Southern, Danielle A; Pincus, Harold A; Romano, Patrick S; Burnand, Bernard; Harrison, James; Forster, Alan J; Moskal, Lori; Quan, Hude; Droesler, Saskia E; Sundararajan, Vijaya; Colin, Cyrille; Gurevich, Yana; Brien, Susan E; Kostanjsek, Nenad; Üstün, Bedirhan; Ghali, William A
The World Health Organization (WHO) plans to submit the 11th revision of the International Classification of Diseases (ICD) to the World Health Assembly in 2018. The WHO is working toward a revised classification system that has an enhanced ability to capture health concepts in a manner that reflects current scientific evidence and that is compatible with contemporary information systems. In this paper, we present recommendations made to the WHO by the ICD revision's Quality and Safety Topic Advisory Group (Q&S TAG) for a new conceptual approach to capturing healthcare-related harms and injuries in ICD-coded data. The Q&S TAG has grouped causes of healthcare-related harm and injuries into four categories that relate to the source of the event: (a) medications and substances, (b) procedures, (c) devices and (d) other aspects of care. Under the proposed multiple coding approach, one of these sources of harm must be coded as part of a cluster of three codes to depict, respectively, a healthcare activity as a 'source' of harm, a 'mode or mechanism' of harm and a consequence of the event summarized by these codes (i.e. injury or harm). Use of this framework depends on the implementation of a new and potentially powerful code-clustering mechanism in ICD-11. This new framework for coding healthcare-related harm has great potential to improve the clinical detail of adverse event descriptions, and the overall quality of coded health data.
Bhat, Pookala S.; Pardal, P.K.; M Diwakar
Self-mutilation, the deliberate destruction occurs in a variety of psychiatric disorders.Many methods of self-destructive behavior have been described in literature. Patients of schizophrenia are known to attempt self-harm due to command hallucination, catatonic excitement or because of associated depression, however severe glossal injury by biting has not been reported so far.Authors report case of self-harm of glossal injury by biting in schizophrenia. Treatment and management issues are di...
Ballard, Elizabeth D; Kalb, Luther G; Vasa, Roma A; Goldstein, Mitchell; Wilcox, Holly C
Although injuries are a known cause of morbidity and mortality among children and adolescents, little is known about the epidemiology of injury-related emergency department (ED) visits in the United States by injury intent. The objective of this analysis was to examine ED outcomes, defined as death in the ED, inpatient admission, and visit cost, among ED visits stratified by injury intent (i.e., self-harm, assault, and injury with undetermined intent, as compared with unintentional injuries). All injury-related ED visits in the United States for children and adolescents, ages 8 to 17 years, were identified using the 2008 Nationwide Emergency Department Sample. Multivariate survey weighted logistic and linear regression analyses were then used to estimate the likelihood of death on ED visit, inpatient admission, and cost across the 4 injury types. In 2008, with the use of weighted estimates, there were 66,895 self-harm, 176,125 assault, 24,144 undetermined injury, and 4,244,589 unintentional injury ED visits among children 8 to 17 years. Visits due to self-harm, assault and undetermined injuries were more likely to result in death during the ED visit compared with visits due to unintentional injuries. Self-harm and undetermined intent were also associated with greater odds of inpatient admission as well as 90% and 60% higher ED visit costs, respectively. Data from this nationwide sample of pediatric ED visits highlight the resource burden of self-harm, undetermined intent, and assault injury visits. Pediatric EDs may provide a window of opportunity for better case identification and intervention with children experiencing violence and injury.
Pookala S Bhat
Full Text Available Self-mutilation, the deliberate destruction occurs in a variety of psychiatric disorders.Many methods of self-destructive behavior have been described in literature. Patients of schizophrenia are known to attempt self-harm due to command hallucination, catatonic excitement or because of associated depression, however severe glossal injury by biting has not been reported so far.Authors report case of self-harm of glossal injury by biting in schizophrenia.Treatment and management issues are discussed.
de Jong, Peter J.; Peters, Madelon L.
There is increasing evidence that blood-injection-injury (1311) phobia is qualitatively different from the other specific phobias in the sense that phobic distress takes the form of disgust rather than (threat-induced) fear. Following this, we tested the relative importance of harm and
Møhl, Bo; la Cour, Peter; Skandsen, Annika
Background: Non-suicidal self-injury (NSSI) and indirect self-harm are prevalent among adolescents, but it is rare to see them described as related topics. Objective: The purpose of this study was to investigate whether there is a correlation between the frequencies of NSSI and indirect self...
Jackson, Debra; Hutchinson, Marie; Barnason, Susan; Li, William; Mannix, Judy; Neville, Stephen; Piper, Donella; Power, Tamara; Smith, Graeme D; Usher, Kim
To analyse influential policies that inform practice related to pressure injury management in Australia, England, Hong Kong, New Zealand, Scotland and the United States of America. Pressure injuries are associated with significant harm to patients, and carry economic consequences for the health sector. Internationally, preventing and managing pressure injuries is a key nursing activity and quality indicator. Comparative review and synthesis of pressure injury policies that inform practice. The predominant focus of policy is on patient risk assessment, compliance with documentation and pressure relief. Financial penalty for institutions is emerging as a strategy where pressure injuries occur. Comparisons of prevalence rates are hampered by the lack of consensus on data collection and reporting. To date there has been little evaluation of policy implementation and implemented policy strategies, associated guidelines remain founded upon expert opinion and low-level evidence. The pressure injury policy agenda has fostered a discourse of attention to incidents, compliance and penalty (sanctions). Prevention and intervention strategies are informed by technical and biomedical interpretations of patient risk and harm, with little attention given to the nature or design of nursing work. Considerable challenges remain if this policy agenda is successfully to eliminate pressure injury as a source of patient harm. © 2016 John Wiley & Sons Ltd.
Diep, Pham Bich; Knibbe, Ronald A; Giang, Kim Bao; De Vries, Nanne
This study examines the prevalence of and risk factors for alcohol-related harm and types of harm among medical students from Hanoi Medical University (Vietnam). Risk factors include aspects of drinking patterns and relevant socio-demographic variables. A cross-sectional study involving 1st to 6th year students (N=1216; response rate 96.5%). Of these, 210 students from each academic year were randomly selected from a sampling frame covering all students from each academic year. Data were collected using a questionnaire distributed in class by researchers. Drinkers completed 23 questions on alcohol-related harm categorized into: 1) 'negative influence on daily activities'; 2) 'social conflict'; 3) 'loss of control, acute consequences, and withdrawal'; 4) 'mental health conditions'; and 5) 'physical and medical health problems'. Logistic and Poisson regression models were used to identify the predictors of alcohol-related harm and the amount of harm, respectively. The prevalence of alcohol use associated with at least one or more of the five types of harm was higher in men (81.8%) than in women (60.4%). In female and male students, the most common harm category was 'loss of control, acute consequences, and withdrawal' (51.8 and 75.6%, respectively), followed by 'negative influence on daily activities' (29.4 and 55.8%, respectively). Age, living away from home, and average number of standard drinks per occasion among male drinkers, and age and frequency of drinking per week among female drinkers were associated with alcohol-related harm. These data suggest that alcohol-related harm represents a serious public health problem among young educated individuals in Vietnam. The risk factors indicate that prevention should be aimed at aspects of drinking patterns and specific subpopulations defined by gender, age, and (for men only) type of living situation.
Utz-Billing, I; Kentenich, H
This article gives an overview over the huge topic of 'female genital mutilation' (FGM). FGM means non-therapeutic, partial or complete removal or injury of each of the external female genitals. It concerns about 130 million women around the world. FGM is performed in about 30 countries, most of which are located in Africa. Four types of FGM are distinguished: type I stands for the removal of the clitoral foreskin, type II means the removal of the clitoris with partial or total excision of the labia minora. Type III is the extreme type of FGM. Not only the clitoris but also the labia minora and majora were removed. The orificium vaginae is sewn up, leaving only a small opening for urine or menstruation blood. Other types like pricking, piercing of clitoris or vulva, scraping of the vagina, etc. were defined as type IV of FGM. The mentioned reasons for FGM are: encouragement of the patriarchal family system, method for birth control, guarantee of moral behaviour and faithfulness to the husband, protection of women from suspicions and disgrace, initiation ritual, symbol of feminity and beauty, hygienic, health and economic advantages. Acute physical consequences of FGM include bleeding, wound infections, sepsis, shock, micturition problems and fractures. Chronic physical problems like anemia, infections of the urinary tract, incontinence, infertility, pain, menstruation problems and dyspareunia are frequent. Women also have a higher risk for HIV infections. During pregnancy and delivery, examinations and vaginal application of medicine are more difficult. Women have a higher risk for a prolonged delivery, wound infections, a postpartum blood loss of more than 500 mL, perineal tears, a resuscitation of the infant and an inpatient perinatal death. Mental consequences after FGM include the feelings of incompleteness, fear, inferiority and suppression. Women report chronic irritability and nightmares. They have a higher risk for psychiatric and psychosomatic diseases
Mishra, Avinash; Verma, Ashok K
Every year > 600,000 sports and recreation related eye injuries occur, out of which roughly 13,500 of these result in permanent loss of sight. Up to 90% of these sports related eye injuries are preventable by using adequate eye protection equipment. Protective eyewear is made of polycarbonate, a highly impact-resistant plastic which is now easily available as prescription and non-prescription eyewear and all players should be encouraged to use them. The medical officers by educating their patients regarding the risks of eye injuries in various sports and the confirmed benefits of using protective equipment have the potential to prevent injury to over thousands of eyes every year. The medical fraternity can also play a very important role in educating the coaches, parents, and children and thus put an end to unnecessary blindness and vision loss from sports related ocular injuries, therefore ensuring a lifetime of healthy vision.
Jayarao, Mayur; Chin, Lawrence S; Cantu, Robert C
Fatalities in boxing are most often due to traumatic brain injury that occurs in the ring. In the past 30 years, significant improvements in ringside and medical equipment, safety, and regulations have resulted in a dramatic reduction in the fatality rate. Nonetheless, the rate of boxing-related head injuries, particularly concussions, remains unknown, due in large part to its variability in clinical presentation. Furthermore, the significance of repeat concussions sustained when boxing is just now being understood. In this article, we identify the clinical manifestations, pathophysiology, and management of boxing-related head injuries, and discuss preventive strategies to reduce head injuries sustained by boxers.
Nonsuicidal self-injury (NSSI) is a newly proposed diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Some contemporary historiography dismisses NSSI as a fiction of modern psychiatry. Although the exact definition and psychological meaning attributed to self-harm has not been static over history, there is a clear thread that connects Western asylum psychiatrists' thinking about self-harm to the current stand-alone diagnostic category of NSSI. Nineteenth-century psychiatrists identified a clinically meaningful difference between self-harm with and without the intent to die, between self-injurers who were psychotic and those who were not, and between self-injurers who made a single, serious mutilation and those who repetitively self-injured without causing permanent bodily damage. These same distinctions are apparent in the definition of NSSI. Thus, NSSI is a formalization of long-held observations about a category of people who repetitively self-injure without suicidal intent.
Sanchez-Ramirez, Diana C; Voaklander, Donald
Evidence supports the expectation that changes in time of alcohol sales associate with changes in alcohol-related harm in both directions. However, to the best of our knowledge, no comprehensive systematic reviews had examined the effect of policies restricting time of alcohol trading on specific alcohol-related harms. To compile existing evidence related to the impact of policies regulating alcohol trading hours/days of on specific harm outcomes such as: assault/violence, motor vehicle crashes/fatalities, injury, visits to the emergency department/hospital, murder/homicides and crime. Systematic review of literature studying the impact of policies regulation alcohol trading times in alcohol-related harm, published between January 2000 and October 2016 in English language. Results support the premise that policies regulating times of alcohol trading and consumption can contribute to reduce injuries, alcohol-related hospitalisations/emergency department visits, homicides and crime. Although the impact of alcohol trading policies in assault/violence and motor vehicle crashes/fatalities is also positive, these associations seem to be more complex and require further study. Evidence suggests a potential direct effect of policies that regulate alcohol trading times in the prevention of injuries, alcohol-related hospitalisations, homicides and crime. The impact of these alcohol trading policies in assault/violence and motor vehicle crashes/fatalities is less compelling. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Volkmann, Tyson; Lozada, Remedios; Anderson, Christy M; Patterson, Thomas L; Vera, Alicia; Strathdee, Steffanie A
To assess factors associated with drug-related harms related to policing among injection drug users (IDUs) in Tijuana, Mexico. IDUs who were over 18 years old and had injected drugs within the last six months were recruited via respondent-driven sampling and underwent questionnaires and testing for HIV (human immunodeficiency virus), syphilis and TB (tuberculosis). Random effects logistic regression was used to simultaneously model factors associated with five drug-related harms related to policing practices in the prior six months (i.e., police led them to rush injections; affected where they bought drugs; affected locations where they used drugs; feared that police will interfere with their drug use; receptive syringe sharing). Of 727 IDUs, 85% were male; median age was 38 years. Within the last 6 months, 231 (32%) of IDUs reported that police had led them to rush injections, affected where they bought or used drugs or were very afraid police would interfere with their drug use, or shared syringes. Factors independently associated with drug-related harms related to policing within the last six months included: recent arrest, homelessness, higher frequencies of drug injection, use of methamphetamine, using the local needle exchange program and perceiving a decrease in the purity of at least one drug. IDUs who experienced drug-related harms related to policing were those who were most affected by other micro and macro influences in the physical risk environment. Police education programs are needed to ensure that policing practices do not exacerbate risky behaviors or discourage protective behaviors such as needle exchange program use, which undermines the right to health for people who inject drugs.
Hart, Ellen; Burns, Sharyn
Issue addressed Research has shown that Australian university students consume alcohol at a higher level than their peers from the general population and are therefore more likely to witness and experience alcohol-related harm. This study measured the prevalence of alcohol consumption among 18-24-year-old university students and the association between alcohol consumption and witnessed and experienced harms. Methods A random cross-sectional sample of university students aged 18-24 years (n=2466) was recruited via the University Survey Office and through random intercept at campus market day. All participants completed an online survey that included the Alcohol Use Disorders Identification Test, Alcohol Problems Scale and an additional scale measuring witnessed harm. Results Principal Components Analysis revealed three factors within the Alcohol Problems Scale; i.e. Criminal and Aggressive Behaviour, Health and Emotional Harms and Sexual Harms. Students who consume alcohol at high-risk levels were significantly more likely to score highly on each factor, 1.6 times more likely to experience harm and 1.1 times more likely to witness harm than students who consume alcohol at low-risk levels. Conclusions The positive association between alcohol consumption and alcohol-related harm supports previous findings. This study adds previous research through the categorisation of harm into factors. So what? Integrated and comprehensive interventions addressing alcohol consumption among young university students that are informed by evidence-based research can be tailored to ensure that they meet the needs of the target group.
Zwaan, L.; Thijs, A.; Wagner, C.; Wal, G. van der; Timmermans, D.R.M.
Purpose: The relationship between faults in diagnostic reasoning, diagnostic errors, and patient harm has hardly been studied. This study examined suboptimal cognitive acts (SCAs; i.e., faults in diagnostic reasoning), related them to the occurrence of diagnostic errors and patient harm, and studied
Mikhailovich, Katja; George, Amanda; Rickwood, Debra; Parker, Rhian
Studies documenting the harm associated with excessive drinking amongst university students are numerous. Fewer studies have explored the experience of non-drinkers in the university setting. In 2008, 826 students aged 18-29 years responded to an online survey aiming to investigate alcohol use and alcohol related harm at an Australian university.…
Gosling, Cameron McR; Gabbe, Belinda J; Forbes, Andrew B
Triathlon is a popular participation sport that combines swimming, cycling and running into a single event. A number of studies have investigated the incidence of injury, profile of injuries sustained and factors contributing to triathlon injury. This paper summarises the published literature in the context of the evidence base for the prevention of triathlon related injuries. Relevant articles on triathlon injuries were sourced from peer-reviewed English language journals and assessed using the Translating Research into Injury Prevention Practice (TRIPP) framework. This review highlights the significant knowledge gap that exists in the published literature describing the incidence of injury, the profile of injuries sustained and evidence for the prevention of injury in triathlon. Despite the number of studies undertaken to address TRIPP Stages 1 and 2 (injury surveillance, aetiology and mechanism of injury), most triathlon studies have been limited by retrospective designs with substantial, and unvalidated, recall periods, inconsistency in the definitions used for a reportable injury and exposure to injury, or a failure to capture exposure data at all. Overall, the paucity of quality, prospective studies investigating the incidence of injury in triathlon and factors contributing to their occurrence has led to an inability to adequately inform the development of injury prevention strategies (TRIPP Stages 3-6) for this sport, a situation that must be rectified if gains are to be made in reducing the burden of triathlon related injury.
Li, Xue-feng; Wang, Xian
Cardiac injury is the most serious adverse event in acupuncture therapy. The causes include needling chest points near the heart, the cardiac enlargement and pericardial effusion that will enlarge the projected area on the body surface and make the proper depth of needling shorter, and the incorrect needling method of the points. Therefore, acupuncture practitioners must be familiar with the points of the heart projected area on the chest and the correct needling methods in order to reduce the risk of acupuncture therapy related cardiac injury.
Muehlenkamp Jennifer J
Full Text Available Abstract Background The behaviours of non-suicidal self-injury (NSSI and deliberate self-harm (DSH are prevalent among adolescents, and an increase of rates in recent years has been postulated. There is a lack of studies to support this postulation, and comparing prevalence across studies and nations is complicated due to substantial differences in the methodology and nomenclature of existing research. Methods We conducted a systematic review of current (2005 - 2011 empirical studies reporting on the prevalence of NSSI and DSH in adolescent samples across the globe. Results Fifty-two studies fulfilling the inclusion criteria were obtained for analysis. No statistically significant differences were found between NSSI (18.0% SD = 7.3 and DSH (16.1% SD = 11.6 studies. Assessment using single item questions led to lower prevalence rates than assessment with specific behaviour checklists. Mean prevalence rates have not increased in the past five years, suggesting stabilization. Conclusion NSSI and DSH have a comparable prevalence in studies with adolescents from different countries. The field would benefit from adopting a common approach to assessment to aide cross-cultural study and comparisons.
Hahn, Robert A; Kuzara, Jennifer L; Elder, Randy; Brewer, Robert; Chattopadhyay, Sajal; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci; Middleton, Jennifer Cook; Lawrence, Briana
Local, state, and national policies that limit the hours that alcoholic beverages may be available for sale might be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of such policies. All of the studies included in this review assessed the effects of increasing hours of sale in on-premises settings (in which alcoholic beverages are consumed where purchased) in high-income nations. None of the studies was conducted in the U.S. The review team's initial assessment of this evidence suggested that changes of less than 2 hours were unlikely to significantly affect excessive alcohol consumption and related harms; to explore this hypothesis, studies assessing the effects of changing hours of sale by less than 2 hours and by 2 or more hours were assessed separately. There was sufficient evidence in ten qualifying studies to conclude that increasing hours of sale by 2 or more hours increases alcohol-related harms. Thus, disallowing extensions of hours of alcohol sales by 2 or more should be expected to prevent alcohol-related harms, while policies decreasing hours of sale by 2 hours or more at on-premises alcohol outlets may be an effective strategy for preventing alcohol-related harms. The evidence from six qualifying studies was insufficient to determine whether increasing hours of sale by less than 2 hours increases excessive alcohol consumption and related harms.
Carhart-Harris, Robin Lester; Nutt, David John
A web-based survey was used to consult the opinions of experienced drug users on matters related to drug harms. We identified a rare sample of 93 drug users with personal experience with 11 different illicit drugs that are widely used in the UK. Asked to assess the relative harms of these drugs, they ranked alcohol and tobacco as the most harmful, and three "Class A" drugs (MDMA, LSD, and psilocybin) and one class B (cannabis) were ranked as the four least harmful drugs. When asked to assess the relative potential for benefit of the 11 drugs, MDMA, LSD, psilocybin, and cannabis were ranked in the top four; and when asked why these drugs are beneficial, rather than simply report hedonic properties, they referred to potential therapeutic applications (e.g., as tools to assist psychotherapy). These results provide a useful insight into the opinions of experienced drug users on a subject about which they have a rare and intimate knowledge.
Kingsland, Melanie; Wiggers, John H; Vashum, Khanrin P; Hodder, Rebecca K; Wolfenden, Luke
Elevated levels of risky alcohol consumption and alcohol-related harm have been reported for sportspeople and supporters compared to non-sporting populations. Limited systematic reviews have been conducted to assess the effect of interventions targeting such behaviours. A review was undertaken to determine if interventions implemented in sports settings decreased alcohol consumption and related harms. Studies were included that implemented interventions within sports settings; measured alcohol consumption or alcohol-related injury or violence and were either randomised controlled trials, staggered enrollment trials, stepped-wedged trials, quasi-randomised trials, quasi-experimental trials or natural experiments. Studies without a parallel comparison group were excluded. Studies from both published and grey literature were included. Two authors independently screened potential studies against the eligibility criteria, and two authors independently extracted data from included studies and assessed risk of bias. The results of included studies were synthesised narratively. The title and abstract of 6382 papers and the full text of 45 of these papers were screened for eligibility. Three studies met the inclusion criteria for the review. One of the included studies was a randomised controlled trial (RCT) of a cognitive-behavioural intervention with athletes within an Olympic training facility in the USA. The study reported a significant change in alcohol use between pre-test and follow-up between intervention and control groups. The other two studies were RCTs in community sports clubs in Ireland and Australia. The Australian study found a significant intervention effect for both risky alcohol consumption at sports clubs and overall risk of alcohol-related harm. The Irish study found no significant intervention effect. A limited number of studies have been conducted to assess the effect of interventions implemented in sports settings on alcohol consumption and related
Vallance, Kate; Stockwell, Tim; Pauly, Bernie; Chow, Clifton; Gray, Erin; Krysowaty, Bonnie; Perkin, Kathleen; Zhao, Jinhui
Background Managed alcohol programs (MAPs) are a harm reduction strategy for people with severe alcohol dependence and unstable housing. MAPs provide controlled access to alcohol usually alongside accommodation, meals, and other supports. Patterns of alcohol consumption and related harms among MAP participants and controls from a homeless shelter in Thunder Bay, Ontario, were investigated in 2013. Methods Structured interviews were conducted with 18 MAP and 20 control participants assessed as...
Firestone, Michelle; Tyndall, Mark; Fischer, Benedikt
There is evidence of increasing trends in substance use and related harms among Aboriginal populations in Canada. This paper provides a review of data on alcohol, tobacco, and illicit drug use and related harms. A comprehensive review of public data, journal publications, and grey literature published between 2000 and 2014 were reviewed if data included: people who self-identify as Aboriginal and who live in Canada; drug use; and morbidity and mortality related to drug use. Data were structured by major substance categories and compared with non-Aboriginal sample data where possible. Over 100 documents were reviewed and revealed a disproportionate burden of substance use and harms, particularly among Aboriginal youth. Significant gaps in data exist, specifically, for urban populations. This review reinforces concerns of many Aboriginal communities and organizations in Canada as well as highlights where prevention, programming, and policy efforts might be most effective.
Tang, Yi-lang; Xiang, Xiao-jun; Wang, Xu-yi; Cubells, Joseph F; Babor, Thomas F; Hao, Wei
In China, alcohol consumption is increasing faster than anywhere else in the world. A steady increase in alcohol production has also been observed in the country, together with a rise in alcohol-related harm. Despite these trends, China's policies on the sale and consumption of alcoholic beverages are weak compared with those of other countries in Asia. Weakest of all are its policies on taxation, drink driving laws, alcohol sale to minors and marketing licenses. The authors of this descriptive paper draw attention to the urgent need for public health professionals and government officials in China to prioritize population surveillance, research and interventions designed to reduce alcohol use disorders. They describe China's current alcohol policies and recent trends in alcohol-related harm and highlight the need for health officials to conduct a thorough policy review from a public health perspective, using as a model the World Health Organization's global strategy to reduce the harmful use of alcohol.
van Doormaal, J.E.; Rommers, M.K.; Kosterink, J.G.; Teepe-Twiss, I.M.; Haaijer-Ruskamp, F.M.; Mol, P.G.
Background With the introduction of Computerised Physician Order Entry (CPOE) in routine hospital care, a great deal of effort has been put into refining Clinical Decision Support Systems (CDSS) to identify patients at risk of preventable medication-related harm. Objectives This study compared a CPO
Hasking, Penelope; Shortell, Carly; Machalek, Mireille
A total of 371 university students were asked to estimate the amount of alcohol contained in a standard drink and to estimate the number of standard drinks contained in popular alcoholic beverages. In addition, students completed questionnaires assessing their perception of short and long term harm related to the consumption of beer, wine, spirits…
van Doormaal, J.E.; Rommers, M.K.; Kosterink, J.G.; Teepe-Twiss, I.M.; Haaijer-Ruskamp, F.M.; Mol, P.G.
Background With the introduction of Computerised Physician Order Entry (CPOE) in routine hospital care, a great deal of effort has been put into refining Clinical Decision Support Systems (CDSS) to identify patients at risk of preventable medication-related harm. Objectives This study compared a CPO
van Doormaal, J.E.; Rommers, M.K.; Kosterink, J.G.; Teepe-Twiss, I.M.; Haaijer-Ruskamp, F.M.; Mol, P.G.
Background With the introduction of Computerised Physician Order Entry (CPOE) in routine hospital care, a great deal of effort has been put into refining Clinical Decision Support Systems (CDSS) to identify patients at risk of preventable medication-related harm. Objectives This study compared a
Cerulli, Giulio; Carboni, Andrea; Mercurio, Alessandra; Perugini, Maurizio; Becelli, Roberto
The authors assessed the rate of craniomaxillofacial fractures in soccer and the areas where they occur, describing above all the injury pattern of this sport. Over a 5-year period (1995-2000) 46 cases of 329 with fractures associated with different sports activities have been surgically operated at the maxillofacial surgery department of the Policlinico "Umberto I" Hospital, University "La Sapienza" of Rome. All data collected have been selected on the basis of sex, age, anatomic site of the fracture, and the practiced sport. Information on injury patterns, severity, and play circumstances have been documented. The department examined 7 sports disciplines, but soccer was responsible for sports-related maxillofacial fractures in 34 of 46 cases (73.9%). All 34 fractures occurred to men. In soccer, the zygomatic and nasal regions are mainly involved. In fact the authors examined zygomatic fractures in 15 cases and nasal fractures in 10 cases. Direct contact between players generally causes soccer-related maxillofacial fractures: head-elbow impacts (21 cases) or head-head impacts (14 cases). The male:female ratio is 6.6:1, while the average age is 25 years for males and 23 years for females. In comparison with other sports (rugby, football, etc.) where physical contact occurs more frequently and the higher incidence of traumatic events justifies the use of protective measures, soccer is not a particularly violent sport. In soccer, maxillofacial traumas are caused by violent impacts between players that take place mainly when the ball is played with the forehead. In this moment there can be an elbow-head impact or a head-head impact. The authors believe that the low incidence of fractures, severity of the lesions, and discomfort caused by possible protective masks make their use unjustified. The data collected during this study witness that in soccer 21 of 34 cases of maxillofacial fractures are caused by elbow-head impacts. This fact suggests a preventive strategy
Seddon, Mary E; Jackson, Aaron; Cameron, Chris; Young, Mary L; Escott, Linda; Maharaj, Ashika; Miller, Nigel
To measure the extent of patient harm caused by medications (rate of Adverse Drug Events) in three DHBs, using a standardised trigger tool method. Counties Manukau, Capital and Coast and Canterbury DHBs decided to work collaboratively to implement the ADE Trigger Tool (TT). Definitions of ADE were agreed on and triggers refined. A random sample of closed charts (from March 2010 to February 2011) was obtained excluding patients who were admitted for <48 hours, children under the age of 18 and psychiatric admissions. In each DHB trained reviewers scanned these in a structured way to identify any of the 19 triggers. If triggers were identified, a more detailed, though time-limited review of the chart was done to determine whether an ADE had occurred. The severity of patient harm was categorised using the National Coordinating Council for Medication Error Reporting and Prevention Index. No attempt was made to determine preventability of harm and ADEs from acts of omission were excluded. The ADE TT was applied to 1210 charts and 353 ADE were identified, with an average rate of 28.9/100 admissions and 38/1,000 bed days. 94.5% of the ADE identified were in the lower severity scales with temporary harm, however in 5 patients it was considered that the ADE contributed to their death, 9 required an intervention to sustain life and 4 suffered permanent harm. The most commonly implicated drugs were morphine and other opioids, anticoagulants, antibiotics, Non Steroidal Anti-Inflammatory Drugs (NSAIDs) and diuretics. Patients who suffered an ADE were more likely to be female, older with more complex medical illnesses, and have a longer length of stay. The rate of medication-related harm identified by the ADE TT is considerably higher than that identified through traditional voluntary reporting mechanisms. The ADE TT provides a standardised measure of harm over time that can be used to determine trends and the effect of medication safety improvement programmes. This study not
... difficulty expressing words or thoughts; dysarthric speech Head Injury Prevention Tips Buy and use helmets or protective head gear approved by the ASTM for specific sports 100 percent of the time. The ASTM has ...
Nielsen, Rasmus Østergaard; Buist, Ida; Sørensen, Henrik
The purpose of this systematic review was to examine the link between training characteristics (volume, duration, frequency, and intensity) and running related injuries.......The purpose of this systematic review was to examine the link between training characteristics (volume, duration, frequency, and intensity) and running related injuries....
Nielsen, Rasmus Østergaard; Buist, Ida; Sørensen, Henrik;
The purpose of this systematic review was to examine the link between training characteristics (volume, duration, frequency, and intensity) and running related injuries.......The purpose of this systematic review was to examine the link between training characteristics (volume, duration, frequency, and intensity) and running related injuries....
Møhl, Bo; la Cour, Peter; Skandsen, Annika
-harm (e.g., eating problems, alcohol and drug use) and how this may be influenced by gender. Method: Questionnaires about NSSI (e.g., cutting, burning, scratching, hitting oneself) and indirect self-harm were distributed to high school students in theCopenhagen area (N = 5650; response rate 53%; females...... of NSSI as compared with females, and clinicians must look for gender-specific signs of NSSI. It is argued that NSSI can be perceived as a “social pathology,” but it is also indicated that NSSI and indirect self-harm can be evaluated as an expression of ordinary behavior among modern high school students...... 60.8%). Results: A total of 21.5% of the survey respondents had engaged in NSSI (lifetime prevalence), and 16.2% had practiced NSSI within the previous year. Gender differences in NSSI methods were identified. A total of 53.9% of the students had engaged in one or more types of indirect self...
Møhl, Bo; la Cour, Peter; Skandsen, Annika
-harm (e.g., eating problems, alcohol and drug use) and how this may be influenced by gender. Method: Questionnaires about NSSI (e.g., cutting, burning, scratching, hitting oneself) and indirect self-harm were distributed to high school students in theCopenhagen area (N = 5650; response rate 53%; females...... 60.8%). Results: A total of 21.5% of the survey respondents had engaged in NSSI (lifetime prevalence), and 16.2% had practiced NSSI within the previous year. Gender differences in NSSI methods were identified. A total of 53.9% of the students had engaged in one or more types of indirect self...... of NSSI as compared with females, and clinicians must look for gender-specific signs of NSSI. It is argued that NSSI can be perceived as a “social pathology,” but it is also indicated that NSSI and indirect self-harm can be evaluated as an expression of ordinary behavior among modern high school students...
Colville-Ebeling, Bonnie; Lynnerup, Niels; Banner, Jytte
the operator or a bystander is impacted by an object mobilized from the grass by the rotating mower blades. This type of injury often leaves only modest external trauma, which increases the risk of overlooking an entry wound. In this paper we present a case of a fatal lawn mower related projectile injury which...
Driscoll, T; Hanson, M
This study attempted to identify and describe all work-related injuries in a cohort of trade apprentices at the Canberra Institute of Technology over an approximate one-year period. In 997 persons followed for a total of 198,456 days of exposure there were 771 injuries of which 191 were classed as serious (defined as at least one day off work and/or received sutures and/or required hospital treatment). The most common circumstance of injury was a cut to the fingers or hand while using a sharp-edged, non-powered hand tool. At least 52 persons required hospital treatment and another 51 required suturing. Overall rates of injury were 222 (95 per cent confidence interval (CI) = 193 to 256) injuries per 1000 full time equivalents (FTEs) and 169 (95% CI = 147 to 193) injured persons per 1000 persons. Injury rates adjusted for stage (year of course) were significantly different between schools and were highest in the construction and engineering trades groups (chi 2(5) = 57.30, P work-related injury and provides important insights into the characteristics of work-related injuries in trade apprentices. These have significant implications for the safety expectations apprentices may bring to the workplace and for the appropriate targeting of occupational health and safety training of apprentices in the trade occupations.
Scheuring, Rick; McCulloch, Pat; Van Baalen, Mary; Watson, Richard; Bowen, Steve; Blatt, Terri
There are multiple factors associated with the mechanism of injury that leads to shoulder injury requiring surgical repair. Despite the injury prevention measures taken from the 2003 Shoulder Tiger Team recommendations, shoulder injuries and subsequent shoulder surgeries remain relatively unchanged.
During 1980-1993, the incidence of landmine-related injuries doubled, resulting in an estimated 2000 deaths or injuries each month. Approximately 120 million landmines are buried in 71 countries throughout the world, and 2-5 million new landmines are planted each year. Some countries, such as Afghanistan, Angola, and Cambodia, have approximately 10 million landmines each. Landmines can have profound medical, environmental, and economic consequences, particularly for the civilian populations of those countries burdened with landmines. However, the consequences of landmines extend beyond the borders of those countries. Health-care workers and nongovernmental organizations are increasingly asked to assist emergency-affected, displaced, and refugee populations in regional conflicts, resulting in their increased exposure to landmines. This report describes three cases of landmine-related injury and illustrates the public health consequences of those injuries and the potential role for public health workers in preventing those injuries.
Hides, Leanne; Limbong, Jesani; Vallmuur, Kirsten; Barker, Ruth; Daglish, Mark; Young, Ross McD
The rate of alcohol-related emergency department (ED) presentations in young people has increased dramatically in recent decades. Injuries are the most common type of youth alcohol-related ED presentation, yet little is known about these injuries in young people. This paper describes the characteristics of alcohol-related ED injury presentations in young people over a 13-year period and determines if they differ by gender and/or age group (adolescents: 12-17 years; young adults: 18-24 years). The Queensland Injury Surveillance Unit (QISU) database collects injury surveillance data at triage in participating EDs throughout Queensland, Australia. A total of 4667 cases of alcohol-related injuries in young people (aged 12-24 years) were identified in the QISU database between January 1999 and December 2011, using an injury surveillance code and nursing triage text-based search strategy. Overall, young people accounted for 38% of all QISU alcohol-related ED injury presentations in patients aged 12 years or over. The majority of young adults presented with injuries due to violence and falls, whereas adolescents presented due to self-harm or intoxication without other injury. Males presented with injuries due to violence, whereas females presented with alcohol-related self-harm and intoxication. There is a need for more effective ways of identifying the degree of alcohol involvement in injuries among young people presenting to EDs. © 2014 Australasian Professional Society on Alcohol and other Drugs.
Vallance, Kate; Stockwell, Tim; Pauly, Bernie; Chow, Clifton; Gray, Erin; Krysowaty, Bonnie; Perkin, Kathleen; Zhao, Jinhui
Managed alcohol programs (MAPs) are a harm reduction strategy for people with severe alcohol dependence and unstable housing. MAPs provide controlled access to alcohol usually alongside accommodation, meals, and other supports. Patterns of alcohol consumption and related harms among MAP participants and controls from a homeless shelter in Thunder Bay, Ontario, were investigated in 2013. Structured interviews were conducted with 18 MAP and 20 control participants assessed as alcohol dependent with most using non-beverage alcohol (NBA). Qualitative interviews were conducted with seven participants and four MAP staff concerning perceptions and experiences of the program. Program alcohol consumption records were obtained for MAP participants, and records of police contacts and use of health services were obtained for participants and controls. Some participants' liver function test (LFT) results were available for before and after MAP entry. Compared with periods off the MAP, MAP participants had 41 % fewer police contacts, 33 % fewer police contacts leading to custody time (x (2) = 43.84, P NBA use was significantly less frequent for MAP participants versus controls (t = -2.34, P NBA consumption, and decreases in some alcohol-related harms. These encouraging trends are being investigated in a larger national study.
Canale, Natale; Vieno, Alessio; Griffiths, Mark D
Objectives To examine whether the "prevention paradox" applies to British individuals in relation to gambling-related harm. Methods Data were derived from 7,756 individuals participating in the British Gambling Prevalence Survey 2010, a comprehensive interview-based survey conducted in Great Britain between November 2009 and May 2010. Gambling-related harm was assessed using an adapted version of the DSM-IV Pathological Gambling criteria. The previous year's prevalence of problem gamblers was examined using the Problem Gambling Severity Index. Gambling involvement was measured by gambling frequency and gambling participation (gambling volume as expressed by time and money spent gambling). Results The prevalence rates for past-year gambling harms were dependence harm (16.4%), social harm (2.2%), and chasing losses (7.9%). Gambling-related harms were distributed across low- to moderate-risk gamblers (and not limited to just problem gamblers) and were reported by the majority of gamblers who were non-high time and spend regular gamblers than high time and spend regular gamblers. Conclusions The prevention paradox is a promising way of examining gambling-related harm. This suggests that prevention of gambling might need to consider the population approach to minimizing gambling harm.
Full Text Available Many of the EDM events known as “transformational festivals” provide psychedelic support spaces: volunteer projects caring for festivalgoers undergoing difficult drug experiences. Mostly drawn from the festival community, many volunteer carers (“sitters” subscribe to psychedelic culture discourse which frames these substances as aids to personal growth if handled appropriately. However, within the dominant paradigm of international drug prohibition, support projects must employ the contrasting discourse of harm reduction in order to gain access to events, visibility to festivalgoers, and integration with other support staff. Harm reduction, a paradigm for the care of drug users which began as a grassroots heroin addict advocacy movement, has since become associated with neoliberal, medicalised views of drugs, drug users and the self. This article considers how psychedelic support workers negotiate this discourse dichotomy in the course of caregiving, within differing national and local drug policy climates. Early findings are presented from ethnographic fieldwork as a psychedelic support volunteer with three organisations at seven festivals, combining participant observation and in-depth interviews with nineteen support workers. Events in the UK, the US and Portugal were studied due to these countries’ contrasting policy regimes. Points of conflict between the psychedelic and harm reduction discourses were found to create tensions both within the support organisations and in their relations with on-site medics, security guards, festival organisers and police. The findings suggest that mainstream harm reduction discourses may be a poor fit for psychedelics and that risks inhere in their adoption by festival support spaces, such as abjection of drug users in difficulty which may create a trust-damaging divide between users and workers.
Rass, Olga; Pacek, Lauren R; Johnson, Patrick S; Johnson, Matthew W
Awareness and use of electronic cigarettes (e-cigarettes) is increasing. Questions regarding positive (e.g., smoking reduction/cessation) and negative (e.g., delay of cessation) potential public health consequences of e-cigarettes may be informed by studying dual users of e-cigarettes and tobacco cigarettes. A cross-sectional online survey assessed demographics, product use patterns, and beliefs about relative product benefits and harms among dual users (n = 350) in the United States using the website Amazon Mechanical Turk. Compared to tobacco cigarettes, e-cigarettes were used less often and were associated with lower dependence. Participants reported a 30% reduction in self-reported tobacco cigarette smoking since beginning to use e-cigarettes. Reported primary reasons for e-cigarette use were harm reduction and smoking cessation. E-cigarette use was reported as more likely in settings with smoking restrictions and when others' health could be adversely affected. Conversely, participants reported having used tobacco cigarettes more often than e-cigarettes in hedonic situations (e.g., after eating, drinking coffee or alcohol, or having sex), outdoors, or when stressed. Participants were twice as likely to report wanting to quit tobacco cigarettes compared to e-cigarettes in the next year and intended to quit tobacco cigarettes sooner. Tobacco cigarettes were described as more harmful and addictive, but also as more enjoyable than e-cigarettes. Participants provided evidence consistent with both positive and negative public health consequences of e-cigarettes, highlighting the need for experimental research, including laboratory studies and clinical trials. Policies should consider potential public health benefits of e-cigarettes, in addition to potential harms. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
Koisaari, Tapio; Leivo, Tiina; Sahraravand, Ahmad; Haavisto, Anna-Kaisa; Sulander, Pekka; Tervo, Timo M T
We studied the correlation between airbag deployment and eye injuries using 2 different data sets. The registry of the Finnish Road Accident (FRA) Investigation Teams was analyzed to study severe head- and eyewear-related injuries. All fatal passenger car or van accidents that occurred during the years 2009-2012 (4 years) were included (n = 734). Cases in which the driver's front airbag was deployed were subjected to analysis (n = 409). To determine the proportion of minor, potentially airbag-related eye injuries, the results were compared to the data for all new eye injury patients (n = 1,151) recorded at the Emergency Clinic of the Helsinki University Eye Hospital (HUEH) during one year, from May 1, 2011, to April 30, 2012. In the FRA data set, the unbelted drivers showed a significantly higher risk of death (odds ratio [OR] = 5.89, 95% confidence interval [CI], 3.33-10.9, P = 2.6E-12) or of sustaining head injuries (OR = 2.50, 95% CI, 1.59-3.97, P = 3.8E-5). Only 4 of the 1,151 HUEH patients were involved in a passenger car accident. In one of the crashes, the airbag operated, and the belted driver received 2 sutured eye lid wounds and showed conjunctival sugillation. No permanent eye injuries were recorded during the follow-up. The calculated annual airbag-related eye injury incidence was less than 1/1,000,000 people, 4/100,000 accidents, and 4/10,000 injured occupants. Airbag-related eye injuries occurred very rarely in car accidents in cases where the occupant survived and the restraint system was appropriately used. Spectacle use did not appear to increase the risk of eye injury in restrained occupants.
Longo, Marie C; Henry-Edwards, Susan M; Humeniuk, Rachel E; Christie, Paul; Ali, Robert L
Since late 2000, anecdotal reports from drug users and health professionals have suggested that there was a reduction in the supply of heroin in Adelaide in the first half of 2001, referred to as a heroin 'drought'. The aim of this paper was to critically review evidence for this, using data obtained from 100 injecting drug users surveyed for the 2001 Illicit Drug Reporting System (IDRS). This project is carried out annually in all Australian jurisdictions, and collects up-to-date information on the markets for heroin, methamphetamine, cocaine and cannabis. This paper also investigates the possible implications of this 'drought' on patterns of drug use and drug-related harms. The 2001 IDRS found consistent reports by users of an increase in the price of heroin, together with decreases in purity and availability. These factors resulted in a decrease in the frequency of self-reported heroin use among those surveyed in 2001, and a concomitant increase in the use of other drugs, in particular methamphetamine and morphine. The heroin 'drought' appears to have had a substantial impact on several indices of drug-related harm. There was a marked decrease in the number of opioid-related fatalities, and hospital data also showed reductions in heroin-related presentations. Treatment service data showed an increase in the number of admissions related to amphetamines. There is a need for health promotion and education on the adverse effects of methamphetamine use, and the development of improved treatment protocols for methamphetamine abuse and dependence.
Daly, Justine B; Campbell, Elizabeth M; Wiggers, John H; Considine, Robyn J
This study aimed to determine the prevalence of responsible hospitality policies in a group of licensed premises associated with alcohol-related harm. During March 1999, 108 licensed premises with one or more police-identified alcohol-related incidents in the previous 3 months received a visit from a police officer. A 30-item audit checklist was used to determine the responsible hospitality policies being undertaken by each premises within eight policy domains: display required signage (three items); responsible host practices to prevent intoxication and under-age drinking (five items); written policies and guidelines for responsible service (three items); discouraging inappropriate promotions (three items); safe transport (two items); responsible management issues (seven items); physical environment (three items) and entry conditions (four items). No premises were undertaking all 30 items. Eighty per cent of the premises were undertaking 20 of the 30 items. All premises were undertaking at least 17 of the items. The proportion of premises undertaking individual items ranged from 16% to 100%. Premises were less likely to report having and providing written responsible hospitality documentation to staff, using door charges and having entry/re-entry rules. Significant differences between rural and urban premises were evident for four policies. Clubs were significantly more likely than hotels to have a written responsible service of alcohol policy and to clearly display codes of dress and conditions of entry. This study provides an indication of the extent and nature of responsible hospitality policies in a sample of licensed premises that are associated with a broad range of alcohol related harms. The finding that a large majority of such premises appear to adopt responsible hospitality policies suggests a need to assess the validity and reliability of tools used in the routine assessment of such policies, and of the potential for harm from licensed premises.
Full Text Available OBJECTIVE: Anxiety symptoms are common in chronic pain patients. High levels of anxiety are associated with increased pain experience and disability. Proneness to anxiety has a large interindividual variation. The aim of the study was to determine whether the anxiety-related temperament trait Harm Avoidance (HA, is associated with pain-related anxiety. METHODS: One hundred chronic pain patients in a multidisciplinary pain clinic participated in the study. The patients were assessed using the HA scale of the Temperament and Character Inventory (TCI of Cloninger and Pain Anxiety Symptoms Scale-20 (PASS-20. Both the HA total score and the four subscales of HA were analyzed. Current pain intensity was measured using the Visual Analogue Scale (VAS. The Beck Depression Inventory (BDI was used to control for the influence of depression on the personality measurement. RESULTS: The HA total score was associated with PASS-20, but the association became non-significant after controlling for depression. The HA4 Fatigability subscale was associated with the PASS scales. Depression did not influence this association. Pain intensity was not correlated with HA or the PASS scales. However, the association between HA4 Fatigability and PASS was influenced by pain intensity. Higher pain intensity was associated with stronger association between the scales. CONCLUSION: Harm Avoidance, representing temperament and trait-related anxiety, has relevance in pain-related anxiety. Assessing personality and temperament may deepen the clinician's understanding of the pain experience and behavior in chronic pain patients.
Stock, J G; Cornell, F M
Sports-related eye injury is an important cause of vision loss. Many eye injuries can be prevented through the supervision of play, the enforcement of game rules and the use of eye protective devices. State-of-the-art eye protective devices incorporate highly impact-resistant optical material, usually polycarbonate lenses, in a sturdy frame. Protective devices are available for use in racquet sports, baseball, basketball, football, ice hockey and other sports.
Full Text Available The orthopedic and x-ray studies of children of different ages with combined diseases of the spine and pelvis, living under constant effects of the harmful production factors induced by the aluminium production of Irkutsk region, have been conducted. The priority factor of exogenous risk to health is fluoride compounds. It has been established that in the structure of the combined pathology, the pelvis asymmetry ranks first, scoliosis ranks second, Legg – Calve – Perthes disease ranks third. According to the assessment of age structure of combined pathology we can conclude that at the equal manifestations of scoliosis, Spina bifida, retrospondylolisthesis, pelvis asymmetry, children of 11–15 y.o. more often have Legg – Calve – Perthes disease, children of 16–21 y.o. – coxarthrosis. We established statistically significant correlation between Legg – Calve – Perthes disease and age and sex of the children (Pearson's χ 2 at p < 0.01 makes 15.821 and 21.228 correspondingly. It’s important to mention that Legg – Calve – Perthes disease was registered in all examined boys and only in 35.5 % of girls. Correlation between this pathology and ecological factors was also statistically proved (χ 2 = 5.264, p < 0.05: within the radius of 5 km from the production facility the proportion of avascular necrosis was the highest (75 % cases. I and II degrees of manifestation of clinicoroentgenologic disorders of combined spine and pelvis pathology prevail. The relevance of further search for evidence of the relationship of chemical risk factors and the development of diseases of the musculoskeletal system was determined. Regular medical follow-up monitoring of children living in ecologically unfavorable territories in terms of early diagnosis of combined orthopedic pathology is recommended, including its premorbid period of development.
Harrison, Tracie; Legarde, Brittany; Kim, Sunhun; Walker, Janiece; Blozis, Shelley; Umberson, Debra
This article reports the experiences of women aged 55 to 75 with mobility impairments who attributed aspects of their limitations to workplace injuries and provides insight into worker's compensation policies. The study sample includes Mexican American (MA) and non-Hispanic White (NHW) women aged 55 to 75 who participated in a 4-year ethnographic study of disablement. Ninety-two of the 122 participants in the study attributed aspects of their functional limitations to employment, and their experiences were analyzed using data from 354 meetings. Using Lipscomb and colleagues' conceptual model of work and health disparities, the women's experiences were grouped into three categories according to type of injury, assistance gained, and the consequences of a workplace injury; the results have broad implications for policies that influence aging outcomes. Workplace injuries causing permanent functional limitations compound the effects of age and gender on employment outcomes. Policies addressing health disparities should consider work related influences.
Salonen, Anne H; Alho, Hannu; Castrén, Sari
Background Information about public gambling attitudes and gambling participation is crucial for the effective prevention of gambling-related harm. This study investigates female and male attitudes towards gambling, gambling participation, and gambling-related harm in the Finnish population aged 15–74. Methods Cross-sectional random sample data were collected in 2011 (n = 4484) and 2015 (n = 4515). The data were weighted based on gender, age and region of residence. Attitudes were measured us...
