 31, 2009, from all nonfederal hospitals were identified. Data extracted from uniform billing files were compared between cases and controls in a multivariable logistic regression model controlling for sociodemographic and clinical covariables. RESULTS: Thirty percent of patients with acute TSCI had at least 1 of 4 conditions compared with 18% of patients with LEF (P < .0001). Persons with acute TSCI were 4 times more likely (odds ratio [OR], 4.05; 95% CI, 1.65-9.97) to have obesity, 2.7 times more likely to have heart disease (P < .001), 2 times more likely to have hypertension (P < .001), and 1.7 times more likely to have diabetes (P = .044) at the onset of TSCI. Disproportionately more Blacks than Whites have TSCI and chronic diseases. CONCLUSION: This study suggests that there is an increased burden of cardiovascular and cardiometabolic diseases among persons with acute TSCI compared with LEF trauma controls. Unattended comorbid conditions will affect quality of life and the recovery process. This warrants continuous monitoring and management of chronic diseases during the rehabilitation process.

Implementing a multidisciplinary disaster simulation for undergraduate nursing students.

A liberal-arts-based undergraduate nursing program engaged in curriculum enhancement activities that led to the implementation of a disaster simulation for 81 multidisciplinary undergraduate students. A pretest/posttest design was used to determine the effectiveness of preparation for the simulation. Nursing students in three levels of the program received didactic preparation in disaster preparedness and were assigned to five different simulation response teams. One-way ANOVA revealed statistically significant differences for pretest and posttest scores, p = 0.05. An evaluation of student performance indicated that five of the eight nursing students assigned to the disaster site correctly triaged 81.2 percent of the victims; all eight nursing students assigned to the emergency department correctly reassessed the victims. Classroom didactic content, followed by a simulated learning experience, was found to be an effective teaching strategy for preparing undergraduate nursing students in disaster preparedness.

Prevalence, predictors, and attitudes toward cosleeping in an urban pediatric center.

Cosleeping is the normative practice in many of the world's societies but is not endorsed by the Consumer Products Safety Commission or by the American Academy of Pediatrics. A survey was performed on 101 caregivers in an urban setting, designed to assess the prevalence of cosleeping and parental attitudes for this practice. Cosleeping rate was 88% with predictors being as follows: single parent (p=0.006), high school or less education (p=0.035), 2 or fewer rooms used for sleeping (p=0.023). A majority (65%) stated that cosleeping was acceptable.