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Biomedical subjects

S Coffman

Publications and source records attributed to S Coffman.

At least 19 recordsLinked to original sources
PubMed1998

Perceptions, safety behaviors, and learning needs of parents of children brought to an emergency department.

INTRODUCTION: This study was conducted at a level II Pediatric Trauma Center to assess the perceptions, safety behaviors, and learning needs of parents who brought their children to the emergency department. METHODS: Surveys were distributed in the emergency department, and 412 parents/caretakers responded. A descriptive design provided the framework for data analysis. RESULTS: A profile of caretakers of children in three age groups (1 to 4, 5 to 12, and 13 to 15 years) emerged. Whereas most parents and older children knew how to call 911, only half of the parents knew child CPR. Parents tended to underestimate their children's risks for motor vehicle-related and immersion injuries and were more concerned about kidnapping and assault. Less than half of the parents believed that most injuries can be prevented. Learning needs were indicated by 34% of parents, and CPR was mentioned most frequently. Parents' desires for learning tended to focus on care after injuries happened. DISCUSSION: Health professionals need to spend more time teaching parents about the link between child development and risks for injury, to emphasize prevention. Interventions based on study results include the hospital Safety Helmet Discharge Plan.

Adolescent↗
PubMed1998

Children's reactions to disaster.

Children's reactions to disaster are influenced by their developmental stage, as well as by situational, personal, and family factors. This review describes children's experiences during man-made and natural disasters and uses drawings and narrative to illustrate specific reactions. Mental health outcomes, including post-traumatic stress disorder, are identified, as are approaches to working with children and families after disaster.

Adaptation, Psychological↗
PubMed1998

Parental perception of injury prevention practices in a multicultural metropolitan area.

INTRODUCTION: This study was conducted to survey parents of children seen in the emergency department regarding parent and child safety-related behaviors, parents' perceptions of their children's risks for injury, and educational needs. METHODS: The descriptive design involved three questionnaires with age-specific items related to children in groups 0-4 years, 5-12 years, and 13-15 years. Parents voluntarily completed the questionnaires in the emergency department waiting area. Data were analyzed by descriptive statistics, parametric tests, and content analysis. RESULTS: The culturally diverse sample included 81% minority group representation. Parents tended to underestimate their children's risks for injury from motor vehicle crashes. Less than one half of caretakers believed that most injuries can be prevented. Only one third of parents listed needs for future learning, although parents of younger children listed more needs. High response rates were received for knowing how to call 911, use of child car seats and seat belts, and smoke detectors in the home. DISCUSSION: Survey results provide evidence that parents have misconceptions about childhood injury. Through strategic planning, we have expanded our community education programs to focus on cardiopulmonary resuscitation and activating the emergency medical system, water safety, use of safety helmets, and injury prevention in the home.

Accident Prevention↗
PubMed1998

Profile of pediatric bicycle injuries.

BACKGROUND: Bicycle injury data from local communities are important for developing injury prevention and control programs. This study represents the efforts of one community trauma center to describe bicycle injuries. METHODS: We conducted a retrospective analysis of bicycle injury data from hospital charts, emergency medical services reports, and medical examiner reports. The review encompassed a 4-year period. The study sample included 211 trauma alert patients, ages 1 through 15 years, who were treated for bicycle-related injuries at our level II pediatric trauma center. RESULTS: Bicycle injuries accounted for 18% of all pediatric trauma alert patients. The mean age of injured children was 10 years, and 79% were males. Bicycle-motor vehicle collisions caused 84% of injuries. Only 3 children (1.4%) wore bicycle helmets. Resulting injuries included external wounds (86%), head injuries (47%), fractures (29%), and internal organs (9%). Six children died. CONCLUSIONS: Bicycle injuries are a significant cause of mortality and morbidity for children in our community. Use of safety helmets by child bicyclists is inadequate. The data from this study can be used as a baseline in testing the effectiveness of local and state interventions, including new legislation mandating helmet use by children in our state.

Accidents, Traffic↗
PubMed1998

Clinical evaluation of the ASTY colorimetric microdilution panel for antifungal susceptibility testing.

