WorldWideScience

Sample records for australasian trauma society

  1. Are Australian and New Zealand trauma service resources reflective of the Australasian Trauma Verification Model Resource Criteria?

    Science.gov (United States)

    Leonard, Elizabeth; Curtis, Kate

    2014-01-01

    The Australasian Trauma Verification Program was developed in 2000 to improve the quality of care provided at services in Australia and New Zealand. The programme outlines resources required for differing levels of trauma services. This study compares the human resources in Australia and New Zealand trauma services with those recommended by the Australasian College of Surgeons Trauma Verification Program. In September 2011, all trauma nurse coordinators in Australia and New Zealand were invited to participate in an electronic survey endorsed by the Australasian Trauma Society. This study expands on previous bi-national research and aimed to identify demographic and trauma service human resource levels. Fifty-three surveys (78%) were completed and all 27 Level 1 trauma centres represented. Of the Level 1 trauma centres, a trauma director and fellow were available at 16 (51.8%) and 14 (40.7%) centres, respectively. The majority (93%) had a full-time trauma coordinator although a trauma case manager was only available at 14 (48.1%) of Level 1 trauma centres. Despite the large amount of data collection and extraction required, trauma services had limited access to a data manager (50.9%) or clerical staff (36.9%). Human resources in Australian and NZ trauma services are not reflective of those recommended by the Australasian Trauma Verification Program. This impacts on the ability to coordinate trauma monitoring and performance improvement. Review of the Australasian Trauma Verification Model Resource Criteria is required. Injury surveillance in Australia and NZ is hampered by insufficient trauma registry resources. © 2014 Royal Australasian College of Surgeons.

  2. The Australasian Society for Infectious Diseases Annual Scientific Meeting 2010.

    Science.gov (United States)

    Senanayake, Sanjaya N; Daveson, Kathryn L

    2010-10-01

    The 2010 Australasian Society for Infectious Diseases Annual Scientific Meeting took place in May in the Northern Territory (Australia) and focussed on infections in the region. The meeting highlights included the changing spectrum of malaria and dengue in endemic regions, the latest on influenza epidemiology, multidrug-resistant organisms and infectious diseases in the Australian indigenous population. This was complemented by subspeciality interest group research encompassing mycobacterial disease, infection control, mycology and virology.

  3. Some personal thoughts on the Australasian Society of Clinical and Experimental Pharmacologists in the 1980s.

    Science.gov (United States)

    Johnston, Graham A R

    2017-02-01

    There were a number of highly significant events regarding ASCEP in the 1980s: a tour of China by ASCEP pharmacologists; the Sydney IUPHAR Congress; and the initiation of the Australasian Visitor to the BPS scheme. ASCEP appointed a professional secretariat, established an investment portfolio, and initiated Special Interest Groups. The Society entered the 1990s welcoming toxicologists into the new ASCEPT. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. German Society for Immunology and Australasian Society for Immunology joint Workshop 3(rd) -4(th) December 2015 - Meeting report.

    Science.gov (United States)

    Kurts, Christian; Gottschalk, Catherine; Bedoui, Sammy; Heinzel, Susanne; Godfrey, Dale; Enders, Anselm

    2016-02-01

    The German Society for Immunology (DGfI) and the Australasian Society for Immunology (ASI) hosted the first DGfI-ASI joint workshop from December 3-4, 2015 in Canberra, Australia. A delegation of 15 distinguished German immunologists discussed the workshop topic "immune regulation in infections and immune mediated diseases" with the aim to establish new German-Australasian collaborations, discuss new concepts in the field of immune regulation and build a scientific network to create more utilizable resources for excellent (trans-border) immunological research. The workshop was associated with the 45(th) Annual Scientific Meeting of the ASI held from Nov 29-Dec 3, 2015, opening up even more opportunities for finding new collaboration partners. A return meeting will be linked to the annual DGfI meeting that will take place in 2017 in Erlangen. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Proceedings of the 2013 Meeting of the Australasian Section of the American Oil Chemists Society (AAOCS

    Directory of Open Access Journals (Sweden)

    Karen Murphy

    2013-12-01

    Full Text Available The Australasian section of the American Oil Chemists Society (AAOCS held their biennial meeting in Newcastle, Australia from 6 to 8 November, 2013. Over 150 scientists, researchers and industry representatives gathered for three days of talks and discussions on a variety of lipid related topics. The AAOCS awarded its inaugural AAOCS Award for Scientific Excellence in Lipid Research to Dr Allan Green from the Commonwealth Scientific and Industrial Research Organisation (CSIRO. Dr Green is deputy chief of the CSIRO Division of Plant Industry and has been active in lipid research for several decades. His main research focus is on plant breeding and genetic engineering techniques to develop improved oilseeds with enhanced human nutritional value and novel industrial uses. Refer to “AAOCS Award for Scientific Excellence in Lipid Research” for more detail of his contributions [1].

  6. The Australasian radiation protection society's position statement on risks from low levels of ionizing radiation

    International Nuclear Information System (INIS)

    Don, Higson; Ches, Mason; Andrew, McEwan; Peter, Burns; Riaz, Akber; Ron, Cameron; Pamela, Sykes; Joe, Young

    2006-01-01

    At its Annual General Meeting in 2004, the Australasian Radiation Protection Society (A.R.P.S.) set up a working group to draft a statement of the Society's position on risks from low levels of exposure to ionizing radiation. The resulting position statement was adopted by the Society at its Annual General Meeting in 2005. Its salient features are as follows: First, there is insufficient evidence to establish a dose-effect relationship for doses that are less than a few tens of milli sieverts in a year. A linear extrapolation from higher dose levels should be assumed only for the purpose of applying regulatory controls. Secondly, estimates of collective dose arising from individual doses that are less than some tens of milli sieverts in a year should not be used to predict numbers of fatal cancers. Thirdly, the risk to an individual of doses significantly less than 100 micro sieverts in a year is so small, if it exists at all, that regulatory requirements to control exposure at this level are not warranted. (authors)

  7. The Australasian radiation protection society's position statement on risks fro low levels of ionizing radiation

    International Nuclear Information System (INIS)

    Higson, D.J.

    2006-01-01

    Full text: Controversy continues in the radiation protection literature on whether or not ionizing radiation is harmful at low doses, with unresolved scientific uncertainty about effects below a few tens of millisieverts. To settle what regulatory controls (if any) should apply in this dose region, an assumption has to be made relating dose to the possibility of harm or benefit. The assumption made and the way it is applied can have far-reaching effects, not only on the scale of regulatory compliance required but also on public perception of risk, and therefore on the technological choices made by society. It is important therefore that decisions reached concerning the regulation of low doses of ionizing radiation derive from rational arguments and are perceived to have an ethical basis. It is also important that such decisions are neither portrayed nor perceived as resolving the scientific uncertainties: rather, they serve merely to facilitate the implementation of appropriate measures to ensure safety. At its Annual General Meeting in 2004, the Australasian Radiation Protection Society (ARPS) set up a working group to draft a statement of the Society's position on this matter. The resulting position statement was adopted by the Society at its Annual General Meeting on 14 November 2005. Its salient features are as follows: There is insufficient evidence to establish a dose-effect relationship for doses that are less than a few tens of millisieverts in a year. A linear extrapolation from higher dose levels should be assumed only for the purpose of applying regulatory controls; Estimates of collective dose arising from individual doses that are less than some tens of millisieverts in a year should not be used to predict numbers of fatal cancers; The risk to an individual of doses significantly less than 100 microsieverts in a year is so small, if it exists at all, that regulatory requirements to control exposure at this level are not warranted. The paper will

  8. Australasian Society of Infectious Diseases updated guidelines for the management of Clostridium difficile infection in adults and children in Australia and New Zealand.

    Science.gov (United States)

    Trubiano, J A; Cheng, A C; Korman, T M; Roder, C; Campbell, A; May, M L A; Blyth, C C; Ferguson, J K; Blackmore, T K; Riley, T V; Athan, E

    2016-04-01

    The incidence of Clostridium difficile infection (CDI) continues to rise, whilst treatment remains problematic due to recurrent, refractory and potentially severe nature of disease. The treatment of C. difficile is a challenge for community and hospital-based clinicians. With the advent of an expanding therapeutic arsenal against C. difficile since the last published Australasian guidelines, an update on CDI treatment recommendations for Australasian clinicians was required. On behalf of the Australasian Society of Infectious Diseases, we present the updated guidelines for the management of CDI in adults and children. © 2016 Royal Australasian College of Physicians.

  9. Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine HIV pre-exposure prophylaxis: clinical guidelines.

    Science.gov (United States)

    Wright, Edwina; Grulich, Andrew; Roy, Katy; Boyd, Mark; Cornelisse, Vincent; Russell, Darren; O'Donnell, Darryl; Whittaker, Bill; Crooks, Levinia; Zablotska, Iryna

    2017-07-01

    Daily use of coformulated tenofovir and emtricitabine for HIV pre-exposure prophylaxis (PrEP) by populations at high risk of HIV infection is now recommended in guidelines from the United States, Europe and Australia and globally through the 2015 WHO guidelines. These 2017 Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine's (ASHM) PrEP Guidelines are an updated adaptation of the 2014 US Centers for Disease Control's PrEP guidelines and are designed to: •Support the prescription of PrEP using forms of coformulated tenofovir and emtricitabine that have been registered in Australia by the Therapeutic Goods Administration and other bioequivalent generic drugs that are available in Australia through self-importation, private prescription or Australian PrEP clinical trials•Assist clinicians in the evaluation of patients who are seeking PrEP•Assist clinicians in commencing and monitoring patients on PrEP including PrEP dosing schedules, management of side-effects and toxicity, use of PrEP in pregnancy and in chronic hepatitis B infection and how to cease PrEP Daily PrEP with co-formulated tenofovir and emtricitabine, used continuously or for shorter periods of time, is recommended in these guidelines as a key HIV-prevention option for men who have sex with men (MSM), transgender men and women, heterosexual men and women, and people who inject drugs (PWID) at substantial risk of HIV acquisition.

  10. The history of Croatian Trauma Society - a brief overview.

    Science.gov (United States)

    Bakota, B; Vlahovic, T; Staresinic, M; Dobric, I; Civaric, T

    2013-09-01

    Croatian Trauma Society (CTS) has a 51 year of history and tradition. This article represents a brief overview from the times when it was founded, June 30, 1961, until the present time. It tells us about the idea how, where and when the "Section for Traumatology" was founded, its activities and influence not only to promote patient trauma care but initiation of other societies dealing with traumatized patients as well, including the evolution of the CTS itself. The authors thank to all the contributors that made this article possible. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Academic model of trauma healing in post-war societies

    Directory of Open Access Journals (Sweden)

    Amra Delić

    2014-05-01

    Full Text Available Objective. The aim of this paper is to examine the implications for healing in a contemporary Balkan post-war context, and to provide a bridge-building model of trauma transformation, reconciliation and recovery through academic reconstruction and cross-border dialogue. Post-war societies are marked by the effects of massive, large group traumatization, and if not properly dealt with, long-term rehabilitation and social recovery cannot be expected. Unprocessed cumulative trauma that has become deeply embedded in the collective memory of the Balkan peoples over centuries, „chosen trauma“, its trans-generational transmission and periodical reactivations across the Balkan have often been addressed in recent literature, in ethno-psychology, psychoanalysis, psychiatry, sociology and anthropology. In order to deepen our understanding of the roots of collective (social trauma and the specific traumatic experiences of different groups, and to offer different perspectives and information on how trauma can be dealt with, the “Trauma Trust Memory” multinational interdisciplinary research network is being established, and a groundbreaking workshop was held in May 2013 in Tuzla, Bosnia-Herzegovina. Conclusion. The Tuzla Workshop showed that the active participation of affected groups in adequate coping with the past is required for post-conflict reconstruction, trauma healing and peacebuilding in the long run.

  12. The American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies Joint Committee recommendations for education and training in ultrasound-guided interventional pain procedures.

    Science.gov (United States)

    Narouze, Samer N; Provenzano, David; Peng, Philip; Eichenberger, Urs; Lee, Sang Chul; Nicholls, Barry; Moriggl, Bernhard

    2012-01-01

    The use of ultrasound in pain medicine for interventional axial, nonaxial, and musculoskeletal pain procedures is rapidly evolving and growing. Because of the lack of specialty-specific guidelines for ultrasonography in pain medicine, an international collaborative effort consisting of members of the Special Interest Group on Ultrasonography in Pain Medicine from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies developed the following recommendations for education and training in ultrasound-guided interventional pain procedures. The purpose of these recommendations is to define the required skills for performing ultrasound-guided pain procedures, the processes for appropriate education, and training and quality improvement. Training algorithms are outlined for practice- and fellowship-based pathways. The previously published American Society of Regional Anesthesia and Pain Medicine and European Society of Regional Anaesthesia and Pain Therapy education and teaching recommendations for ultrasound-guided regional anesthesia served as a foundation for the pain medicine recommendations. Although the decision to grant ultrasound privileges occurs at the institutional level, the committee recommends that the training guidelines outlined in this document serve as the foundation for educational training and the advancement of the practice of ultrasonography in pain medicine.

  13. The Australasian Society for Infectious Diseases and Refugee Health Network of Australia recommendations for health assessment for people from refugee-like backgrounds: an abridged outline.

    Science.gov (United States)

    Chaves, Nadia J; Paxton, Georgia A; Biggs, Beverley-Ann; Thambiran, Aesen; Gardiner, Joanne; Williams, Jan; Smith, Mitchell M; Davis, Joshua S

    2017-04-17

    In 2009, the Australasian Society of Infectious Diseases published guidelines on the post-arrival health assessment of recently arrived refugees. Since then, the number of refugees and asylum seekers reaching Australia has increased substantially (17 555 refugees in 2015-16) and the countries of origin have changed. These groups are likely to have had poor access to health care pre-arrival and, consequently, are at risk of a range of chronic and infectious diseases. We established an advisory group that included infectious diseases physicians, general practitioners, public health specialists, paediatricians and refugee health nurses to update the 2009 guidelines.Main recommendations: All people from refugee-like backgrounds, including children, should be offered a tailored comprehensive health assessment and management plan, ideally within 1 month of arrival in Australia. This can be offered at any time if initial contact with a GP or clinic is delayed. Recommended screening depends on history, examination and previous investigations, and is tailored based on age, gender, countries of origin and transit and risk profile. The full version of the guidelines is available at http://www.asid.net.au/documents/item/1225.Changes in management as a result of this guideline: These guidelines apply to all people from refugee-like backgrounds, including asylum seekers. They provide more information about non-communicable diseases and consider Asia and the Middle East as regions of origin as well as Africa. Key changes include an emphasis on person-centred care; risk-based rather than universal screening for hepatitis C virus, malaria, schistosomiasis and sexually transmissible infections; updated immunisation guidelines; and new recommendations for other problems, such as nutritional deficiencies, women's health and mental health.

  14. Physician assistants in Australasian emergency departments.

    Science.gov (United States)

    Close, Benjamin; Zolcinski, Robert

    2016-08-01

    A physician assistant (PA) is a university qualified health professional who's primary role is to provide medical care under the direction and supervision of medical staff. This is a new profession in Australasia. The PA is well suited to working in both rural, regional and urban settings that deliver emergency medical care. A perspective is presented on their role and scope of practice within the Australasian emergency care system supported by some early findings from their use in a tertiary ED. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  15. Ultrasound use in Australasian emergency departments: a survey of Australasian College for Emergency Medicine Fellows and Trainees.

    Science.gov (United States)

    Craig, Simon; Egerton-Warburton, Diana; Mellett, Tanya

    2014-06-01

    To describe current practice of EDUS by ACEM Trainees and Fellows; to describe potential barriers to US use in the Australasian setting; to determine compliance with current college guidelines regarding US credentialing. Data were collected by a cross-sectional online survey. Respondents were Trainees and Fellows of the ACEM. Outcome measures included the percentage of respondents currently undergoing or that had completed US credentialing for Focused Assessment with Sonography for Trauma (FAST) and assessment of abdominal aortic aneurysm (AAA) scans. The perceived barriers to use of emergency US were explored. There were 512 survey respondents, giving an overall response rate of 15%. Fellows were more likely to be credentialed compared with Trainees. There were 61% of respondents not credentialed for FAST and assessment of AAA scans. However, a significant proportion performed these scans regularly, and did not routinely seek independent confirmation of their findings. Barriers to credentialing included limited time and no credentialing programme at the individual's hospital. The present study showed that only a minority of ACEM Trainees and Fellows are credentialed to perform routine ED scans. Many non-credentialed ACEM Trainees and Fellows are performing scans, many without independent confirmation of their findings. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  16. Australasian Diabetes Data Network

    Science.gov (United States)

    Clapin, Helen; Phelan, Helen; Bruns, Loren; Sinnott, Richard; Colman, Peter; Craig, Maria; Jones, Timothy

    2016-01-01

    Australasia is a region with a high incidence of type 1 diabetes (T1D). There are approximately 140 000 individuals with T1D, and of these 10 000 are children. Although the region covers a huge geographical area, most children with T1D are managed by tertiary academic centers in the major capital cities. Local longitudinal data collection has been in place for several decades in most of these centers, however ongoing national data collection had not been attempted. In 2012, with funding from the Juvenile Diabetes Research Foundation (JDRF) Australian Type 1 Clinical Research Network, a national collaboration was formed to provide ongoing longitudinal collection of T1D patient characteristics and outcomes. The initial phase of this collaboration, known as the Australasian Diabetes Data Network or ADDN, was led by the Australasian Paediatric Endocrine Group (APEG) and thus included only children and adolescents. The next phase, commenced in 2016, will see adult sites added through collaboration with the Australian Diabetes Society (ADS). As most of the initial centers had longitudinal data collection in place the model employed was to establish the transfer and collation of data already collected into a central database. This required the definition of a common data dictionary, ethics and governance procedures and the employment of technology to enable efficient and accurate information transfer and accessibility. The ADDN project received widespread support from the diabetes research community with study investigators representing 20 pediatric centers across the region. The first phase focused on the 5 largest centers and at the end of 2015 these centers were uploading patient data to the ADDN database on a quarterly basis resulting in 5271 patients with 83 506 diabetes visits. PMID:27257171

  17. Proceedings of the Joint Conference of Australasian College of Physical Scientists and Engineers in Medicine and IEAust College of Biomedical Engineers; Asia/Pacific Region of the IEEE Engineering in Medicine and Biology Society

    International Nuclear Information System (INIS)

    1996-01-01

    This is a celebration of the centenary of Rontgen''s discovery of Xrays. It is also the 50th anniversary of the first hospital physicist appointment in New Zealand. The historical element of the programme will complement the emphasis on current applications of the physical and engineering sciences to medicine and an anticipation of future developments. For the first time the Australasian College of Physical Scientists and Engineers in Medicine, together with the IEAust College of Biomedical Engineers, are joined by the Asia/Pacific Region of the IEEE Engineering in Medicine and Biology Society to make this a truly international conference. The proceedings include many papers on radiology and radiotherapy

  18. 2014 Australasian sky guide

    CERN Document Server

    Lomb, Nick

    2013-01-01

    Compact, easy to use and reliable, this popular guide contains everything you need to know about the southern night sky with monthly astronomy maps, viewing tips and highlights, and details of all the year's exciting celestial events. Wherever you are in Australia or New Zealand, easy calculations allow you to estimate local rise and set times for the Sun, Moon and planets. The 2014 Australasian Sky Guide also provides information on the solar system, updated with the latest findings from space probes. Published annually since 1991, the Sky Guide continues to be a favourite with photographers,

  19. 2015 Australasian sky guide

    CERN Document Server

    Lomb, Nick

    2014-01-01

    Compact, easy to use and reliable, this popular guide has been providing star gazers with everything they need to know about the southern night sky for the past 25 years. The 2015 guide will celebrate this landmark with highlights from the past as well as monthly astronomy maps, viewing tips and highlights, and details of the year's exciting celestial events.Wherever you are in Australia or New Zealand, easy calculations allow you to estimate local rise and set times for the Sun, Moon and planets. The 2015 Australasian Sky Guide also provides information on the solar system, updated with the l

  20. Changing my perspective: How the development of emergency medicine in Sri Lanka can inform the Australasian experience.

    Science.gov (United States)

    Taylor, Nicholas

    2016-10-01

    When compared to an Australasian ED, the two major differences in the emergency medicine practice at Teaching Hospital Karapitiya are which patients are selected at triage and how those selected present. These differences have caused me to reflect on emergency medicine practice in Australasia and wonder if this practice is sustainable. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  1. Trauma Registry of the Pan-American Trauma Society: One year of experience in two hospitals in southwest Colombia

    Science.gov (United States)

    Ordoñez, Carlos A; Rojas-Mirquez, Johanna Carolina; Bonilla-Escobar, Francisco Javier; Badiel, Marisol; Miñán Arana, Fernando; González, Adolfo; Pino, Luis Fernando; Uribe-Gómez, Amadeus; Herrera, Mario Alain; Gutiérrez-Martínez, Maria Isabel; Puyana, Juan Carlos; Abutanos, Michael; Ivatury, Rao R

    2016-01-01

    Background: Trauma information systems are needed to improve decision making and to identify potential areas of intervention. Objective: To describe the first year of experience with a trauma registry in two referral centers in southwest Colombia. Methods: The study was performed in two referral centers in Cali. Patients with traumatic injuries seen between January 1 and December 31, 2012, were included. The collected information included demographics, mechanism of trauma, injury severity score (ISS), and mortality. A descriptive analysis was carried out. Results: A total of 17,431 patients were registered, of which 67.8% were male with an average age of 30 (±20) years. Workplace injuries were the cause of emergency consultations in 28.2% of cases, and falls were the most common mechanism of trauma (37.3%). Patients with an ISS ≥15 were mostly found in the 18-35-year age range (6.4%). Most patients who suffered a gunshot wound presented an ISS ≥15. A total of 2.5% of all patients died, whereas the mortality rate was 54% among patients with an ISS ≥15 and a gunshot wound. Conclusion: Once the trauma registry was successfully implemented in two institutions in Cali, the primary causes of admission were identified as falls and workplace injuries. The most severely compromised patients were in the population range between 18 and 35 years of age. The highest mortality was caused by gunshot wounds. PMID:27821894

  2. TRAUMA

    African Journals Online (AJOL)

    Increasing temperatures are associated with increased attendances. Soccer matches and their outcomes have no significant effect on IPV-related attendances. Conclusion: Temporal and weather factors can help predict which trauma unit shifts will be busiest. Keywords: trauma unit, assault, motor vehicle collision, weather, ...

  3. TRAUMA

    African Journals Online (AJOL)

    Blunt trauma. (n = 17). 3 (17.6%). 2. 14 (82.4%). 0. Table 2. Types of complications according to Clavien-Dindo classification. Clavien-Dindo Grading. Postoperative Complications (number). I. Wound Sepsis (3), Ileus (1). II. Pneumonia (2). III a. Nil. III b. Empyema of chest (1)*. IV a. Acute Kidney Injury (1), Respiratory Failure ...

  4. TRAUMA

    African Journals Online (AJOL)

    2017-11-04

    Nov 4, 2017 ... and via a password protected mobile application program within 6 hours. The alcohol levels were reported in grams. TRAUMA. Serum alcohol levels ..... restricts advertising on alcohol consumption.22 In addition, the South African Department of Health has published the. MiniDrug MasterPlan 23 which ...

  5. The struggle for wholeness: addressing individual and collective trauma in violence-ridden societies.

    Science.gov (United States)

    C, Carolina López

    2011-01-01

    The present article begins with an overview of how staff at the Center for Dialogue and Human Wellbeing (CDBH)-at Tecnológico de Monterrey University in Chihuahua, México-approach the process of conflict transformation. Specifically, it focuses on CDBH's strategies for dealing with historical injury, as well as the individual and collective trauma existing between and among communities engaged in ongoing conflict. It proceeds to examine how traumatic memories are stored in the mind/brain, and how trauma can impact on individuals and communities locked into a cycle of violence. The ensuing section provides an overview of the debate and the literature concerning psychotherapeutic and holistic-kinesthetic approaches for addressing individual and collective trauma. A hypothetical workshop is then offered to give readers a clear idea of how trauma work is actually carried out. The article ends by asking what approaches can best be applied for transforming collective trauma into sacred memories, which can become the driving force for a continuing commitment to building and sustaining peace among segments of communities that had previously been in conflict with one another. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Development of the Australasian vascular surgical audit.

    Science.gov (United States)

    Bourke, Bernie M; Beiles, Charles Barry; Thomson, Ian A; Grigg, Michael J; Fitridge, Rob

    2012-01-01

    The purpose of this study was to describe the development of the Australasian Vascular Audit that was created to unify audit activities under the umbrella of the Australian and New Zealand Society for Vascular Surgery as a Web-based application. Constitutional change in late 2008 deemed participation in this audit compulsory for Society members. The Web-based application was developed and tested during 2009. Data for all open vascular surgery and for all endovascular procedures are collected at two points in the admission episode: at the time of operation and at discharge, and entered into the application. Data are analyzed to produce risk-adjusted outcomes. An algorithm has been developed to deal with outliers according to natural justice and to comply with the requirements of regulatory bodies. The Audit is protected by legislated privilege and is officially endorsed and indemnified by the Royal Australasian College of Surgeons. Confidentiality of surgeons and patients alike is ensured by a legally protected coding system and computer encryption system. Validation is by a verification process of 5% of members per year who are randomly selected. The application is completely funded by the Society. Data entry commenced on January 1, 2010. Over 40,000 vascular procedures were entered in the first year. The Audit application allows instantaneous on-line access to individual data and to deidentified group data and specific reports. It also allows real-time instantaneous production of log books for vascular trainees. The Audit has already gained recognition in the Australasian public arena during its first year of operation as an important benchmark of correct professional surgical behavior. Compliance has been extremely high in public hospitals but less so in private hospitals such that only 60% of members received a certificate of complete participation at the end of its first year of operation. An Internet-based compulsory audit of complete surgical practice is

  7. Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference (cooperative guidelines of the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology -Section of Vascular and Interventional Radiology- and the World Society of Emergency Surgery).

    Science.gov (United States)

    Magnone, Stefano; Coccolini, Federico; Manfredi, Roberto; Piazzalunga, Dario; Agazzi, Roberto; Arici, Claudio; Barozzi, Marco; Bellanova, Giovanni; Belluati, Alberto; Berlot, Giorgio; Biffl, Walter; Camagni, Stefania; Campanati, Luca; Castelli, Claudio Carlo; Catena, Fausto; Chiara, Osvaldo; Colaianni, Nicola; De Masi, Salvatore; Di Saverio, Salomone; Dodi, Giuseppe; Fabbri, Andrea; Faustinelli, Giovanni; Gambale, Giorgio; Capponi, Michela Giulii; Lotti, Marco; Marchesi, Gianmariano; Massè, Alessandro; Mastropietro, Tiziana; Nardi, Giuseppe; Niola, Raffaella; Nita, Gabriela Elisa; Pisano, Michele; Poiasina, Elia; Poletti, Eugenio; Rampoldi, Antonio; Ribaldi, Sergio; Rispoli, Gennaro; Rizzi, Luigi; Sonzogni, Valter; Tugnoli, Gregorio; Ansaloni, Luca

    2014-03-07

    Hemodynamically Unstable Pelvic Trauma is a major problem in blunt traumatic injury. No cosensus has been reached in literature on the optimal treatment of this condition. We present the results of the First Italian Consensus Conference on Pelvic Trauma which took place in Bergamo on April 13 2013. An extensive review of the literature has been undertaken by the Organizing Committee (OC) and forwarded to the Scientific Committee (SC) and the Panel (JP). Members of them were appointed by surgery, critical care, radiology, emergency medicine and orthopedics Italian and International societies: the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology, Section of Vascular and Interventional Radiology and the World Society of Emergency Surgery. From November 2012 to January 2013 the SC undertook the critical revision and prepared the presentation to the audience and the Panel on the day of the Conference. Then 3 recommendations were presented according to the 3 submitted questions. The Panel voted the recommendations after discussion and amendments with the audience. Later on a email debate took place until December 2013 to reach a unanimous consent. We present results on the 3 following questions: which hemodynamically unstable patient needs an extraperitoneal pelvic packing? Which hemodynamically unstable patient needs an external fixation? Which hemodynamically unstable patient needs emergent angiography? No longer angiography is considered the first therapeutic maneuver in such a patient. Preperitoneal pelvic packing and external fixation, preceded by pelvic binder have a pivotal role in the management of these patients

  8. [Analysis of the results [corrected] of survey on trauma systems: The neglected disease of the modern society].

    Science.gov (United States)

    Costa Navarro, David; Jiménez Fuertes, Montiel; Ceballos Esparragón, José; Montón Condón, Soledad; Jover Navalón, José María; Turégano Fuentes, Fernando; Navarro Soto, Salvador

    2013-01-01

    Trauma injuries are the main cause of death in the world. The aim of this study is to determine how trauma patients are treated in Spain at an organizational level. A questionnaire was prepared consisting of 14 questions regarding aspects of the trauma care organization and trauma education. It was posted on the web site of the Spanish College of Surgeons and all members were encouraged to participate. One hundred and ninety questionnaires from 110 different hospitals were received. More than two-thirds (67.3%) of the centers had protocols for treating trauma patients, with 81% of them based on ATLS guidelines. Almost three-quarters (72.6%) of the doctors had completed the ATLS course, and 38.9% the DSTC course. There was a specific education program in trauma in 24.5% of the centers, and 35.5% had a Trauma Committee. There was a rehabilitation program in 24.5% of the centers. Very few of the participating centers would fulfill the requirements of the American College of Surgeons accreditation for trauma centers. Trauma care in Spain has improved a lot in the recent years, but there is still a lot to do to reach the level of that in the United States of America. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  9. "Recommendations for uniform reporting of data following major trauma--the Utstein style" (as of July 17, 1999). An International Trauma Anaesthesia and Critical Care Society (ITACCS).

    Science.gov (United States)

    Dick, W F; Baskett, P J; Grande, C; Delooz, H; Kloeck, W; Lackner, C; Lipp, M; Mauritz, W; Nerlich, M; Nicholl, J; Nolan, J; Oakley, P; Parr, M; Seekamp, A; Soreide, E; Steen, P A; van Camp, L; Wolcke, B; Yates, D

    2000-01-01

    Basic and advanced care of trauma patients has always been an important aspect of prehospital and immediate in-hospital emergency medicine, involving a broad spectrum of disciplines, specialties and skills delivered through Emergency Medical Services Systems which, however, may differ significantly in structure, resources and operation. This complex background has, at least in part, hindered the development of a uniform pattern or set of criteria and definitions. This in turn has hitherto rendered data incompatible, with the consequence that such differing systems or protocols of care cannot be readily evaluated or compared with acceptable validity. Guided by previous consensus processes evolved by the ERC, the AHA and other International Organizations--represented in ILCOR--on 'Uniform reporting of data following out-of-hospital and in-hospital cardiac arrest--the Utstein style' an international working group of ITACCS has drafted a document, 'Recommendations for uniform reporting of data following major trauma--the Utstein style'. The reporting system is based on the following considerations: A structured reporting system based on an "Utstein style template" which would permit the compilation of data and statistics on major trauma care, facilitating and validating independent or comparative audit of performance and quality of care (and enable groups to challenge performance statistics which did not take account of all relevant information). The recommendations and template should encompass both out-of-hospital and in-hospital trauma care. The recommendations and template should further permit intra- and inter-system evaluation to improve the quality of delivered care and identification of the relative benefits of different systems and innovative initiatives. The template should facilitate studies setting out to improve epidemiological understanding of trauma; for example such studies might focus on the factors that determine survival. The document is structured

  10. Recommendations for uniform reporting of data following major trauma--the Utstein Style: an initiative. International Trauma Anaesthesia and Critical Care Society (ITACCS)

    Science.gov (United States)

    1999-01-01

    Basic and advanced care of trauma patients always has been an important aspect of prehospital and immediate in-hospital Emergency Medicine, involving a broad spectrum of disciplines, specialties, and skills delivered through Emergency Medical Services Systems which, however, may differ significantly in structure, resources, and operation. This complex background, at least in part, has hindered the development of a uniform pattern or set of criteria and definitions. This in turn, has rendered data incompatible, with the consequence that such differing systems or protocols of care cannot be evaluated or compared readily with acceptable validity. Guided by previous consensus processes evolved by the ERC, the AHA, and other International Organisations represented in ILCOR--on Uniform Reporting of Data following Out-of-hospital and In-hospital Cardiac Arrest--the Utstein Style, an international working group of ITACCS, has drafted a document, Recommendations for Uniform Reporting of Data following Major Trauma--the Utstein Style. The reporting system is based on the following considerations: 1) A structured reporting system based on an "Utstein style template" that would permit the compilation of data and statistics on major trauma care, facilitating and validating independent or comparative audit of performance, and quality of care (and enable groups to challenge performance statistics that did not take account of all relevant information); 2) The Recommendations and Template should encompass both out-of-hospital and in-hospital trauma care; 3) The Recommendations and Template should permit further intra- and inter-system evaluation to improve the quality of delivered care and identification of the relative benefits of different systems and innovative initiatives; and 4) The Template should facilitate studies setting out to improve epidemiological understanding of trauma; for example, such studies might focus on the factors that determine survival. The document is

  11. Why change the name of the College from Australasian to Australian and New Zealand?

    Science.gov (United States)

    Ardagh, Michael

    2017-12-01

    Australasian is the adjectival version of the name of a geographical region. The region is defined differently by different people. It includes islands other than Australia and New Zealand and variably includes or excludes New Guinea. It has nothing to do with Asia. The adjective is often misunderstood, it leaves New Zealand invisible to many readers and it is an incorrect description of who we are as a college. Australian and New Zealand describes who we are - fellows from two sovereign nations - Australia and New Zealand. Changing the name is not about secession, division nor ingratitude and does not undermine the College's commitment to helping other nations in the greater region. It is a positive acknowledgement of who we are and a strong foundation for a united College's future growth. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  12. Piloting an online incident reporting system in Australasian emergency medicine.

    Science.gov (United States)

    Schultz, Timothy J; Crock, Carmel; Hansen, Kim; Deakin, Anita; Gosbell, Andrew

    2014-10-01

    Medical-specific incident reporting systems are critical to understanding error in healthcare but underreporting by doctors reduces their value. We conducted a pilot study of the implementation of an online ED-specific incident reporting system in Australasian hospitals and evaluated its use. The reporting system was based on the literature and input of experts. Thirty-one hospital EDs were approached to pilot the Emergency Medicine Events Register (EMER). The pilot evaluated: website usage and analytics, reporting behaviours and rates, the quality of information collected in EMER. Semi-structured interviews of three site champions responsible for implementing EMER were conducted. Seventeen EDs expressed interest; however, due to delays and other barriers reporting only occurred at three sites. Over 354 days, the website received 362 unique visitors and 77 incidents. The median time to report was 4.6 min. The reporting rate was 0.07 reports per doctor month, suggesting a reporting rate of 0.08% of ED presentations. Data quality, as measured by the number of completed non-mandatory fields and ability to classify incidents, was very high. The interviews identified enablers (the EMER system, site champions) and barriers (chiefly the context of EM) to EMER uptake. Collecting patient safety information by frontline doctors is essential to actively engage the profession in patent safety. Although the EMER system allowed easy online reporting of high quality incident data by doctors, site recruitment and system uptake proved difficult. System use by ED doctors requires dedicated and conscious effort from the profession. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  13. Experimenting with clinical networks: the Australasian experience.

    Science.gov (United States)

    Cunningham, Frances C; Morris, Andrew D; Braithwaite, Jeffrey

    2012-01-01

    Australian states have embraced clinical networking as a mechanism for managing, organising and improving the quality of care. Using these individualised state approaches to clinical networks, in this paper the authors aim to examine this Australasian "experimentation" and present lessons for other health systems. The paper draws on current knowledge from the literature on clinical networks. The 2010 Inaugural Australasian Clinical Networks Conference also serves as a primary resource, as well as the authors' extensive discussions with policy-makers, managers and clinicians in Australasian systems. Key themes from the literature include: network type (mandated or natural, and hybrids); network purpose; the importance of network objectives; drivers of network success and barriers; the need for consumer engagement; and the difficulty of evaluating network effectiveness. Policy challenges include the establishment of networks for some specialty areas and not others; how to develop common standards across networks; and the need for performance metrics to assess network impact on patient outcomes. Australian networks report difficulties with achieving greater involvement of rural clinicians and indigenous populations, and with private sector clinical engagement. There are challenges too with implementation, at service level, of models of care and recommendations. Clinical networks are becoming a fundamental vehicle for clinical improvement and change across complex organisational and professional boundaries. How to nurture and sustain effective clinical networks is of import to every health system and the authors invite stakeholders in health systems to network and share their empirical research on clinical networks to assist with distinguishing the evidence from the rhetoric.

  14. Australasian Diabetes Data Network: Building a Collaborative Resource.

    Science.gov (United States)

    Clapin, Helen; Phelan, Helen; Bruns, Loren; Sinnott, Richard; Colman, Peter; Craig, Maria; Jones, Timothy

    2016-09-01

    Australasia is a region with a high incidence of type 1 diabetes (T1D). There are approximately 140 000 individuals with T1D, and of these 10 000 are children. Although the region covers a huge geographical area, most children with T1D are managed by tertiary academic centers in the major capital cities. Local longitudinal data collection has been in place for several decades in most of these centers, however ongoing national data collection had not been attempted. In 2012, with funding from the Juvenile Diabetes Research Foundation (JDRF) Australian Type 1 Clinical Research Network, a national collaboration was formed to provide ongoing longitudinal collection of T1D patient characteristics and outcomes. The initial phase of this collaboration, known as the Australasian Diabetes Data Network or ADDN, was led by the Australasian Paediatric Endocrine Group (APEG) and thus included only children and adolescents. The next phase, commenced in 2016, will see adult sites added through collaboration with the Australian Diabetes Society (ADS). As most of the initial centers had longitudinal data collection in place the model employed was to establish the transfer and collation of data already collected into a central database. This required the definition of a common data dictionary, ethics and governance procedures and the employment of technology to enable efficient and accurate information transfer and accessibility. The ADDN project received widespread support from the diabetes research community with study investigators representing 20 pediatric centers across the region. The first phase focused on the 5 largest centers and at the end of 2015 these centers were uploading patient data to the ADDN database on a quarterly basis resulting in 5271 patients with 83 506 diabetes visits. © 2016 Diabetes Technology Society.

  15. Australasian disasters of national significance: an epidemiological analysis, 1900-2012.

    Science.gov (United States)

    Bradt, David A; Bartley, Bruce; Hibble, Belinda A; Varshney, Kavita

    2015-04-01

    A regional epidemiological analysis of Australasian disasters in the 20th century to present was undertaken to examine trends in disaster epidemiology; to characterise the impacts on civil society through disaster policy, practice and legislation; and to consider future potential limitations in national disaster resilience. A surveillance definition of disaster was developed conforming to the Centre for Research on the Epidemiology of Disasters (CRED) criteria (≥10 deaths, ≥100 affected, or declaration of state emergency or appeal for international assistance). The authors then applied economic and legislative inclusion criteria to identify additional disasters of national significance. The surveillance definition yielded 165 disasters in the period, from which 65 emerged as disasters of national significance. There were 38 natural disasters, 22 technological disasters, three offshore terrorist attacks and two domestic mass shootings. Geographic analysis revealed that states with major population centres experienced the vast majority of disasters of national significance. Timeline analysis revealed an increasing incidence of disasters since the 1980s, which peaked in the period 2005-2009. Recent seasonal bushfires and floods have incurred the highest death toll and economic losses in Australasian history. Reactive hazard-specific legislation emerged after all terrorist acts and after most disasters of national significance. Timeline analysis reveals an increasing incidence in natural disasters over the past 15 years, with the most lethal and costly disasters occurring in the past 3 years. Vulnerability to disaster in Australasia appears to be increasing. Reactive legislation is a recurrent feature of Australasian disaster response that suggests legislative shortsightedness and a need for comprehensive all-hazards model legislation in the future. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  16. Diagnosis of subarachnoid haemorrhage: a survey of Australasian emergency physicians and trainees.

    Science.gov (United States)

    Rogers, Andrew; Furyk, Jeremy; Banks, Colin; Chu, Kevin

    2014-10-01

    This study aims to establish current practice among Australasian emergency physicians and trainees on several aspects of the investigation of suspected subarachnoid haemorrhage (SAH). An electronic questionnaire (SurveyMonkey™) was distributed to emergency physicians and trainees by email through the ACEM. Survey recipients were asked about demographics, followed by a series of questions relating to the investigation of SAH. There were 878 survey respondents (response rate 24%). Our data showed that 47.3% of respondents agreed or strongly agreed that a CT brain within 6 h of headache onset is sufficient to exclude a diagnosis of SAH. For a CT performed within 12 h of ictus, 14.4% were satisfied that SAH could be excluded. After a negative CT scan, for further investigation of SAH, 88% of respondents preferred lumbar puncture to CT angiography. For detection of xanthochromia in the cerebrospinal fluid, 57.7% of respondents felt that spectrophotometry (vs visual inspection) is necessary to accurately diagnose SAH. A range of information was collected regarding the investigation of suspected SAH. We report significant differences in the diagnostic approach of Australasian emergency physicians and trainees to this condition, in particular the utility of CT within 6 h for exclusion of SAH. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  17. Lessons learnt from incidents involving the airway and breathing reported from Australasian emergency departments.

    Science.gov (United States)

    Crock, Carmel; Hansen, Kim; Fogg, Toby; Cahill, Angela; Deakin, Anita; Runciman, William B

    2018-02-01

    To review incident reports relating to problems encountered during the ED management of patients with 'airway or breathing' problems, with the aim of finding and highlighting common themes within these rare events, and making recommendations to further improve patient safety in the areas in which deficiencies have been identified. Thematic analysis of 36 incidents reported from Australasian EDs, which were related to problems with airway and breathing. In all, 51 problems were identified among the 36 incidents related to airway and/or breathing. Fourteen involved clinical decision-making, 11 equipment, nine communication, seven intubation, five surgical access and five pneumothorax. Eight incidents involved children and there were nine deaths within hours or days. Recommendations for improving preparedness of ED staff and facilities have been made for each of the problem areas identified with respect to clinical practice, equipment, communication and clinical process. Analysis of incidents from the Australasian Emergency Medicine Events Register allows clusters of like-events to be identified and characterised, providing the possibility of getting a better idea of how problems present and progress, with some information about contributing factors, characteristics and context. This will pave the way for earlier and better detection of life-threatening problems and the development and reinforcement of preventive and corrective strategies. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  18. TRAUMA SURGERY

    African Journals Online (AJOL)

    and track this epidemic. A number of socio-political changes have continued, and these will impact on the trauma patterns seen in the country. Gun control legislation has been enforced since the turn of the millennium, and there have been ongoing attempts to demilitarise society by removing assault weapons. The ongoing ...

  19. Mental health problems in Pakistani society as a consequence of violence and trauma: a case for better integration of care

    Directory of Open Access Journals (Sweden)

    Muhammad Tahir Khalily

    2011-10-01

    Full Text Available Objectives: This paper discusses the increasing incidence of mental health problems in Pakistan, and specifically in the Swat valley, in relation to the growing insurgency and current violence in Pakistani society. The paper argues that the health care system's response in Pakistan is not adequate to meet the current challenges and that changes in policy are needed to build mental health care services as an important component of the basic health package at primary care level in the public sector.Method: This paper reviews the existing mental health situation in Pakistan with reference to the findings of a case study in the Swat valley in Khyber Pukhtoonkhwa Pakistan. The figures presented in the case study are used to support the need for an integrated national mental health policy.Conclusion: Mental health care needs to be incorporated as a core service in primary care and supported by specialist services. There is a strong need to provide adequate training for general practitioners and postgraduate training for mental health professionals to meet the current demands. A collaborative network between stakeholders in the public and private sector, as well as non-governmental organisations are required that promotes mental health care and advocates for changes in mental health policy.

  20. References in the Australasian Medical Journal

    Directory of Open Access Journals (Sweden)

    Prakash Adhikari

    2010-12-01

    Full Text Available BackgroundReferences serve as an important tool in providing credibility to the published literature and to assist retrieval of the cited and related information. This study was done to observe the accuracy of references in articles published in Australasian Medical Journal.Method Fifty references were randomly selected from two different issues of Australasian Medical Journal (AMJ: Volume 3, Number 11, 2010 and Volume 3, Number 10, 2010. The instructions for authors of this journal were examined. References from each article were compared with the original for accuracy, using the following six elements: 1 authors; including spelling, initials, order and number; 2 title, including spelling and punctuation; 3 journal name, including use of correct abbreviation as listed in Index Medicus; 4 year; 5 volume; and 6 page numbers, including first and last page numbers. Citations were considered incorrect if there was an error in any of these six elements. References not cited from indexed journals were excluded. Statistical analysis was done by using frequency and percentage.ResultsResults show that 14.0% references in AMJ were inaccurate. Most common errors were author’s name and journal name. Author’s names were found to be incorrect in 10.0% references while journal name (either incorrect abbreviations or incorrect instructions or punctuation errors were found to be incorrect in 4.0%. Least common error was found in writing the title of the article (2.0%. There were no errors found in other elements.ConclusionErrors in citing the references are also found in the AMJ. The quoted error in this study (14.0% is comparable to other international literature. The majority of errors are avoidable. So, the authors, editors and the reviewers have to check for any errors seriously before publication in the journal.

  1. Public health in Australasian emergency departments: Attitudes, barriers and current practices.

    Science.gov (United States)

    Egerton-Warburton, Diana; Gosbell, Andrew; Moore, Katie; Jelinek, George A

    2015-12-01

    To understand the attitudes of consultant emergency medicine physicians and advanced trainees and the perceived barriers to public health interventions in Australasian EDs. This was a voluntary cross-sectional, mixed-methods online survey of consultant emergency physicians and advanced trainees of the ACEM, conducted between December 2011 and March 2012. Eight hundred and fifty-six ACEM members responded to the survey - a response rate of 33%. A similar number of consultants (70%) and trainees (75%) believed public health initiatives should be provided in the ED. Barriers identified by a similar majority of consultants and trainees to the implementation of public health interventions in EDs included dedicated time available for staff to be involved; available public health resources; available funding; clinical staff skills and expertise in public health; and the availability of staff training. Public health and health promotion are perceived by the majority of emergency medicine physicians as important in emergency medicine; however, substantial barriers exists to their implementation. Development of an evidence-based approach to public health interventions, which are effective and feasible in the ED environment, will facilitate a more comprehensive approach to public health initiatives in emergency medicine. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  2. New occurrences of Australasian microtektites in the Central Indian Basin

    Digital Repository Service at National Institute of Oceanography (India)

    ShyamPrasad, M.

    Thirty-three microtektites have been recovered from four different sites in the Central Indian Basin. Based on their physical properties, geographical occurrence and chemical composition, they are identified as belonging to the Australasian tektite...

  3. Does the presence of an emergency physician influence pre-hospital time, pre-hospital interventions and the mortality of severely injured patients? A matched-pair analysis based on the trauma registry of the German Trauma Society (TraumaRegister DGU®).

    Science.gov (United States)

    Bieler, Dan; Franke, Axel; Lefering, Rolf; Hentsch, Sebastian; Willms, Arnulf; Kulla, Martin; Kollig, Erwin

    2017-01-01

    The role of emergency physicians in the pre-hospital management of severely injured patients remains controversial. In Germany and Austria, an emergency physician is present at the scene of an emergency situation or is called to such a scene in order to provide pre-hospital care to severely injured patients in approximately 95% of all cases. By contrast, in the United States and the United Kingdom, paramedics, i.e. non-physician teams, usually provide care to an injured person both at the scene of an incident and en route to an appropriate hospital. We investigated whether physician or non-physician care offers more benefits and what type of on-site care improves outcome. In a matched-pair analysis using data from the trauma registry of the German Trauma Society, we retrospectively (2002-2011) analysed the pre-hospital management of severely injured patients (ISS ≥16) by physician and non-physician teams. Matching criteria were age, overall injury severity, the presence of relevant injuries to the head, chest, abdomen or extremities, the cause of trauma, the level of consciousness, and the presence of shock. Each of the two groups, i.e. patients who were attended by an emergency physician and those who received non-physician care, consisted of 1235 subjects. There was no significant difference between the two groups in pre-hospital time (61.1 [SD 28.9] minutes for the physician group and 61.9 [SD 30.9] minutes for non-physician group). Significant differences were found in the number of pre-hospital procedures such as fluid administration, analgosedation and intubation. There was a highly significant difference (ppre-hospital care. It shows, however, that there was no significant difference in mortality although patients who were attended by non-physician teams received fewer pre-hospital interventions with similar scene times. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Prospects after Major Trauma

    NARCIS (Netherlands)

    Holtslag, H.R.

    2007-01-01

    Introduction. After patients survived major trauma, their prospects, in terms of the consequences for functioning, are uncertain, which may impact severely on patient, family and society. The studies in this thesis describes the long-term outcomes of severe injured patients after major trauma. In

  5. Effect of a pager notification system on Australasian Triage Scale category 2 patients in a paediatric emergency department.

    Science.gov (United States)

    Cheng, Daryl R; McCartney, Laura E; West, Adam; Craig, Simon S

    2016-08-01

    Australasian EDs have introduced innovative processes to ensure safe and timely management of patients. Our ED introduced a dedicated pager system to provide rapid assessment of Australasian Triage Scale (ATS) category 2 patients in an attempt to expedite ED care. The present paper aims to evaluate the impact of this initiative on time to clinician, ED length of stay (LOS) and clinical outcomes in a tertiary paediatric ED. Retrospective structured chart review on patients presenting in a 2 month period before the intervention (August-September 2009) and the same time 1 year later. Patients were grouped into common ATS category 2 presentations and analysed in these subcategories. Clinical indicators of appropriate and timely performance were selected from best practice performance guidelines. 779 ATS category 2 patients were seen during the two periods: 370 pre-intervention and 409 post-intervention. The overall percentage of ATS category 2 patients seen within the target time increased by 22.3%, although there was no significant change in ED LOS. The median time for patients from triage to being seen by an ED clinician improved from 10 to 6 min (P Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  6. Driving the Profession of Health Informatics: The Australasian College of Health Informatics.

    Science.gov (United States)

    Pearce, Christopher; Veil, Klaus; Williams, Peter; Cording, Andrew; Liaw, Siaw-Teng; Grain, Heather

    2015-01-01

    Across the world, bodies representing health informatics or promoting health informatics are either societies of common interest or universities with health informatics courses/departments. Professional colleges in Health Informatics (similar to the idea of professional colleges in other health fields) are few and far between. The Australasian College of Health Informatics has been in existence since 2001, and has an increasing membership of nearly 100 fellows and members, acting as a national focal point for the promotion of Health Informatics in Australasia. Describing the activities of the college, this article demonstrates a need for increasing professionalization of Health informatics beyond the current structures.

  7. The Australasian Psoriasis Collaboration view on methotrexate for psoriasis in the Australasian setting.

    Science.gov (United States)

    Rademaker, Marius; Gupta, Monisha; Andrews, Megan; Armour, Katherine; Baker, Chris; Foley, Peter; Gebauer, Kurt; George, Jacob; Rubel, Diana; Sullivan, John

    2017-08-01

    The Australasian Psoriasis Collaboration reviewed methotrexate (MTX) in the management of psoriasis in the Australian and New Zealand setting. The following comments are based on expert opinion and a literature review. Low-dose MTX (< 0.4 mg/kg per week) has a slow onset of action and has moderate to good efficacy, together with an acceptable safety profile. The mechanism of action is anti-inflammatory, rather than immunosuppressive. For pretreatment, consider testing full blood count (FBC), liver and renal function, non-fasting lipids, hepatitis serology, HbA1c and glucose. Body mass index and abdominal circumference should also be measured. Optional investigations in at-risk groups include an HIV test, a QuantiFERON-TB Gold test and a chest X-ray. In patients without complications, repeat the FBC at 2-4 weeks, then every 3-6 months and the liver/renal function test at 3 months and then every 6 months. There is little evidence that a MTX test dose is of value. Low-dose MTX rarely causes clinically significant hepatotoxicity in psoriasis. Most treatment-emergent liver toxicity is related to underlying metabolic syndrome and non-alcoholic fatty liver disease or non-alcoholic steatohepatitis. Alcohol itself is not contraindicated, but should be limited to < 20 gm/day. [Correction added on 6 January 2017, after first online publication: '20 mg/day' has been corrected to '20 gm/day'.] Although MTX is a potential teratogen post-conception, there is little evidence for this pre-conception. MTX does not affect the quality of sperm. There is no evidence that MTX reduces healing, so there is no specific need to stop MTX peri-surgery. MTX may be used in combination with cyclosporine, acitretin, prednisone and anti-tumour necrosis factor biologics. © 2016 The Australasian College of Dermatologists.

  8. Biodiversity and parasites of wildlife: helminths of Australasian marsupials.

    Science.gov (United States)

    Beveridge, Ian; Spratt, David M

    2015-04-01

    Despite current attempts to document the extent of biodiversity on Earth, significant problems exist in fully documenting the helminth parasites of wildlife. Using the Australasian marsupials as an example, we examine some of these difficulties, including challenges in collecting uncommon host species, the ongoing description of new species of marsupials, the presence of cryptic species, and the decline in taxonomic expertise in Australia. Although optimistic global predictions have been made concerning the rate of discovery and description of new species of animals, these predictions may not apply in the case of specific groups of animals such as the Australasian marsupials. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Unveiling the diversification dynamics of Australasian predaceous diving beetles in the Cenozoic.

    Science.gov (United States)

    Toussaint, Emmanuel F A; Condamine, Fabien L; Hawlitschek, Oliver; Watts, Chris H; Porch, Nick; Hendrich, Lars; Balke, Michael

    2015-01-01

    During the Cenozoic, Australia experienced major climatic shifts that have had dramatic ecological consequences for the modern biota. Mesic tropical ecosystems were progressively restricted to the coasts and replaced by arid-adapted floral and faunal communities. Whilst the role of aridification has been investigated in a wide range of terrestrial lineages, the response of freshwater clades remains poorly investigated. To gain insights into the diversification processes underlying a freshwater radiation, we studied the evolutionary history of the Australasian predaceous diving beetles of the tribe Hydroporini (147 described species). We used an integrative approach including the latest methods in phylogenetics, divergence time estimation, ancestral character state reconstruction, and likelihood-based methods of diversification rate estimation. Phylogenies and dating analyses were reconstructed with molecular data from seven genes (mitochondrial and nuclear) for 117 species (plus 12 outgroups). Robust and well-resolved phylogenies indicate a late Oligocene origin of Australasian Hydroporini. Biogeographic analyses suggest an origin in the East Coast region of Australia, and a dynamic biogeographic scenario implying dispersal events. The group successfully colonized the tropical coastal regions carved by a rampant desertification, and also colonized groundwater ecosystems in Central Australia. Diversification rate analyses suggest that the ongoing aridification of Australia initiated in the Miocene contributed to a major wave of extinctions since the late Pliocene probably attributable to an increasing aridity, range contractions and seasonally disruptions resulting from Quaternary climatic changes. When comparing subterranean and epigean genera, our results show that contrasting mechanisms drove their diversification and therefore current diversity pattern. The Australasian Hydroporini radiation reflects a combination of processes that promoted both diversification

  10. A review of the water mite fauna from the Australasian and Pacific region (Acari: Hydrachnidia)

    NARCIS (Netherlands)

    Smit, H.

    2005-01-01

    A review is given of the water mite fauna of the Australasian and Pacific region. Within the Australasian region, New Zealand has the highest percentage of endemism. It is concluded that the water mite fauna of the islands in the South Pacific is of Australasian origin, while the water mite fauna of

  11. Iron Redox Variations in Australasian Muong Nong-Type Tektites

    Science.gov (United States)

    Giuli, G.; Cicconi, M. R.; Trapananti, A.; Eeckhout, S. G.; Pratesi, G.; Paris, E.; Koeberl, C.

    2013-09-01

    The Fe oxidation state along profiles across dark and light layers of two Australasian Muong Nong tektite samples have been studied by Fe K-edge XANES. The dark layer results to be slightly but reproducibly more oxidized respect to the light layers.

  12. Development of the Australasian Survey of Student Engagement (AUSSE)

    Science.gov (United States)

    Coates, Hamish

    2010-01-01

    Student learning and development are the core business of the academy, yet until recently Australian and New Zealand universities lacked data on students' engagement in effective educational practices. This paper reports the foundations and development of the Australasian Survey of Student Engagement (AUSSE)--the largest educationally focused…

  13. Setting the pace: the 2011 Australasian Podiatry Council conference

    Directory of Open Access Journals (Sweden)

    Firth Julia

    2011-07-01

    Full Text Available Abstract The 2011 Australasian Podiatry Council conference was held from April 26 to 29 in Melbourne, Victoria, Australia. This commentary provides a brief overview of the conference, including the speakers and topic areas covered, selected original research highlights, and award winning presentations.

  14. Setting the pace: the 2011 Australasian Podiatry Council conference

    Science.gov (United States)

    2011-01-01

    The 2011 Australasian Podiatry Council conference was held from April 26 to 29 in Melbourne, Victoria, Australia. This commentary provides a brief overview of the conference, including the speakers and topic areas covered, selected original research highlights, and award winning presentations. PMID:21762520

  15. Childhood trauma and risky alcohol consumption: a study of Australian adults with low housing stability.

    Science.gov (United States)

    Keane, Carol; Magee, Christopher A; Lee, Jeong Kyu

    2015-01-01

    This paper examined whether recall of childhood trauma was associated with adult alcohol consumption in a sample of Australians with low housing security. The secondary aim was to examine whether risky alcohol consumption predicted subsequent housing instability. Sociodemographic factors were examined as potential moderators of these associations. This paper utilised data collected through the Journeys Home Study, a longitudinal study of a representative sample of individuals who were homeless or at risk of homelessness. This paper focused on 1224 participants aged 18 years and over. Data on alcohol use, childhood trauma and sociodemographic characteristics were collected through interviews at baseline. Homeless status at 6- to 12-month follow-up was assessed via interview. Logistic regression modelling was used to examine associations of alcohol consumption with childhood abuse, sociodemographic factors and changes in homelessness status. Self-reported recall of childhood experiences of violence was more likely among current drinkers, risky or not, than among abstainers. Recall of childhood neglect was more common among abstainers than among risky drinkers. The relationships between recall of childhood trauma and adult alcohol consumption are likely to be complex. Risky consumption may contribute to continuing homelessness among adults with unstable housing. [Correction added on 29 December 2014, after first online publication: The Results, and Discussion and Conclusion sections in the abstract have been replaced.]. © 2014 Australasian Professional Society on Alcohol and other Drugs.

  16. American Society of Anesthesiologists

    Science.gov (United States)

    ... Trauma ASA and CAE Healthcare’s virtual O.R. Popular Courses Member Exclusive Difficult Airway Algorithm Member login ... You Industry Supporters Whose contributions allow the American Society of Anesthesiologists ® to create world-class education and ...

  17. Validation of Australian data in the Australasian Vascular Audit.

    Science.gov (United States)

    Beiles, Charles Barry; Bourke, Bernie M

    2014-09-01

    Accuracy of data is important in any clinical audit. It is necessary to determine how complete the dataset is as well as the accuracy of the data that have been entered. The Australasian Vascular Audit has been operational for 4 years and a data validation process has been undertaken. An independent data source is available, which is collected by the Australian Institute of Health and Welfare. This collects all public and private hospital data and is available for interrogation. Similarly, private-only data are available from the Medicare website. This has been compared with the Australasian Vascular Audit dataset to establish completeness of data collection. Quality of data collected has been verified by comparing accuracy of data fields with that present in patient records in a 5% random sample. For the 2 years studied, there was a 63% capture rate in Australia for all patients. In the private sector, only 50% of patients were captured with a significant decrease noted in 2013. The quality of data entered had a 2.6% error rate. There is a need to increase compliance with vascular audit in Australia and data accuracy is acceptable but could be improved. © 2014 Royal Australasian College of Surgeons.

  18. Management of colorectal trauma: a review.

    Science.gov (United States)

    Cheong, Ju Yong; Keshava, Anil

    2017-07-01

    Traumatic colorectal injuries are common during times of military conflict, and major improvements in their care have arisen in such periods. Since World War II, many classification systems for colorectal trauma have been proposed, including (i) Flint Grading System; (ii) Penetrating Abdominal Trauma Index; (iii) Colonic/Rectal Injury Scale; and (iv) destructive/non-destructive colonic injuries. The primary goal of these classifications was to aid surgical management and, more particularly, to determine whether a primary repair or faecal diversion should be performed. Primary repair is now the preferred surgical option. Patients who have been identified as having destructive injuries have been found to have higher anastomotic leak rates after a primary repair. Damage control principles need to be adhered to in surgical decision-making. In this review, we discuss the mechanisms of injury, classifications, clinical presentation and current recommendations for the management of colorectal trauma. © 2017 Royal Australasian College of Surgeons.

  19. Are Australasian Genetic Counselors Interested in Private Practice at the Primary Care Level of Health Service?

    Science.gov (United States)

    Sane, Vrunda; Humphreys, Linda; Peterson, Madelyn

    2015-10-01

    This study explored the perceived interest in development of private genetic counseling services in collaboration with primary care physicians in the Australasian setting by online survey of members of the Australasian Society of Genetic Counselors. Four hypothetical private practice models of professional collaboration between genetic counselors and primary care physicians or clinical geneticists were proposed to gauge interest and enthusiasm of ASGC members for this type of professional development. Perceived barriers and facilitators were also evaluated. 78 completed responses were included for analysis. The majority of participants (84.6 %) showed a positive degree of interest and enthusiasm towards potential for clinical work in private practice. All proposed practice models yielded a positive degree of interest from participants. Model 4 (the only model of collaboration with a clinical geneticist rather than primary care physician) was the clearly preferred option (mean = 4.26/5), followed by Model 2 (collaboration with a single primary care practice) (mean = 4.09/5), Model 3 (collaboration with multiple primary care clinics, multidisciplinary clinic or specialty clinic) (mean = 3.77/5) and finally, Model 1 (mean = 3.61/5), which was the most independent model of practice. When participants ranked the options in the order of preference, Model 4 remained the most popular first preference (44.6 %), followed by model 2 (21.6 %), model 3 (18.9 %) and model 1 was again least popular (10.8 %). There was no significant statistical correlation between demographic characteristics (age bracket, years of work experience, current level of work autonomy) and participants' preference for private practice models. Support from clinical genetics colleagues and the professional society was highly rated as a facilitator and, conversely, lack of such support as a significant barrier.