Heat-related injuries in aquatics classes are possible, though 100 percent preventable. The article discusses heat-related syndromes; how bodies generate and dissipate heat; how elevated heart rates that burn calories differ from those that dissipate heat; and modification of exercise intensity to provide calorie-burning workouts without…
Increased intensity of sports activities combined with a decrease in daily physical activity is making overuse injuries in children more common. These injuries are located mainly in the epiphyseal cartilage. The broad term for these injuries is osteochondrosis, rather than osteochondritis, which more specifically refers to inflammatory conditions of bone and cartilage. The osteochondrosis may be epiphyseal, physeal, or apophyseal, depending on the affected site. The condition can either be in the primary deformans form or the dissecans form. While there is no consensus on the etiology of osteochondrosis, multiple factors seem to be involved: vascular, traumatic, or even microtraumatic factors. Most overuse injuries involve the lower limbs, especially the knees, ankle and feet. The most typical are Osgood-Schlatter disease and Sever's disease; in both conditions, the tendons remain relatively short during the pubescent grown spurt. The main treatment for these injuries is temporary suspension of athletic activities, combined with physical therapy in many cases. Surgery may be performed if conservative treatment fails. It is best, however, to try to prevent these injuries by analyzing and correcting problems with sports equipment, lifestyle habits, training intensity and the child's level of physical activity, and by avoiding premature specialization. Pain in children during sports should not be considered normal. It is a warning sign of overtraining, which may require the activity to be modified, reduced or even discontinued. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
If recreational marijuana is legalized for adults in California, a rational implementation of public policy would neither criminalize youth possession, nor medically pathologize it by conflating possession with addiction. The harms of a criminal justice approach to juveniles should not exceed the harms of the drug itself. Juvenile arrests and probation have consequences: (1) arrest records, probation, and juvenile hall; (2) an incarceration subculture, "crime school," psychological and re-entry costs; (3) school "zero-tolerance" expulsions and suspensions; (4) ineligibility for federal school loans; (5) employment screening problems; (6) racial disparities in arrests; (7) fines and attorney's fees; and (8) immigration/naturalization problems. Marijuana-related arrest rates in California dropped after a 2011 law making possession under 1 oz. an infraction for all, but juvenile marijuana arrests continue to outnumber arrests for hard drugs. Recommendations for prudent implementation policy include: stable marijuana tax funding for Student Assistance Programs (SAPs) in high schools; elimination of "zero-tolerance" suspension/expulsion policies in favor of school retention and academic remediation programs; juvenile justice transparency discriminating among infractions, misdemeanors, and felonies. Criminal sanctions and durations must be proportional to the offense. Probation-based interventions should be reserved for larger possession amounts and recidivist offenders, and outcomes should be independently evaluated.
O'Brien, Kerry S; Lynott, Dermot; Miller, Peter G
Although there is evidence that alcohol sponsorship in sport is related to greater drinking, there is no empirical research on whether alcohol sponsorship is associated with alcohol-related harms. We examined whether there is an association between receipt of alcohol industry sponsorship, and attendance at alcohol sponsor's drinking establishments (e.g. bars), and alcohol-related aggression and antisocial behaviour in university students who play sport. University sportspeople (n = 652) completed surveys (response rate >80%) assessing receipt of alcohol industry sponsorship, attendance at sponsor's establishments and confounders [i.e. age, gender, sport type, location and alcohol consumption measured by Alcohol Use Disorders Identification Test--alcohol consumption (AUDIT-C) scores]. Participants also completed measures assessing displays and receipt of aggressive and antisocial behaviours (e.g. assaults, unwanted sexual advance, vandalism). Logistic regression models including confounders and reported attendance at alcohol sponsor's establishments showed that sportspeople receiving alcohol industry sponsorship were more likely to have been the victim of aggression (adjusted odds ratio 2.62, 95% confidence interval 1.22-5.64). Attending an alcohol sponsor's establishment was not associated with higher rates of other aggressive or antisocial behaviour. However, significant associations where found between AUDIT-C scores and having displayed and received aggression, and having damaged or had property damaged. Male sportspeople were more likely to have displayed and received aggressive and antisocial behaviour. Higher AUDIT-C scores, gender and receipt of alcohol industry sponsorship were associated with alcohol-related aggression/antisocial behaviours in university sportspeople. Sport administrators should consider action to reduce the harms associated with excessive alcohol consumption and alcohol industry sponsorship in sport. © 2012 Australasian Professional
Webb, Roger T; Antonsen, Sussie; Carr, Matthew J; Appleby, Louis; Pedersen, Carsten B; Mok, Pearl L H
Development of a better understanding of subsequent pathways for individuals who experienced trauma during childhood might usefully inform clinicians and public health professionals regarding the causes of self-harm and interpersonal violence. We aimed to examine these risks during late adolescence and early adulthood among people admitted to hospital following injuries or poisonings during their childhood. This national cohort study included Danish people born between Jan 1, 1977, and Dec 31, 1997, and was linked to the National Patient Register and Psychiatric Central Research Register to identify all people exposed to hospital admissions for injuries or poisonings due to self-harm, interpersonal violence, or accidents before their 15th birthday. Linkage to these two registers and to the National Crime Register enabled ascertainment of self-harm and violent offending, respectively, as adverse outcomes at ages 15-35 years. Sex-specific incidence rate ratios (IRRs; relative risks) and cumulative incidence percentage values (absolute risks) were estimated. The confounding influence of parental socioeconomic status was also explored. 1 087 672 Danish people were included in this study. The prevalence of any trauma-related hospital admission was 10% (105 753 per 1 087 672; males: 64 454 [11%]; females: 44 299 [8%]) and for both sexes, accident was by far the most prevalent of the categories assessed (males: 59 011 [11%]; females: 40 756 [8%]). Similar patterns of increased risk for self-harm and violent criminality were observed in both sexes, although the IRRs were consistently and significantly larger in women (self-harm: IRR 1·94 [95% CI 1·85-2·02]; violent criminality: 2·16 [1·97-2·36]) than in men (self-harm: 1·61 [1·53-1·69]; violent criminality: 1·58 [1·53-1·63]). Confounding by parental socioeconomic status explained little of the increased risks observed. For young adult men, the highest absolute risk observed was for violent
Izzedine, Hassane; Gueutin, Victor; Gharbi, Chems; Mateus, Christine; Robert, Caroline; Routier, Emilie; Thomas, Marina; Baumelou, Alain; Rouvier, Philippe
Monoclonal antibodies directed against the immune checkpoint protein cytotoxic T-lymphocyte antigen-4 (CTLA-4; CD152) have been investigated in metastatic melanoma and other cancers and have shown promising results. Inhibition of CTLA-4 characteristically induces well-known side effects called "immune-related adverse events" (irAEs). IrAEs mainly include colitis, dermatitis, hepatitis, endocrinopathies; uveitis, iridocyclitis, neuropathies, and inflammatory myopathy have occasionally been reported. Kidney involvement is rare. We report 2 cases of acute granulomatous interstitial nephritis and present, based on literature review, renal disorders related to Ipilimumab therapy. Autoimmune symptoms have to be carefully checked for patients treated with CTLA-4 inhibitors. In order to reduce the risk of sequelae, early recognition of irAEs and treatment initiation are crucial.
Dungan, James A; Chakroff, Alek; Young, Liane
Recent efforts to partition the space of morality have focused on the descriptive content of distinct moral domains (e.g., harm versus purity), or alternatively, the relationship between the perpetrator and victim of moral violations. Across three studies, we demonstrate that harm and purity norms are relevant in distinct relational contexts. Moral judgments of purity violations, compared to harm violations, are relatively more sensitive to the negative impact perpetrators have on themselves versus other victims (Study 1). This pattern replicates across a wide array of harm and purity violations varying in severity (Studies 2 and 3). Moreover, while perceptions of harm predict moral judgment consistently across relational contexts, perceptions of purity predict moral judgment more for self-directed actions, where perpetrators violate themselves, compared to dyadic actions, where perpetrators violate other victims (Study 3). Together, these studies reveal how an action's content and its relational context interact to influence moral judgment, providing novel insights into the adaptive functions of harm and purity norms.
Calabria, Bianca; Shakeshaft, Anthony P; Havard, Alys
This review identified published studies evaluating interventions delivered outside educational settings, designed for young people with existing alcohol use problems, or who participate in behaviour that places them at high risk of alcohol-related harm, critiqued their methodology and identified opportunities for new interventions. A systematic search of the peer-reviewed literature interrogated 10 electronic databases using specific search strings, limited to 2005-09. No additional studies were found by a librarian searching other collections and clearing-houses, or by hand-searching review paper reference lists. The 1697 articles identified were reviewed against criteria from the Dictionary for the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. The methodological quality of existing studies is variable, and needs to be both more rigorous and more consistent. Particular problems include the lack of blinding outcome assessors, a reliance solely on self-report measures, highly variable consent and follow-up rates, infrequent use of intention-to-treat analyses and the absence of any economic or cost analyses. The range of interventions evaluated is currently limited to individually focused approaches, almost exclusively implemented in the United States. There is a great need for more intervention trials for young people at high risk of experiencing alcohol-related harm that are both methodologically rigorous and have a broader community focus, to complement the psychological interventions that currently dominate the relevant literature. Such trials would improve outcomes for high-risk young people themselves and would improve the evidence base, both in their own right and by facilitating future meta-analyses. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.
Jawa, Randeep S; Anillo, Sergio; Kulaylat, Mahmoud N
Transfusion-related acute lung injury (TRALI) refers to a clinical syndrome of acute lung injury that occurs in a temporal relationship with the transfusion of blood products. Because of the difficulty in making its diagnosis, TRALI is often underreported. Three not necessarily mutually exclusive hypotheses have been described to explain its etiogenesis: antibody mediated, non-antibody mediated, and two hit mechanisms. Treatment is primarily supportive and includes supplemental oxygen. Diuretics are generally not indicated, as hypovolemia should be avoided. Compared with many other forms of acute lung injury, including the acute respiratory distress syndrome, TRALI is generally transient, reverses spontaneously, and carries a better prognosis. A variety of prevention strategies have been proposed, ranging from restrictive transfusion strategies to using plasma derived only from males.
Vollman, David; Khosla, Kimberly; Shields, Brenda J; Beeghly, B Christine; Bonsu, Bema; Smith, Gary A
Despite current prevention efforts, approximately 9,400 children younger than 18 years continue to receive emergency care for lawn mower-related injuries each year in the United States. In this study, we analyzed data from a consecutive series of children treated for lawn mower-related injuries during a 53-consecutive-month period in the emergency department of a large, academic children's hospital. The objective of this study was to describe the epidemiology of lawn mower-related injuries to these children and to investigate the beliefs of parents regarding lawn mower use. There were 85 children treated for lawn mower-related injuries during the study period. The mean age was 7.6 years (SD, 4.3 years; median, 5 years), and 65% were boys. Thirty-four patients (40.0%) were admitted to the hospital, including 3 (3.5%) to the pediatric intensive care unit, and 30 (35.3%) required surgical intervention in the operating room. There were 25 children with lacerations (29.4%), 22 with fractures (25.9%), 18 with amputations (21.2%), and 10 with burns (11.8%). The most common body region injured was the lower extremity, accounting for 57.6% (49 of 85) of injuries, including 33 injuries (38.8%) to the foot/toe and 16 injuries (18.8%) to the leg. The hand/finger and head/neck regions each accounted for another 18.8% of injuries. The leading mechanism of injury was run-over/back-over (22.4%), followed by other blade contact (17.6%), thrown object (12.9%), burn (10.6%), and a fall off the mower (7.0%). Lacerations accounted for 68.8% (11 of 16) of injuries to the head/neck compared with 20.3% (14 of 69) to other body regions (p children 5 years of age or younger compared with 2.4% (1 of 42) of injuries to children older than 5 years of age (p = 0.02; RR, 8.79; 95% CI, 1.16 children. Parental education should promote compliance with the American Academy of Pediatrics policy recommendation that children should be at least 16 years old before operating a ride-on mower. Automatic
Full Text Available BACKGROUND: Although it is well established that sex is a risk factor in acquiring a traumatic brain injury (TBI among adolescents, it has not been established whether it also moderates the influence of other TBI psychological health correlates. METHODS AND FINDINGS: Data were derived from a 2011 population-based cross-sectional school survey, which included 9,288 Ontario 7th-12th graders who completed anonymous self-administered questionnaires in classrooms. Response rate was 62%. Preliminary analyses found no evidence of nonresponse bias in the reporting of TBI. TBI was defined as a hit or blow to the head that resulted in a 5 minutes loss of consciousness or at least one overnight hospitalization due to symptoms associated with it. Reports of lifetime TBI were more common among males than females (23.1%, 95% CI: 20.5, 25.8 vs. 17.1%, 95% CI: 14.7, 19.8. Thirteen correlates were examined and included cigarette smoking, elevated psychological distress, suicide ideation, bully victimization (at school, as well as cyber bullying, bullying others, cannabis use, cannabis dependence and drug use problems, physical injuries, daily smoking, drinking alcohol, binge drinking, use of cannabis, and poor academic performance. Among the outcomes examined, sex moderated the relationship between lifetime TBI and cigarette smoking. In addition, sex and age jointly moderated the relationship between lifetime TBI and daily smoking, alcohol use and physical injuries. Late adolescent males who reported lifetime TBI, relative to females, displayed elevated daily smoking and injuries, whereas their females counterparts displayed elevated past year drinking. Possible bias related to self-report procedures and the preclusion of causal inferences due to the cross-sectional nature of the data are limitations of this study. CONCLUSIONS: TBI differences in outcomes need to be assessed for potential moderating effects of sex and age. Results have important implications for
Lamy, Francois R; Daniulaityte, Raminta; Nahhas, Ramzi W; Barratt, Monica J; Smith, Alan G; Sheth, Amit; Martins, Silvia S; Boyer, Edward W; Carlson, Robert G
Synthetic Cannabinoid Receptor Agonists (SCRA), also known as "K2" or "Spice," have drawn considerable attention due to their potential of abuse and harmful consequences. More research is needed to understand user experiences of SCRA-related effects. We use semi-automated information processing techniques through eDrugTrends platform to examine SCRA-related effects and their variations through a longitudinal content analysis of web-forum data. English language posts from three drug-focused web-forums were extracted and analyzed between January 1st 2008 and September 30th 2015. Search terms are based on the Drug Use Ontology (DAO) created for this study (189 SCRA-related and 501 effect-related terms). EDrugTrends NLP-based text processing tools were used to extract posts mentioning SCRA and their effects. Generalized linear regression was used to fit restricted cubic spline functions of time to test whether the proportion of drug-related posts that mention SCRA (and no other drug) and the proportion of these "SCRA-only" posts that mention SCRA effects have changed over time, with an adjustment for multiple testing. 19,052 SCRA-related posts (Bluelight (n=2782), Forum A (n=3882), and Forum B (n=12,388)) posted by 2543 international users were extracted. The most frequently mentioned effects were "getting high" (44.0%), "hallucinations" (10.8%), and "anxiety" (10.2%). The frequency of SCRA-only posts declined steadily over the study period. The proportions of SCRA-only posts mentioning positive effects (e.g., "High" and "Euphoria") steadily decreased, while the proportions of SCRA-only posts mentioning negative effects (e.g., "Anxiety," 'Nausea," "Overdose") increased over the same period. This study's findings indicate that the proportion of negative effects mentioned in web forum posts and linked to SCRA has increased over time, suggesting that recent generations of SCRA generate more harms. This is also one of the first studies to conduct automated content analysis
Roccia, Fabio; Diaspro, Alberto; Nasi, Andrea; Berrone, Sid
By analyzing sports-related maxillofacial fractures, we sought to describe preventive measures and recovery times until sporting activities could be resumed. Between January 2001 and December 2006, 1241 patients were hospitalized as a result of maxillofacial fractures. The patients with sports-related maxillofacial fractures were analyzed based on age, sex, type of sport, injury mechanism, trauma site, presence of associated fractures, hospitalization, treatment method, and recovery time until the resumption of sporting activities. One hundred thirty-eight patients (11.4%) sustained sports-related maxillofacial fractures: 121 males and 17 females (ratio 8:1), aged between 11 and 72 years. The sport producing the greatest number of injuries was soccer (62.3%), followed by skiing (14.5%), and horseback riding (6.5%). The injuries involved mainly the middle third of the face (71.6%), and the mandible was the most affected site (27.2%), followed by the maxillary-zygomatic-orbital complex (25.9%). Treatment was surgery in 93.5% of the patients, with an average hospitalization period of 3.5 days. The protocol created to manage the follow-up of maxillofacial injury patients advised resuming sports activities at least 40 days after the trauma, except in the case of combat sports, when a period of 3 months was required. Although the results of this study indicate a reduction in the total incidence of sports-related maxillofacial injuries, they also show an alarming secondary increase in trauma resulting from the most popular sport in Italy-soccer. Therefore, stricter regulations are needed to discourage violent play, rather than relying on the use of protective equipment. Moreover, patients should be advised when they can resume sports activities, particularly in the case of professionals and semiprofessionals.
Full Text Available Abstract Background Excess alcohol consumption has serious adverse effects on health and violence-related harm. In the UK around 37% of men and 29% of women drink to excess and 20% and 13% report binge drinking. The potential impact on population health from a reduction in consumption is considerable. One proposed method to reduce consumption is to reduce availability through controls on alcohol outlet density. In this study we investigate the impact of a change in the density of alcohol outlets on alcohol consumption and alcohol-related harms to health in the community. Methods/Design A natural experiment of the effect of change in outlet density between 2005–09, in Wales, UK; population 2.4 million aged 16 years and over. Data on outlets are held by the 22 local authorities in Wales under The Licensing Act 2003. The study outcomes are change in (1 alcohol consumption using data from annual Welsh Health Surveys, (2 alcohol-related hospital admissions using the Patient Episode Database for Wales, (3 Accident & Emergency department attendances between midnight–6am, and (4 alcohol-related violent crime against the person, using Police data. The data will be anonymously record-linked within the Secure Anonymised Information Linkage Databank at individual and 2001 Census Lower Super Output Area levels. New methods of network analysis will be used to estimate outlet density. Longitudinal statistical analysis will use (1 multilevel ordinal models of consumption and logistic models of admissions and Accident & Emergency attendance as a function of change in individual outlet exposure, adjusting for confounding variables, and (2 spatial models of the change in counts/rates of each outcome measure and outlet density. We will assess the impact on health inequalities and will correct for population migration. Discussion This inter-disciplinary study requires expertise in epidemiology and public health, health informatics, medical statistics
Carvalho, Célia Barreto; Nunes, Carolina; Castilho, Paula; da Motta, Carolina; Caldeira, Suzana; Pinto-Gouveia, José
Non-suicidal self-injury (NSSI) is the deliberate, self-inflicted destruction of body tissue without suicidal intent and an important clinical phenomenon. Rates of NSSI appear to be disproportionately high in adolescents and young adults, and is a risk factor for suicidal ideation and behavior. The present study reports the psychometric properties of the Impulse, Self-harm and Suicide Ideation Questionnaire for Adolescents (ISSIQ-A), a measure designed to comprehensively assess the impulsivity, NSSI behaviors and suicide ideation. An additional module of this questionnaire assesses the functions of NSSI. Results of Confirmatory Factor Analysis (CFA) of the scale on 1722 youths showed items' suitability and confirmed a model of four different dimensions (Impulse, Self-harm, Risk-behavior and Suicide ideation) with good fit and validity. Further analysis showed that youth׳s engagement in self-harm may exert two different functions: to create or alleviate emotional states, and to influence social relationships. Our findings contribute to research and assessment on non-suicidal self-injury, suggesting that the ISSIQ-A is a valid and reliable measure to assess impulse, self-harm and suicidal thoughts, in adolescence.
Young, Robert; Sproeber, Nina; Groschwitz, Rebecca C; Preiss, Marthe; Plener, Paul L
Background: The term ‘self-harm’ encompasses both attempted suicide and non-suicidal self-injury (NSSI). Specific adolescent subpopulations such as ethnic or sexual minorities, and more controversially, those who identify as ‘Alternative’ (Goth, Emo) have been proposed as being more likely to self-harm, while other groups such as ‘Jocks’ are linked with protective coping behaviours (for example exercise). NSSI has autonomic (it reduces negative emotions) and social (it communicates distres...
Polanco-Roman, Lillian; Jurska, Justyna; Quiñones, Victoria; Miranda, Regina
The present study examined the relation between cognitive response styles (i.e., brooding, reflection, distraction) and cognitive inflexibility in differentially predicting history of non-suicidal self-injury (NSSI) only, suicide attempt (SA) only, or both (NSSI + SA). College students (N = 352) completed self-report measures of rumination, distraction, and self-harm history, a diagnostic interview, and a computerized task measuring cognitive flexibility. Brooding uniquely predicted SA-only history, while reflection uniquely predicted history of NSSI-only and NSSI + SA. Distraction was associated with lower odds of NSSI-only and NSSI + SA. Cognitive inflexibility was not significantly associated with self-harm history. Cognitive vulnerabilities may help identify individuals who are at risk for self-harm and may differentiate between NSSI and SA.
Polanco-Roman, Lillian; Jurska, Justyna; Quiñones, Victoria; Miranda, Regina
Objectives The present study examined the relation between cognitive response styles (i.e., brooding, reflection, distraction) and cognitive inflexibility in differentially predicting history of non-suicidal self-injury (NSSI) only, suicide attempt (SA) only, or both (NSSI+SA). Methods College students (N = 352) completed self-report measures of rumination, distraction, and self-harm history, a diagnostic interview, and a computerized task measuring cognitive flexibility. Results Brooding uniquely predicted SA-only history, while reflection uniquely predicted history of NSSI-only and NSSI+SA. Distraction was associated with lower odds of NSSI-only and NSSI+SA. Cognitive inflexibility was not significantly associated with self-harm history. Conclusion Cognitive vulnerabilities may help identify individuals who are at risk for self-harm and may differentiate between NSSI and SA. PMID:25517765
Filipowicz, Ewa; Staszków, Monika
Acute kidney injury (AKI) in obstetrics may be caused by the same disorders that are observed in the general population or may be specific for a pregnancy such as: preeclampsia, HELLP syndrome or acute fatty liver of pregnancy. The renal changes may be only temporary, and resolve within a few weeks postpartum, or may become irreversible leading to a progression of chronic kidney disease (CKD). In the article the most important pregnancy related syndromes associated with AKI have been shortly reviewed.
Berman, Noah C; Wheaton, Michael G; Abramowitz, Jonathan S
The present study used an in vivo paradigm to examine whether the victim's vulnerability in a harm-related intrusion affects beliefs about the importance of thoughts (i.e., Thought Action Fusion; TAF). Sixty-six undergraduate students at a large university were randomly assigned to imagine either a vulnerable (e.g., elderly man) or able-bodied individual (e.g., strong youthful male) they know getting into a car accident and provided in vivo ratings of anxiety, guilt, likelihood, moral wrongness, and urges to neutralize. Results indicated that thinking of car accident involving a vulnerable, compared to an able-bodied person, provoked more distress (anxiety and guilt), stronger feelings of moral wrongness, greater urges to cancel the effects of thinking such thoughts, and higher estimates of the likelihood that the collision would occur. The findings of our study broadly support Rachman's (1998) assertion that more significance and importance is attached to negative thoughts about vulnerable or helpless people. Current findings are discussed in terms of the cognitive-behavioral model of obsessions and clinical implications are addressed.
Norup, Anne; Petersen, Janne; Lykke Mortensen, Erik
improvement. Higher initial level of symptoms of depression was seen in female relatives. Higher initial level of anxiety was associated with younger patient age, lower level of function and consciousness in the patient and the relative being female or the spouse. CONCLUSION: Future research and interventions...... relatives of patients with severe brain injury. METHODS: The relatives were assessed on the anxiety and depression scales from the Symptom Checklist-90-Revised and latent variable growth curve models were used to model the trajectories. The effects of patient's age, patient's Glasgow Coma Score, level...... of function and consciousness, gender and relationship of the relatives were modelled. RESULTS: Improvement was found in both symptoms of anxiety and depression during the 12-month study period. The analysis revealed different trajectories for symptoms of anxiety and depression, as anxiety had a more rapid...
Baarveld, Frank; Visser, Chantal A. N.; Kollen, Boudewijn J.; Backx, Frank J. G.
Methods. Survey study conducted in 612 patients with sports-related injuries by 21 GP trainees in as many GP practices. Inclusion of study subjects took place between September 2007 and April 2009. Results. In total, 694 sports-related injuries were registered. The incidence of sports-related injuri
Pluck, Graham; Lee, Kwang-Hyuk; Parks, Randolph W
Homelessness is associated with an increased incidence of mental illness and risk of self-harm, including suicide. To assess the prevalence of self-harm (including nonsuicidal self-injury and attempted suicide) among a UK sample of homeless adults and to compare demographic, clinical, and homeless-related variables to determine which are linked to self-harm in this population. A sample of 80 homeless adults were interviewed regarding history of self-harm, mental health history, demographic, and homeless-related information. Sixty-eight percent of the sample reported past acts of self-harm. Those with histories of self-harm started using significantly more substances since becoming homeless and were younger when they first became homeless. They were also significantly more likely to have a past psychiatric admission and thoughts of self-harm in the past year. Self-harm is common among homeless adults and linked to long-term and enduring social and mental health concerns.
Studer, Joseph; Baggio, Stéphanie; Deline, Stéphane; N'Goran, Alexandra A; Henchoz, Yves; Mohler-Kuo, Meichun; Daeppen, Jean-Bernard; Gmel, Gerhard
Alcohol consumption--in particular drinking volume (DV) and risky single occasion drinking (RSOD)--has been related to a wide range of negative consequences and health problems. Previous studies also suggested that drinking in certain locations may be more strongly associated with the occurrence of alcohol-related harm than drinking in others. However, they were conducted in countries culturally and legally different from European countries and were limited to cross-sectional designs. This study investigates the cross-sectional and longitudinal associations of alcohol-related harm with DVs in different locations in a sample of young Swiss men. A representative sample of 4536 young Swiss male drinkers completed baseline and 15-month follow-up questionnaires. These assessed DVs in 11 locations, alcohol-related harm (i.e. number of alcohol-related consequences and alcohol use disorder criteria) and frequency of RSOD. Cross-sectional and longitudinal associations of alcohol-related harm with DVs in each location were tested using regression models, with and without adjustment for frequency of RSOD. Both cross-sectional and longitudinal analyses showed significant positive associations between alcohol-related harm and DVs at friends' homes, in discos/nightclubs and in outdoor public places, when controlling for frequency of RSOD. In contrast, the contribution of DVs at one's own home and in restaurants was consistently not significant when adjusted for frequency of RSOD. When controlling for RSOD, associations between alcohol-related harm and DVs in bars/pubs, when playing sports, during other leisure activities, at cinemas/theatres, during sporting events, and during special events were not consistent between cross-sectional and longitudinal analyses. Results suggest that prevention interventions should not only target reducing the overall volume of alcohol consumed and the frequency of RSOD in general, but they should additionally focus on limiting alcohol consumption
Full Text Available Abstract Background While alcohol-related health and social problems amongst youths are increasing internationally, both consumption and associated harms are particularly high in British youth. Youth drinking patterns, including bingeing, frequent drinking and drinking in public spaces, are associated with increased risks of acute (e.g. violence and long-term (e.g. alcohol-dependence health problems. Here we examine economic, behavioural and demographic factors that predict these risky drinking behaviours among 15–16 year old schoolchildren who consume alcohol. A cross-sectional survey was conducted among schoolchildren in North West England (n = 10,271 using an anonymous questionnaire delivered in school settings. Analysis utilised logistic regression to identify independent predictors of risky drinking behaviour. Results Of all respondents, 87.9% drank alcohol. Of drinkers, 38.0% usually binged when drinking, 24.4% were frequent drinkers and 49.8% drank in public spaces. Binge, frequent and public drinking were strongly related to expendable income and to individuals buying their own alcohol. Obtaining alcohol from friends, older siblings and adults outside shops were also predictors of risky drinking amongst drinkers. However, being bought alcohol by parents was associated with both lower bingeing and drinking in public places. Membership of youth groups/teams was in general protective despite some association with bingeing. Conclusion Although previous studies have examined predictors of risky drinking, our analyses of access to alcohol and youth income have highlighted eradicating underage alcohol sales and increased understanding of children's spending as key considerations in reducing risky alcohol use. Parental provision of alcohol to children in a family environment may also be important in establishing child-parent dialogues on alcohol and moderating youth consumption. However, this will require supporting parents to ensure they
Scholes-Balog, Kirsty E.; Hemphill, Sheryl A.; Patton, George C.; Toumbourou, John W.
The current study documents the changing rates of cannabis use, misuse and cannabis-related social harms among Australian adolescents as they grow into young adulthood. It utilised data from a longitudinal study of young people at ages 15, 16, 17, and 19. The rates of cannabis use were found to increase as participants aged; past year use…
Scholes-Balog, Kirsty E.; Hemphill, Sheryl A.; Patton, George C.; Toumbourou, John W.
The current study documents the changing rates of cannabis use, misuse and cannabis-related social harms among Australian adolescents as they grow into young adulthood. It utilised data from a longitudinal study of young people at ages 15, 16, 17, and 19. The rates of cannabis use were found to increase as participants aged; past year use…
Despite an ethical and legal obligation, the information given to patients in the event of a care-related injury is still often poor. It is expected by patients but the situation is difficult for health professionals. In order to be beneficial for all parties, it requires professionals to have a certain amount of expertise and people skills to enable them to empathise and communicate. It should be included in initial and continuing training and in institutions' quality of care policies. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Phillips, Shawn; Woessner, Derek
Concussions have garnered more attention in the medical literature, media, and social media. As such, in the nomenclature according to the Centers for Disease Control and Prevention, the term concussion has been supplanted by the term mild traumatic brain injury. Current numbers indicate that 1.7 million TBIs are documented annually, with estimates around 3 million annually (173,285 sports- and recreation-related TBIs among children and adolescents). The Sideline Concussion Assessment Tool 3 and the NFL Sideline Concussion Assessment Tool are commonly used sideline tools.
Monchai Siribamrungwong; Pawadee Chinudomwong
Acute kidney injury (AKI) is a serious problem during pregnancy. Once occurred, it brings about devastating maternal and fetal outcomes. Among developed nations, the trend of pregnancy-related AKI (PRAKI) is on a decline due to the advances in obstetrics care and the legality of abortion. On the contrary, this situation remains one of the major health problems in the developing countries. Though some improvements have been observed, PRAKI still causes high maternal morbidity and mortality, le...
Craig, J.G.; Holsbeek, M.T. van [Div. of Musculoskeletal Radiology, Henry Ford Hospital, Detroit MI (United States); Gauthier, T.P.; Cook, W.J. [Philips Ultrasound, Bothell WA (United States)
Sports-related injuries of the musculoskeletal system affect millions of individuals every year. Integrating high-frequency Tissue Harmonic Imaging ultrasound with MRI and CT gives the greatest opportunity for diagnosing specific injuries. (orig.)
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Douwes, M.; Kraker, H. de
To support health and safety practitioners in their obligation of risk assessment the 'Hand Arm Risk Assessment Method' (HARM) was developed. This tool can be used by any type of company for risk assessment of developing arm, neck or shoulders symptoms (pain) resulting from light manual tasks.This p
Reeser, J C; Verhagen, E; Briner, W W; Askeland, T I; Bahr, R
Although the overall injury rate in volleyball and beach volleyball is relatively low compared with other team sports, injuries do occur in a discipline specific pattern. Epidemiological research has revealed that volleyball athletes are, in general, at greatest risk of acute ankle injuries and overuse conditions of the knee and shoulder. This structured review discusses both the known and suspected risk factors and potential strategies for preventing the most common volleyball related injuries: ankle sprains, patellar tendinopathy, and shoulder overuse.
Reeser, J C; Verhagen, E; Briner, W W; Askeland, T I; Bahr, R
Although the overall injury rate in volleyball and beach volleyball is relatively low compared with other team sports, injuries do occur in a discipline specific pattern. Epidemiological research has revealed that volleyball athletes are, in general, at greatest risk of acute ankle injuries and overuse conditions of the knee and shoulder. This structured review discusses both the known and suspected risk factors and potential strategies for preventing the most common volleyball related injuries: ankle sprains, patellar tendinopathy, and shoulder overuse. PMID:16799111
Craven, John A
To identify the frequency, variety and disposition of horse-related injury presentations to the ED and to use this information to evaluate the existing institutional trauma team activation criteria following horse-related injuries. A retrospective case analysis was performed of all horse-related injury presentations to the ED of Women's and Children's Hospital, Adelaide, Australia, in the 5 year period between January 1999 and December 2003. A total of 186 children presented with horse-related injuries during the 5 year study period. The median age of injury was 9 years (range 1-17 years), with 81% of presentations female and 60% of patients hospitalized. The mechanism of injury was divided into four groups: 148 falls (79%), 28 kicks (15%), 7 tramples (4%) and 5 bites (3%). There was one death. Seven presentations rated an Injury Severity Score >15, with full trauma team activation occurring for two of these presentations. Although horse-related injury presentations are uncommon, severe injuries do occur. Patients presenting with severe horse-related injuries do not always activate a full trauma team response based on current trauma team activation criteria. These severe injury presentations are supported by a limited trauma team response, which activates on the mechanism of injury. The effectiveness of this as a contingency system needs to be evaluated.
Approximately one person in 5,000 will experience an episode of transfusion-related acute lung injury (TRALI) in conjunction with the transfusion of whole blood or blood components. Its hallmarks include hypoxemia, dyspnea, fever, hypotension, and bilateral pulmonary edema (noncardiogenic). The mortality for reported cases is 16.3%. The incidence and mortality may be even higher than estimated because of under-recognition and under-reporting. Although TRALI was identified as a clinical entity in the 1980s, a lack of consensus regarding a definition was present until 2004. An exact cause has yet to be identified; however, there are two theories regarding the etiology: the "antibody" and the "two-hit" theories. These theories involve both donor and recipient factors. Further education and research are needed to assist in the development of strategies for the prevention and treatment of TRALI.
Full Text Available Research on drinking in Estonia, mainly surveys, indicates that alcohol consumption has increased steadily over the last fifteen years. However, these quantitative studies provide little information about drinking habits and the meanings that are attributed to different consumption patterns. In addition, there is no research that explores how alcohol-related harm is controlled or managed, especially among young people. Current research on alcohol-related harm, primarily from the UK, emphasises calculated hedonism and shows clearly that drinking ‘depends on the context’. Relying on Goffman’s concept of ‘framework’, the aim of the current paper is to analyse or give structure to the ‘context’ by distinguishing the frameworks of drinking time, space and networks that guide young Estonians in their interpretations and perceptions of alcohol related harm, and that also act as a basis for legitimising drinking practices. Differentiating the frames helps to show the dynamics of drinking practices and the interactions in ‘context’. The research is based on open-ended and focus group interviews with young people from rural and urban areas in Estonia and is supported by participant observation in different situations where alcohol is consumed in order to provide a broader view and interpretation on young people’s drinking.
Bull, Nils; Høvding, Gunnar; Riise, Trond; Moen, Bente E
The eyes are among the organs most frequently hurt in occupational injuries. The characteristics of eye injuries were studied in order to suggest preventive measures. Analyses were performed on work-related eye injuries reported to the Norwegian Injury Surveillance System from a selection of emergency centres during the period 1990-2002, and on injuries reported by employers to the National Insurance Administration 1998-2001. The occurrence of injuries was stable over the period. Men sustained 94.4% of the injuries registered in injury surveillance system. The highest incidence was among those 20 to 24 years of age. Metal cutters and tools for polishing were involved in 25.7% of cases. Analyses of the injuries reported to the National Insurance Administration showed an odds ratio of 8.8 (95% CI 7.6-10.1) for injuries to workers in metal industry, 18.8 (95% CI 17.0-20.8) in automotive industry, and only 0.5 (95% CI 0.1-3.4) in oil refineries. Workers in oil refineries have a potentially hazardous work environment, but there, eye protection is mandatory. There was no decline in the incidence of work-related eye injuries from 1990 to 2002. Workers in metal industry have a high risk of injuries and employers should consider requiring the use of eye protection.
Full Text Available Abstract Anti-harm-reduction advocates sometimes resort to pseudo-analogies to ridicule harm reduction. Those opposed to the use of smokeless tobacco as an alternative to smoking sometimes suggest that the substitution would be like jumping from a 3 story building rather than 10 story, or like shooting yourself in the foot rather than the head. These metaphors are grossly inappropriate for several reasons, notably including the fact that they are misleading about the actual risk levels. Based on the available literature on mortality from falls, we estimate that smoking presents a mortality risk similar to a fall of about 4 stories, while mortality risk from smokeless tobacco is no worse than that from an almost certainly non-fatal fall from less than 2 stories. Other metaphors are similarly misleading. These metaphors, like other false and misleading anti-harm-reduction statements are inherently unethical attempts to prevent people from learning accurate health information. Moreover, they implicitly provide bad advice about health behavior priorities and are intended to persuade people to stick with a behavior that is more dangerous than an available alternative. Finally, the metaphors exhibit a flippant tone that seems inappropriate for a serious discussion of health science.
Baarveld, Frank; Visser, Chantal A. N.; Kollen, Boudewijn J.; Backx, Frank J. G.
Methods. Survey study conducted in 612 patients with sports-related injuries by 21 GP trainees in as many GP practices. Inclusion of study subjects took place between September 2007 and April 2009. Results. In total, 694 sports-related injuries were registered. The incidence of sports-related
Conclusion: We can conclude that heavy drinking leads to an increase of alcohol-related injuries. This shows a new dimension on the consequences of this public concern already related with a variety of health and social problems. Furthermore, our results allow us to suggest that about half of alcohol-related injuries could be avoided by removing this consumption pattern.
Pedersen, Willy; Von Soest, Tilmann
Recent studies have challenged the idea that illegal substances are necessarily associated with more harm than those that are legal. This study investigates perceived drug harm among students at the University of Oslo (UO) and at a smaller university located on Norway's coast in a more conservative and religious region, called 'Coastal University' (CU). This study consisted of surveys (n=458) about perceived physical harm, mental health conditions, dependence, injuries and social consequences that may be associated with the use of tobacco, alcohol and cannabis. Information about substance use was also collected. Analyses of variance and multiple regression analyses were used to examine whether harm ratings differed for different drugs, whether drug type, gender and university site interacted in predicting harm ratings, and what role the participants' own substance use played in their harm ratings. UO students rated cannabis as overall less harmful than alcohol, while the opposite was true for CU students. Tobacco received the highest physical harm score. Alcohol was rated as most harmful with regard to injuries; cannabis was rated as most harmful with regard to mental health consequences. Use of the substance in question was associated with a reduced harm rating. This was particularly true for cannabis. Norwegian students rate the harm of substances differently from previous reports from the Norwegian general population. Most importantly, their relative ratings of cannabis harm were lower. However, the pattern was most evident among students from the urban Oslo area. © 2015 the Nordic Societies of Public Health.
Introduction In recent years, several massive earthquakes have occurred across the globe. Multidetector computed tomography (MDCT) is reliable in detecting spinal injuries. The purpose of this study was to compare the features of spinal injuries resulting from the Sichuan earthquake with those of non-earthquake-related spinal trauma using MDCT. Methods Features of spinal injuries of 223 Sichuan earthquake-exposed patients and 223 non-earthquake-related spinal injury patients were retrospectively compared using MDCT. The date of non-earthquake-related spinal injury patients was collected from 1 May 2009 to 22 July 2009 to avoid the confounding effects of seasonal activity and clothing. We focused on anatomic sites, injury types and neurologic deficits related to spinal injuries. Major injuries were classified according to the grid 3-3-3 scheme of the Magerl (AO) classification system. Results A total of 185 patients (82.96%) in the earthquake-exposed cohort experienced crush injuries. In the earthquake and control groups, 65 and 92 patients, respectively, had neurologic deficits. The anatomic distribution of these two cohorts was significantly different (P spinal injuries were more common in the control group (risk ratio (RR) = 2.12, P spinal injuries were more common in the earthquake-related spinal injuries group (277 of 501 injured vertebrae; 55.29%). The major types of injuries were significantly different between these cohorts (P = 0.002). Magerl AO type A lesions composed most of the lesions seen in both of these cohorts. Type B lesions were more frequently seen in earthquake-related spinal injuries (RR = 1.27), while we observed type C lesions more frequently in subjects with non-earthquake-related spinal injuries (RR = 1.98, P = 0.0029). Conclusions Spinal injuries sustained in the Sichuan earthquake were located mainly in the lumbar spine, with a peak prevalence of type A lesions and a high occurrence of neurologic deficits. The anatomic distribution and
de Groot Florentine
Full Text Available Abstract Background This project will provide a comprehensive investigation into the prevalence of alcohol-related harms and community attitudes in the context of community-based interventions being implemented to reduce harm in two regional centres of Australia. While considerable experimentation and innovation to address these harms has occurred in both Geelong and Newcastle, only limited ad-hoc documentation and analysis has been conducted on changes in the prevalence of harm as a consequence, leaving a considerable gap in terms of a systematic, evidence-based analysis of changes in harm over time and the need for further intervention. Similarly, little evidence has been reported regarding the views of key stakeholder groups, industry, government agencies, patrons or community regarding the need for, and the acceptability of, interventions to reduce harms. This project will aim to provide evidence regarding the impact and acceptability of local initiatives aimed at reducing alcohol-related harms. Methods/Design This study will gather existing police data (assault, property damage and drink driving offences, Emergency Department presentations and Ambulance attendance data. Further, the research team will conduct interviews with licensed venue patrons and collect observational data of licensed venues. Key informant interviews will assess expert knowledge from key industry and government stakeholders, and a community survey will assess community experiences and attitudes towards alcohol-related harm and harm-reduction strategies. Overall, the project will assess: the extent of alcohol-related harm in the context of harm-reduction interventions, and the need for and acceptability of further intervention. Discussion These findings will be used to improve evidence-based practice both nationally and internationally. Ethical Approval This project has been approved by Deakin University HREC.
Full Text Available Introduction: Legislation making seatbelt use mandatory is considered to have reduced fatal and serious injuries by 25%, with UK government estimates predicting more than 50,000 lives saved since its introduction. However, whilst the widespread use of seatbelts has reduced the incidence of major traumatic injury and death from road-traffic collisions (RTCs, their use has also heralded a range of different injuries. The first ever seatbelt related injury was described in 1956, and since then clear patterns of seatbelt-related injuries have been recognised. Methodology and Findings: This review of the published literature demonstrates that the combination of airbags and three-point seatbelts renders no part of the body free from injury. Serious injuries can, and do, occur even when passengers are properly restrained and attending clinicians should have a high index of suspicion for overt or covert intra-abdominal injuries when patients involved in RTCs attend the Emergency Department. Bruising to the trunk and abdomen in a seatbelt distribution is an obvious sign that suggests an increased risk of abdominal and thoracic injury, but bruising may not be apparent and its absence should not be falsely reassuring. A high index of suspicion should be retained for other subtler signs of injury. Children and pregnant women represent high-risk groups who are particularly vulnerable to injuries. Conclusion: In this review we highlight the common patterns of seatbelt-related injuries. A greater awareness of the type of injuries caused by seatbelt use will help clinicians to identify and treat overt and covert injuries earlier, and help reduce the rates of morbidity and mortality following RTCs.
Masudi, Tahir; McMahon, Helen Capitelli; Scott, Jennifer L.; Lockey, Andrew S.
Introduction: Legislation making seatbelt use mandatory is considered to have reduced fatal and serious injuries by 25%, with UK government estimates predicting more than 50,000 lives saved since its introduction. However, whilst the widespread use of seatbelts has reduced the incidence of major traumatic injury and death from road-traffic collisions (RTCs), their use has also heralded a range of different injuries. The first ever seatbelt related injury was described in 1956, and since then clear patterns of seatbelt-related injuries have been recognised. Methodology and Findings: This review of the published literature demonstrates that the combination of airbags and three-point seatbelts renders no part of the body free from injury. Serious injuries can, and do, occur even when passengers are properly restrained and attending clinicians should have a high index of suspicion for overt or covert intra-abdominal injuries when patients involved in RTCs attend the Emergency Department. Bruising to the trunk and abdomen in a seatbelt distribution is an obvious sign that suggests an increased risk of abdominal and thoracic injury, but bruising may not be apparent and its absence should not be falsely reassuring. A high index of suspicion should be retained for other subtler signs of injury. Children and pregnant women represent high-risk groups who are particularly vulnerable to injuries. Conclusion: In this review we highlight the common patterns of seatbelt-related injuries. A greater awareness of the type of injuries caused by seatbelt use will help clinicians to identify and treat overt and covert injuries earlier, and help reduce the rates of morbidity and mortality following RTCs.
Kaliki Hymavathi Reddy
Full Text Available Acute Kidney Injury (AKI is associated with increased mortality and morbidity unless timely diagnosed and promptly managed. An understanding of the renal physiologic changes that occur during pregnancy is essential for Proper evaluation, diagnosis, and management of Pregnancy Related AKI (PRAKI. In the general population, AKI can occur from prerenal, intrinsic/renal, and post-renal causes. Major causes of pre-renal azotemia include hyperemesis gravidarum and uterine hemorrhage in the setting of placental abruption. Intrinsic etiologies include infections from acute pyelonephritis and septic abortion, bilateral cortical necrosis, and acute tubular necrosis. Particular attention should be paid to specific conditions that lead to AKI during the second and third trimesters, such as preeclampsia, HELLP syndrome, acute fatty liver of pregnancy, and TTP-HUS. An understanding of the various etiologies of AKI in the pregnant patient is key to the appropriate clinical management and prevention of adverse maternal/fetal outcomes. Sometimes PRAKI may require intensive management and even dialysis adding additional economical burden to the patient. We here, with report an interesting case of PRAKI diagnosed and managed in time by simple medical measures thus delivering an effective treatment at a much lesser cost. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 486-489
Full Text Available A cross-sectional study was done to evaluate the rate of sleepiness and its relation to occupational injuries in Indian Traditional Industries. Data was collected using pretested and structured questionnaire about eight sleep habits, symptoms of depression, occupational injury due to fatigue, demographics, presence of diseases and lifestyle factors from 920 workers between the ages of 18-65 (mean 433.5 year in small scale industries. Occupational injury was assessed by asking subjects 'Have you ever been injured during your work, including minor scratches and cuts (Yes/ No? Both sleep and injury were assessed over the previous one year period. One-third of workers answered that they had experienced injury. Workers with sleep features of DIS, sleeping poorly at night, insufficient sleep, and insomnia had a significantly higher prevalence for injury after adjusting for multiple confounders. The findings suggest that poor nocturnal sleep habits are associated with self-reported occupational injury.
Lischuk, Andrew W; Dorantes, Thomas M; Wong, William; Haims, Andrew H
A normally functioning hip joint is imperative for athletes who use their lower extremities with running, jumping, or kicking activities. Sports-related injuries of the hip and groin are far less frequent than injuries to the more distal aspect of the extremity, accounting for less than 10% of lower extremity injuries. Despite the lower incidence, hip and groin injuries can lead to significant clinical and diagnostic challenges related to the complex anatomy and biomechanical considerations of this region. Loads up to 8 times normal body weight have been documented in the joint in common daily activities, such as jogging, with significantly greater force expected during competitive athletics. Additionally, treatment for hip and groin injuries can obviate the participation of medical and surgical specialties, with a multidisciplinary approach frequently required. Delay in diagnosis and triage of these injuries may cause loss of time from competition and, potentially, early onset of degenerative changes. Magnetic resonance imaging (MRI) of the hip has proven to be the gold standard for the diagnosis of sports-related hip and groin injuries in the setting of negative radiographs. With its exquisite soft tissue contrast, multiplanar capabilities, and lack of ionizing radiation, MRI is unmatched in the noninvasive diagnosis of intra-articular and extra-articular pathology, as well as intraosseous processes. This review focuses on MRI of common athletic injuries of the hip and groin, including acetabular labral tears, femoral acetabular impingement syndrome, muscle injuries around the hip and groin (including athletic pubalgia), and athletic osseous injuries.
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to add two procedures to our swine testing protocol. One was to monitor the electroencephalographic ( EEG ) signals from the swine brain pre- and post...brain injury, Open field testing of swine and PMHS, Computer modeling of swine and human brain, brain injury mechanisms 16. SECURITY CLASSIFICATION ...Investigation of the over predicted intracranial pressure 22 ICP) at the frontal lobe 3. Analysis of sensor location sensitivity on model predicted 25 ICP
Hayashi, Kanna; Ti, Lianping; Fairbairn, Nadia; Kaplan, Karyn; Suwannawong, Paisan; Wood, Evan; Kerr, Thomas
For decades, Thailand has experienced high rates of illicit drug use and related harms. In response, the Thai government has relied on drug law enforcement to address this problem. Despite these efforts, high rates of drug use persist, and Thailand has been contending with an enduring epidemic of human immunodeficiency virus (HIV) among people who inject drugs (IDU). In response to concerns regarding drug-related harm in Thailand and a lack of research focused on the experiences and needs of Thai IDU, the Mitsampan Community Research Project was launched in 2008. The project involved administering surveys capturing a range of behavioral and other data to community-recruited IDU in Bangkok in 2008 and 2009. In total, 468 IDU in Bangkok were enrolled in the project. Results revealed high rates of midazolam injection, non-fatal overdose and incarceration. Syringe sharing remained widespread among this population, driven primarily by problems with access to syringes and methamphetamine injection. As well, reports of police abuse were common and found to be associated with high-risk behavior. Problems with access to evidence-based drug treatment and HIV prevention programs were also documented. Although compulsory drug detention centers are widely used in Thailand, data suggested that these centers have little impact on drug use behaviors among IDU in Bangkok. The findings from this project highlight many ongoing health and social problems related to illicit drug use and drug policies in Bangkok. They also suggest that the emphasis on criminal justice approaches has resulted in human rights violations at the hands of police, and harms associated with compulsory drug detention and incarceration. Collectively, the findings indicate the urgent need for the implementation of evidence-based policies and programs in this setting.
