Leona Baumgartner

The Inadequacy of Routine Reporting of Fetal Deaths : As Evidenced by a Comparison of Such Reporting with Maternity Cases Paid for under the Emergency Maternity and Infant Care (EMIC) Program

PUBLIC health workers for many years have been greatly concerned with the reduction of infant mortality. Important as such reductions are, it is becoming increasingly clear that the saving of lives lost after birth is only part of the problem of preventing loss of life in this period. Thousands of prospective lives are lost each year through deaths of viable infants born at or near termination of pregnancy, representing a tremendous wastage of pregnancy. For example, in 1947 the number of infant deaths (i.e., deaths within the first year of life) reported in New York City was 4,517, while the number of fetal deaths reported was 14,077. Bringing a larger number of these fetuses to a later stage of pregnancy enhances the chances for a live birth. More and more, then, it becomes important to focus on the problem of fetal deaths. Before attacking the problem, one has to know the extent of it. Many attempts have been made in different countries and within the United States to obtain

Control of common radiation hazards in New York City

The extensive radiation control system adopted by New York City is described. The program is interdepartmental, with major responbibility vested in the health department. A new section of the New York City Health Code requires registration of every source of radiation in the city and notification of hazardous shipments of radiation materials, of all newly installed radiation installations, and of all accidents, incidents, and overexposures. Emphasis is placed on helping physicians and dentists to reduce to a minimum the radiation dose to patients from x-ray equipment. Steps have also heen taken to control the use of radium, to deal with problems involving radioactive isotopes, the transportation of radioactive materials, the disposal of radioactive wastes, and problems involving fallout. (C.H.)

The opinions of private physicians of a medical care program; experience in the emergency maternity and infant care program in New York City.

Abstract The opinions of all physicians (a total of 5,575) who themselves cared for EMIC patients in New York City during World War II were solicited through a questionnaire with specific questions to which “yes” or “no” or “no opinion” answers could be given. About 50 per cent of physicians responded and this group of respondents was found to be representative of the entire group who cared for patients. Data were secured through three separate mailings and one telephone inquiry to a random sample. The similarity of the data so collected and the unusually large number of returns make it sound to conclude that this study reflects reasonably accurately the opinions of all the physicians in the community who cared for EMIC patients. About 90 per cent thought the program reached its objective of raising morale. Slightly fewer, but still more than three-fourths of the total, were satisfied with the procedures of application and authorization and with the general administration of the program. More than 90 per cent were satisfied with the method of payment directly to the physician and only a very small number, fewer than 1 per cent, would have preferred a cash payment to the patient. More than 90 per cent of the physicians thought that the functioning of the plan had not interfered with the patient-physician relationship. Of the small number who thought the plan had produced a change, almost one-fifth thought it made the relationship better rather than worse. Pediatricians seemed more likely to think it better. Availability of consultation services was generally appreciated but there was not as much positive expression of approval for special nursing service as for medical consultation by specialists and services of visiting nurses. The greatest dissatisfaction was in the amount of the fee paid, particularly the obstetric fee. In general, more participation, i.e., caring for a greater number of cases, was associated with a more favorable opinion of EMIC. This analysis is thought to be unique in that it is apparently the only one recorded so far in which the opinions of physicians who actually cared for EMIC patients in a community have been secured and analyzed. It is suggested that similar studies of the opinions of the physicians participating in and the patients receiving care from the many medical care programs now being tried out in this country be made.

A critical survey of the New York program for the care of premature infants

Summary 1. The premature program of thepast decade for New York City is described. 2. Statistics relating to mortalityrates for premature infants in 4 weight groupings under 2,500 grams are presented for hospitals with approved premature centers and for the City as a whole. 3. A downward trend is noted in themortality rate in each weight group, except in the less than 1,000 gram group. 4. Comparison of mortality rates ofpremature infants (classified by weight groups) born in a borough as yet not included in the premature program with those of infants born in hospitals with centers supports the hypothesis that premature center care increases the survival rate. 5. In each weight group infantscared for in approved centers had a higher survival rate than was the case for the City as a whole. 6. A higher proportion of motherswho delivered prematurely had late or no prenatal care than did those who delivered at term. 7. Emphasis is put on the importance of paying greater attention to the care of the “large premature infant”. 8. The need for intensive and continuedfollow-up care after discharge from the hospital is emphasized. 9. The need for continued and intensifiedresearch is indicated.

New York City Plan for Care of Poliomyelitis Patients in Respirators.

The problem of patients with poliomyelitis who need care in a respirator is becoming a matter of concern to those interested in the field of long-term illness or chronic disease. The basic problems are, of course, the increase of fundamental understanding of the epidemiology of poliomyelitis and the development of methods of preventing the disease. Considerable progress is being made in these areas. There is, nevertheless, the immediate problem of adequate care of poliomyelitis patients. Public health officials, hospital administrators, and physicians have paid particular attention to the care of poliomyelitis patients in the acute stage of illness and to the rehabilitation of those patients who are orthopedically handicapped. The problems of those patients who need care in a respirator seem to have received less

L. Emmett Holt: Pioneer of a Children's Century

We may not be able to make you love reading, but l emmett holt pioneer of a childrens century will lead you to love reading starting from now. Book is the window to open the new world. The world that you want is in the better stage and level. World will always guide you to even the prestige stage of the life. You know, this is some of how reading will give you the kindness. In this case, more books you read more knowledge you know, but it can mean also the bore is full.