  20. Mediastinal staging of non-small-cell lung cancer among Australasian thoracic physicians: clinical practice and constraints on minimally invasive techniques.

    Science.gov (United States)

    Dabscheck, E J; Steinfort, D P; Irving, L B; Hew, M

    2012-06-01

    We determined current practice among Australasian thoracic physicians in the mediastinal staging of non-small-cell lung cancer (NSCLC). We focused on the availability of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) and constraints to its use, as there has been no systematic analysis regarding the availability and uptake of this new technology among thoracic physicians. Physician members of the Thoracic Society of Australia and New Zealand were emailed a survey seeking their current approach to three scenarios requiring mediastinal staging of NSCLC. Respondents were also asked for their preferred investigation for each scenario if any current constraints were removed. Relevant demographic information was sought. We received 164 responses from 512 Australasian physicians (34%). Without constraints, EBUS-TBNA was the preferred investigation for all three clinical scenarios, but only 33% of respondents had access to EBUS-TBNA. Constraints included lack of availability and lack of expertise. Reduced EBUS-TBNA access was associated with a number of clinician factors. Australasian thoracic physicians prefer EBUS-TBNA for the mediastinal staging of NSCLC, but access to EBUS-TBNA services is limited. We recommend targeted measures to improve access to EBUS-TBNA use and optimise mediastinal staging of NSCLC. © 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.

  1. Building an Australasian paramedicine research agenda: a narrative review.

    Science.gov (United States)

    O'Meara, Peter; Maguire, Brian; Jennings, Paul; Simpson, Paul

    2015-12-15

    The need for paramedicine research has been recognised internationally through efforts to develop out-of-hospital research agendas in several developed countries. Australasia has a substantial paramedicine research capacity compared to the discipline internationally and is well positioned as a potential leader in the drive towards evidence-based policy and practice in paramedicine. Our objective was to draw on international experiences to identify and recommend the best methodological approach that should be employed to develop an Australasian paramedicine research agenda. A search and critical appraisal process was employed to produce an overview of the literature related to the development of paramedicine research agendas throughout the world. Based on these international experiences, and our own analysis of the Australasian context, we recommend that a mixed methods approach be used to develop an inclusive Australasian Paramedicine Research Agenda. This approach will capture the views and interests of a wide range of expert stakeholders through multiple data collection strategies, including interviews, roundtable discussions and an online Delphi consensus survey. Paramedic researchers and industry leaders have the opportunity to use this multidisciplinary process of inquiry to develop a paramedicine research agenda that will provide a framework for the development of a culture of open evaluation, innovation and improvement. This research agenda would assess the progress of paramedicine research in Australia and New Zealand, map the research capacity of the paramedicine discipline, paramedic services, universities and professional organisations, identify current strengths and opportunities, make recommendations to capitalize on opportunities, and identify research priorities. Success will depend on ensuring the participation of a representative sample of expert stakeholders, fostering an open and collaborative roundtable discussion, and adhering to a predefined

  2. Beryllium-10 in Australasian tektites - Evidence for a sedimentary precursor

    Science.gov (United States)

    Pal, D. K.; Moniot, R. K.; Kruse, T. H.; Herzog, G. F.; Tuniz, C.

    1982-01-01

    Each of seven Australasian tektites contains about 100 micron atoms of beryllium-10 (half-life, 1.53 million years) per gram. Cosmic-ray bombardment of the australites cannot have produced the measured amounts of beryllium-10 either at the earth's surface or in space. The beryllium-10 contents of these australites are consistent with a sedimentary precursor that adsorbed from precipitation beryllium-10 produced in the atmosphere. The sediments must have spent several thousand years at the earth's surface within a few million years of the tektite-producing event.

  3. Australasian microtektites: Impactor identification using Cr, Co and Ni ratios

    Science.gov (United States)

    Folco, L.; Glass, B. P.; D'Orazio, M.; Rochette, P.

    2018-02-01

    Impactor identification is one of the challenges of large-scale impact cratering studies due to the dilution of meteoritic material in impactites (typically Australasian tektite/microtektite strewn field, i.e., the largest Cenozoic strewn field (∼15% of the Earth's surface), the youngest (∼0.78 Myr old) on Earth, and the only one without an associated impact crater so far, is an outstanding issue. We identify a chondritic impactor signature in 77 Australasian microtektites (size range: ∼200-700 μm) from within 3000 km from the hypothetical impact location in Indochina (∼17°N, 107°E) based on variations of Cr, Co and Ni interelement ratios in a Co/Ni vs Cr/Ni space (46 microtektites analyzed in this work by Laser Ablation-Inductively Coupled Plasma -Mass Spectrometry and 31 from literature by means of Neutron Activation Analyses with Cr, Co and Ni concentrations up to ∼370, 50 and 680 μg/g, respectively). Despite substantial overlap in Cr/Ni versus Co/Ni composition for several meteorite types with chondritic composition (chondrites and primitive achondrites), regression calculation based on ∼85% of the studied microtektites best fit a mixing line between crustal compositions and an LL chondrite. However, due to some scatter mainly in the Cr versus Ni ratios in the considered dataset, an LL chondrite may not be the best fit to the data amongst impactors of primitive compositions. Eight high Ni/Cr and five low Ni/Cr outlier microtektites (∼15% in total) deviate from the above mixing trend, perhaps resulting from incomplete homogenization of heterogeneous impactor and target precursor materials at the microtektite scale, respectively. Together with previous evidence from the ∼35 Myr old Popigai impact spherules and the ∼1 Myr old Ivory Coast microtektites, our finding suggests that at least three of the five known Cenozoic distal impact ejecta were generated by the impacts of large stony asteroids of chondritic composition, and possibly of

  4. Facial trauma

    Science.gov (United States)

    Maxillofacial injury; Midface trauma; Facial injury; LeFort injuries ... Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier ...

  5. Pancreatic trauma

    International Nuclear Information System (INIS)

    Sosa Martin, Gimel; Morales Portuondo, Kelvis; Baez Franco, Zenia

    2010-01-01

    Pancreas is an intra-abdominal organ in retroperitoneal location chow trauma is uncommon. Degree classification helps in more effective treatment practice and in decrease of complications appeared s consequence of traumas or the surgical treatment, which may be simple or involves large resections. The case of a patient with closed abdominal trauma of 3 days course. Diagnostic and clinic and complementary examinations were carried out being necessary surgical treatment. The aim of present paper was to expose the clinical elements, complementary results and surgical findings in this patient, as well as to motivate the suspicion of this affection in abdominal trauma. (author)

  6. Habitat-specific foraging strategies in Australasian gannets

    Directory of Open Access Journals (Sweden)

    Melanie R. Wells

    2016-07-01

    Full Text Available Knowledge of top predator foraging adaptability is imperative for predicting their biological response to environmental variability. While seabirds have developed highly specialised techniques to locate prey, little is known about intraspecific variation in foraging strategies with many studies deriving information from uniform oceanic environments. Australasian gannets (Morus serrator typically forage in continental shelf regions on small schooling prey. The present study used GPS and video data loggers to compare habitat-specific foraging strategies at two sites of contrasting oceanographic regimes (deep water near the continental shelf edge, n=23; shallow inshore embayment, n=26, in south-eastern Australia. Individuals from the continental shelf site exhibited pelagic foraging behaviours typical of gannet species, using local enhancement to locate and feed on small schooling fish; in contrast only 50% of the individuals from the inshore site foraged offshore, displaying the typical pelagic foraging strategy. The remainder adopted a strategy of searching sand banks in shallow inshore waters in the absence of conspecifics and other predators for large, single prey items. Furthermore, of the individuals foraging inshore, 93% were male, indicating that the inshore strategy may be sex-specific. Large inter-colony differences in Australasian gannets suggest strong plasticity in foraging behaviours, essential for adapting to environmental change.

  7. Physical Activity Promotion, Beliefs, and Barriers Among Australasian Oncology Nurses.

    Science.gov (United States)

    Keogh, Justin W L; Pühringer, Petra; Olsen, Alicia; Sargeant, Sally; Jones, Lynnette M; Climstein, Mike

    2017-03-01

    To describe the physical activity (PA) promotion practices, beliefs, and barriers of Australasian oncology nurses and gain preliminary insight into how PA promotion practices may be affected by the demographics of the nurses.
. Cross-sectional survey.
. Australia and New Zealand.
. 119 registered oncology nurses.
. Self-reported online survey completed once per participant.
. Questions assessed the PA promotion beliefs (e.g., primary healthcare professionals responsible for PA promotion, treatment stage), PA benefits (e.g., primary benefits, evidence base), and PA promotion barriers of oncology nurses.
. Oncology nurses believed they were the major providers of PA advice to their patients. They promoted PA prior to, during, and post-treatment. The three most commonly cited benefits of PA for their patients were improved quality of life, mental health, and activities of daily living. Lack of time, lack of adequate support structures, and risk to patient were the most common barriers to PA promotion. Relatively few significant differences in the oncology nurses' PA promotion practices, beliefs, and barriers were observed based on hospital location or years of experience.
. Despite numerous barriers, Australasian oncology nurses wish to promote PA to their patients with cancer across multiple treatment stages because they believe PA is beneficial for their patients.
. Hospitals may need to better support oncology nurses in promoting PA to their patients and provide better referral pathways to exercise physiologists and physiotherapists.

  8. Habitat-specific foraging strategies in Australasian gannets.

    Science.gov (United States)

    Wells, Melanie R; Angel, Lauren P; Arnould, John P Y

    2016-07-15

    Knowledge of top predator foraging adaptability is imperative for predicting their biological response to environmental variability. While seabirds have developed highly specialised techniques to locate prey, little is known about intraspecific variation in foraging strategies with many studies deriving information from uniform oceanic environments. Australasian gannets (Morus serrator) typically forage in continental shelf regions on small schooling prey. The present study used GPS and video data loggers to compare habitat-specific foraging strategies at two sites of contrasting oceanographic regimes (deep water near the continental shelf edge, n=23; shallow inshore embayment, n=26), in south-eastern Australia. Individuals from the continental shelf site exhibited pelagic foraging behaviours typical of gannet species, using local enhancement to locate and feed on small schooling fish; in contrast only 50% of the individuals from the inshore site foraged offshore, displaying the typical pelagic foraging strategy. The remainder adopted a strategy of searching sand banks in shallow inshore waters in the absence of conspecifics and other predators for large, single prey items. Furthermore, of the individuals foraging inshore, 93% were male, indicating that the inshore strategy may be sex-specific. Large inter-colony differences in Australasian gannets suggest strong plasticity in foraging behaviours, essential for adapting to environmental change. © 2016. Published by The Company of Biologists Ltd.

  9. Current management of acute diverticulitis: a survey of Australasian surgeons.

    Science.gov (United States)

    Jaung, Rebekah; Robertson, Jason; Rowbotham, David; Bissett, Ian

    2016-03-11

    To evaluate the current practice and degree of consensus amongst Australasian surgeons regarding non-surgical management of acute diverticulitis (AD) and to determine whether newer approaches to management are being translated into practice. An online survey was distributed to all Australasian colorectal surgeons and all general surgeons in the Auckland region. Responses were collected over two months and analysed to identify points of consensus and areas of significant difference in opinion between these groups. Responses were received from a total of 99 of 200 (49.5%) colorectal surgeons, and 19 of 36 (52.7%) general surgeons. The Hinchey Classification was the most commonly used measure of disease severity, used by 67 (95.7%) colorectal surgeons and 12 (92.3%) general surgeons. There was lack of consensus around important aspects of AD management, including antibiotic therapy, and use and modality of follow-up imaging. Selective antibiotic therapy and use of anti-inflammatory medication as adjuncts to treatment were practised by a minority of those surveyed. Newer approaches to management were being utilised by some respondents. The lack of consensus regarding management of AD may be a consequence of a paucity of high-level evidence to support specific management approaches, particularly in patients with uncomplicated AD.

  10. Enfoque Integral al Manejo del Trauma Craneoencefálico en Adulto Mayor desde la relación ciencia- tecnología y sociedad Senior Citizens Craniocerebral Trauma Management: a Comprehensive Approach based on the Science-Technology- Society relation

    Directory of Open Access Journals (Sweden)

    Gretel Mosquera Betancourt

    2008-08-01

    Full Text Available El trabajo constituye un análisis de los diferentes factores que intervienen en la elevada morbimortalidad del Traumatismo Craneoencefálico (TCE en el Adulto Mayor. El objetivo general es proporcionar un estudio desde la perspectiva del enfoque Ciencia, Tecnología y Sociedad y argumentar la necesidad de un proyecto de innovación tecnológica de tipo organizacional que brinde un manejo integral al TCE en el anciano. Se describen los factores socioambientales que juegan el papel más importante en el origen del TCE y que pueden ser modificados desde la comunidad. Por último, se argumenta con la ayuda del enfoque Ciencia Tecnología y Sociedad, la génesis del enfoque integral al manejo del TCE como problema de salud, lo que puede contribuir a su solución logrando una adecuada interrelación entre los distintos niveles de atención médica. De esta forma se brindará un enfoque novedoso al manejo del TCE en los pacientes mayores de 60 años.This research is a thoughtful analysis of the different factors that play a role in the high morbidity and mortality of senior citizens due to craniocerebral trauma. Its main objective is to provide a careful analysis of this condition from the perspective of the Science-Technology-Society approach, as well as to support the necessity of an organizational project of technologic innovation that promotes its comprehensive management. The socio-environmental factors, which play the most important role in the occurrence of craniocerebral trauma and can be modified in the community, are described. Finally, the genesis of a comprehensive approach to its management is argumented from the perspective of the Science-Technology-Society approach, which can successfully deal with this disorder by achieving an appropriate interrelation among the different levels of medical attention. In this way, an innovative approach to senior citizens craniocerebral trauma management is presented.

  11. Childhood Trauma.

    Science.gov (United States)

    Falasca, Tony; Caulfield, Thomas J.

    1999-01-01

    Describes some classic causes of trauma and symptoms that can result when a child has been traumatized. Lists several factors that effect the degree to which a child is affected by trauma. Categories a wide range of behaviors displayed by the victims into three groups: affect, memories, and behaviors. Discusses various considerations when…

  12. Australasian respiratory and emergency physicians do not use the pneumonia severity index in community-acquired pneumonia.

    Science.gov (United States)

    Serisier, David J; Williams, Sophie; Bowler, Simon D

    2013-02-01

    The value of community-acquired pneumonia (CAP) severity scoring tools is almost exclusively reliant upon regular and accurate application in clinical practice. Until recently, the Australasian Therapeutic Guidelines has recommended the use of the Pneumonia Severity Index (PSI) in spite of poor user-friendliness. Electronic and postal survey of respiratory and emergency medicine physician and specialist registrar members of the Royal Australasian College was undertaken to assess the use of the PSI and the accuracy of its application to hypothetical clinical CAP scenarios. The confusion, urea, respiratory rate, blood pressure, age 65 or older (CURB-65) score was also assessed as a simpler alternative. Five hundred thirty-six (228 respiratory, 308 emergency) responses were received. Only 12% of respiratory and 35% of emergency physicians reported using the PSI always or frequently. The majority were unable to accurately approximate PSI scores, with significantly fewer respiratory than emergency physicians recording accurate severity classes (11.8% vs 21%, OR 0.50, 95% CI: 0.37-0.68, P Australasian specialist physicians primarily responsible for the acute management of CAP report infrequent use of the PSI and are unable to accurately apply its use to hypothetical scenarios. Furthermore, respiratory and emergency physicians contrasted distinctly in their use and application of the two commonest severity scoring systems--the recent recommendation of two further alternative scoring tools by Australian guidelines may add to this confusion. A simple, coordinated approach to pneumonia severity assessment across specialties in Australasia is needed. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

  13. Australasian Society for Parenteral and Enteral Nutrition guidelines for supplementation of trace elements during parenteral nutrition.

    Science.gov (United States)

    Osland, Emma J; Ali, Azmat; Isenring, Elizabeth; Ball, Patrick; Davis, Melvyn; Gillanders, Lyn

    2014-01-01

    This work represents the first part of a progressive review of AuSPEN's 1999 Guidelines for Provision of Micronutrient Supplementation in Adult Patients receiving Parenteral Nutrition, in recognition of the developments in the literature on this topic since that time. A systematic literature review was undertaken and recommendations were made based on the available evidence and with consideration to specific elements of the Australian and New Zealand practice environment. The strength of evidence underpinning each recommendation was assessed. External reviewers provided feedback on the guidelines using the AGREE II tool. Reduced doses of manganese, copper, chromium and molybdenum, and an increased dose of selenium are recommended when compared with the 1999 guidelines. Currently the composition of available multi-trace element formulations is recognised as an obstacle to aligning these guidelines with practice. A paucity of available literature and limitations with currently available methods of monitoring trace element status are acknowledged. The currently unknown clinical impact of changes to trace element contamination of parenteral solutions with contemporary practices highlights need for research and clinical vigilance in this area of nutrition support practice. Trace elements are essential and should be provided daily to patients receiving parenteral nutrition. Monitoring is generally only required in longer term parenteral nutrition, however should be determined on an individual basis. Industry is encouraged to modify existing multi-trace element solutions available in Australia and New Zealand to reflect changes in the literature outlined in these guidelines. Areas requiring research are highlighted.

  14. First Geodetic Results from the Australasian VLBI Network

    Science.gov (United States)

    Titov, Oleg; Lovell, Jim; Takeguchi, Hiroshi; Quick, Jonathan; Shabala, Stanislav; McCallum, Jamie; Sun, Jing; Dawson, John; de Witt, Aletha; Reynolds, Cormac; Bignall, Hayley; Natusch, Tim; Weston, Stuart; Gulyaev, Sergei

    2014-12-01

    The Australasian geodetic Very Long Baseline Interferometry (VLBI) array consisting of three new 12-meter radio telescopes in Australia (Hobart, Katherine, and Yarragadee), a 12-meter radio telescope in New Zealand (Warkworth), and a correlation facility in Perth started operations in 2011. The daily positions of the AuScope array are estimated with a precision of a few mm, whereas their daily estimates vary within a range of 20-30 mm on the annual scale. Analysis of geodetic VLBI sessions also reveals small linear trends in the time series of baseline lengths between the Australian and New Zealand stations. A seasonal signal with amplitude of about 10 mm was detected for the baseline Hobart-Katherine. This signal is consistent with seasonal variations of baselines between co-located GNSS stations. We argue this signal should be incorporated in the fitting model to improve the estimates of positions and linear velocities.

  15. Trauma Africa

    Directory of Open Access Journals (Sweden)

    Victor Y. Kong

    2013-11-01

    Full Text Available “Major Trauma. Dr. Kong, please come to the Trauma Unit immediately. Dr. Kong, please come to the Trauma Unit immediately.” Even though I have been working at Edendale Hospital as a trauma registrar for over a year, whenever I hear this announcement over the hospital intercom system, my heart beats just a little faster than normal. When I first arrived at Edendale my colleagues told me that the adrenaline rush I would experience after being called out to attend a new emergency would decrease over time, and indeed they were right. However, it is also true to say that on some occasions more than others, it is still felt more strongly than ever.

  16. Tailbone trauma

    Science.gov (United States)

    ... in snow or on ice. Alternative Names Coccyx injury Images Tailbone (coccyx) References Choi SB, Cwinn AA. Pelvic trauma. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier ...

  17. Paediatric horse-related trauma.

    Science.gov (United States)

    Theodore, Jane E; Theodore, Sigrid G; Stockton, Kellie A; Kimble, Roy M

    2017-06-01

    This retrospective cohort study reported on the epidemiology of horse-related injuries for patients presenting to the only tertiary paediatric trauma hospital in Queensland. The secondary outcome was to examine the use of helmets and adult supervision. Traumatic brain injury (TBI) was examined in relation to helmet use. Morbidity and mortality were also recorded. Included were all patients presenting with any horse-related trauma to the Royal Children's Hospital in Brisbane from January 2008 to August 2014. Data were retrospectively collected on patient demographics, hospital length of stay (LOS), mechanism of injury (MOI), safety precautions taken, diagnoses and surgical procedures performed. Included in the analysis were 187 incidents involving 171 patients. Most patients were aged 12-14 years (36.9%) and female (84.5%). The most common MOI were falls while riding horses (97.1%). Mild TBI (24.6%) and upper limb fractures (20.9%) were common injuries sustained. Patients who wore helmets had significantly reduced hospital LOS and severity of TBI when compared with those who did not wear helmets (P horses, in addition to being a compulsory requirement whilst horse riding. Prompts in documentation may assist doctors to record the use of safety attire and adult supervision. This will allow future studies to further investigate these factors in relation to clinical outcomes. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  18. ABDOMINAL TRAUMA

    Directory of Open Access Journals (Sweden)

    Alojz Pleskovič

    2003-12-01

    Full Text Available Background. The most common cause of abdominal trauma is blunt trauma, gunshot wounds and stab wounds are rare. Most commonly injured organs in abdominal cavity are the spleen and the liver.Conclusions. Early diagnosis is very important and include precise phisical examination and all available diagnostic methods. The final decission about the method of treatmet depends on patients clinical condition, surgeon’s experience and other local conditions.

  19. Smaller beaks for colder winters: Thermoregulation drives beak size evolution in Australasian songbirds.

    Science.gov (United States)

    Friedman, Nicholas R; Harmáčková, Lenka; Economo, Evan P; Remeš, Vladimír

    2017-08-01

    Birds' beaks play a key role in foraging, and most research on their size and shape has focused on this function. Recent findings suggest that beaks may also be important for thermoregulation, and this may drive morphological evolution as predicted by Allen's rule. However, the role of thermoregulation in the evolution of beak size across species remains largely unexplored. In particular, it remains unclear whether the need for retaining heat in the winter or dissipating heat in the summer plays the greater role in selection for beak size. Comparative studies are needed to evaluate the relative importance of these functions in beak size evolution. We addressed this question in a clade of birds exhibiting wide variation in their climatic niche: the Australasian honeyeaters and allies (Meliphagoidea). Across 158 species, we compared species' climatic conditions extracted from their ranges to beak size measurements in a combined spatial-phylogenetic framework. We found that winter minimum temperature was positively correlated with beak size, while summer maximum temperature was not. This suggests that while diet and foraging behavior may drive evolutionary changes in beak shape, changes in beak size can also be explained by the beak's role in thermoregulation, and winter heat retention in particular. © 2017 The Author(s). Evolution © 2017 The Society for the Study of Evolution.

  20. Long-distance dispersal and speciation of Australasian and American species of Cortinarius sect. Cortinarius.

    Science.gov (United States)

    Harrower, Emma; Bougher, Neale L; Henkel, Terry W; Horak, Egon; Matheny, P Brandon

    2015-01-01

    We present a multigene phylogeny (partial nuc rDNA and RPB2) of Cortinarius sect. Cortinarius (i.e. the C. violaceus group), which reveals eight species distributed in Europe, Australasia, South America, Central America and North America. Relaxed molecular clock analyses suggested that diversification began during the Miocene, thus rejecting more ancient Gondwanan origin scenarios among the taxa currently occurring in the northern and southern hemispheres. There was strong support for an Australasian origin of the C. violaceus group with initial dispersal to the Neotropics, followed by migration into North America and Europe. A dispersal-extinction cladogenesis model that includes a parameter for founder effects was the most highly supported biogeographic model in the program BioGeoBEARS. A maximum likelihood analysis showed the most recent common ancestor of sect. Cortinarius was an angiosperm ectomycorrhizal associate. Ancestral associations at the plant family level, however, were ambiguous. Of eight recovered species-level lineages, C. violaceus is the only one that associates with Pinaceae and the only species to associate with both Pinaceae and angiosperms. This analysis showed that long-distance dispersal and founder event speciation have been important factors during evolution of the C. violaceus group. © 2015 by The Mycological Society of America.

  1. Geriatric trauma.

    Science.gov (United States)

    Adams, Sasha D; Holcomb, John B

    2015-12-01

    The landscape of trauma is changing due to an aging population. Geriatric patients represent an increasing number and proportion of trauma admissions and deaths. This review explores recent literature on geriatric trauma, including triage criteria, assessment of frailty, fall-related injury, treatment of head injury complicated by coagulopathy, goals of care, and the need for ongoing education of all surgeons in the care of the elderly. Early identification of high-risk geriatric patients is imperative to initiate early resuscitative efforts. Geriatric patients are typically undertriaged because of their baseline frailty being underappreciated; however, centers that see more geriatric patients do better. Rapid reversal of anticoagulation is important in preventing progression of brain injury. Anticipation of difficult disposition necessitates early involvement of physical therapy for rehabilitation and case management for appropriate placement. Optimal care of geriatric trauma patients will be based on the well established tenets of trauma resuscitation and injury repair, but with distinct elements that address the physiological and anatomical challenges presented by geriatric patients.

  2. Abdominal trauma

    International Nuclear Information System (INIS)

    Giordany, B.R.

    1985-01-01

    Abdominal injury is an important cause of morbidity and mortality in childhood. Ten percent of trauma-related deaths are due to abdominal injury. Thousands of children are involved in auto accidents annually; many suffer severe internal injury. Child abuse is a second less frequent but equally serious cause of internal abdominal injury. The descriptions of McCort and Eisenstein and their associates in the 1960s first brought to attention the frequency and severity of visceral injury as important manifestations of the child abuse syndrome. Blunt abdominal trauma often causes multiple injuries; in the past, many children have been subjected to exploratory surgery to evaluate the extent of possible hidden injury. Since the advent of noninvasive radiologic imaging techniques including radionuclide scans and ultrasound and, especially, computed tomography (CT), the radiologist has been better able to assess (accurately) the extent of abdominal injury and thus allow conservative therapy in many cases. Penetrating abdominal trauma occurs following gunshot wounds, stabbing, and other similar injury. This is fortunately, a relatively uncommon occurrence in most pediatric centers and will not be discussed specifically here, although many principles of blunt trauma diagnosis are valid for evaluation of penetrating abdominal trauma. If there is any question that a wound has extended intraperitonelly, a sinogram with water-soluble contrast material allows quick, accurate diagnosis. The presence of large amounts of free intraperitoneal gas suggests penetrating injury to the colon or other gas-containing viscus and is generally considered an indication for surgery

  3. Multivariate assessment of the phenetic affinities of Australasian oystercatchers (Aves: Charadriiformes)

    NARCIS (Netherlands)

    Baker, Allan J.

    1977-01-01

    Phenetic affinities of Australasian oystercatchers were elucidated by multivariate statistical analysis of seven morphometric characters taken from museum skins. Nineteen operational taxonomie units (OTUs), representing all the currently recognized species and most of the subordinate taxa, were used

  4. Hypothetical Source Crater for Australasian Tektites: Moving from Indochina to Northwest China?

    Science.gov (United States)

    Mizera, J.; Řanda, Z.; Kameník, J.; Klokočník, J.; Kostelecký, J.

    2016-08-01

    We argue against the generally accepted hypothetical location of the unknown source crater for Australasian tektites to Indochina, and present a hypothesis of a possible location of the AAT source crater in deserts of NW China.

  5. Highlights from the HTLV-1 symposium at the 2017 Australasian HIV and AIDS Conference held jointly with the 2017 Australasian Sexual Health Conference, November 2017, Canberra, Australia.

    Science.gov (United States)

    Einsiedel, Lloyd; Purcell, Damian; Schinke, Shane; Haynes, Katelin; Taylor, Graham P; Martin, Fabiola

    2018-01-01

    We are pleased to report on the inaugural HTLV-1 symposium at the 2017 Australasian HIV and AIDS Conference joint with 2017 Australasian Sexual Health Conference in Canberra, Australia. Our understanding of HTLV-1 epidemiology, pathogenesis, laboratory diagnostics and treatment options for HTLV-1 diseases has advanced tremendously over the last 40 years. However, the awareness of healthcare providers and the general population about HTLV-1, and the effective promotion and implementation of HTLV-1 transmission-prevention strategies, lag behind current knowledge. Here we present a summary of the symposium, plenary and poster presentations on HTLV-1.

  6. Australasian microtektites from Antarctica: XAS determination of the Fe oxidation state

    Science.gov (United States)

    Giuli, Gabriele; Cicconi, Maria Rita; Eeckhout, Sigrid Griet; Pratesi, Giovanni; Paris, Eleonora; Folco, Luigi

    2014-04-01

    The Fe oxidation state and coordination number of 29 impact glass spherules recently recovered from the Transantarctic Mountains (Antarctica) have been determined by X-ray absorption near edge structure (XANES) spectroscopy. Based on geochemical, isotopic, and fission track data, these spherules are considered as microtektites from the Australasian tektite/microtektite strewn field. Their find location is the farthest so far discovered from the possible source crater region, and their alkali content is the lowest compared with other published data on Australasian microtektite glasses. The Fe3+/(Fe2++Fe3+) ratio, determined from the analysis of the pre-edge peak energy position and integrated intensity, is below 0.1 (±0.04) for all the samples, and is comparable to that of most tektites and microtektites from the Australasian strewn field. Also, the pre-edge peak integrated intensity, which is sensitive to the average Fe coordination geometry, is comparable to that of other Australasian microtektites reported in the literature. The agreement of the Fe oxidation state and coordination number, between the Transantarctic Mountain microtektites (TAM) and the Australasian tektites and microtektites, further confirms the impact origin of these glass spherules and provides an independent suggestion that they represent a major extension southeastward of the Australasian strewn field. The fact that similar redox conditions are observed in tektites and microtektites within the Australasian strewn field regardless of the distance from the source crater area (up to approximately 11000 km) could be an important constraint for better understanding the different processes affecting microtektite formation and transport. The fact that the Fe oxidation state of microtektites does not increase with distance, as in the case of North American microtektites, means that thermal and redox histories of Australasian and TAM microtektites could differ significantly from those of North

  7. Comprehensive Australasian multicentre dosimetric intercomparison: issues, logistics and recommendations.

    Science.gov (United States)

    Ebert, M A; Harrison, K M; Cornes, D; Howlett, S J; Joseph, D J; Kron, T; Hamilton, C S; Denham, J W

    2009-02-01

    The present paper describes the logistics of the 2004-2008 Australasian Level III Dosimetry Intercomparison. Dosimetric intercomparisons (or 'audits') can be used in radiotherapy to evaluate the accuracy and quality of radiation delivery. An intercomparison was undertaken in New Zealand and Australia to evaluate the feasibility and logistics of ongoing dosimetric intercomparisons that evaluate all steps in the radiotherapy treatment process, known as a 'Level III' intercomparison. The study commenced in 2002 with the establishment of a study team, definition of the study protocol, acquisition of appropriate equipment and recruitment of participating radiotherapy centres. Measurements were undertaken between October 2004 and March 2008, and included collation of data on time, costs and logistics of the study. Forty independent Australian and New Zealand radiotherapy centres agreed to participate. Measurement visits were made to 37 of these centres. Data is presented on the costs of the study and the level of support required. The study involved the participation of 16 staff at the study centre who invested over 4000 hours in the study, and of over 200 professionals at participating centres. Recommendations are provided for future phantom-based intercomparisons. It is hoped that the present paper will be of benefit to any centres or groups contemplating similar activities by identifying the processes involved in establishing the study, the potential hazards and pitfalls, and expected resource requirements.

  8. Movement and Physiological Demands of Australasian National Rugby League Referees.

    Science.gov (United States)

    Brightmore, Amy; O'Hara, John; Till, Kevin; Cobley, Steve; Hubka, Tate; Emmonds, Stacey; Cooke, Carlton

    2016-11-01

    To evaluate the movement and physiological demands of Australasian National Rugby League (NRL) referees, officiating with a 2-referee (ie, lead and pocket) system, and to compare the demands of the lead and pocket referees. Global positioning system devices (10 Hz) were used to obtain 86 data sets (lead, n = 41; pocket, n = 45) on 19 NRL referees. Total distance, relative distance covered, and heart rate per half and across match play were examined within and between referees using t tests. Distance, time, and number of movement "efforts" were examined in 6 velocity classifications (ie, standing 7.0 m/s) using analysis of variance. Cohen d effect sizes are reported. There were no significant differences between the lead and pocket referees for any movement or physiological variable. There was an overall significant (large, very large) effect for distance (% distance) and time (% time) (P 5.51 m/s. Findings highlight the intermittent nature of rugby league refereeing but show that there were no differences in the movement and physiological demands of the 2 refereeing roles. Findings are valuable for those responsible for the preparation, training, and conditioning of NRL referees and to ensure that training prepares for and simulates match demands.

  9. Ballistic trauma

    Directory of Open Access Journals (Sweden)

    Parvathi Devi Munishwar

    2016-01-01

    Full Text Available Gunshot injuries are rather serious but uncommon type of trauma in India. Radiologists can contribute substantially in the evaluation and treatment of patients with gunshot wounds. Foreign bodies that enter a patient as a result of trauma are contaminated and produce a range of symptoms. Oral and maxillofacial gunshot injuries are usually fatal due to close proximity with vital structures. Here, we report a case in which radiographic evidence of foreign bodies in the right orofacial region exposed a history of a gunshot injury. The patient did not have any major complaints except for reduced mouth opening. These foreign bodies were clinically silent for approximately 12 years.

  10. Trauma Ultrasound.

    Science.gov (United States)

    Wongwaisayawan, Sirote; Suwannanon, Ruedeekorn; Prachanukool, Thidathit; Sricharoen, Pungkava; Saksobhavivat, Nitima; Kaewlai, Rathachai

    2015-10-01

    Ultrasound plays a pivotal role in the evaluation of acute trauma patients through the use of multi-site scanning encompassing abdominal, cardiothoracic, vascular and skeletal scans. In a high-speed polytrauma setting, because exsanguinations are the primary cause of trauma morbidity and mortality, ultrasound is used for quick and accurate detection of hemorrhages in the pericardial, pleural, and peritoneal cavities during the primary Advanced Trauma Life Support (ATLS) survey. Volume status can be assessed non-invasively with ultrasound of the inferior vena cava (IVC), which is a useful tool in the initial phase and follow-up evaluations. Pneumothorax can also be quickly detected with ultrasound. During the secondary survey and in patients sustaining low-speed or localized trauma, ultrasound can be used to help detect abdominal organ injuries. This is particularly helpful in patients in whom hemoperitoneum is not identified on an initial scan because findings of organ injuries will expedite the next test, often computed tomography (CT). Moreover, ultrasound can assist in detection of fractures easily obscured on radiography, such as rib and sternal fractures. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  11. Eye trauma

    African Journals Online (AJOL)

    2011-02-02

    Feb 2, 2011 ... 66. CME FEBRUARY 2011 Vol.29 No.2. Eye trauma. To a clinician without experience, a person with an eye injury presents a dilemma. This article should reassure you that methodical assessment and treatment of most injuries is simple and within the ambit of every doctor. JONatHaN PONs, MB ChB, Dip ...

  12. Trauma Theory

    DEFF Research Database (Denmark)

    Pedersen, Bodil Maria

    There are two main trends in psychological approaches to human suffering related to what we term trauma. Although they have their respective limitations both approaches may help us explore and alleviate human suffering. One trend, primarily using concepts like traumatic events and traumatisation ...

  13. TRAUMA SURGERY

    African Journals Online (AJOL)

    deaths due to other trauma types (gunshot wounds, road traffic fatalities and assault) ... the axillary artery was ligated during surgery. Type of ... Left axillary artery. Ischaemic left upper limb. 3. Fifth intercostal space on the left. Bilateral pneumothorax and haemothorax still present at autopsy. (intercostal drain only inserted on ...

  14. Trauma care in Germany: an inclusive system.

    Science.gov (United States)

    Sturm, Johannes A; Pape, Hans-Christoph; Dienstknecht, Thomas

    2013-09-01

    Development of trauma systems is a demanding process. The United States and Germany both have sophisticated trauma systems. This manuscript is a summary of political, economic, and medical changes that have led to the development of both trauma systems and the current high-quality standards. We specifically asked three questions: (1) What tasks are involved in developing a modern trauma system? (2) What is the approach to achieve this task? (3) Do these systems work? We conducted a systematic review of relevant articles by searching electronic databases (PubMed, Embase, Cochrane library) using the following search terms: "trauma system", "polytrauma", "trauma networks", and "trauma registry". Of 2573 retrieved manuscripts, the authors made a personal selection of studies. A personal study selection from our experiences was added when their contribution to the topic was judged important. Worldwide, similar tasks concerning trauma care have to be addressed. In most societies, traffic accidents and firearm-related injuries contribute to a high number of trauma victims. The German approach has been to decrease the number of accidents through injury prevention and to provide better care by establishing an emergency medical system. For in-hospital treatment, clinical care has constantly improved and a close interaction with members from the American Association for the Surgery of Trauma and the Orthopaedic Trauma Association has helped a great deal to achieve these improvements. The German healthcare system was developed as a powerful healthcare tool covering patients from injury to rehabilitation. In addition, trauma and injury research has been strengthened to deal with various questions of trauma care. Organized injury prevention programs and systematized professional patient care can address the issues associated with the global burden of trauma. These trauma systems require constant monitoring and improvement.

  15. An Australasian hockey stick and associated climate wars

    Science.gov (United States)

    Karoly, David; Gergis, Joelle; Neukom, Raphael; Gallant, Ailie

    2017-04-01

    Multiproxy warm season (September-February) temperature reconstructions are presented for the combined land-ocean region of Australasia (0°-50°S, 110°E-180°) covering the last millennium (1000-2001CE). Using between 2 (R2) and 28 (R28) paleoclimate records, four 1000-member ensemble reconstructions of regional temperature are developed using four different statistical methods: principal component regression (PCR), composite plus scale (CPS), Bayesian hierarchical models (LNA), and pairwise comparison (PaiCo). The reconstructions are then compared with a three-member ensemble of GISS-E2-R climate model simulations and independent paleoclimate records. Decadal fluctuations in Australasian temperatures are remarkably similar between the four reconstruction methods. There are, however, differences in the amplitude of temperature variations between the different statistical methods and proxy networks. When the largest R28 network is used, the warmest 30-yr periods occur after 1950 in 77% of ensemble members over all methods. However, reconstructions based on only the longest records (R2 and R3 networks) indicate that single 30- and 10-yr periods of similar or slightly higher temperatures than in the late twentieth century may have occurred during the first half of the millennium. Regardless, the most recent instrumental temperatures (1985-2014) are above the 90th percentile of all 12 reconstruction ensembles (four reconstruction methods based on three proxy networks — R28, R3, and R2). An earlier manuscript describing this study and its results was accepted for publication in the Journal of Climate in May 2012, after two thorough rounds of review. However, as described by Gergis (2016), after the early online release of the paper, a typo in the methods section was identified. While the paper said the study had used "detrended" data - observed temperature data from which the longer-term trends had been removed - the study had in fact used raw data. Both raw and

  16. Sexual Size Dimorphism and Body Condition in the Australasian Gannet.

    Directory of Open Access Journals (Sweden)

    Lauren P Angel

    Full Text Available Sexual size dimorphism is widespread throughout seabird taxa and several drivers leading to its evolution have been hypothesised. While the Australasian Gannet (Morus serrator has previously been considered nominally monomorphic, recent studies have documented sexual segregation in diet and foraging areas, traits often associated with size dimorphism. The present study investigated the sex differences in body mass and structural size of this species at two colonies (Pope's Eye, PE; Point Danger, PD in northern Bass Strait, south-eastern Australia. Females were found to be 3.1% and 7.3% heavier (2.74 ± 0.03, n = 92; 2.67 ± 0.03 kg, n = 43 than males (2.66 ± 0.03, n = 92; 2.48 ± 0.03 kg, n = 43 at PE and PD, respectively. Females were also larger in wing ulna length (0.8% both colonies but smaller in bill depth (PE: 2.2%; PD: 1.7% than males. Despite this dimorphism, a discriminant function provided only mild accuracy in determining sex. A similar degree of dimorphism was also found within breeding pairs, however assortative mating was not apparent at either colony (R2 < 0.04. Using hydrogen isotope dilution, a body condition index was developed from morphometrics to estimate total body fat (TBF stores, where TBF(% = 24.43+1.94*(body mass/wing ulna length - 0.58*tarsus length (r2 = 0.84, n = 15. This index was used to estimate body composition in all sampled individuals. There was no significant difference in TBF(% between the sexes for any stage of breeding or in any year of the study at either colony suggesting that, despite a greater body mass, females were not in a better condition than males. While the driving mechanism for sexual dimorphism in this species is currently unknown, studies of other Sulids indicate segregation in foraging behaviour, habitat and diet may be a contributing factor.

  17. Impact Crater of the Australasian Tektites, Southern Laos

    Science.gov (United States)

    Sieh, K.; Herrin, J. S.; Wiwegwin, W.; Charusiri, P.; Singer, B. S.; Singsomboun, K.; Jicha, B. R.

    2015-12-01

    The Australasian strewn field, a horizon of glassy clasts formed of molten ejecta from the impact of a bolide about 770,000 years ago, covers about a tenth of the Earth - from Indochina to Australia and from the Indian to western Pacific oceans. The distribution of chemical and physical characteristics of these tektites implies a very large impact somewhere in central Indochina. A half-century of unsuccessful searching for the impact crater implies obscuration by either erosion or burial. Geomorphological and stratigraphic evidence suggests that the crater lies buried beneath lavas and cinder cones of a 100-km wide volcanic shield centered atop the Bolaven Plateau of southern Laos. One critical test of this hypothesis, using precise 40Ar/39Ar dating, is now in progress - are these highly weathered basalts younger than the tektites? Although volcanic rocks cover most of the area proximal to our purported impact site, a thick, crudely bedded, bouldery to pebbly breccia that crops out southeast of the obscured crater rim appears to be part of an ejecta blanket. The basal unit of this fining-upward sequence comprises large boulders of late-Mesozoic sandstone bedrock that display in situ shattering. This implies emplacement ballistically rather than by debris-flow. Old surfaces in the surrounding region (as others have noted) and on the Plateau have a mantle of pebbly, detrital lateritic debris that in its upper 15 cm contains angular tektite fragments. We hypothesize that this debris is a proximal fall bed produced by shock-induced comminution and ejection of a lateritic soil that covered the Plateau bedrock. Deposition was nearly complete when sparse tektite fragments ejected from nearer the center of the impact began to land. At many sites this pebbly, lateritic bed is overlain by a thick silty bed that others have associated with aeolian erosion of a barren, incinerated tropical landscape. See Herrin et al (this meeting) for more on the volcanic rocks.

  18. Missed Injuries in Polytrauma Patients after Trauma Tertiary Survey in Trauma Intensive Care Unit.

    Science.gov (United States)

    Tammelin, E; Handolin, L; Söderlund, T

    2016-02-29

    Injuries are often missed during the primary and secondary surveys in trauma patients. Studies have suggested that a formal tertiary survey protocol lowers the number of missed injuries. Our aim was to determine the number, severity, and consequences of injuries missed by a non-formalized trauma tertiary survey, but detected within 3 months from the date of injury in trauma patients admitted to a trauma intensive care unit. We conducted a cohort study of trauma patients admitted to a trauma intensive care unit between 1 January and 17 October 2013. We reviewed the electronic medical records of patients admitted to the trauma intensive care unit in order to register any missed injuries, their delay, and possible consequences. We classified injuries into four types: Type 0, injury detected prior to trauma tertiary survey; Type I, injury detected by trauma tertiary survey; Type II, injury missed by trauma tertiary survey but detected prior to discharge; and Type III, injury missed by trauma tertiary survey and detected after discharge. During the study period, we identified a total of 841 injuries in 115 patients. Of these injuries, 93% were Type 0 injuries, 3.9% were Type I injuries, 2.6% were Type II injuries, and 0,1% were Type III injuries. Although most of the missed injuries in trauma tertiary survey (Type II) were fractures (50%), only 2 of the 22 Type II injuries required surgical intervention. Type II injuries presumably did not cause extended length of stay in the intensive care unit or in hospital and/or morbidity. In conclusion, the missed injury rate in trauma patients admitted to trauma intensive care unit after trauma tertiary survey was very low in our system without formal trauma tertiary survey protocol. These missed injuries did not lead to prolonged hospital or trauma intensive care unit stay and did not contribute to mortality. Most of the missed injuries received non-surgical treatment. © The Finnish Surgical Society 2016.

  19. Haemorrhagia post partum; an implementation study on the evidence-based guideline of the Dutch Society of Obstetrics and Gynaecology (NVOG) and the MOET (Managing Obstetric Emergencies and Trauma-course) instructions; the Fluxim study

    Science.gov (United States)

    2010-01-01

    Background One of the most important causes of maternal mortality and severe morbidity worldwide is post partum haemorrhage (PPH). Factors as substandard care are frequently reported in the international literature and there are similar reports in the Netherlands. The incidence of PPH in the Dutch population is 5% containing 10.000 women a year. The introduction of an evidence-based guideline on PPH by the Dutch society of Obstetrics and Gynaecology (NVOG) and the initiation of the MOET course (Managing Obstetrics Emergencies and Trauma) did not lead to a reduction of PPH. This implies the possibility of an incomplete implementation of both the NVOG guideline and MOET-instructions. Therefore, the aim of this study is to develop and test a tailored strategy to implement both the NVOG guideline and MOET-instructions Methods/Design One step in the development procedure is to evaluate the implementation of the guideline and MOET-instructions in the current care. Therefore measurement of the actual care will be performed in a representative sample of 20 hospitals. This will be done by prospective observation of the third stage of labour of 320 women with a high risk of PPH using quality indicators extracted from the NVOG guideline and MOET instructions. In the next step barriers and facilitators for guideline adherence will be analyzed by performance of semi structured interviews with 30 professionals and 10 patients, followed by a questionnaire study among all Dutch gynaecologists and midwives to quantify the barriers mentioned. Based on the outcomes, a tailored strategy to implement the NVOG guideline and MOET-instructions will be developed and tested in a feasibility study in 4 hospitals, including effect-, process- and cost evaluation. Discussion This study will provide insight into current Dutch practice, in particular to what extent the PPH guidelines of the NVOG and the MOET-instructions have been implemented in the actual care, and into the barriers and

  20. Haemorrhagia post partum; an implementation study on the evidence-based guideline of the Dutch Society of Obstetrics and Gynaecology (NVOG and the MOET (Managing Obstetric Emergencies and Trauma-course instructions; the Fluxim study

    Directory of Open Access Journals (Sweden)

    Grol Richard P

    2010-01-01

    Full Text Available Abstract Background One of the most important causes of maternal mortality and severe morbidity worldwide is post partum haemorrhage (PPH. Factors as substandard care are frequently reported in the international literature and there are similar reports in the Netherlands. The incidence of PPH in the Dutch population is 5% containing 10.000 women a year. The introduction of an evidence-based guideline on PPH by the Dutch society of Obstetrics and Gynaecology (NVOG and the initiation of the MOET course (Managing Obstetrics Emergencies and Trauma did not lead to a reduction of PPH. This implies the possibility of an incomplete implementation of both the NVOG guideline and MOET-instructions. Therefore, the aim of this study is to develop and test a tailored strategy to implement both the NVOG guideline and MOET-instructions Methods/Design One step in the development procedure is to evaluate the implementation of the guideline and MOET-instructions in the current care. Therefore measurement of the actual care will be performed in a representative sample of 20 hospitals. This will be done by prospective observation of the third stage of labour of 320 women with a high risk of PPH using quality indicators extracted from the NVOG guideline and MOET instructions. In the next step barriers and facilitators for guideline adherence will be analyzed by performance of semi structured interviews with 30 professionals and 10 patients, followed by a questionnaire study among all Dutch gynaecologists and midwives to quantify the barriers mentioned. Based on the outcomes, a tailored strategy to implement the NVOG guideline and MOET-instructions will be developed and tested in a feasibility study in 4 hospitals, including effect-, process- and cost evaluation. Discussion This study will provide insight into current Dutch practice, in particular to what extent the PPH guidelines of the NVOG and the MOET-instructions have been implemented in the actual care, and into

  1. The biological effects of childhood trauma.

    Science.gov (United States)

    De Bellis, Michael D; Zisk, Abigail

    2014-04-01

    Trauma in childhood is a psychosocial, medical, and public policy problem with serious consequences for its victims and for society. Chronic interpersonal violence in children is common worldwide. Developmental traumatology, the systemic investigation of the psychiatric and psychobiological effects of chronic overwhelming stress on the developing child, provides a framework and principles when empirically examining the neurobiological effects of pediatric trauma. This article focuses on peer-reviewed literature on the neurobiological sequelae of childhood trauma in children and in adults with histories of childhood trauma. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders.

    Science.gov (United States)

    López-Castro, Teresa; Hu, Mei-Chen; Papini, Santiago; Ruglass, Lesia M; Hien, Denise A

    2015-05-01

    Despite advances towards integration of care for women with co-occurring substance use disorder (SUD) and post-traumatic stress disorder (PTSD), low abstinence rates following SUD/PTSD treatment remain the norm. The utility of investigating distinct substance use trajectories is a critical innovation in the detection and refining of effective interventions for this clinical population. The present study reanalysed data from the largest randomised clinical trial to date for co-occurring SUD and PTSD in women (National Drug Abuse Treatment Clinical Trials Network; Women and Trauma Study). Randomised participants (n = 353) received one of two interventions in addition to treatment as usual for SUD: (i) trauma-informed integrative treatment for PTSD/SUD; or (ii) an active control psychoeducation course on women's health. The present study utilised latent growth mixture models (LGMM) with multiple groups to estimate women's substance use patterns during the 12-month follow-up period. Findings provided support for three different trajectories of substance use in the post-treatment year: (i) consistently low likelihood and use frequency; (ii) consistently high likelihood and use frequency; and (iii) high likelihood and moderate use frequency. Covariate analyses revealed improvement in PTSD severity was associated with membership in a specific substance use trajectory, although receiving trauma-informed treatment was not. Additionally, SUD severity, age and after-care efforts were shown to be related to trajectory membership. Findings highlight the necessity of accounting for heterogeneity in post-treatment substance use, relevance of trauma-informed care in SUD recovery and benefits of incorporating methodologies like LGMM when evaluating SUD treatment outcomes. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  3. The Australasian Antarctic Expedition 2013-2014: Practicing 'Citizen-Science' in a Changing World

    Science.gov (United States)

    Fogwill, C. J.; Turney, C. S.

    2014-12-01

    Government funding is the cornerstone of modern science. But with declining investment in science across most of the Western World, a major challenge for society is where best to place what little resource we have. Which research questions should have the greatest priority? Nowhere are these issues more pressing than in the Antarctic, where bases have and continue to play host to 'big-science', multi-year programmes of research, locking up logistical support and costs. But in a warming world, the areas with the greatest effects of climate change aren't always near government research stations. With this in mind, in 2012 a plan was formed to visit Commonwealth Bay, a remote area off the East Antarctic Ice Sheet, where in 2010, an iceberg the size of Rhode Island, known as B09B, dramatically knocked a 60-mile long tongue of ice off the Mertz Glacier into the Southern Ocean, setting off a cascade of change. Inspired by the expeditions of the past, we advertised berths for sale to take citizen scientists south with us, harnessing their interest, experience and investment. People responded far and wide. We were oversubscribed, and the Australasian Antarctic Expedition 2013-2014 was born. With the Russian-owned MV Akademik Shokalskiy as the expedition vessel, we set out south from the New Zealand port of Bluff in late November 2013. During our journey south and on the ice we undertook a number of scientific firsts for the region actively engaging the volunteer scientists on board in projects ranging from oceanography, biology, ecology, geology and glaciaology. The expedition demostrated how private funding could support targeted programmes of research and communicate it to the wider world. Small-science research can capture the public's imagination and also reap real scientific outputs. Although it is a funding model developed in the Antarctic a hundred years ago, the beauty is it can applied anywhere in the world.

  4. Citizen Science and the Unsolved Austral-Asian Tektite Mystery

    Science.gov (United States)

    Harris, T. H. S.; Davias, M. E.

    2015-12-01

    A growing body of mid-Pleistocene evidence suggests a 786 ka cosmic impact (MIS 20) at an oblique angle onto the North American ice sheet may have created both the Carolina Bays on the US Eastern coastal plane, as well as the 60 billion tons of Australasian (AA) tektites that cover ¼ to ⅓ of Earth. No AA impact structure has ever been identified. ~12 ka after the AA tektite event came the Brunhes-Matuyama geomagnetic reversal, Earth's most recent. In 1986, Richard Muller's paper "Geomagnetic Reversals from Impacts on the Earth" explained how a geologically rapid change of Earth's crustal spin rate relative to the liquid core would upset its convective cellular dynamo structure, disrupting and dismantling Earth's magnetic field. Muller proposed an impact-induced mini ice age to transport 10 meters of low- and mid-latitude sea into ice at the poles, changing the crustal polar moment of inertia and accelerating rotation relative to the core. Muller's impact ice age is a weak point, but oblique cosmic impacts deliver tangential impulse directly. The Carolina Bays are a depositional formation of high purity quartz sand, angular to subangular in grain texture, covering approximately 5% of the continental US, with an estimated volume of 1600 km3 over the east coastal plain and some of Nebraska. The bays themselves are depressions in the sand layer, expressed through depositional overburden. They range from a few hundred meters to several kilometers in scale. Carolina Bays are now characterized with LiDAR altimetry. Their alignment is systematic by latitude. They conform to 6 archetype ovoid shapes, easily derived using suborbital mechanics. This implies suborbital mechanics was a governor of their transport: the imprint is a snapshot of the emplacement process. Suborbital Analysis using co-aligned axes of 45,000 Carolina Bays indicates the ice sheet impact region was the Georgian Bay, across Lake Huron to Michigan's Saginaw Bay. The average downrange distance of the

  5. Radiotherapy for early infradiaphragmatic Hodgkin's disease: the Australasian experience

    International Nuclear Information System (INIS)

    Barton, M.; Boyages, J.; Crennan, E.; Davis, S.; Fisher, R.J.; Hook, C.; Johnson, N.; Joseph, D.; Khoo, V.; Liew, K.H.; Morgan, G.; O'Brien, P.; Pendlebury, S.; Pratt, G.; Quong, G.; Roos, D.E.; Thornton, D.; Trotter, G.; Walker, Q.; Wallington, M.

    1996-01-01

    Purpose: To review the Australasian results of Stage I and IIA Infradiaphragmatic Hodgkin's Disease (IHD) treated solely by irradiation. Methods and materials: Eligible patients had IHD only and were treated by irradiation with curative intent over the period of 1969 to 1988. Ten radiation oncology centres from within Australia and New Zealand were surveyed for patient, tumour and treatment variables. Disease free rates, survival and complications were analysed. Results: 106 patients with IHD were studied. The average potential follow up was 9.4 years. The male to female ratio was 3.3:1. The median age was 37.5 years. Histological subgroups were as follows; lymphocyte predominant 43%, mixed cellularity 21%, lymphocyte depleted 5%, nodular sclerosing 27% and unclassifiable 4%. Fifty nine patients had laparotomy of which 22 (37%) were positive for tumour. Nine laparotomies were performed for diagnosis and the remainder for staging. One patient was up-staged by laparotomy and three were down-staged. Sixty-eight patients presented with inguinal disease alone, five with abdominal disease alone, 19 with two sites of involvement and 12 with inguinal, pelvic and abdominal disease. In two patients the site was unknown. There was no correlation between site of involvement, age, sex or histological subtype. Forty seven cases were clinically staged (CS) as follows: CS IA - 23, CS IIA - 24. The other 59 were pathologically staged (PS) as follows: PS IA - 37, PS IB - 1, PS IIA - 21. Treatment consisted of involved field alone (16), inverted Y (68), inverted Y and spleen (13), para-aortic irradiation only (3), or total nodal irradiation (6). Mean dose was 37 Gy. There were 30 recurrences to give an actuarial 10-year disease-free rate of 70%. In multivariate analysis lower number of tumour sites, lymphocyte predominant histology and higher dose were all significantly correlated with higher disease free rates. Eight patients died of Hodgkin's disease and 19 of other causes. The 10

  6. Sexual Size Dimorphism and Body Condition in the Australasian Gannet

    Science.gov (United States)

    Angel, Lauren P.; Wells, Melanie R.; Rodríguez-Malagón, Marlenne A.; Tew, Emma; Speakman, John R.; Arnould, John P. Y.

    2015-01-01

    Sexual size dimorphism is widespread throughout seabird taxa and several drivers leading to its evolution have been hypothesised. While the Australasian Gannet (Morus serrator) has previously been considered nominally monomorphic, recent studies have documented sexual segregation in diet and foraging areas, traits often associated with size dimorphism. The present study investigated the sex differences in body mass and structural size of this species at two colonies (Pope’s Eye, PE; Point Danger, PD) in northern Bass Strait, south-eastern Australia. Females were found to be 3.1% and 7.3% heavier (2.74 ± 0.03, n = 92; 2.67 ± 0.03 kg, n = 43) than males (2.66 ± 0.03, n = 92; 2.48 ± 0.03 kg, n = 43) at PE and PD, respectively. Females were also larger in wing ulna length (0.8% both colonies) but smaller in bill depth (PE: 2.2%; PD: 1.7%) than males. Despite this dimorphism, a discriminant function provided only mild accuracy in determining sex. A similar degree of dimorphism was also found within breeding pairs, however assortative mating was not apparent at either colony (R2 < 0.04). Using hydrogen isotope dilution, a body condition index was developed from morphometrics to estimate total body fat (TBF) stores, where TBF(%) = 24.43+1.94*(body mass/wing ulna length) – 0.58*tarsus length (r2 = 0.84, n = 15). This index was used to estimate body composition in all sampled individuals. There was no significant difference in TBF(%) between the sexes for any stage of breeding or in any year of the study at either colony suggesting that, despite a greater body mass, females were not in a better condition than males. While the driving mechanism for sexual dimorphism in this species is currently unknown, studies of other Sulids indicate segregation in foraging behaviour, habitat and diet may be a contributing factor. PMID:26637116

  7. Review of Australasian spider flies (Diptera, Acroceridae) with a revision of Panops Lamarck.

    Science.gov (United States)

    Winterton, Shaun L

    2012-01-01

    The Australasian spider flies (Diptera: Acroceridae) are reviewed, with all eight currently recognized genera diagnosed and figured. The panopine genus Panops Lamarck, 1804 from Australia and Indonesia is revised with four new species described, increasing the total number of species in the genus to nine: Panops aurumsp. n., Panops danielsisp. n., Panops jadesp. n. and Panops schlingerisp. n. Five species of Panops are redescribed: Panops austrae Neboiss, 1971, Panops baudini Lamarck, 1804, Panops boharti (Schlinger, 1959), comb. n., Panops conspicuus (Brunetti, 1926) and Panops grossi (Neboiss, 1971), comb. n. The monotypic genera Neopanops Schlinger, 1959 and Panocalda Neboiss, 1971 are synonymized with Panops. Keys to genera of Australasian Acroceridae and species of Panops, Helle Osten Sacken, 1896 and Australasian Pterodontia Gray, 1832 are included.

  8. Mortality after open aortic aneurysm surgery by Australasian surgeons trained in the endovascular era.

    Science.gov (United States)

    Beiles, C Barry; Walker, Stuart

    2016-07-01

    Reduced exposure of trainees to open repair (OR) of abdominal aortic aneurysm (AAA) during training has been considered detrimental to outcome. The Australasian experience is examined. The Australasian Vascular Audit (AVA) was interrogated for AAA procedures between 1 January 2010 and 31 December 2014. Surgeons completing training before 2006 (group 1) were compared with those attaining their qualification subsequently (group 2). The Australian Institute of Health and Welfare (AIHW) database was also interrogated to confirm the trends over time of open and endovascular repair (EVAR) since 2000. Actual exposure to OR and EVAR of AAA by trainees from 2010 to 2014 was also extracted. One hundred and forty-six surgeons in group 1 performed 3049 OR compared with 997 for the 66 surgeons in group 2. Overall mortality for group 1 was 9.8% and for group 2, 15% (P Australasian College of Surgeons.

  9. Urethral trauma

    International Nuclear Information System (INIS)

    Carrington, B.M.; Hricak, H.; Dixon, C.; McAninch, J.W.