Intimate partner violence (IPV) has a detrimental impact on women and children's emotional, physical and social well-being and has been identified as one of the most common contributors to women's experiences of housing instabilities and homelessness. Women affected by IPV often experience a great level of uncertainty around housing solutions when trying to leave an abusive partner. This study explores women's responses to IPV and the related risk of homelessness through women's narratives (n = 22) in Queensland, Australia. Of particular interest are women's decisions and actions to minimise the impact of IPV as well as homelessness on their and their children's safety and well-being. Findings reveal that women's agency in relation to harm minimisation can take various forms, including the decision to stay with, leave or return to an abusive partner. The data offer insights into women's strategic attempts to manage IPV and the related risk of homeless while trying to minimise the harm associated with one and the other. Implications for understanding women's agency in managing IPV and the related risk of homelessness and providing adequate support mechanisms to improve women and children's social, emotional and physical well-being are discussed.
Plener, Paul L; Schumacher, Teresa S; Munz, Lara M; Groschwitz, Rebecca C
Non-suicidal self-injury (NSSI) has been proposed as diagnostic entity and was added to the section 3 of the DSM 5. Nevertheless, little is known about the long-term course of this disorder and many studies have pointed to the fact that NSSI seems to be volatile over time. We aimed to assemble studies providing longitudinal data about NSSI and furthermore included studies using the definition of deliberate self-harm (DSH) to broaden the epidemiological picture. Using a systematic search strategy, we were able to retrieve 32 studies reporting longitudinal data about NSSI and DSH. We furthermore aimed to describe predictors for the occurrence of NSSI and DSH that were identified in these longitudinal studies. Taken together, there is evidence for an increase in rates of NSSI and DSH in adolescence with a decline in young adulthood. With regards to predictors, rates of depressive symptoms and female gender were often reported as predictor for both NSSI and DSH.
丁宛海; 牛朝诗; 傅先明; 张建宁
目的 研究颅脑损伤(TBI)后应激不良发生的情况.方法分析271例TBI患者伤后3 d 8:00的基础皮质醇(COR)水平,并于伤后3 d 24:00时予地塞米松0.75 mg口服,并测定伤后4 d 8:00的COR水平,若COR下降未达到其正常值的50%,即确定发生应激不良反应.结果 轻型、中型、重型和特重型TBI应激不良发生率分别为0%(0/31)、12.28% (7/57)、32.48%(38/117)、40.91%(27/66),4组间比较差异有统计学意义(P<0.05).应激良好组的医院肺部感染发生率、平均住院天数和格拉斯哥预后评分分别为6%、(8.91±1.46)d和(4.3±0.3)分(中型),11.39%、(14.71±2.23)d和(3.5±0.3)分 (重型),48.72%、(29.64±4.86) d和(3.1±0.3)分(特重型);应激不良组分别为28.57%、(12.75±2.19) d和(3.9±0.2)分(中型),34.31%、(19.94±3.96) d和(3.1±0.3)分(重型),74.07%、(39.27±7.14) d和(2.5±0.2)分(特重型),应激良好组和不良组间比较差异有统计学意义(P<0.05 ).结论 随着TBI严重程度,应激不良发生率明显增高;应激良好组的平均住院天数、肺部感染发生率及预后明显优于应激不良组.%Objective To study the harmful stress after traumatic brain injury. Methods The levels of 271 patients ' serum cortisol at 8 : 00 3 d after traumatic brain injury were taken as basal cortisol levels; patients were administrated dexamethasone 0. 75 mg at 24 : 00 3 d after injury, cortisol levels at 8 : 00 4 d after injury; the harmful stress was determined. Results In the mild, medium, severe and highly severe traumatic brain injuries, the harmful stress incidences were 0%( 0/31 ),12. 28% ( 7/57 ),32. 48%( 38/117 ),and 40. 91%( 27/66 );differences a-mong the four groups were statistically significant ( P <0. 05 ). In addition, the beneficial stress group' s hospital pulmonary infection rate, average days of hospitalization and GOS were 6% , 8. 91 ± 1. 46 and 4. 3 ±0. 3( medium ), 11. 39% , 14. 71 ±2. 23 and 3. 5 ±0. 3 ( severe ), 48. 72% ,29. 64 ±4. 86 and
Papi, L; Farusi, F; Teti, G; Dini, V; Romanelli, M
Amniocentesis is one of the most important prenatal diagnostic procedures available to assess congenital abnormalities. It is performed worldwide due to its simplicity of execution and lack of risk. The most frequent known accidents in amniocentesis are abortion, oligohydramnios, amniositis and placental abruption, while direct fetal injuries produced by contact with the needle are rarely seen. The injuries produced are extremely variable in severity, but the most frequent is skin wounds, which usually heal as small, round depressed scars. The cases we describe concern the occurrence of iatrogenic cutaneous wound lesions to a fetus during amniocentesis. The medical-legal analysis of the cases required dermatological expertise in order to exclude a different pathogenesis for the skin injuries to the child and were assigned by the court, in order to assess the administrative compensation due to the parents of the child as a result of medical malpractice.
Fagher, K; Lexell, J
The number of athletes with disabilities participating in organized sports and the popularity of the Paralympic Games is steadily increasing around the world. Despite this growing interest and the fact that participation in sports places the athlete at risk for injury, there are few studies concerning injury patterns, risk factors, and prevention strategies of injuries in disabled athletes. In this systematic literature search and critical review, we summarize current knowledge of the epidemiology of sports-related injuries in disabled athletes and describe their characteristics, incidence, prevalence, and prevention strategies. The outcomes of interest were any injury, either an acute trauma or an overuse event. PubMed, EMBASE, CINAHL, and Google Scholar were systematically searched and 25 of 605 identified studies met the inclusion criteria. Lower extremity injuries were more common in walking athletes, whereas upper extremity injuries were more prevalent in wheelchair athletes. The methodologies and populations varied widely between the studies. Few studies were sports or disability specific, which makes it difficult to determine specific risk factors, and few studies reported injury severity and prevention of injuries. Further longitudinal, systematic sports and disability specific studies are needed in order to identify and prevent injuries in athletes with disabilities.
Becker, T M; Trinkaus, K M; Buckley, D I
Although woodworking is a popular hobby and the woodworking industry employs thousands of workers nationwide, few studies have examined injuries associated with this activity, especially in relation to woodshop tool use. We conducted a survey of amateur and professional woodworkers (n = 283) in New Mexico to determine histories and rates of tool-specific injuries. Injuries associated with woodshop tool use were reported by 64% of all respondents. Hammers, chisels/gouges, and table saws were most frequently reported in association with injuries, although the highest tool-specific injury rates were associated with use of jointer-planers (4.9 injuries per 1000 person-hours of use), chisels/ gouges (3.3 injuries), and drill presses (3.1 injuries). One third reported tool use-associated injuries that were severe enough to require professional medical attention; 5% of all respondents suffered partial amputations. Courses in the safe use of shop tools may help to reduce rates of injuries among woodworkers.
Monchai Siribamrungwong; Pawadee Chinudomwong
Acute kidney injury (AKI) is a serious problem during pregnancy. Once occurred, it brings about devastating maternal and fetal outcomes. Among developed nations, the trend of pregnancy-related AKI (PRAKI) is on a decline due to the advances in obstetrics care and the legality of abortion. On the contrary, this situation remains one of the major health problems in the developing countries. Though some improvements have been observed, PRAKI still causes high maternal morbidity and mortality, leading to fetal losses. This article aims to review current studies with regards to obstetrics related AKI. Most of the studies in this review were carried out in observational, both prospective and retrospective, studies. Results demonstrated a variety of major PRAKI causes such as hypertensive disorders in pregnancy, obstetric hemorrhage, sepsis, thrombotic micro-angiopathy and acute fatty liver in pregnancy. Aside from awareness of the etiologies of PRAKI, understanding the physiological renal adaptation during pregnancy is crucial for early detection, diagnosis, and proper management to prevent the obstetric complications.
Full Text Available Acute kidney injury (AKI is a serious problem during pregnancy. Once occurred, it brings about devastating maternal and fetal outcomes. Among developed nations, the trend of pregnancy-related AKI (PRAKI is on a decline due to the advances in obstetrics care and the legality of abortion. On the contrary, this situation remains one of the major health problems in the developing countries. Though some improvements have been observed, PRAKI still causes high maternal morbidity and mortality, leading to fetal losses. This article aims to review current studies with regards to obstetrics related AKI. Most of the studies in this review were carried out in observational, both prospective and retrospective, studies. Results demonstrated a variety of major PRAKI causes such as hypertensive disorders in pregnancy, obstetric hemorrhage, sepsis, thrombotic microangiopathy and acute fatty liver in pregnancy. Aside from awareness of the etiologies of PRAKI, understanding the physiological renal adaptation during pregnancy is crucial for early detection, diagnosis, and proper management to prevent the obstetric complications.
02139 D. Moore Defense and Veterans Brain Injury Center (WRAMC) 6900 Georgia Ave. NW, Washington, DC 20307 L. Noels University of Liege Chemin des...chevreuils 1, B4000 Liege , Belgium ABSTRACT Recent military conflicts in Iraq and Afghanistan have highlighted the wartime effect of traumatic brain in
Boffano, Paolo; Roccia, Fabio; Gallesio, Cesare; Karagozoglu, K. Hakki; Forouzanfar, Tymour
Objective. Bicycle-related injuries account for an important proportion of road injuries all over the world. As only few reports have focused on the characteristics of maxillofacial fractures sustained in bicycle accidents, the purpose of this study was to present and compare epidemiological data ab
Boffano, P.; Roccia, F.; Gallesio, C.; Karagozoglu, K.H.; Forouzanfar, T.
Objective Bicycle-related injuries account for an important proportion of road injuries all over the world. As only few reports have focused on the characteristics of maxillofacial fractures sustained in bicycle accidents, the purpose of this study was to present and compare epidemiological data abo
adolescent injury-related risk behaviours at six sites in South. Africa. Design. The identical ... rural areas for behaviour involving motor vehicles, but there were no consistent ..... Injury and Safety Monitor 2004; 3: 2-5. 5. Flisher AJ, Ziervogel CF, ...
Erkal, Sibel; Gerberich, Susan G.; Ryan, Andrew D.; Alexander, Bruce H.; Renier, Colleen M.
Purpose: To determine the incidence, associated consequences, and potential risk factors for horse-related injuries among youth and adults residing in Midwestern agricultural households. Methods: Demographic, injury, and exposure data were collected for 1999 and 2001 among randomly selected agricultural households within a 5-state region. A causal…
Erkal, Sibel; Gerberich, Susan G.; Ryan, Andrew D.; Alexander, Bruce H.; Renier, Colleen M.
Purpose: To determine the incidence, associated consequences, and potential risk factors for horse-related injuries among youth and adults residing in Midwestern agricultural households. Methods: Demographic, injury, and exposure data were collected for 1999 and 2001 among randomly selected agricultural households within a 5-state region. A causal…
Li, Xiaoxuan; Yun, Zhe; Li, Xiaoxiang; Wang, Yucai; Yang, Tongtao; Zheng, Lianhe; Qian, Jixian
Although electric bicycle-related injuries have become the most common reason for hospitalization due to a road crash in China, no study has comprehensively investigated electric bicycle collisions and their impact on orthopedic injuries; such a study may provide evidence to support a new road safety policy. A retrospective review of orthopedic injuries from electric bicycle collisions was performed in an urban trauma center. We collected variables including age, gender, location of fracture, presence of open or closed fractures, concomitant vascular, and neurologic injuries. A total of 2,044 cases were involved in electric bicycle collisions. The orthopedic injury victims were predominantly male and middle aged. The most common orthopedic injury was a femur fracture. Open fractures frequently involved the forearm and tibia/fibula. Male patients were more likely to suffer from multiple fractures and associated injuries than female patients. Fewer patients age 60 years old or older wore helmets at the time of the accident compared to those in other age groups. Orthopedic injuries from electric bicycle-related accidents cause patients substantial suffering that could lead to serious social consequences. Helmet use and protective clothing or similar safety gear, especially for electric bicycle users, should be required to provide greater protection.
Aug 23, 2006 ... Injuries are among the leading causes of death and contribute substantially to ... and of those, nearly one-third were sustained by children and youth under ... adolescents, relatively little research on risk behaviour is available.
Most of the fireworks accidents occurred in or around the patients' homes. There were more fireworks-related injuries around Guy Fawkes Day (85%) than New Year's ... Current legislation should be more strictly enforced, especially the sale to ...
Haraoka, Tomoko; Hayasaka, Shinya; Murata, Chiyoe; Yamaoka, Taiji; Ojima, Toshiyuki
Fatalities and injuries during an earthquake can be reduced by taking preemptive measures before-hand, and furniture anchoring is an important safety measure for all residents. This study sought to clarify the factors associated with furniture anchoring within the home. A self-administered mail survey was completed from July to August 2010 by 3500 men and women between the ages of 20 and 69 years who were chosen at random from an official government resident registry of 2 cities in Japan. Of the 1729 valid responses, 37.1% reported furniture anchoring. An association with furniture anchoring was observed for having viewed earthquake intensity maps or damage predictions (odds ratio [OR] 1.92, 95% C1 1.54-2.39), expressing concern about a future earthquake (OR 2.07, 95% C1 1.36-3.15), feelings of urgency (OR 1.90, 95% CI 1.47-2.45), accuracy of the government disaster preparedness information (OR 1.68, 95% CI 1.17-2.42), knowledge of the meaning of emergency earthquake warnings (OR 1.67, 95% CI 1.12-2.48), and participation in voluntary disaster preparedness activities (OR 1.40, 95% C1 1.12-1.75). Furniture anchoring was found to be associated with risk awareness, risk perception, disaster preparedness information provided by government to residents, knowledge of earthquakes, participation in voluntary disaster preparedness activities, nonwooden structures, and marital status. An increase in furniture anchoring is important and can be achieved through education and training in daily life.
Jones, Kerina H; Laurie, Graeme; Stevens, Leslie; Dobbs, Christine; Ford, David V; Lea, Nathan
It is widely acknowledged that breaches and misuses of health-related data can have serious implications and consequently they often carry penalties. However, harm due to the omission of health data usage, or data non-use, is a subject that lacks attention. A better understanding of this 'other side of the coin' is required before it can be addressed effectively. This article uses an international case study approach to explore why data non-use is difficult to ascertain, the sources and types of health-related data non-use, its implications for citizens and society and some of the reasons it occurs. It does this by focussing on issues with clinical care records, research data and governance frameworks and associated examples of non-use. The non-use of health-related data is a complex issue with multiple explanations. Individual instances of data non-use can be associated with harm, but taken together, they can describe a trail of data non-use that may complicate and compound its impacts. There is ample indirect evidence that health data non-use is implicated in the deaths of many thousands of people and potentially £billions in financial burdens to societies. Harm due to the non-use of health data is difficult to attribute unequivocally and actual proven evidence is sparse. Although it can be elusive, it is nevertheless a real problem with widespread and serious, if largely unquantifiable, consequences. The most effective initiatives to address specific contexts of data non-use will be those that: firstly, understand the pertinent sources, types and reasons for data non-use in a given domain in order to meet the challenges and create appropriate incentives and repercussions; and secondly, are cognisant of the multiple aspects to this complex issue in other domains to keep benefits and limitations in perspective, to move steadily towards socially responsible reuse of data becoming the norm to save lives and resources. Copyright Â© 2016 The Authors. Published by
Coomber, Kerri; Mayshak, Richelle; Hyder, Shannon; Droste, Nicolas; Curtis, Ashlee; Pennay, Amy; Gilmore, William; Lam, Tina; Chikritzhs, Tanya; Miller, Peter G.
This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries. PMID:28085105
Kanoff, Justin M; Turalba, Angela V; Andreoli, Michael T; Andreoli, Christopher M
To evaluate the characteristics and outcomes of patients treated for open globe injuries sustained at work and to compare these results to patients injured outside of work. Retrospective chart review of 812 consecutive patients with open globe injuries treated at the Massachusetts Eye and Ear Infirmary between 1999 and 2008. A total of 146 patients with open globe injuries sustained at work were identified and their characteristics and outcomes were compared with the rest of the patients in the database. Of the patients injured at work, 98% were men, and the average age of the patients was 35.8 years (17-72 years). The most common mechanism of injury was penetrating trauma (56%); 38 patients examined had intraocular foreign bodies (IOFB). Nine work-related open globe injuries resulted in enucleation. There was a higher incidence of IOFBs (P = .0001) and penetrating injuries (P = .0005) in patients injured at work. Both the preoperative (P = .0001) and final best-corrected visual acuity (P = .0001) was better in the work-related group. The final visual acuity was better than 20/200 in 74.1% of cases of work-related open globe injuries. However, there was no difference observed in the rate of enucleations (P = .4). Work-related injuries can cause significant morbidity in a young population of patients. Based on average patient follow-up and final visual acuity, those injured at work do at least as well as, if not potentially better than, those with open globe injuries sustained outside of work. While the statistically higher rate of IOFB in the work population is not surprising, it does emphasize the importance of strict adherence to the use of eye protection in the workplace. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Full Text Available PURPOSE: Massive earthquakes are harmful to humankind. This study of a historical cohort aimed to investigate the difference between earthquake-related crush thoracic traumas and thoracic traumas unrelated to earthquakes using a multi-detector Computed Tomography (CT. METHODS: We retrospectively compared an earthquake-exposed cohort of 215 thoracic trauma crush victims of the Sichuan earthquake to a cohort of 215 non-earthquake-related thoracic trauma patients, focusing on the lesions and coexisting injuries to the thoracic cage and the pulmonary parenchyma and pleura using a multi-detector CT. RESULTS: The incidence of rib fracture was elevated in the earthquake-exposed cohort (143 vs. 66 patients in the non-earthquake-exposed cohort, Risk Ratio (RR = 2.2; p<0.001. Among these patients, those with more than 3 fractured ribs (106/143 vs. 41/66 patients, RR=1.2; p<0.05 or flail chest (45/143 vs. 11/66 patients, RR=1.9; p<0.05 were more frequently seen in the earthquake cohort. Earthquake-related crush injuries more frequently resulted in bilateral rib fractures (66/143 vs. 18/66 patients, RR= 1.7; p<0.01. Additionally, the incidence of non-rib fracture was higher in the earthquake cohort (85 vs. 60 patients, RR= 1.4; p<0.01. Pulmonary parenchymal and pleural injuries were more frequently seen in earthquake-related crush injuries (117 vs. 80 patients, RR=1.5 for parenchymal and 146 vs. 74 patients, RR = 2.0 for pleural injuries; p<0.001. Non-rib fractures, pulmonary parenchymal and pleural injuries had significant positive correlation with rib fractures in these two cohorts. CONCLUSIONS: Thoracic crush traumas resulting from the earthquake were life threatening with a high incidence of bony thoracic fractures. The ribs were frequently involved in bilateral and severe types of fractures, which were accompanied by non-rib fractures, pulmonary parenchymal and pleural injuries.
Moure-Rodríguez, Lucía; Caamaño-Isorna, Francisco; Doallo, Sonia; Juan-Salvadores, Pablo; Corral, Montserrat; Rodríguez-Holguín, Socorro; Cadaveira, Fernando
The main objective of this study is to evaluate the effect of heavy drinking on alcohol-related injuries. We carried out an open cohort study among university students in Spain (n=1,382). Heavy drinking and alcohol-related injuries were measured by administrating AUDIT questionnaires to every participant at the ages of 18, 20, 22 and 24. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for consumption of alcohol and cannabis. The response rate at the beginning of the study was 99.6% (1,369 students). The incidence rate of alcohol-related injuries was 3.2 per 100 students year. After adjusting for alcohol consumption and cannabis use, the multivariate model revealed that a high frequency of heavy drinking was a risk factor for alcohol-related injuries (Odds Ratio=3.89 [95%CI: 2.16 - 6.99]). The proportion of alcohol-related injuries in exposed subjects attributable to heavy drinking was 59.78% [95%CI: 32.75 - 75.94] while the population attributable fraction was 45.48% [95%CI: 24.91 - 57.77]. We can conclude that heavy drinking leads to an increase of alcohol-related injuries. This shows a new dimension on the consequences of this public concern already related with a variety of health and social problems. Furthermore, our results allow us to suggest that about half of alcohol-related injuries could be avoided by removing this consumption pattern. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.
Rayan, G M
The five patients reported herein had various archery-related injuries of the upper extremities. Acute injuries included arrow laceration of a digital nerve and artery, contusion of forearm skin and subcutaneous tissue, and compression neuropathy of digital nerves from the bowstring. Chronic injuries included bilateral medial epicondylitis and median nerve compression at the wrist, de Quervain's tenosynovitis, and median nerve compression at the elbow. Essential measures for archery safety include use of archery protective gear, use of a light-weight bow, conditioning of the forearm flexor muscles, and modifications in drawing the bowstring.
Paulus, Martin P; Rogalsky, Corianne; Simmons, Alan; Feinstein, Justin S; Stein, Murray B
Decision making and risk taking are interrelated processes that are important for daily functioning. The somatic marker hypothesis has provided a conceptual basis for processes involved in risk-taking decision making and has been used to link discrete neural substrates to risk-related behaviors. This investigation examined the hypothesis that the degree of risk-taking is related to the degree of activation in the insular cortex. Seventeen healthy, right-handed subjects performed a risk-taking decision-making task during functional magnetic resonance imaging (fMRI) using a fast event-related design. This investigation yielded three main findings. First, right insula (BA 13) activation was significantly stronger when subjects selected a "risky" response versus selecting a "safe" response. Second, the degree of insula activation was related to the probability of selecting a "safe" response following a punished response. Third, the degree of insula activation was related to the subjects' degree of harm avoidance and neuroticism as measured by the TCI and NEO personality questionnaires, respectively. These results are consistent with the hypothesis that insula activation serves as a critical neural substrate to instantiate aversive somatic markers that guide risk-taking decision-making behavior.
Matshes, Evan W; Lew, Emma O
Occasionally, individuals accused of inflicting fatal injuries on infants and young children will claim some variant of the "CPR defense," that is, they attribute the cause of injuries found at autopsy to their "untrained" resuscitative efforts. A 10-year (1994-2003) historical fixed cohort study of all pediatric forensic autopsies at the Miami-Dade County Medical Examiner Department was undertaken. To be eligible for inclusion in the study, children had to have died of atraumatic causes, with or without resuscitative efforts (N(atraumatic) = 546). Of these, 382 had a history of cardiopulmonary resuscitation (CPR; average age of 4.17 years); 248 had CPR provided by trained individuals only; 133 had CPR provided by both trained and untrained individuals; 1 had CPR provided by untrained individuals only. There was no overlap between these 3 distinct groups. Twenty-two findings potentially attributable to CPR were identified in 19:15 cases of orofacial injuries compatible with attempted endotracheal intubation; 4 cases with focal pulmonary parenchymal hemorrhage; 1 case with prominent anterior mediastinal emphysema; and 2 cases with anterior chest abrasions. There were no significant hollow or solid thoracoabdominal organ injuries. There were no rib fractures. The estimated relative risk of injury subsequent to resuscitation was not statistically different between the subset of decedents whose resuscitative attempts were made by trained individuals only, and the subset who received CPR from both trained and untrained individuals. In the single case of CPR application by an untrained individual only, no injuries resulted. The remaining 164 children dying from nontraumatic causes and who did not undergo resuscitative efforts served as a control group; no injuries were identified. This study indicates that in the pediatric population, injuries secondary to resuscitative efforts are infrequent or rare, pathophysiologically inconsequential, and predominantly orofacial in
Dau, Brynie Kaplan; Gilardi, Kirsten V K; Gulland, Frances M; Higgins, Ali; Holcomb, Jay B; Leger, Judy St; Ziccardi, Michael H
We reviewed medical records from select wildlife rehabilitation facilities in California to determine the prevalence of injury in California Brown Pelicans (Pelecanus occidentalis), gulls (Larus spp.), and pinniped species (Zalophus californianus, Mirounga angustirostris, and Phoca vitulina) due to fishing gear entanglement and ingestion from 2001 to 2006. Of 9,668 Brown Pelican, gull, and pinniped cases described during the 6-yr study period (2001-06), 1,090 (11.3%) were fishing gear-related. Pelican injuries caused by fishing gear were most common in the Monterey Bay region, where 59.6% of the pelicans rescued in this area and admitted to a rehabilitation center were injured by fishing gear over the 6-yr period. The highest prevalence of fishing gear-related injury in gulls was documented in the Los Angeles/Orange County region (16.1%), whereas the highest prevalences in pinnipeds were seen in the San Diego region (3.7%). Despite these higher prevalences of gull and pinniped fishing gear-related injuries in these specific regions, there was no statistical significance in these trends. Juvenile gulls and pinnipeds were more commonly injured by fishing gear than adults (gulls: P = 0.03, odds ratio = 1.29; pinnipeds: P = 0.01, odds ratio = 2.07). Male pinnipeds were twice as likely to be injured by fishing gear as females (P gear-related injury cases that were successfully rehabilitated and released (percentage of cases successfully rehabilitated to the point of release out of the total number of fishing gear-related injury cases) was high in all three species groups (pelicans: 63%; gulls: 54%; pinnipeds: 70%). Fishing gear-related injuries in Brown Pelicans and gulls were highest in the fall, but there was only a significant difference between seasons for fishing gear-related injuries in pelicans. Fishing gear-related injuries in pinnipeds most commonly occurred in summer; however, a statistical difference was not detected between seasons for pinnipeds. Derelict
Timsit, S; Rougeau, T; Grevent, D; Chéron, G
No pediatric recommendations exist in France on the exercise of boxing by children and adolescents despite the risk of traumatic injury, sometimes serious. We report the case of a 15-year-old boy who participated in amateur boxing and had a subdural hematoma. Brain injuries and concussions are frequent and multiple. Severity is not always correlated with the intensity of the blows. There are age-related features. Several international medical organizations oppose boxing for children and adolescents.
Jones, Sandra C; Hall, Sabine; Kypri, Kypros
'Responsible drinking' campaigns emerged in the early 1970s as a means of addressing hazardous drinking and its related consequences. While these were initially the product of public health agencies and health-related NGOs, they are increasingly being developed and disseminated by the alcohol industry. There is considerable debate as to whether industry-generated campaigns are designed to reduce hazardous drinking and related problems (as argued by their developers) or are designed to avoid government regulation or even to increase sales. The aim of the present study was to explore the way that recent industry-developed responsible drinking campaigns are perceived and interpreted by the general public. That is, do they promote low-risk drinking, promote risky drinking, or just muddy the waters. Two sub-studies were conducted. The first, a mall intercept study with 180 adults in two Australian shopping districts, explored participants' understanding of slogans/taglines. The second, an online survey with 480 Australian adults, explored understandings and interpretations of television/online commercials. The results of the two studies revealed diversity in participants' interpretation of the 'responsible drinking' advertisements. Terminology utilised in industry-developed advertisements was found to be ambiguous; for example, what age group was being referred to in the tagline 'Kids and alcohol don't mix', and whether 'Drink Properly' meant not drinking to excess or drinking in a way that made you look more sophisticated. In Study Two, the government-developed campaign ('Know when to say when') was clearly interpreted as warning against risky consumption of alcohol; whereas the industry-developed campaigns ('How to drink properly', 'Kids absorb your drinking', 'Friends are waiting') were interpreted to have a range of different meanings, including some seemingly unrelated to alcohol. These findings are consistent with the literature evaluating anti-smoking campaigns
Full Text Available Background : Golfing has become an increasingly popular sport enjoyed by both men and women. Although the game is not viewed as hazardous, golfers do sustain injuries connected with the game. However, golf injuries have received little attention in the literature and there is no study from Asia. Methods : A prospective study was undertaken to analyze the incidence, cause and type of injury among amateur golfers. Open ended questionnaires were sent to 1000 golfers; 240 responded (Av age 51 years, 200 males and 40 females. The respondents played an average of 2 rounds per week. Results : One hundered and ten (46% responders had sustained one or more orthopaedic injuries. Both among men and women, the lower back was the most common site of injury followed by shoulder and dorsal spine. There was a difference in the injury pattern in skilled and relatively unskilled players. Lack of warm up, excessive practice and improper swing mechanics were the most common causes. Conclusion : Golf injuries perhaps could be prevented or reduced by proper technique, controlled practice routines, physical conditioning and pre-play stretching exercises. The most important factor in this playing population seems to be prevention.
Jiménez-Ruiz, Carlos; Solano, Segismundo; Viteri, Soledad Alonso; Ferrero, Miguel Barrueco; Torrecilla, Miguel; Mezquita, Miguel Hernández
Smokers with chronic obstructive pulmonary disease (COPD) appear to represent a hard-core group, and this presents a dilemma for chest physicians. A reduction in cigarette smoking benefits health, and nicotine replacement therapy (NRT) can aid smoking reduction. Hence we studied the efficacy of nicotine gum in helping hard-core smokers with severe COPD to quit. Seventeen smokers with severe COPD (FEV(1) 38-47% of predicted normal) who smoked >30 cigarettes/day but were unable to quit were encouraged to reduce their smoking as much as possible by using 4-mg nicotine gum. Five gradually reduced their daily tobacco consumption and, 18 months after starting NRT, were smoking an average of 6 cigarettes/day while still using nicotine gum. Compared to baseline, their respiratory symptoms had improved, and both FEV(1) and FVC had increased. There was no improvement in pulmonary function in the group of smokers who did not reduce their cigarette consumption. No adverse events relating to nicotine occurred among the patients who used NRT to reduce their smoking. We propose that this reduction approach should be considered for patients with respiratory disease who are unable or unwilling to stop smoking. Copyright 2002 S. Karger AG, Basel
Rozenfeld, Michael; Givon, Adi; Peleg, Kobi
To demonstrate the gap between injury epidemiology of terror-related stabbings (TRS) and non-terror-related intentional stabbings. Terror attacks with sharp instruments have multiplied recently, with many victims of these incidents presented to hospitals with penetrating injuries. Because most practical experience of surgeons with intentional stabbing injuries comes from treating victims of interpersonal violence, potential gaps in knowledge may exist if injuries from TRS significantly differ from interpersonal stabbings (IPS). A retrospective study of 1615 patients from intentional stabbing events recorded in the Israeli National Trauma Registry during the period of "Knife Intifada" (January 2013-March 2016). All stabbings were divided into TRS and IPS. The 2 categories were compared in terms of sustained injuries, utilization of hospital resources, and clinical outcomes. TRS patients were older, comprised more females and were ethnically homogenous. Most IPS incidents happened on weekdays and at night hours, whereas TRS events peaked midweek during morning and afternoon hours. TRS patients had more injuries of head, face, and neck, and severe head and neck injuries. IPS patients had more abdomen injuries; however, respective injuries in the TRS group were more severe. Greater injury severity of the TRS patients reflected on their higher hospital resources utilization and greater in-hospital mortality. Victims of terror stabbings are profoundly different in their characteristics, sustain injuries of a different profile and greater severity, require more hospital resources, and have worse off clinical outcomes, emphasizing the need of the healthcare systems to adjust itself appropriately to deal successfully with future terror attacks.
Vanlaar, Ward; McAteer, Heather; Brown, Steve; Crain, Jennifer; McFaull, Steven; Hing, Marisela Mainegra
Off-road vehicles (ORVs; this includes snowmobiles, all-terrain vehicles or ATVs and dirt bikes) were once used primarily for work and travel. Such use remains common in Canada, although their recreational use has also gained popularity in recent years. An epidemiological injury profile of ORV users is important for better understanding injuries and their risk factors to help inform injury prevention initiatives. The Traffic Injury Research Foundation (TIRF) partnered with the Public Health Agency of Canada (PHAC) to analyze the epidemiology of ORV-related injuries. The primary aim was to assess crashes and injuries in Canada, including the extent of alcohol involvement. Secondly, the burden of injury among children and teen ORV drivers in Canada, as well as passengers, was investigated. Descriptive and inferential epidemiological statistics were generated using the following data sources: first, TIRF's National Fatality Database, which is a comprehensive, pan-Canadian, set of core data on all fatal motor vehicle crashes; second, TIRF's Serious Injury Database, which contains information on persons seriously injured in crashes; and, third, PHAC's Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), a surveillance system currently operating in the emergency departments of some pediatric and general hospitals across Canada. Exposure data have been used in the analyzes where available. Between 1990 and 2010, fatality rates increased among ATV and dirt bike operators. The fatality rate among snowmobilers declined during this period. Of particular concern, among fatally injured female ATV users, children aged 0-15 years comprised the highest proportion of any age group at 33.8%. Regarding alcohol use, among fatally injured snowmobile and ATV/dirt bike operators tested for alcohol, 66% and 55% tested positive, respectively. Alcohol involvement in adult ORV crashes remains an important factor. In light of the growing popularity of ORVs, prevention and
Full Text Available Background Built environment is a major determinant in injuries and deaths during natural disasters. Purpose of the present paper was to study the effect of built environment on tsunami injuries.Methods A retrospective residential cohort was constructed one month after the tsunami, based on the cross sectional household survey. Household structure was categorised as a binary variable based on the definition used department of census and statistics for the census.Results The constructed cohort consisted of 4178 individuals, 2143 (51.3% males and 2034 (48.7% females from 1047 households. Mean age of the study sample was 25 years with a standard deviation of 17 years. Out of the 4178 study units studied, 43 (1.1% died during the acute incidence and 19(0.5% died later due to complications. Twenty eight (0.7% people were reported missing at the time of data collection. Moderate to severe injuries were reported by 508 individuals (12.5%. To investigate the injury incidence all tsunami related deaths, missing personals and injuries were classified in to a single group as injuries. Reported number of injuries were 302 (14.4%, and 296 (14.9% among males and females respectively. In multivariate analysis, living in a temporary shelter (OR=0.259, 95% CI 0.351-0.797 shown a protective effect on injuries whereas, residing within the 100 meter boundary from sea (OR 1.43, 95% CI 1.1-1.8 and destruction of house (OR 1.53 95% CI 1.14-2.07 were predictors of injuries.Conclusion Policies on building construction in coastal areas should be done considering these findings to mitigate the effect of future disasters.
Wilkinson, Claire; Livingston, Michael; Room, Robin
Legislative limits on trading hours for licensed premises have a long history in Australia as a key policy approach to managing alcohol-related problems. In recent years, following substantial extensions to permitted hours of sale, there has been renewed attention to policies aimed at reducing late-night trading hours. Restrictions on on-premise alcohol sales have been implemented in Australia after 3.30 am in Newcastle, and after 3 am in Kings Cross and the Sydney central business district in New South Wales. In July 2016, similar restrictions were introduced state-wide after 2 am, or 3 am in 'safe night precincts', in Queensland. Similar policy changes have occurred internationally (e.g. in the UK and the Nordic countries) and there is a growing body of research examining the impacts of trading hour policies on alcohol-related harm. Although there has been a series of reviews of the research in this area, the most recent is now 5 years old and limited to studies published before March 2008. Objective and importance of study: To examine recent (2005-2015) research about the impact of changing the hours of sale of alcohol on alcohol-related harms. The ongoing public discussion about trading hours policy in Australia can benefit from an up-to-date and comprehensive review of the research. Systematic review of the literature that considered the impact of policies that extended or restricted trading hours. MEDLINE, Core Collection, PsychINFO and EMBASE databases were searched from January 2005 to December 2015. Articles were summarised descriptively, focusing on studies conducted in Australia and published since the previous reviews. The search identified 21 studies, including seven from Australia. There were 14 studies published since previous reviews. A series of robust, well-designed Australian studies demonstrate that reducing the hours during which on-premise alcohol outlets can sell alcohol late at night can substantially reduce rates of violence. The Australian
Vitale, Melissa A; Mertz, Kristen J; Gaines, Barbara; Zuckerbraun, Noel S
To describe injuries due to golf-related activities among pediatric patients requiring hospital admission. We conducted a retrospective analysis of all sports-related injuries from 2000 to 2006 using a level 1 trauma center database. Of 1005 children admitted with sports-related injuries, 60 (6%) had golf-related injuries. The mean injury severity score was significantly higher for golf-related injuries (11.0) than that for all other sports-related injuries (6.8). Most golf-related injuries occurred in children younger than 12 years (80%), at home (48%), and by a strike from a club (57%) and resulted in trauma to the head or neck (68%). Golf-related injuries, although an infrequent cause of sports-related injuries, have the potential to result in severe injuries, especially in younger children. Preventive efforts should target use of golf clubs by younger children in the home setting.
Full Text Available Hopelessness is a well-established predictor of suicide, and inspiring hope is an important goal in mental health care, but there are few studies of hope among persons with suicidal behavior. The aim of this study was to interpret the lived experience of hope in some patients hospitalized for intentional self-harm. Twelve persons that had engaged in suicidal behavior by ingesting an overdose of medication were interviewed shortly after hospitalization and asked to narrate about their hopes. The transcripts were analyzed using a phenomenological hermeneutic method inspired by Ricoeur's theory of interpretation. The naïve reading was one of hope being relational. The structural analysis identified three themes: hopes for life, hopes for death, and the act of hoping. We interpreted the common theme of the interviews as being definite and indefinite relational hopes for life and death. For clinicians, expressions of indefinite hopes may raise concerns about the low likelihood of fulfillment. However, the expression of indefinite hope may serve to avoid experiencing failure, disappointment, and hopelessness.
Kim, Hee Yul; Ju, Chang Il; Kim, Seok Won
We report an extremely rare case of traumatic cervical spinal subdural hematoma not related to intracranial injury. There has been no report on traumatic cervical spinal subdrual hematoma not related to intracranial injury. A 27-year-old female patient was admitted to our emergency room due to severe neck pain and right arm motor weakness after car collision. On admission, she presented with complete monoplegia and hypoesthesia of right arm. Magnetic resonance imaging (MRI) revealed subdural hematoma compressing spinal cord. Lumbar cerebrospinal fluid (CSF) analysis revealed 210,000 red blood cells/mm(3). She was managed conservatively by administrations of steroid pulse therapy and CSF drainage. Her muscle power of right arm improved to a Grade III 16 days after admission. Follow-up MRI taken 16th days after admission revealed almost complete resolution of the hematoma. Here, the authors report a traumatic cervical spinal SDH not associated with intracranial injury.
Io, Aro; Yoshimoto, Hisashi
Japan passed the national law "Basic Act on Measures against Alcohol-related Health Harm" on December 2013. This law is expected to prevent inappropriate drinking that leads to alcohol-related problems such as physical and mental disorder, drunk driving, suicide, domestic violence, child abuse, and poor work performance. The physician's responsibilities under this law are described as follows: i) to provide high quality and appropriate medical care concerning alcohol-related health harm; ii) to reduce or eliminate the consumption of alcohol, thus preventing the progression of alcohol-related health harm; and iii) to coordinate these efforts amongst medical institutions. Based on this law, we believe that Japanese physicians will have essential roles in achieving the goals of this law and that we can fulfill our responsibilities by observing the following aspects: a) changing our message to the patients from "drink sensibly and moderately" to "low-risk drinking; but any drinking has a risk of harm and low-risk drinking is not risk-free"; b) encouraging the spread and use of Screening, Brief Intervention, and Referral to Treatment (SBIRT); and c) establishing community healthcare systems for alcohol-related problems, including dementia in the elderly and during alcohol emergencies.
Scheuring, R. A.; McCulloch, P.; Van Baalen, Mary; Minard, Charles; Watson, Richard; Blatt, T.
Introduction: For every one hour spent performing extravehicular activity (EVA) in space, astronauts in the US space program spend approximately six to ten hours training in the EVA spacesuit at NASA-Johnson Space Center's Neutral Buoyancy Lab (NBL). In 1997, NASA introduced the planar hard upper torso (HUT) EVA spacesuit which subsequently replaced the existing pivoted HUT. An extra joint in the pivoted shoulder allows increased mobility but also increased complexity. Over the next decade a number of astronauts developed shoulder problems requiring surgical intervention, many of whom performed EVA training in the NBL. This study investigated whether changing HUT designs led to shoulder injuries requiring surgical repair. Methods: US astronaut EVA training data and spacesuit design employed were analyzed from the NBL data. Shoulder surgery data was acquired from the medical record database, and causal mechanisms were obtained from personal interviews Analysis of the individual HUT designs was performed as it related to normal shoulder biomechanics. Results: To date, 23 US astronauts have required 25 shoulder surgeries. Approximately 48% (11/23) directly attributed their injury to training in the planar HUT, whereas none attributed their injury to training in the pivoted HUT. The planar HUT design limits shoulder abduction to 90 degrees compared to approximately 120 degrees in the pivoted HUT. The planar HUT also forces the shoulder into a forward flexed position requiring active retraction and extension to increase abduction beyond 90 degrees. Discussion: Multiple factors are associated with mechanisms leading to shoulder injury requiring surgical repair. Limitations to normal shoulder mechanics, suit fit, donning/doffing, body position, pre-existing injury, tool weight and configuration, age, in-suit activity, and HUT design have all been identified as potential sources of injury. Conclusion: Crewmembers with pre-existing or current shoulder injuries or certain
Feng, Zhiying; Raghuwanshi, Rakesh P; Xu, Zigang; Huang, Dayong; Zhang, Chong; Jin, Tao
To examine the rising casualty rate related to electric bicycle usage. Analysis of the Hangzhou Police Bureau's data on electric-bicycle-related injuries and deaths. Hangzhou, China, 2004-2008. PATIENTS OR SUBJECTS: Electric-bicycle riders. Electric-bicycle-related casualty rates in Hangzhou from 2004 to 2008. There was a significant average annual increase in electric-bicycle-related casualty rates of 2.7 per 100,000 population (95% CI 1.5 to 3.9, p=0.005). At the same time, overall road traffic and manual-bicycle-related deaths and injuries decreased. As it is difficult to ban the use of electric bicycles in China, laws, rules and regulations need to be reinforced and strengthened. New regulations should be created for the safety of electric bicycle riders and others on the road, and mandatory helmet use should be considered.
Čermáková, Z; Kořískta, M; Blahutová, Š; Dvořáčková, J; Brát, R; Valkovský, I; Hrdličková, R
Transfusion-related acute lung injury (TRALI) is a severe life-threatening complication of blood transfusion, characterized by acute lung injury developing within 2-6 h of transfusion. However, TRALI is difficult to diagnose, and the initial report or suspicion of TRALI depends on close collaboration between clinical departments and transfusion centres. A total of 17 adverse post-transfusion reactions were reported to the Blood Centre of the University Hospital Ostrava as suspected TRALI between 2005 and 2010. We report two cases of serious TRALI with different pathogenetic mechanisms.
This book provides a state-of-the-art update, as well as perspectives on future directions of research and clinical applications in the implementation of biomechanical and biophysical experimental, theoretical and computational models which are relevant to military medicine. Such experimental and modeling efforts are helpful, on the one hand, in understanding the aetiology, pathophysiology and dynamics of injury development and on the other hand in guiding the development of better equipment and protective gear or devices that should ultimately reduce the prevalence and incidence of injuries or lessen their hazardous effects. The book is useful for military-oriented biomedical engineers and medical physicists, as well as for military physiologists and other medical specialists who are interested in the science and technology implemented in modern investigations of military related injuries.
Britt Marie Stålnacke
Full Text Available Background. Postconcussion symptoms (PCSs—such as fatigue, headache, irritability, dizziness, and impaired memory—are commonly reported in patients who have mild traumatic brain injuries (MTBIs. Evaluation of PCS after MTBI is proposed to have a diagnostic value although it is unclear whether PCS are specific to MTBI. After whiplash injuries, patients most often complain of headaches and neck pain; the other PCS are not as closely evaluated. In patients with chronic pain because of other injuries, the presence of PCS is unclear. This study aimed to describe the frequency of PCS in patients with injury-related pain and to examine the relationships between PCS, pain, and psychological factors. Methods. This study collected data using questionnaires addressing PCS (Rivermead Postconcussion Questionnaire, RPQ, pain intensity (Visual Analogue Scale, depression, anxiety (Hospital, Anxiety, and Depression Scale, and posttraumatic stress (Impact of Event Scale. Results. Fatigue (90.7%, sleep disturbance (84.9%, headache (73.5%, poor concentration (88.2%, and poor memory (67.1% were some of the most commonly reported PCS. Significant relationships were found between PCS and posttraumatic stress, depression, and anxiety. Conclusion. To optimize treatment, it is important to assess each patient’s PCS, the mechanism of injury, and factors such as posttraumatic stress and depression.
Kramer, William L M; Haaring, Gert-Jan
Three children, a 6-year-old boy and two girls aged 5 and 4 years, were seen at an emergency department due to distal lower-leg injuries sustained from the spokes of bicycle wheels. All three patients had been passengers on rear carrying seats of moving bicycles. Only the third bicyclist had used a special child safety seat. The second girl had drawn her foot up from underneath a strap and suffered a tibial fracture later treated with an osteosynthetic plate. The other two patients recovered after conservative casting treatment. Bicycle spoke-related injuries are sustained when the foot or lower limb makes contact with the spokes of a bicycle wheel and usually by children who are bicycle passengers. In the Netherlands, approximately 4600 children are seen at emergency departments with such injuries each year. Bicycle spoke-related accidents can cause severe damage that can result in lengthy recovery periods. Not only physical complications but also psychological ones can occur. The latter are often overlooked but do deserve proper treatment. The physician treating a spoke-related injury is in a good position to advice parents as to preventive measures, particularly on the use of special child safety seats.
Bullock, Steven H; Jones, Bruce H; Gilchrist, Julie; Marshall, Stephen W
The Military Training Task Force of the Defense Safety Oversight Council chartered a Joint Services Physical Training Injury Prevention Working Group to: (1) establish the evidence base for making recommendations to prevent injuries; (2) prioritize the recommendations for prevention programs and policies; and (3) substantiate the need for further research and evaluation on interventions and programs likely to reduce physical training-related injuries. A work group was formed to identify, evaluate, and assess the level of scientific evidence for various physical training-related injury prevention strategies through an expedited systematic review process. Of 40 physical training-related injury prevention strategies identified, education, leader support, and surveillance were determined to be essential elements of a successful injury prevention program and not independent interventions. As a result of the expedited systematic reviews, one more essential element (research) was added for a total of four. Six strategies were not reviewed. The remaining 31 interventions were categorized into three levels representing the strength of recommendation: (1) recommended; (2) not recommended; and (3) insufficient evidence to recommend or not recommend. Education, leadership support, injury surveillance, and research were determined to be critical components of any successful injury prevention program. Six interventions (i.e., prevent overtraining, agility-like training, mouthguards, semirigid ankle braces, nutrient replacement, and synthetic socks) had strong enough evidence to become working group recommendations for implementation in the military services. Two interventions (i.e., back braces and pre-exercise administration of anti-inflammatory medication) were not recommended due to evidence of ineffectiveness or harm, 23 lacked sufficient scientific evidence to support recommendations for all military services at this time, and six were not evaluated. Six interventions
Krahl, Pamela L; Jankosky, Christopher J; Thomas, Richard J; Hooper, Tomoko I
Motor vehicle crashes account for nearly one third of U.S. military fatalities annually. The objective of this review is to summarize the published evidence on injuries due specifically to military motor vehicle (MMV) crashes. A search of 18 electronic databases identified English language publications addressing MMV crash-related injuries between 1970 and 2006 that were available to the general public. Documents limited in distribution to military or government personnel were not evaluated. Relevant articles were categorized by study design. The search identified only 13 studies related specifically to MMV crashes. Most were case reports or case series (n=8); only one could be classified as an intervention study. Nine of the studies were based solely on data from service-specific military safety centers. Few studies exist on injuries resulting from crashes of military motor vehicles. Epidemiologic studies that assess injury rates, type, severity, and risk factors are needed, followed by studies to evaluate targeted interventions and prevention strategies. Interventions currently underway should be evaluated for effectiveness, and those proven effective in the civilian community, such as graduated driver licensing, should be considered for implementation and evaluation in military populations. Published by Elsevier Inc.
Taylor, Lewis A., III
An accessible business school population of undergraduate students was investigated in three independent, but related studies to determine effects on grades due to cutting class and failing to take advantage of optional reviews and study quizzes. It was hypothesized that cutting classes harms exam scores, attending preexam reviews helps exam…
It has been difficult to secure funding in Denmark to conduct research on third party harm from alcohol. The author relates her experiences in this area and challenges Danish society to examine how other societies have begun to examine this problem....
