L. Fleming Fallon

Succession planning for local health department top executives: reducing risk to communities.

This study assessed the degree to which local health departments (LHDs) are preparing to replace retiring top executives. Questionnaires were sent to all 134 local health departments in Ohio. It is typical of many states in terms of the organization of LHDs. Ninety-two LHD top executives responded. The questionnaire addressed aspects of departmental succession planning and demographic parameters of their departments. Approximately half (51.7%) of responding LHD top executives rated having succession plans as being important. Overall, local boards of health are not very concerned about actually having a succession plan. One in four (27.6%) local health departments reported that they have succession plans. Half of those were grooming a successor. Succession planning is not a high priority among the majority of LHDs, despite the fact that 43.7% of top executives reported planning to leave their current position within six years. Experienced and continuous LHD leadership is important for strong responses to public health crises like major disease outbreaks and natural disasters. Having a succession plan in place that identifies how leadership voids are filled can help minimize risks to populations in an emergency.

Methemoglobinemia : An industrial outbreak among rubber molding workers

Objective: This case series documents an occupational outbreak of methemoglobinemia among five steam press operators at a rubber plant. Investigative findings identified the cause as repeated exposure (through manual handling) to an adhesive containing dinitrobenzene. Results: The workers presented with yellow-stained hands and a variety of clinical manifestations. Methemoglobinemia levels obtained in the emergency room ranged from 3.8% to 41.2%. Methylthioninium chloride (methylene blue) rapidly reversed the cyanosis and alleviated associated symptoms in the rubber molding workers requiring treatment. Conclusions: Prompt action by plant officials and subsequent investigation by National Institute of Occupational Safety and Health/Occupational Safety & Health Administration personnel resulted in the timely and successful resolution of the problem. Individual presentations, assessment, and management are discussed along with recommendations for occupational investigation and referral.

Importance of uniformity in local emergency management agency web sites

This study focused on the uniformity of Web sites operated by local emergency management agencies (EMAs) as they pertain to the availability of relevant emergency preparedness and response information. Of the 3,128 counties (or county equivalents) in the United States, we found Internet homepages for 1,612 local EMAs (51.5%). We reviewed each homepage to document the presence (or absence) of nine elements deemed to be essential for effective communications during emergency or disaster situations. Local EMA Web site homepages had a mean of 4.5 (± 1.5) elements. Among the findings, this review revealed that about four out of five (82.3%) of the local EMAs included the agency phone number, more than half (52.0%) provided links to other agencies with emergency preparedness information, and about two in five (38.3%) listed an agency email address. A few more than one in five (21.1%) of the local EMA homepages reviewed allowed visitors to sign up for automatic alerts or notifications. The nine communication elements identified in our study provide a minimal standard for content. We suggest that these results be used as a starting point in developing a uniform template containing the nine homepage elements. Such a template compliments National Incident Management System (NIMS) protocols and can provide a recognizable source of consistent and reliable information for people during emergency or disaster incidents.

Factors Related to Accidents and Falls among Older Individuals

The number and percentage of older individuals in contemporary American society has risen dramatically during the past century. This has mandated that increased attention be given to older individuals and to developing strategies for improving the quality of life in their later years. Maintaining independence while growing older is a concern for individuals, families and society. Independent living frequently becomes a concern as health-related issues impact on individuals. Understanding how types of injuries and factors associated with their causes may help to reduce the risks associated with accidents in homes. In turn, this may help individuals to maintain their independence for as long as possible. Data are presented from a questionnaire study of 300 randomly selected older persons from Ohio. Accidents were found to be commonplace in homes. More women reported accidents than did men. Individuals living alone reported more accidents than did those living with others. Good health, gender and living status are factors that tend to prevent accidents or minimize their impact. Language: en

Communications between local health departments and the public during emergencies: the importance of standardized web sites.

Of the 2790 local health departments (LHDs) in the United States, Internet homepages were located for 1986. We reviewed each homepage to document the presence of 9 elements deemed to be critical for effective communications during emergency or disaster situations. LHD Web site homepages had a mean of 4.1 (±1.4) elements. Among the findings, this review revealed that 4 of 5 (80.5%) of the LHDs included the agency phone number, half (49.4%) provided links to emergency information, and about 1 in 5 (19.6%) listed an agency e-mail address. Fewer than 1 in 20 (4.3%) of the LHD homepages reviewed allowed visitors to sign up for automatic alerts or notifications. We suggest that these results be used as a starting point in developing a standardized template containing the 9 homepage elements. Such a template complements National Incident Management System protocols and can provide a recognizable source of consistent and reliable information for people during a public health emergency or disaster.

Psychogenic Cough in an Asthmatic Child: Case Report with Unusual Findings

A 9-year-old girl with known mild intermittent asthma presented with a persistent cough. Her cough exhibited a four-beat staccato rhythm, was nonproductive, and persisted only while awake. On physical examination, she displayed several unique findings not previously described. An extensive yet non-diagnostic medical workup coupled with absence of aggressive medical treatment for the more usual causes of cough lead to psychologic investigation and intervention with subsequent cough resolution. The appropriate use of psychologic consultation, testing, and success with supportive reinforcement therapy confirmed a psychogenic etiology. Extended medical follow-up of the patient concerning cough reoccurrence remains uneventful.

A survey of speech-language pathology and audiology needs of older adults

A needs assessment for an agency that serves older adults in a northwestern Ohio county in the United States was conducted by a team of researchers. Data obtained from 301 completed survey questionnaires, from an original 850 that were mailed, pertaining to the disciplines of speech-language pathology and audiology are presented. Specifically, results are discussed that relate to a self-reported need or desire for speech-language pathology or audiology services, self-perceptions of needs related to basic functional communication skills, and current and previous diagnoses of communicative and cognitive disorders. Implications for practicing clinical speech-language pathologists and audiologists are also discussed.

Assessing sheriff's office emergency and disaster website communications

Sheriff’s offices are an integral component of the public health emergency preparedness and response system in the USA. During a public health emergency or disaster, sheriff’s offices need to communicate with people affected by the event. Sheriff’s office websites are logical sources for information about disaster preparedness and response efforts. No prior research evaluates emergency preparedness and response resources available through sheriff’s office websites. The current research is a national study of sheriff’s office websites to assess the availability of information relating to emergency preparedness and response. A content analysis of 2590 sheriff’s office website homepages was conducted to determine the presence or absence of nine communications elements important to people seeking information during an emergency or disaster. We found that 71.9% of sheriff’s office website homepages include links to agency services and programs, but only 6.5% provide links to emergency preparedness information. The findings of the study are useful to assess emergency preparedness and the amount of response information available, as well as to identify opportunities to improve sheriff’s office website homepages.