    1990-01-01

    This paper evaluates the role of MR imaging in posterior urethral trauma. Fifteen patients with posttraumatic membranous urethral strictures underwent prospective MR imaging with a 1.5-T unit before open urethroplasty. All patients had transaxial T1-weighted (500/20) and T2-weighted (2,500/70) spin-echo images and T2-weighted sagittal and coronal images (matrix, 192 x 256; section thickness, 4 mm with 20% gap). Conventional retrograde and cystourethrography were performed preoperatively. Compared with conventional studies, MR imaging defined the length and location of the urethral injury and provided additional information regarding the direction and degree of prostatic and urethral dislocation

  10. Australasian emergency nurses' willingness to attend work in a disaster: a survey.

    Science.gov (United States)

    Arbon, Paul; Ranse, Jamie; Cusack, Lynette; Considine, Julie; Shaban, Ramon Z; Woodman, Richard J; Bahnisch, Laura; Kako, Mayumi; Hammad, Karen; Mitchell, Belinda

    2013-05-01

    The type of disaster, individual demographic factors, family factors and workplace factors, have been identified in the international, multidisciplinary literature as factors that influence a person's willingness to attend and assist in their workplace during a disaster. However, it is unknown if these factors are applicable to Australasian emergency nurses. The research aims to determine the extent to which Australasian emergency nurses are willing to attend their workplace in a disaster. This research was exploratory and descriptive study design, using online and paper based surveys as a means of data collection. Australasian emergency nurses from two Australasian emergency nursing colleges and four Australian hospitals were recruited to participate. Data analysis was conducted using both descriptive and inferential statistics. In total, 451 Australasian emergency nurses participated in this research. Participants were more willing to attend their workplace during a conventional disaster (p ≤ 0.001), if they worked full-time (p = 0.01), had received formal education pertaining to disasters (p ≤ 0.001), had a family disaster plan (p = 0.008), did not have children (p = 0.001) and worked in an environment in which they perceived their colleagues, managers and organisation to be prepared. The factors that influenced Australasian emergency nurses to attend their workplace in a disaster were similar to that described in the international multidisciplinary literature. Of particular note, improving disaster knowledge and skills, having a family disaster plan and improving the perceptions of the nurses' workplace preparedness can enhance the nurses' willingness to assist in a disaster. Copyright © 2013 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  11. On the nature of the Ni-rich component in splash-form Australasian tektites

    Science.gov (United States)

    Goderis, Steven; Tagle, Roald; Fritz, Jörg; Bartoschewitz, Rainer; Artemieva, Natalia

    2017-11-01

    The Australasian tektite strewn field is exceptional, not only as the largest and most recent, but also as the only strewn field without an identified source impact crater. Therefore, scenarios without the formation of an impact crater, such as a low altitude cometary airburst, have proven hard to discard. Here, new geochemical evidence is presented for mixing of projectile and target material, which implies the formation of an Australasian tektite-related impact crater. First, ninety-two Australasian tektites were grouped according to their Cr, Co and Ni concentrations. Based on this data, Australasian tektites with the highest Ni contents (>200 μg/g) occur more than 1500 km south-southeast (SSE) of the northern Indochina region, with the highest concentration of Ni-rich tektites in South Vietnam, the islands of Borneo, Belitung, and Java, and reports in literature for Ni-rich tektites in central Australia. The tektites with the highest Cr and Ni abundances often also show highly siderophile element (HSE) enrichments of up to 4 ng/g Ir. The most Ni-rich samples exhibit broadly chondrite-relative HSE proportions. However, a chondritic impactor contribution appears to be inconsistent with the observed Ni/Cr, Ni/Co, and Cr/Co ratios. A previously suggested significant terrestrial mantle contribution can also not explain the siderophile element enrichments in combination with relatively low FeOtot (populations across the central part of the Australasian tektite strewn field could represent projectile-enriched material preferentially ejected downrange. Continued tracing of this Ni-rich component across the strewn field may help to constrain the location of the yet to be identified source crater of the Australasian (micro)tektites.

  12. Images in kidney trauma

    International Nuclear Information System (INIS)

    Rodriguez, Jose Luis; Rodriguez, Sonia Pilar; Manzano, Ana Cristina

    2007-01-01

    A case of a 3 years old female patient, who suffered blunt lumbar trauma (horse kick) with secondary kidney trauma, is reported. Imaging findings are described. Renal trauma classification and imaging findings are reviewed

  13. Trauma surgeons' attitude towards family presence during trauma resuscitation: a nationwide survey.

    Science.gov (United States)

    Kirchhoff, Chlodwig; Stegmaier, Julia; Buhmann, Sonja; Leidel, Bernd A; Biberthaler, Peter; Mutschler, Wolf; Kanz, Karl-Georg

    2007-11-01

    Trauma is the foremost cause of death in young patients. Not only the patient but also the family experience the consequences of trauma. Interactions of medical staff with family members in the emergency situation may fail psychological and emotional needs. In this context the concept of family presence (FP) during resuscitation is controversial. Therefore, the aim of this study was to analyse the attitude of trauma surgeons towards FP during trauma resuscitation. A questionnaire concerning beliefs and attitudes towards FP during trauma resuscitation was mailed to level I trauma centres of the Trauma Network of the German Trauma Society (DGU). Statistical difference was determined by Rank-Sum test to analyse ordinal variables, for analysing three groups Kruskal-Wallis and Dunn's testing were used. Data are given in mean+/-S.D. or absolute percentage. The questionnaire was answered by 464 of 545 (85%) trauma surgeons between July 2005 and September 2005. One hundred and sixty seven surgeons (37.9%) already knew about FP, 349 (75.2%) considered it a relevant topic, but 232 (50%) would never allow FP during trauma resuscitation. One hundred and sixty eight surgeons (36.2%) had experience of FP during trauma resuscitation with positive results in 56%. Female respondents tend to be better informed about FP and would promote FP more supportively. Those women with experience with FP reported predominantly positive experiences (87% versus 50%, pfamily support and the option of entering the resuscitation room with permission of the staff.

  14. The European Trauma Course (ETC) and the team approach

    DEFF Research Database (Denmark)

    Lott, Carsten; Araujo, Rui; Cassar, Mary Rose

    2009-01-01

    The European Trauma Course (ETC) was officially launched during the international conference of the European Resuscitation Council (ERC) in 2008. The ETC was developed on behalf of ESTES (European Society of Trauma and Emergency Surgery), EuSEM (European Society of Emergency Medicine), the ESA (E...

  15. A New Tektite Discovery in the Guangdong Province, China, and the Search for the Source Crater of the Australasian Tektite Strewn Field

    Science.gov (United States)

    Kenkmann, T.; Maier, R. V.; Sturm, S.; Zhu, Meng-Hua.

    2014-09-01

    A new tektite location in South China is presented that belongs to the Australasian tektite strewnfield. We also investigated a 30 km circular structure in the Guangdong and Guangxi Province that might be related to the Australasian impact event.

  16. Digital health technology and trauma: development of an app to standardize care.

    Science.gov (United States)

    Hsu, Jeremy M

    2015-04-01

    Standardized practice results in less variation, therefore reducing errors and improving outcome. Optimal trauma care is achieved through standardization, as is evidenced by the widespread adoption of the Advanced Trauma Life Support approach. The challenge for an individual institution is how does one educate and promulgate these standardized processes widely and efficiently? In today's world, digital health technology must be considered in the process. The aim of this study was to describe the process of developing an app, which includes standardized trauma algorithms. The objective of the app was to allow easy, real-time access to trauma algorithms, and therefore reduce omissions/errors. A set of trauma algorithms, relevant to the local setting, was derived from the best available evidence. After obtaining grant funding, a collaborative endeavour was undertaken with an external specialist app developing company. The process required 6 months to translate the existing trauma algorithms into an app. The app contains 32 separate trauma algorithms, formatted as a single-page flow diagram. It utilizes specific smartphone features such as 'pinch to zoom', jump-words and pop-ups to allow rapid access to the desired information. Improvements in trauma care outcomes result from reducing variation. By incorporating digital health technology, a trauma app has been developed, allowing easy and intuitive access to evidenced-based algorithms. © 2015 Royal Australasian College of Surgeons.

  17. The type-material of Oriental and Australasian Muscidae (Diptera) in the Zoological Museum, Amsterdam

    NARCIS (Netherlands)

    Pont, Adrian C.

    1970-01-01

    The type-material of Oriental und Australasian Muscidae in the University Zoological Museum, Amsterdam, is discussed. Of 131 species considered, the primary types of 112 are located in Amsterdam, and the location of the other types is also listed. 40 lectotypes are designated and 19 new combinations

  18. A Review of Australasian Investigations into Problem Solving and the Novice Programmer

    Science.gov (United States)

    de Raadt, Michael

    2007-01-01

    This Australasian focused review compares a number of recent studies that have identified difficulties encountered by novices while learning programming and problem solving. These studies have shown that novices are not performing at expected levels and many novices have only a fragile knowledge of programming, which may prevent them from learning…

  19. Educational Technology Research Journals: "Australasian Journal of Educational Technology," 2003-2012

    Science.gov (United States)

    Hadlock, Camey Andersen; Clegg, J. Aleta; Hickman, Garrett R.; Huyett, Sabrina Lynn; Jensen, Hyrum C.; West, Richard E.

    2014-01-01

    The authors analyzed all research articles in the "Australasian Journal of Educational Technology" from 2003 to 2012 to determine the types of research methodologies published, major contributing authors, and most frequently referenced keywords, abstract terms, and cited articles. During this decade, the majority of articles published…

  20. Conceptualising and Measuring Student Engagement through the Australasian Survey of Student Engagement (AUSSE): A Critique

    Science.gov (United States)

    Hagel, Pauline; Carr, Rodney; Devlin, Marcia

    2012-01-01

    Student engagement has rapidly developed a central place in the quality agenda of Australian universities since the introduction of the Australasian Survey of Student Engagement (AUSSE). The AUSSE is based on one developed in the USA. The main arguments given for adopting this survey in Australia are that it provides a valid instrument for…

  1. Australasian microtektites in a substrate: A new constraint on ferromanganese crust accumulation rates

    Digital Repository Service at National Institute of Oceanography (India)

    ShyamPrasad, M.

    composition. The ferromanganese crust has a thickness range of 6-17 mm, and its chemistry and mineralogy indicate hydrogenic accretion. Because the Australasian strewn field has an age of approximately 0.77 Ma, this finding implies that the overlying Fe...

  2. The Challenges and Opportunities for Professional Societies in Higher Education in Australasia: A PEST Analysis

    Science.gov (United States)

    Doherty, Iain; Steel, Caroline; Parrish, Dominique

    2012-01-01

    Professional societies, established to support academic and professional staff in higher education, need to be vigilant of regional and international trends that affect their core business. In this paper, we provide an analysis of political, economic, social and technological factors that are impacting upon the Australasian higher education…

  3. A Civilian/Military Trauma Institute: National Trauma Coordinating Center

    Science.gov (United States)

    2012-10-01

    maxillofacial Trauma, Trauma Mental Health, Neurosurgery, Craniofacial, Anesthesiology, and Burn Surgery . Page | 5 A. National Coordinating...research information to the trauma community 3. Breakouts included; Trauma/Critical Care, Orthopedic Trauma, Emergency Care, Trauma Nursing, Oral ...was presented at the 2012 Annual American Association for the Surgery of Trauma (AAST) meeting in September 2012, in Kauai, Hawaii (Appendix A

  4. Autism Society

    Science.gov (United States)

    ... Español Improving the lives of all affected by autism. The Autism Society is the nation's leading grassroots ... more Improving the lives of all affected by autism. The Autism Society is the nation's leading grassroots ...

  5. Mass Society

    DEFF Research Database (Denmark)

    Borch, Christian

    2017-01-01

    Mass society is a societal diagnosis that emphasizes – usually in a pejorative, modernity critical manner – a series of traits allegedly associated with modern society, such as the leveling of individuality, moral decay, alienation, and isolation. As such, the notion of mass society generalizes...

  6. External quality assurance in nongynecologic cytology: The Australasian experience.

    Science.gov (United States)

    Shield, Paul W; Frost, Felicity; Finnimore, Jo L; Wright, R Gordon; Cummings, Margaret C

    2017-05-01

    The Royal College of Pathologists of Australasia Cytopathology Quality Assurance Program has operated an external quality assurance program in nongynecologic cytopathology since 1993. Glass slide preparations of a wide range of nongynecologic cases were circulated to approximately 200 cytopathology laboratories in 16 countries. General nongynecologic cytology cases were manufactured from residual specimens after routine diagnosis. Fine-needle aspiration (FNA) cases were made by sampling fresh tissue and making direct specimens. The majority of cases consisted of both air-dried and fixed preparations. Results returned to laboratories included illustrated case discussions highlighting diagnostic features, key differential diagnoses, and useful adjunctive tests. The current study reviewed >22,000 results for 123 nongynecologic cases. Cases found to cause the most diagnostic difficulties included serous effusion cases with metastatic carcinoma in a dispersed pattern, well-differentiated carcinoma, and cellular reactive cases; urine specimens with sparse malignant cells; reactive pneumocytes in a bronchoalveolar lavage; breast FNA cases with papillary lesions; gestational specimens; and fibroadenoma. FNA specimens from the lung and thyroid, particularly papillary thyroid carcinoma, generally were well reported. The use of multiple preparations of the same specimen has allowed interlaboratory comparison, and the quality assurance program has played an educational role as well as informing the laboratory accreditation process. Cancer Cytopathol 2017;125:349-361. © 2017 American Cancer Society. © 2017 American Cancer Society.

  7. [The top ten researches of Chinese ocular trauma research in recent five years].

    Science.gov (United States)

    2015-08-01

    Ten researches that may represent the progress in Chinese ocular trauma related studies were selected through voting by specialists from Chinese Ocular Trauma Society. These researches focused on the following fields: new strategies for the treatment of ocular trauma, study of vitreoretinal surgery and new technique application for severe ocular trauma, establishment of animal modal for basic research of ocular trauma, prevention of infectious endophthalmitis, clinical and basic study of ocular chemical burn, establishment of the public service and research platform of ocular trauma. These studies represented the level and influence of Chinese ocular trauma specialists in the international academic community and they were the landmark studies of our areas of expertise.

  8. Key innovations and island colonization as engines of evolutionary diversification: a comparative test with the Australasian diplodactyloid geckos.

    Science.gov (United States)

    Garcia-Porta, J; Ord, T J

    2013-12-01

    The acquisition of key innovations and the invasion of new areas constitute two major processes that facilitate ecological opportunity and subsequent evolutionary diversification. Using a major lizard radiation as a model, the Australasian diplodactyloid geckos, we explored the effects of two key innovations (adhesive toepads and a snake-like phenotype) and the invasion of new environments (island colonization) in promoting the evolution of phenotypic and species diversity. We found no evidence that toepads had significantly increased evolutionary diversification, which challenges the common assumption that the evolution of toepads has been responsible for the extensive radiation of geckos. In contrast, a snakelike phenotype was associated with increased rates of body size evolution and, to a lesser extent, species diversification. However, the clearest impact on evolutionary diversification has been the colonization of New Zealand and New Caledonia, which were associated with increased rates of both body size evolution and species diversification. This highlights that colonizing new environments can drive adaptive diversification in conjunction or independently of the evolution of a key innovation. Studies wishing to confirm the putative link between a key innovation and subsequent evolutionary diversification must therefore show that it has been the acquisition of an innovation specifically, not the colonization of new areas more generally, that has prompted diversification. © 2013 The Authors. Journal of Evolutionary Biology © 2013 European Society For Evolutionary Biology.

  9. Source of the Australasian tektite strewn field - A possible off-shore impact site

    Science.gov (United States)

    Schnetzler, C. C.; Walter, L. S.; Marsh, J. G.

    1988-01-01

    Although there is a preponderance of evidence that tektites were formed by asteroid impacts on the earth, no source crater has been found for the largest and youngest of the strewn fields - the Austalasian strewn field. A combined Seasat/Geos 3 altimeter data set of sea surface heights in the northern portion of the Australasian strewn field has been examined for negative gravity anomalies on the continental shelf and slope which might be related to the source crater for these tektites. A large negative anomaly called the Qui Nhon Slope Anomaly is a sea surface depression of approximately 1.5 meters over an area of 100 km diameter. It corresponds to a gravity anomaly of about -50 mgal. It is proposed that this anomaly may be due to the impact structure that produced the Australasian strewn field.

  10. The phylogenetic relationships of endemic Australasian trichostrongylin families (Nematoda: Strongylida) parasitic in marsupials and monotremes.

    Science.gov (United States)

    Chilton, Neil B; Huby-Chilton, Florence; Koehler, Anson V; Gasser, Robin B; Beveridge, Ian

    2015-10-01

    The phylogenetic relationships of the endemic (or largely endemic) Australasian trichostrongylin nematode families Herpetostrongylidae, Mackerrastrongylidae and Nicollinidae as well as endemic trichostrongylin nematodes currently placed in the families Trichostrongylidae and Molineidae were examined using the complete large subunit (28S) ribosomal RNA gene. The Herpetostrongylinae proved to be monophyletic. However, representatives of the Nicollinidae nested with the Herpetostrongylinae. The Mackerrastrongylidae was also a monophyletic group and included Peramelistrongylus, currently classified within the Trichostrongylidae. The Globocephaloidinae, currently considered to be a subfamily of the Herpetostrongylidae, was excluded from the family in the current analysis. Ollulanus and Libyostrongylus, included for the first time in a molecular phylogenetic analysis, were placed within the Trichostrongylidae. This study provided strong support for the Herpetostrongylidae (including within it the Nicollinidae, but excluding the Globocephaloidinae) and the Mackerrastrongylidae as monophyletic assemblages. Additional studies are required to resolve the relationships of the remaining endemic Australasian trichostrongylin genera.

  11. On a possible parent crater for Australasian tektites: Geochemical, isotopic, geographical and other constraints

    Czech Academy of Sciences Publication Activity Database

    Mizera, Jiří; Řanda, Zdeněk; Kameník, Jan

    2016-01-01

    Roč. 154, MAR (2016), s. 123-137 ISSN 0012-8252 R&D Projects: GA ČR GA13-22351S; GA MŠk(CZ) LM2011019 Institutional support: RVO:67985891 ; RVO:61389005 Keywords : Australasian tektite * Parent crater * Geochemical analysis * Isotope analysis * Chinese loess * Badain Jaran Subject RIV: BG - Nuclear, Atomic and Molecular Physics, Colliders; DD - Geochemistry (USMH-B) Impact factor: 7.051, year: 2016

  12. Secular changes in aerobic fitness test performance of Australasian children and adolescents.

    Science.gov (United States)

    Tomkinson, Grant R; Olds, Timothy S

    2007-01-01

    There have been an increasing number of reports in recent years which have highlighted that the aerobic fitness test performances of Australian and New Zealand children and adolescents are declining. Some researchers have previously commented on secular changes in performance, but have used data dating back only to 1985. Using a metaanalytical approach, this study aimed to quantify the secular changes in the aerobic fitness test performances of Australasian (Australian and New Zealand) children and adolescents over the past half a century. Forty-six studies reporting on the aerobic fitness test performances of healthy Australasian children and adolescents were included in the analysis. Corrections for methodological variation were made where possible, and data for each aerobic fitness test were expressed in a common metric. Raw data were merged with pseudo data generated from reported means and standard deviations using Monte Carlo simulation. Changes in aerobic test performance were calculated at the country x age x sex x test level using least squares linear regression. Secular changes were calculated for 161,419 6-17-year-old tested on five different maximal field-running tests of aerobic fitness between 1961 and 2002. Overall, the aerobic performance of young Australasians declined at an average rate of -0.24% per annum (95% confidence interval -0.22 to -0.26% per annum). The pattern of change, however, was not consistent over time. Early in the 1960s, changes in performance shifted from improvements to declines, with the rate of decline accelerating until about 1990, and slowing thereafter. Secular changes were reasonably similar for boys and girls, but quite different for children and adolescents. There has been a marked decline in aerobic fitness test performances of Australasian children and adolescents in recent decades. It is likely that this secular decline is caused by a network of social, behavioral, physical, psychosocial and physiological factors.

  13. Major clades of Australasian Rutoideae (Rutaceae) based on rbcL and atpB sequences.

    Science.gov (United States)

    Bayly, Michael J; Holmes, Gareth D; Forster, Paul I; Cantrill, David J; Ladiges, Pauline Y

    2013-01-01

    Rutaceae subfamily Rutoideae (46 genera, c. 660 species) is diverse in both rainforests and sclerophyll vegetation of Australasia. Australia and New Caledonia are centres of endemism with a number of genera and species distributed disjunctly between the two regions. Our aim was to generate a high-level molecular phylogeny for the Australasian Rutoideae and identify major clades as a framework for assessing morphological and biogeographic patterns and taxonomy. Phylogenetic analyses were based on chloroplast genes, rbcL and atpB, for 108 samples (78 new here), including 38 of 46 Australasian genera. Results were integrated with those from other molecular studies to produce a supertree for Rutaceae worldwide, including 115 of 154 genera. Australasian clades are poorly matched with existing tribal classifications, and genera Philotheca and Boronia are not monophyletic. Major sclerophyll lineages in Australia belong to two separate clades, each with an early divergence between rainforest and sclerophyll taxa. Dehiscent fruits with seeds ejected at maturity (often associated with myrmecochory) are inferred as ancestral; derived states include woody capsules with winged seeds, samaras, fleshy drupes, and retention and display of seeds in dehisced fruits (the last two states adaptations to bird dispersal, with multiple origins among rainforest genera). Patterns of relationship and levels of sequence divergence in some taxa, mostly species, with bird-dispersed (Acronychia, Sarcomelicope, Halfordia and Melicope) or winged (Flindersia) seeds are consistent with recent long-distance dispersal between Australia and New Caledonia. Other deeper Australian/New Caledonian divergences, some involving ant-dispersed taxa (e.g., Neoschmidia), suggest older vicariance. This comprehensive molecular phylogeny of the Australasian Rutoideae gives a broad overview of the group's evolutionary and biogeographic history. Deficiencies of infrafamilial classifications of Rutoideae have long been

  14. Planetary Society

    Science.gov (United States)

    Murdin, P.

    2000-11-01

    Carl Sagan, Bruce Murray and Louis Friedman founded the non-profit Planetary Society in 1979 to advance the exploration of the solar system and to continue the search for extraterrestrial life. The Society has its headquarters in Pasadena, California, but is international in scope, with 100 000 members worldwide, making it the largest space interest group in the world. The Society funds a var...

  15. Atrial fibrillation after cardiac surgery: Prevention and management: The Australasian experience.

    Science.gov (United States)

    Alawami, Mohammed; Chatfield, Andrew; Ghashi, Rajaie; Walker, Laurence

    2018-01-01

    Atrial fibrillation (AF) after cardiac surgery is a major health problem that is associated with a significant financial burden. This paper aims to highlight this problem and review the current guidelines in the prevention and management of AF after cardiac surgery, providing our experience in the Australasian centers. We conducted a literature review using mainly PubMed to compare the current practice with the available evidence. EMBASE and Cochrane library were also searched. We concurrently developed an online questionnaire to collect data from other Australasian centers regarding their approach to this problem. We identified 194 studies that were considered relevant to our research. We did not find any formal protocols published in the literature. From our Australasian experience; seven centers (58%) had a protocol for AF prophylaxis. The protocols included electrolytes replacement, use of amiodarone and/or β-blockers. Other strategies were occasionally used but were not part of a structured protocol. The development of an integrated medical and surgical protocol for the prophylaxis of AF after cardiac surgery is an important aspect for the care of postoperative cardiac patients. Considerations of prophylactic strategies other than those routinely used should be included in the protocol. This area should receive considerable attention in order to reduce the postoperative complications and health costs.

  16. Predictive factors for publication of abstracts at the Royal Australasian College of Surgeons Annual Scientific Congress.

    Science.gov (United States)

    Udovicich, Cristian; Soh, Bryan; Law, Sam; Hoe, Venetia; Lanfranco, Dion; Perera, Kalpa; Duong, Cuong; Chan, Steven

    2018-01-01

    A key metric of the research quality of medical conferences is the publication rate of abstracts. The study objective was to determine the publication rate of abstracts presented at the Royal Australasian College of Surgeons Annual Scientific Congress (RACS ASC) and to examine for any predictive factors associated with publication. Abstracts presented at the RACS ASC from 2011 to 2013 were analysed. Abstract characteristics such as presentation format, study type, study design, study site, cohort size and author origin were recorded. Abstracts published were identified by a PubMed search using a strict algorithm. Univariate and multivariable logistic regressions were used to analyse for predictive factors of publication. Overall, 1438 abstracts were presented and 423 abstracts (29%) were published. The median time to publication was 15.2 months (interquartile range: 8-26) with 110 in Australasian journals (26%). The median number of citations for published abstracts was 6 (interquartile range: 2-16). After multivariable analysis, publication was significantly associated with prospective study design (odds ratio (OR) = 1.34, P = 0.02), multicentre study site (OR = 1.43, P = 0.02), cohort size ≥100 (OR = 2.00, P Australasian College of Surgeons.

  17. Stretching out the Australasian microtektite strewn field in Victoria Land Transantarctic Mountains

    Science.gov (United States)

    Folco, Luigi; D'Orazio, Massimo; Gemelli, Maurizio; Rochette, Pierre

    2016-06-01

    Petrographic and geochemical studies of microtektites collected in newly explored summit plateaus of the Transantarctic Mountains (i.e., Schroeder Spur, Killer Nunatak, Miller Butte in the inland catchment of the Rennick Glacier, and Allan Hills, in the inland catchment of the Mackay-David Glaciers) document a regional distribution of Australasian microtektites in Victoria Land. A geochemical comparison with Australasian microtektites from deep sea sediments at lower latitudes identifies a possible projectile geochemical signature for the first time, and confirms that Transantarctic Mountains microtektites experienced higher thermal regimes. Ballistic calculations reveal that the extraordinary distance of the Transantarctic Mountains microtektites from the hypothetical impact location in Indochina (∼11,000 km) could be more efficiently attained at relatively low ejection angles (20°-40°). Finally, the occurrence of Australasian microtektites (∼0.8 Ma old) on specific glacial surfaces of the Antarctic bedrock constrains the glacial history of the East Antarctic Ice Sheet in Victoria Land. In particular, data from Allan Hills supports a glaciological scenario envisaging an extremely stable East Antarctic Ice Sheet over at least the last ∼1 Ma in the inland catchment of the Mackay/David glaciers. This is consistent with the large accumulation of meteorites in the adjacent blue ice fields.

  18. Coeval ages of Australasian, Central American and Western Canadian tektites reveal multiple impacts 790 ka ago

    Science.gov (United States)

    Schwarz, Winfried H.; Trieloff, Mario; Bollinger, Klemens; Gantert, Niklas; Fernandes, Vera A.; Meyer, Hans-Peter; Povenmire, Hal; Jessberger, Elmar K.; Guglielmino, Massimo; Koeberl, Christian

    2016-04-01

    High resolution 40Ar-39Ar step heating dating of australites and indochinites, representing a large area of the Australasian strewn field, and more recently discovered tektite-like glasses from Central America (Belize) and Western Canada, were carried out. Precise plateau ages were obtained in all cases, yielding indistinguishable ages of 789 ± 9 ka for four australites, 783 ± 5 ka for four indochinites, 783 ± 17 ka for one Western Canadian and 769 ± 16 ka for one Belize impact glass. Concerning major elements and REEs, australites and the Western Canadian impact glass are indistinguishable. If the Western Canadian sample was transported by impact ejection and belongs to the Australasian strewn field, this implies extremely far ballistic transport of 9000 km distance, assuming a source crater in southern Asia. The distinct major element and REE composition of the Belize impact glass suggests formation in another separate impact event. We conclude that the Australasian/Western Canadian impact glasses formed 785 ± 7 ka ago in a single event and Belize impact glass in a separate event 769 ± 16 ka ago. The two impact events forming these two strewn fields occurred remarkably closely related in time, i.e., separated by <30 ka.

  19. Survey of Australasian geriatricians' satisfaction with, and preferences for, continuing professional development.

    Science.gov (United States)

    Etherton-Beer, C; Katz, B; Naganathan, V

    2016-07-01

    Continuing professional development (CPD) is an obligation for all Australasian geriatricians; however, there are no systematic data regarding Australian and New Zealand geriatricians' satisfaction with, and preferences for, CPD. To inform understanding of Australasian geriatricians' satisfaction with, and preferences for, CPD. An electronic survey to collect data relating to demographics, current CPD activities, preferred CPD activities and perceived major barriers to CPD was distributed to 706 geriatricians in Australia and New Zealand. Two hundred and thirteen (30%) responses were received. Respondents commonly reported CPD through participation in conferences (n = 205 (96%)) and research/educational activity (n = 146 (70%)). Most respondents agreed that the annual scientific meeting (n = 168 (79%)) and state-based meetings (n = 135 (63%)) are valuable for their CPD. Respondents perceived their professional (n = 155 (73%)) and non-professional (n = 21 (57%)) commitments as the major barriers to quality CPD. Respondents supported additional electronic CPD resources being made available, improved integration of assessment in CPD activities and flexible methods of CPD participation to meet the diverse needs of geriatricians. Respondents perceived the face-to-face CPD opportunities currently available to them as valuable for their CPD but seek additional, flexible products to enable CPD participation based on individual needs and preferences. © 2016 Royal Australasian College of Physicians.

  20. Suspension Trauma / Orthostatic Intolerance

    Science.gov (United States)

    ... Technology Assessment Printer Friendly Version Suspension Trauma/Orthostatic Intolerance Safety and Health Information Bulletin SHIB 03-24- ... with important information about the hazards of orthostatic intolerance and suspension trauma when using fall arrest systems. ...

  1. Acute coagulopathy of trauma

    DEFF Research Database (Denmark)

    Johansson, P I; Ostrowski, S R

    2010-01-01

    Acute coagulopathy of trauma predicts a poor clinical outcome. Tissue trauma activates the sympathoadrenal system resulting in high circulating levels of catecholamines that influence hemostasis dose-dependently through immediate effects on the two major compartments of hemostasis, i...

  2. Representativeness of Honeypot Trial Participants to Australasian PD Patients.

    Science.gov (United States)

    Zhang, Lei; Badve, Sunil V; Pascoe, Elaine M; Beller, Elaine; Cass, Alan; Clark, Carolyn; de Zoysa, Janak; Isbel, Nicole M; Liu, Xusheng; McTaggart, Steven; Morrish, Alicia T; Playford, Geoffrey; Scaria, Anish; Snelling, Paul; Vergara, Liza A; Hawley, Carmel M; Johnson, David W

    2017-01-01

    The HONEYPOT trial failed to establish the superiority of exit-site application of Medihoney compared with nasal mupirocin prophylaxis for the prevention of peritonitis in peritoneal dialysis (PD) patients. This study aimed to assess the representativeness of the patients in the HONEYPOT trial to the Australian and New Zealand PD population. This study compared baseline characteristics of the 371 PD patients in the HONEYPOT trial with those of 6,085 PD patients recorded on the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Compared with the PD population, the HONEYPOT sample was older (standardized difference [ d ] = 0.19, p = 0.003), more likely to be treated with automated PD ( d = 0.58, p < 0.001), had higher residual renal function ( d = 0.26, p < 0.001) and a higher proportion of participants with end-stage kidney disease due to polycystic kidney disease ( d = 0.17) and lower proportion due to diabetes ( d = -0.17) and glomerulonephritis ( d = -0.18) ( p < 0.001), and lower proportions of indigenous people ( d = -0.17, p < 0.001), current smokers ( d = -0.10, p < 0.001), and people with prior histories of hemodialysis ( d = -0.16, p < 0.001), diabetes mellitus ( d = -0.18, p < 0.001), and coronary artery disease ( d = -0.15, p < 0.001). HONEYPOT trial participants tended to be healthier than the Australian and New Zealand PD patient population. Although the differences between the groups were generally modest, it is possible that their cumulative effect may have had some impact on external generalizability, which is not an uncommon occurrence in clinical trials. Copyright © 2017 International Society for Peritoneal Dialysis.

  3. Trauma Facts for Educators

    Science.gov (United States)

    National Child Traumatic Stress Network, 2008

    2008-01-01

    This paper offers facts which can help educators deal with children undergoing trauma. These include: (1) One out of every 4 children attending school has been exposed to a traumatic event that can affect learning and/or behavior; (2) Trauma can impact school performance; (3) Trauma can impair learning; (4) Traumatized children may experience…

  4. Anaesthesia for trauma patients

    African Journals Online (AJOL)

    in trauma patients can be used. However, some modifications have been made to adapt it to unstable trauma patients, where reawakening the patient is not an option because of the need for emergency airway control (Figure 3).4. Anaesthetists working in high-volume trauma centers should determine their own algorithm, ...

  5. Trauma resuscitation time.

    NARCIS (Netherlands)

    Olden, G.D.J. van; Vugt, A.B. van; Biert, J.; Goris, R.J.A.

    2003-01-01

    Documenting the timing and organisation of trauma resuscitation can be utilised to assess performance standards, and to ensure a high quality of trauma resuscitation procedures. Since there is no European literature available on trauma resuscitation time (TRT) in the emergency room, the aim of this

  6. Pelvic trauma: WSES classification and guidelines.

    Science.gov (United States)

    Coccolini, Federico; Stahel, Philip F; Montori, Giulia; Biffl, Walter; Horer, Tal M; Catena, Fausto; Kluger, Yoram; Moore, Ernest E; Peitzman, Andrew B; Ivatury, Rao; Coimbra, Raul; Fraga, Gustavo Pereira; Pereira, Bruno; Rizoli, Sandro; Kirkpatrick, Andrew; Leppaniemi, Ari; Manfredi, Roberto; Magnone, Stefano; Chiara, Osvaldo; Solaini, Leonardo; Ceresoli, Marco; Allievi, Niccolò; Arvieux, Catherine; Velmahos, George; Balogh, Zsolt; Naidoo, Noel; Weber, Dieter; Abu-Zidan, Fikri; Sartelli, Massimo; Ansaloni, Luca

    2017-01-01

    Complex pelvic injuries are among the most dangerous and deadly trauma related lesions. Different classification systems exist, some are based on the mechanism of injury, some on anatomic patterns and some are focusing on the resulting instability requiring operative fixation. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic impairment of pelvic ring function and the associated injuries. The management of pelvic trauma patients aims definitively to restore the homeostasis and the normal physiopathology associated to the mechanical stability of the pelvic ring. Thus the management of pelvic trauma must be multidisciplinary and should be ultimately based on the physiology of the patient and the anatomy of the injury. This paper presents the World Society of Emergency Surgery (WSES) classification of pelvic trauma and the management Guidelines.

  7. The malignant epidemic-changing patterns of trauma | Bowley ...

    African Journals Online (AJOL)

    Objectives and Setting. The worldwide burden of trauma is increasing, but is unequally distributed between nations. Trauma in South Africa targets the young and productive in society and imposes a major burden on the health infrastructure. We undertook a review of injury trends among patients attending the ...

  8. Emerging technologies in hemostasis diagnostics: a report from the Australasian Society of Thrombosis and Haemostasis Emerging Technologies Group.

    Science.gov (United States)

    Adams, Murray; Ward, Chris; Thom, Jim; Bianchi, Alessandra; Perrin, Emma; Coghlan, Douglas; Smith, Mark

    2007-04-01

    Technology in hemostasis laboratories has evolved enormously during the last 30 years. Although many scientists and clinicians will remember the traditional tilt-tube techniques to screen for coagulation abnormalities and to monitor anticoagulant therapy, the hemostasis laboratory today uses a variety of modern technologies. These include flow cytometry, chromogenic assays, molecular typing (e.g., polymerase chain reaction), immunologic assays (e.g., enzyme-linked immunosorbent assays), functional assays of specific coagulation proteins, and platelet function analyzers. Although these advances in technology have resulted in greater capability, productivity, sensitivity, specificity, and ultimately, improvement in the clinical care of patients, controversies and limitations remain. This article highlights new and emerging technologies in hemostasis and discusses whether they have improved or are likely to improve laboratory diagnostics by specifically addressing the following: (1) Can new technologies help predict likelihood of thrombosis recurrence? (2) Has an understanding of the role of A Disintegrin-like And Metalloprotease with Thrombo Spondin type 1 motifs (ADAMTS13) in microangiopathy resulted in improved diagnostic methods for this disorder? (3) Does thrombelastography allow better definition of bleeding risk than conventional hemostasis assays, especially in settings of acute hemostatic pathology?

  9. [Trauma and emergency thoracoscopy].

    Science.gov (United States)

    Ochmann, J; Vrastyák, J; Svoboda, P; Kantorová, I; Zelnícek, P; Cierny, M

    1996-08-01

    Authors present their first experience with urgent videothoracoscopy in polytraumatism and in isolated thoracic trauma patients. During the prospective study in 1993-1995 thoracoscopically was treated 41 (18%) from 229 multiple trauma patients including thorax trauma, hospitalised in our Institute. Thoracoscopy underwent 62 (4%) from 1452 patients with simple thoracic trauma. Thoracoscopy has been indicated above all for continued bleeding into peritoneal cavity, for suspected diafragmatic injury and for the diagnosis and treatment of posttraumatic complications. Authors suggest that thoracoscopy is in experienced hands and adequatelly equipped workplaces an accurate and safe method for the diagnosis and in some cases also for therapy of hemodynamic stabile patients with thoracic trauma.

  10. Vicarious Trauma: Predictors of Clinicians' Disrupted Cognitions about Self-Esteem and Self-Intimacy

    Science.gov (United States)

    Way, Ineke; VanDeusen, Karen; Cottrell, Tom

    2007-01-01

    This study examined vicarious trauma in clinicians who provide sexual abuse treatment (N = 383). A random sample of clinical members from the Association for the Treatment of Sexual Abusers and American Professional Society on the Abuse of Children were surveyed. Vicarious trauma was measured using the Trauma Stress Institute Belief Scale…

  11. Effective Bullying-Trauma Intervention Technique

    Science.gov (United States)

    Pierce, Kenneth L.

    2010-01-01

    There is considerable interest in many sectors of society in trauma intervention. School yard bullying has been getting a lot of attention as of late. It is widely reported and analyzed repeatedly in the media. As a clinical psychologist and adjunct psychology professor for over 30 years, the author has had occasion to see bullying in many forms…

  12. THE AUSTRALASIAN APPROACH TO THE DEFINITION OF MENTAL DISORDER IN A MENTAL HEALTH ACT.

    Science.gov (United States)

    Dawson, John B

    2017-12-27

    How should the mental element be defined in the legal standards governing a person's 'sectioning' or placement under the Mental Health Act (MHA)? This article considers how this mental element is defined in many MHAs in Australasia: via a statutory list of disorders of mental function said to 'characterise' the necessary state of mind. This article assesses the assumptions behind the adoption of this approach. It discusses the views of several English law reform committees that have explored how the mental element should be defined. It examines the philosophy of psychiatry, expounded clearly by Aubrey Lewis, that lies behind the Australasian approach, one that emphasises the need to identify mental disturbance by reference to disorders of 'part-function of the mind', not by reference to behaviour alone. It considers how the Australasian statutes address the question of personality disorder's covered by the Act. In conclusion, it endorses cautiously the Australasian approach, principally on the ground that it may contribute positively to the conduct of review proceedings for compulsory patients under the Act. It may concentrate the attention of tribunals on particular features of the patient's mental state, on how those features are linked to associated dangers or risks, and on how the presence of those features may justify placing decisions about the patient's treatment in others' hands. Throughout, comparisons are made with the manner in which the mental element has been defined in mental health legislation for England and Wales. © The Author 2017. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Transforming Society

    DEFF Research Database (Denmark)

    Enemark, Stig; Dahl Højgaard, Pia

    2017-01-01

    This paper provides an understanding of the cadastral evolution in Denmark with a focus on establishing the cadastre as an outcome of the enclosure movement in the late 1700s. The purpose of the cadastre was collection of tax based on the yielding capacity of the soil. The Danish cadastre, this way......, was a result of transforming society from a feudal system to a capitalistic and market based economy. This story is interesting in itself - but it also provides a key to understanding the cadastral system of today. The system has evolved over time and now serves a whole range of functions in society. The paper...

  14. Centroid Moment Tensor Inversion in a 3D heterogeneous Earth: Application to the Australasian region

    Science.gov (United States)

    Hejrani, B.; Tkalcic, H.; Fichtner, A.

    2015-12-01

    Australia is surrounded by active complex tectonic belts causing significant seismicity. The recent expansion of permanent seismic networks in the Australasian region provides great opportunity to study Earth structure and a great variety of physical mechanisms responsible for earthquakes.On one hand, a better understanding of the Australasian lithosphere, which is now available through tomographic images from full waveform modelling (Fichtner et al. 2010), provides a powerful tool to scrutinize the determination of earthquake source parameters. Even at relatively long periods (40-200s), the 3D effects of regional structure were shown to significantly alter the global centroid moment tensor solutions (Hingee et al. 2012). Thus, we can now explore other types of uncertainties and test the accuracy of global centroid moment tensor (GCMT) solution for the earthquakes in the Australasian region while checking for the systematic inconsistencies in the solutions. This has a significant bearing on tectonic interpretations. For example, azimuth and plunge of fault planes can be investigated in search for systematic biases.On the other hand, the time has come to take a full advantage of the 3D Earth structural model and embrace ongoing advances in computational power and storage. We develop a semi-automated procedure to calculate the Centroid Moment Tensors in a 3D heterogeneous Earth. We utilize the reciprocity theorem to create Green's functions for point sources covering seismogenic zones of Australasia. We focus on improving the capacity of the method to fully complement the existing monitoring tools at Geosciences Australia. Furthermore, we investigate the effects of detailed velocity structure on Centroid location and double-couple percentages. Moreover Azimuth and Plunge of focal mechanisms in GCMT (Global CMT), were investigated in search for any systematic bias.References: Fichtner, A., Kennett, B.L.N., Igel, H., Bunge, H.-P., 2010. Full waveform tomography for

  15. Balancing consumer and societal requirements for sheep meat production: an Australasian perspective.

    Science.gov (United States)

    Ferguson, D M; Schreurs, N M; Kenyon, P R; Jacob, R H

    2014-11-01

    Although there has been a decline in sheep numbers in Australia and New Zealand, both countries remain significant producers and exporters of sheep meat. The ongoing demand for more sustainable and ethical animal farming systems and practices requires sheep production industries to be both vigilant and responsive to consumer and the broader societal needs. Demonstration of continuous improvement in animal welfare is paramount and the welfare risks and challenges confronting Australasian sheep industries now and into the future are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Australasian code for reporting of mineral resources and ore reserves (the JORC code)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-06-01

    The latest revision of the Code first published in 1989 becomes effective in September 1999. It was prepared by the Joint Ores Reserves Committee of the Australasian Institute of Mining and Metallurgy, Australian Institute of Geoscientists and Minerals Council of Australia (JORC). It sets out minimum standards, recommendations and guidelines for public reporting of exploration results, mineral resources and ore reserves in Australasia. In this edition, the guidelines, which were previously separated from the Code, have been placed after the respective Code clauses. The Code is applicable to all solid minerals, including diamonds, other gemstones and coal for which public reporting is required by the Australian and New Zealand Stock Exchanges.

  17. Trauma in children due to wheeled recreational devices.

    Science.gov (United States)

    Kaddis, Mina; Stockton, Kellie; Kimble, Roy

    2016-01-01

    The aim of this study was to describe trauma in children secondary to the use of wheeled recreational devices (WRDs). This study retrospectively described trauma secondary to use of WRDs sustained by children 16 years or younger over a period of 12 months at two tertiary paediatric hospitals in Brisbane, Queensland. Data were analysed from the Paediatric Trauma Registry at these two facilities. Data were also retrieved from The Commission for Children and Young People and Child Guardian to provide information regarding deaths in Queensland from the use of WRDs for the period January 2004 to September 2013. Outcome measures included age, gender, types of injuries, Injury Severity Scores, admission to Intensive Care, and length of hospital stay for all hospital admissions greater than 24 h. A total number of 45 children were admitted with trauma relating to WRDs during the 12 months, representing 5.3% of all trauma admissions of greater than 24 h during this time period. Of these, 34 were male with a median age of 11.0 years (IQR = 9-13). Limbs accounted for the majority (54.5%) of injuries, with other common injuries being spine/cranial fractures (14.5%), lacerations (12.7%), internal organ injuries (9.1%), and intracranial bleeds (9.1%). There were six admissions to the Paediatric Intensive Care Unit and one death. WRDs contribute significantly to injuries sustained by children. A large proportion of these injuries may be preventable, suggesting that mandating the use of protective equipment in Queensland may be of great benefit. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  18. Ultrasonography in trauma

    DEFF Research Database (Denmark)

    Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C

    2017-01-01

    .9%) facilities. CONCLUSION: Ultrasonography was used in a non-uniform fashion by multiple specialties in Danish trauma facilities. Very few images from FAST examinations were stored and documentation was scanty. National guidelines on application and documentation of ultrasonography in trauma are called for.......BACKGROUND: The Focused Assessment with Sonography in Trauma (FAST) protocol is considered beneficial in emergent evaluation of trauma patients with blunt or penetrating injury and has become integrated into the Advanced Trauma Life Support (ATLS) protocol. No guidelines exist as to the use....... Twenty-one (95.5%) of the guidelines included and recommended FAST as part of trauma assessment. The recommended person to perform the examination was the radiologist in n = 11 (50.0%), the surgeon in n = 6 (27.3%), the anesthesiologist in n = 1 (4.5%), and unspecified in n = 3 (13.6%) facilities. FAST...

  19. Management of duodenal trauma

    Directory of Open Access Journals (Sweden)

    CHEN Guo-qing

    2011-02-01

    Full Text Available 【Abstract】Duodenal trauma is uncommon but nowadays seen more and more frequently due to the increased automobile accidents and violent events. The management of duodenal trauma can be complicated, especially when massive injury to the pancreatic-duodenal-biliary complex occurs simultaneously. Even the patients receive surgeries in time, multiple postoperative complications and high mortality are common. To know and manage duodenal trauma better, we searched the recent related literature in PubMed by the keywords of duodenal trauma, therapy, diagnosis and abdomen. It shows that because the diagnosis and management are complicated and the mortality is high, duodenal trauma should be treated in time and tactfully. And application of new technology can help improve the management. In this review, we discussed the incidence, diagnosis, management, and complications as well as mortality of duodenal trauma. Key words: Duodenum; Wounds and injuries; Diagnosis; Therapeutics

  20. The education and training of clinical medical physicists in 25 European, 2 North American and 2 Australasian countries: similarities and differences.

    Science.gov (United States)

    Stefanoyiannis, A P; Christofides, S; Psichis, K; Geoghegan, D S; Gerogiannis, I; Round, W H; Geronikola-Trapali, X; Armeniakos, I; Kaplanis, P A; Prentakis, A; Chatziioannou, S N

    2012-07-01

    The clinical medical physicist is part of a team responsible for safe and competent provision of radiation-based diagnostic examinations and therapeutic practices. To ensure that the physicist can provide an adequate service, sufficient education and training is indispensable. The aim of this study is to provide a structured description of the present status of the clinical medical physicist education and training framework in 25 European, 2 North American and 2 Australasian countries. For this study, data collection was based on a questionnaire prepared by the European Federation of Organizations in Medical Physics (EFOMP) and filled-in either by the corresponding scientific societies-organizations or by the authors. In the majority of cases, a qualified medical physicist should have an MSc in medical physics and 1-3 years of clinical experience. Education and training takes place in both universities and hospitals and the total duration of the programs ranges from 2.5 to 9 years. In 56% of all European countries, it is mandatory to hold a diploma or license to work as a medical physicist, the situation being similar in Australasian and 4 states of USA. Generally, there are national registers of medical physicists with inclusion on the register being voluntary. There are renewal mechanisms in the registers usually based on a Continuing Professional Development (CPD) system. In conclusion, a common policy is followed in general, on topics concerning education and training as well as the practice of the medical physicist profession, notwithstanding the presence of a few differences. Copyright © 2011 Associazione Italiana di Fisica Medica. All rights reserved.

  1. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans Health Administration? Cancel Unsubscribe Working... Subscribe Subscribed Unsubscribe 18K ...

  2. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... Queue __count__/__total__ Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans Health Administration? Cancel Unsubscribe ...

  3. [Trauma registry and injury].

    Science.gov (United States)

    Shapira, S C

    2001-10-01

    The trauma registry network constitutes an essential database in every injury prevention system. In order to rationally estimate the extent of injury in general, and injuries from traffic accidents in particular, the trauma registry systems should contain the most comprehensive and broad database possible, in line with the operational definitions. Ideally, the base of the injury pyramid should also include mild injuries and even "near-misses". The Israeli National Trauma Registry has come a long way in the last few years. The eventual inclusion of all trauma centers in Israel will enable the establishment of a firm base for the allocation of resources by decision-makers.

  4. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans Health Administration? Cancel Unsubscribe Working... Subscribe Subscribed Unsubscribe 19K ...

  5. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans Health Administration? Cancel Unsubscribe Working... Subscribe Subscribed Unsubscribe 18K Loading... ...

  6. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans Health Administration? Cancel Unsubscribe Working... Subscribe Subscribed Unsubscribe 19K Loading... ...

  7. Analysis of meteorological variables in the Australasian region using ground- and space-based GPS techniques

    Science.gov (United States)

    Kuleshov, Yuriy; Choy, Suelynn; Fu, Erjiang Frank; Chane-Ming, Fabrice; Liou, Yuei-An; Pavelyev, Alexander G.

    2016-07-01

    Results of analysis of meteorological variables (temperature and moisture) in the Australasian region using the global positioning system (GPS) radio occultation (RO) and GPS ground-based observations verified with in situ radiosonde (RS) data are presented. The potential of using ground-based GPS observations for retrieving column integrated precipitable water vapour (PWV) over the Australian continent has been demonstrated using the Australian ground-based GPS reference stations network. Using data from the 15 ground-based GPS stations, the state of the atmosphere over Victoria during a significant weather event, the March 2010 Melbourne storm, has been investigated, and it has been shown that the GPS observations has potential for monitoring the movement of a weather front that has sharp moisture contrast. Temperature and moisture variability in the atmosphere over various climatic regions (the Indian and the Pacific Oceans, the Antarctic and Australia) has been examined using satellite-based GPS RO and in situ RS observations. Investigating recent atmospheric temperature trends over Antarctica, the time series of the collocated GPS RO and RS data were examined, and strong cooling in the lower stratosphere and warming through the troposphere over Antarctica has been identified, in agreement with outputs of climate models. With further expansion of the Global Navigation Satellite Systems (GNSS) system, it is expected that GNSS satellite- and ground-based measurements would be able to provide an order of magnitude larger amount of data which in turn could significantly advance weather forecasting services, climate monitoring and analysis in the Australasian region.

  8. The contribution of private and public information in foraging by Australasian gannets.

    Science.gov (United States)

    Machovsky-Capuska, Gabriel E; Hauber, Mark E; Libby, Eric; Amiot, Christophe; Raubenheimer, David

    2014-07-01

    Predators that forage on foods with temporally and spatially patchy distributions may rely on private or public sources of information to enhance their chances of foraging success. Using GPS tracking, field observations, and videography, we examined potential sites and mechanisms of information acquisition in departures for foraging trips by colonially breeding Australasian gannets (Morus serrator). Analyses of the bill-fencing ceremony between mated pairs of breeding gannets did not detect correlations between parameters of this reciprocal behavior and foraging trips, as would have been predicted if gannets used this behavior as a source of private information. Instead, 60% of the departing birds flew directly to join water rafts of other conspecific en route to the feeding grounds. The departure of solitary birds from the water rafts was synchronized (within 60 s) with the arrival of incoming foragers and also among departing birds. Furthermore, solitary departing birds from the rafts left in the same directional quadrant (90º slices) as the prior arriving (67%) and also prior departing forager (79%). When associated plunge dives of conspecific were visible from the colony, providing a public source of information, gannets more often departed from the water rafts in groups. Our study thus provides evidence for the use of water rafts, but not the nest site, as locations of information transfer, and also confirms the use of local enhancement as a strategy for foraging flights by Australasian gannets.

  9. Utilizing the Experience of Consumers in Consultation to Develop the Australasian Oncofertility Consortium Charter.

    Science.gov (United States)

    Anazodo, Antoinette C; Gerstl, Brigitte; Stern, Catharyn J; McLachlan, Robert I; Agresta, Franca; Jayasinghe, Yasmin; Cohn, Richard J; Wakefield, Claire E; Chapman, Michael; Ledger, William; Sullivan, Elizabeth A

    2016-09-01

    In Australia and New Zealand, there has not been a national systematic development of oncofertility services for cancer patients of reproductive age although many cancer and fertility centers have independently developed services. A number of barriers exist to the development of these services, including a lack of clear referral pathways, a lack of communication between clinicians and patients about fertility preservation, differences in the knowledge base of clinicians about the risk of cancer treatment causing infertility and fertility preservation options, a lack of national health insurance funding covering all aspects of fertility preservation, and storage costs and cultural, religious, and ethical barriers. The development of strategies to overcome these barriers is a high priority for oncofertility care to ensure that equitable access to the best standard of care is available for all patients. The FUTuRE Fertility Research Group led a collaborative consultation process with the Australasian Oncofertility Consumer group and oncofertility specialists to explore consumers' experiences of oncofertility care. Consumers participated in qualitative focus group meetings to define and develop a model of consumer driven or informed "gold standard oncofertility care" with the aim of putting together a Charter that specifically described this. The finalized Australasian Oncofertility Consortium Charter documents eight key elements of gold standard oncofertility care that will be used to monitor the implementation of oncofertility services nationally, to ensure that these key elements are incorporated into standard practice over time.

  10. Biologics and dermatology life quality index (DLQI) in the Australasian psoriasis population.

    Science.gov (United States)

    Norris, Diana; Photiou, Louise; Tacey, Mark; Dolianitis, Con; Varigos, George; Foley, Peter; Baker, Chris

    2017-12-01

    Psoriasis is a chronic condition that may require long-term treatment for disease control. This analysis utilizes data from the Australasian Psoriasis Registry with particular attention to the impact of biologic therapy on DLQI, and the differences between the biologics in terms of DLQI score change. A retrospective review of patients enrolled in the Australasian Psoriasis Registry from April 2008 to August 2016 was conducted. All subjects from the registry that had DLQI and Psoriasis Assessment Severity Index (PASI) scores recorded at a baseline time point of treatment commencement, in addition to week 12 and 24 post commencement were included in the study. A window of ±3 weeks was permitted at these time points. Multivariate linear regression analysis was undertaken to identify significant predictors associated with change in DLQI. Significant predictors of reduction in DLQI and PASI score from baseline to week 24 include use of adalimumab, infliximab, secukinumab and ustekinumab. Other therapies, including etanercept and oral systemic agents did not show significant change. Each class of biologic showed significant reductions in DLQI score, with IL-12/23 blockade showing the greatest reduction. Significant predictors of lack of reduction in DLQI score include a baseline PASI score psoriasis who are treated with biologics show the greatest reduction in DLQI score, compared with other treatments. Australian dermatologists are prescribing biologics when patients qualify for them in keeping with current guidelines.

  11. Impact of the Royal Australasian College of Physicians' clinical examination preparation on basic physician trainee assessment of jugular venous pressure.

    Science.gov (United States)

    Sibbin, C P; Bihari, S; Russell, P

    2016-09-01

    Australian internal medicine trainees undergo intensive training in preparation for the Royal Australasian College of Physicians (RACP) clinical examination. Trainees preparing for the 2013 RACP clinical examination assessed the jugular venous pressure (JVP) of patients, with central venous pressure monitoring in the intensive care unit before and after the exam. RACP clinical examination preparation was associated with improvements of trainees' ability to identify JVP that were not elevated, although the JVP examination was performed marginally as a diagnostic test. Ongoing training might further improve this skill. © 2016 Royal Australasian College of Physicians.

  12. Trauma and the truth

    NARCIS (Netherlands)

    Meeter, Martijn

    2016-01-01

    Witnessing horrible things may leave a person scarred for life — an effect usually referred to as psychological trauma. We do not know exactly what it does or how it worms its way into our psyche, but psychological trauma has been linked to a wide range of fear- and depression-related symptoms

  13. Trauma - the malignant epidemic

    African Journals Online (AJOL)

    murdered by the time he is aged 35 years.5 Trauma is respon- sible for the deaths of ISO000 Americans each ... people than malignant disease, hean disease and AIDS com- bined.7. South Mrica. South Africa has no ... away trauma patients, the IeU has also to refuse care for those patients who.require intensive monitoring ...

  14. Platelet aggregation following trauma

    DEFF Research Database (Denmark)

    Windeløv, Nis A; Sørensen, Anne M; Perner, Anders

    2014-01-01

    We aimed to elucidate platelet function in trauma patients, as it is pivotal for hemostasis yet remains scarcely investigated in this population. We conducted a prospective observational study of platelet aggregation capacity in 213 adult trauma patients on admission to an emergency department (ED...

  15. Haemostatic resuscitation in trauma

    DEFF Research Database (Denmark)

    Stensballe, Jakob; Ostrowski, Sisse Rye; Johansson, Par I.

    2016-01-01

    PURPOSE OF REVIEW: To discuss the recent developments in and evolvement of next generation haemostatic resuscitation in bleeding trauma. RECENT FINDINGS: Mortality from major trauma is a worldwide problem, and massive haemorrhage remains a major cause of potentially preventable deaths. Developmen...

  16. Asian/Australasian region intercalibration and intercomparison programme for radon, thoron and daughters. Asian/Australasian region radon intercomparison, September 1987 - September 1988

    International Nuclear Information System (INIS)

    Peggie, J.R.; Gan, Tianghong; Solomon, S.B.

    1993-05-01

    The International Intercalibration and Intercomparison Programme for radon, thoron and daughters monitoring equipment, abbreviated IIIP, was a programme organized jointly by the Nuclear Energy Agency of the Organization for Economic Cooperation and Development and the Radiation Protection Research Programme of the Commission of European Communities. The broad purpose of the IIIP was to determine if the diverse calibration procedures used in different countries were equivalent. The general approach was to select four regional reference laboratories and entrust then with the details of project definition and execution. The Australian Radiation Laboratory (ARL) was selected to co-ordinate IIIP activities between OECD member countries in the Pacific region. As the regional programme precluded the participation of non-OECD member countries in the Western Pacific Region, an intercomparison series for radon was initiated by ARL in 1987 between twenty eight laboratories from nine countries in the Asian/Australasian region. The methodology and protocols for grab sampler, solid state nuclear track detectors (SSNTD) and charcoal measurements are described in this report. Generally the results showed reasonable agreement between the majority of laboratories for grab sampler measurements consistent with previous intercomparison. However there were large systematic differences in the results of the passive monitors for some laboratories. For all samplers, it was found that the overall random uncertainty or replication error, which included random uncertainties associated with the counting and calibration, were the main sources of variability between individual measurements of participants and the ARL reference value, with calibration uncertainties predominating. 23 tabs

  17. Cryptozoology Society

    Science.gov (United States)

    Richman, Barbara T.

    Reports of Loch Ness monsters, Bigfoot, and the Yeti spring u p from time to time, sparking scientific controversy about the veracity of these observations. Now an organization has been established to help cull, analyze, and disseminate information on the alleged creatures. The International Society of Cryptozoology, formed at a January meeting at the U.S. National Museum of Natural History of the Smithsonian Institution, will serve as the focal point for the investigation, analysis, publication, and discussion of animals of unexpected form or size or of unexpected occurrences in time or space.

  18. Network Society

    DEFF Research Database (Denmark)

    Clausen, Lars; Tække, Jesper

    2017-01-01

    the five strands of theory on the network society. Each theoretical position has its specific implications for acting toward strategic goals. In its entirety, the five perspectives give a thorough understanding of the conditions for successful strategic communication in the 21st century.......Strategic communication needs a thorough understanding of the social forms of interaction, organization and social structure, it works within and through. Success is a scarce resource, and organizations compete to fulfill their mission and advance toward specific goals. In this chapter, we present...

  19. Network Society

    DEFF Research Database (Denmark)

    Clausen, Lars; Tække, Jesper

    2017-01-01

    Strategic communication needs a thorough understanding of the social forms of interaction, organization and social structure, it works within and through. Success is a scarce resource, and organizations compete to fulfill their mission and advance toward specific goals. In this chapter, we present...... the five strands of theory on the network society. Each theoretical position has its specific implications for acting toward strategic goals. In its entirety, the five perspectives give a thorough understanding of the conditions for successful strategic communication in the 21st century....

  20. Network Society

    DEFF Research Database (Denmark)

    Clausen, Lars; Tække, Jesper

    2018-01-01

    Strategic communication needs a thorough understanding of the social forms of interaction, organization and social structure, it works within and through. Success is a scarce resource, and organizations compete to fulfill their mission and advance toward specific goals. In this chapter, we present...... the five strands of theory on the network society. Each theoretical position has its specific implications for acting toward strategic goals. In its entirety, the five perspectives give a thorough understanding of the conditions for successful strategic communication in the 21st century....

  1. Special report of the first Australasian Diagnostic Error in Medicine Conference from 23 to 25 May, 2017.

    Science.gov (United States)

    Watanuki, Satoshi; Aoyagi, Yuki; Yukawa Orimoto, Kumiko

    2017-12-01

    We attended the first Australasian Diagnostic Error in Medicine Conference (Aus DEM) in Melbourne from 23 to 25 May, 2017. We believe hosting the DEM conference in Japan is vital in promoting diagnostic error prevention initiatives in our region. We hope all the stakeholders in health care will join the DEM conference to be hosted in our country to address issues surrounding diagnostic errors.

  2. Phylogenetic relationships of the anoplocephaline cestodes of Australasian marsupials and resurrection of the genus Wallabicestus Schmidt, 1975.

    Science.gov (United States)

    Hardman, L M; Haukisalmi, V; Beveridge, I

    2012-05-01

    A phylogenetic analysis was carried out on rDNA of 45 species of anoplocephaline cestodes from marsupial hosts. The exclusively Australasian genera Progamotaenia Nybelin, 1917, Triplotaenia Boas, 1902, Paramoniezia Maplestone & Southwell, 1923 and Phascolotaenia Beveridge, 1976 formed a monophyletic clade, and the previously suggested relationship between the Australasian species of the cosmopolitan genus Bertiella Stiles & Hassall, 1902 and species of Progamotaenia was supported. A low degree of phyletic co-evolution was detected within endemic Australasian clades. Colonisation rather than co-speciation appeared to be the principal means of diversification within the Australasian anoplocephaline radiation. The clade of bile duct-inhabiting Progamotaenia species emphasises the role of microhabitat rather than host species as a driver of speciation. Triplotaenia undosa Beveridge, 1976 described from a wide variety of macropodid hosts was found to be polyphyletic and a proposition was made to resurrect Wallabicestus Schmidt, 1975, with W. ewersi Schmidt, 1975 as the type-species and including W. ualabati (Beveridge, 2009) n. comb. [previously Progamotaenia ualabati Beveridge, 2009].

  3. The European Trauma Course (ETC) and the team approach

    DEFF Research Database (Denmark)

    Lott, Carsten; Araujo, Rui; Cassar, Mary Rose

    2009-01-01

    The European Trauma Course (ETC) was officially launched during the international conference of the European Resuscitation Council (ERC) in 2008. The ETC was developed on behalf of ESTES (European Society of Trauma and Emergency Surgery), EuSEM (European Society of Emergency Medicine), the ESA...... (European Society of Anaesthesiology) and the ERC. The objective of the ETC is to provide an internationally recognised and certified life support course, and to teach healthcare professionals the key principles of the initial care of severely injured patients. Its core elements, that differentiates it from...