McKenzie, Stephen; Droste, Nic; Hickford, Salli; Miller, Peter
Deakin University's RuralLife alcohol and other drug (AOD) research initiative was commissioned by St John of God Hospital and Barwon Youth to evaluate their Youth Engagement Program (YEP), which is an AOD harm-reduction program intended to engage young people with AOD problems in a region that has a higher-than-state-average proportion of young…
Myers, Melvin L; Cole, Henry P; Westneat, Susan C
Early studies of injuries associated with overturns indicate that more fatalities occurred when a tractor overturned beyond 90 degrees (continuous roll) relative to the impact plane. Recently, the principle of preventing continuous rolls has re-emerged for the protection of riding lawnmower operators. Related to tractors, a population-based study was conducted that compared the severity of fatal and nonfatal injuries between a 90 degrees and continuous roll for tractors equipped with rollover protective structures (ROPS) and not equipped with a ROPS (non- ROPS). In 2002, the Kentucky Farm Tractor Overturn Survey was administered to an 8% random sample (6,063) of Kentucky farm operators. The farmers responded to questions that differentiated between the types of overturns and operator injury outcomes for ROPS-equipped and non-ROPS tractors during overturn events. Overturn characteristics were collected that included 90 degrees to the side, beyond 90 degrees to the side, and to the rear for both ROPS-equipped and non-ROPS tractors. Of the 541 overturns reported in this study, 535 (99%) of the respondents reported the most recent overturn characteristics of the tractor: 92 (17%) were ROPS-equipped and 443 (83%) were non-ROPS. For side overturns, 67% of the rolls occurred with ROPS-equipped tractors, and 54% occurred with non-ROPS tractors. The percentages of deaths related to rolls to the side for ROPS-equipped and non-ROPS tractors were, respectively, 1.6% and 3.7%. There was one (2%) deaths related to 90 degrees rolls for ROPS-equipped tractors, whereas for continuous rolls there were 6.4% fatalities related to side overturns, 13% resulted in non-fatal injuries with an average of 1 day of hospitalization for ROPS-equipped tractors, and 39% resulted in non-fatal injuries with an average of 18 days of hospitalization for non-ROPS tractors. The results from this study indicated that a ROPS was more effective at stopping an overturn at 90 degrees than no ROPS, with an
Full Text Available Abstract Background There is a lack of empirical analyses examining how alcohol consumption patterns in children relate to harms. Such intelligence is required to inform parents, children and policy relating to the provision and use of alcohol during childhood. Here, we examine drinking habits and associated harms in 15-16 year olds and explore how this can inform public health advice on child drinking. Methods An opportunistic survey of 15-16 year olds (n = 9,833 in North West England was undertaken to determine alcohol consumption patterns, drink types consumed, drinking locations, methods of access and harms encountered. Cost per unit of alcohol was estimated based on a second survey of 29 retail outlets. Associations between demographics, drinking behaviours, alcohol pricing and negative outcomes (public drinking, forgetting things after drinking, violence when drunk and alcohol-related regretted sex were examined. Results Proportions of drinkers having experienced violence when drunk (28.8%, alcohol-related regretted sex (12.5% and forgetting things (45.3%, or reporting drinking in public places (35.8%, increased with drinking frequency, binge frequency and units consumed per week. At similar levels of consumption, experiencing any negative alcohol-related outcome was lower in those whose parents provided alcohol. Drunken violence was disproportionately associated with being male and greater deprivation while regretted sex and forgetting things after drinking were associated with being female. Independent of drinking behaviours, consuming cheaper alcohol was related to experiencing violence when drunk, forgetting things after drinking and drinking in public places. Conclusion There is no safe level of alcohol consumption for 15-16 year olds. However, while abstinence removes risk of harms from personal alcohol consumption, its promotion may also push children into accessing drink outside family environments and contribute to higher risks of
Bellis, Mark A; Phillips-Howard, Penelope A; Hughes, Karen; Hughes, Sara; Cook, Penny A; Morleo, Michela; Hannon, Kerin; Smallthwaite, Linda; Jones, Lisa
There is a lack of empirical analyses examining how alcohol consumption patterns in children relate to harms. Such intelligence is required to inform parents, children and policy relating to the provision and use of alcohol during childhood. Here, we examine drinking habits and associated harms in 15-16 year olds and explore how this can inform public health advice on child drinking. An opportunistic survey of 15-16 year olds (n = 9,833) in North West England was undertaken to determine alcohol consumption patterns, drink types consumed, drinking locations, methods of access and harms encountered. Cost per unit of alcohol was estimated based on a second survey of 29 retail outlets. Associations between demographics, drinking behaviours, alcohol pricing and negative outcomes (public drinking, forgetting things after drinking, violence when drunk and alcohol-related regretted sex) were examined. Proportions of drinkers having experienced violence when drunk (28.8%), alcohol-related regretted sex (12.5%) and forgetting things (45.3%), or reporting drinking in public places (35.8%), increased with drinking frequency, binge frequency and units consumed per week. At similar levels of consumption, experiencing any negative alcohol-related outcome was lower in those whose parents provided alcohol. Drunken violence was disproportionately associated with being male and greater deprivation while regretted sex and forgetting things after drinking were associated with being female. Independent of drinking behaviours, consuming cheaper alcohol was related to experiencing violence when drunk, forgetting things after drinking and drinking in public places. There is no safe level of alcohol consumption for 15-16 year olds. However, while abstinence removes risk of harms from personal alcohol consumption, its promotion may also push children into accessing drink outside family environments and contribute to higher risks of harm. Strategies to reduce alcohol-related harms in children
Deng, Xiao; Jin, Ye; Ye, Pengpeng; Gao, Xin; Wang, Yuan; Ji, Cuirong; Er, Yuliang; Wang, Linhong; Duan, Leilei
To understand the trend and characteristics of sports and recreation related injuries reported from National Injury Surveillance System (NISS) to provide basis for corresponding prevention strategies and decision-making. Descriptive analysis was applied to display the overall trend, general information, injury event and clinical characteristics of sports and recreation related injuries from 2009 to 2013. The proportion of sports and recreation related injuries among all injuries increased from 2009 to 2013, with an annual increase exceeding 45% (46.21%, 47.32%, 48.14%, 52.00%, 53.65%, respectively). Sports and recreation related injuries mainly involved males, with 15-29 age groups, particularly in summer and autumn. Sports and recreation related injuries mostly occurred at home, with annual rates of proportion as 33.07%, 34.16%, 32.98%, 34.57 and 36.22%, mostly caused by falls (41.19%, 41.64%, 44.70%, 47.41%, 47.96%). Contusion and abrasion were the leading types of injuries (43.49%, 44.56%, 45.14%, 45.02%, 45.62%) with the serious leading types as fracture, concussion/cerebral contusion or laceration, and sharp force injury/bite/open wounds. Head was the part mainly involved (31.30%, 32.48%, 31.89%, 30.88%, 29.44%) in injuries. Most sports and recreation related injuries were minor and most of the patients headed home after treatment. Sports and recreation related injury appeared a growing public health problem in China. Children and the elderly should be the target groups for intervention. Falls prevention in sports and the use of protection gears should be the focus countermeasures for prevention.
Wilde, Elisabeth A; Li, Xiaoqi; Hunter, Jill V; Narayana, Ponnada A; Hasan, Khader; Biekman, Brian; Swank, Paul; Robertson, Claudia; Miller, Emmy; McCauley, Stephen R; Chu, Zili David; Faber, Jessica; McCarthy, James; Levin, Harvey S
To study the relation of loss of consciousness (LOC) to white matter integrity after mild traumatic brain injury (mTBI), we acquired diffusion tensor imaging (DTI) at 3 Tesla in 79 participants with mTBI and normal computed tomography (age 18 to 50 years) whom we imaged after a mean post-injury interval of 25.9 h (standard deviation = 12.3) and at 3 months. For comparison, 64 participants with orthopedic injury (OI) underwent DTI at similar intervals. Quantitative tractography was used to measure fractional anisotropy (FA) and mean diffusivity (MD) in the left and right uncinate fasciculus (UF), left and right inferior frontal occipital fasciculus (IFOF), and the genu of the corpus callosum. Generalized estimating equation models assessed the association between LOC and both MD and FA across time after mTBI and compared their DTI metrics with the OI group. LOC was significantly related to MD in UF and IFOF (p values ranged from p < 0.0001 to 0.0270) and to FA in left UF (p = 0.0104) and right UF (p = 0.0404). Between-group differences in MD were significant for left UF, left and right IFOF, and the genu of the corpus callosum on initial DTI, but not at 3 months post-injury, and these differences were specific to the mTBI subgroup with LOC. Groups did not differ in FA at either occasion. Early DTI may provide a biomarker for mTBI with LOC, even in patients whose consciousness recovers by arrival in the emergency department. MD better differentiates mTBI from OI than FA on early DTI, but this is specific to mTBI with LOC. DTI findings support a continuum of white matter injury in early mTBI.
Full Text Available The perceived health risk of recently introduced nicotine and tobacco products may influence both their uptake and continued use. The aim of the study was to assess how adolescents rate relative harmfulness of slim and menthol cigarettes, water pipes, e-cigarettes, and smokeless tobacco compared to regular cigarettes. Cross-sectional survey data from students aged 13–19 years from Piotrkowski district, Poland were analyzed. Among the sample of 4050 students, 3552 respondents completed anonymous, confidential, self-administered questionnaire adapted from the Global Youth Tobacco Survey (GYTS. The study results indicate that the students perceived slim cigarettes and menthol cigarettes as less harmful, which is in line with the message created by tobacco companies. On the other hand, less popular products such as water pipes and smokeless tobacco were considered as more harmful. The current study indicates insufficient and misleading perception of harmfulness of different tobacco/nicotine products available on the Polish market. Simultaneously, there is insufficient countrywide public health education in this matter. Preventive measures are necessary to discourage young people from smoking uptake and to ensure that potential consumers can, based on objective data, make informed decisions about cigarettes and non-cigarette tobacco products.
Kaleta, Dorota; Polanska, Kinga; Bak-Romaniszyn, Leokadia; Wojtysiak, Piotr
The perceived health risk of recently introduced nicotine and tobacco products may influence both their uptake and continued use. The aim of the study was to assess how adolescents rate relative harmfulness of slim and menthol cigarettes, water pipes, e-cigarettes, and smokeless tobacco compared to regular cigarettes. Cross-sectional survey data from students aged 13-19 years from Piotrkowski district, Poland were analyzed. Among the sample of 4050 students, 3552 respondents completed anonymous, confidential, self-administered questionnaire adapted from the Global Youth Tobacco Survey (GYTS). The study results indicate that the students perceived slim cigarettes and menthol cigarettes as less harmful, which is in line with the message created by tobacco companies. On the other hand, less popular products such as water pipes and smokeless tobacco were considered as more harmful. The current study indicates insufficient and misleading perception of harmfulness of different tobacco/nicotine products available on the Polish market. Simultaneously, there is insufficient countrywide public health education in this matter. Preventive measures are necessary to discourage young people from smoking uptake and to ensure that potential consumers can, based on objective data, make informed decisions about cigarettes and non-cigarette tobacco products.
Kaleta, Dorota; Polanska, Kinga; Bak-Romaniszyn, Leokadia; Wojtysiak, Piotr
The perceived health risk of recently introduced nicotine and tobacco products may influence both their uptake and continued use. The aim of the study was to assess how adolescents rate relative harmfulness of slim and menthol cigarettes, water pipes, e-cigarettes, and smokeless tobacco compared to regular cigarettes. Cross-sectional survey data from students aged 13–19 years from Piotrkowski district, Poland were analyzed. Among the sample of 4050 students, 3552 respondents completed anonymous, confidential, self-administered questionnaire adapted from the Global Youth Tobacco Survey (GYTS). The study results indicate that the students perceived slim cigarettes and menthol cigarettes as less harmful, which is in line with the message created by tobacco companies. On the other hand, less popular products such as water pipes and smokeless tobacco were considered as more harmful. The current study indicates insufficient and misleading perception of harmfulness of different tobacco/nicotine products available on the Polish market. Simultaneously, there is insufficient countrywide public health education in this matter. Preventive measures are necessary to discourage young people from smoking uptake and to ensure that potential consumers can, based on objective data, make informed decisions about cigarettes and non-cigarette tobacco products. PMID:27608034
San Antonio, Texas 78234 (e-mail: firstname.lastname@example.org). Copyright © 2014 by Lippincott Williams & Wilkins e258 | www.jorthotrauma.com J Orthop...highest and second highest impact scores in the J Orthop Trauma Volume 28, Number 11, November 2014 Combat-Related Hindfoot Injury 2014 Lippincott ...2014 Lippincott Williams & Wilkins surgeons. Although multiple scoring systems that incorporate a variety of clinical parameters have been proposed
Ying Zhang; Fu-Kui Zhang; Xiao-Ning Wu; Tai-Ling Wang; Ji-Dong Jia; Bao-En Wang
Hepatic injury is rarely associated with undifferentiated connective tissue diseases (UCTD).We report,here,a case of a middle-aged woman with UCTD-related hepatic injury,including its case history,clinical manifestations,laboratory findings,treatment and its short-term effect.The patient was admitted to the hospital with symptoms of fatigue,anorexia,low-grade fever and skin rashes.She had a past history of left knee joint replacement.Laboratory tests showed elevated levels of serum transaminase,IgG and globulin,accelerated erythrocyte sedimentation rate,eosinophilia and a high titer of antinuclear antibodies (1:320).Imaging studies showed interstitial pneumonitis and hydropericardium.Liver biopsy showed the features which were consistent with those of connective tissue diseases-related polyangitis.After treatment with a low-dose of oral prednisone,both symptoms and laboratory findings were significantly improved.UCTD-related hepatic injury should be considered in the differential diagnosis of connective tissue diseases with abnormal liver function tests.Lowdose prednisone may effectively improve both symptoms and laboratory tests.
Jordan, Barry D
Acute and chronic sports-related traumatic brain injuries (TBIs) are a substantial public health concern. Various types of acute TBI can occur in sport, but detection and management of cerebral concussion is of greatest importance as mismanagement of this syndrome can lead to persistent or chronic postconcussion syndrome (CPCS) or diffuse cerebral swelling. Chronic TBI encompasses a spectrum of disorders that are associated with long-term consequences of brain injury, including chronic traumatic encephalopathy (CTE), dementia pugilistica, post-traumatic parkinsonism, post-traumatic dementia and CPCS. CTE is the prototype of chronic TBI, but can only be definitively diagnosed at autopsy as no reliable biomarkers of this disorder are available. Whether CTE shares neuropathological features with CPCS is unknown. Evidence suggests that participation in contact-collision sports may increase the risk of neurodegenerative disorders such as Alzheimer disease, but the data are conflicting. In this Review, the spectrum of acute and chronic sport-related TBI is discussed, highlighting how examination of athletes involved in high-impact sports has advanced our understanding of pathology of brain injury and enabled improvements in detection and diagnosis of sport-related TBI.
Mizobuchi, Yoshifumi; Nagahiro, Shinji
We review current topics in sport-related head injuries including acute subdural hematoma (ASDH), traumatic cerebrovascular disease, cerebral concussion, and chronic traumatic encephalopathy (CTE). Sports-related ASDH is a leading cause of death and severe morbidity in popular contact sports like American football and Japanese judo. Rotational acceleration can cause either cerebral concussion or ASDH due to rupture of a parasagittal bridging vein. Although rare, approximately 80% of patients with cerebral infarction due to sport participation are diagnosed with ischemia or infarction due to arterial dissection. Computed tomography angiography, magnetic resonance angiography, and ultrasound are useful for diagnosing arterial dissection; ultrasound is particularly useful for detecting dissection of the common and internal carotid arteries. Repeated sports head injuries increase the risks of future concussion, cerebral swelling, ASDH, and CTE. To avoid fatal consequences of CTE, it is essential to understand the criteria for safe post-concussion sports participation. Once diagnosed with a concussion, an athlete should not be allowed to return to play on the same day and should not resume sports before the concussion symptoms have completely resolved. Information about the risks and management of head injuries in different sports should be widely disseminated in educational institutions and by sport organization public relations campaigns.
Suicide prevention efforts in Asia have increasingly turned to 'quick win' means restriction, while more complicated cognitive restriction and psychosocial programs are limited. This article argues the development of cognitive restriction programs requires greater consideration of suicide methods as social practices, and of how suicide cognitive schemata form. To illustrate this, the article contributes an ethnographically grounded study of how self-poisoning becomes cognitively available in Sri Lanka. I argue the overwhelming preference for poison as a method of self-harm in the country is not simply reflective of its widespread availability, but rather how cognitive schemata of poison-a 'poison complex'-develops from early childhood and is a precondition for suicide schemata. Limiting cognitive availability thus requires an entirely novel approach to suicide prevention that draws back from its immediate object (methods and causes of self-harm) to engage the wider poison complex of which suicide is just one aspect.
Swanton, Amanda R; Young, Tracy L; Leinenkugel, Kathy; Torner, James C; Peek-Asa, Corinne
To identify tractor-related injuries using data from a statewide trauma system, to characterize the mechanisms of nonfatal tractor-related injury, and to determine which injuries are associated with higher severity injury. A retrospective observational study was conducted using the Iowa State Trauma Registry to identify cases of nonfatal tractor-related injuries over an 11-year period from 2002 to 2012. Frequency of injury was reported by age, sex, severity, and nature. Injuries were classified by mechanism and a polytomous regression model was used to predict injury severity adjusting for sex and age. Five-hundred thirteen nonfatal tractor-related injuries were identified with 18% classified as severe. Injuries were most frequent among males and among those ≥45years of age. Rollovers were the most frequent mechanism of both total (25%) and severe injury (38%), although the frequency of injury mechanism varied by age. Falls were the next most frequent mechanism of injury (20%) but resulted in fewer high-severity injuries. Collision (adjOR=1.89, 95% CI=1.01-3.51), rollover (adjOR=2.03, 95% CI=1.21-3.40), and run over/rolled on (adjOR=2.06, 95% CI=1.17-3.62) injuries were significantly associated with higher injury severity. Advanced age was also a significant predictor of higher severity injury (adjOR=1.82, 95% CI=1.06-3.12). Mechanisms of nonfatal tractor-related injuries are heterogeneous, differ by age, and are associated with varying level of severity. This work shows the burden of nonfatal tractor injuries on a rural state trauma system. These findings also demonstrate the heterogeneous nature of nonfatal tractor injuries and underscore the need for a multi-level approaches to injury prevention. Copyright © 2015 Elsevier Ltd. All rights reserved.
Van Ness, Michael; Jensen, Hanne; Adamson, Grete N
Intracellular components of transfusion-related acute lung injury (TRALI) were investigated by transmission electron microscopy.......Intracellular components of transfusion-related acute lung injury (TRALI) were investigated by transmission electron microscopy....
Sulistyowati Tuminah Darjoko
Women and stroke sufferers were at higher risk of fall-related injury among older persons. Prevention of fall-related injury should be done by older persons through periodic control of their health condition.
West, Bethany A; Naumann, Rebecca B
A previous analysis of National Vital Statistics System data for 2003-2007 that examined disparities in rates of motor vehicle-related death by race/ethnicity and sex found that death rates for American Indians/Alaska Natives were two to four times the rates of other races/ethnicities. To address the disparity in motor vehicle-related injuries and deaths among American Indians/Alaska Natives, CDC funded four American Indian tribes during 2004-2009 to tailor, implement, and evaluate evidence-based road safety interventions. During the implementation of these four motor vehicle-related injury prevention pilot programs, seat belt and child safety seat use increased and alcohol-impaired driving decreased. Four American Indian/Alaska Native tribal communities-the Tohono O'odham Nation, the Ho-Chunk Nation, the White Mountain Apache Tribe, and the San Carlos Apache Tribe-implemented evidence-based road safety interventions to reduce motor vehicle-related injuries and deaths. Each community selected interventions from the Guide to Community Preventive Services and implemented them during 2004-2009. Furthermore, each community took a multifaceted approach by incorporating several strategies, such as school and community education programs, media campaigns, and collaborations with law enforcement officers into their programs. Police data and direct observational surveys were the main data sources used to assess results of the programs. Results included increased use of seat belts and child safety seats, increased enforcement of alcohol-impaired driving laws, and decreased motor vehicle crashes involving injuries or deaths. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion as an example of a program that might be effective for reducing motor vehicle-related injury disparities in the United States. The Guide to Community Preventive Services recognizes these selected interventions as effective; this report examines the
Claassen, Cynthia A; Larkin, Gregory Luke; Hodges, Gayle; Field, Craig
To investigate criminal and high-risk lifestyle factors that predict emergency department (ED) recidivism, a longitudinal (8-year) cohort study of ED trauma patients was conducted. Study patients provided risk and lifestyle behavior information via semi-structured interview. ED revisit and re-injury rates for 1995-2003 were acquired through hospital record review. Lifetime criminal arrest data were obtained for each study subject via record linkage from PublicData.com, an internet-based service. The 8-year ED re-visit rate was 47% (75/161), but revisits were more often medical than injury-related (30% vs. 17%, respectively). Over half (58%) of all injured ED patients had a documented arrest history, and arrests were significantly more common in those who came back to the ED for repeat trauma vs. those who did not revisit the ED (70.4% vs. 55.9%, respectively; p violence-related crimes, 23% (37/161) of 98 drug-related offenses, and 17.4% (28/161) of 89 other non-traffic-related crimes. ED recidivism for trauma care was associated with multiple substance abuse behaviors and drug-related arrests. Significant risk factors for ED recidivism seem to be high-risk substance-abuse-related behaviors and criminal activity, constituting important targets for effective ED-based intervention, referral, and follow-up.
Jennings, Fabio; Lambert, Elaine; Fredericson, Michael
Most individuals seeking consultation at sports medicine clinics are young, healthy athletes with injuries related to a specific activity. However, these athletes may have other systemic pathologies, such as rheumatic diseases, that may initially mimic sports-related injuries. As rheumatic diseases often affect the musculoskeletal system, they may masquerade as traumatic or mechanical conditions. A systematic review of the literature found numerous case reports of athletes who presented with apparent mechanical low back pain, sciatica pain, hip pain, meniscal tear, ankle sprain, rotator cuff syndrome and stress fractures and who, on further investigation, were found to have manifestations of rheumatic diseases. Common systemic, inflammatory causes of these musculoskeletal complaints include ankylosing spondylitis (AS), gout, chondrocalcinosis, psoriatic enthesopathy and early rheumatoid arthritis (RA). Low back pain is often mechanical among athletes, but cases have been described where spondyloarthritis, especially AS, has been diagnosed. Neck pain, another common mechanical symptom in athletes, can be an atypical presentation of AS or early RA. Hip or groin pain is frequently related to injuries in the hip joint and its surrounding structures. However, differential diagnosis should be made with AS, RA, gout, psudeogout, and less often with haemochromatosis and synovial chondochromatosis. In athletes presenting with peripheral arthropathy, it is mandatory to investigate autoimmune arthritis (AS, RA, juvenile idiopathic arthritis and systemic lupus erythematosus), crystal-induced arthritis, Lyme disease and pigmented villonodular synovitis. Musculoskeletal soft tissue disorders (bursitis, tendinopathies, enthesitis and carpal tunnel syndrome) are a frequent cause of pain and disability in both competitive and recreational athletes, and are related to acute injuries or overuse. However, these disorders may occasionally be a manifestation of RA, spondyloarthritis
Full Text Available Abstract Background Statistics on occupational accidents are based on data from registered employees. With the increasing number of immigrants employed illegally and/or without regular working visas in many developed countries, it is of interest to estimate the injury rate among such unregistered workers. Findings The current study was conducted in an area of North-Eastern Italy. The sources of information employed in the present study were the Accidents and Emergencies records of a hospital; the population data on foreign-born residents in the hospital catchment area (Health Care District 4, Primary Care Trust 20, Province of Verona, Veneto Region, North-Eastern Italy; and the estimated proportion of illegally employed workers in representative samples from the Province of Verona and the Veneto Region. Of the 419 A&E records collected between January and December 2004 among non European Union (non-EU immigrants, 146 aroused suspicion by reporting the home, rather than the workplace, as the site of the accident. These cases were the numerator of the rate. The number of illegally employed non-EU workers, denominator of the rate, was estimated according to different assumptions and ranged from between 537 to 1,338 individuals. The corresponding rates varied from 109.1 to 271.8 per 1,000 non-EU illegal employees, against 65 per 1,000 reported in Italy in 2004. Conclusions The results of this study suggest that there is an unrecorded burden of illegally employed immigrants suffering from work related injuries. Additional efforts for prevention of injuries in the workplace are required to decrease this number. It can be concluded that the Italian National Institute for the Insurance of Work Related Injuries (INAIL probably underestimates the incidence of these accidents in Italy.
Pollard, Katherine A; Shields, Brenda J; Smith, Gary A
This study describes the epidemiology of pediatric volleyball-related injuries treated in US hospital emergency departments. Data for children younger than 18 years obtained from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission from 1990 through 2009 were analyzed. An estimated 692 024 volleyball-related injuries to children younger than 18 years occurred during the study period. The annual number of injuries declined significantly by 23% during the study period; however, the annual injury rate remained unchanged, and the number of volleyball-related concussions/closed head injuries increased significantly. Upper (48%) and lower (39%) extremity injuries occurred most frequently, as did strains/sprains (54%). Contact with the net/pole was associated with concussions/closed head injury our findings indicate opportunities for making volleyball an even safer sport for children. Protective padding, complying with US volleyball standards, should cover all volleyball poles and protruding hardware to prevent impact-related injuries.
McInnes, Judith Anne; MacFarlane, Ewan M.; Sim, Malcolm R.; Smith, Peter
It has been reported that weather-related high ambient temperature is associated with an increased risk of work-related injury. Understanding this relationship is important because work-related injuries are a major public health problem, and because projected climate changes will potentially expose workers to hot days, including consecutive hot days, more often. The aim of this study was to quantify the impact of exposure to sustained periods of hot weather on work-related injury risk for workers in Melbourne, Australia. A time-stratified case crossover study design was utilised to examine the association between two and three consecutive days and two and three consecutive nights of hot weather and the risk of work-related injury, using definitions of hot weather ranging from the 60th to the 95th percentile of daily maximum and minimum temperatures for the Melbourne metropolitan area, 2002-2012. Workers' compensation claim data was used to identify cases of acute work-related injury. Overall, two and three consecutive days of hot weather were associated with an increased risk of injury, with this effect becoming apparent at a daily maximum temperature of 27.6 °C (70th percentile). Three consecutive days of high but not extreme temperatures were associated with the strongest effect, with a 15% increased risk of injury (odds ratio 1.15, 95% confidence interval 1.01-1.30) observed when daily maximum temperature was ≥33.3 °C (90th percentile) for three consecutive days, compared to when it was not. At a threshold of 35.5 °C (95th percentile), there was no significant association between temperature and injury for either two or three consecutive days of heat. These findings suggest that warnings to minimise harm to workers from hot weather should be given, and prevention protocol initiated, when consecutive warm days of temperatures lower than extreme heat temperatures are forecast, and well before the upper ranges of ambient daytime temperatures are reached.
Vajani, Madhavi; Annest, Joseph L.; Crosby, Alex E.; Alexander, Janice D.; Millet, Lisa M.
Fatal and nonfatal injuries due to suicidal behavior among younger adolescents are of growing concern for many communities. We examined the incidence and patterns of these injuries among persons aged 10-14 years using three databases, two national and a third from Oregon. Suffocation and firearm gunshot were the leading external causes of suicide;…
Worp, M.P. van der
Running is a popular sport worldwide and has a positive effect on health and well-being. However, the rate of running-related injuries and the associated costs are high. Van der Worp performed a systematic review to examine which factors increase the risk of running injuries, and whether this is the
... OF VETERANS AFFAIRS MEDICAL Research-Related Injuries § 17.85 Treatment of research-related injuries... apply to: (1) Treatment for injuries due to noncompliance by a subject with study procedures, or (2... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Treatment of...
Effat MERGHATI KHOI
Full Text Available Background: Spinal cord injury (SCI imposes a significant burden on the social and marital life. Here, we assessed the divorce rate and changes in marital status among a sample of Iranian individuals with SCI.Methods: Referred patients to Brain and Spinal Cord Injury Research Center were invited to participate in this cross-sectional investigation. The Main exclusion criteria were coincidental brain injury, history of chronic diseases before SCI and substance use. Demographic characteristics (including age, gender, educational level, marital status before and after injury and duration of marriage and Injury characteristics (level of the injury, American spinal injury association (ASIA scale and Spinal cord independence measure III (SCIM were collected.Results: Total of 241 subjects with SCI participated in this investigation (164 (68% male and 77 (32% female. Among men, 16.5% [95% CI: 10.81%-22.18%] and among women 18.2% [95% CI: 9.58%-26.81%] got divorced after injury. Duration of marriage before injury was significantly related to lower divorce rate (P< 0.001 and 0.016 in men and women, respectively. Injury characteristics had no relationship with marital longevity. Age was a protective factor against marital dissolution only in men (P< 0.004.Conclusion: Our study revealed the divorce rate of 17% [95% CI: 13%-20.9%] after SCI in a sample of Iranian population. The protective influence of age in maintenance of marriage was only detected in men, which proposes existence of a sexual polymorphism in the role of age. Divorce rate was similar between two genders and injury characteristics were not related to divorce rate as well. Keywords: Marital status, Spinal cord injury, Divorce, Iran
Full Text Available Problem. Chain saws are a commonly used tool with the potential to inflict severe injuries. Methods. Descriptive epidemiological estimates for emergency department (ED visits for injuries associated with the use of a chain saw were calculated using data from the National Electronic Injury Surveillance System for the years 2009–2013. Results. A total of 115,895 ED visits for injuries related to the use of a chain saw occurred during the study period. Most injury visits occurred among males (95% and persons aged 30–59 years and during the months of September through November. The main body sites injured were the hand/fingers and knee. The majority of injuries were lacerations (80%. Conclusions. Chain saw injuries present with characteristic patterns which can aid in prevention of injuries related to the use of these tools. Examination of the epidemiology of chain saw injuries will help to ascertain targeted needs for prevention and control efforts.
Kabuusu, Richard M; Keku, Emmanuel O; Kiyini, Robert; McCann, Theresa J
To establish the prevalence, patterns and risk factors of animal-related injuries among veterinarians, self-administered questionnaires were given to 60 veterinarians practicing in metropolitan Kampala. The prevalence of animal-related injuries in metropolitan Kampala was 72% (95%CI, 57~84). Some veterinarians (34%) suffered multiple injuries with a mean and median of 2.1 and 2.0 injuries per veterinarian, respectively. Of a total of 70 self-reported animal related injuries, cattle accounted for 72%, cats for 25%, dogs for 23%, self inoculation for 15% and birds for 13%. Injuries associated with poultry did not require hospital treatment. The upper limb was the most the frequently (68%) injured anatomical body part of veterinarians, and vaccination of animals (25%) was the major activity associated with injury. Animal-related injuries are common among practicing veterinarians in metropolitan Kampala; however, they did not differ significantly based on the veterinarian's gender, experience or risk awareness.
Spencer, Sandra P; Shields, Brenda J; Smith, Gary A
This study was conducted to describe the epidemiology of childhood bathtub-related injuries and to recommend methods for prevention of bathtub-related slips and falls. A consecutive series of 204 children, who were treated for bathtub-related injuries in a pediatric emergency department during a 3-year period were included in the study. The age range was 4 months to 16 years (mean 3.1, SD 2.8, median 2.8 years). Slips and falls accounted for 82.3% (168/204) of mechanisms of injuries. Lacerations, the most common injury type, accounted for 66.7% (136/204) of cases. The most frequent anatomic location of injury was the head or face (68.1%, 139/204). Adult supervision was present during 84.8% (67/79) of the injuries among children younger than 5 years. Parents changed the bathing environment after the patients' injury in 82.3% (65/79) of cases. Injuries due to slips and falls are the most common type of childhood bathtub-related injury. Increased supervision alone will not be sufficient to prevent these injuries, given that adult supervision is already present in most cases. These injuries are most effectively prevented by passive methods, such as providing an effective slip-resistant bathtub surface. The large number of bathtub-related injuries associated with slips and falls argues for exploring a higher coefficient of friction standard for bathtubs, which may lead to fewer injuries.
Shoesmith, Wendy Diana; Oo Tha, Naing; Naing, Khin Saw; Abbas, Roslee Bin Haji; Abdullah, Ahmad Faris
To investigate recorded and unrecorded alcohol and the relation to alcohol-related harm in a region with high taxation, economic deprivation and cultural use of alcohol. Two participants per household were systematically sampled from 12 different villages chosen using stratified random sampling in the North of Sabah, Malaysia. Participants were asked about each type and amount of drink consumed; price paid, whether tax was paid, number of days sick in the last year and whether they had experienced various health problems. A brief screen for mental disorders (PHQ) and an alcohol disorder screening test (AUDIT) were completed. Village heads were also interviewed about alcohol-related problems at village level. 470 people were interviewed. The most commonly drunk beverages were beer and Montoku (a local distilled beverage), which had average prices of RM3.85 and RM0.48 per standard drink respectively. Montoku was more likely to be drunk by problem drinkers. Only 3.1% of alcohol drunk was believed by respondents to be taxed. Men with an AUDIT score of more than 15 were more likely to have had a sick day in the last year and have a female household member with symptoms of mental disorder on PHQ. Change in the taxation structure needs to be considered to reduce alcohol-related harm. Most alcohol consumed in rural Sabah is smuggled or informal. The low price of local spirits is likely to be contributing to alcohol-related harm. Differential effects on minority populations need to be considered when designing alcohol policy. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.
Nippert, Angela H; Smith, Aynsley M
Injury rates are high among children and adolescent athletes. Psychosocial stressors, such as personality, history of stressors, and life event stress can influence injury occurrence. After injury, those same factors plus athletic identity, self-esteem, and significant others-such as parents, coaches, and teammates-can affect injury response, recovery and subsequent sport performance. Goal setting, positive self-talk, attribution theory, and relaxation or mental imagery are psychologic interventions that can help injured athletes cope with psychosocial stressors. Medical professionals should be aware of the potential influence that psychosocial stressors and psychologic interventions can have on injury occurrence, injury recovery, and sport performance.
Gaw, Christopher E; Chounthirath, Thiphalak; Smith, Gary A
The goal of this study was to determine the epidemiology of injuries associated with nursery products among young children treated in US emergency departments. Data from the National Electronic Injury Surveillance System were retrospectively analyzed for patients aged injuries among children aged injuries per 10 000 children. The annual injury rate decreased significantly by 33.9% from 1991 to 2003, followed by a significant increase of 23.7% from 2003 to 2011. The decrease was driven by a significant decline in baby walker/jumper/exerciser-related injuries; the increase was driven by a significant increase in concussions and closed head injuries. Nursery product-related injuries were most commonly associated with baby carriers (19.5%), cribs/mattresses (18.6%), strollers/carriages (16.5%), or baby walkers/jumpers/exercisers (16.2%). The most common mechanism of injury was a self-precipitated fall (80.0%), and the most frequently injured body region was the head or neck (47.1%). Although successful injury prevention efforts with baby walkers led to a decline in nursery product-related injuries from 1991 to 2003, the number and rate of these injuries have been increasing since 2003. Greater efforts are warranted to prevent injuries associated with other nursery products, especially baby carriers, cribs, and strollers. Prevention of falls and concussions/closed head injuries associated with nursery products also deserves special attention. Copyright © 2017 by the American Academy of Pediatrics.
Kluitenberg, Bas; van der Worp, Henk; Huisstede, Bionka M A; Hartgens, Fred; Diercks, Ron; Verhagen, Evert; van Middelkoop, Marienke
Objectives: The incidence of running-related injuries is high. Some risk factors for injury were identified in novice runners, however, not much is known about the effect of training factors on injury risk. Therefore, the purpose of this study was to examine the associations between training factors
Full Text Available Hospitalisation for adversity-related injury (violent, drug/alcohol-related, or self-inflicted injury has been described as a "teachable moment", when intervention may reduce risks of further harm. Which adolescents are likely to benefit most from intervention strongly depends on their long-term risks of harm. We compared 10-y risks of mortality and re-admission after adversity-related injury with risks after accident-related injury.We analysed National Health Service admissions data for England (1 April 1997-31 March 2012 for 10-19 y olds with emergency admissions for adversity-related injury (violent, drug/alcohol-related, or self-inflicted injury; n = 333,009 or for accident-related injury (n = 649,818. We used Kaplan-Meier estimates and Cox regression to estimate and compare 10-y post-discharge risks of death and emergency re-admission. Among adolescents discharged after adversity-related injury, one in 137 girls and one in 64 boys died within 10 y, and 54.2% of girls and 40.5% of boys had an emergency re-admission, with rates being highest for 18-19 y olds. Risks of death were higher than in adolescents discharged after accident-related injury (girls: age-adjusted hazard ratio 1.61, 95% CI 1.43-1.82; boys: 2.13, 95% CI 1.98-2.29, as were risks of re-admission (girls: 1.76, 95% CI 1.74-1.79; boys: 1.41, 95% CI 1.39-1.43. Risks of death and re-admission were increased after all combinations of violent, drug/alcohol-related, and self-inflicted injury, but particularly after any drug/alcohol-related or self-inflicted injury (i.e., with/without violent injury, for which age-adjusted hazard ratios for death in boys ranged from 1.67 to 5.35, compared with 1.25 following violent injury alone (girls: 1.09 to 3.25, compared with 1.27. The main limitation of the study was under-recording of adversity-related injuries and misclassification of these cases as accident-related injuries. This misclassification would attenuate the relative risks of death
Jambon, Marc; Smetana, Judith G.
We assessed 5-to 11-year-olds' (N = 76) judgments of straightforward moral transgressions (prototypical harm) as well as their evaluations of complex, hypothetical scenarios in which an actor transgresses in order to prevent injury (necessary harm). The nature of the actor's transgression (psychological or physical harm) varied across…
Cushman, R; Down, J; MacMillan, N; Waclawik, H
The number of bicycle-related injuries has risen significantly with the increased popularity of bicycle riding in Canada. The risk of injury is highest among children. To assess the magnitude of the problem and to identify the contributing factors we used a questionnaire, injury reports and patient charts to survey bicycle-related injuries among children brought to the emergency department of the Children's Hospital of Eastern Ontario, Ottawa, between May 1 and Sept. 30, 1988. The questionnai...
Sawyer, Jeffrey R; Beebe, Michael; Creek, Aaron T; Yantis, Matthew; Kelly, Derek M; Warner, William C
With increases in use and power of all-terrain vehicles (ATVs), there have been dramatic increases in both the number and severity of ATV-related injuries. The KIDS database showed a 240% increase in the number of children admitted to a hospital for an ATV-related injury between 1997 and 2006. Over the same time period, there was a 476% increase in the number of children with ATV-related spine injuries. To better understand the nature of these injuries, a series of pediatric ATV-related spine fractures at a regional pediatric trauma center were analyzed. Records and radiographs of children and adolescents who presented to a regional pediatric trauma center with a spine injury as a result of an ATV accident were reviewed. In addition to demographic data, information was collected regarding length of stay, Glasgow Coma Score, Pediatric Trauma Score, treatment type, associated injuries, and hospital charges. Patients were divided into 2 groups based on age and American Academy of Orthopaedic Surgeons guidelines for ATV use: younger children (age, 0 to 15 y) and older children (age, 16 to 18 y). Fifty-three spine injuries were identified in 29 children (mean, 1.8 injuries/child) with an average age of 15.7 years; 16 (55%) had associated nonspine injuries and 13 had multiple spine injuries, contiguous in 9 and noncontiguous in 4. Four patients, all in the younger age group, had neurological injuries. Children older than 16 years had significantly lower Pediatric Trauma Scores and were more likely to have a thoracic spine fracture than younger children, who were more likely to have a lumbar fracture. Fourteen patients required surgery for their injuries, 7 for spine injuries and 7 for nonspine injuries; the mean hospital charge was almost $75,000 per patient. ATV-related spine injuries in children and adolescents are high-energy injuries with a high rate of associated spine and nonspine injuries. ATV-related spine injuries are different from other ATV-related injuries in
McKee, Ann C; Robinson, Meghan E
Mild traumatic brain injury (mTBI) includes concussion, subconcussion, and most exposures to explosive blast from improvised explosive devices. mTBI is the most common traumatic brain injury affecting military personnel; however, it is the most difficult to diagnose and the least well understood. It is also recognized that some mTBIs have persistent, and sometimes progressive, long-term debilitating effects. Increasing evidence suggests that a single traumatic brain injury can produce long-term gray and white matter atrophy, precipitate or accelerate age-related neurodegeneration, and increase the risk of developing Alzheimer's disease, Parkinson's disease, and motor neuron disease. In addition, repetitive mTBIs can provoke the development of a tauopathy, chronic traumatic encephalopathy. We found early changes of chronic traumatic encephalopathy in four young veterans of the Iraq and Afghanistan conflict who were exposed to explosive blast and in another young veteran who was repetitively concussed. Four of the five veterans with early-stage chronic traumatic encephalopathy were also diagnosed with posttraumatic stress disorder. Advanced chronic traumatic encephalopathy has been found in veterans who experienced repetitive neurotrauma while in service and in others who were accomplished athletes. Clinically, chronic traumatic encephalopathy is associated with behavioral changes, executive dysfunction, memory loss, and cognitive impairments that begin insidiously and progress slowly over decades. Pathologically, chronic traumatic encephalopathy produces atrophy of the frontal and temporal lobes, thalamus, and hypothalamus; septal abnormalities; and abnormal deposits of hyperphosphorylated tau as neurofibrillary tangles and disordered neurites throughout the brain. The incidence and prevalence of chronic traumatic encephalopathy and the genetic risk factors critical to its development are currently unknown. Chronic traumatic encephalopathy has clinical and
Airbags are designed to protect occupants of motor vehicles from injuries in the event of a crash but have been implicated in some serious .... risk of severe ocular injury, and posterior segment trauma. ... safety devices installed in vehicles.
Damashek, Amy; Williams, Natalie A.; Sher, Kenneth; Peterson, Lizette
Objective The present study used a case-crossover design to investigate the association of caregiver alcohol consumption and supervision to children's injury occurrence and severity. Method A community sample of 170 mothers of toddlers was interviewed biweekly about their children's daily injuries for a period of 6 months. Results Proximal caregiver-reported alcohol use predicted higher likelihood of injury occurrence and higher injury severity, whereas caregiver-reported supervision predicte...
Jacquet, Gabrielle A; Hansoti, Bhakti; Vu, Alexander; Bayram, Jamil D
Children are a special population, particularly susceptible to injury. Registries for various injury types in the pediatric population are important, not only for epidemiological purposes but also for their implications on intervention programs. Although injury registries already exist, there is no uniform injury classification system for traumatic mass casualty events such as earthquakes. To systematically review peer-reviewed literature on the patterns of earthquake-related injuries in the pediatric population. On May 14, 2012, the authors performed a systematic review of literature from 1950 to 2012 indexed in Pubmed, EMBASE, Scopus, Web of Science, and Cochrane Library. Articles written in English, providing a quantitative description of pediatric injuries were included. Articles focusing on other types of disasters, geological, surgical, conceptual, psychological, indirect injuries, injury complications such as wound infections and acute kidney injury, case reports, reviews, and non-English articles were excluded. A total of 2037 articles were retrieved, of which only 10 contained quantitative earthquake-related pediatric injury data. All studies were retrospective, had different age categorization, and reported injuries heterogeneously. Only 2 studies reported patterns of injury for all pediatric patients, including patients admitted and discharged. Seven articles described injuries by anatomic location, 5 articles described injuries by type, and 2 articles described injuries using both systems. Differences in age categorization of pediatric patients, and in the injury classification system make quantifying the burden of earthquake-related injuries in the pediatric population difficult. A uniform age categorization and injury classification system are paramount for drawing broader conclusions, enhancing disaster preparation for future disasters, and decreasing morbidity and mortality.
Grauwmeijer, Erik; van der Naalt, Joukje; ribbers, gerard
Despite an increased awareness of the long-term consequences of traumatic brain injury, health care professionals often consider traumatic brain injury as an incident. However, patients with traumatic brain injury may experience long-term neurological, cognitive and behavioural problems. Due to the
Dons, R. F.; Fohlmeister, U.
The risk of combined injury (CI) to space travelers is a function of exposure to anomalously large surges of a broad spectrum of particulate and photon radiations, conventional trauma (T), and effects of weightlessness including decreased intravascular fluid volume, and myocardial deconditioning. CI may occur even at relatively low doses of radiation which can synergistically enhance morbidity and mortality from T. Without effective countermeasures, prolonged residence in space is expected to predispose most individuals to bone fractures as a result of calcium loss in the microgravity environment. Immune dysfunction may occur from residence in space independent of radiation exposure. Thus, wound healing would be compromised if infection were to occur. Survival of the space traveler with CI would be significantly compromised if there were delays in wound closure or in the application of simple supportive medical or surgical therapies. Particulate radiation has the potential for causing greater gastrointestinal injury than photon radiation, but bone healing should not be compromised at the expected doses of either type of radiation in space.
Johansson, Mats Peter; Baann Liane, Martin Skogheim; Bendix, Tom; Kasch, Helge; Kongsted, Alice
The mechanisms for developing long-lasting neck pain after whiplash injuries are still largely unrevealed. In the present study it was investigated whether a kyphotic deformity of the cervical spine, as opposed to a straight or a lordotic spine, was associated with the symptoms at baseline, and with the prognosis one year following a whiplash injury. MRI was performed in 171 subjects about 10 d after the accident, and 104 participated in the pain recording at 1-year follow-up. It was demonstrated that postures as seen on MRI can be reliably categorized and that a straight spine is the most frequent appearance of the cervical spine in supine MRI. In relation to symptoms it was seen that a kyphotic deformity was associated with reporting the highest intensities of headache at baseline, but not with an increased risk of long-lasting neck pain or headache. In conclusion, a kyphotic deformity is not significantly associated with chronic whiplash associated pain. Moreover, it is a clear clinical implication that pain should not be ascribed to a straight spine on MRI. We suggest that future trials on cervical posture focus upon the presence of kyphotic deformity rather than just on the absence of lordosis.
Patel, Darshan P; Redshaw, Jeffrey D; Breyer, Benjamin N; Smith, Thomas G; Erickson, Bradley A; Majercik, Sarah D; Gaither, Thomas W; Craig, James R; Gardner, Scott; Presson, Angela P; Zhang, Chong; Hotaling, James M; Brant, William O; Myers, Jeremy B
Most high-grade renal injuries (American Association for Surgery of Trauma (AAST) grades III-V) result from motor vehicle collisions associated with numerous concomitant injuries. Sports-related blunt renal injury tends to have a different mechanism, a solitary blow to the flank. We hypothesized that high-grade renal injury is often isolated in sports-related renal trauma. We identified patients with AAST grades III-V blunt renal injuries from four level 1 trauma centres across the United States between 1/2005 and 1/2014. Patients were divided into "Sport" or "Non-sport" related groups. Outcomes included rates of hypotension (systolic blood pressure 110bpm), concomitant abdominal injury, and procedural/surgical intervention between sports and non-sports related injury. 320 patients met study criteria. 18% (59) were sports-related injuries with the most common mechanisms being skiing, snowboarding and contact sports (25%, 25%, and 24%, respectively). Median age was 24 years for sports and 30 years for non-sports related renal injuries (p=0.049). Males were more commonly involved in sports related injuries (85% vs. 72%, p=0.011). Median injury severity score was lower for sports related injuries (10 vs. 27, ptrauma was more likely to be isolated without other significant injury (69% vs. 39% (ptrauma is more likely to occur in isolation without other abdominal or thoracic injuries and clinicians must have a high suspicion of renal injury with significant blows to the flank during sports activities. Copyright © 2015 Elsevier Ltd. All rights reserved.
Bastos, Francisco I
Brazil, the 6th largest world economy, has experienced rapid economic, demographic, and social structural changes during the last decade. Notwithstanding, Brazil being one of the most unequal societies worldwide, 40 million of 200 million Brazilians have moved from poverty to middle-class standards during this period. This review analyzes the success of different Brazilian initiatives aiming to reduce drug consumption-related harms, as well as the failed attempts to curb structural violence, despite some very recent initiatives have yet to be fully implemented and evaluated.
An injury is damage to your body. It is a general term that refers to harm caused by accidents, ... millions of people injure themselves every year. These injuries range from minor to life-threatening. Injuries can ...
Nam, Dong-Ha; Adams, Douglas H; Reyier, Eric A; Basu, Niladri
Tissue levels of mercury (Hg; total, organic) and selenium (Se) were assessed in juvenile lemon sharks (Negaprion brevirostris) from Florida nearshore waters collected during a harmful algal bloom (HAB, brevetoxin) event and compared with sharks not exposed to HABs. In all sharks studied, total Hg levels in the muscle were generally present in a molar excess over Se (which may protect against Hg toxicity) and mean muscle Hg levels (0.34 microg/g) exceed safe human consumption guidelines. While there was generally no difference in tissue Hg and Se levels following exposure of sharks to HABs, hepatic Hg levels were significantly lower (56% reduction) in the HAB-exposed sharks compared to controls. As Hg and HABs are globally increasing in scope and magnitude, further work is warranted to assess their interactions and biotic impacts within aquatic ecosystems, especially for a species such as the lemon shark that is classified as a near-threatened species by the International Union for the Conservation of Nature.
Itodo C Elachi
Full Text Available Background: Motorcycle-related injuries lead to considerable morbidity and mortality. The aim of this study is to determine the pattern and outcome of motorcycle-related injuries at Benue State University Teaching Hospital, Makurdi, Nigeria. Patients and Methods: Case records of all patients who presented to the accident and emergency department with motorcycle-related injuries between July 2012 and June 2013 were analysed for age, gender, injury host status (i.e. rider, pillion or pedestrian, nature of collision (motorcycle versus other vehicles, motorcycle versus motorcycle, motorcycle versus pedestrian or lone riders, body region injured, injury severity score (ISS at arrival, length of hospital stay (LOS and mortality. Results: Seventy - nine patients with motorcycle-related injuries were included in the study. They consisted of 63 males (61.8% and 16 females (15.7%. The age range was 5-65 years with a mean of 32.4 ± 14.0. Motorcycle versus vehicle collisions were the most common mechanism of injury (n = 46, 58.2%. Musculoskeletal injuries constituted the most common injuries sustained (n = 50, 47.6% and the tibia was the most frequently fractured bone (n = 14, 35.9%. The majority of patients (57.0% sustained mild/moderate injuries ( ISS ≤ 15. There was no statistically significant difference between the sexes for sustaining mild/moderate injuries or severe/profound injuries (P > 0.05. Mortality rate was 6.3% with head injuries being involved in all cases. Conclusion: Young males were mostly injured in motorcycle-related trauma. Musculoskeletal injuries were the most common injuries sustained and head injuries were involved in all the deaths. Enforcement of motorcycle crash bars and helmet usage is recommended.
