Yolanda's story: An antenarratological approach to understanding mothering work.

PURPOSE: Mothering work has been studied by social and occupational scientists, as well as a few occupational therapists. However, there remains a lack of in depth qualitative analysis that provides a trajectory view of a mother's experience, particularly after traumatic events involving their children. This study sought to further understand a mothering experience from a mothering work lens following the near-drowning experience of a child in South Florida. METHOD: Antenarratology is a relatively new approach for analyzing qualitative data. It provides a way to understand the complexities of phenomena over a period of time from a more contextual approach. This method was used to analyze a mother's blog post injury of her child. This report introduces the method and its application to one mother's experience using a case study format. RESULTS: Analysis of data using antenarratology methodology revealed a variety of disparate, inconsistent and common threads, which is acceptable in antenarratological explorations. This more appropriately mirrors the variations of life that a mother's work experiences in child care work entail, particularly post injury.

[First therapy of drowning accident]. / Ertrinkungsunfälle - Präklinische und klinische Behandlungsstrategien.

Rescue and medical care of people in a drowning accident is a rather rare incident which still needs special attention. The rescue process can be technically challenging and only a well experienced team will be able to act professionally without any time loss. At a first step all team members have to protect themselves. Especially close collaboration of technical and medical rescue teams are of high significance and should be part of future exercises. Hypothermic persons should be protected from further cooling and gently rescued in a horizontally way. If a patient has no circulation continued cardiopulmonary resuscitation and immediate transport as soon as possible to the nearest hospital with an extracorporeal rewarming device is recommended. To avoid any time loss it is essential that the respective hospital is informed immediately and the fastest mode of transport selected. Astonishing cases show that this procedure is very promising even after long time submersion.

The Capacity Profile: a method to classify additional care needs in children with neurodevelopmental disabilities.

The aim of this study was to determine the interrater reliability and stability over time of the Capacity Profile (CAP). The CAP is a standardized method for classifying additional care needs indicated by current impairments in five domains of body functions: physical health, neuromusculoskeletal and movement-related, sensory, mental, and voice and speech, in children from 3 to 18 years of age. The intensity of care in each domain is defined from 0 (no need for additional care) to 5 (needs help with every activity). The intensity of additional care in each of the five separate domains indicates the CAP for the individual child. We developed the CAP to inform the parents and other caregivers of children with non-progressive, permanent neurodevelopmental disabilities, such as cerebral palsy and myelomeningocele, about the consequences of these conditions. To determine interrater agreement and stability over time, the CAPs of 67 children (39 males, 28 females) with a neurodevelopmental disability (mean age 18y [SD 1.2y]; range 14-22y) were assessed based on a semi-structured interview. In addition, the CAPs of the same individuals at the age of 3 years were determined based on a chart review. Interrater agreement of the CAP at the age of 3 was good to very good (weighted kappa 0.64-0.92). Agreement between the CAP at the age of 18 and the CAP at the age of 3 (providing evidence for stability over time) was also good (weighted kappa 0.68-0.77), except for the domain 'physical health functions', about which agreement was relatively poor (0.47). We conclude that the CAP is a reliable instrument for classifying the additional needs of a child with a non-progressive, permanent neurodevelopmental disability. The preliminary evidence for the stability over time of such needs according to the CAP should be validated in a prospective study.

Near-drowning in an infant: case report.

A case is presented of an infant who may have been immersed in water for 15 minutes, presenting apparently dead by instant assessment criteria, who was resuscitated and rehabilitated to make an excellent recovery.

[Recovery from apparently hopeless fresh-water drowning (author's transl)]. / Uberleben bei scheinbar aussichtslosen Ertrinkungs-unfällen.

Report of 3 cases of drowning (children). 2 patients survived without severe injury, 1 patient died after 13 days. The protective action of hypothermia to the brain and heart in hypothermic drowning is emphasized. Even in apparently hopeless cases resuscitation should be started immediately and should not be discontinued too early. Especially in hypothermic drowning efforts can be successful after more than 60 min. of resuscitation. In cases of drowning an emergency physician should be called immediately (emergency-ambulance, rescue-helicopter). A short survey of pathologic physiology, emergency therapy and intensive care of drowning is given.

[Successful treatment of a severe drowning accident after 20 minutes submersion]. / Erfolgreiche Behandlung eines schweren Ertrinkungsunfalls nach 20minütiger Submersion

Report on successful post-drowning cardiopulmonary resuscitation of a 2-year-old boy who had lain for 20 min in cold water at 5-7 degrees C. Because of severe pulmonary complications after primary resuscitation--e.g. pulmonary edema, repeated mediastinal and subcutaneous emphysema, pneumoperitoneum and bilateral pneumothorax--spontaneous respiration remained insufficient for 36 days. Under appropriate treatment the patient recovered completely except for slight muscular hypotrophy of the left thigh. 14 months after the submersion no other neurological or pulmonary sequelae could be detected.