  4. What do giant titanosaur dinosaurs and modern Australasian megapodes have in common?

    Science.gov (United States)

    Hechenleitner, E Martín; Grellet-Tinner, Gerald; Fiorelli, Lucas E

    2015-01-01

    Titanosauria is a globally distributed clade of sometimes extremely large Mesozoic herbivorous sauropod dinosaurs. On the basis of current evidence these giant dinosaurs seem to have reproduced in specific and localized nesting sites. However, no investigations have been performed to understand the possible ecological and geological biases that acted for the selection of these nesting sites worldwide. In this study, observations were performed on the best-known Cretaceous nesting sites around the world. Our observations strongly suggest their eggs were incubated with environmental sources of heat, in burial conditions. Taking into account the clutch composition and geometry, the nature and properties of the sediments, the eggshells' structures and conductance, it would appear that titanosaurs adopted nesting behaviors comparable to the modern Australasian megapodes, using burrow-nesting in diverse media and mound-building strategies.

  5. What do giant titanosaur dinosaurs and modern Australasian megapodes have in common?

    Directory of Open Access Journals (Sweden)

    E. Martín Hechenleitner

    2015-10-01

    Full Text Available Titanosauria is a globally distributed clade of sometimes extremely large Mesozoic herbivorous sauropod dinosaurs. On the basis of current evidence these giant dinosaurs seem to have reproduced in specific and localized nesting sites. However, no investigations have been performed to understand the possible ecological and geological biases that acted for the selection of these nesting sites worldwide. In this study, observations were performed on the best-known Cretaceous nesting sites around the world. Our observations strongly suggest their eggs were incubated with environmental sources of heat, in burial conditions. Taking into account the clutch composition and geometry, the nature and properties of the sediments, the eggshells’ structures and conductance, it would appear that titanosaurs adopted nesting behaviors comparable to the modern Australasian megapodes, using burrow-nesting in diverse media and mound-building strategies.

  6. e-VLBI observations of GRB 080409 afterglow with an Australasian radio telescope network

    Science.gov (United States)

    Moin, Aquib; Edwards, Philip G.; Tingay, Steven J.; Phillips, Chris J.; Tzioumis, Anastasios K.; Amy, Shaun W.; An, Tao; Sekido, Mamoru; Wang, Zhong-Xiang

    2016-11-01

    Transcontinental e-VLBI observations were conducted in June 2008 with telescopes in Australia, China and Japan. Detections were made of the radio-loud quasar PKS B0727-115, which shows superluminal motion, and the intra-day variable quasar PKS B0524+034. The latter source was used as a phase reference calibrator for observations at the position of the gamma-ray burst GRB 080409, for which an upper limit to the radio emission is set. Australia Telescope Compact Array data were also used to derive a limit on the radio flux density of the GRB afterglow. These observations demonstrate the capability to form a large Australasian radio telescope network for e-VLBI, with data transported and processed in realtime over high capacity networks. This campaign represents the first step towards more regular e-VLBI observations in this region.

  7. Establishing a clinical trials network in nephrology: experience of the Australasian Kidney Trials Network

    Science.gov (United States)

    Morrish, Alicia T; Hawley, Carmel M; Johnson, David W; Badve, Sunil V; Perkovic, Vlado; Reidlinger, Donna M; Cass, Alan

    2014-01-01

    Chronic kidney disease is a major public health problem globally. Despite this, there are fewer high-quality, high-impact clinical trials in nephrology than other internal medicine specialties, which has led to large gaps in evidence. To address this deficiency, the Australasian Kidney Trials Network, a Collaborative Research Group, was formed in 2005. Since then, the Network has provided infrastructure and expertise to conduct patient-focused high-quality, investigator-initiated clinical trials in nephrology. The Network has not only been successful in engaging the nephrology community in Australia and New Zealand but also in forming collaborations with leading researchers from other countries. This article describes the establishment, development, and functions of the Network. The article also discusses the current and future funding strategies to ensure uninterrupted conduct of much needed clinical trials in nephrology to improve the outcomes of patients affected by kidney diseases with cost-effective interventions. PMID:24088955

  8. A 2009 survey of the Australasian clinical medical physics and biomedical engineering workforce.

    Science.gov (United States)

    Round, W Howell

    2010-06-01

    A survey of the Australasian clinical medical physics and biomedical engineering workforce was carried out in 2009 following on from a similar survey in 2006. 621 positions (equivalent to 575 equivalent full time (EFT) positions) were captured by the survey. Of these 330 EFT were in radiation oncology physics, 45 EFT were in radiology physics, 42 EFT were in nuclear medicine physics, 159 EFT were in biomedical engineering and 29 EFT were attributed to other activities. The survey reviewed the experience profile, the salary levels and the number of vacant positions in the workforce for the different disciplines in each Australian state and in New Zealand. Analysis of the data shows the changes to the workforce over the preceding 3 years and identifies shortfalls in the workforce.

  9. Establishing a clinical trials network in nephrology: experience of the Australasian Kidney Trials Network.

    Science.gov (United States)

    Morrish, Alicia T; Hawley, Carmel M; Johnson, David W; Badve, Sunil V; Perkovic, Vlado; Reidlinger, Donna M; Cass, Alan

    2014-01-01

    Chronic kidney disease is a major public health problem globally. Despite this, there are fewer high-quality, high-impact clinical trials in nephrology than other internal medicine specialties, which has led to large gaps in evidence. To address this deficiency, the Australasian Kidney Trials Network, a Collaborative Research Group, was formed in 2005. Since then, the Network has provided infrastructure and expertise to conduct patient-focused high-quality, investigator-initiated clinical trials in nephrology. The Network has not only been successful in engaging the nephrology community in Australia and New Zealand but also in forming collaborations with leading researchers from other countries. This article describes the establishment, development, and functions of the Network. The article also discusses the current and future funding strategies to ensure uninterrupted conduct of much needed clinical trials in nephrology to improve the outcomes of patients affected by kidney diseases with cost-effective interventions.

  10. Dental Trauma Guide

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva; Gerds, Thomas Alexander

    2012-01-01

    Diagnosis and treatment for traumatic dental injuries are very complex owing to the multiple trauma entities represented by six luxation types and nine fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and luxation injuries are often...... problems in selecting proper treatment for some of these trauma types. To remedy this situation, an Internet-based knowledge base consisting of 4000 dental trauma cases with long-term follow up is now available to the public and the professions on the Internet using the address http://www.Dental...

  11. The practice and perception of precautionary allergen labelling by the Australasian food manufacturing industry.

    Science.gov (United States)

    Zurzolo, G A; Peters, R L; Koplin, J J; de Courten, M; Mathai, M L; Tye-Din, J A; Tang, M L K; Campbell, D E; Ponsonby, A-L; Prescott, S L; Gurrin, L; Dharmage, S C; Allen, K J

    2017-07-01

    The precautionary allergen labelling (PAL) and Voluntary Incidental Trace Allergen Labelling (VITAL ® ) tools were designed by industry to assist consumers with selecting safe foods for consumption. However, a sizeable proportion of food products bear no label, and it is unclear whether these products are free from allergens and therefore safe to consume or have simply not undergone a risk assessment and therefore remain unlabelled for that reason. To assess the prevalence of unlabelled products that have undergone a risk assessment process and to examine the factors influencing industry's uptake of the VITAL ® process. A web-based questionnaire was distributed to Australasian food and grocery manufacturers. One hundred and thirty-seven Australasian manufacturers were contacted, and 59 questionnaires were returned (response rate: 43%). The respondents represented 454 different manufacturing sites. Manufacturers reported that 23% (95% CI 19-28) of products (n=102/434) that had been through the VITAL ® risk assessment process had no PAL statement on the label. 34% (95% CI 30-38), (n=204/600) of products that had undergone another (non-VITAL ® ) risk assessment process had no PAL statement. In examining the factors that influenced industry's uptake of the VITAL ® process, 25 manufacturers reported on factors that influenced the uptake of the VITAL ® process, 76% (CI 95% 55-91) reported that VITAL ® was an effective tool because it was based on science; 52% (CI 95% 31-72) reported that it was too time-consuming and 36% (CI 95% 18-57) identified a concern with it not being endorsed by the government. Currently, we estimate that at least 30% of products may have been through a risk assessment process and yet bear no PAL statement on the label. Permissive labelling could be incorporated onto these products if they have been assessed to be safe for consumption. © 2017 John Wiley & Sons Ltd.

  12. Low-resolution Australasian palaeoclimate records of the last 2000 years

    Directory of Open Access Journals (Sweden)

    B. C. Dixon

    2017-10-01

    Full Text Available Non-annually resolved palaeoclimate records in the Australasian region were compiled to facilitate investigations of decadal to centennial climate variability over the past 2000 years. A total of 675 lake and wetland, geomorphic, marine, and speleothem records were identified. The majority of records are located near population centres in southeast Australia, in New Zealand, and across the maritime continent, and there are few records from the arid regions of central and western Australia. Each record was assessed against a set of a priori criteria based on temporal resolution, record length, dating methods, and confidence in the proxy–climate relationship over the Common Era. A subset of 22 records met the criteria and were endorsed for subsequent analyses. Chronological uncertainty was the primary reason why records did not meet the selection criteria. New chronologies based on Bayesian techniques were constructed for the high-quality subset to ensure a consistent approach to age modelling and quantification of age uncertainties. The primary reasons for differences between published and reconstructed age–depth models were the consideration of the non-singular distribution of ages in calibrated 14C dates and the use of estimated autocorrelation between sampled depths as a constraint for changes in accumulation rate. Existing proxies and reconstruction techniques that successfully capture climate variability in the region show potential to address spatial gaps and expand the range of climate variables covering the last 2000 years in the Australasian region. Future palaeoclimate research and records in Australasia could be greatly improved through three main actions: (i greater data availability through the public archiving of published records; (ii thorough characterisation of proxy–climate relationships through site monitoring and climate sensitivity tests; and (iii improvement of chronologies through core-top dating

  13. Toward a 530,000-year Hydroclimate History for the Southern Half of the Australasian Monsoon

    Science.gov (United States)

    Gagan, M. K.; Scroxton, N. G.; Kimbrough, A. K.; Krause, C.; Hantoro, W. S.; Ayliffe, L. K.; Dunbar, G. B.; Cheng, H.; Edwards, R. L.; Hellstrom, J. C.; Shen, C. C.; Scott-Gagan, H.; Suwargadi, B. W.; Rifai, H.

    2015-12-01

    Speleothem 18O/16O records have revealed key aspects of past hydroclimates in the northern Australasian monsoon domain on orbital to millennial scales, but much less is known about the southern half of the monsoon system. We aim to develop a hydroclimate history for the southern Australasian monsoon based on speleothems from southwest Sulawesi and Flores, Indonesia (latitudes 5-9oS), which extend back to ~530 kyr BP and 90 kyr BP, respectively. To date, the 18O/16O record for Sulawesi covers glacial terminations TIV (~340 kyr BP), TIII (~245 kyr BP) and TI (~18 kyr BP). The details of each termination are different, however two important hydroclimate patterns are emerging. First, the 18O/16O record shows sharp weakening of the monsoon immediately before each termination. This surprisingly robust pattern marks a southern extension of the northern 'weak monsoon interval', and reinforces the idea that southward monsoon displacement is a fundamental feature of terminations. Second, monsoon intensification around Sulawesi lags the rise in atmospheric CO2 and Antarctic temperature by several thousand years, but parallels the 18O/16O decrease in atmospheric O2. Our finding extends that of Wang et al. (2008) and Cheng et al. (2009) who noted the influence of the low-latitude hydrological cycle on the 18O/16O of tropical transpiration, and its potential for correlating ice core and paleomonsoon records. Further south, the 90-kyr 18O/16O record for Flores shows clear precession-scale antiphasing with China, and southerly positioning of the summer monsoon rainfall belt during Heinrich stadials. Heinrich stadials 5, 4, 2 and 1 occur during wetter intervals in Flores that accompanied relatively high southern summer insolation. Intriguingly, these events are associated with abrupt atmospheric CH4 signals that may be due to increased Southern Hemisphere CH4 production related to intensification of monsoon rainfall over southern tropical land areas (Rhodes et al., 2014).

  14. Abdominal aortic aneurysm repair in New Zealand: a validation of the Australasian Vascular Audit.

    Science.gov (United States)

    Khashram, Manar; Thomson, Ian A; Jones, Gregory T; Roake, Justin A

    2017-05-01

    In New Zealand (NZ), there are two major sources of operative data for abdominal aortic aneurysm (AAA) repair: the Australasian Vascular Audit (AVA) and the National Minimum Data Set (NMDS). Since the introduction of the AVA in NZ, there has not been any attempt at the validation of outcome data. The aims of this study were to report the outcomes of AAA repair and validate the AAA data captured by AVA using the NMDS. AAA procedures performed in NZ from January 2010 to December 2014 were extracted from the AVA and NMDS. Patients identified from the AVA had their survival status matched to the NMDS. Only primary AAA procedures were included for the analysis, with re-interventions and graft infections excluded. Demographical, risk factors and outcome data were used for validation. The number of patients undergoing primary AAA procedure from AVA and NMDS was 1713 and 2078, respectively. The AVA inpatient mortality for elective and rupture AAA was 1.6 and 32.2%, respectively. The NMDS 30-day mortality from AAA was 2.5 and 31.5%. Overall, 1604 patients were available for matching, and the NMDS correctly reported 98.1% of endovascular aneurysm repair and 94.2% of elective AAA repairs; however, there were major differences in comorbidity reporting between the data sets. Both data sets were incomplete, but combining administrative (NMDS) and clinical (AVA) data sets provided a more accurate assessment of mortality figures. More than 80% of AAA repairs are captured by AVA, but further work to improve compliance and comorbidity documentation is required. © 2016 Royal Australasian College of Surgeons.

  15. Participation in medical college activities: a case study of the Australasian experience.

    Science.gov (United States)

    McNeil, Nicola; Leggat, Sandra; Bartram, Timothy

    2015-01-01

    Medical Colleges rely on the volunteer labour of their Fellows to undertake their key functions. In the Australasian context, there is anecdotal evidence to suggest that Fellow participation is declining. The purpose of this paper is to examine the main factors that influence Fellows' participation in the activities of a Medical College. The authors conducted three focus groups with Fellows who exhibit varying levels of participation with the Medical College in 2012. The research identified individual and organisational factors which influence the propensity of Fellows to volunteer their time to the Medical College. At an individual level, Fellows cite a number of factors which motivate them to volunteer their time to the Medical College, including: altruistic reasons; giving back to the profession and community; and the benefits that Fellow's receive from their participation in College activities, including enhancing their status within the profession. However, Fellows also report issues of work-family integration, balancing Medical College and work-related responsibilities as factors precluding them from participating in Medical College activities. Fellows also noted several factors related to the operation of the Medical College which inhibited their participation in the Medical College, including the perceived exclusivity of the Medical College, a lack of service orientation towards Fellows, a lack of recognition of the work of Fellows and a perceived lack of advocacy on the part of the Medical College. This paper highlights that the participation of Fellows in their Medical Colleges is essential to maintaining quality standards and the effective operation of Australasian healthcare. These preliminary results indicate that there are several factors which discourage Fellow participation in Medical College activities, suggesting a need for Medical Colleges to develop strategies to address these issues.

  16. Low-resolution Australasian palaeoclimate records of the last 2000 years

    Science.gov (United States)

    Dixon, Bronwyn C.; Tyler, Jonathan J.; Lorrey, Andrew M.; Goodwin, Ian D.; Gergis, Joëlle; Drysdale, Russell N.

    2017-10-01

    Non-annually resolved palaeoclimate records in the Australasian region were compiled to facilitate investigations of decadal to centennial climate variability over the past 2000 years. A total of 675 lake and wetland, geomorphic, marine, and speleothem records were identified. The majority of records are located near population centres in southeast Australia, in New Zealand, and across the maritime continent, and there are few records from the arid regions of central and western Australia. Each record was assessed against a set of a priori criteria based on temporal resolution, record length, dating methods, and confidence in the proxy-climate relationship over the Common Era. A subset of 22 records met the criteria and were endorsed for subsequent analyses. Chronological uncertainty was the primary reason why records did not meet the selection criteria. New chronologies based on Bayesian techniques were constructed for the high-quality subset to ensure a consistent approach to age modelling and quantification of age uncertainties. The primary reasons for differences between published and reconstructed age-depth models were the consideration of the non-singular distribution of ages in calibrated 14C dates and the use of estimated autocorrelation between sampled depths as a constraint for changes in accumulation rate. Existing proxies and reconstruction techniques that successfully capture climate variability in the region show potential to address spatial gaps and expand the range of climate variables covering the last 2000 years in the Australasian region. Future palaeoclimate research and records in Australasia could be greatly improved through three main actions: (i) greater data availability through the public archiving of published records; (ii) thorough characterisation of proxy-climate relationships through site monitoring and climate sensitivity tests; and (iii) improvement of chronologies through core-top dating, inclusion of tephra layers where possible

  17. Psoriasis in those planning a family, pregnant or breast-feeding. The Australasian Psoriasis Collaboration.

    Science.gov (United States)

    Rademaker, Marius; Agnew, Karen; Andrews, Megan; Armour, Katherine; Baker, Chris; Foley, Peter; Frew, John; Gebauer, Kurt; Gupta, Monisha; Kennedy, Debra; Marshman, Gillian; Sullivan, John

    2017-05-23

    The Australasian Psoriasis Collaboration has reviewed the evidence for managing moderate to severe psoriasis in those who are pregnant or are breast-feeding, or planning a family. The severity of the psoriasis, associated comorbidities and specific anti-psoriasis treatment, along with other exposures, can have a deleterious effect on pregnancy outcomes. Psoriasis itself increases the risk of preterm and low birthweight babies, along with spontaneous and induced abortions, but no specific birth defects have been otherwise demonstrated. The baseline risk for a live born baby to have a major birth defect is 3%, and significant neuro-developmental problem is 5%. In Australia, pregnant women with psoriasis are more likely to be overweight or obese, depressed, or smoke in their first trimester, and are also less likely to take prenatal vitamins or supplements. Preconception counselling to improve maternal, pregnancy and baby health is therefore strongly encouraged. The topical and systemic therapies commonly used in psoriasis are each discussed separately, with regards to pregnancy exposure, breast-feeding and effects on male fertility and mutagenicity. The systemic therapies included are acitretin, adalimumab, apremilast, certolizumab, ciclosporin, etanercept, infliximab, ixekizumab, methotrexate, NBUVB, prednisone, PUVA, secukinumab and ustekinumab. The topical therapies include dithranol (anthralin), calcipotriol, coal tar, corticosteroids (weak, potent and super-potent), moisturisers, salicylic acid, tacrolimus, and tazarotene. As a general recommendation, effective drugs that have been widely used for years are preferable to newer alternatives with less foetal safety data. It is equally important to evaluate the risks of not treating, as severe untreated disease may negatively impact both mother and the foetus. © 2017 The Australasian College of Dermatologists.

  18. Summary and recommendations from the Australasian guidelines for the management of pancreatic exocrine insufficiency.

    Science.gov (United States)

    Smith, Ross C; Smith, Sarah F; Wilson, Jeremy; Pearce, Callum; Wray, Nick; Vo, Ruth; Chen, John; Ooi, Chee Y; Oliver, Mark; Katz, Tamarah; Turner, Richard; Nikfarjam, Mehrdad; Rayner, Christopher; Horowitz, Michael; Holtmann, Gerald; Talley, Nick; Windsor, John; Pirola, Ron; Neale, Rachel

    2016-01-01

    Because of increasing awareness of variations in the use of pancreatic exocrine replacement therapy, the Australasian Pancreatic Club decided it was timely to re-review the literature and create new Australasian guidelines for the management of pancreatic exocrine insufficiency (PEI). A working party of expert clinicians was convened and initially determined that by dividing the types of presentation into three categories for the likelihood of PEI (definite, possible and unlikely) they were able to consider the difficulties of diagnosing PEI and relate these to the value of treatment for each diagnostic category. Recent studies confirm that patients with chronic pancreatitis receive similar benefit from pancreatic exocrine replacement therapy (PERT) to that established in children with cystic fibrosis. Severe acute pancreatitis is frequently followed by PEI and PERT should be considered for these patients because of their nutritional requirements. Evidence is also becoming stronger for the benefits of PERT in patients with unresectable pancreatic cancer. However there is as yet no clear guide to help identify those patients in the 'unlikely' PEI group who would benefit from PERT. For example, patients with coeliac disease, diabetes mellitus, irritable bowel syndrome and weight loss in the elderly may occasionally be given a trial of PERT, but determining its effectiveness will be difficult. The starting dose of PERT should be from 25,000-40,000 IU lipase taken with food. This may need to be titrated up and there may be a need for proton pump inhibitors in some patients to improve efficacy. Copyright © 2016 IAP and EPC. Published by Elsevier India Pvt Ltd. All rights reserved.

  19. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... it free Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans ... is Cognitive Processing Therapy (CPT) [for posttraumatic stress disorder]? - Duration: 2:01. Veterans Health Administration 27,844 ...

  20. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... Try it free Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from ... Veterans Health Administration 2,027 views 25:30 Language: English Location: United States Restricted Mode: Off History ...

  1. About Military Sexual Trauma

    Science.gov (United States)

    ... Try it free Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from ... Veterans Health Administration 2,027 views 25:30 Language: English Location: United States Restricted Mode: Off History ...

  2. Pediatric Ocular Trauma

    Science.gov (United States)

    ... What are the most common causes of eye injuries in children? Pediatric eye trauma most often occurs at school ... should happen when a child gets an eye injury? A child that sustains an eye injury should seek immediate ...

  3. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... it free Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans ... MST. http://www.mentalhealth.va.gov/msthom... Category Education License Standard YouTube License Show more Show less ...

  4. Paediatric trauma care

    African Journals Online (AJOL)

    . The injury prevention ... for even more injuries than motor vehicle accidents, accounting for almost as many trauma admissions, as is also seen .... IS Secondly, seat-belt legislation and enforcement have only recently come into effect, despite ...

  5. Thromboembolic Complications Following Trauma

    Science.gov (United States)

    2009-12-01

    these physiologic derangements, it is estimated that hypercoagulable disorders, such as factor V Leiden and hyperhomocysteinemia, may be present in...risk factors of venous thrombosis. Hum Genet 2001;109:369-84. 3. Knudson MM, Ikossi DG. Venous thromboembolism after trauma. Curr Opin Crit Care...R E V I E W A R T I C L E Thromboembolic complications following trauma Daniel F. McLaughlin, Charles E. Wade, Howard R. Champion, Jose Salinas, and

  6. Quality of trauma care and trauma registries.

    Science.gov (United States)

    Pino Sánchez, F I; Ballesteros Sanz, M A; Cordero Lorenzana, L; Guerrero López, F

    2015-03-01

    Traumatic disease is a major public health concern. Monitoring the quality of services provided is essential for the maintenance and improvement thereof. Assessing and monitoring the quality of care in trauma patient through quality indicators would allow identifying opportunities for improvement whose implementation would improve outcomes in hospital mortality, functional outcomes and quality of life of survivors. Many quality indicators have been used in this condition, although very few ones have a solid level of scientific evidence to recommend their routine use. The information contained in the trauma registries, spread around the world in recent decades, is essential to know the current health care reality, identify opportunities for improvement and contribute to the clinical and epidemiological research. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  7. Head trauma in China.

    Science.gov (United States)

    Jiang, Ji-Yao

    2013-11-01

    The Chinese Head Trauma Data Bank (CHTDB) has been established, which includes 7,145 hospitalised cases with acute head trauma patients in 47 hospitals. We explored factors that might affect the outcome of acute traumatic brain injury. There was no statistical difference in the mortality rate between male (7.5%) and female (7.2%) patients (P>0.05). The mortality rate in children (65 years) was 7.3%, 7.2% and 9.0%, respectively (P>0.05). The mortality rate of patients with mild (2.7%), moderate (5.0%) and severe (21.8%) head trauma was significantly different (P40 mm Hg was 6.3%, 21.4% and 93.1%, respectively (Phead trauma data bank in China, has one of the largest numbers of cases of any head trauma data bank in the world. Our major findings on mortality may be helpful to neurosurgeons for predicting the outcome of acute head trauma patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Airway management in trauma.

    Science.gov (United States)

    Langeron, O; Birenbaum, A; Amour, J

    2009-05-01

    Maintenance of a patent and prevention of aspiration are essential for the management of the trauma patient, that requires experienced physicians in airway control techniques. Difficulties of the airway control in the trauma setting are increased by the vital failures, the risk of aspiration, the potential cervical spine injury, the combative patient, and the obvious risk of difficult tracheal intubation related to specific injury related to the trauma. Endotracheal intubation remains the gold standard in trauma patient airway management and should be performed via the oral route with a rapid sequence induction and a manual in-line stabilization maneuver, to decrease the risks previously mentioned. Different techniques to control the airway in trauma patients are presented: improvement of the laryngoscopic vision, lighted stylet tracheal intubation, retrograde technique for orotracheal intubation, the laryngeal mask and the intubating laryngeal mask airways, the combitube and cricothyroidotomy. Management of the airway in trauma patients requires regular training in these techniques and the knowledge of complementary techniques allowing tracheal intubation or oxygenation to overcome difficult intubation and to prevent major complications as hypoxemia and aspiration.

  9. Trauma team activation: Not just for trauma patients

    Directory of Open Access Journals (Sweden)

    Phoenix Vuong

    2017-01-01

    Full Text Available Specialized trauma teams have been shown to improve outcomes in critically injured patients. At our institution, an the American College of Surgeons Committee on trauma level I Trauma center, the trauma team activation (TTA criteria includes both physiologic and anatomic criteria, but any attending physician can activate the trauma team at their discretion outside criteria. As a result, the trauma team has been activated for noninjured patients meeting physiologic criteria secondary to nontraumatic hemorrhage. We present two cases in which the trauma team was activated for noninjured patients in hemorrhagic shock. The utilization of the TTA protocol and subsequent management by the trauma team are reviewed as we believe these were critical factors in the successful recovery of both patients. Beyond the primary improved survival outcomes of severely injured patients, trauma center designation has a “halo effect” that encompasses patients with nontraumatic hemorrhage.

  10. The sequential trauma score - a new instrument for the sequential mortality prediction in major trauma*

    Directory of Open Access Journals (Sweden)

    Huber-Wagner S

    2010-05-01

    Full Text Available Abstract Background There are several well established scores for the assessment of the prognosis of major trauma patients that all have in common that they can be calculated at the earliest during intensive care unit stay. We intended to develop a sequential trauma score (STS that allows prognosis at several early stages based on the information that is available at a particular time. Study design In a retrospective, multicenter study using data derived from the Trauma Registry of the German Trauma Society (2002-2006, we identified the most relevant prognostic factors from the patients basic data (P, prehospital phase (A, early (B1, and late (B2 trauma room phase. Univariate and logistic regression models as well as score quality criteria and the explanatory power have been calculated. Results A total of 2,354 patients with complete data were identified. From the patients basic data (P, logistic regression showed that age was a significant predictor of survival (AUCmodel p, area under the curve = 0.63. Logistic regression of the prehospital data (A showed that blood pressure, pulse rate, Glasgow coma scale (GCS, and anisocoria were significant predictors (AUCmodel A = 0.76; AUCmodel P + A = 0.82. Logistic regression of the early trauma room phase (B1 showed that peripheral oxygen saturation, GCS, anisocoria, base excess, and thromboplastin time to be significant predictors of survival (AUCmodel B1 = 0.78; AUCmodel P +A + B1 = 0.85. Multivariate analysis of the late trauma room phase (B2 detected cardiac massage, abbreviated injury score (AIS of the head ≥ 3, the maximum AIS, the need for transfusion or massive blood transfusion, to be the most important predictors (AUCmodel B2 = 0.84; AUCfinal model P + A + B1 + B2 = 0.90. The explanatory power - a tool for the assessment of the relative impact of each segment to mortality - is 25% for P, 7% for A, 17% for B1 and 51% for B2. A spreadsheet for the easy calculation of the sequential trauma

  11. Patterns of ocular trauma

    International Nuclear Information System (INIS)

    Babar, T.F.; Khan, M.T.; Marwat, M.; Shah, A.; Murad, Y.; Khan, M.D.

    2007-01-01

    To describe the patterns of ocular trauma, cause of injury and its effects on eye. A retrospective case series. Medical records of 1105 patients admitted with ocular trauma were reviewed. The details of patients regarding age, gender, literacy, cause of injury and its effects on eye were entered into specially-designed performa. Sample selection consisted of all patients with history of ocular trauma and who were admitted to hospital. Population details consisted patients who were referred to the hospital from all parts of N.W.F.P. Thus, the frequency of trauma in the hospital admissions was analysed. Ophthalmic trauma comprised 6.78% of the hospital admission. One thousand one hundred and five patients presented with eye injuries. Out of them, 21 patients suffered from trauma to both eyes. Almost 80% patients were male and 69% patients were below 30 years of age. Delayed presentation was more common and 63.61% patients presented after one week. Open globe injuries were more common (520 eyes (46.18%)) than closed globe injuries (484 eyes (42.98%)). 23.26% of open globe injuries were associated with intraocular and intra-orbital foreign bodies. Superficial non-perforating, eyelid and adnexal and burns were seen in 122 eyes (10.83%). Among the complications, lens damage and hyphema was seen in more than 50% of the patients, 16.60% eyes were infected at the time of admission and 4.88% of eyes needed enucleation or evisceration. The common causes of injury were violence in 37.37%, occupational in 24.43% and domestic accidents in 19.18%. Ophthalmic trauma is a major public health problem. Majority of the involved are male and under 30 years of age. Delayed presentation is more common. Open globe injuries are more frequent. Violence and occupational injuries are the major causes. (author)

  12. Epidemiology of severe trauma.

    Science.gov (United States)

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions. Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  13. Trauma in pregnancy

    Directory of Open Access Journals (Sweden)

    A Rudra

    2007-01-01

    Full Text Available Trauma is the most common non-obstetrical cause of death in pregnant women. Pregnancy must always be suspected in any female trauma patient of childbearing age until proved otherwise. Unique changes in anatomy and physiology that takes place during pregnancy alter the pathophysiology and location of maternal injuries in pregnancy, which may be significantly different from the non-pregnant state. Trauma from road traffic accidents, falls and domestic violence are the most common causes of abdominal blunt trauma. As pregnancy progresses, the change of accidental injury increases. Head and neck injuries, respiratory failure, and hypovolemic shock constitute the most frequent causes of trauma related maternal death in pregnancy. Even the pregnant woman with minor injuries should be carefully observed. Initial management is directed at resuscitation and stabilization of the mother that takes precedence over that of the fetus, unless vital signs cannot be maintained and perimortem cesarean section decided upon. Fetal monitoring should be maintained after satisfactory resuscitation and stabilization of the mother. Preventive measures include proper seat belt use and identifying and counseling victims of suspected domestic violence.

  14. Male genital trauma

    International Nuclear Information System (INIS)

    Jordan, G.H.; Gilbert, D.A.

    1988-01-01

    We have attempted to discuss genital trauma in relatively broad terms. In most cases, patients present with relatively minimal trauma. However, because of the complexity of the structures involved, minimal trauma can lead to significant disability later on. The process of erection requires correct functioning of the arterial, neurologic, and venous systems coupled with intact erectile bodies. The penis is composed of structures that are compliant and distensible to the limits of their compliance. These structures therefore tumesce in equal proportion to each other, allowing for straight erection. Relatively minimal trauma can upset this balance of elasticity, leading to disabling chordee. Likewise, relatively minimal injuries to the vascular erectile structures can lead to significantly disabling spongiofibrosis. The urethra is a conduit of paramount importance. Whereas the development of stricture is generally related to the nature of the trauma, the extent of stricture and of attendant complications is clearly a function of the immediate management. Overzealous debridement can greatly complicate subsequent reconstruction. A delicate balance between aggressive initial management and maximal preservation of viable structures must be achieved. 38 references

  15. Maternofetal Trauma in Craniosynostosis.

    Science.gov (United States)

    Swanson, Jordan; Oppenheimer, Adam; Al-Mufarrej, Faisal; Pet, Mitchell; Arakawa, Chris; Cunningham, Michael; Gruss, Joseph; Hopper, Richard; Birgfeld, Craig

    2015-08-01

    Premature cranial suture fusion may prevent neonatal skull malleability during birth, increasing the risk of unplanned cesarean delivery and neonatal birth trauma caused by cephalopelvic disproportion. We sought to determine the incidence of perinatal maternofetal complications in cases of craniosynostosis. Records of children presenting with nonsyndromic craniosynostosis to a tertiary pediatric hospital from 1996 to 2012 were reviewed retrospectively with focus on birth history and birth-related complications. Six hundred eighteen births were reviewed. Rates of cesarean delivery among mothers of children with craniosynostosis [n = 201 (32.5 percent)] exceeded the overall regional rate of 24.5 percent (OR, 1.50; p delivery occurred in 19.7 percent of births, and were most associated with nulliparous mothers, breech fetal presentations, and lambdoid or multisuture synostosis patterns. Eleven neonates (1.8 percent) exhibited cranial birth trauma, including cephalohematoma and subgaleal hematoma. Neonates with sagittal or multisuture synostosis patterns were more likely to suffer birth trauma and had a higher mean head circumference than those who did not (81st versus 66th percentile, p birth trauma is increased-for mothers in the form of increased cesarean delivery risk, and for fetuses in the form of subgaleal and subperiosteal perinatal bleeding. Difficult maternal labor may be mediated especially by multisuture or lambdoid synostosis, whereas fetal birth trauma may be mediated to a greater extent by large head size. Prenatal diagnosis of craniosynostosis could influence decision-making in the management of labor. Risk, IV.

  16. Trauma Induced Coagulopathy

    DEFF Research Database (Denmark)

    Genét, Gustav Folmer; Johansson, Per; Meyer, Martin Abild Stengaard

    2013-01-01

    It remains debated whether traumatic brain injury (TBI) induces a different coagulopathy compared to non-TBI. This study investigated traditional coagulation tests, biomarkers of coagulopathy and endothelial damage in trauma patients with and without TBI. Blood from 80 adult trauma patients were...... sampled (median of 68 min (IQR 48-88) post-injury) upon admission to our trauma centre. Plasma/serum were retrospectively analysed for biomarkers reflecting sympathoadrenal activation (adrenaline, noradrenaline), coagulation activation/inhibition and fibrinolysis (protein C, activated protein C, tissue......+other had significantly higher plasma levels of adrenaline, noradrenaline, annexinV, d-dimer, IL6, syndecan-1, solubel thrombomodulin, and reduced protein C and factor XIII levels (all p...

  17. Terrorism, Trauma and Children.

    Science.gov (United States)

    Harjai, M M; Chandrashekhar, N; Raju, Uma; Jog, S S; Arora, P

    2005-10-01

    Terrorist attacks, armed conflict and all forms of catastrophe, tax our ability to cope, understand and respond to the situation. Children are more vulnerable. 16 children, victims of a terrorist attack in an army residential camp were managed for their physical injuries and evaluated for psychological trauma. All patients recovered from physical injuries, except one baby of two months, who died due to severe chest trauma. 5 children presented with Acute Stress Reaction. 3 recovered well and two, showed persistent poor scholastic performance even after one year. A terrorist attack, not only results in physiscal scars but also causes psychological trauma, which requires emotional support and needs to be followed up on a long term basis.

  18. Exploring the interface between 'physician-assisted death' and palliative care: cross-sectional data from Australasian palliative care specialists.

    Science.gov (United States)

    Sheahan, L

    2016-04-01

    Legalisation of physician-assisted dying (PAD) remains a highly contested issue. In the Australasian context, the opinion and perspective of palliative care specialists have not been captured empirically, and are required to inform better the debate around this issue, moving forward. To identify current attitudes and experiences of palliative care specialists in Australasia regarding requests for physician-assisted suicide and voluntary euthanasia, and to capture the opinion of palliative care specialists on the legalisation of these practices in the Australasian context. An anonymous, cross-sectional, online survey of Australasian specialists in palliative care, addressing the following six areas: (i) demographics; (ii) frequency of requests, and response given; (iii) understanding of the term 'voluntary euthanasia'; (iv) opinion regarding legalisation of physician-assisted suicide and voluntary euthanasia in Australasia, and willingness to participate if legal; (v) identification of the most important values guiding this opinion; and (vi) anticipated impact that legalisation of assisted death would have on palliative care practice. Important findings include: (i) palliative care specialists are largely opposed to the legalisation of PAD; (ii) the proportional titration of opioids is not understood by any palliative care specialist studied to be 'voluntary euthanasia'; and (iii) there is a wide variation in frequency of requests, and one-third of palliative care specialists express discomfort in dealing with requests for assisted suicide or euthanasia. Key areas for future research at the interface between PAD and best practice end-of-life care are identified, including exploration into why palliative care specialists are largely opposed to PAD, and consideration of the impact 'the opioid misconception' may have on the literature informing this debate. © 2016 Royal Australasian College of Physicians.

  19. Trauma cardiaco cerrado

    OpenAIRE

    Alvarado, Camilo; Vargas, Fernando; Guzmán, Fernando; Zárate, Alejandro; Correa, José L.; Ramírez, Alejandro; Quintero, Diana M.; Ramírez, Erika M.

    2016-01-01

    El trauma cardiaco constituye una de las primeras causas de mortalidad en la población general. Requiere alto índice de sospecha en trauma cerrado severo, mecanismo de desaceleración y en presencia de signos indirectos como: equimosis, huella del volante o del cinturón en el tórax anterior. Las lesiones incluyen: conmoción cardiaca, ruptura cardiaca, lesión cardiaca indirecta como la trombosis coronaria aguda, lesión aórtica, lesión del pericardio y herniación cardiaca. Entre las manifestacio...

  20. Sonography of scrotal trauma

    Directory of Open Access Journals (Sweden)

    Meka Srinivasa Rao

    2012-01-01

    Full Text Available The purpose of this article is to depict the spectrum of scrotal injuries in blunt trauma. Scrotal injuries are not very common and are mostly due to blunt trauma from direct injury, sports injuries or motor vehicle accidents. To minimize complications and ensure testicular salvage, rapid and accurate diagnosis is necessary. High-resolution USG is the investigation of choice, as it is readily available, accurate and has been seen to improve outcomes. An understanding of and familiarity with the sonographic appearance of scrotal injuries on the part of the radiologist/sonographer is therefore of key importance.

  1. [The Academy of Trauma Surgery (AUC). Service provider and management organization of the DGU].

    Science.gov (United States)

    Sturm, J A; Hoffmann, R

    2016-02-01

    At the beginning of this century the German Trauma Society (DGU) became extensively active with an initiative on quality promotion, development of quality assurance and transparency regarding treatment of the severely injured. A white book on "Medical care of the severely injured" was published, focusing on the requirements on structural quality and especially procedural quality. The impact of the white book was immense and a trauma network with approved trauma centers, structured and graded for their individual trauma care performance, was developed. In order to monitor and document the required quality of care, a registry was needed. Furthermore, for cooperation within the trauma networks innovative methods for digital transfer of radiological images and patient documents became necessary. Finally, the auditing criteria for trauma centers had and still have to be completed with advanced medical education and training programs. In order to realize the implementation of such a broad spectrum of economically relevant and increasingly complex activities the Academy of Trauma Surgery (AUC) was established as a subsidiary of the DGU in 2004. The AUC currently has four divisions: 1) networks and health care structures, 2) registries and research management, 3) telemedicine, 4) medical education and training, all of which serve the goal of the initiative. The AUC is a full service provider and management organization in compliance with the statutes of the DGU. According to these statutes the business operations of the AUC also cover projects for numerous groups of patients, projects for the joint society the German Society for Orthopedics and Trauma (DGOU) as well as other medical institutions. This article describes the success stories of the trauma network (TraumaNetzwerk DGU®), the TraumaRegister DGU®, the telecooperation platform TKmed®, the new and fast-growing orthogeriatric center initiative (AltersTraumaZentrum DGU®) and the division of medical education and

  2. Analyses of sex and individual differences in vocalizations of Australasian gannets using a dynamic time warping algorithm.

    Science.gov (United States)

    Krull, C R; Ranjard, L; Landers, T J; Ismar, S M H; Matthews, J L; Hauber, M E

    2012-08-01

    The study of the evolution of sexual differences in behavioral and morphological displays requires analyses of the extent of sexual dimorphism across various sensory modalities. In the seabird family Sulidae, boobies show dramatic sexual dimorphism in their vocalizations, and gannet calls have also been suggested to be dimorphic to human observers. This study aimed to evaluate the presence of sexually dimorphic calls in the Australasian gannet (Morus serrator) through the first comprehensive description of its vocalizations recorded at two localities; Cape Kidnappers, where individuals were banded and sexed from DNA samples, and at the Muriwai gannetry, both on the North Island of New Zealand. Calls were first inspected using basic bioacoustic features to establish a library of call element types for general reference. Extensive multivariate tests, based on a dynamic time warping algorithm, subsequently revealed that no sexual differences could be detected in Australasian gannet calls. The analyses, however, indicated extensive and consistent vocal variation between individuals, particularly so in female gannets, which may serve to signal individual identity to conspecifics. This study generates predictions to identify whether differences in Australasian gannet vocalizations play perceptual and functional roles in the breeding and social biology of this long-lived biparental seabird species.

  3. Knowledge and confidence of a convenience sample of australasian emergency doctors in managing dental emergencies: results of a survey.

    Science.gov (United States)

    Samaei, Hossein; Weiland, Tracey Joy; Dilley, Stuart; Jelinek, George Alexander

    2015-01-01

    Background. We aimed to determine Australasian Specialist Emergency Physicians' and Emergency Physicians in Training (Trainees') level of knowledge of common dental emergencies. We also explored confidence in managing dental emergencies; predictors of confidence and knowledge; and preferences for further dental education. Methods. A questionnaire was distributed electronically (September 2011) and directly (November 2011) to Fellows and Trainees of the Australasian College for Emergency Medicine. It explored demographics, confidence, knowledge of dental emergencies, and educational preferences. Results. Response rate was 13.6% (464/3405) and college members were proportionally represented by region. Fewer than half (186/446; 42%) had received dental training. Sixty-two percent (244/391, 95% CI 57.5-67.1) passed (>50%) a knowledge test. More than 60% incorrectly answered questions on dental fracture, periodontal abscess, tooth eruption dates, and ulcerative gingivitis. Forty percent (166/416) incorrectly answered a question about Ludwig's Angina. Eighty-three percent (360/433) were confident in the pharmacological management of toothache but only 26% (112/434) confident in recognizing periodontal disease. Knowledge was correlated with confidence (r = 0.488). Interactive workshops were preferred by most (386/415, 93%). Conclusions. The knowledge and confidence of Australasian Emergency Physicians and Trainees in managing dental emergencies are varied, yet correlated. Interactive training sessions in dental emergencies are warranted.

  4. Neodymium and strontium isotopic study of Australasian tektites - New constraints on the provenance and age of target materials

    Science.gov (United States)

    Blum, Joel D.; Papanastassiou, D. A.; Wasserburg, G. J.; Koeberl, C.

    1992-01-01

    The Nd and Sr isotopic compositions of Australasian tectites (including two flanged Australian tectites, two low-SiO2 Muong Nong-type tectites, and three high-SiO2 Muong Nong-type tectites) and the Nd, Sm, Sr, and Rb concentrations were investigated by isotope-dilution thermal ionization mass spectrometry, and the Sm-Nd and Rb-Sr isotope systematics were used to study the characteristics of the parental material. It is shown that the Nd and Sr isotopic data provide evidence that all Australasian tektites were derived from a single sedimentary formation with a narrow range of stratigraphic ages close to 170 Ma. It is suggested that all of the Australasian tektites were derived from a single impact event and that the australites represent the upper part of a melt sheet ejected at high velocity, whereas the indochinites represent melts formed at a lower level in the target material distributed closer to the area of the impact.

  5. Does the Australasian “Health Star Rating” Front of Pack Nutritional Label System Work?

    Science.gov (United States)

    Hamlin, Robert; McNeill, Lisa

    2016-01-01

    This article describes an experiment to measure the impact of the Australasian “Health Star Rating” front of pack nutritional label system on consumer choice behaviour. This system presents a one-half to five star rating of nutritional quality via the front facings of food product packages. While this system has been recently rolled out across Australasia, no test of its impact on food choice has been conducted. A sample of 1200 consumers was recruited on exit from supermarkets in New Zealand. A 2 × 2 factorial design was used with two levels of cold cereal product nutritional status (high, five star/low, two star) and two levels of the Health Star Rating label (present/absent). The dependent variable was revealed choice behaviour. The results indicated that the presence of the label had a significant depressive effect on consumer preference, but that this impact was not moderated in any way by the nutritional status expressed by the label. The result represents a significant functional failure of the Health Star Rating label in this research environment. The nature of the failure is consistent with the consumers processing the label in much the same way as the nominal brand cues that dominate the retail food packaging. PMID:27258305

  6. Does the Australasian "Health Star Rating" Front of Pack Nutritional Label System Work?

    Science.gov (United States)

    Hamlin, Robert; McNeill, Lisa

    2016-06-01

    This article describes an experiment to measure the impact of the Australasian "Health Star Rating" front of pack nutritional label system on consumer choice behaviour. This system presents a one-half to five star rating of nutritional quality via the front facings of food product packages. While this system has been recently rolled out across Australasia, no test of its impact on food choice has been conducted. A sample of 1200 consumers was recruited on exit from supermarkets in New Zealand. A 2 × 2 factorial design was used with two levels of cold cereal product nutritional status (high, five star/low, two star) and two levels of the Health Star Rating label (present/absent). The dependent variable was revealed choice behaviour. The results indicated that the presence of the label had a significant depressive effect on consumer preference, but that this impact was not moderated in any way by the nutritional status expressed by the label. The result represents a significant functional failure of the Health Star Rating label in this research environment. The nature of the failure is consistent with the consumers processing the label in much the same way as the nominal brand cues that dominate the retail food packaging.

  7. Bandicoot fossils and DNA elucidate lineage antiquity amongst xeric-adapted Australasian marsupials

    Science.gov (United States)

    Kear, Benjamin P.; Aplin, Ken P.; Westerman, Michael

    2016-11-01

    Bandicoots (Peramelemorphia) are a unique order of Australasian marsupials whose sparse fossil record has been used as prima facie evidence for climate change coincident faunal turnover. In particular, the hypothesized replacement of ancient rainforest-dwelling extinct lineages by antecedents of xeric-tolerant extant taxa during the late Miocene (~10 Ma) has been advocated as a broader pattern evident amongst other marsupial clades. Problematically, however, this is in persistent conflict with DNA phylogenies. We therefore determine the pattern and timing of bandicoot evolution using the first combined morphological + DNA sequence dataset of Peramelemorphia. In addition, we document a remarkably archaic new fossil peramelemorphian taxon that inhabited a latest Quaternary mosaic savannah-riparian forest ecosystem on the Aru Islands of Eastern Indonesia. Our phylogenetic analyses reveal that unsuspected dental homoplasy and the detrimental effects of missing data collectively obscure stem bandicoot relationships. Nevertheless, recalibrated molecular clocks and multiple ancestral area optimizations unanimously infer an early diversification of modern xeric-adapted forms. These probably originated during the late Palaeogene (30-40 Ma) alongside progenitors of other desert marsupials, and thus occupied seasonally dry heterogenous habitats long before the onset of late Neogene aridity.

  8. Rapid interhemispheric climate links via the Australasian monsoon during the last deglaciation

    Science.gov (United States)

    Ayliffe, Linda K.; Gagan, Michael K.; Zhao, Jian-Xin; Drysdale, Russell N.; Hellstrom, John C.; Hantoro, Wahyoe S.; Griffiths, Michael L.; Scott-Gagan, Heather; Pierre, Emma St; Cowley, Joan A.; Suwargadi, Bambang W.

    2013-12-01

    Recent studies have proposed that millennial-scale reorganization of the ocean-atmosphere circulation drives increased upwelling in the Southern Ocean, leading to rising atmospheric carbon dioxide levels and ice age terminations. Southward migration of the global monsoon is thought to link the hemispheres during deglaciation, but vital evidence from the southern sector of the vast Australasian monsoon system is yet to emerge. Here we present a 230thorium-dated stalagmite oxygen isotope record of millennial-scale changes in Australian-Indonesian monsoon rainfall over the last 31,000 years. The record shows that abrupt southward shifts of the Australian-Indonesian monsoon were synchronous with North Atlantic cold intervals 17,600-11,500 years ago. The most prominent southward shift occurred in lock-step with Heinrich Stadial 1 (17,600-14,600 years ago), and rising atmospheric carbon dioxide. Our findings show that millennial-scale climate change was transmitted rapidly across Australasia and lend support to the idea that the 3,000-year-long Heinrich 1 interval could have been critical in driving the last deglaciation.

  9. Ultraconserved elements (UCEs) resolve the phylogeny of Australasian smurf-weevils.

    Science.gov (United States)

    Van Dam, Matthew H; Lam, Athena W; Sagata, Katayo; Gewa, Bradley; Laufa, Raymond; Balke, Michael; Faircloth, Brant C; Riedel, Alexander

    2017-01-01

    Weevils (Curculionoidea) comprise one of the most diverse groups of organisms on earth. There is hardly a vascular plant or plant part without its own species of weevil feeding on it and weevil species diversity is greater than the number of fishes, birds, reptiles, amphibians and mammals combined. Here, we employ ultraconserved elements (UCEs) designed for beetles and a novel partitioning strategy of loci to help resolve phylogenetic relationships within the radiation of Australasian smurf-weevils (Eupholini). Despite being emblematic of the New Guinea fauna, no previous phylogenetic studies have been conducted on the Eupholini. In addition to a comprehensive collection of fresh specimens, we supplement our taxon sampling with museum specimens, and this study is the first target enrichment phylogenomic dataset incorporating beetle specimens from museum collections. We use both concatenated and species tree analyses to examine the relationships and taxonomy of this group. For species tree analyses we present a novel partitioning strategy to better model the molecular evolutionary process in UCEs. We found that the current taxonomy is problematic, largely grouping species on the basis of similar color patterns. Finally, our results show that most loci required multiple partitions for nucleotide rate substitution, suggesting that single partitions may not be the optimal partitioning strategy to accommodate rate heterogeneity for UCE loci.

  10. Supermatrix phylogeny and biogeography of the Australasian Meliphagides radiation (Aves: Passeriformes).

    Science.gov (United States)

    Marki, Petter Z; Jønsson, Knud A; Irestedt, Martin; Nguyen, Jacqueline M T; Rahbek, Carsten; Fjeldså, Jon

    2017-02-01

    With nearly 300 species, the infraorder Meliphagides represents one of the largest and most conspicuous Australasian bird radiations. Although the group has been the focus of a number of recent phylogenetic studies, a comprehensive species-level phylogenetic hypothesis is still lacking. This has impeded the assessment of broad-scale evolutionary, biogeographic and ecological hypotheses. In the present study, we use a supermatrix approach including five mitochondrial and four nuclear markers to infer a time-calibrated phylogeny of the Meliphagides. Our phylogeny, which includes 286 of the 289 (99%) currently recognized species, is largely congruent with previous estimates. However, the addition of 60 newly sequenced species reveals some novel relationships. Our biogeographic analyses suggest an Australian origin for the group in the early Oligocene (31.3Mya, 95% HPD 25.2-38.2Mya). In addition, we find that dispersal events out of Australia have been numerous and frequent, particularly to New Guinea, which has also been the source of multiple back-colonizations to the Australian mainland. The phylogeny provides an important framework for studying a wide variety of macroecological and macroevolutionary themes, including character evolution, origin and timing of diversification, biogeographic patterns and species responses to climate change. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Isolation and evolutionary analysis of Australasian topotype of bluetongue virus serotype 4 from India.

    Science.gov (United States)

    Reddy, Y V; Susmitha, B; Patil, S; Krishnajyothi, Y; Putty, K; Ramakrishna, K V; Sunitha, G; Devi, B V; Kavitha, K; Deepthi, B; Krovvidi, S; Reddy, Y N; Reddy, G H; Singh, K P; Maan, N S; Hemadri, D; Maan, S; Mertens, P P; Hegde, N R; Rao, P P

    2018-04-01

    Bluetongue (BT) is a Culicoides-borne disease caused by several serotypes of bluetongue virus (BTV). Similar to other insect-borne viral diseases, distribution of BT is limited to distribution of Culicoides species competent to transmit BTV. In the tropics, vector activity is almost year long, and hence, the disease is endemic, with the circulation of several serotypes of BTV, whereas in temperate areas, seasonal incursions of a limited number of serotypes of BTV from neighbouring tropical areas are observed. Although BTV is endemic in all the three major tropical regions (parts of Africa, America and Asia) of the world, the distribution of serotypes is not alike. Apart from serological diversity, geography-based diversity of BTV genome has been observed, and this is the basis for proposal of topotypes. However, evolution of these topotypes is not well understood. In this study, we report the isolation and characterization of several BTV-4 isolates from India. These isolates are distinct from BTV-4 isolates from other geographical regions. Analysis of available BTV seg-2 sequences indicated that the Australasian BTV-4 diverged from African viruses around 3,500 years ago, whereas the American viruses diverged relatively recently (1,684 CE). Unlike Australasia and America, BTV-4 strains of the Mediterranean area evolved through several independent incursions. We speculate that independent evolution of BTV in different geographical areas over long periods of time might have led to the diversity observed in the current virus population. © 2017 Blackwell Verlag GmbH.

  12. Cytomegalovirus (CMV) infection and pregnancy-potential for improvements in Australasian maternity health providers' knowledge.

    Science.gov (United States)

    Shand, A W; Luk, W; Nassar, N; Hui, L; Dyer, K; Rawlinson, W

    2017-07-11

    To assess the knowledge, practice and attitudes of maternity clinicians regarding congenital cytomegalovirus (CMV). It is the most common congenital infection, and well-recognized cause of neurodevelopmental disability and hearing loss. New consensus recommendations state all pregnant women and health-care providers should be educated about congenital CMV infection and preventive measures. An email questionnaire was distributed in October 2015 to specialists, diplomates (general practitioners), and trainees of the Royal Australian New Zealand College of Obstetricians and Gynaecologists (RANZCOG), and Victorian and New South Wales midwives. 774 responded: (37.3% specialists, 17.3% diplomates, 16.8% trainees, 28.6% midwives). Clinicians had variable knowledge of fetal sequelae, transmission routes and prevention. Overall, 30.2% felt confident about discussing CMV in pregnancy: less than 10% of midwives (7.4%) and less than half of specialists (47.1%, p Australasian maternity clinicians lack confidence and knowledge about congenital CMV. Few (<10%) routinely provide advice on prevention. There is urgent need for clinical guidance and patient information to reduce the burden of disease.

  13. Mechanism of Muong Nong-type tektite formation and speculation on the source of Australasian tektites

    Science.gov (United States)

    Schnetzler, C. C.

    1992-01-01

    The source crater of the youngest and largest of the tektite strewnfields, the Australasian strewnfield, has not been located. A number of lines of evidence indicate that the Muong Nong-type tektites, primarily found in Indochina, are more primitive than the much more abundant and widespread splash-form tektites, and are proximal to the source. In this study the spatial distribution of Muong Nong-type tektite sites and chemical character have been used to indicate the approximate location of the source. The variation of Muong Nong-type tektite chemical composition appears to be caused by mixing of two silicate rock end-members and a small amount of limestone, and not by vapor fractionation. The variation in composition is not random, and does not support in situ melting or multiple impact theories. The distribution of both Muong Nong and splash-form tektite sites suggest the source is in a limited area near the southern part of the Thailand-Laos border.

  14. Does the Australasian “Health Star Rating” Front of Pack Nutritional Label System Work?

    Directory of Open Access Journals (Sweden)

    Robert Hamlin

    2016-06-01

    Full Text Available This article describes an experiment to measure the impact of the Australasian “Health Star Rating” front of pack nutritional label system on consumer choice behaviour. This system presents a one-half to five star rating of nutritional quality via the front facings of food product packages. While this system has been recently rolled out across Australasia, no test of its impact on food choice has been conducted. A sample of 1200 consumers was recruited on exit from supermarkets in New Zealand. A 2 × 2 factorial design was used with two levels of cold cereal product nutritional status (high, five star/low, two star and two levels of the Health Star Rating label (present/absent. The dependent variable was revealed choice behaviour. The results indicated that the presence of the label had a significant depressive effect on consumer preference, but that this impact was not moderated in any way by the nutritional status expressed by the label. The result represents a significant functional failure of the Health Star Rating label in this research environment. The nature of the failure is consistent with the consumers processing the label in much the same way as the nominal brand cues that dominate the retail food packaging.

  15. Cannabis and depression: an integrative data analysis of four Australasian cohorts.

    Science.gov (United States)

    Horwood, L John; Fergusson, David M; Coffey, Carolyn; Patton, George C; Tait, Robert; Smart, Diana; Letcher, Primrose; Silins, Edmund; Hutchinson, Delyse M

    2012-12-01

    This study presents an integrative data analysis of the association between frequency of cannabis use and severity of depressive symptoms using data from four Australasian cohort studies. The integrated data comprised observations on over 6900 individuals studied on up to seven occasions between adolescence and mature adulthood. Repeated measures data on frequency of cannabis use (not used/depression scores were pooled over the four cohorts. Regression models were fitted to estimate the strength of association between cannabis use and depression. Fixed effects regression methods were used to control for confounding by non-observed fixed factors. Increasing frequency of cannabis use was associated with increasing depressive symptoms (pcannabis had depression scores that were 0.32 (95%CI 0.27-0.37) SD higher than non-users. The association was reduced but remained significant (pdepression scores for weekly users were 0.24 (95%CI 0.18-0.30) SD higher than non-users. The adjusted associations were similar across cohorts. There was a weak age×cannabis use interaction (pcannabis use was associated with modest increases in rates of depressive symptoms. This association was stronger in adolescence and declined thereafter. However, it was not possible from the available data to draw a definitive conclusion as to the likely direction of causality between cannabis use and depression. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  16. Gênero e trauma Gender and trauma

    Directory of Open Access Journals (Sweden)

    Gláucio Ary Dillon Soares

    2005-04-01

    Full Text Available As conseqüências sociais e psicológicas da violência urbana sobre os parentes e amigos de pessoas vitimadas por mortes violentas (homicídio, suicídio ou acidentes são analisadas à luz das diferenças de gênero. A literatura especializada nesta área propõe que mulheres e homens vivenciam experiências traumáticas de forma peculiar. Porém, os traumas típicos são diferentes em cada gênero, deixando em aberto a questão sobre quanto das diferenças entre as respostas se devem a gênero e quanto se devem ao tipo de trauma. Testamos a hipótese de que as mulheres são mais suscetíveis à desordem de estresse pós-trauma (DEPT numa situação traumática comum, usando dados qualitativos e quantitativos. Comparamos os sintomas do trauma e as percepções sobre o significado da perda de seus entes queridos. A amostra, de 425 mulheres (62% e 265 homens (38%, foi retirada de uma lista de parentes de pessoas que sofreram morte violenta na cidade do Rio de Janeiro. Incluímos trinta relatos de parentes e amigos próximos das vítimas diretas. Os resultados revelaram que 54% das mulheres e 41% dos homens tiveram o cotidiano alterado depois da morte de um parente/amigo. Há diferenças estatisticamente significativas nos problemas de saúde e na diversão. Essa área foi a mais afetada, atingindo metade dos entrevistados. Uma variável intimamente correlacionada com os sintomas da DEPT é o contato com o corpo: controlando a extensão do contato (fez o reconhecimento do corpo; viu, mas não reconheceu e nem viu nem reconheceu. Em cada uma dessas categorias, as mulheres foram mais afetadas do que os homens. O artigo conclui que as mulheres sentem mais as perdas do que os homens, mas que parte das diferenças não são internas aos gêneros, mas externas a eles, dependendo das interações e dos contatos pessoais.The social and psychological consequences endured by friends and relatives of people victimized by violent death (homicide, suicide or

  17. Developing a trauma curriculum for anesthesiology residents and fellows.

    Science.gov (United States)

    Tobin, Joshua M

    2014-04-01

    The board certification process for qualification by the American Board of Anesthesiology is undergoing significant review. A basic sciences examination has been added to the process and the traditional oral examination is evolving into a combined oral interview and practical skills assessment. These recent developments, as well as the growing body of evidence regarding the resuscitation of trauma patients, call for a revision in the curriculum beyond the documentation of participation in the anesthetics of 20 trauma patients. The implications of the 80-h work week are beginning to be appreciated. The development of a new trauma curriculum must take this significant change in residency training into account while incorporating modern educational theory (e.g. simulation) and new data on the resuscitation of trauma patients. Currently, the curriculum for trauma anesthesia requires only that residents participate in the anesthetics of 20 trauma patients. There is no plan for, and little literature regarding, a more extensive educational program. This offers a unique opportunity to innovate a novel curriculum in the anesthesiology residency. The American Society of Anesthesiologists Committee on Trauma and Emergency Preparedness has designed a curriculum that can serve as a template for this important step forward in anesthesiology education.

  18. Trauma-related guilt and posttraumatic stress among journalists.

    Science.gov (United States)

    Browne, Tess; Evangeli, Michael; Greenberg, Neil

    2012-04-01

    This study explored the psychological impact of exposure to work-related trauma among journalists. It was hypothesised that positive associations would exist between (a) exposure and PTSD symptoms, (b) exposure and guilt cognitions, and (c) guilt cognitions and PTSD symptoms, and that the relationship between exposure and PTSD symptoms would be mediated by guilt cognitions. The sample consisted of 50 journalists (response rate = 15%), who had recently been exposed to work-related trauma. They were predominantly male, aged 40 years or older, well-educated, and most had worked in journalism for at least 15 years. Participants completed an online questionnaire that explored their work-related experiences of trauma, PTSD symptoms, and trauma-related guilt cognitions. The findings showed that higher levels of exposure to work-related trauma were significantly associated with higher levels of PTSD symptoms (r = .36) and trauma-related guilt cognitions (r = .29). Guilt cognitions were significantly and positively independently associated with PTSD symptoms (r = .12) and were consistent with partial mediation of relationship between exposure to work-related trauma and PTSD symptoms. This study provides greater insight into the psychological processing of work-related traumatic events among journalists and emphasizes the importance of posttrauma appraisals of guilt regarding their experiences. Copyright © 2012 International Society for Traumatic Stress Studies.