Full Text Available Aim: This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. Materials and Methods: A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referred to us by the physician team. The type of injury (facial laceration, facial fractures, jaw dislocation, etc., site of facial injury (jaw, nose, malar bone, teeth, etc., dental injuries (tooth fracture, displacement, luxation, and avulsion, causative sport (boxing, taekwondo, kickboxing, and Muay Thai as well as demographic data were recorded. Injuries were examined clinically and radiographically, and treated accordingly by a specialist. Treatment data and demographics were recorded for each subject. Recorded data were assessed, and c2 , ANOVA, and Kruskal-Wallis tests were used to statistically analyze and compare the data. Results: Of 120 subjects, 95 male subjects (79.2%, aged 18-25 years (avg. 20 years, had at least one traumatic injury to the face requiring medical treatment. These injuries included facial laceration, bone fractures (nose, mandible, and zygoma, dental injuries (displacement, luxation, fracture, and avulsion, and mandibular dislocation which were recorded in 83 (69.2%, 55 (45.1%, 53 (44.2%, and 8 (6.7% cases respectively. Statistically significant differences were encountered among various injuries and the sports; kickboxing caused the most maxillofacial injuries and was identified as more injurious. Tooth fractures (59.7% were the most common dental injuries, and the nose (84.7% was the most frequently fractured facial bone. Lacerations were more common in Thai-boxers (93.3%. Injuries were significantly greater in professional rather
Shirani, Gholamreza; Kalantar Motamedi, Mohammad Hosein; Ashuri, Alireza; Eshkevari, Pooyan Sadr
This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai) who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referred to us by the physician team. The type of injury (facial laceration, facial fractures, jaw dislocation, etc.), site of facial injury (jaw, nose, malar bone, teeth, etc.), dental injuries (tooth fracture, displacement, luxation, and avulsion), causative sport (boxing, taekwondo, kickboxing, and Muay Thai) as well as demographic data were recorded. Injuries were examined clinically and radiographically, and treated accordingly by a specialist. Treatment data and demographics were recorded for each subject. Recorded data were assessed, and χ(2), ANOVA, and Kruskal-Wallis tests were used to statistically analyze and compare the data. Of 120 subjects, 95 male subjects (79.2%), aged 18-25 years (avg. 20 years), had at least one traumatic injury to the face requiring medical treatment. These injuries included facial laceration, bone fractures (nose, mandible, and zygoma), dental injuries (displacement, luxation, fracture, and avulsion), and mandibular dislocation which were recorded in 83 (69.2%), 55 (45.1%), 53 (44.2%), and 8 (6.7%) cases respectively. Statistically significant differences were encountered among various injuries and the sports; kickboxing caused the most maxillofacial injuries and was identified as more injurious. Tooth fractures (59.7%) were the most common dental injuries, and the nose (84.7%) was the most frequently fractured facial bone. Lacerations were more common in Thai-boxers (93.3%). Injuries were significantly greater in professional rather than amateur athletes. In this study
Loisel, F; Bonin, S; Jeunet, L; Pauchot, J; Tropet, Y; Obert, L
The primary objective of this study was to describe the injury characteristics and demographics of patients injured during woodworking activities, upon their arrival to the emergency department in a regional of France where this industry is prevalent. The secondary objective was to compare patient and injury characteristics for work-related and hobby-related accidents. A cohort of 87 patients who had suffered a woodworking accident over a two-year period was evaluated; 79 were available for follow-up. The context and circumstances of the accident, nature and location of the injuries and patient demographics were recorded. Hobby-related accidents accounted for two-thirds of the accidents (51/79). Most of the injured workers were either loggers (35%) or carpenters (46%). The hand was injured in 53 cases (67%). Work-related accidents resulted in significantly more serious consequences in terms of hospital stay, work stoppage, resumption of work or retraining than hobby-related accidents. For the workplace accidents, 86% occurred on new machines; more than 25% of the machines involved in accidents at home were over 15 years. Sixty-eight per cent of workers were wearing their safety gear, while only 31% of those injured during recreational woodworking wore the appropriate gear. Several elements of prevention should be improved: information about the need to maintain the equipment, protect the worker with suitable clothing, and learn which maneuvers are considered hazardous. Safety gear should be regularly inspected in the workplace.
Murphy, Colin G; McGuire, Ciara M; O'Malley, Natasha; Harrington, Paul
Bovine-related injuries to farmers are common in rural communities. Many injuries are significant requiring hospital admission and surgery. We reviewed all cattle-related injuries admitted to a regional trauma centre over 10 years and detail the nature of the injuries. A retrospective review was undertaken, using hospital inpatient coding system (HIPE) to identify patients admitted following cow-related trauma for the last 10 years. From retrieved charts mechanism of injury was identified, demographics recorded and Injury Severity Score (ISS) and Trauma Injury Severity Score (TRISS) calculated based on the injuries sustained. 47 patients were identified, with a median age of 53 years. 4 injuries occurred in children, and 12 in patients over 65 years old. Three-quarters of those injured were male. Kicking was the most common mechanism of injury (n=21), but charge/head-butt injuries and trampling injuries were associated with more serious injury scores. 72% of patients were admitted under Orthopaedics as their primary care team, 25% under General Surgeons, with one patient admitted medically. Mean ISS score was 6.9 (range 1-50). 41 operative interventions were performed on 30 patients during their admission. 6.3% of patients required admission to Intensive Care with a mean length of stay of 12.3 days (range 2-21 days). There was no mortality. Cow-related trauma is a common among farming communities and is a potentially serious mechanism of injury that appears to be under-reported in a hospital context. Bovine-related head-butt and trampling injuries should be considered akin to high-velocity trauma. (c) 2009 Elsevier Ltd. All rights reserved.
Murphy, Colin G
INTRODUCTION: Bovine-related injuries to farmers are common in rural communities. Many injuries are significant requiring hospital admission and surgery. We reviewed all cattle-related injuries admitted to a regional trauma centre over 10 years and detail the nature of the injuries. METHOD: A retrospective review was undertaken, using hospital inpatient coding system (HIPE) to identify patients admitted following cow-related trauma for the last 10 years. From retrieved charts mechanism of injury was identified, demographics recorded and Injury Severity Score (ISS) and Trauma Injury Severity Score (TRISS) calculated based on the injuries sustained. RESULTS: 47 patients were identified, with a median age of 53 years. 4 injuries occurred in children, and 12 in patients over 65 years old. Three-quarters of those injured were male. Kicking was the most common mechanism of injury (n=21), but charge\\/head-butt injuries and trampling injuries were associated with more serious injury scores. 72% of patients were admitted under Orthopaedics as their primary care team, 25% under General Surgeons, with one patient admitted medically. Mean ISS score was 6.9 (range 1-50). 41 operative interventions were performed on 30 patients during their admission. 6.3% of patients required admission to Intensive Care with a mean length of stay of 12.3 days (range 2-21 days). There was no mortality. CONCLUSION: Cow-related trauma is a common among farming communities and is a potentially serious mechanism of injury that appears to be under-reported in a hospital context. Bovine-related head-butt and trampling injuries should be considered akin to high-velocity trauma.
Full Text Available Srihari Gopal1, Joris Berwaerts1, Isaac Nuamah1, Kasem Akhras2, Danielle Coppola1, Ella Daly1, David Hough1, Joseph Palumbo11Johnson & Johnson Pharmaceutical Research & Development, LLC, Raritan, NJ, USA; 2Johnson & Johnson Pharmaceutical Services, LLC, Raritan, NJ, USABackground: We analyzed data retrieved through a PubMed search of randomized, placebo-controlled trials of first-generation antipsychotic long-acting injectables (haloperidol decanoate, bromperidol decanoate, and fluphenazine decanoate, and a company database of paliperidone palmitate, to compare the benefit-risk ratio in patients with schizophrenia.Methods: From the eight studies that met our selection criteria, two efficacy and six safety parameters were selected for calculation of number needed to treat (NNT, number needed to harm (NNH, and the likelihood of being helped or harmed (LHH using comparisons of active drug relative to placebo. NNTs for prevention of relapse ranged from 2 to 5 for paliperidone palmitate, haloperidol decanoate, and fluphenazine decanoate, indicating a moderate to large effect size.Results: Among the selected maintenance studies, NNH varied considerably, but indicated a lower likelihood of encountering extrapyramidal side effects, such as akathisia, tremor, and tardive dyskinesia, with paliperidone palmitate versus placebo than with first-generation antipsychotic depot agents versus placebo. This was further supported by an overall higher NNH for paliperidone palmitate versus placebo with respect to anticholinergic use and Abnormal Involuntary Movement Scale positive score. LHH for preventing relapse versus use of anticholinergics was 15 for paliperidone palmitate and 3 for fluphenazine decanoate, favoring paliperidone palmitate.Conclusion: Overall, paliperidone palmitate had a similar NNT and a more favorable NNH compared with the first-generation long-acting injectables assessed.Keywords: long-acting injectables, first-generation antipsychotics
Cockenpot, Eric; Lefebvre, Guillaume; Demondion, Xavier; Chantelot, Christophe; Cotten, Anne
Hand and wrist injuries are common occurrences in amateur and professional sports and many of them are sport-specific. These can be divided into two categories: traumatic injuries and overuse injuries. The aim of this article is to review the most common hand and wrist sports-related lesions. Acute wrist injuries are predominantly bone fractures, such as those of the scaphoid, hamate hook, and ulnar styloid. Ligament lesions are more challenging for radiologists and may lead to carpal instability if undiagnosed. Overuse wrist injuries are mainly represented by tendinous disorders, with De Quervain syndrome and extensor carpi ulnaris tendon disorders being the most common among them; however, there are other possible disorders such as impaction syndromes, stress fractures, and neurovascular lesions. Finally, finger lesions, including closed-tendon injuries (mallet and boutonniere injuries, jersey finger, and boxer's knuckle), flexor pulley injuries, and skier's thumb, should also be detected. (©) RSNA, 2016 Online supplemental material is available for this article.
Monkhouse Simon J
Full Text Available Abstract Introduction This case of a man who sustained an airbag-induced thoracic injury and burn, highlights the potential harm that can be caused by airbags. It also serves to illustrate that a surface burn which looks small and benign can actually be a surface marker of a more serious injury. Staff working in emergency departments need to be aware of the risk of possible airbag-associated injuries. Case presentation A 65-year-old man was the driver in a frontal collision. He was wearing a seatbelt. The airbag was activated and caused a superficial chest wall burn. Initial chest x-rays were unremarkable but following deterioration in his condition, a computed tomography scan revealed a serious sternal fracture. The location of the fracture was marked on the surface by the burn. Conclusion Airbags can cause significant chest wall injuries and burns. Surface burns at the point of impact should not be dismissed as trivial as the forces involved can cause significant injury. We recommend that all people with chest wall injuries and/or burns due to airbags should have more detailed chest imaging as initial emergency radiographs can be falsely reassuring.
Davies, Kimberly L
In the United States motor vehicle crashes are the leading cause of death in children. Although laws and public awareness campaigns have increased the use of passive restraints, many children continue to be unrestrained or improperly restrained. Age-appropriate child restraint systems are a vital means to prevent injury and death. The young school-aged child presents unique challenges to standardized vehicle restraint systems. As these children outgrow child safety seats, they frequently are placed in lap/shoulder belt systems designed for the adult. When prematurely graduated to the vehicle's restraint systems they are predisposed to injuries to the abdomen and lumbar spine known as the "seat belt syndrome" or "lap belt complex." These injuries often present subtly, and are not as obvious as the often life-threatening injuries found in the unrestrained pediatric trauma patient. However if undetected or missed these injuries can significantly impact the child's recovery and functional outcome. This article will provide a comprehensive overview of pediatric seat belt injuries. Content will explore the mechanisms responsible for producing the typical patterns of injury, recognition of these potential injuries during the trauma assessment, diagnostic evaluation and management of children with suspected or actual seat belt injuries. Prevention strategies will be discussed that will enable trauma nurses to effectively advocate the use of booster seats for the young school-aged child.
Bigler, Erin D; Zielinski, Brandon A; Goodrich-Hunsaker, Naomi; Black, Garrett M; Huff, B S Trevor; Christiansen, Zachary; Wood, Dawn-Marie; Abildskov, Tracy J; Dennis, Maureen; Taylor, H Gerry; Rubin, Kenneth; Vannatta, Kathryn; Gerhardt, Cynthia A; Stancin, Terry; Yeates, Keith Owen
In a sample of children with traumatic brain injury, this magnetic resonance imaging (MRI)-based investigation examined whether presence of a focal lesion uniquely influenced cortical thickness in any brain region. Specifically, the study explored the relation of cortical thickness to injury severity as measured by Glasgow Coma Scale score and length of stay, along with presence of encephalomalacia, focal white matter lesions or presence of hemosiderin deposition as a marker of shear injury. For comparison, a group of children without head injury but with orthopedic injury of similar age and sex were also examined. Both traumatic brain injury and orthopedic injury children had normally reduced cortical thickness with age, assumed to reflect neuronal pruning. However, the reductions observed within the traumatic brain injury sample were similar to those in the orthopedic injury group, suggesting that in this sample traumatic brain injury, per se, did not uniquely alter cortical thickness in any brain region at the group level. Injury severity in terms of Glasgow Coma Scale or longer length of stay was associated with greater reductions in frontal and occipitoparietal cortical thickness. However, presence of focal lesions were not related to unique changes in cortical thickness despite having a prominent distribution of lesions within frontotemporal regions among children with traumatic brain injury. Because focal lesions were highly heterogeneous, their association with cortical thickness and development appeared to be idiosyncratic, and not associated with group level effects.
O'Neil, Joseph; Steele, Gregory K; Huisingh, Carrie; Smith, Gary A
This study describes the epidemiology of elevator-related injuries among children in the United States from 1990 to 2004. A retrospective cohort analysis was performed using data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission. Reported cases were used to project national estimates. An estimated 29 030 elevator-related injuries occurred among children in the United States during 1990 to 2004. The mean age was 8.1 years (SD, 6.1 years), with 53.3% of injuries among boys. The overall injury rate was 2.5 injuries per 100,000 population. The injury rate for children aged 0-4 years was 4.2 per 100,000 population, and for children aged 5-19 years the injury rate was 1.9 per 100,000 population. The most frequent cause of injury was the elevator door closing on a body part, the most frequently injured body region was the upper extremity, and soft-tissue injuries were the most frequent type of injury. Children should be closely supervised on or near elevators to reduce the risk of injury.
Sousa, Paulo; Holbrook, Colin; Piazza, Jared
In this article, we discuss the range of concerns people weigh when evaluating the acceptability of harmful actions and propose a new perspective on the relationship between harm and morality. With this aim, we examine Kelly, Stich, Haley, Eng and Fessler's [Kelly, D., Stich, S., Haley, K., Eng, S., & Fessler, D. (2007). Harm, affect, and the…
A notable feature of Australian drug policy is the limited public and professional attention given to the financial costs of drug abuse and to the levels and patterns of government expenditures incurred in preventing and responding to this. Since 1991, Collins and Lapsley have published scholarly reports documenting the social costs of drug abuse in Australia and their reports also contain estimates of governments' drug budgets: revenue and expenditures. They show that, in 2004-2005, Australian governments expended at least $5288 million on drug abuse, with 50% of the expenditure directed to preventing and dealing with alcohol-related problems, 45% to illicit drugs and just 5% to tobacco. Some 60% of the expenditure was directed at drug crime and 37% at health interventions. This pattern of resource allocation does not adequately reflect an evidence-informed policy orientation in that it largely fails to focus on the drug types that are the sources of the most harm (tobacco and alcohol rather than illicit drugs), and the sectors for which we have the strongest evidence of the cost-effectiveness of the available interventions (treatment and harm reduction rather than legislation and law enforcement). The 2010-2014 phase of Australia's National Drug Strategy should include incremental changes to the resource allocation mix, and not simply maintain the historical resource allocation formulae.
Weddle, Gina; Gandy, Kimberly; Bratcher, Denise; Pahud, Barbara; Jackson, Mary Anne
This report defines the role of Apophysomyces as an aggressive fungal pathogen seen after a tornado injury. Clinical and laboratory manifestations of infections after environmentally contaminated wounds incurred during a tornado are outlined, emphasizing mechanism of injury, comorbidities, and diagnostic and treatment challenges. Therapy with systemic antifungal therapy and aggressive serial tissue debridement was successful in achieving cure.
Tarim, Mehmet Akin
Liquefied petroleum gas (LPG) is a fuel that is widely used for domestic, agricultural, and industrial purposes. LPG is also commonly used in restaurants, industries, and cars; however, the home continues to be the main site for accidents. In Turkey, the increased usage of LPG as a cooking or heating fuel has resulted in many burn injuries from LPG mishaps. Between January 2000 and June 2011, 56 LPG-burned patients were compared with 112 flame-burned patients. There were no significant differences with respect to the mean age, sex, hospitalization time, and mortality in both groups. In the LPG-caused burn cases, 41 burns (73.2%) occurred at home, seven (12.5) were work-related mishaps, and eight (14.3) were associated with car accidents. The majority of the LPG burns (82%, 46 patients) resulted from a gas leak, and 18% of them were related to the failure to close LPG tubes in the patients' kitchens (10 patients). Burns to the face and neck (82 vs 67%, P = .039) and upper (62 vs 23%, P = .000) and lower (70 vs 45%, P = .002) extremities were significantly higher in LPG-caused burn cases than flame-burned cases. General awareness regarding the risk of LPG and first aid for burns appears to be lacking. The LPG delivery system should be standardized throughout countries that widely use LPG.
Martin, Keith J; Chounthirath, Thiphalak; Xiang, Huiyun; Smith, Gary A
This study investigates the effect of the 2004 US shopping cart safety standard on shopping-cart-related injuries among children younger than 15 years of age by retrospectively analyzing data from the National Electronic Injury Surveillance System. An estimated 530 494 children younger than 15 years were treated in US emergency departments for shopping-cart-related injuries from 1990 to 2011, averaging 24 113 children annually. The most commonly injured body region was the head (78.1%). The annual concussion/closed head injury rate per 10 000 children increased significantly (P shopping cart safety standard was implemented in the United States in 2004, the overall number and rate of injuries associated with shopping carts have not decreased. In fact, the number and rate of concussions/closed head injuries have continued to climb. Increased prevention efforts are needed to address these injuries among children.
Joseph Jonathan Lee
Full Text Available OBJECTIVES: To determine the predictive value and sensitivity of demographic features and injuries (indicators for maltreatment-related codes in hospital discharge records of children admitted with a head or neck injury or fracture. METHODS: STUDY DESIGN: Population-based, cross sectional study. SETTING: NHS hospitals in England. SUBJECTS: Children under five years old admitted acutely to hospital with head or neck injury or fracture. DATA SOURCE: Hospital Episodes Statistics, 1997 to 2009. MAIN OUTCOME MEASURE: Maltreatment-related injury admissions, defined by ICD10 codes, were used to calculate for each indicator (demographic feature and/or type of injury: i the predictive value (proportion of injury admissions that were maltreatment-related; ii sensitivity (proportion of all maltreatment-related injury admissions with the indicator. RESULTS: Of 260,294 childhood admissions for fracture or head or neck injury, 3.2% (8,337 were maltreatment-related. With increasing age of the child, the predictive value for maltreatment-related injury declined but sensitivity increased. Half of the maltreatment-related admissions occurred in children older than one year, and 63% occurred in children with head injuries without fractures or intracranial injury. CONCLUSIONS: Highly predictive injuries accounted for very few maltreatment-related admissions. Protocols that focus on high-risk injuries may miss the majority of maltreated children.
Pan, James; Connolly, Ian D; Dangelmajer, Sean; Kintzing, James; Ho, Allen L; Grant, Gerald
Brain injuries are becoming increasingly common in athletes and represent an important diagnostic challenge. Early detection and management of brain injuries in sports are of utmost importance in preventing chronic neurological and psychiatric decline. These types of injuries incurred during sports are referred to as mild traumatic brain injuries, which represent a heterogeneous spectrum of disease. The most dramatic manifestation of chronic mild traumatic brain injuries is termed chronic traumatic encephalopathy, which is associated with profound neuropsychiatric deficits. Because chronic traumatic encephalopathy can only be diagnosed by postmortem examination, new diagnostic methodologies are needed for early detection and amelioration of disease burden. This review examines the pathology driving changes in athletes participating in high-impact sports and how this understanding can lead to innovations in neuroimaging and biomarker discovery.
JOSÉ TEOTONIO DE OLIVEIRA
Full Text Available O conceito de que movimentos repetitivos ou posturas prolongadas causam lesões não tem suporte científico. Os sintomas dolorosos e sensitivos apresentados pelos pacientes são melhor explicados como um fenômeno psicológico e psicossocial, como insatisfação e desadaptação no trabalho e desejo de obter benefícios. O conceito de lesões por esforços repetitivos é iatrogênico e de custo elevado para a sociedade, devendo ser abandonado.The hypothesis that repetitive movements and postures cause musculoskeletal injury is not supported by scientific data. The sensory and pain symptoms are better explained as of psychological and psychosocial nature, such as job insatisfaction or disajustment, with financial gains objectives. The repetitive strain injury concept is iatrogenic and costly to society, and must be abandonned.
Ahmed, Ishfaq; Islam, Talat; Ali, Ghulam; Nawaz, Muhammad Musarrat
This study aims at investigating the burden and pattern of clothing related pillion riders' injuries and their helmet wearing pattern in Lahore, Pakistan. Data were collected for nine months (July 2013 to March 2014), reporting 13,248 motorcycle related injuries, out of which 8751 (66%) cases were related to the clothing related pillion riders' injuries. Out of these injuries 10.30% were severe injuries which can be prevented or reduced by proper safety measure, e.g. wearing helmet. It was also found that most of the fatalities were not wearing helmet. Injuries due to wearing of loose fitting clothes and absence of helmet are not uncommon in Pakistan and other underdeveloped parts of the world. Such accidents may be reduced by creating awareness and safety sense in the riders, where use of safe dress and helmet should be encouraged in order to avoid such fatal damages.
ZHENG Guo-shou; BAI Xiang-jun; ZHAN Cheng-ye
Objective: To investigate the high risk factors related to acute respiratory distress syndrome ( ARDS ) following serious thoracoabdominal injuries.Methods: The clinical data of 282 patients with serious thoracoabdominal injuries were retrospectively studied. Univariate and Cox multivariate regression analysis were used to determine the risk factors related to ARDS following serious thoracoabdominal injuries.Results: The incidence of ARDS was 31.9% (90/282) in patients with serious thoracoabdominal injuries.The mortality caused by ARDS was 37.8% (34/90). The univariate analysis and multivariate analysis demonstrated that the clinical conditions such as elder age, shock,dyspnea, abnormal arterial blood gas, hemopneumothorax,pulmonary contusion, flail chest, coexisting pulmonary diseases, multiple abdominal injury and high ISS score were the independent high risk factors related to ARDS.Conclusion: There are many high risk factors related to ARDS following severe thoracoabdominal injuries, which should be detected early and treated timely to decrease the incidence and mortality of ARDS.
Gould, Trenton E.; Piland, Scott G.; Caswell, Shane V.; Ranalli, Dennis; Mills, Stephen; Ferrara, Michael S.; Courson, Ron
Objective: To provide athletic trainers, health care professionals, and all those responsible for the care of athletes with clinical recommendations for preventing and managing sport-related dental and oral injuries. Background: Participation in competitive sports continues to grow at both the interscholastic and intercollegiate levels. Therefore, exposure to, and the incidence of athletic-related injury, including orofacial injury, will also likely increase. At the time of this writing, the leading governing agencies for interscholastic (National Federation of State High School Associations) and intercollegiate (National Collegiate Athletic Association) sports require only protective orofacial equipment (eg, mouthguards) for 5 and 4, respectively, of their sanctioned sports. Although orofacial injuries represent a small percentage of all sport-related injuries, the financial burden associated with these injuries (eg, tooth avulsion) can exceed $15 000 over an adult life. Therefore, effective management of sport-related dental injuries is critical to the long-term financial, physical, and emotional health of people who have experienced dental trauma. Recommendations: Based upon the current evidence regarding sport-related orofacial injury, we provide recommendations related to planning considerations, education, and mouthguard efficacy, material, fabrication, and care considerations. Additionally, suggested best practices for managing sport-related dental injury are also given for athletic trainers and other health care professionals. PMID:27875057
Holm, Sara; Schönberger, Michael; Poulsen, Ingrid;
The present study aimed to (1) identify the difficulties most frequently reported by individuals with severe traumatic brain injury (TBI) at the time of discharge from a sub-acute rehabilitation brain injury unit as well as difficulties reported by their relatives, (2) compare patients......' and relatives' reports of patient difficulties, and (3) explore the role of injury severity, disability and other factors on subjective experience of difficulties. The primary measure was the European Brain Injury Questionnaire (EBIQ) administered to patients and to one of their close relatives at discharge...
Scholten, Annemieke C; Polinder, Suzanne; Panneman, Martien J M; van Beeck, Ed F; Haagsma, Juanita A
The main cause of death and serious disability in bicycle accidents is traumatic brain injury (TBI). The aim of this population-based study was to assess the incidence and costs of bicycle-related TBI across various age groups, and in comparison to all bicycle-related injuries, to identify main risk groups for the development of preventive strategies. Data from the National Injury Surveillance System and National Medical Registration were used for all patients with bicycle-related injuries and TBI who visited a Dutch emergency department (ED) between 1998 and 2012. Demographics and national, weighted estimates of injury mechanism, injury severity and costs were analysed per age group. Direct healthcare costs and indirect costs were determined using the incidence-based Dutch Burden of Injury Model. Between 1998 and 2012, the incidence of ED treatments due to bicycle-related TBI strongly increased with 54%, to 43 per 100,000 persons in 2012. However, the incidence of all bicycle-related injuries remained stable, from 444 in 1998 to 456/100,000 in 2012. Incidence of hospital admission increased in both TBI (92%) and all injuries from cycling (71%). Highest increase in incidence of both ED treatments and hospital admissions was seen in adults aged 55+. The injury rate of TBI per kilometre travelled increased (44%) except in children, but decreased (-4%) for all injuries, showing a strong decrease in children (-36%) but an increase in men aged 25+, and women aged 15+. Total costs of bicycle-related TBI were €74.5 million annually. Although bicycle-related TBI accounted for 9% of the incidence of all ED treatments due to cycling, it accounted for 18% of the total costs due to all bicycle-related injuries (€410.7 million). Children and adolescents (aged 0-24) had highest incidence of ED treatments due to bicycle-related injuries. Men in the working population (aged 15-64) had highest indirect costs following injuries from cycling, including TBI. Older cyclists (aged
苯丙胺类物质以损害认知功能为主，使用者主要表现为幻觉、妄想、记忆力下降等精神症状和认知功能障碍，并且在上述精神症状影响下可能出现一系列的冲动、伤人及自伤行为。本文就苯丙胺类物质在我国的滥用趋势、作用机制、相关危害、治疗和干预措施进行介绍，以提高公众对其认识，降低苯丙胺类物质滥用对患者自身和社会的危害。%Amphetamine-type stimulants(AST)can damage the cognitive function of drug addicts who present mental symptoms as cognitive disfunction, delusions and hallucinations, which results in a series of impulse, wounding and self-injury behavior. This article introduces the epidemiological trend, the mechanism, the related hazard, the treatment and interventional measures of AST in our country in order to improve the awareness of AST in the publics and reduce AST harm to drug addicts and society.
Aladelusi, Timothy; Akinmoladun, Victor; Olusanya, Adeola; Akadiri, Oladimeji; Fasola, Abiodun
The objective of this study was to determine the prevalence of road traffic crashes (RTC)-related maxillofacial injuries, the concomitant injuries occurring with them, and to assess the relationship between the severity of maxillofacial and concomitant injuries. This was a prospective study involving 201 victims of RTC seen at the Accident and Emergency Department of the University College Hospital, Ibadan with maxillofacial injuries during the study period. Demographic data of the patients, the types of maxillofacial injuries, and concomitant injuries sustained were recorded. Severity of maxillofacial injury was determined using the maxillofacial injury severity scale (MFISS), while the severity of concomitant injuries was based on the ISS. Correlations between types and severity of maxillofacial injury and types and severity of concomitant injury were conducted to determine the predictability of concomitant injuries based on maxillofacial injury severity. Data were processed using SPSS Statistical software (SPSS, version 20.0 for windows, IBM SPSS Inc, Chicago, IL). Maxillofacial injuries constituted 25.4% of RTC-related admission by the Accident and Emergency Department. A total of 151 (75.1%) patients who presented with concomitant injuries participated in the study. Eighty-one (53.6%) sustained injuries to more than one body region. Head injury was the commonest (99, 65.6%) concomitant injury, followed by orthopedic injury (69, 45.7%). Increasing severity of maxillofacial injury showed a positive correlation with increasing ISS. Also, positive correlation was noted with increasing severity of maxillofacial injury and presence of polytrauma (p = 0.01), traumatic brain injury (p = 0.034), and eye injuries (p = 0.034). There was a high prevalence of maxillofacial injuries in victims of RTC. There was a high incidence of concomitant injuries noted with these maxillofacial injuries. Significantly, this study showed a direct relationship between the
Laing, T A; O'Sullivan, J B; Nugent, N; O'Shaughnessy, M; O'Sullivan, S T
Lawnmower related injuries cause significant morbidity in children and young teenagers. The 'ride-on' mowers which are more powerful than the 'walk behind' mowers are becoming increasingly popular. The incidence and severity of injuries from either type of lawnmower appears to be steadily rising as is the burden placed on local plastic surgical and emergency services in managing the care of these patients. The aims of the study were to demonstrate changing trends in lawnmower-related injuries to children presenting to a single unit over a ten-year period and to identify any association between injury severity and machine subtype ('ride-on' versus 'walk-behind'). Hospital databases, theatre records and medical case notes were reviewed retrospectively of all patients under the age of 16 treated for lawnmower related injuries over a 10 year period from July 1998 to June 2008. Data gathered included patient demographics, injury site and severity, management (type and number of surgical procedures), length of hospital stay and outcome. Injury severity score was also calculated for each case. Controlling for estimated regional population changes, there was a significant increase in the number of ride-on mower related accidents in the time period 2003-2008, compared to the time period 1998-2003. Ride-on injuries had significantly higher injury severity scores, longer hospital stays and were more likely to involve amputations as compared with walk-behind injuries. Children can sustain significant injuries with unsafe lawnmower use. The current study demonstrates the increasing incidence of ride-on mower related injuries in children and identifies a greater morbidity associated with such injuries. Such presentations place intense demands on local plastic surgical services.
Laing, T A
Lawnmower related injuries cause significant morbidity in children and young teenagers. The \\'ride-on\\' mowers which are more powerful than the \\'walk behind\\' mowers are becoming increasingly popular. The incidence and severity of injuries from either type of lawnmower appears to be steadily rising as is the burden placed on local plastic surgical and emergency services in managing the care of these patients. The aims of the study were to demonstrate changing trends in lawnmower-related injuries to children presenting to a single unit over a ten-year period and to identify any association between injury severity and machine subtype (\\'ride-on\\' versus \\'walk-behind\\'). Hospital databases, theatre records and medical case notes were reviewed retrospectively of all patients under the age of 16 treated for lawnmower related injuries over a 10 year period from July 1998 to June 2008. Data gathered included patient demographics, injury site and severity, management (type and number of surgical procedures), length of hospital stay and outcome. Injury severity score was also calculated for each case. Controlling for estimated regional population changes, there was a significant increase in the number of ride-on mower related accidents in the time period 2003-2008, compared to the time period 1998-2003. Ride-on injuries had significantly higher injury severity scores, longer hospital stays and were more likely to involve amputations as compared with walk-behind injuries. Children can sustain significant injuries with unsafe lawnmower use. The current study demonstrates the increasing incidence of ride-on mower related injuries in children and identifies a greater morbidity associated with such injuries. Such presentations place intense demands on local plastic surgical services.
Fatma Gul Helvaci Celik
Full Text Available The deliberate self-harm behaviour which defined as attempting to own body resulting in tisue damage without conscious desire of peolple to die, is a major public health problem worldwide. The causes of deliberate self- harm, risk factors, the relationship between mental disorders and treatment strategies are not fully known. Deliberate self- harm can be observed together with psychiatric disorders such as borderline personality disorder, histrionic personality disorder, eating disorders and mood disorders. Also, deliberate self-harm must be distinguished from suicidal behavior. Psychologi-cal trauma has been suggested as a risk factor for deliberate self- harm behavior. Trauma and traumatic events have long been associated with deliberate self- harm behavior. The aim of this review article is to investigate the etiology and epidemiology of deliberate self-harm behaviour and relationship between psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(2.000: 209-226
Sousa, Nelson; Mendes, Romeu; Monteiro, Graça; Abrantes, Catarina
The benefits of progressive resistance training (PRT) among the older adults are evident, especially in the prevention of sarcopenia and improving muscle strength, which reverse the age-related loss of functional ability. However, PRT carries some risk, particularly when participants are older adults with a certain degree of muscle weakness. The purpose of this article is to discuss the PRT-related injuries, and present an overview of documented shoulder injuries among the elderly, discerning possible mechanisms of injury and risk factors. A literature search was conducted in the PUBMED database to identify the relevant literature using combinations of keywords: strength-training injuries, resistance-training injuries, sports injuries in the elderly, shoulder complex, shoulder injury, and shoulder disorder. Acute and chronic injuries attributed to PRT have been cited in the epidemiological literature. The shoulder complex, has been alluded to as one of the most prevalent regions of injury, particularly in exercises that place the arm extended above the head and posterior to the trunk. However, the risk for injuries appears to be higher for testing than for training itself. One-repetition maximum strength testing may result in a greater injury risk. This technique, though acceptable, needs additional precautions in inexperience older adults to prevent injury. Thus, the best treatment for PRT age-related injuries is prevention. Appropriate and individualized training programs, the use of safe equipment, careful warming up and cooling down, correct range of motion, progressive intensity training, cardiovascular and musculoskeletal fitness are essential aspects of injury prevention among the elderly.
Zhou, Sheng Ang; Ho, Andrew Fu Wah; Ong, Marcus Eng Hock; Liu, Nan; Pek, Pin Pin; Wang, Yi Qing; Jin, Tao; Yan, Guang Zhao; Han, Nan Nan; Li, Gang; Xu, Li Ming; Cai, Wen Wei
Abstract The use of electric bicycles (EBs) in China is growing. In the present study, we aimed to characterize the pattern and outcomes of EB-related injuries presenting to a major general hospital in China. This was a retrospective review of EB-related injuries presenting to Zhejiang Provincial People's Hospital from 2008 to 2011. Cases were identified from medical records according to diagnosis codes. Data captured included demographics, injury characteristics, and outcomes. A total of 3156 cases were reviewed in the present study. There were 1460 cases of traffic accidents, of which 482 cases were EB-related (32.7%). In addition, most of EB-related cases (44.6%) belonged to the 41- to 60-year-old age group. Median injury severity score was 10. Moreover, 34.9% underwent surgery and 24.7% were admitted to intensive care unit. The median hospitalization cost was 14,269 USD. Fracture (56.5%) was the most frequently diagnosed injury type, and head was the most commonly injured body region (31.1%). EB-related injuries have become a major health concern, making up a sizeable proportion of injuries presenting to the emergency department. Therefore, it is necessary to establish injury prevention and strategies for EB road safety. Implementation of policy such as compulsory helmet use, as well as popularization of EB road safety education should be considered to improve the current situation of EB-related injuries in China. PMID:28658174
Zhou, Sheng Ang; Ho, Andrew Fu Wah; Ong, Marcus Eng Hock; Liu, Nan; Pek, Pin Pin; Wang, Yi Qing; Jin, Tao; Yan, Guang Zhao; Han, Nan Nan; Li, Gang; Xu, Li Ming; Cai, Wen Wei
The use of electric bicycles (EBs) in China is growing. In the present study, we aimed to characterize the pattern and outcomes of EB-related injuries presenting to a major general hospital in China.This was a retrospective review of EB-related injuries presenting to Zhejiang Provincial People's Hospital from 2008 to 2011. Cases were identified from medical records according to diagnosis codes. Data captured included demographics, injury characteristics, and outcomes.A total of 3156 cases were reviewed in the present study. There were 1460 cases of traffic accidents, of which 482 cases were EB-related (32.7%). In addition, most of EB-related cases (44.6%) belonged to the 41- to 60-year-old age group. Median injury severity score was 10. Moreover, 34.9% underwent surgery and 24.7% were admitted to intensive care unit. The median hospitalization cost was 14,269 USD. Fracture (56.5%) was the most frequently diagnosed injury type, and head was the most commonly injured body region (31.1%).EB-related injuries have become a major health concern, making up a sizeable proportion of injuries presenting to the emergency department. Therefore, it is necessary to establish injury prevention and strategies for EB road safety. Implementation of policy such as compulsory helmet use, as well as popularization of EB road safety education should be considered to improve the current situation of EB-related injuries in China.
Madiba, T E; Muckart, D J
Retroperitoneal haematoma following blunt or penetrating trauma may arise from injuries to bone, major vascular structures, hollow viscera or solid organs. Clinical significance varies from inconsequential to fatal. Although the guidelines for exploration are clear-cut during laparotomy for associated intra-abdominal injuries, this is not the case with isolated retroperitoneal haematoma. Lateral and pelvic haematomas may be selectively explored and central haematomas always need exploration. All penetrating wound tracts should be explored, irrespective of the site of the haematoma, to exclude vital structural injury.
Nikolaos P Karidis; Gregory Kouraklis; Stamatios E Theocharis
The hepatocyte, the main cellular component of the liver, exhibits variable susceptibility to different types of injury induced by endogenous or exogenous factors.Hepatocellular dysfunction or death and regeneration are dependent upon the complicated interactions between numerous biologically active molecules. Plateletactivating factor (PAF) seems to play a pivotal role as the key mediator of liver injury in the clinical and experimental setting, as implied by the beneficial effects of its receptor antagonists. A comprehensive up-todate overview of the specific functional and regulatory properties of PAF in conditions associated with liver injury is attempted in this review.
Greenaway, Rebecca; Mogg, Karin; Bradley, Brendan P
According to recent models of drug dependence, attentional bias for drug cues provides an index of vulnerability to drug-taking and relapse. The present study examined attentional bias for smoking-related information in pregnant women and its relationship with smoking experience and attitudes. Participants were 71 pregnant women (35 without smoking experience; 36 with experience of smoking, of whom 16 reported currently smoking). Attentional bias was assessed from the interference index of smoking-related words on a modified Stroop task. The attentional bias for smoking cues was positively associated with smoking experience, and with more favourable general attitudes to smoking (i.e. incentive-related bias). The bias was also greater in women who perceived greater harm of passive smoking to their foetus (i.e. threat-related bias), which was independent of smoking experience. Results indicate that attentional bias for smoking-related cues is independently associated with both incentive-related (reward) and threat-related (aversive) evaluations of cigarette smoking in pregnant women. This work highlights the need for longitudinal research to investigate whether the attentional bias provides a cognitive index of vulnerability for persistent smoking behaviour both during and after pregnancy.
Baker, Susan P; Brady, Joanne E; Shanahan, Dennis F; Li, Guohua
Information about injuries sustained by survivors of airplane crashes is scant, although some information is available on fatal aviation-related injuries. Objectives of this study were to explore the patterns of aviation-related injuries admitted to U.S. hospitals and relate them to aviation deaths in the same period. The Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) contains information for approximately 20% of all hospital admissions in the United States each year. We identified patients in the HCUP NIS who were hospitalized during 2000-2005 for aviation-related injuries based on the International Classification of Diseases, 9th Revision, codes E840-E844. Injury patterns were also examined in relation to information from multiple-cause-of-death public-use data files 2000-2005. Nationally, an estimated 6080 patients in 6 yr, or 1013 admissions annually (95% confidence interval 894-1133), were hospitalized for aviation-related injuries, based on 1246 patients in the sample. The average hospital stay was 6.3 d and 2% died in hospital. Occupants of non-commercial aircraft accounted for 32% of patients, parachutists for 29%; occupants of commercial aircraft and of unpowered aircraft each constituted 11%. Lower-limb fracture was the most common injury in each category, constituting 27% of the total, followed by head injury (11%), open wound (10%), upper extremity fracture, and internal injury (9%). Among fatalities, head injury (38%) was most prominent. An average of 753 deaths occurred annually; for each death there were 1.3 hospitalizations. Aviation-related injuries result in approximately 1000 hospitalizations each year in the United States, with an in-hospital mortality rate of 2%. The most common injury sustained by aviation crash survivors is lower-limb fracture.
Otrock, Z K; Liu, C; Grossman, B J
Transfusion-related acute lung injury (TRALI) is a life-threatening complication of transfusion. Greater understanding of the pathophysiology of this syndrome has much improved during the last two decades. Plasma-containing components from female donors with leucocyte antibodies were responsible for the majority of TRALI fatalities before mitigation strategies were implemented. Over the past 15 years, measures to mitigate risk for TRALI have been implemented worldwide and they continued to evolve with time. The AABB requires that all plasma containing components and whole blood for transfusion must be collected from men, women who have not been pregnant, or women who have tested negative for human leucocyte antigen antibodies. Although the incidence of TRALI has decreased following the institution of TRALI mitigation strategies, TRALI is still the most common cause of transfusion-associated death in the United States. In this review, we focus on TRALI risk mitigation strategies. We describe the measures taken by blood collection facilities to reduce the risk of TRALI in the United States, Canada and European countries. We also review the literature for the effectiveness of these measures. © 2017 International Society of Blood Transfusion.
Abraham, Vihas M; Gaw, Christopher E; Chounthirath, Thiphalak; Smith, Gary A
This study investigates the epidemiology of injuries associated with toys among US children by analyzing data from the National Electronic Injury Surveillance System. During 1990-2011, an estimated 3278073 (95% confidence interval = 2762281-3793865) children toy-related injuries, averaging 149003 cases annually. The annual injury rate per 10000 children increased significantly by 39.9% from 18.88 in 1990 to 26.42 in 2011. The number and rate of injuries peaked at age 2 years; 63.4% of patients were male; and 80.3% of injuries occurred at home. Ride-on toys accounted for 34.9% of injuries and 42.5% of hospital admissions. This study is the first to comprehensively investigate toy-related injuries among children using a nationally representative data set. The increasing number and rate of toy-related injuries to children, especially those associated with ride-on toys, underscore the need for increased efforts to prevent these injuries.
Kuehn, D.W.; Fuller, T.K.; Mech, L.D.; Paul, W.J.; Fritts, S.H.; Berg, W.E.
Gray wolves (Canis lupus) captured in traps with toothed jaws offset 1.8 cm incurred fewer injuries than those captured in 3 other types of steel traps. Few wolves seriously damaged canine or carnassial teeth while in traps.
That specific component responsible and the mechanistic pathway for increased human morbidity and mortality after cigarette smoking have yet to be delineated. We propose that 1) injury and disease following cigarette smoking are associated with exposure and retention of particles...
That specific component responsible and the mechanistic pathway for increased human morbidity and mortality after cigarette smoking have yet to be delineated. We propose that 1) injury and disease following cigarette smoking are associated with exposure and retention of particles...
Public campaigns should clearly highlight the risk of injury to this age group, and poor safety practices with regard to children should be specifically targeted. With the ... pedestrian collision in 28 cases (70%), other vehicle-motorcycle collision ...
There are debates on how to define fetal harm in the field of criminal theory. In my opinion, the view of fetal harm constituting the crime of intentional injury is reasonable. According to the criminal legislation, regarding fetus as human violates the principle of legality, so we can only take the legitimate rights and interests of fetus health as the health rights of the mother to be protected. Otherwise, illegal acts against the fetus will be difficult to get a fair deal. This interpretation is also in line with the crime of intentional injury crime: In the subjective aspect, behavior person need not to know that the victim was pregnant, and need not to take the fetus as the purpose of crime; in the objective aspect, even if the fetus’health is damaged after birth, it still can be evaluated as a result of maternal injury.%对伤害胎儿的行为如何定性，刑法理论界依然存在很大的争议。诸多观点之中，按照故意伤害罪处罚具有一定的合理性。依据刑事立法规定，将胎儿解释为人违背了罪刑法定原则，因此只能将胎儿的合法权益解释为母体的健康法益来加以保护，否则，侵害胎儿的违法行为将难以得到公正处理。这一解释结论也符合故意伤害罪的犯罪构成：在主观方面，行为人不需明确认识到被害人为孕妇，且不必以伤害胎儿作为犯罪目的；在客观方面，即便胎儿出生以后健康受损，依然可以被评价为对母体的伤害结果，其间的因果关系并未中断。
Nielsen, R.O.; Nohr, Ellen Aagaard; Rasmussen, Sten;
Many researchers acknowledge the importance of "training errors" as the main cause of running-related injuries. The purpose of this clinical commentary is to present a theoretical framework for the assumption that some running-related injuries among rear-foot strikers develop due to rapidly chang...
Fagher, Kristina; Forsberg, Anna; Jacobsson, Jenny; Timpka, Toomas; Dahlström, Örjan; Lexell, Jan
Our knowledge of sports-related injuries in para-sport is limited and there are no data on how Paralympic athletes themselves perceive an injury. The aim of this qualitative study was to explore Paralympic athletes' perceptions of their experiences of sports-related injuries, risk factors and preventive possibilities. Eighteen Swedish Paralympic athletes with vision impairment, intellectual impairment, spinal cord injury, cerebral palsy, myelomeningocele, dysplasia and neuromuscular disorder, representing 10 different para-sports, were interviewed. The qualitative phenomenographic method was used to interpret the data. The analysis revealed nine categories of perceptions of experiences. The athletes perceived that their impairments were involved in the cause and consequential chains associated with a sports-related injury. Other categories that denoted and described these injuries were: sport overuse, risk behaviour, functional limitations, psychological stressors, the normalised pain, health hazards, individual possibilities to prevent sports-related injuries and unequal prerequisites. This qualitative study revealed that Paralympic athletes' perceptions of their experiences of sports-related injuries are complex and multifactorial, and in several ways differ from able-bodied athletes. This needs to be considered in the sports health and safety work within the Paralympic Movement as well as in the design of future injury surveillance systems and preventive programmes.
Aim: This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. Materials and Methods: A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai) who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referre...
Shirani Gholamreza; Motamedi Mohammad Hosein; Ashuri Alireza; Eshkevari Pooyan
Aim: This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. Materials and Methods: A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai) who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referre...
Smartt, Pamela; Chalmers, David
Although equestrian injury studies to date have provided useful information for injury prevention, these studies have not been detailed enough or inclusive enough, to identify and characterise all sub-populations that may be at risk. One study has reported injury rates for the population-at-risk. The present study was carried out to determine, more precisely, who is injured in horse-related activities in New Zealand, what sorts of injuries they sustain, the circumstances of injury and the cost of treatment. A novel search of linked hospital discharge and compensation claim data for 2002 and 2003 was carried out. Of 716 newly hospitalised cases, 29% were in the 5-19-year and 28% in the 35-49-year age groups. Incidence rates for regular riders peaked at 13-15 years (900/100000) and 50+ years (880/100000). Where the 'place of occurrence' was specified only 12% of cases sustained injury in a 'sports and athletics area'. This new study has highlighted injuries occurring in farm and other 'open' locations such as mountains and forest, injuries to older riders and injuries to bystanders/handlers during non-organised recreational activity. Attention was drawn to the high in-patient cost of hospitalised injuries in persons >40 years and the need for injury information relating to specific riding activities. Current equestrian injury prevention tends to target young females and organised riding; in focusing on these, other significant population groups and injury mechanisms may be overlooked and opportunities for injury prevention missed.
Baker, John I; Griffin, Russell; Brauneis, Paul F; Rue, Loring W; McGwin, Gerald
The purpose of the study was to compare tubing-related injuries to wakeboarding- and water skiing-related injuries. Data was collected from the 2000-2007 National Electronic Injury Surveillance Survey for 1,761 individuals seeking care at an emergency department due to a tubing-, wakeboarding, or water skiing-related injury. Data included patient age and sex, as well as injury characteristics including body region injured (i.e., head and neck, trunk, shoulder and upper extremity, and hip and lower extremity) and diagnosis of injury (e.g., contusion, laceration, or fracture). Case narratives were reviewed to ensure that a tubing-, wakeboarding-, or water skiing-related injury occurred while the individual was being towed behind a boat. Severe injury (defined as an injury resulting in the individual being hospitalized, transferred, held for observation) was compared among the groups using logistic regression. Wakeboard- and tubing-related injuries more commonly involved the head and neck, while water skiing- related injuries were likely to involve the hip and lower extremity. Tubing-related injuries, compared to water skiing-related injuries, were more likely to be severe (OR 2.31, 95% CI 1.23-4. 33). Like wakeboarding and water skiing, tubing has inherent risks that must be understood by the participant. While tubing is generally considered a safer alternative to wakeboarding and water skiing, the results of the current study suggest otherwise. Both the number and severity of tubing- related injuries could be prevented through means such as advocating the use of protective wear such as helmets while riding a tube or having recommended safe towing speeds prominently placed on inner tubes. Key pointsIncrease annual injury rate trend in wakeboard injuries.Wakeboard- and tubing-related injuries more often to head and neck, waterskiing-related injuries more often to hip and lower extremity.Tubing-related injuries over 2-times as likely to be severe compared to
Lee, Josephine; Trudell, Debra; Resnick, Donald L. [Department of Radiology, Veterans Affairs Medical Center, University of California, San Diego, CA (United States); Papakonstantinou, Olympia [Department of Radiology, Veterans Affairs Medical Center, University of California, San Diego, CA (United States); Department of Radiology/MRI Unit, University Hospital of Heraklion (Greece); Brookenthal, Keith R. [Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA (United States)
The ''arcuate sign'' is considered a pathognomonic sign for injuries of the posterolateral (PL) corner of the knee. The purpose of our study was to identify different patterns of injury to the fibular head that may associate with injuries to specific ligaments and tendons of the PL corner of the knee. The anatomic relations between the insertions of fibular collateral ligament (FCL), biceps femoris tendon (BFT), popliteofibular ligament (PFL), and arcuate ligament in normal cadaveric knees were also investigated. Magnetic resonance imaging was performed in two cadaveric knees which subsequently were dissected. Radiopaque markers were placed upon the fibular insertions of the FCL, BFT, PFL, and arcuate ligament in the dissected knees, and knee radiographs were then obtained. Twelve patients with radiographic or MR imaging evidence of isolated injury to the PL corner of the knee were retrospectively reviewed, with regard to avulsion fractures and marrow edema in the fibular head and the integrity of the ligaments of the PL corner of the knee. The PFL and arcuate ligament were seen to attach directly to the posterior and medial aspect of the styloid process of the fibular head. The FCL and BFT attached as a conjoined structure on the lateral aspect of the fibular head lateral, anterior and inferior to the attachment site of the PFL and arcuate ligament. Injury to the arcuate ligament or PFL was diagnosed in 8 patients who presented with a small avulsion fracture of the styloid process of the fibula (n=2), bone marrow edema in the medial aspect of the fibular head (n=3), or both (n=3). In 4 patients with injury to the conjoined tendon or FCL, a larger avulsion fragment and more diffuse proximal fibular edema were seen. Radiographic and MR imaging findings in injuries of the posterolateral corner of the knee may suggest injury to specific structures inserting in the fibular head. (orig.)