A method using a commercially prepared colorimetric microdilution panel (ASTY; Kyokuto Pharmaceutical Industrial Co., Ltd.) was compared in four different laboratories with the National Committee for Clinical Laboratory Standards (NCCLS) reference microdilution method by testing 802 clinical isolates of Candida spp. (C. albicans, C. glabrata, C. tropicalis, C. parapsilosis, C. krusei, C. lusitaniae, C. guilliermondii, C. lipolytica, C. rugosa, and C. zeylanoides) against amphotericin B, 5-fluorocytosine (5FC), fluconazole, and itraconazole. Reference MIC endpoints were established after 48 h of incubation, and ASTY endpoints were established after 24 and 48 h of incubation. ASTY endpoints were determined to be the time at which the color of the first well changed from red (indicating growth) to purple (indicating growth inhibition) or blue (indicating no growth). Excellent agreement (within 2 dilutions) between the reference and colorimetric MICs was observed. Overall agreement was 93% at 24 h and 96% at 48 h. Agreement ranged from 90% with itraconazole and 5FC to 96% with amphotericin B at 24 h and from 92% with itraconazole to 99% with amphotericin B and 5FC at 48 h. The ASTY colorimetric microdilution panel method appears to be comparable to the NCCLS reference method for testing the susceptibilities of Candida spp. to a variety of antifungal agents.

Amphotericin B↗
PubMed1997

Strategies to implement helmet legislation for child bicyclists.

Research in the area of injury prevention has shown that legislation combined with education is the most effective way to increase helmet use in child bicyclists. Legislative activities have been proven to reduce injuries. Nurses can join with other interested stakeholders to form community coalitions, to educate the public, and to influence public policy.

Bicycling↗
PubMed1997

In vitro susceptibilities of clinical yeast isolates to a new echinocandin derivative, LY303366, and other antifungal agents.

LY303366 is a new semisynthetic echinocandin derivative with potent, broad-spectrum fungicidal activity. We investigated the in vitro activity of LY303366, amphotericin B, flucytosine (5FC), fluconazole, and itraconazole against 435 clinical yeast isolates (413 Candida and 22 Saccharomyces cerevisiae isolates) obtained from over 30 different medical centers. MICs for all five antifungal agents were determined by the National Committee for Clinical Laboratory Standards method with RPMI 1640 test medium. LY303366 was also tested in antibiotic medium 3 as specified by the manufacturer. Overall, LY303366 was quite active against all of the yeast isolates when tested in RPMI 1640 (MIC at which 90% of the isolates are inhibited [MIC90], 1.0 microg/ml) but appeared to be considerably more potent when tested in antibiotic medium 3 (MIC90, 0.03 microg/ml). When tested in antibiotic medium 3, LY303366 was 16- to >2,000-fold more active than itraconazole, fluconazole, amphotericin B, or 5FC against all species except Candida parapsilosis. When tested in RPMI 1640, LY303366 was comparable to amphotericin B and itraconazole and more active than fluconazole and 5FC. All of the isolates for which fluconazole and itraconazole had elevated MICs (> or = 128 and > or = 2.0 microg/ml, respectively) were inhibited by < or = 0.007 microg of LY303366/ml when tested in antibiotic medium 3 and < or = 0.5 microg/ml when tested in RPMI 1640. Based on these studies, LY303366 has promising antifungal activity and warrants further in vitro and in vivo investigation.

Anidulafungin↗
PubMed1997

Home-care nurses as strangers in the family.

As nurses move from the hospital into the home setting, they are challenged to examine boundaries of practice and family-nurse relationships. This phenomenological study was undertaken to explore the experiences of nurses working with families of technology-dependent children in the home. The main theme emerging from the data was the nurse's presence as "a stranger in the family." Additional themes focused on the nurse's advocacy for the child and family, boundary setting, collaboration, and occupational demands.

Child↗
PubMed1996

Transmission of Citrobacter koseri from mother to infant documented by ribotyping and pulsed-field gel electrophoresis.

We describe a case in which Citrobacter koseri (formerly C. diversus) was transmitted from a pregnant mother with chorioamnionitis and bacteremia to her infant who was bacteremic at birth and in apparent septic shock. Two highly discriminating molecular methods, ribotyping and pulsed field gel electrophoresis, were used to examine restriction fragment length polymorphisms within the genomic DNA of maternal and infant isolates. Both techniques identified the maternal and infant isolates as the same strain, distinct from epidemiologically unrelated controls, thus confirming their common origin.