  19. Cranial birth trauma

    International Nuclear Information System (INIS)

    Papanagiotou, P.; Roth, C.; Politi, M.; Zimmer, A.; Reith, W.; Rohrer, T.

    2009-01-01

    Injuries to an infant that result during the birth process are categorized as birth trauma. Cranial injuries due to mechanical forces such as compression or traction include caput succedaneum, cephalhematoma, subgaleal hematoma and intracranial hemorrhaging. Hypoxic ischemic encephalopathy is the consequence of systemic asphyxia occurring during birth. (orig.) [de

  20. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... count__/__total__ Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans ... views 4:50 Prolonged Exposure for PTSD - Duration: 2:45. Veterans Health Administration 53,436 views 2: ...

  1. Trauma Aware & Safety Ready

    Science.gov (United States)

    Paterson, Jim

    2017-01-01

    The interwoven issues of trauma and safety have swept through college campuses over the last decade, and they've arrived at doors of admission offices, encouraging officials to think more carefully about those concerns and take a closer look at how they handle them. Experts recommend in this atmosphere that admission offices discuss these topics…

  2. Dental Trauma Guide

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva Fejerskov; Christensen, Søren Steno Ahrensburg

    2012-01-01

    Diagnose and treatment of traumatic dental injuries is very complex due to the multiple trauma entities represented by 6 lunation types and 9 fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and lunation injuries are often combined...

  3. Imaging of vertebral trauma

    International Nuclear Information System (INIS)

    Daffner, R.H.

    1999-01-01

    This translation of the toolbook published in the 'US-ART' series, offers invaluable help to medical radiologists in the diagnostic imaging and evaluation of complex vertebral traumas which are on the rise, inter alia due to increasingly dangerous leisure sports. (orig./CB) [de

  4. Laparoscopy in abdominal trauma

    African Journals Online (AJOL)

    distal pancreatectomy has been advised. Laparoscopy has been successfully used both in acute and delayed distal pancreatectomies following trauma. It has been reported that magnification obtained through laparoscopic camera allows excellent identification of vessels and dissection of pancreas from splenic artery and ...

  5. Obesity in pediatric trauma.

    Science.gov (United States)

    Witt, Cordelie E; Arbabi, Saman; Nathens, Avery B; Vavilala, Monica S; Rivara, Frederick P

    2017-04-01

    The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients. Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated. Outcomes included injury patterns, operative procedures, complications, and hospital utilization parameters. Data from 149,817 pediatric patients were analyzed; higher BMI percentiles were associated with significantly more extremity injuries, and fewer injuries to the head, abdomen, thorax and spine (p values Obese children also had significantly longer lengths of stay and more frequent ventilator requirement. Among children admitted after trauma, increased BMI percentile is associated with increased risk of death and potentially preventable complications. These findings suggest that obese children may require different management than nonobese counterparts to prevent complications. Level III; prognosis study. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. When Trauma Hinders Learning

    Science.gov (United States)

    Barr, Donald A.

    2018-01-01

    Many kindergarten teachers have encountered children who enter school lacking the ability to control their behavior, but they may not understand the social and biological processes behind these children's disruptive behavior. The author reviews research into early childhood brain development to explain how trauma and chronic stress can make it…

  7. Early Childhood Trauma

    Science.gov (United States)

    National Child Traumatic Stress Network, 2010

    2010-01-01

    Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6. Because infants' and young children's reactions may be different from older children's, and because they may not be able to verbalize their reactions to threatening or dangerous events, many people assume that young age protects children from the…

  8. About Military Sexual Trauma

    Medline Plus

    Full Text Available ... count__/__total__ Find out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans ... MST. http://www.mentalhealth.va.gov/msthom... Category Education License Standard YouTube License Show more Show less ...

  9. Neurological Surgery of Trauma,

    Science.gov (United States)

    1965-01-01

    Neurosurgical aspects of Neurogenic Bladder , Urological aspects of Neurogenic Bladder , Sympathetic Blockade, An Acute Cervical Cord Syndrome, Autonomic Hyperreflexia, Physical and Vocational Rehabilitation....Hematomas Associated with Penetrating Wounds, Infection Complicating Penetrating Craniocerebral trauma, Tangential Wounds of Scalp and Skull, Through and

  10. Scintigraphy In skeletal trauma

    African Journals Online (AJOL)

    1989-08-05

    Aug 5, 1989 ... sustained during the trauma. Fig. 2. Case 2. Bone scan of the pelvis (anterior view) showing a fracture through the sacro-iliac joint. Case 3. A 67-year-old woman had a Moore prosthesis in the left hip. She presented 2 weeks after having injured her right hip in a fall. Examination revealed pain on movemen~ ...

  11. Skeleton scintigraphy in trauma

    International Nuclear Information System (INIS)

    Ansari, M.

    2002-01-01

    Skeletal trauma is common and presents both an opportunity and a problem in skeletal scintigraphy. The opportunity arises in the ability of skeletal scintigraphy to demonstrate abnormalities early after direct trauma. It is well recognized that the early detection of fractures in some sites cannot be reliably achieved by standard radiography, especially in the femoral neck and scaphoid bone. The problem comes in recognizing the effects of skeletal trauma when using skeletal scintigraphy for another purpose, such as the detection of metastatic disease. iatrogenic trauma to either the skeleton or soft tissues may be manifest scintigraphic ally. For example Craniotomy typically leaves a rim pattern at the surgical margin. Rib Retraction during thoracotomy can elicit periosteal reaction. Areas of the skeletal receiving curative levels of ionizing radiation (typically 4000 rads or greater) characteristically demonstrate decreased uptake within 6 months to 1 year after therapy. The generally high sensitivity of the skeletal scintigraphy seems to make it an ideal survey test in cases of suspected child abuse especially in which radiographs are unrevealing. Because of difficulties in obtaining a history of trauma from a preschool child or even eliciting a satisfactory description of the location and nature of the pain, skeletal scintigraphy provides a simple and reliable investigation in these children. Subtle trauma, such as that from stress fractures is often difficult to visualize on a plain radiograph. Skeletal scintigraphy is frequently positive at the time of clinical presentation. Skeletal scintigraphy is exquisitely sensitive to the remodeling process and typically shows abnormalities 1 to 2 weeks or more before the appearance of radiographic changes in stress fractures. The periosteal reaction can be visualized within hours of the injury. Insufficiency and fatigue fractures such as vertebral compression fracture, which is probably the most common consequence of

  12. Training in Trauma Surgery

    Science.gov (United States)

    Reilly, Patrick M.; Schwab, C William; Haut, Elliott R.; Gracias, Vicente H.; Dabrowski, G Paul; Gupta, Rajan; Pryor, John P.; Kauder, Donald R.

    2003-01-01

    Objective: To describe outcomes from a clinical trauma surgical education program that places the board-eligible/board-certified fellow in the role of the attending surgeon (fellow-in-exception [FIE]) during the latter half of a 2-year trauma/surgical critical care fellowship. Summary Background Data: National discussions have begun to explore the question of optimal methods for postresidency training in surgery. Few objective studies are available to evaluate current training models. Methods: We analyzed provider-specific data from both our trauma registry and performance improvement (PI) databases. In addition, we performed TRISS analysis when all data were available. Registry and PI data were analyzed as 2 groups (faculty trauma surgeons and FIEs) to determine experience, safety, and trends in errors. We also surveyed graduate fellows using a questionnaire that evaluated perceptions of training and experience on a 6-point Likert scale. Results: During a 4-year period 7,769 trauma patients were evaluated, of which 46.3% met criteria to be submitted to the PA Trauma Outcome Study (PTOS, ie, more severe injury). The faculty group saw 5,885 patients (2,720 PTOS); the FIE group saw 1,884 patients (879 PTOS). The groups were similar in respect to mechanism of injury (74% blunt; 26% penetrating both groups) and injury severity (mean ISS faculty 10.0; FIEs 9.5). When indexed to patient contacts, FIEs did more operations than the faculty group (28.4% versus 25.6%; P FIEs 10.0%). Analysis of deaths using PI and TRISS data failed to demonstrate differences between the groups. Analysis of provider-specific errors demonstrated a slightly higher rate for FIEs when compared with faculty when indexed to PTOS cases (4.1% versus 2.1%; P FIE year; P FIE educational experience “great -5” or “exceptional– 6.” Eighty-five percent consider the current structure of the fellowship (with FIE year) as ideal. Ninety percent would repeat the fellowship. Conclusion: The educational

  13. Traumatismos oculares Ocular traumas

    Directory of Open Access Journals (Sweden)

    Gelen Welch Ruiz

    2007-12-01

    Full Text Available Se realizó un estudio descriptivo de tipo retrospectivo longitudinal cuyo universo estuvo constituido por 72 ojos de 72 pacientes con traumatismos oculares mecánicos que fueron hospitalizados en el Hospital Militar Central “Dr. Carlos J. Finlay” desde enero de 1999 hasta enero de 2005. Para el análisis estadístico de la información se utilizó el programa automatizado SPSS versión 11.5 en el cual también se conformó la base de datos y se realizaron los cálculos de acuerdo con el tipo de variable analizada. Se utilizaron medidas de resumen, tendencia central y asociación estadística con un nivel de significación de p A retrospective longitudinal and descriptive study was carried out in 72 eyes from 72 patients with mechanical occular traumas, who had been hospitalized in “Dr. Carlos J. Finlay” Military Hospital from December 1999 to January 2005. For the statistical data analysis, an automated program (SPSS 11.5 version was used to create the database and estimations were made according to the variable types. Summary measures, central tendency measures and statistical association with significance level equal to p < 0.05 were employed. Males prevailed (95.8%, the average age was 30.26 years with a minimum rate of 17 years and maximum rate of 82 years. The most frequent mechanisms of trauma were aggressions (23. 6% and injures from secondary projectiles (13.9%. The anterior segment traumas were more frequent (61, 1% than posterior segment traumas (6.94%. Both segments of the eyeball were affected in 39, 1% of eyes which evinced the worst visual acuity. The most common associated injures were hyphema (54, 2% and vitreous hemorrhage (16.6%. Closed trauma (contusions were more common and most of the eyes had better final visual acuity (45, 2% with vision range of 0.6-1.0 and 26.2% with vision range of 0.59-0.1. On the other hand, eyes affected by open trauma (simple wound, contusion-wound, wound with intraocular foreign body and

  14. Childhood Trauma and Alexithymia in Patients with Conversion Disorder.

    Science.gov (United States)

    Farooq, Anum; Yousaf, Aasma

    2016-07-01

    To determine the relationship between childhood trauma (physical, sexual, emotional abuse and neglect) and alexithymia in patients with conversion disorder, and to identify it as a predictor of alexithymia in conversion disorder. An analytical study. Multiple public sector hospitals in Lahore, from September 2012 to July 2013. Eighty women with conversion disorder were recruited on the basis of DSM IV-TR diagnostic criteria checklist to screen conversion disorder. Childhood abuse interview to measure childhood trauma and Bermond Vorst Alexithymia Questionnaire, DSM-IV TR Dianostic Criteria Checklist, and Childhood Abuse Interview to assess alexithymia were used, respectively. The mean age of the sample was 18 ±2.2 years. Thirty-six cases had a history of childhood trauma, physical abuse was the most reported trauma (f = 19, 23.8%) in their childhood. Patients with conversion disorder has a significant association with alexithymia (p conversion disorder. Strategies should be devised to reduce this disorder among women in Pakistani society.

  15. MRI for the initial evaluation of acute wrist, knee, and ankle trauma

    NARCIS (Netherlands)

    J.J. Nikken (Jeroen)

    2003-01-01

    textabstractIn this thesis we study the application of MRI in acute trauma of wrist, knee, and ankle, evaluating its potentials, its effects, and its costs. Our aim was to use MRI in all patients with acute trauma of wrist, knee, and ankle, without increasing the overall costs to society,

  16. Imaging in spinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Goethem, J.W.M. van [Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium, Department of Radiology, Edegem (Belgium); Algemeen Ziekenhuis Maria Middelares, Department of Radiology, Sint-Niklaas (Belgium); Maes, Menno; Oezsarlak, Oezkan; Hauwe, Luc van den; Parizel, Paul M. [Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium, Department of Radiology, Edegem (Belgium)

    2005-03-01

    Because it may cause paralysis, injury to the spine is one of the most feared traumas, and spinal cord injury is a major cause of disability. In the USA approximately 10,000 traumatic cervical spine fractures and 4000 traumatic thoracolumbar fractures are diagnosed each year. Although the number of individuals sustaining paralysis is far less than those with moderate or severe brain injury, the socioeconomic costs are significant. Since most of the spinal trauma patients survive their injuries, almost one out of 1000 inhabitants in the USA are currently being cared for partial or complete paralysis. Little controversy exists regarding the need for accurate and emergent imaging assessment of the traumatized spine in order to evaluate spinal stability and integrity of neural elements. Because clinicians fear missing occult spine injuries, they obtain radiographs for nearly all patients who present with blunt trauma. We are influenced on one side by fear of litigation and the possible devastating medical, psychologic and financial consequences of cervical spine injury, and on the other side by pressure to reduce health care costs. A set of clinical and/or anamnestic criteria, however, can be very useful in identifying patients who have an extremely low probability of injury and who consequently have no need for imaging studies. Multidetector (or multislice) computed tomography (MDCT) is the preferred primary imaging modality in blunt spinal trauma patients who do need imaging. Not only is CT more accurate in diagnosing spinal injury, it also reduces imaging time and patient manipulation. Evidence-based research has established that MDCT improves patient outcome and saves money in comparison to plain film. This review discusses the use, advantages and disadvantages of the different imaging techniques used in spinal trauma patients and the criteria used in selecting patients who do not need imaging. Finally an overview of different types of spinal injuries is given

  17. Imaging in spinal trauma

    International Nuclear Information System (INIS)

    Goethem, J.W.M. van; Maes, Menno; Oezsarlak, Oezkan; Hauwe, Luc van den; Parizel, Paul M.

    2005-01-01

    Because it may cause paralysis, injury to the spine is one of the most feared traumas, and spinal cord injury is a major cause of disability. In the USA approximately 10,000 traumatic cervical spine fractures and 4000 traumatic thoracolumbar fractures are diagnosed each year. Although the number of individuals sustaining paralysis is far less than those with moderate or severe brain injury, the socioeconomic costs are significant. Since most of the spinal trauma patients survive their injuries, almost one out of 1000 inhabitants in the USA are currently being cared for partial or complete paralysis. Little controversy exists regarding the need for accurate and emergent imaging assessment of the traumatized spine in order to evaluate spinal stability and integrity of neural elements. Because clinicians fear missing occult spine injuries, they obtain radiographs for nearly all patients who present with blunt trauma. We are influenced on one side by fear of litigation and the possible devastating medical, psychologic and financial consequences of cervical spine injury, and on the other side by pressure to reduce health care costs. A set of clinical and/or anamnestic criteria, however, can be very useful in identifying patients who have an extremely low probability of injury and who consequently have no need for imaging studies. Multidetector (or multislice) computed tomography (MDCT) is the preferred primary imaging modality in blunt spinal trauma patients who do need imaging. Not only is CT more accurate in diagnosing spinal injury, it also reduces imaging time and patient manipulation. Evidence-based research has established that MDCT improves patient outcome and saves money in comparison to plain film. This review discusses the use, advantages and disadvantages of the different imaging techniques used in spinal trauma patients and the criteria used in selecting patients who do not need imaging. Finally an overview of different types of spinal injuries is given

  18. Undertriage in trauma: Does an organized trauma network capture the major trauma victim? A statewide analysis.

    Science.gov (United States)

    Horst, Michael A; Jammula, Shreya; Gross, Brian W; Cook, Alan D; Bradburn, Eric H; Altenburg, Juliet; Von Nieda, Danielle; Morgan, Madison; Rogers, Frederick B

    2018-03-01

    Proper triage of critically injured trauma patients to accredited trauma centers (TCs) is essential for survival and patient outcomes. We sought to determine the percentage of patients meeting trauma criteria who received care at non-TCs (NTCs) within the statewide trauma system that exists in the state of Pennsylvania. We hypothesized that a substantial proportion of the trauma population would be undertriaged to NTCs with undertriage rates (UTR) decreasing with increasing severity of injury. All adult (age ≥15) hospital admissions meeting trauma criteria (ICD-9, 800-959; Injury Severity Score [ISS], > 9 or > 15) from 2003 to 2015 were extracted from the Pennsylvania Health Care Cost Containment Council (PHC4) database, and compared with the corresponding trauma population within the Pennsylvania Trauma Systems Foundation (PTSF) registry. PHC4 contains all hospital admissions within PA while PTSF collects data on all trauma cases managed at designated TCs (Level I-IV). The percentage of patients meeting trauma criteria who are undertriaged to NTCs was determined and Network Analyst Location-Allocation function in ArcGIS Desktop was used to generate geospatial representations of undertriage based on ISSs throughout the state. For ISS > 9, 173,022 cases were identified from 2003 to 2015 in PTSF, while 255,263 cases meeting trauma criteria were found in the PHC4 database over the same timeframe suggesting UTR of 32.2%. For ISS > 15, UTR was determined to be 33.6%. Visual geospatial analysis suggests regions with limited access to TCs comprise the highest proportion of undertriaged trauma patients. Despite the existence of a statewide trauma framework for over 30 years, approximately, a third of severely injured trauma patients are managed at hospitals outside of the trauma system in PA. Intelligent trauma system design should include an objective process like geospatial mapping rather than the current system which is driven by competitive models of financial and

  19. Sexual abuse trauma among Chinese survivors.

    Science.gov (United States)

    Tsun-Yin, E L

    1998-10-01

    As an initial effort to examine Chinese sexual abuse trauma in relation to the cultural construction of sexual victimization of women, this study applies Finkelhor and Browne's (1985) traumagenic dynamics model to examine post-abuse trauma among Chinese child and adolescent survivors in Taiwan. In analyzing sexual abuse trauma in the context of Chinese patriarchal familialism and cultural fetish for female chastity, this study attempts to explore cultural constructional process of sexual abuse in Chinese society. This study conducted in-depth interviews with 19 survivors of, and three social workers on, sexual abuse in Taiwan. These interviews were guided by a semi-structured questionnaire on sexual abuse incidents and post-abuse responses/concerns, and had generated a total of 84 pages of written reports, which serve as the text-data for the analysis. This study identifies sexual stigmatization and senses of disempowerment and betrayal as the most pervasive trauma complex among Chinese sexual abuse survivors in Taiwan. This study found that, in addition to lowering self-esteem, sexual stigmatization results in polarized sexuality among adolescent survivors, as manifested in aversion to and preoccupation with sexuality. The abuse-induced disempowerment is manifested in the survivors' fear for personal safety and heightened sense of vulnerability to re-victimization. The sense of betrayal results in interpersonal difficulties as manifested in self-imposed isolation from others and/or suspicious attitudes toward others, which further impair the survivor's efficacy in meeting her abuse-induced clinging need. Overall, this study observes similar traumatic symptoms between Chinese survivors and their American counterparts as documented in the literature. Nevertheless, this study observes the sexual stigmatization represents the most prevailing post-abuse trauma among Chinese sexual abuse survivors, and reflects the patriarchal fetish for female chastity in the Chinese

  20. Trauma treatment across Europe: where do we stand now from a perspective of seven countries

    Directory of Open Access Journals (Sweden)

    Evaldas Kazlauskas

    2016-03-01

    Full Text Available There is a lack of knowledge about the state of affairs of the trauma treatments in Europe. To start to fill in this gap, key persons from seven European countries—Georgia, Germany, Lithuania, the Netherlands, Poland, Switzerland, and Turkey—accepted the invitation to give their expert opinion on the state of affairs in their country at an invited panel discussion at the XIV 2015 ESTSS Conference in Vilnius, Lithuania. Brief reports from the seven countries reveal significant diversities among different European countries in terms of awareness of health problems related to trauma, the availability of trauma treatments, and treatment approaches. Political and economic differences across the European countries contribute to the diversities in the developments of trauma treatments. European national psychotrauma societies are active in establishing training curricula and dissemination of trauma-focused treatments. Despite the growing acknowledgment of trauma and dissemination of trauma-focused treatments, there is a lack of Europe-wide policies to ensure availability of trauma treatment in Europe for trauma survivors. The need for more detailed analysis of trauma treatment in all European countries and development of European-level trauma-informed health care policies is outlined.

  1. Radiation therapy for early stage Hodgkin's disease: Australasian patterns of care

    International Nuclear Information System (INIS)

    Barton, Michael; Boyages, John; Crennan, Elizabeth; Davis, Sidney; Fisher, Richard J.; Hook, Carolyn; Johnson, Neva; Joseph, David; Liew, Kuen H.; Morgan, Graeme; O'Brien, Peter; Pendlebury, Sue; Pratt, Gary; Quong, George; Thornton, Deborah; Walker, Quenten; Wallington, Margaret; Trotter, Grant

    1995-01-01

    Purpose: Analysis of treatment outcome for Stage I-IIA supradiaphragmatic Hodgkin's disease treated solely by irradiation in Australia and New Zealand. Methods and Materials: Patients with supradiaphragmatic Hodgkin's disease only who were treated by irradiation alone with curative intent between 1969 to 1988 were retrospectively reviewed. Ten radiation oncology departments in Australia and New Zealand contributed patient data to the study. Patient, tumor, and treatment variables were recorded. Disease-free interval, survival, and complications were analyzed. Results: Eight hundred and twenty patients were reviewed. The median age was 29 years. There were 437 men and 383 women. The distribution of 310 clinically staged patients was 170 stage IA, 5 IB, and 135 IIA. Five hundred and ten patients received laparotomies, and pathologic staging was as follows: IA 214, IB 13, IIA 283. The 10-year acturial disease-free rate was 69% and overall survival rate was 79%. Increasing age, male sex, higher number of involved sites, the use of involved field irradiation, no staging laparotomy, and earlier year of treatment were significantly associated with an increased risk of relapse and lower survival. Actuarial 10-year survival following recurrence was 48%. Acute complications requiring interruption to treatment occurred in 46 patients (6%), but < 1% had their treatment permanently suspended. Actuarial complication rates at 10 years were: cardiac 2%, pulmonary 3% and thyroid 5%. There were 44 second malignancies including 10 non-Hodgkin's lymphomas, 3 leukemias, 7 lung, and 6 breast cancers. Mean delay to the development of a second cancer was 6 years. The 10-year actuarial rate of second malignancy was 5%. Conclusions: The Australasian experience of early stage Hodgkin's disease is consistent with the results in the published literature and confirms that irradiation produces a high cure rate with minimal toxicity

  2. The Australasian Diabetes Data Network: first national audit of children and adolescents with type 1 diabetes.

    Science.gov (United States)

    Phelan, Helen; Clapin, Helen; Bruns, Loren; Cameron, Fergus J; Cotterill, Andrew M; Couper, Jennifer J; Davis, Elizabeth A; Donaghue, Kim C; Jefferies, Craig A; King, Bruce R; Sinnott, Richard O; Tham, Elaine B; Wales, Jerry K; Jones, Timothy W; Craig, Maria E

    2017-02-20

    To assess glycaemic control, anthropometry and insulin regimens in a national sample of Australian children and adolescents with type 1 diabetes. Cross-sectional analysis of de-identified, prospectively collected data from the Australasian Diabetes Data Network (ADDN) registry. Five paediatric diabetes centres in New South Wales, Queensland, South Australia, Victoria and Western Australia. Children and adolescents (aged 18 years or under) with type 1 diabetes of at least 12 months' duration for whom data were added to the ADDN registry during 2015. Glycaemic control was assessed by measuring haemoglobin A1c (HbA1c) levels. Body mass index standard deviation scores (BMI-SDS) were calculated according to the CDC-2000 reference; overweight and obesity were defined by International Obesity Task Force guidelines. Insulin regimens were classified as twice-daily injections (BD), multiple daily injections (MDI; at least three injection times per day), or continuous subcutaneous insulin infusion (CSII). The mean age of the 3279 participants was 12.8 years (SD, 3.7), mean diabetes duration was 5.7 years (SD, 3.7), and mean HbA1c level 67 mmol/mol (SD, 15); only 27% achieved the national HbA1c target of less than 58 mmol/mol. The mean HbA1c level was lower in children under 6 (63 mmol/mol) than in adolescents (14-18 years; 69 mmol/mol). Mean BMI-SDS for all participants was 0.6 (SD, 0.9); 33% of the participants were overweight or obese. 44% were treated with CSII, 38% with MDI, 18% with BD. Most Australian children and adolescents with type 1 diabetes are not meeting the recognised HbA1c target. The prevalence of overweight and obesity is high. There is an urgent need to identify barriers to achieving optimal glycaemic control in this population.

  3. Australasian monsoon response to Dansgaard-Oeschger event 21 and teleconnections to higher latitudes

    Science.gov (United States)

    Griffiths, Michael L.; Drysdale, Russell N.; Gagan, Michael K.; Hellstrom, John C.; Couchoud, Isabelle; Ayliffe, Linda K.; Vonhof, Hubert B.; Hantoro, Wahyoe S.

    2013-05-01

    Dansgaard-Oeschger (D-O) cycles were the most prominent, abrupt climate events of the last glacial period whose impact was most strongly felt in the high latitudes of the North Atlantic region. The climate links between the North Atlantic, the Asian and American tropics, and Antarctica during these cycles are well documented. However, the potential role of the Indo-Pacific Warm Pool and Australasian monsoon system in propagating climate impacts across the hemispheres is still unclear. Here, we use tandem measurements of oxygen isotopes in calcite and fluid inclusions, as well as carbon-isotope ratios, from multiple stalagmites from Liang Luar Cave, Flores (southern Indonesia) to examine the monsoon response to D-O event number 21 (~87,000-84,000 years ago), the longest and warmest event recorded in Greenland ice cores. The record shows that there was a rapid decline in monsoon rainfall in Indonesia during D-O21 warming in Greenland and cooling in Antarctica. At around the same time, the East Asian monsoon was intensified, indicating that the intertropical convergence zone (ITCZ) shifted abruptly to the north during this event. Our record also shows that there was a 2-3 °C increase in local air temperature, which would have acted to increase primary productivity and promote the generation of soil carbon for methanogenesis. Therefore, our findings indicate that ITCZ positioning in tropical Australasia—through its influence on large-scale oceanic-atmospheric circulation—played a key role in transmitting the abrupt climate signal between the hemispheres, thereby facilitating the rapid rise of atmospheric CO2 and CH4 concentrations during D-O21 that ultimately led to global warming and the demise of the MIS5b stadial.

  4. Towards Harmonisation of Critical Laboratory Result Management - Review of the Literature and Survey of Australasian Practices

    Science.gov (United States)

    Campbell, CA; Horvath, AR

    2012-01-01

    Timely release and communication of critical test results may have significant impact on medical decisions and subsequent patient outcomes. Laboratories therefore have an important responsibility and contribution to patient safety. Certification, accreditation and regulatory bodies also require that laboratories follow procedures to ensure patient safety, but there is limited guidance on best practices. In Australasia, no specific requirements exist in this area and critical result reporting practices have been demonstrated to be heterogeneous worldwide. Recognising the need for agreed standards and critical limits, the AACB started a quality initiative to harmonise critical result management throughout Australasia. The first step toward harmonisation is to understand current laboratory practices. Fifty eight Australasian laboratories responded to a survey and 36 laboratories shared their critical limits. Findings from this survey are compared to international practices reviewed in various surveys conducted elsewhere. For the successful operation of a critical result management system, critical tests and critical limits must be defined in collaboration with clinicians. Reporting procedures must include how critical results are identified; who can report and who can receive critical results; what is an acceptable timeframe within which results must be delivered or, if reporting fails, what escalation procedures should follow; what communication channels or systems should be used; what should be recorded and how; and how critical result procedures should be maintained and evaluated to assess impact on outcomes. In this paper we review the literature of current standards and recommendations for critical result management. Key elements of critical result reporting are discussed in view of the findings of various national surveys on existing laboratory practices, including data from our own survey in Australasia. Best practice recommendations are made that laboratories

  5. Ceratopetalum (Cunoniaceae) fruits of Australasian affinity from the early Eocene Laguna del Hunco flora, Patagonia, Argentina.

    Science.gov (United States)

    Gandolfo, María A; Hermsen, Elizabeth J

    2017-03-01

    Radially symmetrical, five-winged fossil fruits from the highly diverse early Eocene Laguna del Hunco flora of Chubut Province, Patagonia, Argentina, are named, described and illustrated. The main goals are to assess the affinities of the fossils and to place them in an evolutionary, palaeoecological and biogeographic context. Specimens of fossil fruits were collected from the Tufolitas Laguna del Hunco. They were prepared, photographed and compared with similar extant and fossil fruits using published literature. Their structure was also evaluated by comparing them with that of modern Ceratopetalum (Cunoniaceae) fruits through examination of herbarium specimens. The Laguna del Hunco fossil fruits share the diagnostic features that characterize modern and fossil Ceratopetalum (symmetry, number of fruit wings, presence of a conspicuous floral nectary and overall venation pattern). The pattern of the minor wing (sepal) veins observed in the Patagonian fossil fruits is different from that of modern and previously described fossil Ceratopetalum fruits; therefore, a new fossil species is recognized. An apomorphy (absence of petals) suggests that the fossils belong within crown-group Ceratopetalum . The Patagonian fossil fruits are the oldest known record for Ceratopetalum . Because the affinities, provenance and age of the fossils are so well established, this new Ceratopetalum fossil species is an excellent candidate for use as a calibration point in divergence dating studies of the family Cunoniaceae. It represents the only record of Ceratopetalum outside Australasia, and further corroborates the biogeographic connection between the Laguna del Hunco flora and ancient and modern floras of the Australasian region. © The Author 2017. Published by Oxford University Press on behalf of the Annals of Botany Company.

  6. Racial Differences in Children's Trauma Symptoms Following Complex Trauma Exposure.

    Science.gov (United States)

    Wamser-Nanney, Rachel; Cherry, Kathryn E; Campbell, Claudia; Trombetta, Elise

    2018-03-01

    Complex trauma exposure has been defined as multiple or chronic interpersonal trauma that begins early in life, which leads to widespread dysregulation. Previous studies have reported that minorities may be at greater risk for trauma exposure and symptoms; yet, racial differences have not been investigated in the context of complex trauma. The aim of the present study was to determine if there are racial disparities in children's trauma exposure and outcomes among 167 child survivors of complex trauma (3-18 years, M = 9.90, SD = 3.92; 61.67% female; 62.2% Black). Black children endorsed a greater number of trauma types and were more likely to have experienced community violence and have been placed in child protective custody than White children. Caregivers of White children endorsed higher levels of select internalizing symptoms and social concerns whereas Black children reported higher levels of sexual concerns than White children. White children who experience complex trauma may be at higher risk for some trauma-related difficulties. Alternatively, caregivers of White children may perceive them to have, or be more willing to acknowledge, higher levels of symptoms than Black children. Future work is needed to further investigate the role of race in disclosure of trauma exposure and related symptoms.

  7. Trauma Tactics: Rethinking Trauma Education for Professional Nurses.

    Science.gov (United States)

    Garvey, Paula; Liddil, Jessica; Eley, Scott; Winfield, Scott

    2016-01-01

    According to the National Trauma Institute (2015), trauma accounts for more than 180,000 deaths each year in the United States. Nurses play a significant role in the care of trauma patients and therefore need appropriate education and training (L. ). Although several courses exist for trauma education, many nurses have not received adequate education in trauma management (B. ; L. ). Trauma Tactics, a 2-day course that focuses on high-fidelity human patient simulation, was created to meet this educational need. This descriptive study was conducted retrospectively to assess the effectiveness of the Trauma Tactics course. Pre- and postsurveys, tests, and simulation performance were used to evaluate professional nurses who participated in Trauma Tactics over a 10-month period. Fifty-five nurses were included in the study. Pre- and postsurveys revealed an increase in overall confidence, test scores increased by an average of 2.5 points, and simulation performance scores increased by an average of 16 points. Trauma Tactics is a high-quality course that provides a valuable and impactful educational experience for nurses. Further research is needed to evaluate the long-term effects of Trauma Tactics and its impacts on quality of care and patient outcomes.

  8. Maxillofacial trauma scoring systems.

    Science.gov (United States)

    Sahni, Vaibhav

    2016-07-01

    The changing complexity of maxillofacial fractures in recent years has created a situation where classical systems of classification of maxillofacial injuries fall short of defining trauma particularly that observed with high-velocity collisions where more than one region of the maxillofacial skeleton is affected. Trauma scoring systems designed specifically for the maxillofacial region are aimed to provide a more accurate assessment of the injury, its prognosis, the possible treatment outcomes, economics, length of hospital stay, and triage. The evolution and logic of such systems along with their merits and demerits are discussed. The author also proposes a new system to aid users in quickly and methodically choosing the system best suited to their needs without having to study a plethora of literature available in order to isolate their choice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Videolaparoscopia no trauma abdominal

    Directory of Open Access Journals (Sweden)

    Átila Varela Velho

    Full Text Available A videolaparoscopia (VL vem contribuindo de forma crescente, para diagnóstico e terapêutica de várias afecções cirúrgicas abdominais, introduzindo profundas mudanças na cirurgia contemporânea. Esse avanço incorporou-se também às urgências traumáticas, fazendo parte da avaliação diagnóstica e, às vezes, da terapêutica do trauma abdominal. Os autores apresentam uma revisão concisa da literatura sobre a VL no trauma, atualizando o tema e discutindo os aspectos mais relevantes das indicações, limitações e complicações do método.

  10. Radiology of spinal trauma

    International Nuclear Information System (INIS)

    Kassel, E.E.; Cooper, P.W.; Rubenstein, J.D.

    1983-01-01

    The early diagnostic management of patients with acute spinal canal trauma may be among the most difficult injuries referred to a trauma centre. No standardized protocol exists. Radiographic examinations commence with plain films, including special views. Further radiographic studies, if required, vary and include CT, myelography and conventional tomography. CT and metrizamide myelography are complementary. In more complicated fracture-dislocations, all of the above investigations may be necessary. Recent advances, including water-soluble contrast media, the lateral C1-2 puncture and CT, now offer faster, safer and more thorough follow-up investigations with less radiation exposure. Patients with multiple injuries, previously considered too severely injured to undergo further neurologic investigations, may now be more adequately assessed early in the acute phase of injury such that appropriate surgical decompression or stabilization may be performed. The maximum attainable neurologic improvement for such individuals may be better realized with the improved radio-diagnostic capabilities available

  11. ABDOMINAL TRAUMA- CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Vanaja Ratnakumari Billa

    2017-08-01

    Full Text Available BACKGROUND In the recent times there has been increased incidence of abdominal trauma cases due to several causes. Quick and prompt intervention is needed to decrease the mortality of the patients. So we conducted a study to assess the cause and the management of abdominal trauma cases in our institution. The aim of this study was to know the incidence of blunt and penetrating injuries and their causes, age and sex incidence, importance of various investigations, mode of treatment offered and post-operative complications. To study the cause of death and evolve better management. MATERIALS AND METHODS The present study comprises of patients admitted to and operated in various surgical units in the Department of Surgery at Government General Hospital, attached to Guntur Medical College Guntur, from August 2014 to October 2016. RESULTS Increase incidence seen in age group 20-29 years (30%. Male predominance 77.5%. Mechanism of injury–road traffic accidents 65%. Isolated organ injury–colon and rectum 40%. Other associated injuries–chest injuries with rib fractures 7.5%. Complications–wound infection 17.5%. Duration of hospital stay 8–14 days. Bowel injury management–closure of perforation 84.6%. Resection anastomosis 15.38%. CONCLUSION Thorough clinical examination, diagnostic paracentesis, plain X-ray erect abdomen and ultrasound proved to be very helpful in the diagnosis of intra-abdominal injuries. Spleen is the commonest organ involved in blunt trauma and colon is the commonly injured organ in penetrating abdominal trauma, many patients have associated extremity and axial skeleton injuries. With advances in diagnosis and intensive care technologies, most patients of solid visceral injuries with hemodynamic stability can be managed conservatively. Surgical site infection is the most common complication following surgery. The mortality is high; reason might be patient reaching the hospital late, high incidence of postoperative septic

  12. Trauma and Symbolic Violence

    DEFF Research Database (Denmark)

    Pedersen, Bodil Maria

    2011-01-01

    Our understanding of 'reactions to trauma' is dominated by concepts like Post-Traumatic Stress Disorder. The use of such concepts has been criticised but simultaneously integrated in folk-psychology. Connecting emotional and cognitive processes as well as acts - such as in gendered practices - to...... inclusive of connections between societal practices, aspects of symbolic violence, and the conduct of lives. The analysis is based on an empirical study of victimisation through rape and other forms of sexualised coercion....

  13. Imaging of laryngeal trauma.

    Science.gov (United States)

    Becker, Minerva; Leuchter, Igor; Platon, Alexandra; Becker, Christoph D; Dulguerov, Pavel; Varoquaux, Arthur

    2014-01-01

    External laryngeal trauma is a rare but potentially life-threatening situation in the acutely injured patient. Trauma mechanism and magnitude, maximum focus of the applied force, and patient related factors, such as age and ossification of the laryngeal cartilages influence the spectrum of observed injuries. Their correct diagnosis and prompt management are paramount in order to avoid patient death or long-term impairment of breathing, swallowing and speaking. The current review provides a comprehensive approach to the radiologic interpretation of imaging studies performed in patients with suspected laryngeal injury. It describes the key anatomic structures that are relevant in laryngeal trauma and discusses the clinical role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the acute emergency situation. The added value of two-dimensional multiplanar reconstructions (2D MPR), three-dimensional volume rendering (3D VR) and virtual endoscopy (VE) for the non-invasive evaluation of laryngeal injuries and for treatment planning is discussed. The clinical presentation, biomechanics of injury, diagnostic pitfalls and pearls, common and uncommon findings are reviewed with emphasis of fracture patterns, involvement of laryngeal joints, intra- and extralaryngeal soft tissue injuries, and complications seen in the acute emergency situation. The radiologic appearance of common and less common long-term sequelae, as well as treatment options are equally addressed. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  14. Imaging of laryngeal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Minerva, E-mail: Minerva.Becker@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Leuchter, Igor, E-mail: Igor.Leuchter@hcuge.ch [Department of Otorhinolaryngology and Cervico-facial Surgery, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Platon, Alexandra, E-mail: Alexandra.Platon@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Becker, Christoph D., E-mail: Christoph.Becker@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Dulguerov, Pavel, E-mail: Pavel.Dulguerov@hcuge.ch [Department of Otorhinolaryngology and Cervico-facial Surgery, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland); Varoquaux, Arthur, E-mail: Arthur.Varoquaux@hcuge.ch [Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14 (Switzerland)

    2014-01-15

    External laryngeal trauma is a rare but potentially life-threatening situation in the acutely injured patient. Trauma mechanism and magnitude, maximum focus of the applied force, and patient related factors, such as age and ossification of the laryngeal cartilages influence the spectrum of observed injuries. Their correct diagnosis and prompt management are paramount in order to avoid patient death or long-term impairment of breathing, swallowing and speaking. The current review provides a comprehensive approach to the radiologic interpretation of imaging studies performed in patients with suspected laryngeal injury. It describes the key anatomic structures that are relevant in laryngeal trauma and discusses the clinical role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the acute emergency situation. The added value of two-dimensional multiplanar reconstructions (2D MPR), three-dimensional volume rendering (3D VR) and virtual endoscopy (VE) for the non-invasive evaluation of laryngeal injuries and for treatment planning is discussed. The clinical presentation, biomechanics of injury, diagnostic pitfalls and pearls, common and uncommon findings are reviewed with emphasis of fracture patterns, involvement of laryngeal joints, intra- and extralaryngeal soft tissue injuries, and complications seen in the acute emergency situation. The radiologic appearance of common and less common long-term sequelae, as well as treatment options are equally addressed.

  15. Trauma and Memory in Magical Realism: Eden Robinson’s Monkey Beach as Trauma Narrative

    Directory of Open Access Journals (Sweden)

    Anja Mrak

    2013-06-01

    Full Text Available The fundamental characteristic of magical realism is its duality, which enables alternative representations of society and history. Its specific narrative devices make magical realism a viable form for rendering traumatic experience and memories. Monkey Beach (2000 by Eden Robinson, a member of the Haisla and Heiltsuk First Nations in Canada, is a repository of memories, triggered and fuelled by trauma. Fragmented temporality, mixing of discourses, shifts in focalization, wordplays, repetition, and the magical are some of the devices the novel uses to address the complex landscape of trauma and memory. By unveiling personal memories, Monkey Beach gives way to the unconscious to enter the narrative structure, gradually revealing a much larger issue of the mistreatment of the Haisla people in Canada—and the resulting collective trauma. As trauma cannot be integrated into the narrative, it can only be uncovered indirectly and through a double distancing: firstly through the techniques of magical realism, and secondly, through the seemingly detached point of view of the narrator, who ultimately realises that her life is also encumbered with the dark stain of colonialism.

  16. Splenic trauma: WSES classification and guidelines for adult and pediatric patients.

    Science.gov (United States)

    Coccolini, Federico; Montori, Giulia; Catena, Fausto; Kluger, Yoram; Biffl, Walter; Moore, Ernest E; Reva, Viktor; Bing, Camilla; Bala, Miklosh; Fugazzola, Paola; Bahouth, Hany; Marzi, Ingo; Velmahos, George; Ivatury, Rao; Soreide, Kjetil; Horer, Tal; Ten Broek, Richard; Pereira, Bruno M; Fraga, Gustavo P; Inaba, Kenji; Kashuk, Joseph; Parry, Neil; Masiakos, Peter T; Mylonas, Konstantinos S; Kirkpatrick, Andrew; Abu-Zidan, Fikri; Gomes, Carlos Augusto; Benatti, Simone Vasilij; Naidoo, Noel; Salvetti, Francesco; Maccatrozzo, Stefano; Agnoletti, Vanni; Gamberini, Emiliano; Solaini, Leonardo; Costanzo, Antonio; Celotti, Andrea; Tomasoni, Matteo; Khokha, Vladimir; Arvieux, Catherine; Napolitano, Lena; Handolin, Lauri; Pisano, Michele; Magnone, Stefano; Spain, David A; de Moya, Marc; Davis, Kimberly A; De Angelis, Nicola; Leppaniemi, Ari; Ferrada, Paula; Latifi, Rifat; Navarro, David Costa; Otomo, Yashuiro; Coimbra, Raul; Maier, Ronald V; Moore, Frederick; Rizoli, Sandro; Sakakushev, Boris; Galante, Joseph M; Chiara, Osvaldo; Cimbanassi, Stefania; Mefire, Alain Chichom; Weber, Dieter; Ceresoli, Marco; Peitzman, Andrew B; Wehlie, Liban; Sartelli, Massimo; Di Saverio, Salomone; Ansaloni, Luca

    2017-01-01

    Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be different, children should always be treated in dedicated pediatric trauma centers. In fact, the vast majority of pediatric patients with blunt splenic trauma can be managed non-operatively. This paper presents the World Society of Emergency Surgery (WSES) classification of splenic trauma and the management guidelines.

  17. Lessons learned from the casualties of war: battlefield medicine and its implication for global trauma care.

    Science.gov (United States)

    Chatfield-Ball, Catherine; Boyle, Peter; Autier, Philippe; van Wees, Sibylle Herzig; Sullivan, Richard

    2015-03-01

    According to the Global Burden of Disease, trauma is now responsible for five million deaths each year. High-income countries have made great strides in reducing trauma-related mortality figures but low-middle-income countries have been left behind with high trauma-related fatality rates, primarily in the younger population. Much of the progress high-income countries have made in managing trauma rests on advances developed in their armed forces. This analysis looks at the recent advances in high-income military trauma systems and the potential transferability of those developments to the civilian health systems particularly in low-middle-income countries. It also evaluates some potential lifesaving trauma management techniques, proven effective in the military, and the barriers preventing these from being implemented in civilian settings. © The Royal Society of Medicine.

  18. Childhood trauma and compulsive buying.

    Science.gov (United States)

    Sansone, Randy A; Chang, Joy; Jewell, Bryan; Rock, Rachel

    2013-02-01

    Childhood trauma has been empirically associated with various types of self-regulatory difficulties in adulthood. However, according to the extant literature, no study has examined relationships between various types of childhood trauma and compulsive buying behavior in adulthood. Using a self-report survey methodology in a cross-sectional consecutive sample of 370 obstetrics/gynecology patients, we examined five types of childhood trauma before the age of 12 years (i.e. witnessing violence, physical neglect, emotional abuse, physical abuse, sexual abuse) in relationship to compulsive buying as assessed by the Compulsive Buying Scale (CBS). All forms of trauma demonstrated statistically significant correlations with the CBS. Using a linear regression analysis, both witnessing violence and emotional abuse significantly contributed to CBS scores. Further analyses indicated that race did not moderate the relationship between childhood trauma and compulsive buying. Findings indicate that various forms of childhood trauma are correlated with compulsive buying behavior, particularly witnessing violence and emotional abuse.

  19. Nocturama gen. nov., Nothocladus s. lat. and other taxonomic novelties resulting from the further resolution of paraphyly in Australasian members of Batrachospermum (Batrachospermales, Rhodophyta).

    Science.gov (United States)

    Entwisle, Timothy J; Johnston, Emily T; Lam, Daryl W; Stewart, Sarah A; Vis, Morgan L

    2016-06-01

    The informal "Australasica Group" was established in 2009 to include several Australasian endemic Batrachospermum species, a few species of the cosmopolitan Batrachospermum section Setacea, and the South American endemic Petrohua bernabei. Although useful for communication purposes, no formal taxonomic designation was proposed due to weakly supported basal nodes. The present research took a two-pronged approach of adding more taxa (29 additional specimens) as well as more sequence data (LSU, cox1, psaA, and psbA markers added to rbcL data) to provide better resolution. The resulting tree showed improved statistical support values (Bayesian posterior probability and maximum likelihood bootstrap) for most nodes providing a framework for taxonomic revision. Based on our well-resolved phylogeny, a new genus, Nocturama, is proposed for a clade of Batrachospermum antipodites specimens. The circumscription of Nothocladus is expanded to include Batrachospermum section Setacea and four additional sections composed of at least 10 species, mostly from Australia and New Zealand. One new species added to the data set, N. diatyches, did not form a clade with the other species of section Setaceus, where it was classified previously, rendering that section paraphyletic. To resolve this, N. diatyches and the morphologically similar species N. latericius are included with N. theaquus, in the new section Theaquus within Nothocladus s. lat. A specimen from Australia unaligned to these clades was sister to the Australia-New Zealand genus Psilosiphon and the cosmopolitan B. cayennense, but lacked statistical support. This specimen has the gross morphology of Batrachospermum s. lat. and is here provisionally assigned to that genus, as B. serendipidum sp. nov. © 2016 Phycological Society of America.

  20. Decline in acute urinary toxicities with increased institutional experience: 15-year experience of permanent seed prostate brachytherapy in a single Australasian institution.

    Science.gov (United States)

    Ong, Wee Loon; Matheson, Bronwyn; Millar, Jeremy

    To evaluate the incidence of acute urinary toxicity after permanent seed prostate brachytherapy (BT) over a 15-year period. The study consisted of 782 prostate cancer patients treated with BT. All patients completed self-administered International Prostate Symptoms Score (IPSS) at baseline and during regular follow-up. We evaluated the risk of acute urinary retention (AUR) up to 3 months post-BT and lower urinary tract symptom (LUTS) resolution (defined as return to within two points of baseline IPSS score) at regular intervals, up to 24 months post-BT. Univariate and multivariate logistic regressions were used to evaluate the effect of various patient, tumor, and treatment factors on the risk of AUR and the likelihood of LUTS resolution. Ninety-six patients (12%) developed AUR at a median of 1 day post-BT. Increased peak urinary flow is independently associated with lower risk of AUR (odds ratio [OR] = 0.94; 95% confidence interval [CI] = 0.91-0.97). Decline in incidence of AUR was observed over time with increased institutional experience (p = 0.03). Of the 646 patients with a minimum of 24-month follow-up, 29%, 49%, and 72% had LUTS resolution at 6, 12, and 24 months, respectively. Patients who had pre-BT transurethral resection of prostate (OR = 2.4; 95% CI = 1.5-4.0), cytoreductive neo-adjuvant androgen deprivation (OR = 2.0; 95% CI = 1.0-4.0), and higher baseline IPSS (OR = 1.1; 95% CI = 1.07-1.19) are more likely to report LUTS resolution at 24 months. We reported decline in AUR over time with increased institutional experience in one of the largest Australasian BT series. Approximately three-quarters of patients achieved LUTS resolution at 24-month follow-up. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  1. Diagnosis and treatment of MYH9-RD in an Australasian cohort with thrombocytopenia.

    Science.gov (United States)

    Rabbolini, David J; Chun, Yenna; Latimer, Maya; Kunishima, Shinji; Fixter, Kathleen; Valecha, Bhavia; Tan, Peter; Chew, Lee Ping; Kile, Benjamin T; Burt, Rachel; Radhakrishnan, Kottayam; Bird, Robert; Ockelford, Paul; Gabrielli, Sara; Chen, Qiang; Stevenson, William S; Ward, Christopher M; Morel-Kopp, Marie-Christine

    2017-11-01

    MYH9-related disorders (MYH9-RDs) caused by mutation of the MYH9 gene which encodes non-muscle myosin heavy-chain-IIA (NMMHC-IIA), an important motor protein in hemopoietic cells, are the most commonly encountered cause of inherited macrothrombocytopenia. Despite distinguishing features including an autosomal dominant mode of inheritance, giant platelets on the peripheral blood film accompanied by leucocytes with cytoplasmic inclusion bodies (döhle-like bodies), these disorders remain generally under-recognized and often misdiagnosed as immune thrombocytopenia (ITP). This may result in inappropriate treatment with corticosteroids, immunosupressants and in some cases, splenectomy. We explored the efficacy of next generation sequencing (NGS) with a candidate gene panel to establish the aetiology of thrombocytopenia for individuals who had been referred to our center from hematologists in the Australasian region in whom the cause of thrombocytopenia was suspected to be secondary to an inherited condition but which remained uncharacterized despite phenotypic investigations. Pathogenic MYH9 variants were detected in 15 (15/121, 12.4%) individuals and the pathogenecity of a novel variant of uncertain significance was confirmed in a further two related individuals following immunofluorescence (IF) staining performed in our laboratory. Concerningly, only one (1/17) individual diagnosed with MYH9-RD had been referred with this as a presumptive diagnosis, in all other cases (16/17, 94.1%), a diagnosis was not suspected by referring clinicians, indicating a lack of awareness or a failing of our diagnostic approach to these conditions. We examined the mean platelet diameter (MPD) measurements as a means to better identify and quantify platelet size. MPDs in cases with MYH9-RDs were significantly larger than controls (p < 0.001) and in 91% were greater than a previously suggested threshold for platelets in cases of ITP. In addition, we undertook IF staining in a proportion of

  2. Phylogenetic analysis of the Australasian paralysis ticks and their relatives (Ixodidae: Ixodes: Sternalixodes).

    Science.gov (United States)

    Kwak, Mackenzie L; Beveridge, Ian; Koehler, Anson V; Malipatil, Mallik; Gasser, Robin B; Jabbar, Abdul

    2017-03-02

    The Australasian paralysis ticks and their relatives, Ixodes Latrielle, subgenus Sternalixodes Schulze, are some of the most important ticks in the region. However, very little is known about their phylogenetic relationships. The aim of this study was to elucidate the evolutionary relationships of members of the subgenus Sternalixodes by undertaking phylogenetic analyses of morphological and molecular datasets. Adult females (n = 64) of Sternalixodes, including Ixodes anatis Chilton, 1904, Ixodes confusus Roberts, 1960, Ixodes cornuatus Roberts, 1960, Ixodes cordifer Neumann, 1908, Ixodes dendrolagi Wilson, 1967, Ixodes hirsti Hassall, 1931, Ixodes holocyclus Neumann, 1899, Ixodes myrmecobii Roberts, 1962 and Ixodes trichosuri Roberts, 1960, were examined morphologically. Subsequently, these Ixodes spp. were genetically characterised using cytochrome c oxidase subunit 1 (cox1) gene and the internal transcribed spacer 2 (ITS-2) of the rRNA. Both morphological and molecular datasets were analysed using various phylogenetic methods to assess the evolutionary relationship of various members of the subgenus Sternalixodes. Phylogenetic analyses of the cox1 sequences and morphological characters datasets revealed that the Australian and Papuan Sternalixodes formed a distinct clade with the New Zealand member of the group I. anatis positioned basally, in a separate clade. Ixodes holocyclus, I. cornuatus and I. myrmecobii formed a distinctive clade in both the cox1 and morphological phylogenies. However, based on phylogenetic analysis of the ITS-2 data, I. holocyclus formed a separate clade whereas I. cornuatus and I. myrmecobii grouped in a different clade. The cox1 and morphological data suggest that the subgenus Sternalixodes is paraphyletic, and I. anatis is not a sternalixodid tick; hence, it should not be included in the subgenus. Based on the phylogenetic analyses of cox1 and ITS-2 sequences, it appears that I. myrmecobii and I. cornuatus are not subspecies of I

  3. Combined modality therapy for esophageal carcinoma: preliminary results from a large Australasian multicenter study

    International Nuclear Information System (INIS)

    Burmeister, Bryan H.; Rad, F.F.; Denham, James W.; O'Brien, Maree; Jamieson, Glyn G.; Gill, P. Grantley; Devitt, Peter; Yeoh, Eric; Hamilton, Christopher S.; Ackland, Stephen P.; Lamb, David S.; Spry, Nigel A.; Joseph, David J.; Atkinson, Christopher; Walker, Quenten J.

    1995-01-01

    Purpose: This report updates local control and survival experience and focuses on treatment toxicity in 294 patients with esophageal cancer who have been treated at six Australasian centers using three prospective unrandomized protocols that used concurrent radiation, cisplatin, and modest dose infusional fluorouracil. Methods and Materials: Protocol 1-'definitive' chemoradiation. One hundred and thirty-seven patients have been treated with 'definitive' radiation to 60 Gy in 6 weeks plus two courses of cisplatin (80 mg/m 2 ) and infusional fluorouracil (800 mg/m 2 /day over 4 days) during the first and fourth weeks of radiation. Protocol 2-'preoperative' chemoradiation and surgery. Seventy-eight patients received chemoradiation using the same chemotherapy, but 30-35 Gy in 3-4 weeks prior to surgery. Protocol 3-'palliative' chemoradiation. Seventy-nine patients deemed incurable were treated 'palliatively' with the same chemoradiation protocol without surgery. Follow-up ranges from 6 months to 7 years (mean 22 months) in live patients. Results: Durable palliation of dysphagia in all three treatment groups has been reflected by encouraging 3-year survival expectations of 43.2 ± 5% in definitively treated patients, 40.3 ± 7.65% in surgically treated patients, and 8.5% ± 3.9% in the palliatively treated patients. There are early indications that female patients have fared better than males. Toxicity levels were modest in all three groups. Following definitive treatment, severe myelotoxicity (World Health Organization grades 3 and 4) occurred in 19%, severe esophagitis (World Health Organization grade 3) in 11%, and moderate or severe benign stricture in 17%, depending upon age and sex of the patient (being worse in female patients). Conclusions: These studies demonstrate that the concurrent addition of modest dose cisplatin and infusional dose fluorouracil to radiation in the definitive, preoperative, and palliative settings contribute to high rates of durable

  4. Betrayal trauma among homeless adults: associations with revictimization, psychological well-being, and health.

    Science.gov (United States)

    Mackelprang, Jessica L; Klest, Bridget; Najmabadi, Shadae J; Valley-Gray, Sarah; Gonzalez, Efrain A; Cash, Ralph E Gene

    2014-04-01

    Betrayal trauma theory postulates that traumas perpetrated by a caregiver or close other are more detrimental to mental health functioning than are traumatic experiences in which the victim is not affiliated closely with the perpetrator. This study is the first to examine the concept of betrayal among a sample of individuals with a history of homelessness. A total of 95 homeless or formerly homeless adults completed the Brief Betrayal Trauma Survey, the Posttraumatic Stress Disorder Checklist-Civilian Version, the Center for Epidemiologic Studies Depression Scale the Perceived Stress Scale, and a demographics questionnaire assessing participants' histories of homelessness, health, and relationships with their families. Regression analyses were conducted to explore the associations between high betrayal (HB) and low betrayal (LB) trauma exposure, relationship with family, and physical and mental health symptoms. Exposure to HB traumas in childhood and poor family relationships predicted earlier age at first episode of homelessness, and participants who had been exposed to a greater number of traumas during childhood were more likely to be revictimized during adulthood. Trauma exposure as an adult and earlier age of first homeless episode predicted symptoms of posttraumatic stress disorder, while trauma exposure alone predicted symptoms of depression and perceived stress. Number of medical diagnoses was associated with trauma exposure and becoming homeless at an older age. These findings emphasize that even among the most marginalized and multiply victimized individuals in our society, traumas that are characterized by a higher degree of betrayal are associated with more adverse outcomes.

  5. Trauma and the endocrine system.

    Science.gov (United States)

    Mesquita, Joana; Varela, Ana; Medina, José Luís

    2010-12-01

    The endocrine system may be the target of different types of trauma with varied consequences. The present article discusses trauma of the hypothalamic-pituitary axes, adrenal glands, gonads, and pancreas. In addition to changes in circulating hormone levels due to direct injury to these structures, there may be an endocrine response in the context of the stress caused by the trauma. Copyright © 2010 SEEN. Published by Elsevier Espana. All rights reserved.

  6. Trauma Systems. An Era of Development

    NARCIS (Netherlands)

    Lansink, K.W.W.

    2017-01-01

    The introduction of an inclusive trauma system in the Netherlands during last decade of the past century, has led to an improvement in Dutch trauma care. Eleven trauma regions were formed nationwide each surrounding a level I trauma center. All hospitals in a trauma region were assigned levels I, II

  7. Skeletal scintigraphy following incidental trauma

    International Nuclear Information System (INIS)

    Kim, H.R.; Thrall, J.H.; Keyes, J.W. Jr.

    1979-01-01

    The significance of antecedent trauma in skeletal scintigraphy was assessed in 503 patients, of whom 241 (46%) had prior fracture or tooth extraction. In patients with sufficiently accurate histories for site-by-site analysis, 33 of 131 fracture sites and 16 of 83 dental-procedure sites were positive scintigraphically. In general, the frequency of scan positivity diminished as the interval between trauma and scanning increased, but a significant number of patients showed prolonged uptake at fracture sites. Several patterns of uptake suggested trauma rather than metastatic disease. Knowledge of a history of trauma is often critical in bone scan interpretation

  8. The value of trauma registries.

    Science.gov (United States)

    Moore, Lynne; Clark, David E

    2008-06-01

    Trauma registries are databases that document acute care delivered to patients hospitalised with injuries. They are designed to provide information that can be used to improve the efficiency and quality of trauma care. Indeed, the combination of trauma registry data at regional or national levels can produce very large databases that allow unprecedented opportunities for the evaluation of patient outcomes and inter-hospital comparisons. However, the creation and upkeep of trauma registries requires a substantial investment of money, time and effort, data quality is an important challenge and aggregated trauma data sets rarely represent a population-based sample of trauma. In addition, trauma hospitalisations are already routinely documented in administrative hospital discharge databases. The present review aims to provide evidence that trauma registry data can be used to improve the care dispensed to victims of injury in ways that could not be achieved with information from administrative databases alone. In addition, we will define the structure and purpose of contemporary trauma registries, acknowledge their limitations, and discuss possible ways to make them more useful.

  9. Effectiveness of regionalization of trauma care services: a systematic review.

    Science.gov (United States)

    Vali, Y; Rashidian, A; Jalili, M; Omidvari, A H; Jeddian, A

    2017-05-01

    Improving trauma systems in various forms has always been an important aspect of health policy. While several papers have reported the implementation of a structured trauma system of care, research evidence on the effectiveness of such regionalization for improvement in trauma outcome is limited. Systematic review. Medline, EMbase, EconLit and Health Management Information Consortium were searched, using sensitive search terms, for interventional studies that reported a trauma regionalization system as their intervention, and compared important outcomes such as mortality and preventable deaths. At least two authors assessed eligibility for inclusion and risk of bias, and extracted data from the included studies. As meta-analysis was not possible for all studies, two controlled before-after studies were included in the meta-analysis, and a narrative analysis was conducted for the other studies. After title and abstract sifting, 66 papers were retrieved. After reading the full texts, a total of 24 studies from the USA, UK, Canada, Australia, and the Netherlands were included in this review. In spite of variation in study specifications, most were before-after studies with a high risk of bias. Although a reduction in mortality was shown in most studies, only two studies were eligible for meta-analysis, and the results showed a significant reduction in mortality after implementation of an organized trauma system (odds ratio 0.840, 95% confidence interval 0.756-0.924; P = 0.00). Correlation was found between a regionalized network of trauma care and a reduction in trauma-related mortality, based on studies that did not exclude the effects of other concurrent changes on observed reductions. It is recommended that more studies with robust research designs should be conducted in a more diverse range of countries to assess the effectiveness of regionalization. Despite this limitation, the present findings support the regionalization of trauma care services. Copyright

  10. Operation Brain Trauma Therapy

    Science.gov (United States)

    2012-10-01

    IL‐1B and MIP‐2  concentrations   reduced  NONE  Brain  conc at 4, 8,  12, or 24h; Dose  response seen;  5000 IV gave  highest  brain  conc  18/Xiong et...by the Operation Brain Trauma Therapy consortium Drugs Secondary Injury Mechanisms Inflammation Axonal Injury Excitotoxicity/ Neurotransmitter ...glutamatergic transmission in the prefrontal cortex of stroke-prone spontaneously hypertensive rats. Neurosci Lett. 2002;320:109–112. 45. Nakamura K

  11. Trauma und Terror

    OpenAIRE

    Szyszkowitz, T. (Tessa)

    2007-01-01

    1. Einleitung Ausgehend von der Fragestellung, warum gerade bei Tschetschenen und Palästinensern der Selbstmordterrorismus in den letzten Jahren so populär geworden ist, analysiert die Autorin die Geschichte dieser beiden Völker. Einer der Gründe ist bisher wenig beachtet worden. Der Einfluss eines kollektiven Traumas, das als solches nicht anerkannt, behandelt und auch nicht einer politischen Lösung zugeführt wurde. 2. Geschichte der Palästinenser und Tschetschenen Im Zuge der Err...