Seminati, Elena; Minetti, Alberto Enrico
Overuse injuries are predominant in sports involving the repetition of similar movements patterns, such as in volleyball or beach volleyball, and they may represent as much a problem as do acute injuries. This review discusses the prevalence of two of the most common overuse-related injuries in volleyball: shoulder and back/spine injuries. Risk factors and the aetiology of these injuries are illustrated in order to make possible to initiate preventive programme or post-injuries solutions. Data collected from literature showed a moderately higher injury rate for overuse shoulder injuries compared to the back/spine (19.0 ± 11.2% and 16.8 ± 9.7%, respectively). These data could be underestimated, and future epidemiological studies should consider overuse injuries separately from the others, with new methodological approaches. In addition to age, biomechanical and anatomical features of a volleyball technique utilised in game and the amount of hours played are considered as the main risk factors for overuse upper limb injuries, both for professional and recreational athletes. Together with post-injuries solutions, great importance has to be placed on preventive programmes, such as preventive rehabilitation, stretching, adequate warm up, strength-power exercises, etc. Furthermore, it is particularly suggested that coaches and players work together in order to develop new game/training techniques that minimise stresses and range of motion of the principal anatomical structures involved, while maintaining athletes performance.
Nielsen, Rasmus Oestergaard; Nohr, Ellen Aagaard; Rasmussen, Sten
be prevented in future studies by categorizing injuries into volume or pacing injuries. However, more work is needed to provide further evidence in support of this approach. Future investigations of the link between training patterns and injury development should be designed as large-scale prospective studies......BACKGROUND AND PURPOSE: Many researchers acknowledge the importance of "training errors" as the main cause of running-related injuries. The purpose of this clinical commentary is to present a theoretical framework for the assumption that some running-related injuries among rear-foot strikers...... of patellofemoral pain syndrome, iliotibial band syndrome, and patellar tendinopathy, while change in running pace may be associated with the development of achilles tendinopathy, gastrocnemius injuries, and plantar fasciitis. DISCUSSIONRELATION TO CLINICAL PRACTICE: If this assertion is correct, bias may...
Bandyopadhyay, S; Saha, M; Biswas, S; Ranjan, A; Naskar, A K; Bandyopadhyay, L
Calcium carbide used in fruit ripening industry as a cheap alternative to natural plant hormone ethylene produces highly inflammable acetylene gas. Inadvertent ignition of this gas can cause severe ocular burn injury with unilateral or bilateral blindness. To determine the characteristics and visual outcome of ocular burn injuries from calcium carbide during mango ripening season of West Bengal, eastern India. A prospective study of all cases of calcium carbide related ocular burn injury attending a tertiary care hospital during mango ripening season was carried out. The demographic features, characteristics of the injury, management and outcomes were recorded. Fifty five eyes of 33 patients were studied. Males were more commonly affected (20 patients, 60.6%) than females. The injury was bilateral in 22 patients (66.66%). Seventeen patients (51.51%) were below 20 years of age. Ten eyes had open globe injuries and 45 eyes had closed globe injuries. One eye of a patient had to be enucleated (3%). Children below 14 years of age were mainly injured while playing with indigenous fireworks of shooting carbide. Middle aged women were affected particularly during ignition of evening lamps. Carbide lamp was another source of injury. Males are more commonly affected by calcium carbide related ocular injuries. Children and young adults are the common victims. Such injuries can involve both the eyes and cause a permanent visual disability. © NEPjOPH.
Wibbenmeyer, Lucy; Liao, Junlin; Heard, Jason; Kealey, Lyn; Kealey, Gerald; Oral, Resmiye
The underpinnings of maltreatment in children presenting with burn injuries are necessary to discern as detection and prevention rest on a clear delineation of factors associated with maltreatment. Inaccurate identification of child victims can result in perpetuation of the maltreatment and its attendant neuropsychological sequela. The authors sought to determine factors associated with maltreatment in children presenting with burn injuries, which would guide the burn team in assessing the likelihood of maltreatment. All consenting children admitted with burn injuries were surveyed regarding their injury mechanism and current sociodemographic status. Suspicious injuries were referred by the burn team to the multidisciplinary review team (MRT). The MRT reported injuries with signs of physical abuse, supervision neglect, neglect of other basic needs, or sexual abuse. These children constituted the cases in our study. Variables related to maltreatment were entered into stepwise logistic regression to identify independent predicting variables. Pmaltreatment. Risk factors related to suspicions of maltreatment included: young age, large burns, tap water injury, immersion lines, delay in care, absence of a two-parent family (unconventional family structure), young parents, inconsistent history, and injury pattern. In this single-center prospective study, the authors identified several factors that, when present in injuries with initial suspicion of maltreatment, should trigger a child maltreatment workup. Burn clinicians have an important role as advocates for children and their families. It is important to continue to further the knowledge of maltreatment detection and prevention among children presenting with burn injuries.
Full Text Available Objective: To determine the contribution of corporal punishment to ocular morbidity and visual impairment in Nigerian children. Materials and Methods: A prospective study was conducted of all patients aged 0-15 years seen with ocular injuries over a four year period. Those who sustained ocular injuries during the administration of corporal punishment were further studied. Relevant information was documented using a semistructured questionnaire. Data was analyzed by simple descriptive statistics using SPSS statistical package version 10. Results: A total of 186 children were seen within the study period. Eighty-nine (47.8% had ocular injuries and 27 (30.3% had ocular injuries resulting from corporal punishment. Of the latter group, eighteen were males and nine were females. Their ages ranged from 3-15 years (mean = 8.5 ± 2.4 years. Corporal punishment-associated injuries occurred most commonly as seen in 17 (63% of our study population who were aged 7-12 years. These 27 cases of injuries were sustained in the schools: 13 (48.2%, homes: eight (29.6%, market place: three (11.1%, workshop: two (7.4% and worship houses: one (3.7%. A stick was the object mostly implicated in causing ocular injuries in 13 (48.2% followed by a belt in five (18.5% and a whip in four (14.8%. Severe visual impairment occurred in two (7.4% patients while blindness occurred in three (11.1% patients. Conclusion: Corporal punishment is a major cause of ocular morbidity and blindness in Nigerian children.
Scholten, Annemieke C; Haagsma, Juanita A; Steyerberg, Ewout W; van Beeck, Ed F; Polinder, Suzanne
Insight into the change from pre- to post-injury health-related quality of life (HRQL) of trauma patients is important to derive estimates of the impact of injury on HRQL. Prospectively collected pre-injury HRQL data are, however, often not available due to the difficulty to collect these data before the injury. We performed a systematic review on the current methods used to assess pre-injury health status and to estimate the change from pre- to post-injury HRQL due to an injury. A systematic literature search was conducted in EMBASE, MEDLINE, and other databases. We identified studies that reported on the pre-injury HRQL of trauma patients. Articles were collated by type of injury and HRQL instrument used. Reported pre-injury HRQL scores were compared with general age- and gender-adjusted norms for the EQ-5D, SF-36, and SF-12. We retrieved results from 31 eligible studies, described in 41 publications. All but two studies used retrospective assessment and asked patients to recall their pre-injury HRQL, showing widely varying timings of assessments (soon after injury up to years after injury). These studies commonly applied the SF-36 (n = 13), EQ-5D (n = 9), or SF-12 (n = 3) using questionnaires (n = 14) or face-to-face interviews (n = 11). Two studies reported prospective pre-injury assessment, based on prospective longitudinal cohort studies from a sample of initially non-injured patients, and applied questionnaires using the SF-36 or SF-12. The recalled pre-injury HRQL scores of injury patients consistently exceeded age- and sex-adjusted population norms, except in a limited number of studies on injury types of higher severity (e.g., traumatic brain injury and hip fractures). All studies reported reduced post-injury HRQL compared to pre-injury HRQL. Both prospective studies reported that patients had recovered to their pre-injury levels of physical and mental health, while in all but one retrospective study patients did not regain the
Hong-Feng Zhao; Guo-Wei Zhang; Jie Zhou; Jian-Hua Lin; Zhong-Lin Cui; Xiang-Hong Li
BACKGROUND: There is a controversy over the degree of liver and biliary injury caused by the period of secondary warm ischemia. A liver autotransplantation model was adopted because it excludes the effects of infection and immunological rejection on bile duct injury. This study was undertaken to assess biliary tract injury caused by relative warm ischemia (secondary warm ischemia time in the biliary tract) and reperfusion. METHODS: One hundred and two rats were randomly divided into 5 groups: groupⅠ (control); groupsⅡ toⅤ, relative warm ischemia times of 0 minute, 30 minutes, 1 hour and 2 hours. In addition to the levels of serum alkaline phosphatase, and total bilirubin, pathomorphology assessment and TUNEL assay were performed to evaluate biliary tract damage. RESULTS: Under the conditions that there were no signiifcant differences in warm ischemia time, cold perfusion time and anhepatic phase, group comparisons showed statistically signiifcant differences. The least injury occurred in groupⅡ (portal vein and hepatic artery reperfused simultaneously) but the most severe injury occurred in groupⅤ (biliary tract relative warm ischemia time 2 hours). CONCLUSIONS: Relative warm ischemia is one of the factors that result in bile duct injury, and the relationship between relative warm ischemia time the bile injury degree is time-dependent. Simultaneous arterial and portal reperfusion is the best choice to avoid the bile duct injury caused by relative warm ischemia.
王心; 汪培山; 周蔚
Objective: To assess the incidence, types and risk factors of military training-related injuries in recruits of Chinese People's Armed Police Forces (CPAPF). Methods: A cohort study was made on the risk factors of injuries in 805 male recruits during the military training from December 25, 1999 toDecember 25, 2000. Results: A total of 111 recruits (14%) experienced one or more injuries, and the cumulative incidence was 16.1 injuries per 100 soldiers in a year. And 77.7% of the injuries belonged to overuse injuries of the skeletal and muscular systems, the most common type of which was stress fractures. Most injuries occurred in the 3rd month of training. Univariate analysis and logistic regression analysis of possible risk factors for overuse injuries were carried out, and a number of risk factors were identified: history of agricultural labor, history of lower limb injury, flatfoot and less running exercise before entry into the army. But a suitable body mass index (BMI) was a protective factor. Examination of age, body height, smoking, body flexibility and frequency of 2-mile running revealed no significant association with the injuries. Conclusions: History of agricultural labor, history of lower limb injury, flatfoot, less running exercise before entry into the army and lower BMI were risk factors of the overuse injuries. In order to decrease the incidence of overuse injuries, the young people with good physical ability and shapely body type should be selected during conscription. During the training, nutrition should be improved so as to decrease the incidence of injuries.
Sang Chul Kim
Full Text Available Introduction: Work-related traumatic brain injury (TBI caused by falls is a catastrophic event that leads to disabilities and high socio-medical costs. This study aimed to measure the magnitude of the preventive effect of safety helmets on clinical outcomes and to compare the effect across different heights of fall. Methods: We collected a nationwide, prospective database of work-related injury patients who visited the 10 emergency departments between July 2010 and October 2012. All of the adult patients who experienced work-related fall injuries were eligible, excluding cases with unknown safety helmet use and height of fall. Primary and secondary endpoints were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs of safety helmet use and height of fall for study outcomes, and adjusted for any potential confounders. Results: A total of 1298 patients who suffered from work-related fall injuries were enrolled. The industrial or construction area was the most common place of fall injury occurrence, and 45.0% were wearing safety helmets at the time of fall injuries. The safety helmet group was less likely to have intracranial injury comparing with the no safety helmet group (the adjusted odds ratios (ORs (95% confidence interval (CI: 0.42 (0.24–0.73, however, there was no statistical difference of in-hospital mortality between two groups (the adjusted ORs (95% CI: 0.83 (0.34–2.03. In the interaction analysis, preventive effects of safety helmet on intracranial injury were significant within 4 m height of fall. Conclusions: A safety helmet is associated with prevention of intracranial injury resulting from work-related fall and the effect is preserved within 4 m height of fall. Therefore, wearing a safety helmet can be an intervention for protecting fall-related intracranial injury in the workplace.
Collins, C L; Fields, S K; Comstock, R D
To compare sport and gender differences in injury rates and proportions of injuries related to illegal activity and to describe the epidemiology of injuries related to illegal activity. Descriptive epidemiology study. 100 US high schools. Athletes participating in nine sports: boys' football, soccer, basketball, wrestling, and baseball plus girls' soccer, volleyball, basketball, and softball. Illegal activity-related injuries were analyzed using data from the 2005-06 and 2006-07 National High School Sports-Related Injury Surveillance Study. Nationally, an estimated 98 066 injuries were directly related to an action that was ruled illegal activity by a referee/official or disciplinary committee, giving an injury rate of 0.24 injuries per 1000 athletic competition-exposures. Boys' and girls' soccer had the highest rates of injuries related to illegal activity, and girls' volleyball, girls' softball, and boys' baseball had the lowest. Overall, 6.4% of all high school sports-related injuries were related to illegal activity, with the highest proportion in girls' basketball (14.0%), girls' soccer (11.9%), and boys' soccer (11.4%). A greater proportion of injuries related to illegal activity were to the head/face (32.3%) and were concussions (25.4%) than injuries not related to illegal activity (13.8% (injury proportion ratio 2.35; 95% CI 1.82 to 3.04; preferees/officials may reduce sports-related injuries.
Greenfield, Thomas K; Karriker-Jaffe, Katherine J; Kaplan, Lauren M; Kerr, William C; Wilsnack, Sharon C
Various harms from others’ drinking have been studied individually and at single points in time. We conducted a US population 15-year trend analysis and extend prior research by studying associations of depression with combinations of four harms – family/marriage difficulties, financial troubles, assault, and vandalism – attributed to partners or family members. Data come from four National Alcohol Surveys conducted by telephone in 2000, 2005, 2010, and 2015 (analytic sample = 21,184). Weighted logistic regression models estimated time trends adjusting for victim characteristics (gender, age, race/ethnicity, marital status, poverty, employment, family history of alcohol problems, and drinking maximum). The 2015 survey asked the source of the harm; we used similar models to examine characteristics, including anxiety and depression, associated with various combinations of family/marriage, financial, and assault harms due to partner’s/spouse’s/family members’ drinking. A significant upward trend (P <0.001) from 2000 to 2015 was seen for financial troubles but not for other harms due to someone else’s drinking. In 2015, depression and/or anxiety were strongly associated with exposures to harms and combinations of harms identified as stemming from drinking spouse/partner and/or family members. The results shed new light on 15-year trends and associations of harms with personal characteristics. A replicated finding is how the victim’s own heavy drinking pattern is implicated in risks for exposures to harms from someone else’s drinking. Documenting risk factors for and mental health impacts is important for interventions to reduce alcohol’s harm to others. PMID:26549971
Greenfield, Thomas K; Karriker-Jaffe, Katherine J; Kaplan, Lauren M; Kerr, William C; Wilsnack, Sharon C
Various harms from others' drinking have been studied individually and at single points in time. We conducted a US population 15-year trend analysis and extend prior research by studying associations of depression with combinations of four harms - family/marriage difficulties, financial troubles, assault, and vandalism - attributed to partners or family members. Data come from four National Alcohol Surveys conducted by telephone in 2000, 2005, 2010, and 2015 (analytic sample = 21,184). Weighted logistic regression models estimated time trends adjusting for victim characteristics (gender, age, race/ethnicity, marital status, poverty, employment, family history of alcohol problems, and drinking maximum). The 2015 survey asked the source of the harm; we used similar models to examine characteristics, including anxiety and depression, associated with various combinations of family/marriage, financial, and assault harms due to partner's/spouse's/family members' drinking. A significant upward trend (P <0.001) from 2000 to 2015 was seen for financial troubles but not for other harms due to someone else's drinking. In 2015, depression and/or anxiety were strongly associated with exposures to harms and combinations of harms identified as stemming from drinking spouse/partner and/or family members. The results shed new light on 15-year trends and associations of harms with personal characteristics. A replicated finding is how the victim's own heavy drinking pattern is implicated in risks for exposures to harms from someone else's drinking. Documenting risk factors for and mental health impacts is important for interventions to reduce alcohol's harm to others.
Calosevic, Srdjan; Lovric, Zvonimir
Fatal triad and ipsilateral dyad are patterns of pedestrian injuries related to significant mortality in traffic-related accidents. The aim of this research was to investigate the correlation between specific injury patterns and fatal outcome in other participants of traffic-related accidents. This was a retrospective study of traffic-related accidents in the broader area of the city of Osijek in a five-year period from 1995 to 1999. Autopsy results from the Institute of Pathology and Forensic Medicine of the Clinical Hospital Centre Osijek were analysed of individuals who died after their accident. The total severity of injuries was measured using the ISS. Logistic regression analysis was used for assessing the correlation between specific injury patterns and an early outcome from the severe injury. There were 213 individuals included in the study: 72 pedestrians and 141 other participants (drivers, assistant drivers, passengers, cyclists and motorcyclists). A total of129 individuals died on the spot and 84 died in the hospital during the first 48h. Femoral and pelvic fracture, fatal triad and both variants of ipsilateral dyad were related to higher ISS values. Ipsilateral fracture of upper and lower extremities (ipsilateral dyad 1) was associated with a 4.59 times higher risk of an immediate fatal outcome in the total sample. In pedestrians, the risk was 5.99 higher, and in other participants, the risk was 4.11 times higher. Specific skeletal injuries and injury patterns are a significant indicator for total injury severity and related poor prognosis for all participants of traffic-related injuries, not only for pedestrians. In this study, the ipsilateral fracture of upper and lower extremity was related to the largest total severity of injuries and the poorest prognosis. Copyright © 2015 Elsevier Ltd. All rights reserved.
Kerr, Zachary Y; Marshall, Stephen W; Dompier, Thomas P; Corlette, Jill; Klossner, David A; Gilchrist, Julie
Sports-related injuries can have a substantial impact on the long-term health of student-athletes. The National Collegiate Athletic Association (NCAA) monitors injuries among college student-athletes at member schools. In academic year 2013-14, a total of 1,113 member schools fielded 19,334 teams with 478,869 participating student-athletes in NCAA championship sports (i.e., sports with NCAA championship competition) (1). External researchers and CDC used information reported to the NCAA Injury Surveillance Program (NCAA-ISP) by a sample of championship sports programs to summarize the estimated national cumulative and annual average numbers of injuries during the 5 academic years from 2009-10 through 2013-14. Analyses were restricted to injuries reported among student-athletes in 25 NCAA championship sports. During this period, 1,053,370 injuries were estimated to have occurred during an estimated 176.7 million athlete-exposures to potential injury (i.e., one athlete's participation in one competition or one practice). Injury incidence varied widely by sport. Among all sports, men's football accounted for the largest average annual estimated number of injuries (47,199) and the highest competition injury rate (39.9 per 1,000 athlete-exposures). Men's wrestling experienced the highest overall injury rate (13.1 per 1,000) and practice injury rate (10.2 per 1,000). Among women's sports, gymnastics had the highest overall injury rate (10.4 per 1,000) and practice injury rate (10.0 per 1,000), although soccer had the highest competition injury rate (17.2 per 1,000). More injuries were estimated to have occurred from practice than from competition for all sports, with the exception of men's ice hockey and baseball. However, injuries incurred during competition were somewhat more severe (e.g., requiring ≥7 days to return to full participation) than those acquired during practice. Multiple strategies are employed by NCAA and others to reduce the number of injuries in
Vishal R Tandon
Full Text Available Antiepileptic Drugs (AEDs such as lamotrigine, gabapentin, and oxcarbazepine may have the potential to increase the risk of self-harm or suicidal behavior. We report a case of pregabalin-induced self-inflicted multiple injuries on forearm after its continuous use. This is an interesting adverse drug reaction (ADR that is rare, unusual, and potentially serious.
Hansen, Harald S.; Moesgaard, B.; Hansen, H.H.
mitochondria, and direct inhibition of ceramidase. Anandamide (20:4-NAE) is formed as a minor component along with other NAEs during cell injury. Whether 20:4-NAE has a separate physiological role is at present not known, but some data suggest that 20:4-NAE may be formed, e.g. in the uterus, by a more......The present review focuses on the relationship between formation of N-acylethanolamine phospholipids (NAPEs) and N-acyletransferase (NAEs) catalyzed by N-acyltranferase and NAPE-hydrolyzing phospholipase D, respectively, and cell injury in tissues like brain, heart, and testis. A number...
McKenzie, Lara B; Ahir, Nisha; Stolz, Uwe; Nelson, Nicolas G
The goal was to examine comprehensively the patterns and trends of household cleaning product-related injuries among children treated in US emergency departments. Through use of the National Electronic Injury Surveillance System database, cases of unintentional, nonfatal, household cleaning product-related injuries were selected by using product codes for drain cleaners, ammonia, metal polishes/tarnish removers, turpentine, dishwasher detergents, acids, swimming pool chemicals, oven cleaners, pine oil cleaners/disinfectants, laundry soaps/detergents, toilet bowl products, abrasive cleaners, general-purpose household cleaners, noncosmetic bleaches, windshield wiper fluids, caustic agents, lye, wallpaper cleaners, room deodorizers/fresheners, spot removers, and dishwashing liquids. Products were categorized according to major toxic ingredients, mode of action, and exposure. An estimated 267 269 children
Thambiraj, Dana F; Chounthirath, Thiphalak; Smith, Gary A
The widespread availability of microwave ovens has sparked interest in injuries resulting from their use. Using a retrospective cohort design, the objective of this study is to investigate the epidemiology of microwave oven-related injuries treated in United States emergency departments (EDs) from 1990 through 2010 by analyzing data from the National Electronic Injury Surveillance System. An estimated 155959 (95% confidence interval [CI], 133515-178402) individuals with microwave oven-related injuries were treated in US hospital EDs from 1990 through 2010, which equals an average of 21 individuals per day; 60.7% were female; 63.3% were adults (≥18 years); 98.1% of injury events occurred at home; and 3.9% of patients were hospitalized. During the 21-year study period, the number and rate of microwave oven-related injuries increased significantly by 93.3% and 50.0%, respectively. The most common mechanism of injury was a spill (31.3%), and the most common body region injured was the hand and fingers (32.4%). Patients younger than 18 years were more likely to sustain an injury to their head and neck (relative risk: 1.65; 95% CI, 1.39-1.96) than adults. To our knowledge, this is the first study to investigate microwave oven-related injuries on a national scale. Microwave ovens are an important source of injury in the home in the United States. The large increases in the number and rate of these injuries underscore the need for increased prevention efforts, especially among young children. Copyright © 2013 Elsevier Inc. All rights reserved.
Norup, Anne; Siert, Lars; Lykke Mortensen, Erik
PRIMARY OBJECTIVE: To investigate emotional distress and quality of life in a sample of Danish relatives of patients with severe brain injury at admission to intensive rehabilitation in the sub-acute phase. RESEARCH DESIGN: Clinical convenience sample. METHODS AND PROCEDURES: Participants included...
Klopotowska, Joanna E; Kuiper, Rob; van Kan, Hendrikus J; de Pont, Anne-Cornelie; Dijkgraaf, Marcel G; Lie-A-Huen, Loraine; Vroom, Margreeth B; Smorenburg, Susanne M
Patients admitted to an intensive care unit (ICU) are at high risk for prescribing errors and related adverse drug events (ADEs). An effective intervention to decrease this risk, based on studies conducted mainly in North America, is on-ward participation of a clinical pharmacist in an ICU team. As the Dutch Healthcare System is organized differently and the on-ward role of hospital pharmacists in Dutch ICU teams is not well established, we conducted an intervention study to investigate whether participation of a hospital pharmacist can also be an effective approach in reducing prescribing errors and related patient harm (preventable ADEs) in this specific setting. A prospective study compared a baseline period with an intervention period. During the intervention period, an ICU hospital pharmacist reviewed medication orders for patients admitted to the ICU, noted issues related to prescribing, formulated recommendations and discussed those during patient review meetings with the attending ICU physicians. Prescribing issues were scored as prescribing errors when consensus was reached between the ICU hospital pharmacist and ICU physicians. During the 8.5-month study period, medication orders for 1,173 patients were reviewed. The ICU hospital pharmacist made a total of 659 recommendations. During the intervention period, the rate of consensus between the ICU hospital pharmacist and ICU physicians was 74%. The incidence of prescribing errors during the intervention period was significantly lower than during the baseline period: 62.5 per 1,000 monitored patient-days versus 190.5 per 1,000 monitored patient-days, respectively (P Medication Error Reporting and Prevention severity categories E and F) were reduced from 4.0 per 1,000 monitored patient-days during the baseline period to 1.0 per 1,000 monitored patient-days during the intervention period (P = 0.25). Per monitored patient-day, the intervention itself cost €3, but might have saved €26 to €40 by preventing
Roberts, Kristin J; Nelson, Nicolas G; McKenzie, Lara
Dancing is one of the most physically strenuous activities on the musculoskeletal system. As other literature has previously described, the types, sites, and rates of dance-related injuries are similar to those suffered by athletes in traditional sports. A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System from 1991-2007. Sample weights were used to calculate national estimates of dance-related injuries. Trend significance of the numbers and age-adjusted rates of dance-related injuries over time was analyzed using linear regression. An estimated 113,084 children and adolescents 3-19 years of age were treated in US emergency departments for dance-related injuries. Classical dance (ballet, jazz, tap, modern) accounted for 55.0% of dance-related injuries. Adolescents 15-19 years of age constituted 40.4% of the dance-related injury cases. The majority of injuries (58.1%) occurred to the lower extremities. Sprains or strains were the most common injury (52.4%) and falls were the most common mechanism of injury (44.8%). Dance-related injuries have distinct injury patterns and mechanisms of injury. Injury patterns differ by types of dance and by age. Further research is needed to identify injury prevention strategies specific to these age groups.
Lewis, Stephen P; Santor, Darcy A
Self-harm may have several reasons, and these reasons may have corresponding implied goals. The current study examined reasons for self-harm and whether the a priori goals intended by these reasons were achieved. Fifty-seven individuals with a history of self-harm were recruited online and volunteered their time to complete a series of online questionnaires assessing past self-harm frequency, self-harm reasons, whether the goal associated with these reasons was achieved, and future self-harm intent. Reasons to reduce tension and dissociation associated with more past self-harm, a higher intent to self-harm again, and it was reported that the goals associated with reasons were achieved (i.e., these internal states were extinguished). Achievement of these goals (i.e., reported reductions in tension and dissociation) mediated the relation between corresponding self-harm reasons and intent to self-harm in the future. Findings support the view that self-harm is a maladaptive coping strategy and the reinforcement component of the experiential avoidance model of self-harm. Results have clinical implications and heuristic value for future research, which are discussed.
John Bobbie Roca
Full Text Available Analysis of the annual fireworks-related injury surveillance data collected by the Philippines Department of Health (DOH in 2010–2014 was conducted to describe the profile of such injuries in the Philippines. Surveillance data were collected from DOH’s Online National Electronic Injury Surveillance System and analysed. A case was defined as any person who had sustained injury from fireworks in any form within the 16-day surveillance period (21 December to 5 January and had presented to any of the 50 sentinel hospitals. Of the 4649 cases, there were 4706 fireworks-related injuries involving 5076 anatomic sites in 2010–2014. A significant decrease of cases in 2014 was observed when compared with the previous study years (P = 0.02. The number of cases peaked at public holidays. Males (80% were more commonly injured, and children aged 5 to 14 years were primarily affected (47%. Ignition of illegal fireworks accounted for half (50% of the injuries; most injuries (68% occurred in street settings. The majority of injuries (57% were sustained by fireworks igniters. The most common anatomic injury sites were hands (44%, legs (21% and eyes (14%. Illegal fireworks were related to 100% (4/4 of the deaths and 49% (105/214 of the cases who needed amputations. Fireworks-related injuries declined significantly in 2014. Public awareness campaigns may have contributed to reducing the injury occurrences. As illegal fireworks accounted for all deaths and more than half of the amputations, law enforcement should be directed toward preventing importing, distributing and using illegal fireworks.
S. Polinder (Suzanne); J.A. Haagsma (Juanita); E. Belt (Eefje); R.A. Lyons (Ronan); V. Erasmus (Vicky); J. Lund (Johan); E.F. van Beeck (Ed)
textabstractBackground. It is important to obtain greater insight into health-related quality of life (HRQL) of injury patients in order to document people's pathways to recovery and to quantify the impact of injury on population health over time. We performed a systematic review of studies measurin
competitive as they age, golf is a popular option. Although uncommon, injuries ... the purpose of this study, a golf-related injury was defined as any condition sustained ... and male-to-female golfer distribution were compared with the data for ...
... Vaccine Injury Compensation Program. Notwithstanding the provisions of §§ 4.1, 4.2, and 4.3, service of the Secretary's copies of petitions for compensation under the VICP and of related filings, by mail... Vaccine Injury Compensation Program. 4.6 Section 4.6 Public Welfare DEPARTMENT OF HEALTH AND...
The study assessed the prevalence and predictors of post-traumatic symptomatology and emotional and behavioral difficulties in siblings of children who incurred war-related injuries. It was predicted that injury severity, gender and attributional style would account for a significant amount of the variance in post-traumatic stress symptoms and…
Scaf-Klomp, W.; Sanderman, R.; Ormel, J.; Kempen, G.I J M
Background: objectives of the study were i) to describe changes in depression in independently living people aged 57 or older with fall-related injuries, and ii) to examine the effect of incomplete recovery of physical functions on depression one year post-injury. Method: prospective cohort-study, i
Full Text Available Background and Aims: The harms resulted from home injuries are a major factor in child mortality. The current study aims to evaluate the factors associated with the knowledge and performance level of mothers in terms of adopting preventive behaviors to avoid home injuries. Materials and Methods: The target population of this descriptive - analytical study is all mothers of preschool children suffering from home injuries referring to Imam Hossein and Haft-E-Tir hospitals. Mothers’ data were collected using a valid and reliable questionnaire. After dividing the knowledge level and the status of mothers’ preventive behaviors into two groups, the relationship between factors was assessed by using Chi-square and multivariate logistic regression and the status of mothers preventive behaviors were studied as well. Results: Finally, 230 mothers (mean age 5.2 ± 29.4 were studied. 75.0 of them had good awareness, and 56.0 % also had a good performance. Mother's absence for at least 8 hours per day (0.12 = OR, increase of the number of preschool children (0.03 = OR and employed mother (0.01 = OR are the things that hinder preventive behaviors in home injuries. While the history of home injuries during the past 3 weeks (13.3 = OR, mother’s appropriate awareness of preventive behaviors (28.9 = OR and high-income families (2.4 = OR lead to the adoption of preventive behaviors by mothers. Conclusion: Awareness is the only modifiable factor and it can be improved by educational interventions. Support of assistance and social welfare agencies for employed mothers can improve the current status of preventive behaviors in home injuries. Keywords: Preventive Behaviors, Awareness, Effective Factors
Chaikitmongkol, Voraporn; Leeungurasatien, Thidarat; Sengupta, Sabyasachi
This study was aimed to determine demographics, clinical characteristics, and factors associated with work-related eye injury in Northern Thailand. A prospective case series. Eye injuries from any cause treated at a university-based hospital in Northern Thailand from March 2007 to June 2008 were included. In addition to comprehensive eye examination and standard treatments, patients' occupation, type of activity at the time of injury, alcohol consumption, and eye protection were studied. Eye injuries were classified based on the Birmingham Eye Trauma Terminology System. Demographic and clinical data were documented using a form adapted from the United States Eye Injury Registry. Of the 101 eyes (97 patients) with work-related injury, 94% were men with a mean age of 39.5 ± 12.9 years (range, 19-72 years). Ninety-eight percent (95/97 patients) did not use protective eyewear. Open-globe injuries were found in 58/101 (57%) eyes. Agricultural workers experienced a higher number of open-globe injuries (37/58 eyes, 64%), whereas construction workers experienced a higher number of closed-globe injuries (25/43 eyes, 58%). In multivariable logistic regression models, nailing (odds ratio, 97.2; 95% confidence interval, 2.6-363.4; P = 0.01) and motorized grass trimming (odds ratio, 14.3; 95% confidence interval, 1.0-206.2; P = 0.05) were significantly associated with open-globe injuries when compared with closed-globe injuries. Significantly greater numbers of eyes with open-globe injuries had final vision equivalent to legal blindness (visual acuity, Thailand. Protective eyewear should be aggressively promoted among workers engaged in nailing and motorized grass trimming.
The objective of this study was to determine the prevalence of road traffic crashes (RTC)–related maxillofacial injuries, the concomitant injuries occurring with them, and to assess the relationship between the severity of maxillofacial and concomitant injuries. This was a prospective study involving 201 victims of RTC seen at the Accident and Emergency Department of the University College Hospital, Ibadan with maxillofacial injuries during the study period. Demographic data of the patients, ...
Halstead, Ruth Ogden; Pavkov, Thomas W; Hecker, Lorna L; Seliner, Michelle M
This study tested the relationship between family dynamics and self-injury. A total of 189 participants responded to a web-based survey collecting information related to previous self-injury behaviors and family dynamics. Participants were over 18 years old who had used self-injury (intentionally harming themselves physically to relieve painful emotions without suicidal intent), but who had not used self-injury for over a year. Results indicated that healthy family dynamics were negatively correlated and associated with higher scores of self-injury behaviors. This study offers some evidence that family dynamics influence self-injury behaviors. The implications for family therapy are discussed.
Monea, A.G.; Perre, G. van der; Baeck, K.; Delye, H.H.; Verschueren, P.; Forausebergher, E.; Lierde, C. van; Verpoest, I.; Sloten, J. van der; Goffin, J.; Depreitere, B.
The most frequent head injuries resulting from bicycle accidents include skull fracture acute subdural hematoma (ASDH), cerebral contusions, and diffuse axonal injury (DAI). This review includes epidemiological studies, cadaver experiments, in vivo imaging, image processing techniques, and computer
Qi, R-R; Wang, J-Q; Pan, L-L; Zhou, W; Liu, J-L; Ju, J-T; Cai, Y-L
To investigate the deployment-related medical conditions and shipboard tactical training-related injuries in a Chinese Navy population. A retrospective study with the Chinese Navy was conducted. The medical records of 1543 Navy crewmembers from 2011 to 2015 were collected. The distribution and incidence rate (IR) of different types of medical conditions were provided and compared between the Aden Gulf deployment and nondeployment periods. The occurrence of military training-related injuries in crewmembers receiving 12-week shipboard tactical training was compared with that of 956 marines and 4371 recruits receiving combat and physical training, respectively. The anatomic locations and types of training-related injury were analyzed. Compared with the nondeployment period, the percentages of the following injuries were significantly higher during deployment: injuries and certain other consequences of external causes (16.97% vs 7.76%), diseases of the musculoskeletal system and connective tissue (15.40% vs 10.34%) and mental and behavioral disorders (11.23% vs 3.45%); however, respiratory system diseases had a lower percentage (19.84% vs 28.35%). Far seas deployment significantly increased the IRs of acute upper respiratory infection, skin and eye infection, sprains and low back pain as well as aphthous ulcer, insomnia, and seasickness (P Chinese Navy has experienced novel health issues in crewmembers in recent years. Corresponding countermeasures should be taken to address deployment-related medical conditions and shipboard training-related injuries in the future. Copyright Â© 2016. Published by Elsevier Ltd.
Full Text Available Abstract Introduction Transfusion-related acute lung injury is emerging as a common cause of transfusion-related adverse events. However, awareness about this entity in the medical fraternity is low and it, consequently, remains a very under-reported and often an under-diagnosed complication of transfusion therapy. Case presentation We report a case of a 46-year old woman who developed acute respiratory and hemodynamic instability following a single unit blood transfusion in the postoperative period. Investigation results were non-specific and a diagnosis of transfusion-related acute lung injury was made after excluding other possible causes of acute lung injury. She responded to symptomatic management with ventilatory and vasopressor support and recovered completely over the next 72 hours. Conclusion The diagnosis of transfusion-related acute lung injury relies on excluding other causes of acute pulmonary edema following transfusion, such as sepsis, volume overload, and cardiogenic pulmonary edema. All plasma containing blood products have been implicated in transfusion-related acute lung injury, with the majority being linked to whole blood, packed red blood cells, platelets, and fresh-frozen plasma. The pathogenesis of transfusion-related acute lung injury may be explained by a "two-hit" hypothesis, involving priming of the inflammatory machinery and then activation of this primed mechanism. Treatment is supportive, with prognosis being substantially better than for most other causes of acute lung injury.
rate or disability probability and be related to worker characteristics such as gender . As a result, gender may appear to affect incidence rates and...work following a work- related injury. FECA staff members record a wealth of information in a database when they administer the program. The public ...Understanding the Probability of a Disability Resulting from Work- Related Injuries Nan L. Maxwell, PhD Mathematica Policy Research
AD______________ AWARD NUMBER: W81XWH-14-1-0366 TITLE: Dissecting the Roles of Brain Injury and Combat-Related Stress in Post-Traumatic...Dissecting the Roles of Brain Injury and Combat-Related Stress in Post- Traumatic Headache 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0366 5c...geared to either or both. The goal of this proposal is to determine the respective roles of traumatic brain injury and combat-related stress in
Burger, Nicholas; Lambert, Mike Ian; Viljoen, Wayne; Brown, James Craig; Readhead, Clint; den Hollander, Steve; Hendricks, Sharief
The majority of injuries in rugby union occur during tackle events. The mechanisms and causes of these injuries are well established in senior rugby union. To use information from an injury database and assess video footage of tackle-related injuries in youth rugby union matches to identify environmental factors and mechanisms that are potentially confounding to these injuries. Descriptive epidemiological study. Injury surveillance was conducted at the under-18 Craven Week rugby tournament. Tackle-related injury information was used to identify injury events in match video footage (role-matched noninjury tackle events were identified for the cohort of injured players). Events were coded using match situational variables (precontact, contact, and postcontact). Relative risk ratio (RRR; ratio of probability of an injury or noninjury outcome occurring when a characteristic was observed) was reported by use of logistic regression. In comparison with the first quarter, injury risk was greater in the third (RRR = 9.75 [95% CI, 1.71-55.64]; P = .010) and fourth quarters (RRR = 6.97 [95% CI, 1.09-44.57]; P = .040) for ball carriers and in the fourth quarter (RRR = 9.63 [95% CI, 1.94-47.79]; P = .006) for tacklers. Ball carriers were less likely to be injured when they were aware of impending contact (RRR = 0.14 [95% CI, 0.03-0.66]; P = .012) or when they executed a moderate fend (hand-off) (RRR = 0.22 [95% CI, 0.06-0.84]; P = .026). Tacklers were less likely to be injured when performing shoulder tackles (same side as leading leg) in comparison to an arm-only tackle (RRR = 0.02 [95% CI, 0.001-0.79]; P = .037). Ball carriers (RRR = 0.09 [95% CI, 0.01-0.89]; P = .040) and tacklers (RRR = 0.02 [95% CI, 0.001-0.32]; P =.006) were less likely to be injured when initial contact was made with the tackler's shoulder/arm instead of his head/neck. The relative risk of tackle-related injury was higher toward the end of matches. Incorrect technique may contribute to increased injury
Smith, Caroline K; Williams, Jena
The trucking industry continues to have some of the highest work-related injury and illness rates and costs of any industry in the United States. Until recently, little focus has been placed on addressing non-motor vehicle collision related injuries within the trucking industry. Drivers are exposed to multiple physical risk factors that contribute to occupational injuries in order to complete their job duties, such as loading/unloading freight, decoupling trailers, strapping down loads and ingress and egress from the cab and trailer. About one-fourth of all truck driver injuries in the United States are related to slips, trips, and falls near the truck. The purpose of this descriptive study is to report on recent injuries in the trucking industry in Washington State. Data are presented by occupation and industry sector, in order to better understand the magnitude of specific injuries in terms of time-loss days and workers' compensation costs. All accepted, compensable (time-loss) claims from 2005 to 2010 within the trucking industry in Washington State were reviewed. Counts, rates, median and quartile data are presented. Logistic regression models are presented to identify factors associated with more severe claims. Non-traumatic musculoskeletal disorders of the neck, back and upper extremities are the most frequent injuries across all industry sectors and occupations in the trucking industry. Vehicle related claims had the highest median costs and time loss days and Courier and Messenger claims had the highest risk for higher time loss claims. Injuries varied substantially by sector and within sectors by occupation. It is important to review work-related injuries within the trucking industry by sector and occupation in order to maximize limited resources for injury prevention within this important sector. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Stathokostas, Liza; Theou, Olga; Little, Robert M D; Vandervoort, A A; Raina, Parminder
The purpose of this project is to conduct a comprehensive and systematic scoping review to identify and document the breadth of literature related to physical activity-related injuries in older adults. The population of interest was adults (both males and females) over the age of 65 years, participating in exercise, leisure-time, or sport-type physical activities. The initial search yielded 16,828 articles, with 43 articles ultimately included. The final 43 articles utilized the following study designs: three experimental (two randomized control and one non-randomized control), 14 prospective studies, and 26 retrospective. The results of this scoping review would suggest that it may be premature to provide definitive incidence rates, causes, and correlates of physical activity-related injuries in older adults. However, the current literature does not suggest that older adults are at an increased risk of injury from participation in physical activities. Future research should utilize a consistent definition of 'injury' and consistent and comprehensive descriptors of injuries--including intensity level of engagement of activity and burden/severity of injury. In addition, injury rates in specific populations are needed, particularly for the oldest-old, for those in assisted-living situations, and for subgroups with clinical conditions. Finally, greater surveillance and documentation of older adult initiatives and interventions are needed in order to identify programs successful in reducing the injury rates of their target populations.
Friedman, David E.; Chiang, Sharon; Tobias, Ronnie S.
Seizure-related head injuries (SRHIs) are among the most commonly encountered injuries in people with epilepsy (PWE). Whether head injury has an effect on preexisting epilepsy is not known. The purpose of this study was to systematically assess for any possible effects of SRHIs on seizure frequency and seizure semiology over a 2-year period. We identified 204 patients who have been followed at the Baylor Comprehensive Epilepsy Center from 2008 to 2010. SRHI occurred in 18.1% of the cohort. Most injuries (91%) were classified as mild. Though seizure frequency varied following head injury, overall seizure frequency was not significantly impacted by presence or absence of SRHI over the 2-year study period. Changes in seizure semiology were not observed in those with SRHIs. Although mild SRHI is common among PWE, it does not appear to have an effect on seizure characteristics over a relatively short period. PMID:22227592
Gramling, Joshua J; McGovern, Patricia M; Church, Timothy R; Nachreiner, Nancy M; Gaugler, Joseph E
Health care workers suffer higher rates of violence-related injuries than workers in other industries, with hospital security officers and ED personnel at particularly high risk for injury. Arming hospital security workers with conducted electrical weapons, such as tasers, has been suggested as an intervention to decrease violence-related injuries in the hospital. A retrospective cohort of all security and ED nursing staff at an urban level 1 trauma center was identified from human resources data for the period 4 years before and 7 years after security workers were armed with conducted electrical weapons. A violence-related rate of injury was calculated as all violence-related injuries incurred by each employee for the numerator and the productive hours worked by each person during the study period as the denominator. The hospital employed approximately 30 security staff and 200 nursing staff at the time, with a total of 98 security officers and 468 nursing staff members over the 11 years of study. During the total nursing study period, 98 security officers contributed 452,901 hours; 265 registered nurses from the emergency department contributed 1,535,044 hours; and 203 health care assistants contributed 624,805 hours. Security officers' violence-related rate of injury was 13 times higher than that of the nursing staff. The risk ratio was 1.0 (95% confidence interval [CI] 0.7-1.4) between the 2 examination periods for security officers, with similar results for nurses. However, among security workers, the cost of the injuries decreased in the period after implementation. Carrying conducted electrical weapons by hospital security staff appears to have limited capacity to decrease overall rates of violence-related injury but may decrease the severity of violence-related injuries. The latter could decease costs to health care organizations as well as morbidity of injured staff. Contribution to Emergency Nursing Practice. Copyright © 2017 Elsevier Inc. All rights
Johansson, Mats Peter; Baann Liane, Martin Skogheim; Bendix, Tom
, and with the prognosis one year following a whiplash injury. MRI was performed in 171 subjects about 10 d after the accident, and 104 participated in the pain recording at 1-year follow-up. It was demonstrated that postures as seen on MRI can be reliably categorized and that a straight spine is the most frequent...... is not significantly associated with chronic whiplash associated pain. Moreover, it is a clear clinical implication that pain should not be ascribed to a straight spine on MRI. We suggest that future trials on cervical posture focus upon the presence of kyphotic deformity rather than just on the absence of lordosis.......The mechanisms for developing long-lasting neck pain after whiplash injuries are still largely unrevealed. In the present study it was investigated whether a kyphotic deformity of the cervical spine, as opposed to a straight or a lordotic spine, was associated with the symptoms at baseline...
O'Dell, M Cody; Jaramillo, Diego; Bancroft, Laura; Varich, Laura; Logsdon, Gregory; Servaes, Sabah
With increasing participation and intensity of training in youth sports in the United States, the incidence of sports-related injuries is increasing, and the types of injuries are shifting. In this article, the authors review sports injuries of the lower extremity, including both acute and overuse injuries, that are common in or specific to the pediatric population. Common traumatic injuries that occur in individuals of all ages (eg, tears of the acetabular labrum and anterior cruciate ligament) are not addressed, although these occur routinely in pediatric sports. However, some injuries that occur almost exclusively in high-level athletes (eg, athletic pubalgia) are reviewed to increase awareness and understanding of these entities among pediatric radiologists who may not be familiar with them and thus may not look for them. Injuries are described according to their location (ie, hip, knee, or foot and ankle) and pathologic process (eg, apophysitis, osteochondritis dissecans). Examples of abnormalities and normal variants of the anatomy that are often misdiagnosed are provided. The injuries reviewed represent a common and growing subset of pathologic processes about which all pediatric and musculoskeletal radiologists should be knowledgeable. Understanding physeal injury is especially important because missed diagnoses can lead to premature physeal closure and osteoarthritis. (©)RSNA, 2016.
Full Text Available The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise. In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions. Acutely, repetitive breath-hold diving may result in increased transpulmonary capillary pressure, leading to noncardiogenic oedema and/or alveolar haemorrhage. Furthermore, during a breath-hold dive, the chest and lungs are compressed by the increasing pressure of water. Rapid changes in lung air volume during descent or ascent can result in a lung injury known as pulmonary barotrauma. Factors that may influence individual susceptibility to breath-hold diving-induced lung injury range from underlying pulmonary or cardiac dysfunction to genetic predisposition. According to the available data, breath-holding does not result in chronic lung injury. However, studies of large populations of breath-hold divers are necessary to firmly exclude long-term lung damage.
Mijacika, Tanja; Dujic, Zeljko
The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise.In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions. Acutely, repetitive breath-hold diving may result in increased transpulmonary capillary pressure, leading to noncardiogenic oedema and/or alveolar haemorrhage. Furthermore, during a breath-hold dive, the chest and lungs are compressed by the increasing pressure of water. Rapid changes in lung air volume during descent or ascent can result in a lung injury known as pulmonary barotrauma. Factors that may influence individual susceptibility to breath-hold diving-induced lung injury range from underlying pulmonary or cardiac dysfunction to genetic predisposition.According to the available data, breath-holding does not result in chronic lung injury. However, studies of large populations of breath-hold divers are necessary to firmly exclude long-term lung damage.
Eversman, Michael H.
Professional social work largely has endorsed the empirically supported paradigm of harm reduction in relation to substance abuse issues. Despite literature detailing similarities between social work and harm reduction, little is known about its presence in MSW substance abuse coursework. A purposive sample of 133 social work faculty from…
Self-harm is a public health issue that accounts for thousands of presentations at hospital each year. Self-harm commonly involves self-injury by cutting, burning or poisoning. The incidence of self-harm is increasing in the UK, particularly in young people. Research suggests that people who self-harm experience negative attitudes from healthcare staff, including nurses, on presentation to healthcare services. This is an ethical issue in nursing practice that has implications for the quality of care provided. Nurses with a lack of mental health training provide care for patients who self-harm in emergency departments and acute medical settings. This article presents a literature review exploring the factors affecting nurses' attitudes towards patients hospitalised for self-harm and makes recommendations for improving practice. The article identifies requirements for nurse education and training in mental health and effective provision of care for patients who self-harm and present at the emergency department.