Adult↗
PubMed1996

Experiences in the first year. Community hospital pediatric trauma center.

Demographic and outcome variables of children seen in a community hospital Level II pediatric trauma center are described and patterns of injury classified according to different mechanisms. Records were reviewed retrospectively of 184 patients seen over a one year period, 63% were male and the peak age group was 13-15 years (31%). Descriptive and nonparametric statistics were used to analyze the data. Mechanisms of injury included pedestrian vs auto (27%), falls (23%), motor vehicle occupants (18%), bicycle vs auto (17%), sports injuries (3%), motorcycle crashes (2%), gunshot wounds (2%), and stabbings (2%). Penetrating injuries had higher average trauma scores but blunt injuries were associated with higher mortality. Demographics and mechanisms of injury were similar to national studies. Emphasis on the use of pediatric trauma scores by emergency medical personnel is suggested to decrease the over-triage rate. The frequency of bicycle injuries and lack of helmet use prompted a major helmet promotion campaign.

Accidental Falls↗
PubMed1995

Patterns of injury in pediatric patients in one Florida community and implications for prevention programs.

OBJECTIVES: To meet community needs, injury prevention programs for children should be based on an understanding of the patterns of different mechanisms of injury. This study was conducted by the staff of a level II pediatric trauma center to describe the patterns of injury in pediatric patients with traumatic injuries. METHODS: We conducted a retrospective review of medical records of all 184 pediatric "trauma alert" patients seen during a 1-year period. The trauma alert status is assigned to children with serious injuries or when the mechanism of injury is severe. Data analysis used descriptive statistics. RESULTS: Pedestrian-versus-automobile injuries were the most common and most severe injuries, followed in frequency by falls, motor vehicle occupant, and bicycle-versus-automobile injuries. Younger children tended to have injuries as a result of falls; school-age children were involved more often in pedestrian and bicycle injuries, and adolescents had more motor vehicle occupant injuries. Failure to use safety devices, such as helmets and seat belts, was a common finding. DISCUSSION: Patterns of injury were similar to those described in national studies. An extensive helmet campaign directed at child bicyclists was developed as a result of the priorities generated from the study. Other community programs included bicycle rodeos and a mix-off of nonalcoholic beverages.

Accident Prevention↗
PubMed1995

Infant-mother attachment: relationships to maternal responsiveness and infant temperament.

The purpose of this study was to explore the relationships between maternal responsiveness, infant temperament, and infant-mother attachment as measured in Ainsworth's Strange Situation. Discriminant analysis revealed that infant temperament was more strongly related to attachment than maternal responsiveness. Infants rated as Anxious-Avoidant in attachment were perceived by their mothers as significantly easier in temperament. Possible explanations for findings and implications for nurses working with infants and parents are discussed.

Adult↗
PubMed1993

The experience of struggle, freedom, and growth.

The philosophy contains both constraints and freedoms. Loss of the minority view was expressed as a struggle. Molding to fit the dominant view led to a sense of connectedness. Individuals living within the faculty circle sought both to maintain their own views and to recognize and support the needs of the group. From this struggle, feelings of freedom and growth emerged, as well as respect and support for others. Nevertheless, at the point in time captured by this study, respect for individuals was easier to achieve than respect for the diversity of ideas. In truth, these cannot be separated, and so the struggle to understand and live the philosophy is an ongoing process.

Curriculum↗
PubMed1989

The emergency department diagnosis of Trichomonas vaginitis.

Trichomonas vaginalis is a common cause of vaginitis in emergency department patient populations. While the diagnosis of this condition is usually on the basis of wet-mount microscope slide preparations, other diagnostic technology exists. We studied the accuracy of the traditional wet-mount technique as compared with detection using direct immunofluorescence and culture techniques in ED patients with the presenting complaint of vaginal discharge. Of 157 patients evaluated, the wet-mount technique detected 27 cases of Trichomonas, compared with 35 cases diagnosed by direct immunofluorescence and 52 cases detected by culture. This represents a false-negative rate for the wet-mount technique of 51%; the false-negative rates for direct immunofluorescence and culture technique were 36% and 5%, respectively. Our study suggests that the wet-mount technique is relatively insensitive in the detection of Trichomonas vaginitis.

Animals↗