  12. Trauma Tapping Technique: Practical First Aid for Stress and Trauma

    African Journals Online (AJOL)

    Trauma Tapping Technique: Practical First Aid for Stress and Trauma. Marie Claire Gasanganwa1, Rebecca L White1. 1University of Rwanda, College of Medicine and Health Sciences, Rwanda. Background. Epidemiological studies on posttraumatic stress disorder (PTSD) show a lifetime prevalence rate of up to. 6.8%.

  13. From trauma debriefing to trauma support: A South African ...

    African Journals Online (AJOL)

    This is the basis of the current model used by Traumaclinic. The principles of that model are summarised and examples given of the application of the approach to specific cases. Keywords: acute stress disorder, critical incident stress debriefing, trauma recovery, trauma support. Journal of Psychology in Africa 2005, 15(2): ...

  14. Trauma-Focused CBT for Youth with Complex Trauma

    Science.gov (United States)

    Cohen, Judith A.; Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.

    2012-01-01

    Objectives: Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive…

  15. Looking back at the John Mitchell Crouch Fellowship: the most prestigious research award of the Royal Australasian College of Surgeons.

    Science.gov (United States)

    Boult, Margaret; Babidge, Wendy; Pleass, Susan; Scott, David

    2015-10-01

    The John Mitchell Crouch Fellowship is a generous endowment made to the Royal Australasian College of Surgeons (RACS) by the young neurosurgeon's family, following his death from a brain tumour. In this article, we examine the significance and legacy of the grant since its inception in 1979. This is the highest level of research fellowship awarded by the RACS recognizing early career excellence, as part of its significant research funding programme (over $1.7 million in 2015). John Mitchell Crouch recipients have been pioneers in various areas of medicine where they have developed new technologies, established research centres, improved patient safety and military surgery and embraced evidence-based medicine. The funds they received have directly contributed to research published in numerous highly respected peer-reviewed journals such as The New England Journal of Medicine; established new laboratories, helped fund clinical trials and allowed new directions of research to be pursued. Recipients of the John Mitchell Crouch Fellowship have been recognized with many awards including 11 Australian and New Zealand Honours to date. Many other significant research funds have been subsequently bestowed, including over 120 National Health Medical Research Council (NHMRC) grants to Australian and New Zealand recipients subsequent to their Fellowship. This article also shows the range of disciplines in which the award has supported cutting-edge research leading to benefits for patients and health care. © 2015 Royal Australasian College of Surgeons.

  16. Australasian nutrition research for prevention and management of child obesity: innovation and progress in the last decade.

    Science.gov (United States)

    Golley, R K; McNaughton, S A; Collins, C E; Magarey, A; Garnett, S P; Campbell, K J; Mallan, K; Burrows, T

    2014-12-01

    The Food and Nutrition stream of Australasian Child and Adolescent Obesity Research Network (ACAORN) aims to improve the quality of dietary methodologies and the reporting of dietary intake within Australasian child obesity research (http://www.acaorn.org.au/streams/nutrition/). With 2012 marking ACAORN's 10th anniversary, this commentary profiles a selection of child obesity nutrition research published over the last decade by Food and Nutrition Stream members. In addition, stream activities have included the development of an online selection guide to assist researchers in their selection of appropriate dietary intake methodologies (http://www.acaorn.org.au/streams/nutrition/dietary-intake/index.php). The quantity and quality of research to guide effective child obesity prevention and treatment has increased substantially over the last decade. ACAORN provides a successful case study of how research networks can provide a collegial atmosphere to foster and coordinate research efforts in an otherwise competitive environment. © 2014 The Authors. Pediatric Obesity © 2014 International Association for the Study of Obesity.

  17. Developing the Australasian Hepatology Association's Consensus-based Guidelines for the Nursing Care of Patients with Liver Disease.

    Science.gov (United States)

    Richmond, Jacqueline; Wheeler, Emily; Warner, Sherryne; Mason, Susan

    2014-05-03

    Abstract Purpose: Hepatology nursing is an emerging speciality. To define best practice, the Australasian Hepatology Association developed consensus-based guidelines for the nursing care of patients with liver disease. Methods: Using the Delphi technique, six rounds of consultation were conducted with Australian hepatology nurses and non-nursing hepatology professionals. Input was captured through face-to-face and electronic communication and questionnaires. Results: The experts' opinions were collated and consensus on the delivery of hepatology nursing care was achieved. In total, 90 consensus guidelines were developed. The principles underpinning the Guidelines include patient-centred care, non-discriminatory practice, cultural competence, collaboration and partnership and working within own scope of practice. Conclusion: Internationally, the Australasian Hepatology Association Guidelines are the first to document a consensus on the scope of hepatology nursing practice. The Guidelines reflect the expansion of hepatology nursing, from viral hepatitis to caring for patients with advanced liver disease and hepatocellular carcinoma, and provides a framework for future nursing practice.

  18. [Trauma and pregnancy: Is the Kleihauer-Betke test really useful?

    Science.gov (United States)

    Girard, M; Marchand, F; Uch, R; Bretelle, F

    2017-11-01

    To evaluate the pertinence of Kleihauer-Betke (KB) test, in case of abdominal trauma during pregnancy in forecast of fetal outcomes, according to trauma severity. A single-center retrospective study conducted between January 2014 and April 2016 in a maternity type III and a trauma center, which included the pregnant women admitted for abdominal trauma. The trauma's severity was assessed using the guidelines of the Society of Obstetricians and Gynaecologists of Canada. The impact of a positive KB test, defined as>0.1%, was analyzed. Adverse outcome was defined as one or more of the following complications: intrauterine fetal death, placental abruption, pre-term birth<37 weeks of gestation, and fetal or neonatal anemia. During the study period, 265 pregnancies involved into an abdominal trauma were included: 69% with a minor trauma and 31% with a severe trauma. Of all patients, 5.6% presented a positive KB test, among then 15.4% had an adverse outcome. There was no significant difference in the rate of adverse outcomes in the positive KB group and the KB negative group either in the overall population (P=0.16), in the minor trauma population (P=1) or in the major trauma population (P=0.14). The predictive positive values were respectively in the global population, in the minor trauma group and in the severe trauma group 15.4%, 0% and 25%. The KB test does not seem to be useful in case of trauma during pregnancy to define adverse outcome. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Facial nerve palsy due to birth trauma

    Science.gov (United States)

    Seventh cranial nerve palsy due to birth trauma; Facial palsy - birth trauma; Facial palsy - neonate; Facial palsy - infant ... to this condition. Some factors that can cause birth trauma (injury) include: Large baby size (may be ...

  20. Urinary tract trauma

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, J.E. (Sunnybrook Medical Centre, Toronto, Ontario (Canada))

    1983-09-01

    From a practical point of view, a woman who has blunt injury to the pelvic area with hematuria from the lower urinary tract, has a contused or ruptured bladder. In a man, such a situation calls for retrograde urethrography to determine if the injury is in the urethra or the bladder because the two organs are investigated differently. In both sexes, such injuries are usually associated with pelvic fractures. Massive bladder displacement and severe hemorrhage should alert one to the need for pelvic angiography to find and embolize the bleeding site within the first 24 hours after injury. For blunt trauma to the upper urinary tract an intravenous urogram with tomography is still the main examination. However, a normal intravenous urogram does not exclude serious injury. Therefore, if signs or symptoms persist, a computerized tomographic (CT) examination should be performed if available. Otherwise, a radionuclide study is advisable. Non-excretion on intravenous urography with tomography calls for selective renal arteriography to delineate the etiology. There can be serious renal trauma in the absence of hematuria, which may occur with renal pedicle injury or avulsion of the ureter. Minor forniceal ruptures may occasionally mask severe posterior renal lacerations.

  1. [Cervical spine trauma].

    Science.gov (United States)

    Yilmaz, U; Hellen, P

    2016-08-01

    In the emergency department 65 % of spinal injuries and 2-5 % of blunt force injuries involve the cervical spine. Of these injuries approximately 50 % involve C5 and/or C6 and 30 % involve C2. Older patients tend to have higher spinal injuries and younger patients tend to have lower injuries. The anatomical and development-related characteristics of the pediatric spine as well as degenerative and comorbid pathological changes of the spine in the elderly can make the radiological evaluation of spinal injuries difficult with respect to possible trauma sequelae in young and old patients. Two different North American studies have investigated clinical criteria to rule out cervical spine injuries with sufficient certainty and without using imaging. Imaging of cervical trauma should be performed when injuries cannot be clinically excluded according to evidence-based criteria. Degenerative changes and anatomical differences have to be taken into account in the evaluation of imaging of elderly and pediatric patients.

  2. Management of liver trauma.

    LENUS (Irish Health Repository)

    Badger, S A

    2012-02-01

    BACKGROUND: Blunt and penetrating liver trauma is common and often presents major diagnostic and management problems. METHODS: A literature review was undertaken to determine the current consensus on investigation and management strategies. RESULTS: The liver is the most frequently injured organ following abdominal trauma. Immediate assessment with ultrasound has replaced diagnostic peritoneal lavage in the resuscitation room, but computerised tomography remains the gold standard investigation. Nonoperative management is preferred in stable patients but laparotomy is indicated in unstable patients. Damage control techniques such as perihepatic packing, hepatotomy plus direct suture, and resectional debridement are recommended. Major complex surgical procedures such as anatomical resection or atriocaval shunting are now thought to be redundant in the emergency setting. Packing is also recommended for the inexperienced surgeon to allow control and stabilisation prior to transfer to a tertiary centre. Interventional radiological techniques are becoming more widely used, particularly in patients who are being managed nonoperatively or have been stabilised by perihepatic packing. CONCLUSIONS: Management of liver injuries has evolved significantly throughout the last two decades. In the absence of other abdominal injuries, operative management can usually be avoided. Patients with more complex injuries or subsequent complications should be transferred to a specialist centre to optimise final outcome.

  3. Ballistic Trauma of Limbs

    Science.gov (United States)

    Lamah, Léopold; Keita, Damany; Marie Camara, Ibrahima; Lamine Bah, Mohamed; Sory, Sidimé; Diallo, Mamadou Moustapha

    2017-01-01

    The objective of our study was to report the management and follow-up of a particular case of ballistic trauma and to do the literature review. Observation: A 35-year-old patient, a trader who was the victim of a firearm accident under not very clear circumstances. He was admitted to the emergency department after 3 hours. Clinically, the patient had significant bleeding in the arm and was in a state of clouding of consciousness. We could notice on the right arm, a posterior large transfixing wound of 1 cm and a 6 cm one on the antero-internal side. The limb was cold with a small and thready pulse. Sensitivity was decreased in the radial nerve area. The radiograph showed bone comminution from the middle 1/3 to the superior 1/3 of the humeral diaphysis. The treatment was orthopedic (after debridement) by scapula-brachio-ante-brachiopalmar plaster splint with thoracic strap. The wound healed in 46 days and the patient resumed his activities after 11 months and 2 weeks. Conclusion: The authors presented the value of using the scapulo-brachio-palmar plaster splints with thoracic strap in some severe upper limb trauma in the absence of the external fixator. PMID:28567155

  4. Trauma and dissociation: treatment perspectives.

    Science.gov (United States)

    Kreidler, M C; Zupancic, M K; Bell, C; Longo, M B

    2000-01-01

    How advanced practice nurses can work with trauma survivors to decrease dissociation as a needed coping mechanism. To review the literature on trauma and dissociation as well as current treatment perspectives. Review of the literature and authors' clinical experience. Advanced practice nurses can use knowledge of selected psychopharmacological medications and Erikson's stages of psychosocial development to plan treatment for posttrauma clients.

  5. Sexual Trauma, Spirituality, and Psychopathology

    Science.gov (United States)

    Krejci, Mark J.; Thompson, Kevin M.; Simonich, Heather; Crosby, Ross D.; Donaldson, Mary Ann; Wonderlich, Stephen A.; Mitchell, James E.

    2004-01-01

    This study assessed the association between spirituality and psychopathology in a group of sexual abuse victims and controls with a focus on whether spirituality moderated the association between sexual trauma and psychopathology. Seventy-one sexual trauma victims were compared to 25 control subjects on spiritual well-being, the Eating Disorder…

  6. Bone scintigraphy in children: trauma

    Energy Technology Data Exchange (ETDEWEB)

    Harcke, H.T. (Alfred I. du Pont Institute, Wilmington, DE (USA))

    1983-12-01

    The sensitivity of radionuclide imaging in identifying skeletal trauma in children has been established. Growth plates present a set of problems unique to pediatric studies and diagnotic accuracy is very technique dependent. Imaging for sports injuries and suspected child abuse has been productive. An expanding role for bone scintigraphy in the management of orthopedic problems post-trauma is developing.

  7. Clinical management of abdominal trauma.

    Science.gov (United States)

    Fang, Guo-en; Luo, Tian-hang; DU, Cheng-hui; Bi, Jian-wei; Xue, Xu-chao; Wei, Guo; Weng, Zhao-zhang; Ma, Li-ye; Hua, Ji-de

    2008-08-01

    To improve the prognosis of patients with abdominal trauma. Between January 1993 and December 2005, 415 patients were enrolled in this research. The patients consisted of 347 males and 68 females with mean age of 36 years (ranging from 3-82 years). All abdominal traumas consisted of closed traumas (360 cases, 86.7%) and open traumas (55 cases, 13.3%). A total of 407 cases (98.1%) were fully recovered from trauma and the other 8 cases (1.9%) died of multiple injuries. The mean injury severity score (ISS) of all patients was 22 while the mean ISS of the patients who died in hospital was 42. Postoperative complications were seen in 9 patients such as infection of incisional wounds (6 cases), pancreatic fistula (2 cases) and intestinal fistula (1 case). All these postoperative complications were cured by the conservative treatment. Careful case history inquisition and physical examination are the basic methods to diagnose abdominal trauma. Focused abdominal ultrasonography is always the initial imaging examination because it is non-invasive and can be performed repeatedly with high accuracy. The doctors should consider the severity of local injuries and the general status of patients during the assessment of abdominal trauma. The principle of treatment is to save lives at first, then to cure the injuries. Unnecessary laparotomy should be avoided to reduce additional surgical trauma.

  8. Bone scintigraphy in children: trauma

    International Nuclear Information System (INIS)

    Harcke, H.T.

    1983-01-01

    The sensitivity of radionuclide imaging in identifying skeletal trauma in children has been established. Growth plates present a set of problems unique to pediatric studies and diagnotic accuracy is very technique dependent. Imaging for sports injuries and suspected child abuse has been productive. An expanding role for bone scintigraphy in the management of orthopedic problems post-trauma is developing [fr

  9. Spinal trauma. An imaging approach

    International Nuclear Information System (INIS)

    Cassar-Pullicino, V.N.; Imhof, H.

    2006-01-01

    The diagnosis of trauma to the spine - where the slightest oversight may have catastrophic results - requires a thorough grasp of the spectrum of resultant pathology as well as the imaging modalities used in making an accurate diagnosis. In Spinal Trauma, the internationally renowned team of experts provides a comprehensive, cutting-edge exposition of the current vital role of imaging in the diagnosis and treatment of injuries to the axial skeleton. Beginning with a valuable clinical perspective of spinal trauma, the book offers the reader a unique overview of the biomechanics underlying the pathology of cervical trauma. Acute trauma topics include: - Optimization of imaging modalities - Malalignment - signs and significance - Vertebral fractures - detection and implications - Classification of thoraco-lumbar fractures - rationale and relevance - Neurovascular injury. Distilling decades of clinical and teaching expertise, the contributors further discuss the current role of imaging in special focus topics, which include: - The pediatric spine - Sports injuries - The rigid spine - Trauma in the elderly - Vertebral collapse, benign and malignant - Spinal trauma therapy - Vertebral fractures and osteoporosis - Neuropathic spine. All throughout the book, the focus is on understanding the injury, and its implications and complications, through 'an imaging approach'. Lavishly illustrated with hundreds of superb MR images and CT scans, and clear full-color drawings, the authors conclude with a look into the future, defining clinical trends and research directions. Spinal Trauma - with its broad scope, practical imaging approach, and current focus - is designed to enhance confidence and accuracy, making it essential reading for clinicians and radiologists at all levels. (orig.)

  10. Novel insights in elbow trauma

    NARCIS (Netherlands)

    Claessen, F.M.A.P.

    2016-01-01

    Musculoskeletal trauma is among the ten most common causes for loss of healthy life years (disability adjusted life years) in Western Countries. Nine percent of all musculoskeletal trauma is related to the elbow; in athletes the prevalence is 11 percent. Approximately 80 percent of patients that had

  11. [The TraumaRegister DGU® as the basis of medical quality management. Ten years experience of a national trauma centre exemplified by emergency room treatment].

    Science.gov (United States)

    Helm, M; Bitzl, A; Klinger, S; Lefering, R; Lampl, L; Kulla, M

    2013-07-01

    The trauma register of the German Society of Trauma Surgery (TraumaRegister DGU®/TR-DGU) has been proven to be a valuable tool for external assessment of quality in the treatment of patients with major trauma. This publication shows for the first time how the quality of trauma treatment in a level I trauma centre could be improved over a period of almost ten years with the help of continuous quality management, i.e. recognizing a problem, developing a solution and evaluating its effect. Tracer parameters and indicators of quality are presented in four periods over a total study period from 1st January 1989 to 31st March 2007. The division into four periods is due to major changes in the trauma treatment algorithms or structural changes in the trauma room. The results are displayed for all patients treated in the trauma room and for those patients with an injury severity score (ISS)≥16. Over all four periods a total number of n=2,239 patients were admitted to the trauma room. Based on the results of the trauma register a number of changes were made, not only structural changes, such as the introduction of point-of-care diagnostics, initially conventional X-ray, then digital X-ray and finally multislice computed tomography (CT) scanning in the trauma room but also changes in the way personnel participating in the trauma treatment are trained. Advanced trauma life support (ATLS®) has become the standard training for doctors and prehospital trauma life support (PHTLS®) for nurses. Time efficient treatment algorithms were introduced. All measures led to changes in several parameters which are chosen as indicators for good treatment quality. It was for instance possible to reduce the average total trauma treatment time for patients with an ISS≥16 from initially 90.9±48.6 min to 37.4±18.  min in the final study period. The external quality management performed by the TR-DGU has proved to be a constant source of inspiration. The effects of the changes made can

  12. Prehospital Trauma Care in Singapore.

    Science.gov (United States)

    Ho, Andrew Fu Wah; Chew, David; Wong, Ting Hway; Ng, Yih Yng; Pek, Pin Pin; Lim, Swee Han; Anantharaman, Venkataraman; Hock Ong, Marcus Eng

    2015-01-01

    Prehospital emergency care in Singapore has taken shape over almost a century. What began as a hospital-based ambulance service intended to ferry medical cases was later complemented by an ambulance service under the Singapore Fire Brigade to transport trauma cases. The two ambulance services would later combine and come under the Singapore Civil Defence Force. The development of prehospital care systems in island city-state Singapore faces unique challenges as a result of its land area and population density. This article defines aspects of prehospital trauma care in Singapore. It outlines key historical milestones and current initiatives in service, training, and research. It makes propositions for the future direction of trauma care in Singapore. The progress Singapore has made given her circumstances may serve as lessons for the future development of prehospital trauma systems in similar environments. Key words: Singapore; trauma; prehospital emergency care; emergency medical services.

  13. Evaluating trauma care capabilities in Mexico with the World Health Organization's Guidelines for Essential Trauma Care publication La evaluación de los recursos para el tratamiento de heridos en México a la luz de las pautas publicadas por la Organización Mundial de la Salud, Guidelines for Essential Trauma Care

    OpenAIRE

    Carlos Arreola-Risa; Charles Mock; Felipe Vega Rivera; Eduardo Romero Hicks; Felipe Guzmán Solana; Giovanni Porras Ramírez; Gilberto Montiel Amoroso; Melanie de Boer

    2006-01-01

    OBJECTIVE: To identify affordable, sustainable methods to strengthen trauma care capabilities in Mexico, using the standards in the Guidelines for Essential Trauma Care, a publication that was developed by the World Health Organization and the International Society of Surgery to provide recommendations on elements of trauma care that should be in place in the various levels of health facilities in all countries. METHODS: The Guidelines publication was used as a basis for needs assessments con...

  14. Trauma cardiaco cerrado

    Directory of Open Access Journals (Sweden)

    Camilo Alvarado

    2016-01-01

    Full Text Available El trauma cardiaco constituye una de las primeras causas de mortalidad en la población general. Requiere alto índice de sospecha en trauma cerrado severo, mecanismo de desaceleración y en presencia de signos indirectos como: equimosis, huella del volante o del cinturón en el tórax anterior. Las lesiones incluyen: conmoción cardiaca, ruptura cardiaca, lesión cardiaca indirecta como la trombosis coronaria aguda, lesión aórtica, lesión del pericardio y herniación cardiaca. Entre las manifestaciones clínicas están: la angina refractaria a nitratos, el dolor pleurítico, la hipotensión arterial, la taquicardia, la ingurgitación yugular que aumenta con la inspiración, el galope por tercer ruido, el frote pericárdico, los soplos de reciente aparición, los estertores crepitantes por edema pulmonar. El electrocardiograma es el primer eslabón en el algoritmo diagnóstico con hallazgos como: la taquicardia sinusal, los complejos ventriculares prematuros, la fibrilación auricular, el bloqueo de rama derecha y los bloqueos auriculoventriculares. La radiografía de tórax ayuda a descartar lesiones adicionales óseas y pulmonares. La troponina I tiene un valor predictivo negativo del 93% para el trauma cardiaco, otras enzimas como la creatina quinasa total y la creatina quinasa fracción MB son menos específicas. El ecocardiograma está indicado en caso de hipotensión persistente, electrocardiograma con alteraciones o falla cardiaca aguda. El tratamiento incluye la estabilización inicial y un manejo específico de las lesiones. Entre las complicaciones se incluyen: el taponamiento cardiaco, la contusión miocárdica, el síndrome coronario agudo, las arritmias cardíacas y la lesión aórtica. El pronóstico se determina en mayor medida por los signos vitales al ingreso y la presencia de paro cardiaco durante el abordaje inicial.

  15. Radiology of trauma to kidney and lower urinary tract

    International Nuclear Information System (INIS)

    Dorph, S.

    1995-01-01

    The contents are trauma to kidney, imaging of kidney trauma, management of renal trauma, delayed complications, trauma to the lower urinary tract, trauma to urinary bladder, radiologic diagnosis, ethiology of blunt bladder injury, urethal injury (6 refs.)

  16. Head trauma and CT

    International Nuclear Information System (INIS)

    Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitoshi

    1979-01-01

    In our cases of acute and subacute subdural hematoma, the use of CT was evaluated. In our department of surgery, acute subdural hematoma was found in 46 of 388 patients of head trauma who underwent CT. Acute subdural hematoma, like epidural hematoma was usually visualized as a high-density area along the cranial inner table, and this was easily differenciated from epidural hematoma because of difference in shape from the other. The picture of acute subdural hematoma was occasionally confused with that of intracerebral hematoma or cerebral contusion. Single use of CT does not differenciate subacute subdural hematoma from chronic subdural hematoma. However, CT usually visualized acute hematoma as a high-density area, showing the extent of hematoma. Comparison of the thickness of hematoma with the axis deviation of the median part such as the 3rd cerebral ventricle suggested severity of cerebral edema. CT also revealed bilateral or multiple lesions of cerebral contusion or intracerebral hematoma. (Ueda, J.)

  17. Trauma-affected refugees

    DEFF Research Database (Denmark)

    Sonne, Charlotte Kærgaard

    2016-01-01

    treatment outcome for this patient group. Methods: This thesis includes four papers based on two studies – a literature review and a randomised trial called PTF3: The aim of the literature review was to provide an overview of the existing literature on the pharmacological treatment of refugees with PTSD and....... The aim of PTF3 was to examine differences in the effects of venlafaxine and sertraline on Post-traumatic Stress Disorder (PTSD), depression and functional impairments in trauma-affected refugees as well as research predictors for treatment outcome. The patients included were 207 adult refugees diagnosed...... with PTSD and/or depression who had their first appointment at Competence Centre for Transcultural Psychiatry (CTP) between April 1st 2012 and September 16th 2013. Patients were randomised into one of the two treatment groups: a sertraline group (n=109) or a venlafaxine group (n=98). Patients in both groups...

  18. The management of children with bronchiolitis in the Australasian hospital setting: development of a clinical practice guideline.

    Science.gov (United States)

    O'Brien, Sharon; Wilson, Sally; Gill, Fenella J; Cotterell, Elizabeth; Borland, Meredith L; Oakley, Edward; Dalziel, Stuart R

    2018-02-12

    Bronchiolitis is the commonest respiratory infection in children less than 12 months and cause of hospitalisation in infants under 6 months of age in Australasia. Unfortunately there is substantial variation in management, despite high levels of supporting evidence. This paper reports on the process, strengths and challenges of the hybrid approach used to develop the first Australasian management guideline relevant to the local population. An adaption of the nine steps recommended by the National Health and Medical Research Council (NHMRC) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology were utilised. Following establishment of the Guideline Development Committee (GDC), we identified the population, intervention, comparator, outcomes and time of interest (PICOt) questions, undertook a systematic literature search and graded the evidence and recommendations using the NHMRC and GRADE processes. Using Nominal Group Techniques (NGT), consensus was sought in formulating the clinical practice recommendations and practice points. Key health professional bodies were consulted to ensure relevance in the Australasian emergency and ward settings. From 33 PICOT questions, clinical recommendations for practice that were deemed relevant to the Australasian population were identified. Specific considerations for the management of Australian and New Zealand indigenous infants in relation to the use of azithromycin and risk factors for more serious illness are included. Using NGT, consensus demonstrated by a median Likert score > 8 for all recommendations was achieved. The guideline presents clinical guidance, followed by the key recommendations and evidence review behind each recommendation. Developing evidence-based clinical guidelines is a complex process with considerable challenges. Challenges included having committee members located over two countries and five time zones, large volume of literature and variation of member

  19. COMMUNISM AND THE TRAUMA OF ITS COLLAPSE REVISITED.

    Science.gov (United States)

    Schmidt-Löw-Beer, Catherine; Atria, Moira; Davar, Elisha

    2015-12-01

    This paper focuses on the intertwinement of society and the psyche as a consequence of 70 years of Communist rule and the trauma of its collapse in the 90's. The trauma had profound effects on the psyche. An empirical study that was carried out in 1996/1997, which compared the personality structure of adolescents from Russia and Austria, and a research dialogue in 1999, has been re-evaluated in the light of current political events. One aim that we had was to find out whether we could discover characteristic personality features, resulting from the Communist totalitarian society in Russia, as well as from the trauma of its collapse. This led to the development of the concepts of the "impersonal self" and the "denial mode". The Russians seemed to be frozen in a protective shell with "flat" affects. They were anxious, conflict avoidant, and somewhat lost. Ideas about missing adolescence and the importance of privacy are discussed. Society was shown to not only have intruded into the individual psyche, but also into the members of the intercultural research team in the form of projective identification. The importance of the interaction between society and the individual as a basic psychoanalytic concept dating back to Freud is elaborated. Finally, considerations pertaining to mental health and democracy are presented.

  20. Unregulated and unsafe: the impact of motorcycle trauma on Queensland children.

    Science.gov (United States)

    Pym, Aaron J; Wallis, Belinda A; Franklin, Richard C; Kimble, Roy M

    2013-06-01

    To describe paediatric (0-15 years) motorcycle incidents in Queensland, inform safety policy and identify opportunities to improve data in this area. Population-based study of motorcycle-related child (0-15 years) trauma, resulting in fatality or hospital admission beyond 24 h to any Queensland public hospital (2007-2009). Data compiled by Statewide Trauma Network and Commission for Children and Young People and Child Guardian. Ten child fatalities were recorded (child death rate = 0.36/100,000 population 0-15 years). All were male and primary riders of their motorcycle. Nine fatalities were related to head injury; of these, five wore inadequate head protection. The coroner identified rider factors as contributory (speed, age or substance abuse) in seven cases. Motorcycle-related incidents were the second most common mechanism recorded after bicycles, comprising 6.8% of 9141 paediatric trauma cases (619 motorcycle-related incidents; 1225 injuries; admission rate = 22.2/100,000 population 0-15 years). Compared with the all-trauma population, patients were older (median age = 13 vs. 10 years) and more frequently male (85% vs. 67%). Average admission was 4.4 days (head injuries = 7.0 days; burns = 5.8 days). Most children incurred >1 injury (mean = 2.01 injuries) with fractures (45%) and open wounds (17%) most common. As a proportion of all diagnoses, most injuries were to lower limb (44%), upper limb (26%) or head and neck (16%). These data emphasise the need for children to use full protective equipment, especially helmets. Children are not currently protected by legislation mandating safety standards. Regulating rider age and safety standards (protective equipment, training and vehicle maintenance) may reduce the rate and severity of injury. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  1. Effects of Sleep after Experimental Trauma on Intrusive Emotional Memories.

    Science.gov (United States)

    Kleim, Birgit; Wysokowsky, Julia; Schmid, Nuria; Seifritz, Erich; Rasch, Björn

    2016-12-01

    To investigate sleep's effect in the immediate aftermath of experiencing an analog trauma in the laboratory on reducing intrusive emotional memory formation. Sixty-five healthy women were exposed to an experimental laboratory trauma. They viewed a neutral and a trauma film in the laboratory and were randomly allocated to either a group that slept following film viewing or a group that remained awake. Sleep was recorded with electroencephalogram in a subgroup of participants in the sleep group. All participants recorded intrusive memories in the week following the film. The sleep group experienced fewer and less distressing intrusive trauma memories compared to the wake group. These effects were particularly evident toward the end of the week. Duration spent in stage N2 as opposed to light N1 sleep, a higher number of fast parietal sleep spindles and a lower rapid eye movement sleep density predicted intrusion frequency. Our results have clinical implications and set the ground for early-intervention sleep studies following trauma and prevention of chronic posttrauma disorders. © 2016 Associated Professional Sleep Societies, LLC.

  2. Prevalence, etiology, and types of dental trauma in children and adolescents: systematic review and meta-analysis.

    Science.gov (United States)

    Azami-Aghdash, Saber; Ebadifard Azar, Farbod; Pournaghi Azar, Fatemeh; Rezapour, Aziz; Moradi-Joo, Mohammad; Moosavi, Ahmad; Ghertasi Oskouei, Sina

    2015-01-01

    Dental traumas are common among children and adolescents in many societies posing health and social problems. The aim of this study was to conduct a systematic review and meta-analysis on prevalence, etiology, types, and other epidemiologic aspects of dental trauma in children and adolescents (0-18 years old). In this systematic meta-analytical review, data were collected searching for key words including traumatic dental injuries, dental trauma, dental injury, dental trauma, tooth injuries, tooth trauma, traumatized teeth, dentoalveolar trauma, oral trauma, epidemiology, etiology, prevalence, incidence, occurrence, child*, and adolescence in the following databases: Scopus, CINAHL, Science Direct, PubMed and Google scholar. From the total of 3197 articles, 44 completely relevant papers were included in the study. The prevalence of dental trauma was variable based on geographical area and was estimated 17.5% in the population, with higher prevalence in boys. Falling was the major cause for dental trauma, and the most frequent location was home. The most frequent type of trauma was enamel fracture. A relatively high prevalence was detected for dental trauma, which calls for effective planning and intervention to prevent the occurrence in children and adolescents. These may include special care for children, eliminating fall-prone areas, installing safety measures at homes, using protective appliances in sports, education, and raising the knowledge and availability of services to address enamel fracture. Region-specific criteria should be taken into account in programs and interventions.

  3. Profiles of Childhood Trauma in Patients with Alcohol Dependence and Their Associations with Addiction-Related Problems.

    Science.gov (United States)

    Lotzin, Annett; Haupt, Lena; von Schönfels, Julia; Wingenfeld, Katja; Schäfer, Ingo

    2016-03-01

    The high occurrence of childhood trauma in individuals with alcohol dependence is well-recognized. Nevertheless, researchers have rarely studied which types of childhood trauma often co-occur and how these combinations of different types and severities of childhood trauma are related to the patients' current addiction-related problems. We aimed to identify childhood trauma profiles in patients with alcohol dependence and examined relations of these trauma profiles with the patients' current addiction-related problems. In 347 alcohol-dependent patients, 5 types of childhood trauma (sexual abuse, physical abuse, emotional abuse, emotional neglect, and physical neglect) were measured using the Childhood Trauma Questionnaire. Childhood trauma profiles were identified using cluster analysis. The patients' current severity of addiction-related problems was assessed using the European Addiction Severity Index. We identified 6 profiles that comprised different types and severities of childhood trauma. The patients' trauma profiles predicted the severity of addiction-related problems in the domains of psychiatric symptoms, family relationships, social relationships, and drug use. Childhood trauma profiles may provide more useful information about the patient's risk of current addiction-related problems than the common distinction between traumatized versus nontraumatized patients. Copyright © 2016 by the Research Society on Alcoholism.

  4. Emergency Department Management of Trauma

    DEFF Research Database (Denmark)

    MacKenzie, Colin; Lippert, Freddy

    1999-01-01

    services (EMS) response times and advanced prehospital care increase the number of critically injured patients surviving sufficiently long to reach a hospital “in extremis.” Both scenarios provide challenges in the management of traumatized patients. This article addresses the management of severely......Initial assessment and management of severely injured patients may occur in a specialized area of an emergency department or in a specialized area of a trauma center. The time from injury until definitive management is of essence for survival of life-threatening trauma. The initial care delivered...... injured patients after these patients reach a hospital emergency department or a trauma center....

  5. Trauma complexity and child abuse

    DEFF Research Database (Denmark)

    Riber, Karin

    2017-01-01

    a “Trauma Coding Manual” developed for this study, trauma types were identified in interview transcripts. In both men and women with Iraqi and Palestinian-Lebanese backgrounds, high levels of trauma complexity and high rates of childhood maltreatment were found (63%, n = 27). A number of concepts...... and categories emerged in the domains childhood physical abuse (CPA), childhood emotional abuse (CEA), and neglect. Participants articulated wide personal impacts of child abuse in emotional, relational, and behavioral domains in their adult lives. These narratives contribute valuable clinical information...

  6. Developing the Australasian Hepatology Association's consensus-based guidelines for the nursing care of patients with liver disease.

    Science.gov (United States)

    Richmond, Jacqueline; Wheeler, Emily; Warner, Sherryne; Mason, Susan

    2014-01-01

    Abstract Purpose: Hepatology nursing is an emerging speciality. To define best practice, the Australasian Hepatology Association (AHA) developed consensus-based guidelines for the nursing care of patients with liver disease. Using the Delphi technique, six rounds of consultation were conducted with Australian hepatology nurses and non-nursing hepatology professionals. Input was captured through face-to-face and electronic communication and questionnaires. The experts' opinions were collated and consensus on the delivery of hepatology nursing care was achieved. In total, 90 consensus guidelines were developed. The principles underpinning the Guidelines include patient-centred care, non-discriminatory practice, cultural competence, collaboration and partnership and working within own scope of practice. Internationally, the AHA Guidelines are the first to document a consensus on the scope of hepatology nursing practice. The Guidelines reflect the expansion of hepatology nursing, from viral hepatitis to caring for patients with advanced liver disease and hepatocellular carcinoma, and provides a framework for future nursing practice.

  7. Search for the 700,000-year-old source crater of the Australasian tektite strewn field

    Science.gov (United States)

    Schnetzler, C. C.; Garvin, J. B.

    1992-01-01

    Many tektite investigations have hypothesized that the impact crater that was the source of the extensive Australasian strewn field lies somewhere in or near Indochina. This is due to variations in abundance and size of tektites across the strewn field, variation of thickness of microtektite layers in ocean cores, nature and ablation characteristics across the field, and, above all, the occurrence of the large, blocky, layered Muong Nong-type tektites in Indochina. A recent study of the location and chemistry of Muong Nong-type and splash-form tektites suggests that the source region can be further narrowed to a limited area in eastern Thailand and southern Loas. Satellite multispectral imagery, a digital elevation dataset, and maps showing drainage patterns were used to search within this area for possible anomalous features that may be large degraded impact craters. Four interesting structures were identified from these datasets, and they are presented.

  8. New Geographies of Accumulation, Globalising Firm Networks and the Role of the Auckland Region in the Australasian Economy

    Directory of Open Access Journals (Sweden)

    Richard Le Heron

    2012-01-01

    Full Text Available Surprisingly little theoretical or empirical research is available on Auckland’s actual functional and geographic connectivity, including developments relating to closer economic relations with Australia. This paper draws on the geography of accumulation literatures to argue that close attention must be given to developments in the three circuits of capital (trade, production and finance if the changing character and contributions of globalising firm networks are to be discerned and understood. The empirical investigations show that for Australian owned firms globalising rather than purely Australasian networks are the norm, network complexity is considerable and that it makes sense to think of Auckland’s economy in globalising terms. A globalising networks perspective means that estimates of the magnitude and assessments of the character of employment contributions of Australian owned firms to the Auckland economy reflects these interdependencies.

  9. Scoliosis Research Society

    Science.gov (United States)

    Scoliosis Research Society Close Menu Member Login Become a Member Home Find a Specialist | Calendar Contact | Donate ... a Member Find a Specialist Calendar Contact Donate Scoliosis Research Society Dedicated to the optimal care of ...

  10. American Society of Echocardiography

    Science.gov (United States)

    American Society of Echocardiography Join Ase Renew Member Portal Log In Membership Member Portal Log In Join ASE Renew Benefits Rates FASE – Fellow of the American Society of Echocardiography Member Referral Program FAQs Initiatives Advocacy Awards, Grants, ...

  11. Publication rate of General Surgery abstracts presented at the Royal Australasian College of Surgeons Annual Scientific Congress.

    Science.gov (United States)

    Khajehnoori, Masoomeh; Stupart, Douglas; Watters, David

    2017-07-06

    A commonly used metric for evaluating the quality and impact of presentations at a scientific meeting is the frequency with which the findings presented are published as full research papers in peer-reviewed journals. The purpose of this study was to determine the full article publication rates of abstract presentations for General Surgery and related sub-specialities at the Royal Australasian College of Surgeons Annual Scientific Congress (RACS ASC) from 2010 to 2014. All General Surgical (including its sub-speciality groups) abstracts presented at the RACS ASC from 2010 to 2014 were identified from the ANZ Journal of Surgery. We determined the rates of full paper publication, time to publication, journals of publication and specialty rates of conversion. Full article publications were identified using the PubMed, MEDLINE and Google Scholar databases. A total of 1386 abstracts were identified, of which 356 (26%) were converted to full paper publications. The number of abstracts presented annually increased from 206 in 2010 to 386 in 2014, but the percentage of abstracts converted to full paper publications did not follow any temporal trend. The majority (74%) of full papers were published within 2 years of the abstract presentation. In total, 26% of General Surgery abstracts presented at the RACS ASC from 2010 to 2014 were converted to full paper publications. This could provide a baseline against which to judge the quality of presentations at other national General Surgical congresses, as well as at future RACS ASC meetings. © 2017 Royal Australasian College of Surgeons.

  12. Reclaiming Society Publishing

    Directory of Open Access Journals (Sweden)

    Philip E. Steinberg

    2015-07-01

    Full Text Available Learned societies have become aligned with commercial publishers, who have increasingly taken over the latter’s function as independent providers of scholarly information. Using the example of geographical societies, the advantages and disadvantages of this trend are examined. It is argued that in an era of digital publication, learned societies can offer leadership with a new model of open access that can guarantee high quality scholarly material whose publication costs are supported by society membership dues.

  13. Conceptualizing the harm done by rape: applications of trauma theory to experiences of sexual assault.

    Science.gov (United States)

    Wasco, Sharon M

    2003-10-01

    Based on a review of theory and evidence, this article highlights the limitations of trauma response models and applications of posttraumatic stress to characterize the experiences of women who are raped. There are two primary problems with trauma response theories. First, traditional notions of trauma are likely too narrow to accurately capture the complexities of women's experiences of sexual violence in a gendered society. Second, the symptoms emphasized by clinical applications of the trauma model may legitimate one sociocultural manifestation of distress while excluding others. Alternative conceptualizations are presented to stimulate more ecologically grounded and culturally inclusive study of sexual violence. Using the rape of women as an example, this article illustrates the limitations of Western views of trauma and encourages researchers and practitioners to expand notions of survivors' responses to painful events.

  14. Narrative quality and disturbance pre- and post-emotion-focused therapy for child abuse trauma.

    Science.gov (United States)

    Mundorf, Elisabeth S; Paivio, Sandra C

    2011-12-01

    This study predicted that the quality of trauma narratives written before and following emotion-focused therapy for child abuse trauma would be positively associated with psychological disturbance before and following therapy. Narratives for 37 clients were coded for emotion words, temporal orientation, incoherence, and depth of experiencing. At pretreatment, negative emotion words and experiencing were correlated with abuse resolution, r(35) = -.36, and r(35) = -.34, respectively. At posttreatment, narrative incoherence was correlated with trauma symptoms, r(35) = .33, whereas present-future orientation and experiencing were correlated with abuse resolution, r(35) = -.37, and r(35) = -.31, respectively. Pretreatment incoherence was associated with posttreatment trauma symptoms, r(35) = .42, and pretreatment depth of experiencing was associated with posttreatment abuse resolution, r(35) = -.37. Results support narrative quality as an index of trauma disturbance. Copyright © 2011 International Society for Traumatic Stress Studies.

  15. Secondary Trauma in Children and School Personnel

    Science.gov (United States)

    Motta, Robert W.

    2012-01-01

    A review of childhood secondary trauma is presented. Secondary trauma involves the transfer and acquisition of negative affective and dysfunctional cognitive states due to prolonged and extended contact with others, such as family members, who have been traumatized. As such, secondary trauma refers to a spread of trauma reactions from the victim…

  16. Trauma Preparedness In Nigeria: A Questionnaire Survey ...

    African Journals Online (AJOL)

    Respondents who reported trauma drills in their hospitals were 20(29.4%), standing trauma team 27(39.7%), disaster management team 19(27.9%) and ambulance emergency help line 14(20.6%). Conclusion: Doctors and hospitals in Nigeria are ill-prepared for trauma care. Keywords: Trauma, Preparedness, Nigeria

  17. Imaging of cervicothoracic junction trauma

    Directory of Open Access Journals (Sweden)

    Wongwaisayawan S

    2013-01-01

    Full Text Available Sirote Wongwaisayawan,1 Ruedeekorn Suwannanon,2 Rathachai Kaewlai11Department of Radiology, Ramathibodi Hospital and Mahidol University, Bangkok, Thailand; 2Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, ThailandAbstract: Cervicothoracic junction trauma is an important cause of morbidity and mortality in trauma patients. Imaging has played an important role in identifying injuries and guiding appropriate, timely therapy. Computed tomography is currently a method of choice for diagnosing cervicothoracic junction trauma, in which the pattern of injuries often suggests possible mechanisms and potential injuries. In this article, the authors describe and illustrate common and uncommon injuries that can occur in the cervicothoracic junction.Keywords: cervicothoracic junction, cervical spine, trauma, imaging, radiology

  18. Epidemiology of acute wrist trauma

    DEFF Research Database (Denmark)

    Larsen, C F; Lauritsen, Jens

    1993-01-01

    Epidemiological data on wrist injuries in a population can be used for planning by applying them to criteria for care and thus deriving estimates of provisions for care according to currently desirable standards. In a 1-year study all patients > or = 15 years with acute wrist trauma and treated...... in the emergency room were examined according to an algorithm until a diagnosis was established. The overall incidence of wrist trauma was 69 per 10,000 inhabitants per year. Incidence of wrist trauma requiring x-ray examination was 58 per 10,000 per year. The incidence of distal radius fractures was 27 per 10...... using data from a population-based study. A completeness rate of 0.56 (95% confidence interval: 0.31-0.78) was found. An x-ray had been taken for all patients reporting a fracture thus justifying the use of fractures as an incidence measure when comparing groups of patients with wrist trauma....

  19. Clinical study on renal trauma

    International Nuclear Information System (INIS)

    Kobayashi, Hirohito; Fujita, Kazuhiko; Imaizumi, Kentaro; Mizuno, Taiki; Fujime, Makoto

    2007-01-01

    We analyzed 26 cases of renal trauma, which occurred during the last 7 years and 6 months. Computed tomography was performed in all cases. Four cases were of type Ib, 13 cases of type II, 3 cases of type IIIa, 5 cases of type IIIb and 1 case of type IVa, according to the classification of renal injury by the Japanese association for the surgery of trauma. Conservative treatment was done in 21 cases, selective transcatheter arterial embolization (TAE) in 4 cases, and surgical treatment in 1 case. Conservative treatment was effective for type I and II renal trauma. In the cases of type IIIa and IIIb renal trauma, open surgery could be avoided and the affected kidney preserved by early TAE. (author)

  20. The Information Society

    Directory of Open Access Journals (Sweden)

    Hiranya Nath

    2017-03-01

    Full Text Available This article briefly discusses various definitions and concepts of the so-called information society. The term information society has been proposed to refer to the post-industrial society in which information plays a pivotal role. The definitions that have been proposed over the years highlight five underlying characterisations of an information society: technological, economic, sociological, spatial, and cultural. This article discusses those characteristics. While the emergence of an information society may be just a figment of one’s imagination, the concept could be a good organising principle to describe and analyse the changes of the past 50 years and of the future in the 21st century.

  1. Spinal trauma. An imaging approach

    Energy Technology Data Exchange (ETDEWEB)

    Cassar-Pullicino, V.N. [The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire (United Kingdom). Dept. of Radiology; Imhof, H. [University and General Hospital Vienna (Austria). Dept. of Radiodiagnostics

    2006-07-01

    The diagnosis of trauma to the spine - where the slightest oversight may have catastrophic results - requires a thorough grasp of the spectrum of resultant pathology as well as the imaging modalities used in making an accurate diagnosis. In Spinal Trauma, the internationally renowned team of experts provides a comprehensive, cutting-edge exposition of the current vital role of imaging in the diagnosis and treatment of injuries to the axial skeleton. Beginning with a valuable clinical perspective of spinal trauma, the book offers the reader a unique overview of the biomechanics underlying the pathology of cervical trauma. Acute trauma topics include: - Optimization of imaging modalities - Malalignment - signs and significance - Vertebral fractures - detection and implications - Classification of thoraco-lumbar fractures - rationale and relevance - Neurovascular injury. Distilling decades of clinical and teaching expertise, the contributors further discuss the current role of imaging in special focus topics, which include: - The pediatric spine - Sports injuries - The rigid spine - Trauma in the elderly - Vertebral collapse, benign and malignant - Spinal trauma therapy - Vertebral fractures and osteoporosis - Neuropathic spine. All throughout the book, the focus is on understanding the injury, and its implications and complications, through 'an imaging approach'. Lavishly illustrated with hundreds of superb MR images and CT scans, and clear full-color drawings, the authors conclude with a look into the future, defining clinical trends and research directions. Spinal Trauma - with its broad scope, practical imaging approach, and current focus - is designed to enhance confidence and accuracy, making it essential reading for clinicians and radiologists at all levels. (orig.)

  2. Diagnostic strategies in spinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Heinemann, Uwe [Institut fuer Radiologie und Neuroradiologie, Klinikum Aschaffenburg, Am Hasenkopf 1, 63739 Aschaffenburg (Germany); Freund, Michael [Institut fuer Radiologie und Neuroradiologie, Klinikum Aschaffenburg, Am Hasenkopf 1, 63739 Aschaffenburg (Germany)]. E-mail: michael.freund@klinikum-aschaffenburg.de

    2006-04-15

    Spinal injuries may result in severe neurological deficits, especially if nerve roots or even the spinal cord are affected. Besides presenting the important anatomical and technical basis underlying the imaging findings of spinal injuries, the trauma mechanisms and the resulting injuries are discussed. Based on the current literature and recommendations of scientific organizations, an approach is provided to the radiologic work up of spinal trauma. The different imaging modalities are presented. Advantages and disadvantages of the methods are discussed.

  3. Diagnostic strategies in spinal trauma

    International Nuclear Information System (INIS)

    Heinemann, Uwe; Freund, Michael

    2006-01-01

    Spinal injuries may result in severe neurological deficits, especially if nerve roots or even the spinal cord are affected. Besides presenting the important anatomical and technical basis underlying the imaging findings of spinal injuries, the trauma mechanisms and the resulting injuries are discussed. Based on the current literature and recommendations of scientific organizations, an approach is provided to the radiologic work up of spinal trauma. The different imaging modalities are presented. Advantages and disadvantages of the methods are discussed

  4. Trauma ocular y politrauma Ocular trauma and multitrauma

    Directory of Open Access Journals (Sweden)

    Dunia Cruz Izquierdo

    2012-01-01

    Full Text Available Se realizó una revisión sobre el trauma ocular y su manejo en pacientes politraumatizados. Entre las causas más frecuentes de trauma ocular se encuentran los accidentes domésticos, laborales, juegos, actividades recreativas y deportivas. Involucran en un alto por ciento a niños y jóvenes, y predomina el sexo masculino en casi todos los trabajos revisados. No solo en Cuba sino en el mundo, el trauma ocular es fuente importante de ceguera unilateral o bilateral. Se presenta un breve compendio de los términos y definiciones actuales que son utilizados para el manejo del trauma ocular, su clasificación y la ventaja que ofrece aplicar el Puntaje del Trauma Ocular, OTS (Ocular Trauma Score, para el pronóstico de la agudeza visual final de acuerdo a los hallazgos clínicos encontrados en la evaluación inicial. Se hace referencia a los pacientes con politrauma y los aspectos a tener en cuenta por el oftalmólogo para tomar conducta cuando estos presentan heridas penetrantes o perforantes y tienen compromiso vital. En estos casos se hace necesaria la colaboración urgente de múltiples especialistas para primero mantener al paciente con vida y luego disminuir las complicaciones que repercuten en su pronóstico visual.A review was made on the ocular trauma and its management in multitrauma patients. The most common causes comprise domestic and occupational accidents, games, recreational and sport activities. It involves more frequently a high percentage of young people, with male prevalence in almost all the reviewed papers. Ocular trauma is an important source of unilateral or bilateral blindness not only in Cuba but worldwide as well. A brief summary of the current terms and definitions used to manage ocular trauma, their classification and the advantage of the Ocular Trauma Score (OTS to know the possible final visual acuity, according to the clinical findings at the emergency room, were presented. Reference was also made to the multitrauma

  5. Hypothetical source crater for Australasian tektites: Moving from Indochina to Northwest China?

    Czech Academy of Sciences Publication Activity Database

    Mizera, Jiří; Řanda, Zdeněk; Kameník, Jan; Klokočník, Jaroslav; Kostelecký, J.

    2016-01-01

    Roč. 51, AUG (2016), A467-A467 ISSN 1086-9379. [79th Annual Meeting of the Meteoritical-Society. 07.08.2016-12.08.2016, Berlin] R&D Projects: GA ČR GA13-22351S; GA MŠk LM2015056 Institutional support: RVO:61389005 ; RVO:67985815 Keywords : ATT * Indochina * crater Subject RIV: DD - Geochemistry; BN - Astronomy, Celestial Mechanics, Astrophysics (ASU-R)

  6. Trauma and termination.

    Science.gov (United States)

    Ferraro, F

    1995-02-01

    The author suggests a particular reading of the thesis put forward by Freud in 'Analysis terminable and interminable' that an effective and more definitive conclusion may be expected in analyses of cases with traumatic aetiology. This reading shifts the emphasis from the patient's history to the possibility of its crystallising in focal nuclei emerging within the analytic relationship under the pressure of the termination. The revival of separation anxieties which cannot be worked through, and their crystallisation in precipitating traumatic events, may give rise to decisive psychic work allowing the analysis to be brought to a conclusion. Two case histories are presented to show how the end of the analysis assumes the form of a new trauma, which reactivates in the present, traumatic anxieties from the patient's own infantile history. In the first case a premature birth and in the second a miscarriage, originally experienced as isolated automatic events without time or history, are relived in the terminal phase as vicissitudes of the transference, so that new meaning can be assigned to them and they can be withdrawn from the somatic cycle of repetition. The powerful tendency to act out and the intense countertransference pressure on the analyst are discussed in the light of the specificities of this phase, which is crucial to the success of the analysis. This leads to a re-examination, in the concluding notes, of some theoretical questions inherent in the problem of the termination and, in particular, to a discussion of the ambiguous concept of a natural ending.

  7. Head trauma and CT

    International Nuclear Information System (INIS)

    Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitoshi

    1979-01-01

    It has been said that chronic subdural hematoma cannot be diagnosed by CT. In our cases, CT was used, and the results were described. According to the density of the picture, CT findings of chronic subdural hematoma could be classified into 3 types, those of higher density than that of the cerebral paranchyma, those of isodensity, and those of lower density than that of the cerebral parenchyma. The difference among them appeared to be due to variation in the fluid in hematoma, especially that in hemoglobin concentration. Chronic subdural hematoma was found in 27 of 388 cases of head trauma in which CT was undertaken in our department of surgery for last 2 years. It is difficult to differenciate this disease from subdural edema or subarachnoideal retention of the cerebrospinal fluid. In many cases, use of contrast medium added no change to the CT picture. Cerebral angiography is necessary for definite diagnosis of the disease. Chronic subdural hematoma gives more varieties of findings than other intracranial hematomas. However, if the film is very carefully read, CT is still useful for diagnosing this disease in spite of initially remarked difficulties. (Ueda, J.)

  8. Surgical repair of rupture of the membranous septum after blunt chest trauma.

    Science.gov (United States)

    Tarmiz, Amine; Lopez, Stéphane; Honton, Ben; Riu, Béatrice

    2011-01-01

    Rupture of the membranous septum is a very rare complication of blunt chest trauma. In this report, we describe a 22-year-old man who sustained multiple blunt trauma injuries during a motor vehicle accident. Rupture of the membranous septum was diagnosed 48 hours after the initial trauma and the defect was closed with Gore-Tex (W.L. Gore & Assoc, Flagstaff, AZ). However, the operation was complicated by complete atrioventricular block requiring implantation of a permanent DDD pacemaker. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Narrating Animal Trauma in Bulgakov and Tolstoy

    Directory of Open Access Journals (Sweden)

    Anastassiya Andrianova

    2016-11-01

    Full Text Available Following the recent “animal turn” in literary studies, which has inspired scholars to revisit traditional human-centered interpretations of texts narrated by animals, this article focuses on the convergence of animal studies and trauma theory. It offers new animal-centered close readings of Tolstoy’s Strider and Bulgakov’s Heart of a Dog, paying attention to animal pain rather than seeing it, and the text as a whole, as an allegory of human society. Like many other authors of literary fiction featuring animal narrators, Tolstoy and Bulgakov employ a kind of empathic ventriloquism to narrate animal pain, an important project which, however, given the status of both the animal and trauma outside human language, and thus susceptible to being distorted by it, produces inauthentic discourse (animal-like, rather than animal narration; therefore, these authors get closest to animal pain, not through sophisticated narration, but through the use of ellipses and onomatopoeia. Ultimately, any narratological difficulty with animal focalization is minor compared to the ethical imperative of anti-speciesist animal-standpoint criticism, and the goal is to reconceive the status of animals in literature so as to change their ontological place in the world, urging that this critical work and animal rights advocacy be continued in the classroom.

  10. Awareness of emergency management of dental trauma

    Directory of Open Access Journals (Sweden)

    Ritu Namdev

    2014-01-01

    Full Text Available Aim: Traumatic dental injuries frequently occur in society and may occur at home. The ultimate prognosis of an avulsed tooth occurring in a child may depend on the parents′ knowledge of appropriate emergency measures. This study is aimed at evaluating the awareness level of a sample of Indian (Rohtak, Haryana parents in the management of dental trauma. Materials and Methods: A total of 1500 parents were surveyed using a self-administered structured questionnaire. The questionnaire was divided into three parts. The tabulated data were statistically analyzed using the Chi-square test. Result: This study indicated a low level of knowledge regarding tooth avulsion and replantation procedures to be followed in emergency. The residing area and age of parent did not affect the knowledge and awareness of parents. Moreover, well-educated parents also had very little or no information about dental trauma first-aid. The lack of significance in correct answers between those with and without such experience indicated that past experience did not seem to have increase the knowledge of the correct emergency procedures. Very little or no information about tooth avulsion and replantation had been given to most of them. Conclusion: Dental injury prevention and management should be recognized as a major public health issue and adequate resources to be allocated for research in this area. Educational programs to improve the knowledge and awareness among the parents have to be implemented.

  11. The Australasian Hepatology Association consensus guidelines for the provision of adherence support to patients with hepatitis C on direct acting antivirals

    Directory of Open Access Journals (Sweden)

    Richmond JA

    2016-12-01

    Full Text Available Jacqueline A Richmond,1,2 Suzanne Sheppard-Law,3,4 Susan Mason,5 Sherryne L Warner6,7 1Australian Research Centre in Sex, Health and Society, La Trobe University, 2Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Melbourne, VIC, 3Faculty of Health, University of Technology, 4Sydney Children’s Hospital Network, 5AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW, 6Department of Gastroenterology, Monash Health, 7Department of Medicine, Monash University, Melbourne, VIC, Australia Background: Hepatitis C is a blood-borne virus primarily spread through sharing of drug-injecting equipment. Approximately 150 million people worldwide and 230,000 Australians are living with chronic hepatitis C infection. In March 2016, the Australian government began subsidizing direct acting antivirals (DAAs for the treatment of hepatitis C, which are highly effective (95% cure rate and have few side effects. However, there is limited evidence to inform the provision of adherence support to people with hepatitis C on DAAs including the level of medication adherence required to achieve a cure. Methodology: In February 2016, a steering committee comprising four authors convened an expert panel consisting of six hepatology nurses, a hepatologist, a pharmacist, a consumer with hepatitis C and treatment experience, and a consumer advocate. The expert panel focused on the following criteria: barriers and enablers to DAA adherence; assessment and monitoring of DAA adherence; components of a patient-centered approach to DAA adherence; patients that may require additional adherence support; and interventions to support DAA adherence. The resultant guidelines underwent three rounds of consultation with the expert panel, Australasian Hepatology Association (AHA members (n=12, and key stakeholders (n=7 in June 2016. Feedback was considered by the steering committee and incorporated if consensus was achieved. Results

  12. Adverse events and outcomes of procedural sedation and analgesia in major trauma patients

    Directory of Open Access Journals (Sweden)

    Robert S Green

    2015-01-01

    Full Text Available Context: Trauma patients requiring procedural sedation and analgesia (PSA may have increased risk of adverse events (AEs and poor outcomes. Aims: To determine the incidence of AEs in adult major trauma patients who received PSA and to evaluate their postprocedural outcomes. Settings and Design: Retrospective analysis of adult patients (age >16 who received PSA between 2006 and 2014 at a Canadian academic tertiary care center. Materials and Methods: We compared the incidence of PSA-related AEs in trauma patients with nontrauma patients. Postprocedural outcomes including Intensive Care Unit admission, length of hospital stay, and mortality were compared between trauma patients who did or did not receive PSA. Statistical Analysis Used: Descriptive statistics and multivariable logistic regression. Results: Overall, 4324 patients received PSA during their procedure, of which 101 were trauma patients (107 procedures. The majority (77% of these 101 trauma patients were male, relatively healthy (78% with American Society of Anesthesiologists Physical Status [ASA-PS] 1, and most (85% of the 107 procedures were orthopedic manipulations. PSA-related AEs were experienced by 45.5% of the trauma group and 45.9% of the nontrauma group. In the trauma group, the most common AEs were tachypnea (23% and hypotension (20%. After controlling for age, gender, and ASA-PS, trauma patients were more likely than nontrauma patients to develop hypotension (odds ratio 1.79; 95% confidence interval 1.11-2.89. Conclusion: Although trauma patients were more likely than nontrauma patients to develop hypotension during PSA, their outcomes were not worse compared to trauma patients who did not have PSA.

  13. Radiologic findings of thoracic trauma

    Directory of Open Access Journals (Sweden)

    Akgul Ozmen C

    2017-08-01

    Full Text Available Cihan Akgul Ozmen,1 Serdar Onat,2 Delal Aycicek3 1Department of Radiology, 2Department of Chest Surgery, Dicle University School of Medicine, Diyarbakir, 3Radiology Unit, Siirt State Hospital, Siirt, Turkey Introduction: Chest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department. Methods: A total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included. Most of the patients were male (83.3% and victims of a blunt chest trauma. The images were analyzed with respect to the presence of fractures of bony structures, hemothorax, pneumothorax, mediastinal organ injury, and pulmonary and vascular injuries. Results: MDCT images of the 240 patients yielded a prevalence of 41.7% rib fractures, 11.2% scapular fractures, and 7.5% clavicle fractures. The prevalence of thoracic vertebral fracture was 13.8% and that of sternal fracture was 3.8%. The prevalence of hemothorax, pneumothorax, pneumomediastinum, and subcutaneous emphysema was 34.6%, 62.1%, 9.6%, and 35.4%, respectively. The prevalence of rib, clavicle, and thoracic vertebral fractures and pulmonary contusion was higher in the blunt trauma group, whereas the prevalence of hemothorax, subcutaneous emphysema, diaphragmatic injury, and other vascular lacerations was significantly higher in the penetrating trauma group than in the blunt trauma group (p<0.05. Conclusion: MDCT images may yield a high prevalence of fracture of bony structures, soft tissue lacerations, and vascular lesions, which should be well understood by

  14. Outcome after red trauma alarm at an urban Swedish hospital: implications for prevention.

    Science.gov (United States)

    Bagher, Ali; Andersson, Lina; Wingren, Carl Johan; Ottosson, Anders; Wangefjord, Sakarias; Acosta, Stefan

    2015-07-01

    We applied the new injury severity scoring system and studied mechanisms of injury and risk factors for mortality, in order to find potential preventive measures, in the present Scandinavian trauma cohort triaged through red trauma alarm according to the Medical Emergency Triage and Treatment System. Individuals were identified in hospital and forensic records. New injury severity scoring system >15 was defined as major trauma. Inter-rater reliability of new injury severity scoring system was expressed as intra-class correlation coefficient with 95% confidence intervals. There were 125 major and 303 minor traumas. The intra-class correlation coefficient was 0.83 (95% confidence intervals 0.58-0.94) for major trauma and intra-class correlation coefficient was 0.96 (95% confidence intervals 0.89-0.98) for minor trauma. Traffic (37%) and fall (31%) accidents were the leading mechanisms of injury. Elderly (aged ⩾65 years) were at an increased risk of fall accidents (p40). A higher new injury severity scoring system score (pundergoing forensic toxicological examination suggests that toxicology screening should be integrated into all red trauma alarm admissions, which may have implications on prevention of future trauma morbidity and mortality. © 2015 the Nordic Societies of Public Health.