Mathias Ogbonna Nnanna Nnadi
Full Text Available Summary. With increasing use of motorcycle as means of transport in developing countries, traumatic brain injuries from motorcycle crashes have been increasing. The only single gadget that protects riders from traumatic brain injury is crash helmet. Objective. The objectives were to determine the treatment outcome among traumatic brain injury patients from motorcycle crashes and the rate of helmet use among them. Methods. It was a prospective, cross-sectional study of motorcycle-related traumatic brain injury patients managed in our center from 2010 to 2014. Patients were managed using our unit protocol for traumatic brain injuries. Data for the study were collected in accident and emergency, intensive care unit, wards, and outpatient clinic. The data were analyzed using Environmental Performance Index (EPI info 7 software. Results. Ninety-six patients were studied. There were 87 males. Drivers were 65. Only one patient wore helmet. Majority of them were between 20 and 40 years. Fifty-three patients had mild head injuries. Favorable outcome among them was 84.35% while mortality was 12.5%. Severity of the injury affected the outcome significantly. Conclusion. Our study showed that the helmet use by motorcycle riders was close to zero despite the existing laws making its use compulsory in Nigeria. The outcome was related to severity of injuries.
Backer, Lorraine C.; Manassaram-Baptiste, Deana; LePrell, Rebecca; Bolton, Birgit
Algae and cyanobacteria are present in all aquatic environments. We do not have a good sense of the extent of human and animal exposures to cyanobacteria or their toxins, nor do we understand the public health impacts from acute exposures associated with recreational activities or chronic exposures associated with drinking water. We describe the Harmful Algal Bloom-related Illness Surveillance System (HABISS) and summarize the collected reports describing bloom events and associated adverse human and animal health events. For the period of 2007–2011, Departments of Health and/or Environment from 11 states funded by the National Center for Environmental Health (NCEH), Centers for Disease Control and Prevention contributed reports for 4534 events. For 2007, states contributed 173 reports from historical data. The states participating in the HABISS program built response capacity through targeted public outreach and prevention activities, including supporting routine cyanobacteria monitoring for public recreation waters. During 2007–2010, states used monitoring data to support196 public health advisories or beach closures. The information recorded in HABISS and the application of these data to develop a wide range of public health prevention and response activities indicate that cyanobacteria and algae blooms are an environmental public health issue that needs continuing attention. PMID:25826054
Dec 2, 2013 ... Risk factors for liver injury should be evaluated ... Weight (Kg) using a Salter weighing scale and height (Cms) ... ascertain other risk factors which affect ART related ..... associated with an increased propensity to develop.
Kerr, Zachary Y; Rodriguez, Daniel A; Evenson, Kelly R; Aytur, Semra A
work must determine how the extent of implementation and quality of safety-related content within these plans affects changes in nonfatal and fatal injury rates. Copyright © 2012 Elsevier Ltd. All rights reserved.
Jørgensen, T S H; Hansen, A H; Sahlberg, Marie Irene Elisabeth
-related major injuries. METHODS: Using administrative databases, patients aged 65+ years with in-hospital falls causing fractures or head injuries with need for surgery or intensive observation were identified as cases and were individually matched with five controls. Joinpoint regression was used to examine.......01-1.39) and Parkinson disease (OR = 1.17, CI: 1.01-1.34). CONCLUSIONS: In-hospital falls-related major injuries increased significantly during the study period. Elderly with dementia, osteoporosis, stroke, depression, chronic obstructive pulmonary disease and Parkinson disease were associated with increased OR for in...
Polster, Joshua M.; Ilaslan, Hakan; Subhas, Naveen [Cleveland Clinic, Imaging Institute, Cleveland, OH (United States); Lynch, T.S. [Columbia University Medical Center, Center for Shoulder, Elbow and Sports Medicine, New York, NY (United States); Bullen, Jennifer A. [Cleveland Clinic, Quantitative Health Sciences, Cleveland, OH (United States); Soloff, Lonnie [Cleveland Indians, Cleveland, OH (United States); Schickendantz, Mark S. [Cleveland Clinic, Orthopedic and Rheumatologic Institute, Cleveland, OH (United States)
To describe the MR appearance of a series of throwing-related injuries to the subscapularis muscle-tendon complex among baseball players. A retrospective review of MR scans of the shoulder in players from 1 professional baseball organization over the course of 5 years was performed to identify cases with findings suggestive of subscapularis injury. These findings were graded and the medical record was reviewed to assess clinical findings, treatment, and follow-up. Preinjury baseline measurements of arm external rotation at 90 of abduction were compared to measurements from a noninjured cohort to evaluate whether this measure is a risk factor for injury. A total of 133 MR scans of the shoulder were evaluated. Eleven of the scans demonstrated signal changes suggesting subscapularis injury; 10 of these 11 patients had clinical findings supporting a diagnosis of throwing-related subscapularis strain. There were four grade 1, four grade 2, and two grade 3 injuries. All injuries occurred in the inferior half of the subscapularis at the myotendinous junction. Risk of subscapularis injury increased with lower levels of dominant arm external rotation (odds ratio, 1.12; 95 % CI, 1.07-1.21; p < 0.001). A threshold of dominant arm external rotation of <106 demonstrated sensitivity of 0.700 (95 % CI, 0.392-0.897) and specificity of 0.951 (95 % CI, 0.888-0.982) for subscapularis injury. Throwing-related subscapularis injuries occur in the inferior half of the muscle at the myotendinous junction. Our data suggest that there is an increased risk of these injuries with lower levels of dominant arm external rotation. (orig.)
Full Text Available INTRODUCTION The work of fishermen is considered one of the most dangerous and life-threatening professions all over the world.4 Many fishermen around the world suffer from fatal injuries every year due to harsh and dangerous environments. Hence, there is a need to know the pattern of injury and accordingly design preventive measures against work related injuries among the fishermen. OBJECTIVES To estimate the prevalence and pattern of work related injuries among Fishermen. To study the usage of PPE’s (Personal protective equipment’s among the Fishermen. METHODOLOGY A cross sectional study was conducted among 133 Fishermen in Four rural field practice areas of K. S. Hegde Medical Academy from July – September 2015. The sample size was arrived using prevalence of previous study. The data was analyzed using SPSS version 16 software. RESULTS Among 133 study subjects 125 were males and 8 were females. The mean age of the study subjects was 44 years. Majority (75.1% of them had their education up to primary level. Around 92.2% of the fishermen experienced some or other type of injury in their life time. Majority of the injuries were due to cuts. Majority (85.5% of the injuries were minor and 14.5% were severe. In the past 6 months 41% of the fishermen experienced injury mostly due to cuts and muscle strain. Most (58% of the injuries occurred in the sea. Only 11.7% were using PPEs, 64.7% of them had insurance and 27.1% of them utilized the facility of insurance. CONCLUSIONS Work related injuries among fishermen were high in and use of PPEs were low among the study subjects.
Variance in the Efficacy of Brief Interventions to Reduce Hazardous and Harmful Alcohol Consumption Between Injury and Noninjury Patients in Emergency Departments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Elzerbi, Catherine; Donoghue, Kim; Boniface, Sadie; Drummond, Colin
We adopt a comparative framework to measure the extent to which variance in the efficacy of alcohol brief interventions to reduce hazardous and harmful drinking at less than or equal to 5-, 6-, and 12-month follow-up in emergency department settings can be determined by differences between study populations (targeted injury and noninjury specific). A systematic review and meta-analysis of randomized controlled trials published before September 2016 was undertaken. Twenty-three high-quality and methodologically similar randomized controlled trials were eligible, with a total number of 15,173 participants included. Primary outcome measure was efficacy of brief intervention compared with a control group in reducing quantity of alcohol consumed. An inverse variance model was applied to measure the effect of treatment in standard mean differences for brief intervention and control groups. At 6-month follow-up, an effect in favor of brief intervention over control was identified for targeted injury studies (standardized mean difference=-0.10; 95% confidence interval [CI] -0.17 to -0.02; I(2)=0%). For pooled noninjury-specific studies, small benefits of brief intervention were evident at less than or equal to 5-month follow-up (standardized mean difference=-0.15; 95% CI -0.24 to -0.07; I(2)=0%), at 6-month follow-up (standardized mean difference=-0.08; 95% CI -0.14 to -0.01; I(2)=1%), and at 12-month follow-up (standardized mean difference=-0.08; 95% CI -0.15 to -0.01; I(2)=0%). Meta-analysis identified noninjury-specific studies as associated with better response to brief intervention than targeted injury studies. However, the inclusion of injured patients with noninjured ones in the experimental and control groups of noninjury-specific studies limited the interpretation of this finding. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
Ward, PR; Wong, MD; Moore, R.; Naeim, A
Background: Fall-related injuries are a well-described cause of morbidity and mortality in the community-dwelling elderly population, but have not been well described in patients with cancer. Cancer treatment with chemotherapy can result in many unwanted side effects, including peripheral neuropathy if the drugs are potentially neurotoxic. Peripheral neuropathy and other side effects of chemotherapy may lead to an increased risk of fall-related injuries. Methods: We conducted a retrospective ...
Lachance, Chantelle C; Jurkowski, Michal P.; Dymarz, Ania C.; Mackey, Dawn C.
Introduction Fall-related injuries can have serious consequences for older adults, including increased risk of dependence in daily activities and mortality. Compliant flooring is a passive intervention that may reduce the incidence and severity of fall-related injuries in healthcare settings, including acute and long-term care, but few sites have implemented compliant flooring, in part because synthesised evidence about key performance aspects has not been available. Methods and analysis We w...
Full Text Available Abstract Background Injuries are noted to be an important cause of death among adolescents. There is however limited data on the injury related deaths among adolescents in Ghana. Findings Using data from post-mortem records derived from the Department of Pathology of the Korle-Bu Teaching Hospital (KBTH, Accra Ghana from 2001 to 2003, the causes of injury related deaths among adolescents 10 to 19 years were analyzed by gender and age groups 10 to 14 and 15 to 19 years. There were 151 injury-related deaths constituting 17% of the autopsies performed among adolescents in the study period. The male-to-female ratio was 2.1:1. Drowning was the most common cause of death (37% in the study population. This was followed by road traffic accidents (RTA (33%. Over 70% of the RTA victims were pedestrians knocked downed by a vehicle. Deaths from electrocution, poisoning, burns, stab/gunshot, hanging and other miscellaneous causes (example blast injury, traumatic injury from falling debris, fall from height made up the remaining 30% of the injury related mortality. Among males and in both age categories, drowning was the leading cause of death. In females, the highest mortality was from road traffic accidents accounting for almost half (49% of the deaths; significantly more than that occurring in males (25%, p = .004. Conclusions Findings from Korle-Bu Teaching Hospital post-mortem data on adolescents show that drowning and road traffic accidents are the leading causes of injury-related mortality. Appropriate injury reducing interventions are needed to facilitate a decrease in these preventable deaths.
Full Text Available Objective: Animal-related injuries are major issues of public health in all over the world and in our country as well. These animal-related injuries may result in serious complications like infections. In our study we aimed to investigate the sociodemographic characteristics, the features of contact related to animal bites or exposure to rabies risk, prophylactic treatment strategies and appropriateness of post-exposure prophylaxis in patients with animal-related injuries. Method: This study was retrospectively designed by collecting data of the patients with animal related and bite wound injuries admitted to the emergency department of Ankara Training and Research Hospital during the years of 2010 and 2011. The data was analysed by using SPSS 11.5 software programme. Results: The study was consisted of 7423 patients. Animal related injuries were mostly seen in male patients (66.4% and the mean age of the patients was 31±18. These injuries were mostly during spring and summer. In 80.8% of the patients the injuries were due to animal bites. Of the 7423 patients; 69.8% were injured by dogs, 27.5% by cats and 0.2% by wild animals. The location of the bite wounds were in the upper extremities in 51.6%, lower extremities in 39.7%, head and neck in 4.6%, chest in 2.4% and back in 1.7% of the patients. Lacerations were the most common type of injury. Of the patients 43.6% received 2+1+1 rabies vaccination schedule, 7.1% received 2+1+1 rabies vaccination schedule and immunoglobulin, 12.9% received 5 dosage vaccination schedule. Of the patients 34.4% followed up for 10 days without any rabies prophylaxis. Conclusions: According to the results of our study; most of the animal related injuries are caused by dogs. Dogs mostly cause bite injuries whereas cats cause scatch injuries. Wounds are located generally in the extremities. Head and neck injuries are more common in pediatric group compared with other age groups. Rabies prophylaxis application
Full Text Available Objectives: To describe the epidemiology of head injuries sustained due to bicycle accidents in India. Materials and Methods: Data were retrospectively collected over a period of six months (15 May 2011 to 15 November 2011. Demography of patients, Glasgow coma scale (GCS, clinical and imaging findings, and mortality and outcome using Glasgow outcome scale (GOS, Rivermead post-concussion symptom questionnaire (RPCSQ and Rivermead head injury follow-up questionnaire (RHFUQ, were analyzed. Outcome was assessed by telephonic interview. Results: There were 108 patients (100 males with mean age of 27.7 years. Seventy-four (68.5% were from rural areas. Accidents due to vehicular collision accounted for 60 (55.6% cases. None wore a helmet. The admission GCS was 14-15 in 68.5% cases, 13-3 in 31.5%. The risk of moderate to severe injuries was increased among working laborers (OR = 5, and patients with loss of consciousness (OR = 4. Sixty-three (49% patients had abnormal computed tomography (CT findings; most common finding was skull fracture 25 (23.1%. Four patients needed surgery. The GOS assessment at three to six months revealed favorable outcome in 66 patients (61.1% and death in 8 (7.4%. The common post-concussion symptoms were headache, fatigue, and poor concentration. Conclusion: The majority of hospitalized cyclists were from a rural background and of the lower income group. After three months the majority of patients had good recovery with few persistent concussion symptoms.
Wang, Pin-Chieh; Delp, Linda
Taxi drivers work long hours for low wages and report hypertension, weight gain, and musculoskeletal pain associated with the sedentary nature of their job, stressful working conditions, and poor dietary habits. They also experience a high work-related fatality rate. The objective of this study is to examine the association of taxi drivers' health status and level of job stress with work-related injury and determine if a potential interaction exists. A survey of 309 Los Angeles taxi drivers provides basic data on health status, job stress, and work-related injuries. We further analyzed the data using a Modified Poisson regression approach with a robust error variance to estimate the relative risk (RR) and the 95% confidence intervals (CI) of work-related injuries. Focus group results supplemented and helped interpret the quantitative data. The joint effect of good health and low job stress was associated with a large reduction in the incidence of injuries, consistent with the hypothesis that health status and stress levels modify each other on the risk of work-related injury. These results suggest that the combination of stress reduction and health management programs together with changes in the stressful conditions of the job may provide targeted avenues to prevent injuries.
Vollman, David; Witsaman, Rachel; Comstock, R Dawn; Smith, Gary A
The objective of this study is to describe the epidemiology of playground equipment-related injuries. This is a retrospective analysis of data for children 18 years old and younger from the National Electronic Injury Surveillance System of the United States Consumer Product Safety Commission for 1996 through 2005. There were an estimated 2,136,800 playground equipment-related injuries to children 18 years and younger treated in hospital emergency departments in the United States during the 10-year period. The leading mechanism of injury was falls (75.1%), followed by impact/striking (10.5%), cutting/ pinching/crushing (7.7%), entrapment/ entanglement (1.4%), trip/slip (1.1%), and other/ unknown (4.1%). The leading type of injury sustained by patients was a fracture (35.4%), followed by contusion/ abrasion (19.6%) and laceration (19.6%). The consistency of the large annual number of playground equipment-related injuries to children is evidence that more needs to be done to prevent these injuries. More research should be conducted to develop and implement arm fracture-specific criteria for surface performance.
Srabstein, Jorge Carlos
Bullying is a multifaceted and injurious form of maltreatment, prevalent across social settings and around the globe. Victims and perpetrators of bullying are at significant risk of suffering from an array of morbidity and dying young due to accidental injuries, suicide, and homicide. This study reviews news reports of nonfatal and fatal injuries linked to bullying throughout the Western Hemisphere during 12 months. News reports, obtained through a Google search, of episodes of fatal and nonfatal injuries related to school bullying and violence from July 2011 through June 2012 that affected children and adolescents (ages 5 to 19 years) throughout the Americas were analyzed. News reports were found of 82 cases of bullying-related fatal and nonfatal injuries, occurring in one year, across 24 countries and dependent territories in the Western Hemisphere, which have a combined total youth population of 225.5 million children and adolescents ages 5 to 19 years. Ninety-seven percent of the victims were between 10 and 19 years old; 60% of them were below age 15, with a male/female ratio of 2:1. News reports of fatal and nonfatal injurious events related to bullying and affecting children and adolescents in the Americas in one year represent the tip of the public health iceberg composing the unknown magnitude of injuries associated with this type of maltreatment. Data on the magnitude of mortality linked to bullying, which would be of the essence in developing public health policies for its prevention, have not been documented.
Bhat, S.R.; PrabhaDevi; DeSouza, L.; Verlecar, X.N.; Naik, C.G.
as harmful algal bloom. Bloom formation is a natural process and it enhances biological productivity, but turns worrisome when caused by toxic species, leading to massive fish mortalities and hazards to human health. Incidences of'red tide' are increasing...
Su, Pu-Yu; Hao, Jia-Hu; Huang, Zhao-Hui; Tao, Fang-Biao
To investigate the episodes and influencing factors on self-harm and to explore the relationship between self-harm episodes and suicidal psychology and behaviors in college students. Four universities were selected using cluster sampling method in Anqing city and Chaohu city. Totally, 2713 college students completed this survey. Data were analyzed by Pearson Chi-square and logistic regression. In the last six months, rates of highly lethal self-harm, less lethal self-harm with visible tissue damage, self-injury without visible tissue damage, self-harmful behaviors with latency damage, other self-harmful behaviors with menticide were 1.9%, 5.5%, 15.3%, 21.2% and 17.0% respectively. The total rate of self-harm was 31.3%. 73.1% of the students with self harmful experiences had the above mentioned behaviors more than 3 times in the last six months. The top 3 reasons for taking self-harm actions were: having learning problems (43.1%), failed love affairs (25.0%) and having conflicts with others (23.9%). There were different influencing factors among different kinds of self-harm episodes. Depression was the risk factor of self-harm. The higher score of having high self-esteem was the protective factor of all kinds of self-harm actions except highly lethal ones. Higher score of difficulties in identifying feelings was one of the risk factors. The rates of suicidal psychology and behaviors in students with self-harm were significantly higher than those in students without those behaviors. Result from linear χ(2) test indicated that the graveness of tissue damage of self-harm was higher along with the rates of suicidal psychology and behaviors (P students, about 1/3 adolescents having experienced self-harm in the last 6 months, many with repeated ones. Depression and difficulties in identifying feelings were the two risk factors while self-esteem was the protective factor related to most of the self-harm cases.
Dukes, Richard L; Stein, Judith A; Zane, Jazmin I
Using structural equation modeling, concurrent associations were assessed among physical bullying, relational bullying, physical victimization, relational victimization, injury and weapon carrying using data from the population of 1300 adolescent girls and 1362 adolescent boys in grades 7-12 in a Colorado school district. For both genders, being a relational bully was a significantly stronger predictor of weapon carrying than being a physical bully, and both bullying types were significant predictors of more weapon carrying. For both genders, being a victim of physical bullying, a victim of relational bullying, or being a relational bully significantly predicted more injury. In latent means comparisons, adolescent girls reported more relational victimization and adolescent boys reported more physical bullying and victimization, more weapon carrying, and more injury. The relative strength of relational bullying on weapon carrying, and the health-related consequences of bullying on interpersonal violence and injury support concerted efforts in schools to mitigate these behaviors. Attention to differences related to age and gender also is indicated in the design of bullying mitigation programs.
Potter, Jennifer L; Wade, Shari L; Walz, Nicolay C; Cassedy, Amy; Stevens, M Hank; Yeates, Keith O; Taylor, H Gerry
The goal of this study was to examine how parenting style (authoritarian, authoritative, permissive) and family functioning are related to behavioral aspects of executive function following traumatic brain injury (TBI) in young children. Participants included 75 children with TBI and 97 children with orthopedic injuries (OI), ages 3-7 years at injury. Pre-injury parenting behavior and family functioning were assessed shortly after injury, and postinjury executive functions were assessed using the Behavior Rating Inventory of Executive Functioning (BRIEF; Gioia & Isquith, 2004) at 6, 12, and 18 months postinjury. Mixed model analyses, using pre-injury executive functioning (assessed by the BRIEF at baseline) as a covariate, examined the relationship of parenting style and family characteristics to executive functioning in children with moderate and severe TBI compared to OI. Among children with moderate TBI, higher levels of authoritarian parenting were associated with greater executive difficulties at 12 and 18 months following injury. Permissive and authoritative parenting styles were not significantly associated with postinjury executive skills. Finally, fewer family resources predicted more executive deficits across all of the groups, regardless of injury type. These findings provide additional evidence regarding the role of the social and familial environment in emerging behavior problems following childhood TBI.
Fagan, Kathleen M; Hodgson, Michael J
A 2009 Government Accounting Office (GAO) report, along with numerous published studies, documented that many workplace injuries are not recorded on employers' recordkeeping logs required by the Occupational Safety and Health Administration (OSHA) and consequently are under-reported to the Bureau of Labor Statistics (BLS), resulting in a substantial undercount of occupational injuries in the United States. OSHA conducted a Recordkeeping National Emphasis Program (NEP) from 2009 to 2012 to identify the extent and causes of unrecorded and incorrectly recorded occupational injuries and illnesses. OSHA found recordkeeping violations in close to half of all facilities inspected. Employee interviews identified workers' fear of reprisal and employer disciplinary programs as the most important causes of under-reporting. Subsequent inspections in the poultry industry identified employer medical management policies that fostered both under-reporting and under-recording of workplace injuries and illnesses. OSHA corroborated previous research findings and identified onsite medical units as a potential new cause of both under-reporting and under-recording. Research is needed to better characterize and eliminate obstacles to the compilation of accurate occupational injury and illness data. Occupational health professionals who work with high hazard industries where low injury rates are being recorded may wish to scrutinize recordkeeping practices carefully. This work suggests that, although many high-risk establishments manage recordkeeping with integrity, the lower the reported injury rate, the greater the likelihood of under-recording and under-reporting of work-related injuries and illnesses. Published by Elsevier Ltd.
Full Text Available Objective To investigate the epidemiological characters of ocular injuries related to military training and operations in Chinese army.Methods The data of servicemen with ocular injuries,hospitalized in 11 military evacuation hospitals from 2005-01-01 to 2009-12-31,were entered into a registration table.The data included the time and place when the injury happened,type and cause of injury,examination records,treatment,rehabilitation level,etc.All data were input into the database for statistical analysis.Results Of all the cases of ocular injuries,189(45.5% were related to military training and operations.The mean age of the 189 cases was 23.4±5.4 years,all of them were men,and soldiers accounted for 91.0% and officers accounted for 9.0%.The incidence declined in 2006 compared with that in 2005,and then rose gradually thereafter year by year.Eight patients(4.2% were complicated with bodily injuries,and 4.2% of patients had the history of eye surgery or eye disease before the ocular injury.Of the 189 cases,in 172(91.0% one eye was injured while in 17(9.0% both eyes were injured.After injury,in 35.0% of patients sight restoration to grade 1,in 20.6% to grade 2,in 13.6% to grade 3,in 25.7% to grade 4,and in 4.4% to grade 5.In 87.3% of patients injuries were due to mechanical forces and in 12.7% ocular injuries were not mechanical.Most patients with eye injury occurring in military training and operations were sent to evacuation hospital and treated timely,and good results were obtained.Conclusions Military training and operations related ocular injury is a prevalent ocular injury occurring in Chinese armed forces,and should be paid more attention in prevention.One important measure is to improve the prevention awareness of Chinese servicemen,and a detailed prevention measures should be further studied.
Buist, Ida; Bredeweg, Steef W.; Lemmink, Koen A. P. M.; van Mechelen, Willem; Diercks, Ron L.
Background: The popularity of running is still growing. As participation increases, running-related injuries also increase. Until now, little is known about the predictors for injuries in novice runners. Hypothesis: Predictors for running-related injuries (RRIs) will differ between male and female n
Won, Jong-Uk; Seok, Hongdeok; Rhie, Jeongbae; Yoon, Jin-Ha
We examined associations between hospital quality in the workers' compensation system and injured patients' return to work after controlling for injury severity, occupational factors, and demographic factors. Return to work data of injured workers were constructed from 2 datasets: 23,392 patients injured in 2009-2011 from the Korea Workers' Compensation & Welfare Service and return to work data from Korea Employment Information Services. After de-identifying the data, quality scores were matched for each hospital that cared for injured patients. Injury severity was measured by Abbreviated Injury Scales. Relative risk and 95% confidence interval were calculated using log binomial regression models. After adjusting for age, sex, injury severity, occupation, factory size, city, and hospital type, the relative risk (95% confidence interval) for the total score was 1.04 (1.02-1.06), 1.06 (1.04-1.09), and 1.07 (1.05-1.10) in the 2(nd), 3(rd), and 4(th) quartiles, respectively, compared to the 1(st) quartile. The RR (95% CI) in the 2(nd), 3(rd), and 4(th) quartiles was 1.05 (1.02-1.07), 1.05 (1.02-1.08), and 1.06 (1.04-1.09) for the process score; and 1.02 (1.01-1.04), 1.05 (1.03-1.07), and 1.06 (1.04-1.09) for the outcome score compared to the 1(st) quartile score, respectively. In conclusion, our study design with blinded merge methods shows that total, process, and outcome qualities are related to the return to work of injured workers after controlling for other factors.
We examined associations between hospital quality in the workers’ compensation system and injured patients’ return to work after controlling for injury severity, occupational factors, and demographic factors. Return to work data of injured workers were constructed from 2 datasets: 23,392 patients injured in 2009–2011 from the Korea Workers’ Compensation & Welfare Service and return to work data from Korea Employment Information Services. After de-identifying the data, quality scores were matched for each hospital that cared for injured patients. Injury severity was measured by Abbreviated Injury Scales. Relative risk and 95% confidence interval were calculated using log binomial regression models. After adjusting for age, sex, injury severity, occupation, factory size, city, and hospital type, the relative risk (95% confidence interval) for the total score was 1.04 (1.02–1.06), 1.06 (1.04–1.09), and 1.07 (1.05–1.10) in the 2nd, 3rd, and 4th quartiles, respectively, compared to the 1st quartile. The RR (95% CI) in the 2nd, 3rd, and 4th quartiles was 1.05 (1.02–1.07), 1.05 (1.02–1.08), and 1.06 (1.04–1.09) for the process score; and 1.02 (1.01–1.04), 1.05 (1.03–1.07), and 1.06 (1.04–1.09) for the outcome score compared to the 1st quartile score, respectively. In conclusion, our study design with blinded merge methods shows that total, process, and outcome qualities are related to the return to work of injured workers after controlling for other factors. PMID:27134489
The Great Western Ambulance Service Air Support Unit (ASU) was established in July 2007. The helicopter carries a doctor, providing a Helicopter Emergency Medical Service (HEMS) model of care. Equestrian sport-related injuries account for 6.8% of the unit's total attended case load. Horse riding has a higher rate of severe injury than motorcycle racing and 45% of patients admitted with equestrian injuries require surgical intervention. Orthopaedic injuries to the extremities are commonest, superseding head injuries since the introduction of protective headwear. The majority of equestrian sport-related injuries occur in areas inaccessible to land crews. We conducted a retrospective analysis of the ASU mission database from July 2008 to December 2009 (18 months) and identified 29 patients that were attended to by the ASU. The patient cohort had a female majority with an average age of 31.9. 10 Patients (34.5%) were under the age of 20. The ISS ranged from 1 to 75 (mean, 4.8; median, 1) and injuries to the extremities were commonest. The location of the accident was inaccessible to land ambulance in 55.2% of missions. The average mission time was over 2h. Doctors delivered more advanced (medical) interventions in 20.7% of missions. In 41.4% of missions, there were no such interventions performed by the attending doctor and no access to land ambulance. We therefore conclude that a large proportion of ASU dispatches were due to limited access rather than for the delivery of advanced interventions. However, our results support the opinion that horse riding carries some risk of serious injury and when employed appropriately, HEMS doctors on the ASU are a useful resource for a minority of equestrian sport-related injuries.
Chartier, Karen G; Vaeth, Patrice A C; Caetano, Raul
Alcohol consumption is differentially associated with social and health harms across U.S. ethnic groups. Native Americans, Hispanics, and Blacks are disadvantaged by alcohol-attributed harms compared with Whites and Asians. Ethnicities with higher rates of risky drinking experience higher rates of drinking harms. Other factors that could contribute to the different effects of alcohol by ethnicity are social disadvantage, acculturation, drink preferences, and alcohol metabolism. This article examines the relationship of ethnicity and drinking to (1) unintentional injuries, (2) intentional injuries, (3) fetal alcohol syndrome (FAS), (4) gastrointestinal diseases, (5) cardiovascular diseases, (6) cancers, (7) diabetes, and (8) infectious diseases. Reviewed evidence shows that Native Americans have a disproportionate risk for alcohol-related motor vehicle fatalities, suicides and violence, FAS, and liver disease mortality. Hispanics are at increased risk for alcohol-related motor vehicle fatalities, suicide, liver disease, and cirrhosis mortality; and Blacks have increased risk for alcohol-related relationship violence, FAS, heart disease, and some cancers. However, the scientific evidence is incomplete for each of these harms. More research is needed on the relationship of alcohol consumption to cancers, diabetes, and HIV/AIDS across ethnic groups. Studies also are needed to delineate the mechanisms that give rise to and sustain these disparities in order to inform prevention strategies.
Nicolosi Alfred C
Full Text Available Abstract Background The lanthanide cation, gadolinium (GdCl3 protects the myocardium against infarction following ischemia and reperfusion. Neutrophils and macrophages are the main leukocytes responsible for infarct expansion after reperfusion. GdCl3 interferes with macrophage and neutrophil function in the liver by decreasing macrophage secretion of inflammatory cytokines and neutrophil infiltration. We hypothesized that GdCl3 protects against ischemia and reperfusion injury by decreasing inflammation. We determined the impact of GdCl3 treatment for reperfusion injury on 1 circulating monoctye and neutrophil counts, 2 secretion of inflammatory cytokines, and 3 influx of monocytes and neutrophils into the myocardium. Methods Rats (n = 3-6/gp were treated with saline or GdCl3 (20 μmol/kg 15 min prior to a 30 min period of regional ischemia and 120 min reperfusion. Sham rats were not subject to ischemia. Blood was collected either after 30 min ischemia or 120 min reperfusion and hearts were harvested at 120 min reperfusion for tissue analysis. Blood was analyzed for leukocytes counts and cytokines. Tissue was analyzed for cytokines and markers of neutrophil and monocyte infiltration by measuring myeloperoxidase (MPO and α-naphthyl acetate esterase (ANAE. Results GdCl3 did not affect the number of circulating neutrophils prior to ischemia. Two hours reperfusion resulted in a 2- and 3- fold increase in circulating monocytes and neutrophils, respectively. GdCl3 decreased the number of circulating monocytes and neutrophils during reperfusion to levels below those present prior to ischemia. Furthermore, after 120 min of reperfusion, GdCl3 decreased ANAE and MPO activity in the myocardium by 1.9-fold and 6.5-fold respectively. GdCl3 decreased MPO activity to levels below those measured in the Sham group. Serum levels of the major neutrophil chemoattractant cytokine, IL-8 were increased from pre-ischemic levels during ischemia and reperfusion in both
Preliminary strategies developed at the National Symposium on the Prevention of Leading Work Related Diseases and Injuries, held in Atlanta, Georgia on May 1 to 3, 1985 were revised, elaborated, and further developed. Strategies were developed for the prevention of occupational lung diseases, musculoskeletal injuries, occupational cancers, severe occupational traumatic injuries, and occupational cardiovascular diseases. Lung diseases considered included silicosis, asbestosis, lung cancer mesothelioma, coal workers' pneumoconiosis, byssinosis, occupational asthma, hypersensitivity pneumonitis, asphyxiation, irritation, pulmonary edema, brucellosis, psitticosis, anthrax, mycobacterioses, histoplasmosis, aspergillosis, and coccidioidomycosis. Occupational cancers were discussed as they occur in the lung, pleura, peritoneum, bladder, kidneys, blood, nasal cavity, skin, nasal sinuses, and liver.
Li, Yan-Hong; Rahim, Yousif; Zhou, De-Ding
China is known as the Bicycle Kingdom, but the nature, extent, and costs of bicycle-related injuries remain largely unknown. The authors' findings showed that the bicycle-related mortality rate increased 99% from 1992 to 2004, and it increased with age, from 0.64 per 100,000 population in the 0-14 age group to 5.93 per 100,000 population in the 65 and older age group. Labor force groups represented the majority of fatalities (70.8%) and nonfatal injuries (81.5%). The male mortality rate was 2.4 times higher than the female mortality rate. Head injuries accounted for 71.9% of fatalities and 33.1% of the hospitalizations. People with lower levels of education had higher injury rates. The poorer districts located in the countryside had the highest mortality rates compared to those located in the central, wealthier regions. The total annual cost of bicycle-related injuries was 1.1 billion CHY (Chinese Yuan) (over $137 million U.S.). To reduce bicycle-related injuries, mandatory helmet legislations, environmental modifications, and representative monitoring systems in China are required.
Klauser, A.; Frauscher, F.; Helweg, G.; Nedden, D. zur [Universitaetsklinik fuer Radiodiagnostik, Radiologie II, Universitaet Innsbruck (Austria); Hochholzer, T. [Privatklinik Triumpfpforte, Innsbruck (Austria); Kramer, J. [Inst. fuer CT- und MRT-Diagnostik am Schillerpark, Linz (Austria)
Sport climbing shows an enormous increase in participation, evolving to more popularity, including even school sport activity on high standards. Therefore the number of climbing related injuries is increasing and becomes a more frequently encountered medical problem. Typical climbing associated injuries involve predominantly the upper limb. Overuse injuries are the most common climbing related injuries.The clinical examination is the first line investigation, which is often limited especially in the acute phase. However, an exact diagnosis is desireable for therapeutic management. Imaging modalities have shown to be capable for detection of climbing related injuries. An overview about the current use of x-ray, ultrasound and magnetic resonance imaging in different climbing related overuse injuries is presented. (orig.) [German] Sportklettern zeigt eine zunehmende Popularitaet sowohl im Elitesport als auch im leistungsorientierten Breiten- und Schulsport. Dadurch kommt klettertypischen Beschwerden eine zunehmende medizinische Bedeutung zu. Bei dieser Sportart stehen Ueberlastungen (''overuse'') hauptsaechlich im Bereich der oberen Extremitaet an erster Stelle der Beschwerden. Neben der klinischen Untersuchung, welche in der Akutphase limitiert sein kann, ist die bildgebende Diagnostik zur exakten Abklaerung notwendig, um ein adaequates therapeutisches Management zu gewaehrleisten. Im Rahmen dieser Arbeit wird ein Ueberblick ueber den Einsatz der unterschiedlichen Bildgebungsmodalitaeten wie konventionelles Roentgen, Ultraschall und Magnetresonanztomographie bei den klettertypischen Beschwerdebildern gegeben. (orig.)
Dukes, Richard L.; Stein, Judith A.; Zane, Jazmin I.
Using structural equation modeling, concurrent associations were assessed among physical bullying, relational bullying, physical victimization, relational victimization, injury and weapon carrying using data from the population of 1300 adolescent girls and 1362 adolescent boys in grades 7-12 in a Colorado school district. For both genders, being a…
Peleg, Kobi; Savitsky, Bella
Terrorism victims comprise the minority among trauma injured people, but this small population imposes a burden on the health care system. Thirty percent of the population injured in terrorist activities experienced severe trauma (injury severity score > or =16), more than half of them need a surgical procedure, and 25% of the population affected by terrorism had been admitted to intensive care. Furthermore, compared with patients with non-terrorism-related trauma, victims of terrorism often arrive in bulk, as part of a mass casualty event. This poses a sudden load on hospital resources and requires special organization and preparedness. The present study compared terrorism-related and road accident-related injuries and examined clinical characteristics of both groups of patients. This study is a retrospective study of all patients injured through terrorist acts and road traffic accidents from September 29, 2000 to December 31, 2005, and recorded in the Israel Trauma Registry. Data on the nature of injuries, treatment, and outcome were obtained from the registry. Medical diagnoses were extracted from the registry and classified based on International Classification of Diseases coding. Diagnoses were grouped to body regions, based on the Barell Injury Diagnosis Matrix. The study includes 2197 patients with terrorism-related injuries and 30,176 patients injured in road traffic accidents. All in all, 27% of terrorism-related casualties suffered severe to critical injuries, comparing to 17% among road traffic accident-related victims. Glasgow Coma Scale scores terrorism victims, in contrast with 7.4% among people injured on the roads. The terrorism victims had a significantly higher rate of use of intensive care facilities (24.2% vs 12.4%). The overall inpatient death rate was 6.0% among terrorism victims and 2.4% among those injured in road traffic accidents. Casualties from terrorist events are more severely injured and require more resources relative to casualties
Teasdale, T W; Engberg, A W
From a Danish national register of hospitalizations, all patients were identified who had a discharge diagnosis of traumatic brain injury between the years 1979-1993 inclusive, at ages 18-66 years inclusive. These were classified as having suffered either a concussion (n = 74,398), a cranial...... award appeared to be independent of the injury itself. Rather, being awarded a disability pension appeared to be related to conditions which themselves are risk factors for a traumatic brain injury, e.g. chronic skeletomuscular disease and psychiatric disorders including alcoholism. Comparison...... with population statistics revealed that the relative risk of being assigned a low or intermediate disability pension is markedly elevated among the concussion group, especially at younger ages and among males. For the fracture and contusion groups, a clear post-injury elevation in rate was detectable, especially...
Hadis Sabour, MD, PhD
Full Text Available Persons with spinal cord injury (SCI have a high prevalence of abnormalities in carbohydrate and lipid metabolism. These abnormalities cause adverse coronary heart disease (CHD in patients with SCI. In this study, we performed a detailed analysis of the level-specific cardiometabolic risk factors in individuals with SCI and analyzed the association of injury level on these risk factors. This was a cross-sectional study of 162 patients with SCI, assessing the prevalence of diabetes mellitus, dyslipidemia, hypertension, obesity, and smoking. Fasting blood sugar (>100 was diagnosed in 27 patients (16.7%. Of the total patients, 36 (22.2% had a total cholesterol (TC level of >200. A triglyceride level of >150 was present in 56 patients (34.6%. Hypertension was present in 2.5% of the entire patient group. Body mass index (BMI, TC, and low-density lipoprotein cholesterol (LDL-C were significantly higher in the paraplegia group than the tetraplegia group (24.44 +/– 4.23 vs 22.65 +/– 4.27, p = 0.01; 185.71 +/– 40.69 vs 163.28 +/– 37.92, p < 0.001; and 102.51 +/– 28.20 vs 89.15 +/– 22.35, p = 0.01, respectively. Patients with paraplegia may have increased hypertension, higher BMI, and increasing levels of serum LDL-C and TC than those with tetraplegia. Conventional risk factors for CHD should be identified and treated in individuals with SCI.
Sørensen, Jane Brandt; Jayasena, Chandima; Agampodi, Thilini Chanchala
in the Anuradhapura area. Objectives: The objective of this study was to explore alcohol’s role in cases of self-harm in individuals, families and communities. Methods: A qualitative, exploratory study, was conducted utilizing: (i) serial, narrative, life-story interviews with 19 individuals (12 men and 7 women...... between 20-69 years of age) who self-harmed and where alcohol was involved, and with 22 of their relatives; (ii) 10 focus-group discussions with community members; and (iii) observations in villages and alcohol-selling centers. Results: Only men drank alcohol before self-harm, spanning from heavy, daily...... drinking to social, occasional and even first time drinking. All women had alcohol indirectly involved in their case of self-harm through the negative effects of a relative’s drinking. Findings indicate that two categories of the alcohol-self-harm complex exist, with different characteristics for men...
Illuminati, G; Calio, F G; Bertagni, A; Mangialardi, N; Martinelli, V
Five seat-belt-related injuries occurring in four adults are reported. One injury involved the common carotid artery, two the internal carotid and two the subclavian arteries. Three of the four injured persons were asymptomatic and one had delayed-onset symptoms; none suffered stroke. There was no operative mortality or morbidity. Overall, the functional results of arterial reconstruction were good, with satisfactory patency at follow-up averaging 15 months.
Vos-Draper, Tamara L; Morrow, Melissa M B
The purpose of this review was to (1) assess the factors related to the occurrence of pressure injuries in people with a spinal cord injury (SCI), (2) review methods of pressure injury prevention, and (3) examine compensatory technologies developed to promote in-seat movement to reduce the risk of pressure injuries. Risk factors for seating-related pressure injuries are well documented, yet, ulceration remains a daily concern for individuals with SCI. While prompts and alarms have been shown to be effective at increasing in-seat movement, the devices thus far were not designed for long-term use. Wheelchair users will benefit from continued development of novel technologies designed to help them self-manage pressure injury prevention. Optimized feedback about pressure and movement will help wheelchair users with SCI perform more effective movements to relieve pressure, perform movements more frequently and consistently, and maintain effective and frequent movement behaviors over time while feedback is available.
Driezen, Pete; Abdullah, Abu S; Nargis, Nigar; Hussain, A K M Ghulam; Fong, Geoffrey T; Thompson, Mary E; Quah, Anne C K; Xu, Steve
This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011-2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco's harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO's Framework Convention on Tobacco Control.
Full Text Available This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011–2012 of the International Tobacco Control (ITC Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a cigarette smoking and (b smokeless tobacco use and (c whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco’s harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO’s Framework Convention on Tobacco Control.
Driezen, Pete; Abdullah, Abu S.; Nargis, Nigar; Hussain, A. K. M. Ghulam; Fong, Geoffrey T.; Thompson, Mary E.; Quah, Anne C. K.; Xu, Steve
This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011–2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco’s harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO’s Framework Convention on Tobacco Control. PMID:27571090
Gmitrowicz, Agnieszka; Szczepaniak, Anna; Jabłkowska-Górecka, Karolina
The primary goal of the study was an evaluation of the dominating stress coping styles in adolescent patients with self-harm records, who were psychiatrically treated, taking into account the level of their emotional intelligence vs. the psychiatric diagnosis, the type of motives and decision involved in self-harming and the presence of suicidal attempts (SA) in the past. The secondary goal included an analysis of the correlations between particular stress coping skills and the level of emotional intelligence. The reported studies involved self-harming patients aged of 13-18 years during their psychiatric hospitalisation (n=31). The applied tools included the Coping Inventory for Stressful Situations (CISS) and the Two-Dimensional Inventory of Emotional Intelligence (DINEMO). An evaluation of the correlation between stress coping styles and the levels of emotional intelligence in the studied group and the types of mental disorders did not reveal any significant differences between the evaluated subgroups. Patients, who confirmed an instrumental motive, obtained statistically significantly higher scores on the task-oriented scale vs. those who performed the acts of DSH for reactive or pathological reasons. Taking into consideration the type of decision, involved in self-harming acts, did not show any differences in the stress coping styles of the patients, however, those patients, who had planned an act of DSH, achieved statistically significantly higher scores in the OTHERS scale of the DINEMO. Patients with DSH and with SA in the past (77% studied group), achieved similar results in CISS and DINEMO vs. the self-harming patients without SA in the past. In the study group, one statistically significant correlation was demonstrated between CISS--the avoidance-oriented style--and the I in DINEMO. 1. Patients with DSH records and without SA constitute a fairly uniform group with regards to stress coping styles, taking into account the type of psychic disorders and the
The purpose of the study was to compare tubing-related injuries to wakeboarding- and water skiing-related injuries. Data was collected from the 2000-2007 National Electronic Injury Surveillance Survey for 1,761 individuals seeking care at an emergency department due to a tubing-, wakeboarding, or water skiing-related injury. Data included patient age and sex, as well as injury characteristics including body region injured (i.e., head and neck, trunk, shoulder and upper extremity, and hip and ...
Warms, Catherine A; Backus, Deborah; Rajan, Suparna; Bombardier, Charles H; Schomer, Katherine G; Burns, Stephen P
There are anecdotal reports of adverse events (AEs) associated with exercise in people with spinal cord injury (SCI) and consequent concern by people with SCI and their providers about potential risks of exercise. Enumeration of specific events has never been performed and the extent of risk of exercise to people with SCI is not understood. To systematically review published evidence to identify and enumerate reports of adverse events or AEs associated with training in persons with SCI. Review was limited to peer-reviewed studies published in English from 1970 to 2011: (1) in adults with SCI, (2) evaluating training protocols consisting of repeated sessions over at least 4 weeks to maintain or improve cardiovascular health, (3) including volitional exercise modalities and functional electrical stimulation (FES)-enhanced exercise modalities, and (4) including a specific statement about AEs. Trained reviewers initially identified a total of 145 studies. After further screening, 38 studies were included in the review. Quality of evidence was evaluated using established procedures. There were no serious AEs reported. There were no common AEs reported across most types of interventions, except for musculoskeletal AEs related to FES walking. There were few AEs in volitional exercise studies. There is no evidence to suggest that cardiovascular exercise done according to guidelines and established safety precautions is harmful. To improve the strength of these conclusions, future publications should include definition of AEs, information about pre-intervention screening, and statements of the nature and extent of AEs.
Moen, Ole Martin
A common argument against prostitution states that selling sex is harmful because it involves selling something deeply personal and emotional. More and more of us, however, believe that sexual encounters need not be deeply personal and emotional in order to be acceptable--we believe in the acceptability of casual sex. In this paper I argue that if casual sex is acceptable, then we have few or no reasons to reject prostitution. I do so by first examining nine influential arguments to the contrary. These arguments purport to pin down the alleged additional harm brought about by prostitution (compared to just casual sex) by appealing to various aspects of its practice, such as its psychology, physiology, economics and social meaning. For each argument I explain why it is unconvincing. I then weight the costs against the benefits of prostitution, and argue that, in sum, prostitution is no more harmful than a long line of occupations that we commonly accept without hesitation.
Full Text Available Abstract The current anti-doping policy (‘war on doping’ resembles the ‘war on drugs’ in several aspects, including a zero-tolerance approach, ideology encroaching on human rights and public health principles, high cost using public money for repression and control, and attempts to shape internationally harmonized legal frameworks to attain its aim. Furthermore, even if for different reasons, both wars seem not to be able to attain their objectives, and possibly lead to more harm to society than they can prevent. The Olympic buzz is mounting and we can expect multiple headlines in the media on doping and anti-doping stories related to this event. In this article we describe current anti-doping policy, reflect on its multiple unplanned consequences, and end with a discussion, if lessons learned from harm reduction experiences in the illicit drugs field could be applied to anti-doping.
Burger, Nicholas; Lambert, Mike I; Viljoen, Wayne; Brown, James C; Readhead, Clint; Hendricks, Sharief
Objectives The tackle situation is most often associated with the high injury rates in rugby union. Tackle injury epidemiology in rugby union has previously been focused on senior cohorts but less is known about younger cohorts. The aim of this study was to report on the nature and rates of tackle-related injuries in South African youth rugby union players representing their provinces at national tournaments. Design Observational cohort study. Setting Four South African Youth Week tournaments (under-13 Craven Week, under-16 Grant Khomo Week, under-18 Academy Week, under-18 Craven Week). Participants Injury data were collected from 3652 youth rugby union players (population at risk) in 2011 and 2012. Outcome measures Tackle-related injury severity (‘time-loss’ and ‘medical attention’), type and location, injury rate per 1000 h (including 95% CIs). Injury rate ratios (IRR) were calculated and modelled using a Poisson regression. A χ2 analysis was used to detect linear trends between injuries and increasing match quarters. Results The 2012 under-13 Craven Week had a significantly greater ‘time-loss’ injury rate when compared with the 2012 under-18 Academy Week (IRR=4.43; 95% CI 2.13 to 9.21, p<0.05) and under-18 Craven Week (IRR=3.52; 95% CI 1.54 to 8.00, p<0.05). The Poisson regression also revealed a higher probability of ‘overall’ (‘time-loss’ and ‘medical attention’ combined) and ‘time-loss’ tackle-related injuries occurring at the under-13 Craven Week. The proportion of ‘overall’ and ‘time-loss’ injuries increased significantly with each quarter of the match when all four tournaments were combined (p<0.05). Conclusions There was a difference in the tackle-related injury rate between the under-13 tournament and the two under-18 tournaments, and the tackle-related injury rate was higher in the final quarter of matches. Ongoing injury surveillance is required to better interpret these findings. Injury prevention strategies
Radojevic, Nemanja; Cukic, Dragana; Curovic, Ivana; Golubovic, Mileta
Air guns (air pistols and rifles) are already recognized as being potentially lethal. The diabolo pellet has a calibre of .177 (4.5 mm), a 1250 fps velocity, is high energetic, and is most commonly used in such weapons. In the presented case, the victim sustained an air rifle injury to the neck. The pellet passed through the thyroid cartilage, subsequently causing the extensive laryngeal swelling with haematoma around the pellet channel which fatally obstructed the airway. It is estimated microscopically that at least a number of hours must have passed from the injury to the time of death. For this case, a shooting distance was estimated by using experimental shooting values compared to physics formulas for accelerated motion. The case under question has confirmed an applicable legal approach that can be utilized by countries to classify air rifles as being as harmful as other firearms, especially those with high muzzle velocities. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Frandon, Julien; Rodiere, Mathieu; Arvieux, Catherine; Vendrell, Anne; Boussat, Bastien; Sengel, Christian; Broux, Christophe; Bricault, Ivan; Ferretti, Gilbert; Thony, Frédéric
We aimed to compare clinical outcomes and early adverse events of operative management (OM), nonoperative management (NOM), and NOM with splenic artery embolization (SAE) in blunt splenic injury (BSI) and identify the prognostic factors. Medical records of 136 consecutive patients with BSI admitted to a trauma center from 2005 to 2010 were retrospectively reviewed. Patients were separated into three groups: OM, NOM, and SAE. We focused on associated injuries and early adverse events. Multivariate analysis was performed on 23 prognostic factors to find predictors. The total survival rate was 97.1%, with four deaths all occurred in the OM group. The spleen salvage rate was 91% in NOM and SAE. At least one adverse event was observed in 32.8%, 62%, and 96% of patients in NOM, SAE, and OM groups, respectively (P events: simplified acute physiology score 2 ≥25 for almost all adverse events, age ≥50 years for acute respiratory syndrome, limb fracture for secondary bleeding, thoracic injury for pleural drainage, and at least one associated injury for pseudocyst. Adverse events were not related to the type of BSI management. Patients with BSI present worse outcome and more adverse events in OM, but this is related to the severity of injury. The main predictor of adverse events remains the severity of injury.