  15. Indian Vacuum Society: The Indian Vacuum Society

    Science.gov (United States)

    Saha, T. K.

    2008-03-01

    The Indian Vacuum Society (IVS) was established in 1970. It has over 800 members including many from Industry and R & D Institutions spread throughout India. The society has an active chapter at Kolkata. The society was formed with the main aim to promote, encourage and develop the growth of Vacuum Science, Techniques and Applications in India. In order to achieve this aim it has conducted a number of short term courses at graduate and technician levels on vacuum science and technology on topics ranging from low vacuum to ultrahigh vacuum So far it has conducted 39 such courses at different parts of the country and imparted training to more than 1200 persons in the field. Some of these courses were in-plant training courses conducted on the premises of the establishment and designed to take care of the special needs of the establishment. IVS also regularly conducts national and international seminars and symposia on vacuum science and technology with special emphasis on some theme related to applications of vacuum. A large number of delegates from all over India take part in the deliberations of such seminars and symposia and present their work. IVS also arranges technical visits to different industries and research institutes. The society also helped in the UNESCO sponsored post-graduate level courses in vacuum science, technology and applications conducted by Mumbai University. The society has also designed a certificate and diploma course for graduate level students studying vacuum science and technology and has submitted a syllabus to the academic council of the University of Mumbai for their approval, we hope that some colleges affiliated to the university will start this course from the coming academic year. IVS extended its support in standardizing many of the vacuum instruments and played a vital role in helping to set up a Regional Testing Centre along with BARC. As part of the development of vacuum education, the society arranges the participation of

  16. Trauma-Informed Care in the Massachusetts Child Trauma Project.

    Science.gov (United States)

    Bartlett, Jessica Dym; Barto, Beth; Griffin, Jessica L; Fraser, Jenifer Goldman; Hodgdon, Hilary; Bodian, Ruth

    2016-05-01

    Child maltreatment is a serious public health concern, and its detrimental effects can be compounded by traumatic experiences associated with the child welfare (CW) system. Trauma-informed care (TIC) is a promising strategy for addressing traumatized children's needs, but research on the impact of TIC in CW is limited. This study examines initial findings of the Massachusetts Child Trauma Project, a statewide TIC initiative in the CW system and mental health network. After 1 year of implementation, Trauma-Informed Leadership Teams in CW offices emerged as key structures for TIC systems integration, and mental health providers' participation in evidence-based treatment (EBT) learning collaboratives was linked to improvements in trauma-informed individual and agency practices. After approximately 6 months of EBT treatment, children had fewer posttraumatic symptoms and behavior problems compared to baseline. Barriers to TIC that emerged included scarce resources for trauma-related work in the CW agency and few mental providers providing EBTs to young children. Future research might explore variations in TIC across service system components as well as the potential for differential effects across EBT models disseminated through TIC. © The Author(s) 2015.

  17. Cost-effectiveness of the Cardiac Component of the Focused Assessment of Sonography in Trauma Examination in Blunt Trauma.

    Science.gov (United States)

    Hall, M Kennedy; Omer, Talib; Moore, Chris L; Taylor, R Andrew

    2016-04-01

    patients. The ICER for hypotensive patients was more than 20 times higher than the ICER for normotensive patients. Our results suggest that performing the cFAST exam may not be an effective use of resources in normotensive blunt trauma patients. © 2016 by the Society for Academic Emergency Medicine.

  18. Civil Society and Governance

    DEFF Research Database (Denmark)

    Hulgård, Lars

    An illustration of how important the relationship is between civil society anbd governance. A short historic journey with four snapshots of times and situations that have provided interesting evidence about the connection between civil society and governance. My goal for the short historic journey...... is to make clear and hopefully even verify that providing knowledge about the impact of civil society and citizens’ participation on governance is one of the most urgent research tasks in the current period of time....

  19. INCIDENCE OF OCULAR TRAUMA IN A TERTIARY HOSPITAL IN VISAKHAPATNAM

    Directory of Open Access Journals (Sweden)

    Venkata Madusudanarao Kanukollu

    2017-07-01

    Full Text Available BACKGROUND Ocular trauma is a major cause of preventable ocular blindness in the world. The present available data represents the tip of iceberg. The data pertaining to ocular trauma is just hospital based data which does not accurately represent the population at risk. The ocular morbidity may be disproportionate to the severity of injury. Though eyes represent only 0.21% of body surface area and 4% of facial area, they are the third most common trauma exposed areas after hands and feet. MATERIALS AND METHODS Our study group consisted of 341 patients who attended ophthalmology OPD with history of ocular trauma of whom 221 were males and 121 were females. The study was conducted over a period of one year. A complete anterior and posterior segment evaluation of all the patients was done. Other accessory ocular and systemic investigations wherever essential were done. RESULTS The ocular trauma was more common in males (64.52% predominantly affecting patients of 20-40 years age group (36.07%. Most often the injuries were occupation related (73.90% and the most common work related injury observed was extraocular foreign body in 134 patients (39.29%. Closed globe injuries were more common as compared to open globe injuries. Eyes with better visual acuity at presentation had better visual prognosis. Blinding trauma was observed in 29 patients (8.50%. CONCLUSION Ocular injuries are more commonly occupation related and mostly effect young males who are the main work force of our society. Stringent implementation of preventive norms in industries to all the workers and safety precautions during sports, driving need to be enforced.

  20. American Society of Nephrology

    Science.gov (United States)

    ... Society of Nephrology (CJASN) Kidney News Kidney News Online Kidney Week Abstracts In The Loop Request Missing Publication Advertising Opportunities Advocacy and public policy Legislative Action Center ...

  1. Appendicitis following blunt abdominal trauma.

    Science.gov (United States)

    Cobb, Travis

    2017-09-01

    Appendicitis is a frequently encountered surgical problem in the Emergency Department (ED). Appendicitis typically results from obstruction of the appendiceal lumen, although trauma has been reported as an infrequent cause of acute appendicitis. Intestinal injury and hollow viscus injury following blunt abdominal trauma are well reported in the literature but traumatic appendicitis is much less common. The pathophysiology is uncertain but likely results from several mechanisms, either in isolation or combination. These include direct compression/crush injury, shearing injury, or from indirect obstruction of the appendiceal lumen by an ileocecal hematoma or traumatic impaction of stool into the appendix. Presentation typically mirrors that of non-traumatic appendicitis with nausea, anorexia, fever, and right lower quadrant abdominal tenderness and/or peritonitis. Evaluation for traumatic appendicitis requires a careful history and physical exam. Imaging with ultrasound or computed tomography is recommended if the history and physical do not reveal an acute surgical indication. Treatment includes intravenous antibiotics and surgical consultation for appendectomy. This case highlights a patient who developed acute appendicitis following blunt trauma to the abdomen sustained during a motor vehicle accident. Appendicitis must be considered as part of the differential diagnosis in any patient who presents to the ED with abdominal pain, including those whose pain begins after sustaining blunt trauma to the abdomen. Because appendicitis following trauma is uncommon, timely diagnosis requires a high index of suspicion. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. The study of psychic trauma.

    Science.gov (United States)

    Bacciagaluppi, Marco

    2011-01-01

    This article starts from the DSM definition of psychic trauma. A central source in this field is the 1992 book by Judith Herman. One line of investigation is the sexual abuse of women and children. In an early phase, both Janet and Freud described dissociation as a reaction to trauma. In 1897, Freud disputed the reality of sexual trauma, a position countered later by Ferenczi. In a later phase, this subject was investigated by the American feminist movement. Studies of physical abuse are then described, followed by mental abuse and neglect. Another line of investigation is combat neurosis. The two lines converged in the definition of PTSD and its incorporation into the DSM in 1980. The views on trauma of John Bowlby and Alice Miller are also discussed. The integration of the relational model in psychoanalysis with the trauma literature is presented. The most recent advances are located in neurobiology. The discussion makes a preliminary investigation of the remote causes of war and sexual violence.

  3. Laparoscopy in penetrating abdominal trauma.

    Science.gov (United States)

    Uranues, Selman; Popa, Dorin Eugen; Diaconescu, Bogdan; Schrittwieser, Rudolph

    2015-06-01

    If morbidity and mortality are to be reduced in patients with penetrating abdominal trauma, first priority goes to prompt and accurate determination of peritoneal penetration and identification of the need for surgery. In this setting, laparoscopy may have an important impact on the rate of negative or non-therapeutic laparotomies. We analyzed indications and patient selection criteria for laparoscopy in penetrating trauma along with outcomes. The analysis focused on identification of peritoneal penetration and injuries to the diaphragm, small intestine, and mesentery. Results from the early phase of laparoscopy were compared with those from recent decades with more advanced laparoscopic equipment and instruments and more experienced surgeons. A systematic review of the role of laparoscopy in penetrating abdominal trauma shows a sensitivity ranging from 66.7 to 100%, specificity from 33.3 to 100% and accuracy from 50 to 100%. Publications from the 1990s found trauma laparoscopy to be inadequate for detecting intestinal injuries and so to lead to missed injuries. Twenty-three of the 50 studies including the most recent ones report sensitivity, specificity, and accuracy of 100%. Laparoscopy is more cost effective than negative laparotomy. Laparoscopy can be performed safely and effectively on stable patients with penetrating abdominal trauma. The most important advantages are reduction of morbidity, accuracy in detecting diaphragmatic and intestinal injuries, and elimination of prolonged hospitalization for observation, so reducing the length of stay and increasing cost effectiveness.

  4. Refractions of Civil Society

    DEFF Research Database (Denmark)

    Kuzmanovic, Daniella

    The thesis investigates various perceptions of civil society among civic activists in Turkey, and how these perceptions are produced and shaped. The thesis is an anthropological contribution to studies of civil society in general, as well as to studies on political culture in Turkey....

  5. World Society and Globalisation

    Science.gov (United States)

    Wittmann, Veronika

    2014-01-01

    Purpose: The purpose of this paper is to illustrate discourses on globalisation and world society and to disclose the commonalities and differences of both scientific debates. In particular, it draws attention to theoretical concepts of globalisation and world society. This is considered fruitful for comprehending the complex mechanisms of…

  6. Transformation of Neolithic Societies

    DEFF Research Database (Denmark)

    Iversen, Rune

    and prepared the way for the appearance of Bronze Age societies. The great era of megalithic architecture came to an end as the production and exchange of gold, copper and bronze objects became the driving force in the development of Copper and Bronze Age societies. This development also had a great influence...

  7. Producing Civil Society

    DEFF Research Database (Denmark)

    Feldt, Liv Egholm; Hein Jessen, Mathias

    ’ and as such dominates our way of thinking about civil society. Yet, this view hinders the understanding of how civil society is not a pre-existing or given sphere, but a sphere which is constantly produced both discursively, conceptually and practically. Through two examples; 1,the case of philanthropy in the beginning...

  8. Society-ethics-risk

    International Nuclear Information System (INIS)

    Ruh, H.; Seiler, H.

    1993-01-01

    The aim of the workshops which was reported in this volume, was the interpretation and evaluation of catastrophic risks for society in an interdisciplinary dialogue between representation of society, ethics, as well as natural science and technology. (author) figs., tabs., refs

  9. The Tranquebarian Society

    DEFF Research Database (Denmark)

    Jensen, Niklas Thode

    2015-01-01

    of this development was the establishment of the Tranquebarian Society, the third learned society east of the Cape of Good Hope. The article examines the unique assemblage of scientific networks, people, instruments, institutions, and ideas of local and global origin that converged in Tranquebar, and it investigates...

  10. Constraining the age of the Matuyama-Brunhes reversal using intercalibrated 40Ar/39Ar and astronomical ages of the Bishop Tuff and Australasian Tektite

    DEFF Research Database (Denmark)

    Rivera, Tiffany; Storey, Michael; Palike, Heiko

    -isotopic age is needed on a datable unit from the reversed-polarity side of the MB boundary. The Australasian tektite is a suitable unit from the Matuyama chron for dating the MB boundary because the positions of microtektite layers relative to the MB boundary have been documented in (I)ODP and other drill...... cores. Previous analyses of the drill cores have estimated the duration between the tektite layer and the MB boundary between 8 and 12 ka, and an astronomical age has been assigned to this unit (Horng et al., 2002). Using a Nu Instruments Noblesse multi-collector noble gas mass spectrometer, we present...... 40Ar/39Ar step-heating and fusion age data, relative to the astronomically calibrated Fish Canyon sanidine, on the Australasian tektite, and have updated the tuning model for this layer using the La2004 orbital solutions. Using 40Ar/39Ar ages for these two units that bracket the boundary along...

  11. Temporal bone trauma and imaging

    International Nuclear Information System (INIS)

    Turetschek, K.; Czerny, C.; Wunderbaldinger, P.; Steiner, E.

    1997-01-01

    Fractures of the temporal bone result from direct trauma to the temporal bone or occur as one component of a severe craniocerebral injury. Complications of temporal trauma are hemotympanon, facial nerve paralysis, conductive or sensorineur hearing loss, and leakage of cerebrospinal fluid. Erly recognition and an appropiate therapy may improve or prevent permanent deficits related to such complications. Only 20-30% of temporal bone fractures can be visualized by plain films. CT has displaced plain radiography in the investigation of the otological trauma because subtle bony details are best evaluated by CT which even can be reformatted in multiple projections, regardless of the original plane of scanning. Associated epidural, subdural, and intracerebral hemorrhagic lesions are better defined by MRI. (orig.) [de

  12. The scientific production in trauma of an emerging country.

    Science.gov (United States)

    Fraga, Gustavo Pereira; Augusto de Andrade, Vitor; Schwingel, Ricardo; Neto, Jamil Pastori; Starling, Sizenando Vieira; Rizoli, Sandro

    2012-08-22

    The study aims to examine whether the end of specialty in trauma surgery in 2003 influenced the scientific productivity of the area in Brazil. We identified and classified the manuscripts and their authors, from databases such as PubMed, Scielo and Plataforma Lattes and sites like Google, in addition to the list of members of SBAIT, the sole society in Brazil to congregate surgeons involved in trauma care in the country. We applied statistical tests to compare the periods of 1997-2003 and 2004-2010. We also analyzed the following variables: impact factor of journals in which manuscripts were published, journals, regional origin of authors, time since graduation, and conducting post-doctorate abroad. We observed a significant increase in publication rates of the analyzed groups over the years. There was a predominance of quantitative studies from the Southeast (especially the state of São Paulo). More time elapsed after graduation and the realization of postdoctoral studies abroad influenced the individual scientific productivity. The number of articles published by authors from the area of trauma has been growing over the past 14 years in Brazil. The end of the specialty in trauma surgery in the country did not influence the scientific productivity in the area.

  13. Trauma from a global perspective.

    Science.gov (United States)

    Ray, Susan L

    2008-01-01

    Trauma from widespread collective violence such as genocide and ethnic cleansing has not been discussed from a global perspective. It will be argued that the Western medical model of diagnostic labeling is inadequate for understanding victims of collective violence from around the world. Phenomenology and liberation philosophy will be discussed as alternatives to understanding trauma from collective violence that move beyond the Western medical model of diagnostic labeling. The insights gained from these alternative approaches will contribute to the development of nursing education, research, and practice relevant to the health of victims of collective violence around the globe.

  14. Complicaciones en el trauma raquimedular

    OpenAIRE

    López, M.

    2013-01-01

    El trauma raquimedular es un enfermedad que afecta principalmente a adultos jóvenes y suele resultar en muerte o discapacidad con sus complicaciones implícitas. Las personas con trauma raquimedular presentan complicaciones multisistemicas según el tipo y nivel de lesión, además, su aparición depende del manejo médico y terapéutico temprano. Entre las complicaciones más comunes se encuentran las respiratorias, cardiovasculares (hipotensión ortostatica, disrreflexia autonómica y trombosis venos...

  15. Orbital soft-tissue trauma.

    Science.gov (United States)

    Chazen, J Levi; Lantos, Joshua; Gupta, Ajay; Lelli, Gary J; Phillips, C Douglas

    2014-08-01

    In the clinical assessment of orbital trauma, visual acuity and extraocular muscle motility are critical for rapid evaluation of injury severity. However, assessment of these parameters may be limited by edema and concomitant injuries. Imaging may further delineate the trauma pattern and extent of injury. This review focuses on orbital soft-tissue injuries that can exist with or without orbital fracture. Imaging techniques and soft-tissue injuries, including those involving the anterior chamber, iris and ciliary body, lens, globe, posterior segment, and optic nerve, are reviewed, in addition to intraocular foreign bodies and cavernous-carotid fistulas. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Emergency Department Management of Trauma

    DEFF Research Database (Denmark)

    MacKenzie, Colin; Lippert, Freddy

    1999-01-01

    Initial assessment and management of severely injured patients may occur in a specialized area of an emergency department or in a specialized area of a trauma center. The time from injury until definitive management is of essence for survival of life-threatening trauma. The initial care delivered...... services (EMS) response times and advanced prehospital care increase the number of critically injured patients surviving sufficiently long to reach a hospital “in extremis.” Both scenarios provide challenges in the management of traumatized patients. This article addresses the management of severely...

  17. The "Trauma Coping Inventory" and The "Trauma Coping Resource Inventory"

    Science.gov (United States)

    Tramonte, Michael Robert

    2005-01-01

    In many instances, actual or threatened traumatic events trigger strong reactions for those individuals experiencing them, witnessing them, or learning about a loved one or friend who experienced an unexpected trauma. In addition, those who help traumatized persons can sometimes develop secondary traumatization. This workshop presenter constructed…

  18. Climate and Ancient Societies

    DEFF Research Database (Denmark)

    Climate, and human responses to it, have a strongly interconnected relationship. This when climate change occurs, the result of either natural or human causes, societies should react and adapt to these. But do they? If so, what is the nature of that change, and are the responses positive...... or negative for the long-term survival of social groups? In this volume, scholars from diverse disciplines including archaeology, geology and climate sciences explore scientific and material evidence for climate changes in the past, their causes, their effects on ancient societies and how those societies...

  19. Information society studies

    CERN Document Server

    Duff, Alistair S

    2013-01-01

    We are often told that we are ""living in an information society"" or that we are ""information workers."" But what exactly do these claims mean, and how might they be verified? In this important methodological study, Alistair S. Duff cuts through the rhetoric to get to the bottom of the ""information society thesis."" Wide-ranging in coverage, this study will be of interest to scholars in information science, communication and media studies and social theory. It is a key text for the newly-unified specialism of information society studies, and an indispensable guide to the future of this disc

  20. Australasian Sleep Association position statement regarding the use of psychological/behavioral treatments in the management of insomnia in adults.

    Science.gov (United States)

    Ree, Melissa; Junge, Moira; Cunnington, David

    2017-08-01

    Insomnia disorder is a high prevalence condition with a high disease burden, which, left untreated, can increase risk of poorer health outcomes. Due to Insomnia's tendency towards having a chronic course, long-term treatment approaches are required to reduce the impact of Insomnia over time. After reviewing the available literature, The Australasian Sleep Association (ASA) recommends Cognitive Behavior Therapy for Insomnia (CBT-I) as a first line treatment in the management of Insomnia. The ASA notes that in addition to CBT-I, there is emerging evidence for the use of Mindfulness Based Therapy for Insomnia when used in combination with behavioural techniques (MBT-I). CBT-I should be used whenever possible, and medications should be limited to the lowest necessary dose and shortest necessary duration. CBT-I, whilst the most effective long-term treatment, does not work for everybody across all circumstances, so there will be circumstances in which other treatments are required (e.g., pharmacotherapy). Improving access to CBT-I is an important issue which will involve raising awareness of the effectiveness of CBT-I, increasing the number of trained practitioners, and the development of effective low intensity treatments that can be offered in the first instance. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Chromosome microarray proficiency testing and analysis of quality metric data trends through an external quality assessment program for Australasian laboratories.

    Science.gov (United States)

    Wright, D C; Adayapalam, N; Bain, N; Bain, S M; Brown, A; Buzzacott, N; Carey, L; Cross, J; Dun, K; Joy, C; McCarthy, C; Moore, S; Murch, A R; O'Malley, F; Parker, E; Watt, J; Wilkin, H; Fagan, K; Pertile, M D; Peters, G B

    2016-10-01

    Chromosome microarrays are an essential tool for investigation of copy number changes in children with congenital anomalies and intellectual deficit. Attempts to standardise microarray testing have focused on establishing technical and clinical quality criteria, however external quality assessment programs are still needed. We report on a microarray proficiency testing program for Australasian laboratories. Quality metrics evaluated included analytical accuracy, result interpretation, report completeness, and laboratory performance data: sample numbers, success and abnormality rate and reporting times. Between 2009 and 2014 nine samples were dispatched with variable results for analytical accuracy (30-100%), correct interpretation (32-96%), and report completeness (30-92%). Laboratory performance data (2007-2014) showed an overall mean success rate of 99.2% and abnormality rate of 23.6%. Reporting times decreased from >90 days to 102 days to <35 days for abnormal results. Data trends showed a positive correlation with improvement for all these quality metrics, however only 'report completeness' and reporting times reached statistical significance. Whether the overall improvement in laboratory performance was due to participation in this program, or from accumulated laboratory experience over time, is not clear. Either way, the outcome is likely to assist referring clinicians and improve patient care. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  2. Training practitioners in preparing systematic reviews: a cross-sectional survey of participants in the Australasian Cochrane Centre training program

    Directory of Open Access Journals (Sweden)

    Silagy Chris

    2002-06-01

    Full Text Available Abstract Background Although systematic reviews of health care interventions are an invaluable tool for health care providers and researchers, many potential authors never publish reviews. This study attempts to determine why some people with interest in performing systematic reviews do not subsequently publish a review; and what steps could possibly increase review completion. Methods Cross-sectional survey by email and facsimile of the 179 participants in Australasian Cochrane Centre training events between 1998 and 2000. Results Ninety-two participants responded to the survey (51 percent. Response rate of deliverable surveys was 82 percent (92/112. The remainder of the participants had invalid or no contact information on file. More than 75 percent of respondents felt that the current workshops met their needs for training. The most critical barriers to completion of a Cochrane review were: lack of time (80 percent, lack of financial support (36 percent, methodological problems (23 percent and problems with group dynamics (10 percent. Conclusions Strategies to protect reviewer time and increase the efficiency of the review process may increase the numbers of trained reviewers completing a systematic review.

  3. The Australasian frog family Ceratobatrachidae in China, Myanmar and Thailand: discovery of a new Himalayan forest frog clade.

    Science.gov (United States)

    Yan, Fang; Jiang, Ke; Wang, Kai; Jin, Jie-Qiong; Suwannapoom, Chatmongkon; Li, Cheng; Vindum, Jens V; Brown, Rafe M; Che, Jing

    2016-01-18

    In an effort to study the systematic affinities and specieslevel phylogenetic relationships of the enigmatic anurans variably assigned to the genera Ingerana or Limnonectes (family Dicroglossidae), we collected new molecular sequence data for five species including four Himalayan taxa, Limnonectes xizangensis, Lim. medogensis, Lim. alpina, [corrected] Ingerana borealis and one southeast Asian species, I. tasanae, and analyzed these together with data from previous studies involving other ostensibly related taxa. Our surprising results demonstrate unequivocally that Lim. xizangensis, Lim. medogensis and Lim. alpina [corrected] form a strongly supported clade, the sister-group of the family Australasian forest frog family Ceratobatrachidae. This discovery requires an expansion of the definition of Ceratobatrachidae and represents the first record of this family in China. These three species are distinguished from the species of Ingerana and Limnonectes by the: (1) absence of interdigital webbing of the foot, (2) absence of terminal discs on fingers and toes, (3) absence of circumarginal grooves on the fingers and toes, and (4) absence of tarsal folds. Given their phylogenetic and morphological distinctiveness, we assign them to the oldest available generic name for this clade, Liurana Dubois 1987, and transfer Liurana from Dicroglossidae to the family Ceratobatrachidae. In contrast, Ingerana tasanae was found to be clustered with strong support with the recently described genus Alcalus (Ceratobatrachidae), a small clade of otherwise Sundaic species; this constitutes a new record of the family Ceratobatrachidae for Myanmar and Thailand. Finally, Ingerana borealis clustered with the "true" Ingerana (family Dicroglossidae), for which the type species is I. tenasserimensis.

  4. The Australasian frog family Ceratobatrachidae in China, Myanmar and Thailand: discovery of a new Himalayan forest frog clade

    Science.gov (United States)

    YAN, Fang; JIANG, Ke; WANG, Kai; JIN, Jie-Qiong; SUWANNAPOOM, Chatmongkon; LI, Cheng; Jens, V. VINDUM; Rafe, M. BROWN; CHE, Jing

    2016-01-01

    In an effort to study the systematic affinities and specieslevel phylogenetic relationships of the enigmatic anurans variably assigned to the genera Ingerana or Limnonectes (family Dicroglossidae), we collected new molecular sequence data for five species including four Himalayan taxa, Limnonectes xizangensis, Lim. medogensis, Lim. alpine, Ingerana borealis and one southeast Asian species, I. tasanae, and analyzed these together with data from previous studies involving other ostensibly related taxa. Our surprising results demonstrate unequivocally that Lim. xizangensis, Lim. medogensis and Lim. alpine form a strongly supported clade, the sister-group of the family Australasian forest frog family Ceratobatrachidae. This discovery requires an expansion of the definition of Ceratobatrachidae and represents the first record of this family in China. These three species are distinguished from the species of Ingerana and Limnonectes by the: (1) absence of interdigital webbing of the foot, (2) absence of terminal discs on fingers and toes, (3) absence of circumarginal grooves on the fingers and toes, and (4) absence of tarsal folds. Given their phylogenetic and morphological distinctiveness, we assign them to the oldest available generic name for this clade, Liurana Dubois 1987, and transfer Liurana from Dicroglossidae to the family Ceratobatrachidae. In contrast, Ingerana tasanae was found to be clustered with strong support with the recently described genus Alcalus (Ceratobatrachidae), a small clade of otherwise Sundaic species; this constitutes a new record of the family Ceratobatrachidae for Myanmar and Thailand. Finally, Ingerana borealis clustered with the "true" Ingerana (family Dicroglossidae), for which the type species is I. tenasserimensis. PMID:26828029

  5. Cultural Trauma and Life Stories / Ene Kõresaar

    Index Scriptorium Estoniae

    Kõresaar, Ene

    2007-01-01

    Aili Aarelaid-Tarti 15-aastase uuringu tulemused raamatus "Cultural Trauma and Life Stories", Hesinki, Kikimora Publications, 2006. Uuritud on kolme suurt rahvusgruppi 1940-test tingitud trauma kontekstis: eestlased kodumaal, eestlased eksiilis ja venekeelne rahvusgrupp Eestis postsovetlikus diskursuses

  6. Coping with Unexpected Events: Depression and Trauma

    Science.gov (United States)

    ... DBSAlliance.org. Read more... Coping With Unexpected Events: Depression and Trauma Responding to Traumatic Events When we ... immediately. back to top How to Cope with Depression After Trauma The healing process after a traumatic ...

  7. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    NARCIS (Netherlands)

    Mauritz, M.W.; Goossens, P.J.J.; Draijer, N.; van Achterberg, T.

    2013-01-01

    Background: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. Objective: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. Methods: We

  8. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    NARCIS (Netherlands)

    Mauritz, M.W.; Goossens, P.J.J.; Draijer, N.; Achterberg, T. van

    2013-01-01

    BACKGROUND: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. OBJECTIVE: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. METHODS: We

  9. External validation of the Emergency Trauma Score for early prediction of mortality in trauma patients

    NARCIS (Netherlands)

    Joosse, Pieter; de Jong, Willem-Jan J.; Reitsma, Johannes B.; Wendt, Klaus W.; Schep, Niels W.; Goslings, J. Carel

    2014-01-01

    The Emergency Trauma Score has been developed for early estimation of mortality risk in adult trauma patients with an Injury Severity Score of 16 or higher. Emergency Trauma Score combines four early predictors available at the trauma resuscitation room: age, Glasgow Coma Scale, base excess, and

  10. External Validation of the Emergency Trauma Score for Early Prediction of Mortality in Trauma Patients

    NARCIS (Netherlands)

    Joosse, Pieter; de Jong, Willem-Jan J.; Wendt, Klaus W.; Schep, Niels W.; Goslings, J. Carel; Reitsma, J.

    Objectives: The Emergency Trauma Score has been developed for early estimation of mortality risk in adult trauma patients with an Injury Severity Score of 16 or higher. Emergency Trauma Score combines four early predictors available at the trauma resuscitation room: age, Glasgow Coma Scale, base

  11. Preventing Vicarious Trauma: What Counselors Should Know when Working with Trauma Survivors

    Science.gov (United States)

    Trippany, Robyn L.; Kress, Victoria E. White; Wilcoxon, S. Allen

    2004-01-01

    Counselors in all settings work with clients who are survivors of trauma. Vicarious trauma, or counselors developing trauma reactions secondary to exposure to clients' traumatic experiences, is not uncommon. The purpose of this article is to describe vicarious trauma and summarize the recent research literature related to this construct. The…

  12. Negotiated knowledge positions : communication in trauma teams

    OpenAIRE

    Härgestam, Maria

    2015-01-01

    Background Within trauma teams, effective communication is necessary to ensure safe and secure care of the patient. Deficiencies in communication are one of the most important factors leading to patient harm. Time is an essential factor for rapid and efficient disposal of trauma teams to increase patients’ survival and prevent morbidity. Trauma team training plays an important role in improving the team’s performance, while the leader of the trauma team faces the challenge of coordinating and...

  13. American Society of Hematology

    Science.gov (United States)

    ... Navigation Account Navigation Main Content American Society of Hematology ASH Store ASH Job Center ASH Apps Share ... youtube linkedin Research In This Section Agenda for Hematology Research Sickle Cell Priorities Lymphoma Roadmap Moonshot Initiative ...

  14. Society for Ambulatory Anesthesia

    Science.gov (United States)

    ... SAMBA Link Digital Newsletter Educational Bibliography Research IARS/Anesthesia & Analgesia SCOR About SCOR Sponsor SAMBA Meetings Affinity Sponsor Program We Represent Ambulatory and Office-Based Anesthesia The Society for Ambulatory Anesthesia provides educational opportunities, ...

  15. International Transplant Nurses Society

    Science.gov (United States)

    ... The term "clinical ladder" refers to a "grading structure which facilitates career progression and associated differentiation of ... 20-1589538 Copyright © 2006 - 2014 International Transplant Nurses Society (ITNS). No materials, including graphics, may be reused, ...

  16. Valie EXPORT Society. Overlok

    Index Scriptorium Estoniae

    2001-01-01

    Valie EXPORT Society asutasid 23. okt. 1999. a. Frankfurdis Kadi Estland, Killu Sukmit ja Mari Laanemets, kui olid külastanud austria naiskunstniku Valie Exporti näitust. Rühmituse aktsioonide kirjeldus

  17. Valie EXPORT Society Rooseumis

    Index Scriptorium Estoniae

    2002-01-01

    Malmös Rooseumi Kaasaegse Kunsti Keskuses näitus "Baltic Babel". Projekt koosneb Läänemeremaade linnades tegutsevate innovatiivsete gruppide aktsioonidest. Kuraator Charles Esche. Esinejatest (Eestist Valie Export Society: Kadi Estland, Killu Sukmit)

  18. American Epilepsy Society

    Science.gov (United States)

    ... for the AES Annual Meeting. More info here . Epilepsy Currents American Epilepsy Society Journal Impact Factor More ... P450 enzyme overexpression during spontaneous recurrent seizures More Epilepsy Professional News AES Status Epilepticus guideline for treatment ...

  19. Changing Anthropology, Changing Society

    Science.gov (United States)

    Varughese, Heather

    2009-01-01

    Fifty years after the founding of the field of medical anthropology, the Society for Medical Anthropology of the American Anthropological Association held its first independent meeting on September 24-27, 2009, at Yale University. PMID:20027281

  20. Transnationalising Civil Society?

    DEFF Research Database (Denmark)

    Jørgensen, Martin Bak

    The paper takes a transnational perspective on developing an analytical framework for understanding how transnationalism interacts with civil society and how immigrant organisations use transnational strategies to challenge the pre-given positions of immigrants within given integration- and citiz......The paper takes a transnational perspective on developing an analytical framework for understanding how transnationalism interacts with civil society and how immigrant organisations use transnational strategies to challenge the pre-given positions of immigrants within given integration...

  1. The role of the trauma nurse leader in a pediatric trauma center.

    Science.gov (United States)

    Wurster, Lee Ann; Coffey, Carla; Haley, Kathy; Covert, Julia

    2009-01-01

    The trauma nurse leader role was developed by a group of trauma surgeons, hospital administrators, and emergency department and trauma leaders at Nationwide Children's Hospital who recognized the need for the development of a core group of nurses who provided expert trauma care. The intent was to provide an experienced group of nurses who could identify and resolve issues in the trauma room. Through increased education, exposure, mentoring, and professional development, the trauma nurse leader role has become an essential part of the specialized pediatric trauma care provided at Nationwide Children's Hospital.

  2. Decolonizing Trauma Theory : Retrospect and Prospects

    NARCIS (Netherlands)

    Visser, Irene

    2015-01-01

    Decolonizing trauma theory has been a major project in postcolonial literary scholarship ever since its first sustained engagements with trauma theory. Since then, trauma theory and postcolonial literary studies have been uneasy bedfellows, and the time has now come to take stock of what remains in

  3. Helpers in Distress: Preventing Secondary Trauma

    Science.gov (United States)

    Whitfield, Natasha; Kanter, Deborah

    2014-01-01

    Those in close contact with trauma survivors are themselves at risk for trauma (e.g., Bride, 2007; Figley, 1995). Family, friends, and professionals who bear witness to the emotional retelling and re-enacting of traumatic events can experience what is called "secondary trauma" (Elwood, Mott, Lohr, & Galovski, 2011). The literature…

  4. Addressing Trauma in Substance Abuse Treatment

    Science.gov (United States)

    Giordano, Amanda L.; Prosek, Elizabeth A.; Stamman, Julia; Callahan, Molly M.; Loseu, Sahar; Bevly, Cynthia M.; Cross, Kaitlin; Woehler, Elliott S.; Calzada, Richard-Michael R.; Chadwell, Katie

    2016-01-01

    Trauma is prevalent among clients with substance abuse issues, yet addictions counselors' training in trauma approaches is limited. The purpose of the current article is to provide pertinent information regarding trauma treatment including the use of assessments, empirically supported clinical approaches, self-help groups and the risk of vicarious…

  5. Is paediatric trauma severity overestimated at triage?

    DEFF Research Database (Denmark)

    DO, H Q; Hesselfeldt, R; Steinmetz, J

    2014-01-01

    BACKGROUND: Severe paediatric trauma is rare, and pre-hospital and local hospital personnel experience with injured children is often limited. We hypothesised that a higher proportion of paediatric trauma victims were taken to the regional trauma centre (TC). METHODS: This is an observational fol...

  6. PAEDIATRIC UROLOGICAL TRAUMA AT NNEWI, SOUTH ...

    African Journals Online (AJOL)

    The patient group included neonates up to children aged 15 years. Apart from the biodata, the cause of the trauma, the organ(s) injured, the treatment given and its outcome were critically analyzed. Results: In the two years under review, 257 cases of paediatric trauma were managed. Out of these, urological trauma was ...

  7. Nuclear technology and society

    International Nuclear Information System (INIS)

    Suzuki, Tatsujiro; Tanaka, Yutaka; Taniguchi, Taketoshi; Oyama, Kosuke

    1999-01-01

    This special issue of Journal of the Atomic Energy Society of Japan deals with the relation between nuclear technology and society, and is composed of four papers: (1) Nuclear energy and international politics - sociotechnics around plutonium utilization; (2) Risk recognition and benefit recognition of nuclear facilities and social acceptance; (3) Environmental risk management and radioactive waste problem; and, (4) Public administration around the relation between nuclear energy and society. (1) describes the historical development of nuclear energy since its birth, focusing on how the leading countries tried to control nuclear proliferation. Peaceful utilization of nuclear energy is closely connected with the Non-proliferation problem. (1) also discusses the relation of plutonium utilization of Japan with international society. (2) discusses how nuclear facilities can be accepted by society, analyzing the background of risk recognition, in particular, of psychological character of mass society. (3) introduces an new approach (risk-based or risk-informed regulation) of environmental risk management for radioactive waste disposal problem, focusing on HLW (high-level waste). (4) explains the approach from public administration to nuclear energy and general energy policy and introduces PPA (participatory policy analysis) as a means for policy making. (M.M.)

  8. Triage and mortality in 2875 consecutive trauma patients

    DEFF Research Database (Denmark)

    Meisler, Rikke; Thomsen, A B; Abildstrøm, H

    2010-01-01

    Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage.......Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage....

  9. Meta-analysis of risk factors for secondary traumatic stress in therapeutic work with trauma victims.

    Science.gov (United States)

    Hensel, Jennifer M; Ruiz, Carlos; Finney, Caitlin; Dewa, Carolyn S

    2015-04-01

    Revisions to the posttraumatic stress disorder (PTSD) diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) clarify that secondary exposure can lead to the development of impairing symptoms requiring treatment. Historically known as secondary traumatic stress (STS), this reaction occurs through repeatedly hearing the details of traumatic events experienced by others. Professionals who work therapeutically with trauma victims may be at particular risk for this exposure. This meta-analysis of 38 published studies examines 17 risk factors for STS among professionals indirectly exposed to trauma through their therapeutic work with trauma victims. Small significant effect sizes were found for trauma caseload volume (r = .16), caseload frequency (r = .12), caseload ratio (r = .19), and having a personal trauma history (r = .19). Small negative effect sizes were found for work support (r = -.17) and social support (r = -.26). Demographic variables appear to be less implicated although more work is needed that examines the role of gender in the context of particular personal traumas. Caseload frequency and personal trauma effect sizes were moderated by year of publication. Future work should examine the measurement of STS and associated impairment, understudied risk factors, and effective interventions. Copyright © 2015 International Society for Traumatic Stress Studies.

  10. Pain relief after musculoskeletal trauma

    NARCIS (Netherlands)

    Helmerhorst, G.T.T.

    2018-01-01

    This thesis showed that, in spite of seemingly similar nociception (pathophysiology), there are substantial cultural differences in experiencing and managing pain after surgery of musculoskeletal trauma. The United States and Canada are in the midst of a crisis of opioid use, misuse, overdose, and

  11. Complex therapy for hepatic trauma

    African Journals Online (AJOL)

    diagnosed with the aid of B-Mode ultrasonography,. CT scan and MRI. Hepatic injury grade3. The liver injuries were classified based on the hepatic trauma criteria shown in table 1. Seven patients with. Grades 1 (4 cases) and Grade I1 (3 cases) were treated conservatively. The main surgical procedures for Grade I and I1.

  12. Intravenous urography and childhood trauma

    OpenAIRE

    Okorie, N. M.; MacKinnon, A. E.

    1982-01-01

    Results of intravenous urography (IVU) in 33 patients suspected of suffering from renal trauma were reviewed. It was concluded that when haematuria is only detected microscopically and clears within 24 hr then an IVU is not necessary, in the absence of other evidence of significant urinary tract injury.

  13. Blunt Head Trauma and Headache

    Directory of Open Access Journals (Sweden)

    Ana B Chelse

    2015-04-01

    Full Text Available Investigators from New York Presbyterian Morgan Stanley Children’s Hospital examined whether having an isolated headache following minor blunt head trauma was suggestive of traumatic brain injury (TBI among a large cohort of children 2-18 years of age.

  14. Transforming Cultural Trauma into Resilience

    Science.gov (United States)

    Brokenleg, Martin

    2012-01-01

    One of the biggest challenges facing Aboriginal populations increasingly is being called "intergenerational trauma." Restoring the cultural heritage is a central theme in the book, "Reclaiming Youth at Risk." That work describes the Circle of Courage model for positive development which blends Native child and youth care…

  15. MDCT in blunt intestinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Stefania [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy)]. E-mail: stefromano@libero.it; Scaglione, Mariano [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Tortora, Giovanni [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Martino, Antonio [Trauma Center, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Di Pietto, Francesco [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Romano, Luigia [Department of Diagnostic Imaging, ' A.Cardarelli' Hospital, 80131 Naples (Italy); Grassi, Roberto [Department ' Magrassi-Lanzara' , Section of Radiology, Second University of Naples, 80138 Naples (Italy)

    2006-09-15

    Injuries to the small and large intestine from blunt trauma represent a defined clinical entity, often not easy to correctly diagnose in emergency but extremely important for the therapeutic assessment of patients. This article summarizes the MDCT spectrum of findings in intestinal blunt lesions, from functional disorders to hemorrhage and perforation.

  16. MDCT in blunt intestinal trauma

    International Nuclear Information System (INIS)

    Romano, Stefania; Scaglione, Mariano; Tortora, Giovanni; Martino, Antonio; Di Pietto, Francesco; Romano, Luigia; Grassi, Roberto

    2006-01-01

    Injuries to the small and large intestine from blunt trauma represent a defined clinical entity, often not easy to correctly diagnose in emergency but extremely important for the therapeutic assessment of patients. This article summarizes the MDCT spectrum of findings in intestinal blunt lesions, from functional disorders to hemorrhage and perforation

  17. The Trauma-Sensitive Teacher

    Science.gov (United States)

    Craig, Susan E.

    2016-01-01

    According to the National Center for Mental Health Promotion and Youth Violence Prevention, about one quarter of children in the United States will witness or experience a traumatic event before the age of four. In this article, Susan E. Craig explains how these early trauma histories prime a child's brain to expect certain experiences,…

  18. Bilateral acetabular fracture without trauma

    OpenAIRE

    Rosa, M. A.; Maccauro, G.; D’Arienzo, M.

    1999-01-01

     In the absence of trauma fracture of the acetabulum is an extremely rare injury. We describe a 70 year old man who spontaneously developed fractures in both acetabulae due to bony insufficiency. It was successfully treated by bilateral total hip replacement.

  19. MR imaging in spinal trauma

    International Nuclear Information System (INIS)

    Curati, W.L.; Kingsley, D.P.E.; Kendall, B.E.; Moseley, I.F.

    1987-01-01

    Thirty-five patients with subacute or chronic trauma of the cervical and dorsal spine were examined by MR imaging performed using a Picker international superconductive prototype system operating at 0.26 T. All studies were performed with closely coupled receiver coils (surface coils). Diagnostic criteria for subacute trauma included alterations in vertebral body configuration, presence of kyphosis or scoliosis secondary to trauma, and encroachment on the subarachnoid space (and cord). An additional criterion for chromic trauma was the development of posttraumatic syrinx. The imaging techniques entailed T1-weighted spin-echo (SE) sequences (560/40 msec) in the sagittal and axial planes with multisection imaging and four signal averages (repetitions), and T2-weighted SE sequences (2,000/120 msec) (MAST technique, or motion artifact supression technique) in the midline sagittal plane with two signal averages. The presentation considers the comparative results of MR imaging-CT (or CT myelography) and myelography, and the choice of sequences the authors selected for routine imaging techniques

  20. The Radiology of Renal Trauma

    African Journals Online (AJOL)

    1974-05-15

    May 15, 1974 ... abdomen, excretory urography and of renal angiography in 210 patients who had suffered renal trauma were re- viewed. The role of excretory urography in these cases is examined and the need for renal angiography in ... was a 'spastic' pelvicalyceal system with a definite diminution of the intensity of the ...

  1. Epidemiology of acute wrist trauma

    DEFF Research Database (Denmark)

    Larsen, C F; Lauritsen, Jens

    1993-01-01

    Epidemiological data on wrist injuries in a population can be used for planning by applying them to criteria for care and thus deriving estimates of provisions for care according to currently desirable standards. In a 1-year study all patients > or = 15 years with acute wrist trauma and treated...

  2. Neuropathology of Acquired Cerebral Trauma.

    Science.gov (United States)

    Bigler, Erin D.

    1987-01-01

    To help educators understand the cognitive and behavioral sequelae of cerebral injury, the neuropathology of traumatic brain injury and the main neuropathological features resulting from trauma-related brain damage are reviewed. A glossary with definitions of 37 neurological terms is appended. (Author/DB)

  3. The Society for Scandinavian Art

    DEFF Research Database (Denmark)

    Grand, Karina Lykke

    2016-01-01

    The Society for Nordic Art & the Scandinavian Society [Selskabet for Nordisk Kunst & Skandinavisk Selskab]......The Society for Nordic Art & the Scandinavian Society [Selskabet for Nordisk Kunst & Skandinavisk Selskab]...

  4. INTEGRASI TERAPI SANDTRAY DENGAN PENDEKATAN KONSELING BERFOKUS SOLUSI PADA ANAK YANG MENGALAMI TRAUMA

    Directory of Open Access Journals (Sweden)

    Gian Sugiana Sugara

    2017-02-01

    Full Text Available Traumatic experience makes a person unhappy and often overwhelmed with excessive fear. They need counseling for relieving the symptoms of the traumatic experienced. Sandtray therapy is a therapeutic technique that utilizes the sandtray as a medium in the therapeutic process. Integration sandtray therapy with solution focused brief counseling approach can help traumatized children to become more adaptive to the symptom of trauma and the purpose of counseling is to increase the resilience. Counselors use questioning techniques to help children traumatized by sandtray therapy with a solution focused approach with the aim of finding exceptions and setting of goals of counseling by the client to overcome the symptom of trauma. Trauma therapy model by integrating solution focused brief counseling with sandtray therapy that consists of creating stabiltas sense of security, reconstructing the trauma story and  improve relations with the society.

  5. Trauma Center Staffing, Infrastructure, and Patient Characteristics that Influence Trauma Center Need

    Directory of Open Access Journals (Sweden)

    Faul, Mark

    2014-11-01

    Full Text Available Introduction: The most effective use of trauma center resources helps reduce morbidity and mortality, while saving costs. Identifying critical infrastructure characteristics, patient characteristics and staffing components of a trauma center associated with the proportion of patients needing major trauma care will help planners create better systems for patient care.   Methods: We used the 2009 National Trauma Data Bank-Research Dataset to determine the proportion of critically injured patients requiring the resources of a trauma center within each Level I-IV trauma center (n=443. The outcome variable was defined as the portion of treated patients who were critically injured. We defined the need for critical trauma resources and interventions (“trauma center need” as death prior to hospital discharge, admission to the intensive care unit, or admission to the operating room from the emergency department as a result of acute traumatic injury. Generalized Linear Modeling (GLM was used to determine how hospital infrastructure, staffing Levels, and patient characteristics contributed to trauma center need.     Results: Nonprofit Level I and II trauma centers were significantly associated with higher levels of trauma center need. Trauma centers that had a higher percentage of transferred patients or a lower percentage of insured patients were associated with a higher proportion of trauma center need.  Hospital infrastructure characteristics, such as bed capacity and intensive care unit capacity, were not associated with trauma center need. A GLM for Level III and IV trauma centers showed that the number of trauma surgeons on staff was associated with trauma center need. Conclusion: Because the proportion of trauma center need is predominantly influenced by hospital type, transfer frequency, and insurance status, it is important for administrators to consider patient population characteristics of the catchment area when planning the

  6. Historia y trauma colectivo: Límites, usos y abusos

    Directory of Open Access Journals (Sweden)

    Rafael Pérez Baquero

    2016-05-01

    Full Text Available In the next pages I will design an analysis regarding the implications that the notion of trauma may have in relation to the evolution of the development of societies. I will offer a critical review of the contemporary theories regarding collective trauma from Cathy Caruth, Frank Ankersmitt, Wulf Kansteiner and Dominick Lacapra, in order to give an account of the limits of the transference of this category from the clinical to the social field. Consequently, I will refer to both epistemological and ethic-political issues. The last ones are especially relevant since by studying them it will be possible to explain and discredit the political use and abuse of the symbolic content that comes from traumatic experiences.

  7. Socio-economic status and major trauma in a Scandinavian urban city: A population-based case-control study.

    Science.gov (United States)

    Bagher, A; Andersson, L; Wingren, C J; Ottosson, A; Wangefjord, S; Acosta, S

    2016-03-01

    Epidemiological studies of patients with major trauma, including both hospitalized and immediately deceased whom are undergoing medico-legal autopsy, are very rare. We studied the incidence and mortality of major trauma in all 10 districts in the Scandinavian city of Malmö, Sweden, and the association between socio-economic status and major trauma. Major trauma was defined as a New Injury Severity Score > 15, or a lethal outcome due to trauma. Cases with a registration address in Malmö between 1 January 2011 and 31 December 2013 were identified from the red trauma alarm list in the hospital and the autopsy register in the Forensic Department. Statistics Sweden matched each case with four randomly selected age-, gender- and district-matched controls. Social assistance within the household, level of education, income and capital income were compared. We identified 117 cases (80 men and 37 women) with a median age of 48.0 years (IQR 28.5-65.0). The incidence of major trauma in Malmö was 12.7 (95% CI 10.4-15.0) per 100,000 person-years; and 69 died due to major trauma, with 8.4 (95% CI 6.4-10.4) per 1000 deaths. Lower income (p = 0.024), no income (OR 1.6; 95% CI 1.0-2.4; p = 0.037) and social assistance (OR 2.3; 95% CI 1.3-4.1; p = 0.003) were associated with major trauma. The level of education was not found to be related to major trauma (p = 0.47). Low income and social assistance within the household were associated with major trauma in the city of Malmö, but not the level of education; in this age-, gender- and district-matched case-control study of major trauma. © 2015 the Nordic Societies of Public Health.

  8. Emerging treatment strategies for trauma-induced coagulopathy.

    Science.gov (United States)

    Sorensen, B; Fries, D

    2012-01-01

    Trauma-induced coagulopathy has a multifactorial aetiology. Coagulopathy is related to blood loss including consumption of clotting factors and platelets and haemodilution. Additionally hyperfibrinolysis, hypothermia, acidosis and metabolic changes affect the coagulation system. This is a review of pathophysiology and new treatment strategies for trauma-induced coagulopathy. Paradigms are actively changing and there is still a shortage of data. The aim of any haemostatic therapy is to control bleeding and minimize blood loss and transfusion requirements. Transfusion of allogeneic blood products as well as trauma-induced coagulopathy cause increased morbidity and mortality. Current opinion is based on present studies and results from small case series, combined with findings from experimental studies in animals, in vitro studies and expert opinions, as opposed to large, randomized, placebo-controlled studies. A summary of new and emerging strategies, including medical infusion and blood products, to beneficially manipulate the coagulation system in the critically injured patient is suggested. Future treatment of trauma-induced coagulopathy may be based on systemic antifibrinolytics, local haemostatics and individualized point-of-care-guided rational use of coagulation factor concentrates such as fibrinogen, prothrombin complex concentrate, recombinant factor VIIa and factor XIII. The authors speculate that timely and rational use of coagulation factor concentrates will be more efficacious and safer than ratio-driven use of transfusion packages of allogeneic blood products. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  9. Nonpathologizing trauma interventions in abnormal psychology courses.

    Science.gov (United States)

    Hoover, Stephanie M; Luchner, Andrew F; Pickett, Rachel F

    2016-01-01

    Because abnormal psychology courses presuppose a focus on pathological human functioning, nonpathologizing interventions within these classes are particularly powerful and can reach survivors, bystanders, and perpetrators. Interventions are needed to improve the social response to trauma on college campuses. By applying psychodynamic and feminist multicultural theory, instructors can deliver nonpathologizing interventions about trauma and trauma response within these classes. We recommend class-based interventions with the following aims: (a) intentionally using nonpathologizing language, (b) normalizing trauma responses, (c) subjectively defining trauma, (d) challenging secondary victimization, and (e) questioning the delineation of abnormal and normal. The recommendations promote implications for instructor self-reflection, therapy interventions, and future research.

  10. Trauma torácico, prevención en el área laboral y conducta en las instituciones sanitarias Thoracic trauma, prevention in the working area and behavior at the health institutions

    Directory of Open Access Journals (Sweden)

    Martha Larrea Fabra

    2009-03-01

    Full Text Available El trauma constituye uno de los problemas más grandes de la sociedad moderna y especialmente el torácico ocupa un lugar importante con respecto a la mortalidad. Se realizó una revisión bibliográfica sobre el trauma torácico, la incidencia, evaluación y pronóstico de las lesiones, con el propósito de actualizar los conocimientos sobre su tratamiento en las instituciones sanitarias y promover medidas que disminuyan la incidencia de estos en los centros laborales.Trauma is one of the biggest problems in modern society and the thoracic trauma occupies an important place as regards mortality. A bibliographical revision about thoracic trauma, its update, incidence, evaluation and prognosis of the injuries was made in order to update the knowledge about its treatment at the health institutions and to improve measures that reduce its incidence at the working centers.

  11. Epidemiologia do trauma facial Epidemiology of facial trauma

    Directory of Open Access Journals (Sweden)

    Marcelo Wulkan

    2005-10-01

    Full Text Available OBJETIVO: O objetivo deste estudo é determinar a incidência, etiologia e gravidade do trauma facial e lesões associadas, possibilitando entender melhor o seu alcance e magnitude. MÉTODOS: Foram selecionados 164 pacientes com trauma facial de qualquer intensidade, sem controle de sexo, idade e cor. Os dados encontrados foram avaliados por meio da estatística Qui quadrado de Pearson. RESULTADOS: O sexo mais acometido foi o masculino (78% e sua incidência foi maior na faixa etária dos 20 aos 39 anos. A etiologia principal foi a violência interpessoal (48,1%, seguida de queda (26,2%, atropelamento (6,4%, esporte (5,4%, acidente de carro (4,2%, acidente de motocicleta (3,1%, impacto não relacionado à queda (2,4%, acidente de trabalho (1,8%, ferimento por arma de fogo (1,2%, inespecífica (1,2%. As contusões foram as lesões mais observadas (23,8%, seguidas das fraturas de mandíbula (21,9%, Le Fort/pan facial/complexas (17,8%, nasal (11,6%, zigoma (10,3%, dental (9,1%, órbita (4,9% e maxila (0,6%. Os traumas associados ocorreram em sua maioria em virtude de atropelamento, mas também em acidentes de carro, queda e violência pessoal. CONCLUSÃO: As causas de trauma facial são diretamente relacionadas com idade e tipo de lesão. Não foram encontradas evidências de que as causas estejam relacionadas com sexo e gravidade da lesão.OBJECTIVES: This study aims to determine the incidence, etiology, severity of facial trauma and associated injuries enabling a greater understanding of its range and magnitude METHODS: A hundred and sixty four patients were selected with some degree of facial trauma regardless of gender, age and skin color. Data were analyzed by the Pearson x² statistical method. RESULTS: A male predominance was observed (78% and its peak age was between 20 and 39 years. The major cause was interpersonal violence (48.1%, followed by fall (26.2%, run overs 6.4%, sports (5.4%, car accidents (4.2%, motorcycle accidents (3.1%, non

  12. Civil society sphericules

    DEFF Research Database (Denmark)

    Tufte, Thomas

    2014-01-01

    the organization strategizes about and seeks to articulate amongst Tanzanian youth. Situated in the ‘perverse confluence’ (Dagnino, 2011) between neoliberal and radical democratic agendas in the communicative practices of civil society-driven media platforms, Femina navigates between identities as an NGO, a social...... movement and a media initiative. In the context of the growing literature on social networking sites and their affordances, dynamics and structures, the case of Femina illustrates how a civil society sphericule emerges within the dynamic co-evolution of new and old media platforms. The study is furthermore...... an example of the difficult shift in civil society practice, from service provision to an agenda of public service monitoring, social accountability and community engagement....

  13. Society and education

    DEFF Research Database (Denmark)

    Moutsios, Stavros

    in Europe. Elaborating on the Castoriadian ontology, the book delves into the magma of social imaginary significations that characterise and associate pivotal epochs of the continent’s history, Classical Greece and Modernity, and exemplifies their incarnation in educational systems and in the formation......'Society and Education: An Outline of Comparison' explores the relation of society to education in Europe, as well as its comparative perspective towards overseas societies and their institutions. It is an enquiry into the social-historical institution of education and cross-cultural studies...... of the European and, in general, the Western comparative gaze. With a particular focus on our epoch, Postmodernity and globalisation, the study traces the pervasive dominance of capitalist significations in social institutions, forms, and activities, as well as in education and the way it is compared across...

  14. Science and Society Colloquium

    CERN Multimedia

    Randi, J

    1991-01-01

    Mr. Randi will give an update of his lecture to the American Physical Society on the occasion of his award of the 1989 Forum Prize. The citation said: "for his unique defense of Science and the scientific method in many disciplines, including physics, against pseudoscience, frauds and charlatans. His use of scientific techniques has contributed to refuting suspicious and fraudulent claims of paranormal results. He has contributed significantly to public understanding of important issues where science and society interact". He is a professional magician and author of many books. He worked with John Maddox, the Editor of Nature to investigate the claims of "water with memory".

  15. European Respiratory Society statement

    DEFF Research Database (Denmark)

    Miravitlles, Marc; Dirksen, Asger; Ferrarotti, Ilaria

    2017-01-01

    lung disease. A large proportion of individuals affected remain undiagnosed and therefore without access to appropriate care and treatment.The most recent international statement on AATD was published by the American Thoracic Society and the European Respiratory Society in 2003. Since then there has...... the efficacy and safety of augmentation therapy, the only specific treatment available for the pulmonary disease associated with AATD.As AATD is a rare disease, it is crucial to organise national and international registries and collect information prospectively about the natural history of the disease...

  16. Advanced information society(7)

    Science.gov (United States)

    Chiba, Toshihiro

    Various threats are hiding in advanced informationalized society. As we see car accident problems in motorization society light aspects necessarily accompy shady ones. Under the changing circumstances of advanced informationalization added values of information has become much higher. It causes computer crime, hacker, computer virus to come to the surface. In addition it can be said that infringement of intellectual property and privacy are threats brought by advanced information. Against these threats legal, institutional and insurance measures have been progressed, and newly security industry has been established. However, they are not adequate individually or totally. The future vision should be clarified, and countermeasures according to the visions have to be considered.

  17. Exposure to Childhood Abuse and Later Substance Use: Indirect Effects of Emotion Dysregulation and Exposure to Trauma.

    Science.gov (United States)

    Mandavia, Amar; Robinson, Gabriella G N; Bradley, Bekh; Ressler, Kerry J; Powers, Abigail

    2016-10-01

    Little is known about how emotion dysregulation (ED) and trauma exposure differentially affect the relationship between abuse in childhood and adult substance use. We examined associations between child abuse, trauma exposure, ED, and current substance use in an already existing dataset. Participants (N = 2,014 adults, 90% African American) had been recruited from an urban hospital for a parent study. Analyses showed that drug and alcohol use was significantly positively correlated with child abuse (emotional, physical, and sexual), later trauma exposure, and ED (all ps trauma, and demographic variables (R 2 Δ = .02, p trauma exposure accounted for variance in the association between emotional abuse and substance use (p < .001). A better understanding of vulnerabilities to additional traumatization and emotion-regulation deficits in individuals who have been exposed to child abuse and in addition have comorbid substance use problems may inform treatments that lead to improved outcomes. Copyright © 2016 International Society for Traumatic Stress Studies.

  18. Australasian Gastrointestinal Trials Group (AGITG) Contouring Atlas and Planning Guidelines for Intensity-Modulated Radiotherapy in Anal Cancer

    International Nuclear Information System (INIS)

    Ng, Michael; Leong, Trevor; Chander, Sarat; Chu, Julie; Kneebone, Andrew; Carroll, Susan; Wiltshire, Kirsty; Ngan, Samuel; Kachnic, Lisa

    2012-01-01

    Purpose: To develop a high-resolution target volume atlas with intensity-modulated radiotherapy (IMRT) planning guidelines for the conformal treatment of anal cancer. Methods and Materials: A draft contouring atlas and planning guidelines for anal cancer IMRT were prepared at the Australasian Gastrointestinal Trials Group (AGITG) annual meeting in September 2010. An expert panel of radiation oncologists contoured an anal cancer case to generate discussion on recommendations regarding target definition for gross disease, elective nodal volumes, and organs at risk (OARs). Clinical target volume (CTV) and planning target volume (PTV) margins, dose fractionation, and other IMRT-specific issues were also addressed. A steering committee produced the final consensus guidelines. Results: Detailed contouring and planning guidelines and a high-resolution atlas are provided. Gross tumor and elective target volumes are described and pictorially depicted. All elective regions should be routinely contoured for all disease stages, with the possible exception of the inguinal and high pelvic nodes for select, early-stage T1N0. A 20-mm CTV margin for the primary, 10- to 20-mm CTV margin for involved nodes and a 7-mm CTV margin for the elective pelvic nodal groups are recommended, while respecting anatomical boundaries. A 5- to 10-mm PTV margin is suggested. When using a simultaneous integrated boost technique, a dose of 54 Gy in 30 fractions to gross disease and 45 Gy to elective nodes with chemotherapy is appropriate. Guidelines are provided for OAR delineation. Conclusion: These consensus planning guidelines and high-resolution atlas complement the existing Radiation Therapy Oncology Group (RTOG) elective nodal ano-rectal atlas and provide additional anatomic, clinical, and technical instructions to guide radiation oncologists in the planning and delivery of IMRT for anal cancer.

  19. Molecular phylogenetic analysis supports a Gondwanan origin of the Hyriidae (Mollusca: Bivalvia: Unionida) and the paraphyly of Australasian taxa.

    Science.gov (United States)

    Graf, Daniel L; Jones, Hugh; Geneva, Anthony J; Pfeiffer, John M; Klunzinger, Michael W

    2015-04-01

    The freshwater mussel family Hyriidae (Mollusca: Bivalvia: Unionida) has a disjunct trans-Pacific distribution in Australasia and South America. Previous phylogenetic analyses have estimated the evolutionary relationships of the family and the major infra-familial taxa (Velesunioninae and Hyriinae: Hyridellini in Australia; Hyriinae: Hyriini, Castaliini, and Rhipidodontini in South America), but taxon and character sampling have been too incomplete to support a predictive classification or allow testing of biogeographical hypotheses. We sampled 30 freshwater mussel individuals representing the aforementioned hyriid taxa, as well as outgroup species representing the five other freshwater mussel families and their marine sister group (order Trigoniida). Our ingroup included representatives of all Australian genera. Phylogenetic relationships were estimated from three gene fragments (nuclear 28S, COI and 16S mtDNA) using maximum parsimony, maximum likelihood, and Bayesian inference, and we applied a Bayesian relaxed clock model calibrated with fossil dates to estimate node ages. Our analyses found good support for monophyly of the Hyriidae and the subfamilies and tribes, as well as the paraphyly of the Australasian taxa (Velesunioninae, (Hyridellini, (Rhipidodontini, (Castaliini, Hyriini)))). The Hyriidae was recovered as sister to a clade comprised of all other Recent freshwater mussel families. Our molecular date estimation supported Cretaceous origins of the major hyriid clades, pre-dating the Tertiary isolation of South America from Antarctica/Australia. We hypothesize that early diversification of the Hyriidae was driven by terrestrial barriers on Gondwana rather than marine barriers following disintegration of the super-continent. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Antimicrobial Prescribing in Dogs and Cats in Australia: Results of the Australasian Infectious Disease Advisory Panel Survey.

    Science.gov (United States)

    Hardefeldt, L Y; Holloway, S; Trott, D J; Shipstone, M; Barrs, V R; Malik, R; Burrows, M; Armstrong, S; Browning, G F; Stevenson, M

    2017-07-01

    Investigations of antimicrobial use in companion animals are limited. With the growing recognition of the need for improved antimicrobial stewardship, there is urgent need for more detailed understanding of the patterns of antimicrobial use in this sector. To investigate antimicrobial use for medical and surgical conditions in dogs and cats by Australian veterinarians. A cross-sectional study was performed over 4 months in 2011. Respondents were asked about their choices of antimicrobials for empirical therapy of diseases in dogs and cats, duration of therapy, and selection based on culture and susceptibility testing, for common conditions framed as case scenarios: 11 medical, 2 surgical, and 8 dermatological. A total of 892 of the 1,029 members of the Australian veterinary profession that completed the survey satisfied the selection criteria. Empirical antimicrobial therapy was more common for acute conditions (76%) than chronic conditions (24%). Overall, the most common antimicrobial classes were potentiated aminopenicillins (36%), fluoroquinolones (15%), first- and second-generation cephalosporins (14%), and tetracyclines (11%). Third-generation cephalosporins were more frequently used in cats (16%) compared to dogs (2%). Agreement with Australasian Infectious Disease Advisory Panel (AIDAP) guidelines (generated subsequently) was variable ranging from 0 to 69% between conditions. Choice of antimicrobials by Australian veterinary practitioners was generally appropriate, with relatively low use of drugs of high importance, except for the empirical use of fluoroquinolones in dogs, particularly for otitis externa and 3rd-generation cephalosporins in cats. Future surveys will determine whether introduction of the 2013 AIDAP therapeutic guidelines has influenced prescribing habits. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  1. Improved quality of risk-reducing salpingo-oophorectomy in Australasian women at high risk of pelvic serous cancer.

    Science.gov (United States)

    Lee, Y C; Bressel, M; Grant, P; Russell, P; Smith, C; Picken, S; Camm, S; Kiely, B E; Milne, R L; McLachlan, S A; Hickey, M; Friedlander, M L; Hopper, J L; Phillips, K A

    2017-10-01

    The quality of risk-reducing salpingo-oophorectomy (RRSO) performed in Australasian women was previously reported to be suboptimal. Here we describe the quality of RRSO performed since 2008 in women enrolled in the same cohort and determine whether it has improved. Prospective cohort study of women at high risk of pelvic serous cancer (PSC) in kConFab. Eligible women had RRSO between 2008 and 2014 and their RRSO surgical and pathology reports were reviewed. "Adequate" surgery and pathology were defined as complete removal and paraffin embedding of all ovarian and extra-uterine fallopian tube tissue, respectively. Associations between clinical factors and "adequate" pathology were assessed using logistic regression. Data were compared with published cohort data on RRSO performed prior to 2008 using Chi square test. Of 164 contemporary RRSOs performed in 78 centres, 158/159 (99%) had "adequate" surgery and 108/164 (66%) had "adequate" pathology. Surgery performed by a gynaecologic oncologist rather than a general gynaecologist [OR 8.2, 95%CI (3.6-20.4), p < 0.001], surgery without concurrent hysterectomy [OR 2.5, 95%CI (1.1-6.0), p = 0.03], more recent year of surgery [OR 1.4, 95%CI (1.1-1.8), p = 0.02], and clinical notation that indicated high risk [OR 19.4, 95%CI (3.1-385), p = 0.008] were independently associated with "adequate" pathology. Both surgery and pathology were significantly more likely to be "adequate" (p < 0.001) in this contemporary sample. The quality of RRSOs has significantly improved since our last report. Surgery by a gynaecologic oncologist who informs the pathologist that the woman is at high risk for PSC is associated with optimal RRSO pathology.

  2. Australasian Gastrointestinal Trials Group (AGITG) Contouring Atlas and Planning Guidelines for Intensity-Modulated Radiotherapy in Anal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Michael, E-mail: mng@radoncvic.com.au [Radiation Oncology Victoria, Victoria (Australia); Leong, Trevor [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria (Australia); University of Melbourne (Australia); Chander, Sarat; Chu, Julie [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria (Australia); Kneebone, Andrew [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, NSW (Australia); University of Sydney (Australia); Carroll, Susan [Department of Radiation Oncology, Sydney Cancer Centre, Royal Prince Alfred Hospital, NSW (Australia); University of Sydney (Australia); Wiltshire, Kirsty [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria (Australia); Ngan, Samuel [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Victoria (Australia); University of Melbourne (Australia); Kachnic, Lisa [Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA (United States)

    2012-08-01

    Purpose: To develop a high-resolution target volume atlas with intensity-modulated radiotherapy (IMRT) planning guidelines for the conformal treatment of anal cancer. Methods and Materials: A draft contouring atlas and planning guidelines for anal cancer IMRT were prepared at the Australasian Gastrointestinal Trials Group (AGITG) annual meeting in September 2010. An expert panel of radiation oncologists contoured an anal cancer case to generate discussion on recommendations regarding target definition for gross disease, elective nodal volumes, and organs at risk (OARs). Clinical target volume (CTV) and planning target volume (PTV) margins, dose fractionation, and other IMRT-specific issues were also addressed. A steering committee produced the final consensus guidelines. Results: Detailed contouring and planning guidelines and a high-resolution atlas are provided. Gross tumor and elective target volumes are described and pictorially depicted. All elective regions should be routinely contoured for all disease stages, with the possible exception of the inguinal and high pelvic nodes for select, early-stage T1N0. A 20-mm CTV margin for the primary, 10- to 20-mm CTV margin for involved nodes and a 7-mm CTV margin for the elective pelvic nodal groups are recommended, while respecting anatomical boundaries. A 5- to 10-mm PTV margin is suggested. When using a simultaneous integrated boost technique, a dose of 54 Gy in 30 fractions to gross disease and 45 Gy to elective nodes with chemotherapy is appropriate. Guidelines are provided for OAR delineation. Conclusion: These consensus planning guidelines and high-resolution atlas complement the existing Radiation Therapy Oncology Group (RTOG) elective nodal ano-rectal atlas and provide additional anatomic, clinical, and technical instructions to guide radiation oncologists in the planning and delivery of IMRT for anal cancer.

  3. By how much do we underestimate species diversity of liverworts using morphological evidence? An example from Australasian Plagiochila (Plagiochilaceae: Jungermanniopsida).

    Science.gov (United States)

    Renner, Matt A M; Heslewood, Margaret M; Patzak, Simon D F; Schäfer-Verwimp, Alfons; Heinrichs, Jochen

    2017-02-01

    As a framework for revisionary study of the leafy liverwort Plagiochila in Australia, two methods for species delimitation on molecular sequence data, General Mixed Yule Coalescence model (GMYC) and Automatic Barcode Gap Discovery (ABGD) were applied to a dataset including 265 individuals from Australia, New Zealand, and the Pacific. Groups returned by GMYC and ABGD were incongruent in some lineages, and ABGD tended to lump groups. This may reflect underlying heterogeneity in the history of diversification within different lineages of Plagiochila. GMYC from trees calculated using three different molecular clocks were compared, in some lineages different primary species hypotheses were returned by analyses of trees estimated under different clock models, suggesting clock model selection should be a routine component of phylogeny reconstruction for tree-based species delimitation methods, such as GMYC. Our results suggest that a minimum of 71 Plagiochilaceae species occur in Australasia, 16 more than currently accepted for the region, comprising 8 undetermined species and 8 synonyms requiring reinstatement. Despite modern taxonomic investigation over a four decade period, (1) real diversity is 29% higher than currently recognized; and (2) 12 of 33, or 36%, of currently accepted and previously untested Australasian species have circumscription issues, including polyphyly, paraphyly, internal phylogenetic structure, or combinations of two or more of these issues. These both reflect the many challenges associated with grouping decisions based solely on morphological data in morphologically simple yet polymorphic plant lineages. Our results highlight again the critical need for combined molecular-morphological datasets as a basis for resolving robust species hypotheses in species-rich bryophyte lineages. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Trauma attenuating backing improves protection against behind armor blunt trauma.

    Science.gov (United States)

    Sondén, Anders; Rocksén, David; Riddez, Louis; Davidsson, Johan; Persson, Jonas K; Gryth, Dan; Bursell, Jenny; Arborelius, Ulf P

    2009-12-01

    Body armor is used by military personnel, police officers, and security guards to protect them from fatal gunshot injuries to the thorax. The protection against high-velocity weapons may, however, be insufficient. Complementary trauma attenuating backings (TAB) have been suggested to prevent morbidity and mortality in high-velocity weapon trauma. Twenty-four Swedish landrace pigs, protected by a ceramid/aramid body armor without (n = 12) or with TAB (n = 12) were shot with a standard 7.62-mm assault rifle. Morphologic injuries, cardiorespiratory, and electroencephalogram changes as well as physical parameters were registered. The bullet impact caused a reproducible behind armor blunt trauma (BABT) in both the groups. The TAB significantly decreased size of the lung contusion and prevented hemoptysis. The postimpact apnea, desaturation, hypotension, and rise in pulmonary artery pressure were significantly attenuated in the TAB group. Moreover, TAB reduced transient peak pressures in thorax by 91%. Our results indicate that ordinary body armor should be complemented by a TAB to prevent thoracic injuries when the threat is high-velocity weapons.

  5. Society of Thoracic Surgeons

    Science.gov (United States)

    ... Society of Thoracic Surgeons Facebook Twitter LinkedIn YouTube Instagram Flickr About STS Governance and Leadership Bylaws Policies ... Tweets by @STS_CTsurgery Facebook Twitter LinkedIn YouTube Instagram Flickr Footer menu Home Contact Us CT Surgery ...

  6. Exploratory of society

    Science.gov (United States)

    Cederman, L.-E.; Conte, R.; Helbing, D.; Nowak, A.; Schweitzer, F.; Vespignani, A.

    2012-11-01

    A huge flow of quantitative social, demographic and behavioral data is becoming available that traces the activities and interactions of individuals, social patterns, transportation infrastructures and travel fluxes. This has caused, together with innovative computational techniques and methods for modeling social actions in hybrid (natural and artificial) societies, a qualitative change in the ways we model socio-technical systems. For the first time, society can be studied in a comprehensive fashion that addresses social and behavioral complexity. In other words we are in the position to envision the development of large data and computational cyber infrastructure defining an exploratory of society that provides quantitative anticipatory, explanatory and scenario analysis capabilities ranging from emerging infectious disease to conflict and crime surges. The goal of the exploratory of society is to provide the basic infrastructure embedding the framework of tools and knowledge needed for the design of forecast/anticipatory/crisis management approaches to socio technical systems, supporting future decision making procedures by accelerating the scientific cycle that goes from data generation to predictions.

  7. The Doctor and Society*

    African Journals Online (AJOL)

    The doctor, no less than any other scientist, is a member of society. His situation, however, is unique, inasmuch as in an age of technocracy he must remain human. Despite the pressure of his own discipline he should be an edu- cated person in the general meaning of the word. The necessary attributes of this state are ...

  8. Libraries in society

    DEFF Research Database (Denmark)

    Kristiansson, Michael; Skouvig, Laura Henriette Christine

    2008-01-01

    brought about by the boom of the internet and the advent of the post-modern globalised knowledge-based and network-organised society. Finally, the paper outlines how theoretical and strategic library development can benefit from academic considerations on the dialectics between openness and restrictedness...

  9. Italian Society of Physics

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    The abstracts of most of the papers read at the 53 National Congress of the Italian Society of Physics are presented. The Congress developed in ten sessions: high energy and elementary particle physics, physics of nuclei, condensed matter, quantum electronics, cosmic physics, geophysics, general physics, electronics and applied physics, health physics and hystory of physics. An author index is also included

  10. Big Society, Big Deal?

    Science.gov (United States)

    Thomson, Alastair

    2011-01-01

    Political leaders like to put forward guiding ideas or themes which pull their individual decisions into a broader narrative. For John Major it was Back to Basics, for Tony Blair it was the Third Way and for David Cameron it is the Big Society. While Mr. Blair relied on Lord Giddens to add intellectual weight to his idea, Mr. Cameron's legacy idea…

  11. Reintegrating ghettos into society

    DEFF Research Database (Denmark)

    Mechlenborg, Mette

    2018-01-01

    In 2010, the Danish government launched a ghetto strategy with 32 initiatives in order to “dissolve parallel communities” in Danish housing areas and to (re)integrate them into Danish society (Statsministeret, 2010). Despite its negative offspring in the Muhammed riots (Freiesleben 2016, Houlind...

  12. MARX EMBRYOLOGY OF SOCIETY

    NARCIS (Netherlands)

    WOUTERS, A

    This article presents a new interpretation of Marx's dialectical method. Marx conceived dialectics as a method for constructing a model of society. The way this model is developed is analogous to the way organisms develop according to the German embryologist Karl Ernst von Baer, and, indeed, Marx's

  13. Radiation protection and society

    International Nuclear Information System (INIS)

    Skryabin, A.M.

    1997-01-01

    The radiological protection of population, living on the contaminated territories, is actual 10 years after the Chernobyl accident. Eventually, the whole system of countermeasures application is aimed to protect society as a complex community of individuals . The variety of levels of society, i.e. family, settlement on the whole, can be considered as certain harmonic systems differing in their public consciousness levels and lifestyles, this explain the difference in their 'behaviour' in terms of radiation protection and attitude to the information obtained. Each level of society possesses a certain degree of liberty of choice, that finally influence the magnitude and the character of dose distribution within certain population groups. In general, the dose distribution in the settlement can be explained only on the bases of 'family' analysis. This concerns the rural settlement as a society too. All rural settlement can be divided into two or three classes: with low, high and intermediate social features. Small settlements (< 100 persons), where the advanced in age persons with low material income and high degree of natural economy are applied to the first class. This results in higher doses (2-3 fold), than in the settlements with higher social level. The analysis shows that in socially 'waning' settlements the countermeasures are less efficient and the term of their action is shorter. (this class is the largest, About 50% among all the rural settlements). Due to the deterioration of the economic situation in the Republic of Belarus after 1991-1992 resulted in the increase of doses mainly in the habitants first of all of this class of settlements. It seems problematic to increase countermeasures efficiency in this class of settlements without the refuse of the accustomed lifestyle and radical improvement of social-demographic and economic conditions. The present material shows the necessity of the differential approach based on 'society-analysis' in the

  14. Trauma Symptoms in Abused Children

    Directory of Open Access Journals (Sweden)

    Parvaneh Mohammadkhani

    2003-07-01

    Full Text Available Objective: There are many traumatic events (including natural disasters, physical, psychological and sexual abuse that may befall children and there is clear evidence that such experiences can produce a plethora of negative psychological effects. Children’s exposure to such traumas has been associated with a wide variety of negative mental health outcomes, including anxiety and depression, post-traumatic stress and dissociation and anger and aggression. It seems that the impacts of traumatic events are significantly related to type and intensity of trauma. Materials & Method: Through a systematized clustral sampling 3042 male and female students from junior high school who were participated in a survey study for investigating point prevalence of child abuse, completed Trauma Symptoms Checklist for Children-Alternate Version (TSCC-A and Child Abuse Self-report Scale (CASRS. After recognition of abused children, they were compared based on trauma symptoms. TSCC-A is a self-report measure of post-traumatic distress and related psychological symptomatology in male and female children aged 8-16 years. It is useful in the evaluation of children who have experienced traumatic events, including physical and sexual assault, victimization by peers, major losses, the witnessing of violence done to others and natural disasters. TSCC-A makes no reference to sexual issues. CASRS is a self-report scale to assess child abuse and neglect with 38 items and four subscales (psychological abuse, neglect, physical and sexual abuse. Results: Considering the type of traumatic experiences, the results showed that abused children significantly received higher scores in scales and subscales of TSCC-A than nonabused group. They specially reported more symptoms (depression, anxiety, post-traumatic stress, anger and dissociation comparing normal children. Conclusion: It is concluded that the type and rate of traumatic event is related to intensity of symptomatology.

  15. Thoracic trauma in newborn foals

    International Nuclear Information System (INIS)

    Jean, D.; Laverty, S.; Halley, J.; Hannigan, D.; Leveille, R.

    1999-01-01

    In a report describing life ending fractures (255 horses) from the Livestock Disease Diagnostic Center, Kentucky (1993 and 1994), 32 foals had rib fractures. The purpose of our study was to examine the incidence of rib fractures in newborn foals on a Thoroughbred studfarm by physical and radiographic examination, to determine factors which may contribute to the problem and to document any clinical consequences. All foals (263) included were examined within 3 days of birth. The thoracic cage was palpated externally for abnormalities and all foals were placed in dorsal recumbency to evaluate thoracic cage symmetry. Radiographs were used to diagnose foals with thoraciccage asymmetry (TCA) and rib fracture (RF). A diagnosis of costochondral dislocation (CD) was made when no radiographic evidence of fracture was present but there was severe TCA, Fifty-five foals (20.1%) had TCA (9 RF), One to 5 ribs were fractured on 9 of 40 radiographic studies. No consequences of the thoracic trauma was detected clinically, radiographically or ultrasonographically in this group of foals or at a 2- and 4-week follow-up examination. The percentage of foals with a history of abnormal parturition was higher in the TCA foals (15%) compared to the normal foals (6.8%). There weremore primiparous dams in the TCA group than in the normal foal group. Fillies (56.6%) had a higher incidence of birth trauma than colts (43.4%), Thisstudy demonstrates that thoracic trauma is often present in newborn foals and may not always be of clinical significance. Dystocia foals and foals from primiparous mares should be considered high risk for thoracic trauma

  16. Does spontaneous genital tract trauma impact postpartum sexual function?

    OpenAIRE

    Rogers, Rebecca G.; Borders, Noelle; Leeman, Lawrence M.; Albers, Leah L.

    2009-01-01

    Changes in sexual function are common in postpartum women. In this comparative, descriptive study, a prospective cohort of midwifery patients consented to documentation of genital trauma at birth and assessment of sexual function three months postpartum. The impact of spontaneous genital trauma on postpartum sexual function was the focus of the study. Trauma was categorized into minor trauma (no trauma or 1st degree perineal or other trauma that was not sutured) or major trauma (2nd, 3rd, or ...

  17. MR imaging of spinal trauma

    International Nuclear Information System (INIS)

    Buchberger, W.; Springer, P.; Birbamer, G.; Judmaier, W.; Kathrein, A.; Daniaux, H.

    1995-01-01

    To assess the value of MR imaging in the acute and chronic stages of spinal trauma. 126 MR examinations of 120 patients were evaluated retrospectively. In 15 cases of acute spinal cord injury, correlation of MR findings with the degree of neurological deficit and eventual recovery was undertaken. Cord anomalies in the acute stage were seen in 16 patients. Intramedullary haemorrhage (n=6) and cord transection (n=2) were associated with complete injuries and poor prognosis, whereas patients with cord oedema (n=7) had incomplete injuries and recovered significant neurological function. In the chronic stage, MR findings included persistent cord compression in 8 patients, syringomyelia or post-traumatic cyst in 12, myelomalacia in 6, cord atrophy in 9, and cord transection in 7 patients. In acute spinal trauma, MR proved useful in assessing spinal cord compression and instability. In addition, direct visualisation and characterisation of posttraumatic changes within the spinal cord may offer new possibilities in establishing the prognosis for neurological recovery. In the later stages, potentially remediable causes of persistent or progressive symptoms, such as chronic spinal cord compression or syringomyelia can be distinguished from other sequelae of spinal trauma, such as myelomalacia, cord transection or atrophy. (orig.) [de

  18. Trauma to the nail complex

    Directory of Open Access Journals (Sweden)

    Jefferson Braga Silva

    2014-04-01

    Full Text Available OBJECTIVE: to analyze the results from surgical intervention to treat trauma of the nail complex.METHODS: we retrospectively reviewed a series of 94 consecutive patients with trauma of the nail complex who were treated between 2000 and 2009. In 42 patients, nail bed suturing was performed. In 27 patients, nail bed suturing was performed subsequent to osteosynthesis of the distal phalanx. In 15, immediate grafting was performed, and in 10, late-stage grafting of the nail bed. The growth, size and shape of the nail were evaluated in comparison with the contralateral finger. The results were obtained by summing scores and classifying them as good, fair or poor.RESULTS: the results were considered to be good particularly in the patients who underwent nail bed suturing or nail bed suturing with osteosynthesis of the distal phalanx. Patients who underwent immediate or late-stage nail grafting had poor results.CONCLUSION: trauma of the nail complex without loss of substance presented better results than did deferred treatment for reconstruction of the nail complex.

  19. Consumption in the Information Society

    Science.gov (United States)

    Zherebin, V. M.; Ermakova, N. A.; Makhrova, O. N.

    2010-01-01

    The current state of the economy in the developed countries make it possible to characterize them using concepts and terms such as the postindustrial society, the new economy, the service economy, the creative economy, the posteconomic society, the information society, the knowledge society, and the consumer society. Among these terms and…

  20. Towards an Australian Institute of Trauma Research: learning the lessons of history.

    Science.gov (United States)

    Wigglesworth, E C

    2001-12-01

    Although medical research in Australia in the 20th century has resulted in a reduction of approximately 95% in the death rate from the infectious and parasitic diseases, there has been no such beneficial outcome in road traffic accidents which, it is here suggested, were out of control from 1948 until 1970. In 1970 several concerned community groups (spearheaded by the Royal Australasian College of Surgeons) campaigned for the introduction of mandatory seat belt wearing. As a consequence of that initiative, and the virtual plethora of subsequent research activities, the road traffic accident rate has declined substantially in the last three decades. The death rate from drownings to toddlers (children under 5) was essentially unchanged until the 1970s when research into toddler pool deaths and the implementation of those research findings resulted in a downturn in toddler drownings in the last two decades. These two examples demonstrate the value of accident research and the implementation of research findings. By analogy with the contributions of the large medical research institutes, the creation of an Australian Institute of Trauma Research seems desirable and is here proposed.

  1. Branding Cities, Changing Societies

    DEFF Research Database (Denmark)

    Ooi, Can-Seng

    Societal changes are seldom discussed in the literature on city branding. The time element is important because it highlights the fluctuating reality of society. The city brand message freezes the place but in fact, the city branding exercise is a continuous process. Society emerges too. City...... brands are supposed to accentuate the uniqueness of the city, be built from the bottom-up and reflect the city's identity. This paper highlights three paradoxes, pointing out that city branding processes can also make cities more alike, bring about societal changes and forge new city identities. A city...... branding campaign does not just present the city, it may change the city. The relationships between the branding exercise and the city are intertwined in the evolution of the place....

  2. Connecting Science with Society

    DEFF Research Database (Denmark)

    awareness of the important questions of our society reflected in scientific research and of the answers produced by these research activities. The CRIS2010 conference, entitled “Bringing Science to Society”, therefore seeks to highlight the role of Current Research Information Systems for communicating......CRIS2010, the 10th conference in the bi-annual series organized by euroCRIS, focuses on the connecting role of Current Research Information Systems (CRIS). Aalborg, Denmark where CRIS2010 is held, is located near the intersection of the Northern Sea and Kattegat, a place were not only the waters...... of two seas are exchanged, but also goods and culture. In a similar way, Current Research Information Systems are at the intersection between (publicly funded) research and society. They do not only connect actors, activities and results within the research domain but also play a crucial role in raising...

  3. Branding Cities, Changing Societies

    DEFF Research Database (Denmark)

    Ooi, Can-Seng

    brands are supposed to accentuate the uniqueness of the city, be built from the bottom-up and reflect the city's identity. This paper highlights three paradoxes, pointing out that city branding processes can also make cities more alike, bring about societal changes and forge new city identities. A city......Societal changes are seldom discussed in the literature on city branding. The time element is important because it highlights the fluctuating reality of society. The city brand message freezes the place but in fact, the city branding exercise is a continuous process. Society emerges too. City...... branding campaign does not just present the city, it may change the city. The relationships between the branding exercise and the city are intertwined in the evolution of the place....

  4. Discrimination in Modern Society

    OpenAIRE

    Schekach, E. V.; Щекач, Е. В.

    2013-01-01

    Issues of discrimination in modern society are examined in the article. Types of discrimination, ways of demonstration, methods of combating discrimination and inequality are described. Particular attention is paid to the legal basis and the real life stories, which serve as a material base for judgments how to prevent discrimination. Possible ways are suggested to eliminate such a negative phenomenon of society like discrimination. Статья посвящена вопросам дискриминации в современном общ...

  5. Society and Social Power

    Directory of Open Access Journals (Sweden)

    Janani Harish

    2014-10-01

    Full Text Available Society is the source of immense power. Over the past few centuries humanity has record­ed phenomenal growth in its collective capacity for accomplishment, as reflected in the 12-fold growth in global per capita income since 1800. The remarkable achievements in living standards, longevity, science, technology, industry, education, democracy, human rights, peace and global governance are the result of the exponential development of the capacity of society to harness human energies and convert them into social power for productive purposes. Today, humanity possesses the power and capabilities needed to fully meet the multi-dimensional challenges confronting global society. The source of this energy is people. Human energy is transformed into social power by the increasing reach, frequency and complexity of human relationships. Society is a complex living network of organized relationships between people. Its power issues from channelizing our collective energies in productive ways by means of organizing principles such as coordination, systems, specialization of function, hierarchy of authority, and integration. This immense social power remains largely underutilized. Social science needs to evolve a comprehensive, trans-disciplinary understanding of the roots of social power and the process by which it is generated, distributed and applied. This knowledge is the essential foundation for formulating effective social policies capable of eradicating forever persistent poverty, unemployment and social inequality. This article is based on a series of lectures delivered by the author in the WAAS-WUC course on “Toward a Trans-disciplinary Science of Society” at Dubrovnik on September 1-3, 2014. It traces the development of social power in different fields to show that human and social capital are inexhaustible in potential. The more we harness them, the more they grow. Unleashing, directing, channeling and converting human potential into social

  6. Evolution, museums and society.

    Science.gov (United States)

    MacFadden, Bruce J

    2008-11-01

    Visitors to natural history museums have an incomplete understanding of evolution. Although they are relatively knowledgeable about fossils and geological time, they have a poor understanding of natural selection. Museums in the 21st century can effectively increase public understanding of evolution through interactive displays, novel content (e.g. genomics), engaging videos and cyberexhibits that communicate to a broad spectrum of society, both within the exhibit halls as well as outside the museum.

  7. Creativity In Conscience Society

    OpenAIRE

    Ion Gh. Rosca; Dumitru Todoroi

    2011-01-01

    Creativity is a result of brain activity which differentiates individuals and could ensure an important competitive advantage for persons, for companies, and for Society in general. Very innovative branches – like software industry, computer industry, car industry – consider creativity as the key of business success. Natural Intelligence Creativity can develop basic creative activities, but Artificial Intelligence Creativity, and, especially, Conscience Intelligence Creativity should be devel...

  8. Implementing Major Trauma Audit in Ireland.

    Science.gov (United States)

    Deasy, Conor; Cronin, Marina; Cahill, Fiona; Geary, Una; Houlihan, Patricia; Woodford, Maralyn; Lecky, Fiona; Mealy, Ken; Crowley, Philip

    2016-01-01

    There are 27 receiving trauma hospitals in the Republic of Ireland. There has not been an audit system in place to monitor and measure processes and outcomes of care. The National Office of Clinical Audit (NOCA) is now working to implement Major Trauma Audit (MTA) in Ireland using the well-established National Health Service (NHS) UK Trauma Audit and Research Network (TARN). The aim of this report is to highlight the implementation process of MTA in Ireland to raise awareness of MTA nationally and share lessons that may be of value to other health systems undertaking the development of MTA. The National Trauma Audit Committee of the Royal College of Surgeons in Ireland, consisting of champions and stakeholders in trauma care, in 2010 advised on the adaptation of TARN for Ireland. In 2012, the Emergency Medicine Program endorsed TARN and in setting up the National Emergency Medicine Audit chose MTA as the first audit project. A major trauma governance group was established representing stakeholders in trauma care, a national project co-ordinator was recruited and a clinical lead nominated. Using Survey Monkey, the chief executives of all trauma receiving hospitals were asked to identify their hospital's trauma governance committee, trauma clinical lead and their local trauma data co-ordinator. Hospital Inpatient Enquiry systems were used to identify to hospitals an estimate of their anticipated trauma audit workload. There are 25 of 27 hospitals now collecting data using the TARN trauma audit platform. These hospitals have provided MTA Clinical Leads, allocated data co-ordinators and incorporated MTA reports formally into their clinical governance, quality and safety committee meetings. There has been broad acceptance of the NOCA escalation policy by hospitals in appreciation of the necessity for unexpected audit findings to stimulate action. Major trauma audit measures trauma patient care processes and outcomes of care to drive quality improvement at hospital and

  9. The new totalitarian society

    Directory of Open Access Journals (Sweden)

    Vlajki Emil

    2011-01-01

    Full Text Available The new totalitarian society is a euphemized expression denoting the New World Order, which in itself denotes the American globalization. The underpinning of this mindset is rationality, which is characteristic of Western civilization. Christianity engendered rationality by introducing it through St. Thomas Aquinas, Aristotle, and especially formal logic. Since it is obvious that religion and logic cannot ultimately be harmonized, this combination has proven lethal in many cases throughout history. For instance, the Inquisition, which, contrary to what happened at scholastic universities, severely berated rational thinking in practice. Catholicism helped carry out genocide against the Jews, and Orthodoxy is in a certain manner tied in with Stalinism. The new totalitarian society is anchored in American Protestantism. On the whole, Christian rationalism is a sphere of science, techniques and technologies efficiently employed to promote the West to the status of a society of plenty and the conception of human rights, which turn into their opposite and irrational behavior of the worst kind. An example of such inhumanity is the attack against Yugoslavia/Serbia in 1999.

  10. Consultative Committee on Road Traffic Fatalities: trauma audit methodology.

    Science.gov (United States)

    McDermott, F T; Cordner, S M; Tremayne, A B

    2000-10-01

    Since 1992 the Consultative Committee on Road Traffic Fatalities in Victoria has identified deficiencies and errors in the management of 559 road traffic fatalities in which the patients were alive on arrival of ambulance services. The Committee also assessed the preventability of deaths. Reproducibility of results using its methodology has been shown to be statistically significant. The Committee's findings and recommendations, the latter made in association with the learned Colleges and specialist Societies, led to the establishment of a Ministerial Taskforce on Trauma and Emergency Services. As a consequence, in 2000, a new trauma care system will be implemented in Victoria. This paper presents a case example demonstrating the Committee's methodology. The Committee has two 12 member multidisciplinary evaluative panels. A retrospective evaluation was made of the complete ambulance, hospital and autopsy records of eligible fatalities. The clinical and pathological findings were analysed using a comprehensive data proforma, a narrative summary and the complete records. Resulting multidisciplinary discussion problems were identified and the potential preventability of death was assessed. In the present case example the Committee identified 16 management deficiencies of which 11 were assessed as having contributed to the patient's death; the death, however, was judged to be non-preventable. The presentation of this example demonstrating the Committee's methodology may be of assistance to hospital medical staff undertaking their own major trauma audit.

  11. Assessing sexual trauma histories in homeless women.

    Science.gov (United States)

    Weinrich, Sally; Hardin, Sally; Glaser, Dale; Barger, Mary; Bormann, Jill; Lizarraga, Cabiria; Terry, Micheal; Criscenzo, Jeeni; Allard, Carolyn B

    2016-01-01

    Almost 1 out of every 3 homeless women (32%) in the United States, United Kingdom, and Australia has experienced childhood sexual trauma. We assessed lifetime sexual trauma histories among 29 homeless women from three Southern California community sites: one residential safe house and two safe parking areas. More than half of the women (54%) reported a history of sexual trauma. That rate was higher (86%) among women living at the safe home than among women staying at the safe parking sites (only 42%). All four of the women who had served in the military reported having experienced military sexual trauma. The high percentages of sexual trauma found in homeless women highlight the need for effective interventions for sexual trauma.

  12. Self-evaluated competence in trauma reception

    DEFF Research Database (Denmark)

    Steinthorsdottir, Kristin Julia; Svenningsen, Peter; Fabricius, Rasmus

    2017-01-01

    INTRODUCTION: No formal training requirements exist for trauma teams in Denmark. The aim of this study was to investigate the point prevalence level of training and the self-evaluated competence of doctors involved in trauma care. METHODS: On two nights, all doctors on call at departments involved...... in trauma care were interviewed and answered a structured questionnaire pertaining to their level of training and self-evaluated level of competence in relevant skills. These skills included the ability to perform diagnostics and interventions as mandated by the Advanced Trauma Life Support and Definitive...... Surgical Trauma Care curriculums. RESULTS: All contacted doctors replied to the questionnaire. 58% of doctors were specialists; most often anaesthesiologists (AN) (86%) and doctors working at hospitals with a dedicated trauma centre designation (100%). In total, 45% of orthopaedic (OS) and gastrointestinal...

  13. The prevalence of orodental trauma during epileptic seizures in terms of dental treatment - Survey study.

    Science.gov (United States)

    Gawlak, Dominika; Łuniewska, Joanna; Stojak, Wiktoria; Hovhannisyan, Anahit; Stróżyńska, Anna; Mańka-Malara, Katarzyna; Adamiec, Marcin; Rysz, Andrzej

    Epilepsy is one of the most common neurological disorders. Seizures that occur during attacks may lead to head injuries. It is crucial to establish proper prophylactic management against trauma occurrence, as nowadays prevention is not sufficient. Assessment of the frequency of head and intraoral trauma during epileptic seizures and to evaluate factors that may predispose to injuries. The questionnaire was carried out among 106 patients with epilepsy. Survey conducted questions regarding development of the disease and occurrence of orodental and head trauma. Results were statistically analyzed with the chi-square test (ptrauma during epileptic seizures. The most common were lips, tongue or cheeks injuries. 18% patients suffered from tooth crack and 17% from tooth fracture. 50% of respondents suffered from head trauma during seizures: 41% patients reported bruises, 39% burns, 37% wounds, 10% nose fractures, 7% eye socket trauma and 3% skull crack. 14.1% of respondents experienced dentist refusal to undertake treatment, while 4% of patients had epileptic attack during dental procedures. Dental trauma is common result of epileptic seizures. It is necessary to implement prophylactic management to prevent hard and soft tissues injuries, for example by using custom-made mouthguards. Moreover, specially designed dental programs for this group of patients should be provided. Copyright © 2017 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  14. Clinical Practices and Outcomes on Chemotherapy-Induced Nausea and Vomiting Management in South Korea: Comparison with Asia-Pacific Data of the Pan Australasian Chemotherapy Induced Emesis Burden of Illness Study.

    Science.gov (United States)

    Lee, Myung Ah; Cho, Eun Kyung; Oh, Sung Yong; Ahn, Joong Bae; Lee, Ji Yun; Thomas, Burke; Jung, Hun; Kim, Jong Gwang

    2016-10-01

    This study reported patient outcomes of chemotherapy-induced nausea and vomiting (CINV) prophylaxis for highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC) regimens and evaluated its adherence to acute-phase CINV prophylaxis in the Korean population subset of the Pan Australasian Chemotherapy Induced Emesis burden of illness (PrACTICE) study. This subgroup analysis evaluated 158 Korean patients receiving HEC or MEC and compared the data (wherever possible) with that of 648 patients from the Asia-Pacific (AP) region. Study endpoints included evaluation of primary CINV prophylaxis and adherence to acute-phase CINV prophylaxis in cycle 1 (American Society of Clinical Oncology [ASCO] Quality Oncology Practice Initiative [QOPI]). In South Korea and the AP, a 5-hydroxytryptamine-3 receptor antagonist (5HT 3 -RA) prophylaxis for the acute phase was administered to 79/80 patients (98.8%) for HEC and 70/71 patients (98.6%) for MEC regimens (QOPI-1). Triple regimen (corticosteroid-5HT 3 -RA-neurokinin 1-RA) was initiated in 46/80 patients (57.5%) for prophylaxis of acute CINV in cycle 1 of HEC (QOPI-3). Double regimen (corticosteroid-5HT 3 -RA, with or within NK 1 -RA) was initiated in 61/71 patients (83.1%) for control of acute CINV in cycle 1 of MEC a(QOPI-2). Active management of CINV is necessary in cycle 1 of HEC in South Korea, despite higher rates than the AP region. Adherence to the international guidelines for CINV prophylaxis requires attention in the acute phase in cycle 1 of the HEC regimen.

  15. Disseminated intravascular coagulation or acute coagulopathy of trauma shock early after trauma? A prospective observational study

    DEFF Research Database (Denmark)

    Johansson, Per Ingemar; Sorensen, Anne Marie; Perner, Anders

    2011-01-01

    ABSTRACT: INTRODUCTION: It is debated whether the early trauma induced coagulopathy (TIC) in severely injured patients reflects disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype, acute coagulopathy of trauma shock (ACoTS) or yet other entities. This study investigated...

  16. From dissociation to trauma? Individual differences in dissociation as predictor of 'trauma' perception.

    Science.gov (United States)

    Rassin, Eric; van Rootselaar, Anne-Fleur

    2006-06-01

    In clinical literature, dissociative complaints are generally considered to be the result of traumatic experiences. However, it has been argued that dissociative complaints, in turn, may indulge over-reporting of traumatic experiences. Hence, correlations between dissociation and self-reported trauma may not only reflect the causal path from trauma to dissociation, but possibly also an increased trauma-item endorsement due to dissociation. To test the idea that dissociation fosters a positive response bias on trauma self-reports, participants completed a dissociation scale, and subsequently rated the perceived trauma of ambiguous stimuli. Results indicated that some dissociative complaints indeed predicted increased scores on the trauma ratings, while other manifestations of dissociation were negatively correlated with perceived trauma ratings. Hence, there is reason to argue that people differ in their readiness to perceive a situation as traumatic. However, the association between self-reported dissociation and the perception of 'trauma' is not quite clear-cut.

  17. Post-Eocene climate change across continental Australia and the diversification of Australasian spiny trapdoor spiders (Idiopidae: Arbanitinae).

    Science.gov (United States)

    Rix, Michael G; Cooper, Steven J B; Meusemann, Karen; Klopfstein, Seraina; Harrison, Sophie E; Harvey, Mark S; Austin, Andrew D

    2017-04-01

    The formation and spread of the Australian arid zone during the Neogene was a profoundly transformative event in the biogeographic history of Australia, resulting in extinction or range contraction in lineages adapted to mesic habitats, as well as diversification and range expansion in arid-adapted taxa (most of which evolved from mesic ancestors). However, the geographic origins of the arid zone biota are still relatively poorly understood, especially among highly diverse invertebrate lineages, many of which are themselves poorly documented at the species level. Spiny trapdoor spiders (Idiopidae: Arbanitinae) are one such lineage, having mesic 'on-the-continent' Gondwanan origins, while also having experienced major arid zone radiations in select clades. In this study, we present new orthologous nuclear markers for the phylogenetic inference of mygalomorph spiders, and use them to infer the phylogeny of Australasian Idiopidae with a 12-gene parallel tagged amplicon next-generation sequencing approach. We use these data to test the mode and timing of diversification of arid-adapted idiopid lineages across mainland Australia, and employ a continent-wide sampling of the fauna's phylogenetic and geographic diversity to facilitate ancestral area inference. We further explore the evolution of phenotypic and behavioural characters associated with both arid and mesic environments, and test an 'out of south-western Australia' hypothesis for the origin of arid zone clades. Three lineages of Idiopidae are shown to have diversified in the arid zone during the Miocene, one (genus Euoplos) exclusively in Western Australia. Arid zone Blakistonia likely had their origins in South Australia, whereas in the most widespread genus Aganippe, a more complex scenario is evident, with likely range expansion from southern Western Australia to southern South Australia, from where the bulk of the arid zone fauna then originated. In Aganippe, remarkable adaptations to phragmotic burrow

  18. Mechanisms of Coagulation Abnormalities and Trauma

    Science.gov (United States)

    2013-11-01

    one of four treatment groups: 1) C- control, 2) T- trauma ( laparotomy ), 3) H- hemorrhage (MAP 35mmHg x 60 minutes), 4) TH- trauma+hemorrhage. After...types and degrees of injury. Specifically we are examining laparotomy vs. hind limb fracture and various degrees of shock to determine the relative...Massive Transfusion Protocol Activation: In Press (J Trauma Acute Care Surgery ) Cripps MW, Kutcher ME, McCreery RC, Crane IM, Greenberg MD, Cachola LM

  19. Prehospital administration of tranexamic acid in trauma patients.

    Science.gov (United States)

    Wafaisade, Arasch; Lefering, Rolf; Bouillon, Bertil; Böhmer, Andreas B; Gäßler, Michael; Ruppert, Matthias

    2016-05-12

    Evidence on prehospital administration of the antifibrinolytic tranexamic acid (TXA) in civilian trauma populations is scarce. The aim was to study whether prehospital TXA use in trauma patients was associated with improved outcomes. The prehospital database of the ADAC (General German Automobile Club) Air Rescue Service was linked with the TraumaRegister of the German Trauma Society to reidentify patients documented in both registries. Primarily admitted trauma patients (2012 until 2014) who were treated with TXA during the prehospital phase were matched with patients who had not received prehospital TXA, applying propensity score-based matching. The matching yielded two identical cohorts (n = 258 in each group), since there were no significant differences in demographics or injury characteristics (mean Injury Severity Score 24 ± 14 [TXA] vs. 24 ± 16 [control]; p = 0.46). The majority had sustained blunt injury (90.3 % vs. 93.0 %; p = 0.34). There were no differences with respect to prehospital therapy, including rates of intubation, chest tube insertion or both administration of i.v. fluids and catecholamines. During ER treatment, the TXA cohort received fewer numbers of red blood cells and plasma units, but without reaching statistical significance. Incidences of organ failure, sepsis or thromboembolism showed no significant differences as well, although data were incomplete for these parameters. Early mortality was significantly lower in the TXA group (e.g., 24-h mortality 5.8 % [TXA] vs. 12.4 % [control]; p = 0.01), and mean time to death was 8.8 ± 13.4 days vs. 3.6 ± 4.9 days, respectively (p = 0.001). Overall hospital mortality was similar in both groups (14.7 % vs. 16.3 %; p = 0.72). The most pronounced mortality difference was observed in patients with a high propensity score, reflecting severe injury load. This is the first civilian study, to our knowledge, in which the effect of prehospital TXA use in trauma patients has been examined. TXA was

  20. Trauma pattern in a level I east-European trauma center

    Directory of Open Access Journals (Sweden)

    Bogdan Stoica

    2015-10-01

    Conclusions: Our trauma pattern profile is similar to the one found in west-European countries, with a predominance of traffic-related injuries and falls. The severity and anatomical puzzle for trauma lesions were more complex secondary to motorcycle or bicycle-to-auto vehicles collisions. A trauma registry, with prospective enrollment of patients, is a very effective tool for constant improvements in trauma care.

  1. Emergency Anaesthetic Management of Extensive Thoracic Trauma

    Directory of Open Access Journals (Sweden)

    H C Chandola

    2007-01-01

    Full Text Available High speed vehicles, drug abuse, alcohol and easy availability of handguns are the main reasons of increasing number of trauma especially thoracic trauma. Anaesthesiologist plays an important role in the management of extensive thoracic trauma. Thoracic trauma, penetrating or blunt, may cause damage to organs suspended in thorax viz. pleura, lungs, heart, great vessels, trachea and oesophagus. It may lead to pneumothorax, cardiac tamponade or life threatening haemorrhage. With aggressive care and management of these factors, majority of patients can survive and return to normal life.

  2. Mortality after trauma laparotomy in geriatric patients.

    Science.gov (United States)

    Joseph, Bellal; Zangbar, Bardiya; Pandit, Viraj; Kulvatunyou, Narong; Haider, Ansab; O'Keeffe, Terence; Khalil, Mazhar; Tang, Andrew; Vercruysse, Gary; Gries, Lynn; Friese, Randall S; Rhee, Peter

    2014-08-01

    Geriatric patients are at higher risk for adverse outcomes after injury because of their altered physiological reserve. Mortality after trauma laparotomy remains high; however, outcomes in geriatric patients after trauma laparotomy have not been well established. The aim of our study was to identify factors predicting mortality in geriatric trauma patients undergoing laparotomy. A retrospective study was performed of all trauma patients undergoing a laparotomy at our level 1 trauma center over a 6-y period (2006-2012). Patients with age ≥55 y who underwent a trauma laparotomy were included. Patients with head abbreviated injury scale (AIS) score ≥ 3 or thorax AIS ≥ 3 were excluded. Our primary outcome measure was mortality. Significant factors in univariate regression model were used in multivariate regression analysis to evaluate the factors predicting mortality. A total of 1150 patients underwent a trauma laparotomy. Of which 90 patients met inclusion criteria. The mean age was 67 ± 10 y, 63% were male, and median abdominal AIS was 3 (2-4). Overall mortality rate was 23.3% (21/90) and progressively increased with age (P = 0.013). Age (P = 0.02) and lactate (P = 0.02) were the independent predictors of mortality in geriatric patients undergoing laparotomy. Mortality rate after trauma laparotomy increases with increasing age. Age and admission lactate were the predictors of mortality in geriatric population undergoing trauma laparotomies. Published by Elsevier Inc.

  3. Organizational network in trauma management in Italy

    Directory of Open Access Journals (Sweden)

    Osvaldo Chiara

    2005-10-01

    Full Text Available In Italy, as in other western countries, trauma is a leading cause of death during the first four decades of life, with almost 18.000 of deaths per year. Since 80s organized systems for trauma care, including a pre-hospital emergency medical system and a network of hospitals designated as Trauma Centres, have been developed in north American countries. Effectiveness of trauma systems has been investigated comparing the post-system to the pre-system trauma care with the method of panel evaluation of preventable death rates and comparison of observed survival with expected probability of survival. In Italy, a pre-hospital emergency medical system has been implemented on a national scale, while a trauma network has not been developed. Nowadays, trauma patients are often admitted to the closest hospital, independently from local resources. The Superior Council of Ministry of Health has presented in 2004 a new trauma system model (SIAT based on the recognition in the field of patients with more serious injuries and the transportation to general hospitals with resources and multidisciplinary teams specialized in trauma care (trauma team. The designation of few trauma team hospitals, one highly specialized Centre (CTS and two area Centres (CTZ every two millions of inhabitants allows each Centre to treat at least 250 severe trauma patients per year to increase experience. Less severe injured patients may be treated in non-trauma team acute care facilities, according to the inclusive system model. The development of trauma team services in some Italian hospitals has demonstrated an increase in survival and a decrease in preventable death rate from 42% to 7,6%. Economic studies of Ministry of Health have established that the implementation of a trauma system model on a national scale with a 25% decrease of preventable trauma deaths and disabilities would save 7500 million of euros of public money. Therefore, in our country the concentration of severely

  4. The Selfie Wrist – Selfie induced trauma

    LENUS (Irish Health Repository)

    Lyons, RF

    2017-06-01

    The selfie phenomenon has exploded worldwide over the past two years. Selfies have been linked to a large number of mortalities and significant morbidity worldwide. However, trauma associated with selfies including fractures, is rarely publicised. Here we present a case series of upper extremity trauma secondary to selfies across all age groups during the summer period. Four cases of distal radius and ulna trauma in all age groups were reported. This case series highlights the dangers associated with taking selfies and the trauma that can result.

  5. Sexuality following trauma injury: A literature review

    Directory of Open Access Journals (Sweden)

    Kylie Marie Connell

    2014-04-01

    Full Text Available Restoration of the quality of life (QoL of trauma injury survivors is the aim of trauma rehabilitation. It is generally acknowledged that sexuality is an important component of QoL; however, rehabilitation services frequently fall short of including sexuality as a matter of routine. The literature was reviewed to examine the experiences of trauma survivors from three groups: spinal cord injury (SCI, traumatic brain injury (TBI and burns. The focus was on the impact of trauma on the QoL to identify future research directions and to advocate for the inclusion of sexuality as an integral part of rehabilitation. Databases searched were Proquest, Ovid, Cinahl, Medline, PsycInfo and Cochrane Central Register of controlled trials. A total of 36 eligible studies were included: SCI (n = 25, TBI (n = 6, burns (n = 5. Four themes were identified across the three trauma groups that were labeled as physiological impact of trauma on sexuality, cognitive-genital dissociation (CGD, sexual disenfranchisement (SD and sexual rediscovery (SR. Trauma injury has a significant impact on sexuality, which is not routinely addressed within rehabilitation services. Further sexuality research is required among all trauma groups to improve rehabilitation services and in turn QoL outcomes for all trauma survivors.

  6. Sexuality following trauma injury: A literature review

    OpenAIRE

    Kylie Marie Connell; Rosemary Coates; Fiona Melanie Wood

    2014-01-01

    Restoration of the quality of life (QoL) of trauma injury survivors is the aim of trauma rehabilitation. It is generally acknowledged that sexuality is an important component of QoL; however, rehabilitation services frequently fall short of including sexuality as a matter of routine. The literature was reviewed to examine the experiences of trauma survivors from three groups: spinal cord injury (SCI), traumatic brain injury (TBI) and burns. The focus was on the impact of trauma on the QoL to ...

  7. History of the Dental Trauma Guide

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Christensen, Søren Steno Ahrensburg

    2012-01-01

    The history of the Dental Trauma Guide dates back to 1965, where guidelines were developed for trauma records and treatment of various trauma entities at the Department of Oral and Maxillofacial Surgery at the University Hospital in Copenhagen. In 1972, a unique possibility came up at the Serum......-term follow-up of various trauma entities. This has resulted in 79 clinical studies, and 64 studies in monkeys have examined the effect of various treatment procedures and the aetiology of most healing complications....

  8. 2012 Australasian sky guide

    CERN Document Server

    Lomb, Nick

    2011-01-01

    Compact, easy to use and reliable, this popular guide contains everything you need to know about the southern night sky with monthly star maps, diagrams and details of all the year's exciting celestial events. Wherever you are in Australia or New Zealand, easy calculations allow you to determine when the Sun, Moon and planets will rise and set throughout the year. Also included is information on the latest astronomical findings from space probes and telescopes around the world.

  9. 2013 Australasian sky guide

    CERN Document Server

    Lomb, Nick

    2012-01-01

    Compact, easy to use and reliable, this popular guide contains everything you need to know about the southern night sky with monthly star maps, diagrams and details of all the year's exciting celestial events. Wherever you are in Australia or New Zealand, easy calculations allow you to determine when the Sun, Moon and planets will rise and set throughout the year. Also included is information on the latest astronomical findings from space probes and telescopes around the world. The Sky guide has been published annually by the Powerhouse Museum, Sydney, since 1991. It is recommended for photogr

  10. Trauma in Guilan (North of Iran: An Epidemiologic Study

    Directory of Open Access Journals (Sweden)

    Dehnadimoghadam Anoosh

    2009-10-01

    Full Text Available Injuries, especially traffic accidents are so important causes of death, disability, hospital expenses, economic damages to the society which World Health Organization selected them as the main subjects for investigation and research. We have done an epidemiologic study about trauma in Guilan, a province in north of Iran. This is  a descriptive study carried out on patients with traumatic injuries, admitted in Poursina Teaching Hospital, during September 2005 to July 2006. Data were collected prospectively using a data collection form including demographic information, mechanism of trauma, anatomical site of injuries, according to AIS90 and severity of head trauma according to glasgow coma scale (GCS. Data were processed by SPSS 11.5 and are shown in tables and figures. Overall 3598 patients admitted. Mean age was 31.85 ± 17.76 years with male to female ratio  about 3.5:1. Most of patients were 25-44 years old (33.9%. Traffic accidents were the leading  cause of injuries (73.84% and then fall (15.7%. Motorcycle was the most common mode of transport in our patients (47.07% after that car (24.3%. Occurrence of traffic accidents increased through evening. Forty six percent of patients transported to hospital by people or came themselves (46.42%. Head and neck were the most common injured part of body (82.4 %, however about in 81.66% of patients were mild and then limb and pelvis (34.7%. Finally about 2.8% of them died. A trauma especially traffic accidents are an important public health issue in Guilan, we recommend conducting other studies focusing on risk factors in details, and considering injury prevention in local decision making.

  11. Science, Society and Policy

    Science.gov (United States)

    White, K. S.; Teich, A. H.

    2010-12-01

    Apart from the journals they produce, scientific societies play an important role in communicating scientific findings and norms to the broader society. The American Association for the Advancement of Science (AAAS) includes among its goals to promote and defend the integrity of science and its use; provide a voice for science on societal issues; promote the responsible use of science in public policy; and increase public engagement with science and technology. AAAS websites and programs, including Communicating Science (www.aaas.org/communicatingscience), Working with Congress (http://www.aaas.org/spp/cstc/wwc/book.htm) and ScienceCareers.org (http://sciencecareers.sciencemag.org), provide tools for scientists to become more directly engaged in effectively communicating their findings and involved in the policy process. Education programs work to build the next generation of scientists and a science-literate public. To bridge the current communication gap between scientists, the public and policymakers, AAAS, like other scientific societies, maintains policy and outreach programs with limited budgets and staff. AAAS works to engage policymakers and provide scientific underpinning to key issues through congressional briefings, meetings, policy briefs, and media outreach. AAAS responds to challenges to accepted scientific findings and processes through op-eds, letters to government officials, resolutions, and Board statements. Some of these initiatives occur on a local level in partnership with local civic leaders, whose endorsement makes them more powerful. On a national scale, they assure that the voice of science is included in the debate. The changing media landscape presents opportunities and challenges for future AAAS endeavors.

  12. Risk and society

    International Nuclear Information System (INIS)

    Tubiana, M.; Vrousos, C.; Pages, J.P.; Carde, C.

    1999-01-01

    This book brings together the communications presented at the colloquium 'risk and society' held in Paris (France) on November 1998. During this colloquium, the various aspects of risk and of its management were discussed by medical specialists, historians, industrialists, engineers, philosophers, lawyers, politicians and administration representatives. The first theme concerns the controversies generated by the development of some activities (genetics, bio-technologies, nuclear and radiations use). The second theme concerns the management of risks and the way to conciliate the point of view of authorities and citizens (confidence of the public with respect to experts, scientists, industrialists, government and administrative representatives, role played by the media). The debates that took place during the colloquium have shown that the public opinion concerning the nuclear activities or the new technologies greatly depends on the ideological attitudes and on the public's likes and dislikes with respect to some categories of actors (distrust with respect to public decisions, fears with respect to changes and future, nostalgia of the past). The following aspects are reviewed: Notions of risk and hazard (risk and health, risk in today's society, medicine and society, the point of view of the industrialists and of the scientific and technical specialists); from the psychological aspects of the risk to its social aspects (survey of the risk assessment battlefield, social attenuation and amplification of risk, the feeling of risks in Europe, insecurity and delinquency, controversies around radioactivity and health); the negotiation and communication about risks (risk and public health, negotiation around risks, risks and information dissemination about the public debate, communication and crisis, evolution of risk communication, comparison between American and European approaches, the Seveso directive); the public debate and the evolution of risks management (the

  13. An evolution of trauma care evaluation: A thesis on trauma registry and outcome prediction models

    NARCIS (Netherlands)

    Joosse, P.

    2013-01-01

    Outcome prediction models play an invaluable role in the evaluation and improvement of modern trauma care. Trauma registries underlying these outcome prediction models need to be accurate, complete and consistent. This thesis focused on the opportunities and limitations of trauma registries and

  14. Popular Music and Society

    DEFF Research Database (Denmark)

    2007-01-01

    Fifteen years after the collapse of the Soviet Union, popular music is thriving in the former Soviet territories and covers a broad variety of genres.  Among these are rock bands formed in the Soviet era, surviving legends of Soviet pop, and younger bands and performers of the 1990s and 2000s...... or the Russkii Rok-Klub v Amerike (Russian Rock Club of America).   This special edition of Popular Music and Society aims to present research on contemporary popular music (broadly defined) in the former Soviet republics and their diasporas.  A central issue will be how the musical landscape has changed since...

  15. Membership in cooperative societies

    Directory of Open Access Journals (Sweden)

    Eba Gaminde Egia

    2017-12-01

    Full Text Available In this work we will analyze the practical application of one of the cooperative principles, «voluntary and free membership», referring to the entering of members in cooperative societies. We will first explain the meaning of this principle, and then bring up its normative regulation, with special emphasis on those aspects in which our autonomic laws differ, and ending with a brief reference to the economic aspect and the different ways to make contributions and their consequences.Received: 31 May 2017Accepted: 14 October 2017Published online: 22 December 2017

  16. Verification and Regionalization of Trauma Systems: The Impact of These Efforts on Trauma Care in the United States

    Science.gov (United States)

    2012-01-01

    outcomes in the early phases after major trauma. Curr Opin Crit Care 2011;17:515–9. 27. Lansink KW, Leenen PH . Do designated trauma systems improve...severely injured patients treated in trauma centers following the establishment of trauma systems. J Trauma 2006;60(2):371–8. 30. Papa L, Langland-Orban B

  17. Pneumothorax in severe thoracic traumas

    International Nuclear Information System (INIS)

    Camassa, N.W.; Boccuzzi, F.; Diettorre, E.; Troilo, A.

    1988-01-01

    The authors reviewed CT scans and supine chest X-ray of 47 patients affected by severe thoracic trauma, examined in 1985-86. The sensibility of the two methodologies in the assessment of pneumothorax was compared. CT detected 25 pneumothorax, whereas supine chest X-ray allowed a diagnosis in 18 cases only. In 8 of the latter (44.4%) the diagnosis was made possible by the presence of indirect signs of pneumothorax only - the most frequent being the deep sulcus sign. The characterization of pneumothorax is important especially in the patients who need to be treated with mechanical ventilation therapy, or who are to undergo surgery in total anaesthesia

  18. The trauma of a recession.

    LENUS (Irish Health Repository)

    Murphy, S M

    2011-09-01

    Employment in construction in Ireland fell by 10% from nearly 282,000 in the second quarter of 2007 to 255,000 in the same period of 2008. Our study looks at the differences in soft tissue upper limb trauma dynamics of a pre- and post-recession Ireland. Construction accounted for 330 patients (27%) of all hand injuries in 2006, but only 18 (3%) in 2009. Our data shows a significant drop in hand injuries related to the construction industry, and more home\\/DIY cases and deliberate self-harm presenting in their stead.

  19. Trauma cardíaco

    Directory of Open Access Journals (Sweden)

    Fabio F. Cortés Diaz

    2002-04-01

    Full Text Available El mantener un alto índice de sospecha en toda herida precordial y el uso de nuevos métodos diagnósticos, ha resuelto muchos de los problemas en la evaluación y en el tratamiento de las heridas cardíacas. El siguiente texto revisa la historia, etiologías, clasificaciones, fisiopatología y aspectos relacionados con la valoración y el manejo actual del trauma cardíaco.

  20. Trauma social y memoria colectiva

    Directory of Open Access Journals (Sweden)

    Margarita Iglesias Saldaña

    2009-04-01

    Full Text Available El trauma social y la memoria colectiva, o memorias colectivas están de la mano en la América latina post-dictatorial. Desde fines de los años ochenta, se fueron destituyendo las dictaduras latinoamericanas, la mayoría sobre bases de consensos entre las fuerzas dictatoriales y los negociadores políticos de corrientes democráticas. La fuerza de los movimientos sociales sirvió de puente para las negociaciones, pero no logró estar del todo en las transacciones hacia los procesos de transición. Si así hubiera sido, la justicia y la verdad hubieran tenido un lugar privilegiado en los procesos denominados de "transición a las democracias" en distintos países del cono sur latinoamericano. La memoria colectiva ligada al trauma social tendrá varios componentes que abarcan también la memoria individual, incluyendo los espacios de la experiencia, propia y ajena. Este artículo pretende bucear en las interacciones entre ambos ámbitos de la memoria y sus conexiones con el tiempo presente.__________ABSTRACT:Social trauma and collective memory or collective memories are linked to the post-dictatorial Latin America. Since the late eighties, Latin American dictatorships were progressively dismissing, the majority on the basis of consensus between the dictatorial forces and the political mediators of the democratic part. The strength of social movements formed the bridge to negotiations, but could not entirely participate in the transactions to the transition process. If it would have been so, justice and truth would have had a special place in the process called "transition to democracy" in several Latin American Southern Cone countries. The collective memory linked to social trauma will have several components that also include individual memory, including personal and collective spaces of experience. This article aims to analyze the interactions between the two areas of memory and its connections to the present time.