Occupational health in agriculture is a significant public health issue in industrialised agricultural nations. This article reports on 26 in-depth interviews with farmers throughout New Zealand. Farmers are exposed to a range of technologies which place them at risk of injury and disease and/or prevent injury and disease. In this article these technologies are respectively conceptualised as technologies of harm and technologies of care. Despite being vulnerable to high rates of injury, fatality and occupationally related diseases the uptake of technologies of care amongst farmers in New Zealand is poor. The analysis draws on body theory to explore the meaning attached to injury and disease and to examine the socio-cultural field of agriculture. It is argued that the key features of subjective embodiment and social, cultural and symbolic capital can undermine the uptake of technologies of care, ensuring poor occupational health outcomes on New Zealand farms.
Tretter, Justin T; Jones, Thomas K; McElhinney, Doff B
Aortic wall complications can occur in unrepaired aortic coarctation (CoA) and after surgical repair or endovascular treatment. This review summarizes the available literature and current understanding of aortic wall injury (AWI) surrounding the management of CoA, focusing specifically on acute and follow-up AWI after endovascular treatment. There have been 23 reported cases of aortic rupture after endovascular treatment for CoA, including angioplasty alone, bare metal stenting, and primary covered stent therapy. Even if these published cases represent only a minority of ruptures that have actually occurred, the incidence is substantially <1%. The incidence of acute aneurysm formation was 0% to 13% after angioplasty, 0% to 5% after bare metal stent placement, and <1% after covered stent placement. The reported incidence and natural history of both acute and new AWI during follow-up after endovascular therapy for CoA varies considerably, likely secondary to ascertainment and reporting biases and inconsistent definitions. Although important AWI after endovascular treatment of CoA seems to be declining in frequency with increasing experience and improving technology, it remains one of the most important potential adverse outcomes. Long-term surveillance for new AWI and monitoring of existing AWI is mandatory, with institution of appropriate treatment when necessary. A central research focus in this population should be determination of the appropriate treatment for both native and recurrent CoA across various ages with regard to limiting recurrent CoA and preventing associated aortic wall complications, in addition to determining the appropriate treatment of various AWI. Consistent definitions and reporting are necessary to truly understand the incidence of, risk factors for, and measures protective against AWI after angioplasty or stent implantation for CoA.
John I. Baker
Full Text Available The purpose of the study was to compare tubing-related injuries to wakeboarding- and water skiing-related injuries. Data was collected from the 2000-2007 National Electronic Injury Surveillance Survey for 1,761 individuals seeking care at an emergency department due to a tubing-, wakeboarding, or water skiing-related injury. Data included patient age and sex, as well as injury characteristics including body region injured (i.e., head and neck, trunk, shoulder and upper extremity, and hip and lower extremity and diagnosis of injury (e.g., contusion, laceration, or fracture. Case narratives were reviewed to ensure that a tubing-, wakeboarding-, or water skiing-related injury occurred while the individual was being towed behind a boat. Severe injury (defined as an injury resulting in the individual being hospitalized, transferred, held for observation was compared among the groups using logistic regression. Wakeboard- and tubing-related injuries more commonly involved the head and neck, while water skiing- related injuries were likely to involve the hip and lower extremity. Tubing-related injuries, compared to water skiing-related injuries, were more likely to be severe (OR 2.31, 95% CI 1.23-4. 33. Like wakeboarding and water skiing, tubing has inherent risks that must be understood by the participant. While tubing is generally considered a safer alternative to wakeboarding and water skiing, the results of the current study suggest otherwise. Both the number and severity of tubing- related injuries could be prevented through means such as advocating the use of protective wear such as helmets while riding a tube or having recommended safe towing speeds prominently placed on inner tubes
Nation, Adam D; Nelson, Nicolas G; Yard, Ellen E; Comstock, R Dawn; McKenzie, Lara B
Football is one of the most popular youth sports in the United States despite the high rate of injuries. Previously published studies have investigated football-related injuries that occurred in organized play but have excluded those that occurred during unorganized play. Through use of the National Electronic Injury Surveillance System database, cases of football-related injuries were identified for analysis. Sample weights were used to calculate national estimates. An estimated 5 252 721 children and adolescents 6 to 17 years old were treated in US emergency departments for football-related injuries. The annual number of cases increased by 26.5% over the 18-year study period. The 12- to 17-year-old age group accounted for 77.8% of all injuries and had nearly twice the odds of sustaining a concussion. The findings suggest the need for increased prevention efforts to lower the risk of football-related injury in children and adolescents.
Cohen, E; Sala, D A
The recent increase in sports participation in children and adolescents has resulted in the increase of sport-related injuries and the need for rehabilitation. The purposes of this study were to review studies involving rehabilitation of pediatric musculoskeletal sport-related injuries to determine the study design (level of evidence), inclusion of a reference to skeletal immaturity, adequacy of the description of the rehabilitation program and treatment outcome. Medline(1950-June 2009), CINAHL(1982-June 2009), Cochrane and journals (sports, physical therapy, pediatric orthopedic) were searched using the terms: physical therapy or rehabilitation plus sports/athletic injuries or individual sports plus pediatrics, adolescent, children, youth and young. Inclusion criteria were: published in English peer-reviewed journal, examined rehabilitation/management, subjects sport-related musculoskeletal injury/diagnosis. Study design (level of evidence), injury/diagnosis, sport involved, information regarding skeletal maturity, description of rehabilitation program and treatment outcome were extracted. Fifty-seven studies met the criteria: 75% were case reports, 21% case series, 4% retrospective comparative studies and no randomized-controlled trials. Forty-seven different diagnoses were investigated. Fifty-four percent did not address skeletal immaturity; 26% involved injuries/diagnoses unique to skeletally immature. Components and parameters of each study's rehabilitation program and outcome are reported. Current literature lacks well-designed controlled studies: 1) to address issues relevant to the pediatric injured athlete and 2) to determine the optimum program for each sport-related injury/diagnosis to expedite return to sport. Programs were often inadequately detailed to permit replication.
Rozenfeld, Michael; Peleg, Kobi
To characterize the population of children hospitalized as a result of violence. This retrospective study used data from the Israeli National Trauma Registry on patients aged 0-17 years hospitalized for trauma during 1998-2006. Of 65,430 patients, 2060 (3.1%) had violence-related injuries. Descriptive statistics and bivariate analysis were used to characterize injury patterns and multivariate analysis was used to identify factors associated with severe injury. Half the victims of violence Violence-related trauma occurred more often than other trauma in the street, at school or in a public place or leisure facility, but less often at home. Unarmed brawling and stabbing were the most common types of violence. Brawling affected Jewish children more, while non-Jewish children were more often injured by firearms. The boundaries of age groups with different injury rates corresponded to the 'institutional' childhood stages of the Israeli educational system: the violence-related injury rate dropped after the first year of life, stayed low during kindergarten, rose slightly during elementary school and rose steeply during secondary and high school. The percentage of males increased with each age group. The street became more dangerous with age, while school and home became safer. Adolescents aged 15-17 years, newborn infants and those injured by firearms had the highest risk of severe injury. Age and type of violence were the most important predictors of violence frequency and severity. Ethnicity lost importance when adjusted by these factors. Further research on their influence on violence-related injury is needed.
Benedictus, Marieke R.; Spikman, Jacoba M.; van der Naalt, Joukje
Benedictus MR, Spikman JM, van der Naalt J. Cognitive and behavioral impairment in traumatic brain injury related to outcome and return to work. Arch Phys Med Rehabil 2010;91:1436-41. Objective: To evaluate the cognitive and behavioral disturbances related to return to work (RTW) in patients with tr
Buser, Trevor J.; Peterson, Christina Hamme; Kearney, Anne
The authors recruited college students (N = 648) and investigated relationships among academic and social self-efficacy, relational aggression from parents and peers, and nonsuicidal self-injury (NSSI). Results indicated that both types of self-efficacy were related inversely to NSSI. Academic self-efficacy mediated the relationship between…
Huisman, M.; Oldehinkel, A. J.
Background: The objective of the study was to investigate the relation of income inequality and indicators of social capital to self-inflicted injury mortality (suicide) and violence-related mortality, and to the share of total mortality that is due to these two causes of death in 35 developed count
Sadowsky, Cristina L.; McDonald, John W.
Physical rehabilitation following spinal cord injury-related paralysis has traditionally focused on teaching compensatory techniques, thus enabling the individual to achieve day-to-day function despite significant neurological deficits. But the concept of an irreparable central nervous system (CNS) is slowly being replaced with evidence related to…
McKechnie, Natalie C; Jacobs, Karen
This study asserts that a combination of environmental and physical factors influence the child pianist's risk for developing a music related injury. 26 participants (10 piano students, 10 parents, and 6 piano teachers) were included in this study. Piano students were ages 5 to 11 and currently enrolled in piano lessons. Three questionnaires addressed the factors affecting the participant groups (children, parents, and piano teachers). Participants completed one questionnaire about the factors contributing to the development of music related injuries in child pianists. Descriptive statistics were used to analyze the results. None of the student participants had pain, discomfort, or a history of music related injuries. The majority of parents and teachers reported that the lighting was the most important environmental factor affecting students' playing in the piano lesson. 70% of parents reported that the presence of family members most greatly affected students' practicing at home. 100% of the teachers and parents reported that the most important physical factors contributing to students' injury-free playing were playing with proper technique and learning effective practice strategies. All parents and students who were taking piano lessons in their homes reported the most satisfaction with their piano lesson environment. The results of this study do not support a relationship between environmental or physical factors and the presence of pain, discomfort, or music related injuries in students.
disadvantage on the area level and interpersonal violence, although the differences in the effects of the price reduction between the different areas were small. The findings of the present study suggest that that a reduction in alcohol prices may lead to a substantial increase in alcohol-related mortality and morbidity. However, large population group differences were observed regarding responsiveness to the price changes. In particular, the less privileged, such as the unemployed, were most sensitive. In contrast, at least in the Finnish context, the younger generations and the employed do not appear to be adversely affected, and those in the older age groups may even benefit from cheaper alcohol in terms of decreased rates of CVD mortality. The results also suggest that reductions in alcohol prices do not necessarily affect interpersonal violence. The population group differences in the effects of the price changes on alcohol-related harm should be acknowledged, and therefore the policy actions should focus on the population subgroups that are primarily responsive to the price reduction.
Pressure-related deep tissue injury is the term recommended by the United States National Pressure Ulcer Advisory Panel to describe a potentially life-threatening form of pressure ulcers, characterized by the presence of necrotic tissue under intact skin, and associated with prolonged compression of muscle tissue under bony prominences. In this study, a theoretical model was used to determine the relative contributions of the backrest inclination angle during prolonged wheelchair sitting, the muscle tissue stiffness and curvature of the ischial tuberosities (ITs) to the risk for injury in the gluteus muscles that pad the IT bones during sitting. The model is based on Hertz's theory for analysis of contact pressures between a rigid half-sphere (bone) and an elastic half-space (muscle). Hertz's theory is coupled with an injury threshold and damage law for muscle-both obtained in previous studies in rats. The simulation outputs the time-dependent bone-muscle contact pressures and the injured area in the gluteus. We calculated the full-size (asymptotic) injured area in the gluteus and the time for injury onset for different sitting angles alpha (90-150 degrees), muscle tissue long-term shear moduli G (250-1,200 Pa) and bone diameters D (8-18 mm). We then evaluated the sensitivity of model results to variations in these parameters, in order to determine how injury predictions are affected. In reclined sitting (alpha=150 degrees) the full-size injured area was approximately 2.1-fold smaller and the time for injury onset was approximately 1.3-fold longer compared with erect sitting (alpha=90 degrees). For greater G the full-size injured area was smaller but the time for injury onset was shorter, e.g., increasing G from 250 to 1200 Pa decreased the full-size injured area approximately 2.5-fold, but shortened the time for injury onset 6.2-fold. For smaller D the time for injury onset dropped, e.g., decreased approximately 1.5-fold when D decreased from 18 to 8 mm
European literature contains fictional descriptions of self-harm and self-punishment over a time span of almost 2 500 years. This article presents such descriptions, from Sofocles' tragedy about King Oedipus to contemporary literature. Particular interest is dedicated to the Austrian Nobel prize laureate Elfriede Jelinek and the Norwegian author Karl Ove Knausgård. In Jelinek's fictional universe, self-harm is particularly related to the topic of autonomy in a family context; while Knausgård describes the role of shame in triggering and sustaining self-harming behaviour.
In a television news documentary series such as Boston Med, doctors' duty to their patients may be at odds with the duty of TV journalists to their audience. If this happens, who should win out? The patients. If there is any possibility that harm is being done to patients, we must put them first, and turn off the cameras.
Caamaño-Isorna, Francisco; Moure-Rodríguez, Lucía; Doallo, Sonia; Corral, Montserrat; Rodriguez Holguín, Socorro; Cadaveira, Fernando
The objective of this study is to assess the effects of Heavy Episodic Drinking (HED) on the incidence of alcohol-related injuries among university students in Spain, taking sex into consideration. We carried out an open cohort study among college students in Spain (992 women and 371 men). HED and alcohol-related injuries were measured by question 3rd and 9th of Alcohol Use Disorders Identification Test to every participant at the ages of 18, 20, 22, 24 and 27. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for alcohol and cannabis use. The incidence rate of alcohol-related injuries was 0.028year(-1) for females and 0.036year(-1) for males. The multivariate analysis showed that among females a high frequency of HED and use of cannabis are risk factors for alcohol-related injuries (Odds Ratio [OR]=2.64 and OR=3.68), while being more than 23 is a protective factor (OR=0.34). For males, bivariate analysis also showed HED like risk factor (OR=4.69 and OR=2.51). Finally, the population attributable fraction for HED among females was 37.12%. HED leads to an increase of alcohol-related injuries in both sexes and being over 23 years old acts as a protective factor among women. Our results suggest that about one third of alcohol-related injuries among women could be avoided by removing HED. Copyright © 2016 Elsevier Ltd. All rights reserved.
The aim was to study road-related injuries and fatalities in under 15 year olds in two time periods (1996-2000 and 2004-2008 inclusive) to assess whether progress has been made via cross-sectoral efforts to reduce this injury toll in Ireland. For pedestrian and car-related accidents, police assistance is required and at the time a detailed CT 68 form is completed by the attending officer and sent to the Road Safety Authority for analysis. Details re the severity of injury, light and road conditions and safety measures such as seat belt or car restraint use, seat position and helmet use if a cyclist were recorded. Injuries were sub-classified as fatalities, serious (detained in hospital, fractures, severe head injury, severe internal injuries or shock requiring treatment) or minor. All data for the two time periods was entered onto an SPSS database. A concerted national campaign re road safety media campaign allied to random breath testing, penalty points for driving offences, on the spot fines for speeding and far greater police enforcement took place between the two time frames and continues to this day. When looked at as most likely estimates of death ratios the results were found to be statistically significant with an overall p value of < 0.0001 CI [0.39, 0.69]. When broken down into specific age ranges all were significant apart from the 0-3 age range with a p value of 0.69 CI [0.26, 1.1]. The most significant changes were found in the 7-9 years, 10-12 and 13-15 year age ranges with p values of < 0.0001, 0.0002 and 0.0007 respectively. When results were compared between the two cohorts, car occupant fatalities between both groups dropped by 36%. Pedestrian injuries dropped from 1719 to 1232, pedestrian fatalities decreased by almost 50% as did serious pedestrian injuries from 261 down to 129. Cyclist fatalities saw the most significant fall (76%) with a dramatic reduction in cyclist injuries from 25 down to 6 (63%). The 13-15 year old age group had the highest
Burridge, J D; Marshall, S W; Laing, R M
The aim of this study was to describe the epidemiology of work-related hand and lower-arm injuries in New Zealand. Nonfatal hand and lower-arm injuries were identified from New Zealand's national database of hospital admissions for the period 1979 to 1988. Thirty-seven per cent (9714) of all such injuries (26,228) were work-related. Piercing and cutting instruments (38.5 per cent) and machinery (37.2 per cent) were the two most common agents of work-related hand and lower-arm injury. Specific occupations in which the number of cases was high included meat workers (n = 1020, 3.3 per 1000 employees), carpenters (n = 548, 2.2 per 1000), machine operators (n = 450, 11.9 per 1000) and sawmill workers (n = 498, 7.7 per 1000). The injury rate for meat workers, carpenter-joiners, machine operators and sawmillers increased significantly over the 10-year study period.
Guerrero, Arthur F; Alfonso, Abel
Recent civilian data obtained in those sustaining head injuries, has found a high prevalence of pituitary dysfunction. Currently, there is no data available in the military population. We reviewed the literature for traumatic brain injury (TBI)-related hypopituitarism and found that the prevalence of anterior hypopituitarism may be as high as 30-80% after 24-36 months. Since many of the symptoms of hypopituitarism are similar to those of TBI, it is important to make clinicians caring for combat veterans aware of its occurrence. Herein, we provide an overview of the literature and recommendations for hormonal testing when TBI-related hypopituitarism is suspected.
Lidal, I.B.; Veenstra, M.; Hjeltnes, N.
STUDY DESIGN: A cross-sectional study of all patients with traumatic SCI admitted to Sunnaas Rehabilitation Hospital, Norway between 1961 and 1982. OBJECTIVES: To assess health-related quality of life (HRQOL) in persons with long-standing traumatic spinal cord injury (SCI) in Norway. SETTING....... There were relatively small differences in HRQOL when comparing persons with paraplegia versus tetraplegia and persons with AIS (ASIA Impairment Scale; ASIA, American Spinal Injury Association) A-C versus D-E. Employed persons reported higher HRQOL compared to unemployed persons. HRQOL of individuals...
Jørgensen, Daniel Ramskov; Jensen, Majbritt Lykke; Obling, Kirstine Høj;
There is a paucity of knowledge on the association between different foot posture quantified by Foot Posture Index (FPI) and Quadriceps angle (Q-angle) with development of running-related injuries. Earlier studies investigating these associations did not include an objective measure of the amount...... of running performed. Therefore, the purpose of this study was to investigate if kilometers to running-related injury (RRI) differ among novice runners with different foot postures and Q-angles when running in a neutral running shoe....
Full Text Available Abstract Background It is important to obtain greater insight into health-related quality of life (HRQL of injury patients in order to document people's pathways to recovery and to quantify the impact of injury on population health over time. We performed a systematic review of studies measuring HRQL in general injury populations with a generic health state measure to summarize existing knowledge. Methods Injury studies (1995-2009 were identified with main inclusion criteria being the use of a generic health status measure and not being restricted to one specific type of injury. Articles were collated by study design, HRQL instrument used, timing of assessment(s, predictive variables and ability to detect change over time. Results Forty one studies met inclusion criteria, using 24 different generic HRQL and functional status measures (most used were SF-36, FIM, GOS, EQ-5D. The majority of the studies used a longitudinal design, but with different lengths and timings of follow-up (mostly 6, 12, and 24 months. Different generic health measures were able to discriminate between the health status of subgroups and picked up changes in health status between discharge and 12 month follow-up. Most studies reported high prevalences of health problems within the first year after injury. The twelve studies that reported HRQL utility scores showed considerable but incomplete recovery in the first year after discharge. Conclusion This systematic review demonstrates large variation in use of HRQL instruments, study populations, and assessment time points used in studies measuring HRQL of general injury populations. This variability impedes comparison of HRQL summary scores between studies and prevented formal meta-analyses aiming to quantify and improve precision of the impact of injury on population health over time.
Full Text Available Background: Unintentional injury is a leading threat to children's health. Some human factors have been determined as predictor of unintentional injury. Association between Health-Related Quality of Life (HRQOL as a human factor and unintentional injuries is unclear. The objective of study is to examine the association between HRQOL and unintentional injuries among primary school children. Methods: This study was a cross-sectional conducted in Ahwaz, a city in Iran. Overall, 3375 children aged 6-10 years were randomly selected from primary school. HRQOL was measured by 56 items taken from seven domains of Netherlands Organization for Applied Scientific Research Academic Medical Center (TNO AZL child quality of life (TACQOL parent form. Parents were interviewed to collect information about incidence, cause and a brief description of injury within the past 12 months prior to the study. Results: The response rate was 3375 of 3792 (89%. There was a significant trend for increasing occurrence of injury with decreasing of HRQOL score (P= Sig. Adjusted OR for injury was significantly higher in very low (2.38, 95% CI: 1.45-3.86, low (2.18, 95% CI: 1.34-3.56, and medium (1.73, 95%CI: 1.06-2.83 HRQOL groups compared to reference group (very high HRQOL. The median of total HRQOL (P= Sig and all its domains (P=0.017 (except autonomous functioning was lower in injured group compared to uninjured one. Conclusions: This study found an association between HRQOL and unintentional injury among primary school children. This is a preliminary finding and further investigations with a well-defined analytical design are needed.
Swain, Thomas A; Tully, Albert Scott; Redford, Travis; McGwin, Gerald
Hair removal practices have changed in frequency and location on the body. Previous research on hair removal injuries has focused on a specific body region, age, or gender. This study sought to take a broader perspective of hair removal-associated injuries in the United States which sought treatment at emergency departments. Data from the National Electronic Injury Surveillance System (NEISS) from 1991 to 2014 were used to identify hair removal-related injuries. Incidence rates were determined for the overall population and stratified by gender and age category using US Census Bureau population estimates. From 1991 to 2014, there were an estimated 292 053 hair removal-associated injuries in the United States. The overall incidence rate was highest in 2013 (9/100 000). Those aged 65+ had the highest incidence from 1991 to 2010 with those aged 19-34 having the highest rate starting in 2011. When stratified by body region injured, males had highest injury rates to the face and females had highest rates to the lower limbs. Starting in 2010, those aged 19-34 had higher incidence particularly for pubic and trunk regions. The incidence of hair removal-associated injuries seen by emergency departments increased nearly ninefold between 1991 and 2013. Due to the increased incidence among 19- to 34-year-olds, caution should be taken particularly for this age group when undergoing depilatory practices. Overall, individuals should practice safe and acceptable usage of hair removal products to reduce the risk of injury. © 2016 Wiley Periodicals, Inc.
Conner, Kristen A; Smith, Gary A
This study describes the medical and financial impact (hospital charges) of aggressive driving-related injuries in Ohio. Statewide crash and hospital databases were probabilistically linked for 2004 through 2009. Descriptive analyses and multivariate regression modeling of multiply-imputed data on motor vehicle occupants involved in aggressive driving-related crashes were performed. There were 821,136 motor vehicle occupants involved in aggressive driving-related crashes in Ohio from 2004 through 2009; injuries were sustained by 15.0%. The rate of aggressive driving-related crashes was highest among drivers ages 16 to 19 years (3787.1 crashes per 100,000 licensed drivers). Aggressive driving-related inpatients accrued more than $250.8 million in hospital charges and 28,366 inpatient days of treatment in 2004 through 2009. Occupants ages 16 to 19 years had higher odds of sustaining injury when involved in aggressive driving-related crashes (OR = 1.10; 95% CI = 1.07, 1.12; p injuries have a substantial medical and financial impact in Ohio. Compared with other highway safety issues, prevention efforts aimed specifically at aggressive driving are lacking. Targeted enforcement and public awareness campaigns are needed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Smoot Dustin L
Full Text Available Abstract Background Our American College of Surgeons Level 1 Trauma Center serves a rural population. As a result, there is a unique set of accidents that are not present in an urban environment such as deer related motor vehicle crashes (dMVC. We characterized injury patterns between motorcycle/all-terrain vehicles (MCC and automobile (MVC crashes related to dMVC (deer motor vehicle crash with the hypotheses that MCC will present with higher Injury Severity Score (ISS and that it would be related to whether the driver struck the deer or swerved. Methods The records of 157 consecutive patients evaluated at our institution for injury related to dMVC from January 1st, 1997 to December 31st, 2006 were reviewed from our prospectively collected trauma database. Demographic, clinical, and crash specific parameters were abstracted. Injury severity was analyzed by the Abbreviated Injury Scale score for each body region as well as the overall Injury Severity Score (ISS. Results Motorcycle crashes presented with a higher median ISS than MVCs (14 vs 5, p Within the MVC group, there was no difference between swerving and hitting the deer in any AIS group. Forty-seven percent of drivers were not wearing seat belts which resulted in similar median ISS (6 vs 5 and AIS of all body regions. Conclusions Motorcycle operators suffered higher ISS. There were no significant differences in median ISS if a driver involved in a deer-related motor vehicle crash swerved rather than collided, was helmeted, or restrained.
Gilasi, Hamid Reza; Soori, Hamid; Yazdani, Shahram; Taheri Tenjani, Parisa
Background: Falls and related injuries are common health problems in the elderly. Fractures, brain and internal organ injuries and death are the common consequences of the falls, which result in dependence, decreased self-efficacy, fear of falling, depression, restricted daily activities, hospitalization and admission to the nursing home and impose costs on the individual and the society. Objectives: The purpose of this study was to determine the types of fall-related injuries and the related...
Johansson, Mats Peter; Baann Liane, Martin Skogheim; Bendix, Tom
appearance of the cervical spine in supine MRI. In relation to symptoms it was seen that a kyphotic deformity was associated with reporting the highest intensities of headache at baseline, but not with an increased risk of long-lasting neck pain or headache. In conclusion, a kyphotic deformity...
Full Text Available The incidence of injury in combat sports has not been adequately reported although it is important to identify the nature and frequency of injuries prior to the implementation of prevention programs. This study compared injury rates treated in Hospital Emergency Departments between different combat sports of boxing, wrestling, and martial arts. A secondary objective described anatomic region and diagnosis of these injuries. Data were obtained on all boxing, wrestling, and martial arts-related injuries that were in the National Electronic Injury Surveillance System database and resulted in Emergency Department visits between 2002 and 2005. Pearson's chi-square statistics were calculated to compare injury rates for each activity accounting for complex sample design. Martial arts had lower injury rates compared to boxing and wrestling for all diagnoses (p<0.001. Boxing had lower injury rates compared to wrestling for strains/sprains and dislocations. Boxing and wrestling had similar injury rates for concussions. Injury prevention efforts should consider the distribution of injuries and concentrate on preventing strains/sprains in wrestling, concussions in boxing and wrestling, and fractures for all three activities. The findings of the present study do not provide evidence that combat sports have alarmingly high rates of injuries resulting in emergency department visits
Sarkisian, Laura; Saaby, Lotte; Poulsen, Tina S;
were classified into 5 categories of plausible related conditions: cardiac ischemic, cardiac nonischemic, noncardiac, multifactorial, or indeterminate. Follow-up was a minimum of 3 years, with all-cause mortality as the single end-point. RESULTS: A total of 3762 patients were considered, of whom 1089......BACKGROUND: Elevated cardiac troponins in clinical conditions other than myocardial infarction are well known. For such occurrences, the term "myocardial injury" has been proposed. The long-term outcome in patients with myocardial injury related to various cardiac and noncardiac clinical disorders...... is unknown. METHODS: During January 2010 to January 2011, we prospectively studied hospitalized patients who had cardiac troponin I measured on clinical indication. Patients with cardiac troponin I values >30 ng/L and no evidence of myocardial ischemia were diagnosed as having myocardial injury. Patients...
Eluru, Naveen; Bhat, Chandra R
This paper formulates a comprehensive econometric structure that recognizes two important issues in crash-related injury severity analysis. First, the impact of a factor on injury severity may be moderated by various observed and unobserved variables specific to an individual or to a crash. Second, seat belt use is likely to be endogenous to injury severity. That is, it is possible that intrinsically unsafe drivers do not wear seat belts and are the ones likely to be involved in high injury severity crashes because of their unsafe driving habits. The preceding issues are considered in the current research effort through the development of a comprehensive model of seat belt use and injury severity that takes the form of a joint correlated random coefficients binary-ordered response system. To our knowledge, this is the first instance of such a model formulation and application not only in the safety analysis literature, but in the econometrics literature in general. The empirical analysis is based on the 2003 General Estimates System (GES) data base. Several types of variables are considered to explain seat belt use and injury severity levels, including driver characteristics, vehicle characteristics, roadway design attributes, environmental factors, and crash characteristics. The results, in addition to confirming the effects of various explanatory variables, also highlight the importance of (a) considering the moderating effects of unobserved individual/crash-related factors on the determinants of injury severity and (b) seat belt use endogeneity. From a policy standpoint, the results suggest that seat belt non-users, when apprehended in the act, should perhaps be subjected to both a fine (to increase the chances that they wear seat belts) as well as mandatory enrollment in a defensive driving course (to attempt to change their aggressive driving behaviors).
Mohamed, Safaa; Frize, Monique; Comeau, Gilles
Playing the piano is a repetitive task that involves the use of the hands and the arms. Pain related to piano-playing can result in extending the tissues and ligaments of the hands and arms beyond their mechanical tolerance. Infrared imaging records the skin temperature and produces a thermal map of the imaged body part; small variations in the skin temperature could be a sign of inflammation or stress of the tissues. In this paper, we used statistical analysis to examine the difference in hand and arm temperatures of pianists with pain and pianists without pain related to piano-playing. We found that there is a statistically significant difference in hand temperatures between the two populations, but not in the lower arm and upper arm temperatures.
Schache, Anthony G; Blanch, Peter D; Rath, David A; Wrigley, Tim V; Bennell, Kim L
The purpose of the experiment was to test whether specific anthropometric or kinematic parameters of the lumbo-pelvic-hip complex were related to running injuries. A case-control design was used to compare a group of 22 runners with a history of injury within the previous 12 months to a group of 19 injury-free controls. All runners were pain-free at the time of measurement. Groups were matched for self-reported average running volume per week and average number of running sessions per week. Anthropometric and kinematic parameters, previously speculated as being related to running injuries, were selected for evaluation. Running trials were conducted on a treadmill at a speed of 4.0 m/sec. The three-dimensional angular rotations of the lumbar spine, pelvis, and hip during running were measured using a VICON motion analysis system with seven cameras operating at a sampling rate of 200 Hz. None of the measured anthropometric or kinematic parameters were found to be significantly different between the injured and control groups. Despite the theoretical rationale, no evidence was found in the current experiment demonstrating a clear relationship between anthropometric or kinematic parameters of the lumbo-pelvic-hip complex and running injuries.
Birch, Sarah; Cole, Samantha; Hunt, Kate; Edwards, Blossom; Reaney, Emma
This article presents the results of an audit of self-harming across three women's units over a period of 6 years. All three units use a positive risk-taking approach to self-harm whereby the risk that this behaviour presents is considered in an effort to reduce actual harm. To explore patterns and frequency of self-harm across three units within a women's service. Incidents of deliberate self-harm were collected from incident forms completed across the units from 2004 to 2009. Frequency graphs show a reduction of self-harm over the course of admission, and parametric analyses show that there was a significant difference in the frequency of self-harm during the first and last 3 months of admission. These results are discussed within a psychoanalytical framework, with particular reference to relational security and the value of positive risk-taking.
Singh, Shubha; Smith, Gary A; Fields, Sarah K; McKenzie, Lara B
The objective of this study was to describe the epidemiology of gymnastics-related injuries among children in the United States. A retrospective analysis was conducted of data for children 6 through 17 years of age from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for 1990 through 2005. Sample weights provided by the National Electronic Injury Surveillance System were used to calculate national estimates of gymnastics-related injuries. Injury rates were calculated for the most frequently occurring types of injury using gymnastics participation data. An estimated 425,900 children 6 through 17 years of age were treated in US hospital emergency departments for gymnastics-related injuries during the 16-year period of 1990-2005. The number of injuries averaged 26,600 annually. The number of injuries sustained per 1000 gymnastics participants per year for the pediatric population was 4.8. The number of injuries sustained per 1000 participants per year was greater for the ages 12 to 17 years (7.4) than for the ages 6 to 11 years (3.6). The place where an injury occurred include school (40.0%), a place of recreation or sports (39.7%), home (14.5%), or on other public property (5.8%). The body parts injured were upper extremity (42.3%), lower extremity (33.8%), head/neck (12.9%), trunk (10.4%), and other (0.6%). Injury diagnoses were strain/sprain (44.5%), fracture/dislocation (30.4%), abrasion/contusion (15.6%), laceration/avulsion (3.7%), concussion/closed head injury (1.7%), and other (4.2%). The majority (97.1%) of patients with gymnastics-related injuries were treated and released from the emergency department. Gymnastics has one of the highest injury rates of all girls' sports. Establishment of a national database for gymnastics-related injuries, including exposure data for direct calculation of injury rates, would permit better identification and monitoring of risk factors for gymnastics-related injuries and aid in
Sluys, Kerstin Prignitz; Shults, Justine; Richmond, Therese S
To investigate the impact on health related quality of life (HRQL) during the first year after minor extremity injury and to determine whether there is a difference in recovery patterns and return to work between upper extremity injuries (UEI) and lower extremity injuries (LEI). A total of 181 adults' age 18 years or older randomly selected from patients admitted to an emergency department with minor injuries were studied. HRQL was measured using the Functional Status Questionnaire (FSQ) at 1-2 weeks, 3, 6, and 12-months post-injury. Pre-injury FSQ scores were measured retrospectively at admission. A quasi-least square (QLS) model was constructed to examine differences of FSQ scores at each measuring point for UEI and LEI. Fractures of the knee/lower leg (25%) were the most frequently injured body area. Slips or falls (57%) and traffic-related events (22%) were the most common injury causes. The mean ISS was 4.2 (SD 0.86). Both groups had significant declines in the FSQ scores physical and social functioning at 1-2 weeks after injury. Patients with UEI made larger improvements in the first 3 months post-injury versus patients with LEI whose improvements extended over the first 6 months. None of the groups reached the pre-injury FSQ scores during the first post-injury year except in the subscale work performance where UEI exceeded the pre-injury scores. At 12 months post-injury, significant lower FSQ scores remained in the LEI group compared to the UEI group in intermediate activities of daily living (p=0.036, d 0.4) and work performance (p=0.004, d 0.7). The return to work at 3 months and 12 months were 76% and 88% for UEI and 58% and 77% for LEI. No significant differences were found between groups in the FSQ scale mental health and social interaction. LEI had the highest impact on HRQL and return to work during the first year which exceeded the consequences of UEI. These findings contribute to the information about the consequences of injury in order to give
Rogelio A Coronado
Full Text Available Exercise-induced injury models are advantageous for studying pain since the onset of pain is controlled and both pre-injury and post-injury factors can be utilized as explanatory variables or predictors. In these studies, rest-related pain is often considered the primary dependent variable or outcome, as opposed to a measure of activity-related pain. Additionally, few studies include pain sensitivity measures as predictors. In this study, we examined the influence of pre-injury and post-injury factors, including pain sensitivity, for induced rest and activity-related pain following exercise induced muscle injury. The overall goal of this investigation was to determine if there were convergent or divergent predictors of rest and activity-related pain. One hundred forty-three participants provided demographic, psychological, and pain sensitivity information and underwent a standard fatigue trial of resistance exercise to induce injury of the dominant shoulder. Pain at rest and during active and resisted shoulder motion were measured at 48- and 96-hours post-injury. Separate hierarchical models were generated for assessing the influence of pre-injury and post-injury factors on 48- and 96-hour rest-related and activity-related pain. Overall, we did not find a universal predictor of pain across all models. However, pre-injury and post-injury suprathreshold heat pain response (SHPR, a pain sensitivity measure, was a consistent predictor of activity-related pain, even after controlling for known psychological factors. These results suggest there is differential prediction of pain. A measure of pain sensitivity such as SHPR appears more influential for activity-related pain, but not rest-related pain, and may reflect different underlying processes involved during pain appraisal.
Ramskov, Daniel; Jensen, M L; Obling, K;
There is a paucity of knowledge on the association between different foot posture quantified by Foot Posture Index (FPI) and Quadriceps angle (Q-angle) with development of running-related injuries. Earlier studies investigating these associations did not include an objective measure of the amount...
Norup, Anne; Welling, Karen-Lise; Qvist, Jesper
Primary objective: To investigate the emotional well-being of relatives of patients with a severe brain injury in the acute setting, as well as risk factors associated with high anxiety and depression scores and impaired quality-of-life. Research design: Clinical convenience sample. Methods...
Transfusion-related acute lung injury (TRALI) is a life-threatening disease affecting the lungs. TRALI can develop within 6 hours after transfusion and almost all patients with TRALI require mechanical ventilation at the intensive care department. Nevertheless up to 40% of patients do not recover fr
Pontifex, Matthew B.; Broglio, Steven P.; Drollette, Eric S.; Scudder, Mark R.; Johnson, Chris R.; O'Connor, Phillip M.; Hillman, Charles H.
We assessed the extent to which failures in sustained attention were associated with chronic mild traumatic brain injury (mTBI) deficits in cognitive control among college-age young adults with and without a history of sport-related concussion. Participants completed the ImPACT computer-based assessment and a modified flanker task. Results…
Kiers, H.D.; Boogaard, M.H.W.A. van den; Schoenmakers, M.C.J.; Hoeven, J.G. van der; Swieten, H.A. van; Heemskerk, S.; Pickkers, P.
BACKGROUND: Cardiac surgery-related acute kidney injury (CS-AKI) results in increased morbidity and mortality. Different models have been developed to identify patients at risk of CS-AKI. While models that predict dialysis and CS-AKI defined by the RIFLE criteria are available, their predictive powe
Martin-Herz, Susanne P.; Zatzick, Douglas F.; McMahon, Robert J.
This paper comprehensively reviews the published literature investigating health-related quality of life (HRQOL) following general traumatic injury in individuals between birth and 18 years. Studies were not considered if they primarily compared medical treatment options, evaluated physical function but not other aspects of HRQOL, or focused on…
van der Horn, Harm J.; Spikman, Jacoba M.; Jacobs, Bram; van der Naalt, Joukje
Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center.
Kamarulzaman, A; Saifuddeen, S M
Although drugs are haram and therefore prohibited in Islam, illicit drug use is widespread in many Islamic countries throughout the world. In the last several years increased prevalence of this problem has been observed in many of these countries which has in turn led to increasing injecting drug use driven HIV/AIDS epidemic across the Islamic world. Whilst some countries have recently responded to the threat through the implementation of harm reduction programmes, many others have been slow to respond. In Islam, The Quran and the Prophetic traditions or the Sunnah are the central sources of references for the laws and principles that guide the Muslims' way of life and by which policies and guidelines for responses including that of contemporary social and health problems can be derived. The preservation and protection of the dignity of man, and steering mankind away from harm and destruction are central to the teachings of Islam. When viewed through the Islamic principles of the preservation and protection of the faith, life, intellect, progeny and wealth, harm reduction programmes are permissible and in fact provide a practical solution to a problem that could result in far greater damage to the society at large if left unaddressed.
Michael D Cusimano
Full Text Available BACKGROUND: There is a gap in knowledge about the mechanisms of sports-related brain injuries. The objective of this study was to determine the mechanisms of brain injuries among children and youth participating in team sports. METHODS: We conducted a retrospective case series of brain injuries suffered by children participating in team sports. The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP database was searched for brain injury cases among 5-19 year-olds playing ice hockey, soccer, American football (football, basketball, baseball, or rugby between 1990 and 2009. Mechanisms of injury were classified as "struck by player," "struck by object," "struck by sport implement," "struck surface," and "other." A descriptive analysis was performed. RESULTS: There were 12,799 brain injuries related to six team sports (16.2% of all brain injuries registered in CHIRPP. Males represented 81% of injuries and the mean age was 13.2 years. Ice hockey accounted for the greatest number of brain injuries (44.3%, followed by soccer (19.0% and football (12.9%. In ice hockey, rugby, and basketball, striking another player was the most common injury mechanism. Football, basketball, and soccer also demonstrated high proportions of injuries due to contact with an object (e.g., post among younger players. In baseball, a common mechanism in the 5-9 year-old group was being hit with a bat as a result of standing too close to the batter (26.1% males, 28.3% females. INTERPRETATION: Many sports-related brain injury mechanisms are preventable. The results suggest that further efforts aimed at universal rule changes, safer playing environments, and the education of coaches, players, and parents should be targeted in maximizing prevention of sport-related brain injury using a multifaceted approach.
Nicole Ruas de Sousa
Full Text Available ABSTRACT: Equine sport modalities influence the prevalence and predisposition of musculoskeletal injuries in horses. This study aimed to evaluate the prevalence of location and type of orthopedic injuries of horses undergoing various physical activities. Data from 116 horses of different breeds and ages was analyzed. Physical activities included dressage, racing, polo pony, jumping, work and western performance. All horses had history of orthopedic lameness diagnosed by radiographs and/or ultrasound scans. The effect of sport on the affected anatomical site and type of lesion was performed using Fisher's exact test. Desmitis was more prevalent in animals that performed western sports than in the working ones. The number of fractures was greater in racing and polo pony animals than in working horses. Stifle lesions were more prevalent in dressage horses than working horses and had lower occurrence of shoulder injuries than jumping horses. Hind limb tendon injuries were lower in jumping than in dressage and western horses. We conclude that there is a relationship between location and type of injury and physical activities. In racing horses there is a predominance of young animals and higher prevalence of orthopedic injuries from traumatic events such as tendonitis, desmitis and fractures. In physical activities that require longer training and that animals were used for longer periods, eg. jumping, polo pony, dressage and work, age-related degenerative, such as joint disease, were predominant. In western sport animals the most common lesion was desmitis. Regarding limbs, forelimb injures were more often observed in racing horses, polo pony, jumping and working animals; whereas, dressage and Western sports horses presented more injuries in hind limbs.
Winkler, Ethan A; Yue, John K; Burke, John F; Chan, Andrew K; Dhall, Sanjay S; Berger, Mitchel S; Manley, Geoffrey T; Tarapore, Phiroz E
OBJECTIVE Sports-related traumatic brain injury (TBI) is an important public health concern estimated to affect 300,000 to 3.8 million people annually in the United States. Although injuries to professional athletes dominate the media, this group represents only a small proportion of the overall population. Here, the authors characterize the demographics of sports-related TBI in adults from a community-based trauma population and identify predictors of prolonged hospitalization and increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from adults (age ≥ 18 years) across 5 sporting categories-fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged hospital length of stay (LOS), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α sports-related TBIs were documented in the NTDB, which represented 18,310 incidents nationally. Equestrian sports were the greatest contributors to sports-related TBI (45.2%). Mild TBI represented nearly 86% of injuries overall. Mean (± SEM) LOSs in the hospital or intensive care unit (ICU) were 4.25 ± 0.09 days and 1.60 ± 0.06 days, respectively. The mortality rate was 3.0% across all patients, but was statistically higher in TBI from roller sports (4.1%) and aquatic sports (7.7%). Age, hypotension on admission to the emergency department (ED), and the severity of head and extracranial injuries were statistically significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Traumatic brain injury during aquatic sports was similarly associated with prolonged ICU and hospital LOSs, medical complications, and failure to be discharged to
Ramskov, Daniel; Nielsen, R.O.; Rasmussen, Sten
intensity, time or distance. The Kaplan-Meier method was used to estimate survival mileage until RRI in each group. If a participant reported an injury, their survival mileage was eliminated, they underwent examination and the RRI was diagnosed. To evaluate the outcome, cox-regression model was used......The Quadriceps angle (Q-angle) may be associated with the development of Running Related Injuries (RRI). Only a few studies have investigated the association between Q-angle, and the likelihood of RRI. These studies have not led to any firm conclusions, on the link between Q-angle and development...
Ajay Kumar Jain
Full Text Available Total parenteral nutrition (TPN, a lifesaving therapy, involves providing nutrition by bypassing the gut. Unfortunately it is associated with significant complications including gut atrophy and parenteral nutrition associated liver disease (PNALD. PNALD includes steatosis, cholestasis, disrupted glucose metabolism, disrupted lipid metabolism, cirrhosis, and liver failure. The etiopathogenesis remains poorly defined; however, an altered enterohepatic circulation, disrupting nuclear receptor signaling, is emerging as a promising mechanism. Rodent models and our piglet TPN model have shown that, during regular feeding, bile acids activate farnesoid X receptor (FXR in the gut and enhance fibroblast growth factor 19 (FGF19 level. FGF19 regulates bile acid, lipid, and glucose metabolism. We noted reduced FGF19 with TPN use and substantial improvement in FGF19, bilirubin, and metabolic profiles with the FXR agonist chenodeoxycholic acid (CDCA. Additionally, CDCA caused gut growth and enhanced expression of glucagon like peptides (GLPs. GLPs regulate gut trophic effects, insulin, glucose homeostasis, and hepatic steatosis. GLP secretion is regulated by the CDCA activated receptor TGR5. This leads to an important conclusion that, in addition to a disrupted FXR-FGF19 axis, a disrupted TGR5-GLP axis may contribute to TPN related pathologies. Thus modulators of FXR-FGF19 and the TGR5-GLP axis could help bring forward novel treatment strategies.
ZHAO Zi-long; CHEN Xin; ZHU Hui; ZHANG Bao-liang; CHAI Yan; LI Xin-yuan; DONG Jing-fei
Background Traumatic brain injury (TBI) is a heterogeneous condition that can lead to critical LLLness-related corticosteroid insufficiency (CIRCI) causing a high mortality and morbidity.Glucocorticoids were widely used in the clinical management of TBI,but their benefit has been challenged in some studies and their efficacy,especially for treating CIRCI in TBI patients,remains unclear.Methods We conducted a meta-analysis of published data to determine if the controversy is related to clinical dosing and timing of glucocorticoids (GCs) application.We analyzed published reports in four databases (MEDLINE,EMBASE,the Cochrane Controlled Trials Register,and CBMdisc).The published data were stratified into not only low-and high-dose GCs group but also short-and long-term GCs group to compare their effectiveness in improving TBI outcomes.Results We totally identified 16 reports.For low-dose patients,the pooled relative risks (RRs) for two clinical outcomes of death or a combination of death and severe disability were 0.95 (95％ confidence interval (CI):0.80 to 1.13) and 0.95 (95％ CI:0.83 to 1.09),respectively.The risks for infection and gastrointestinal bleeding were 0.85 (95％ CI:0.50 to 1.45) and 0.64 (95％ Cl:0.15 to 2.70),respectively.For high-dose group,the pooled RR of death is 1.14 (95％ Cl:1.06 to 1.21).The pooled RRs for infection and gastrointestinal bleeding for the high-dose patients were 1.04 (95％ CI:0.93 to 1.15) and 1.26 (95％ CI:0.92 to 1.75),respectively.For long-term use group,the pooled RRs for two clinical outcomes of death or a combination of death and severe disability were 0.98 (95％ CI:0.87 to 1.12) and 1.00 (95％ CI:0.90 to 1.11),respectively.The risks for infection and gastrointestinal bleeding were 0.88 (95％ CI:0.71 to 1.11) and 0.96 (95％ CI:0.35 to 2.66),respectively.For short-term use group,the pooled RR of death is 1.15 (95％ CI:1.07 to 1.23),and importantly the effects on infections were beneficial in terms of TBI patients
Full Text Available Malpractice claims concerning recurrent laryngeal nerve (RLN injuries are often related to thyroid surgery, but they can also involve surgeons of different specialties. Our survey was made considering expert opinions on claims for medical malpractice evaluated at Brescia Institute of Forensic Medicine in Italy during the period 1992–2012. Fifteen cases concerned RLN injury. Malpractice was identified in 10 cases, according to the following conditions: low pre and intra-operative risk of nerve injury, no documentation showing that the nerve was isolated and preserved despite the existence of potential risk factors. An accurate, well written and complete surgical report is the main tool for the expert examination in malpractice claims.
Lachance, Chantelle C; Jurkowski, Michal P; Dymarz, Ania C; Mackey, Dawn C
Introduction Fall-related injuries can have serious consequences for older adults, including increased risk of dependence in daily activities and mortality. Compliant flooring is a passive intervention that may reduce the incidence and severity of fall-related injuries in healthcare settings, including acute and long-term care, but few sites have implemented compliant flooring, in part because synthesised evidence about key performance aspects has not been available. Methods and analysis We will conduct a scoping review to address the question: what is presented about the biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety associated with compliant flooring systems that aim to prevent fall-related injuries? We will conduct a comprehensive and systematic literature search of academic databases (AgeLine, CINAHL, EBM Reviews, MEDLINE (Ovid), SportDiscus and Web of Science) and grey literature (clinical trial registries, theses/dissertations, abstracts/conference proceedings and relevant websites). 2 team members will independently screen records (first titles and abstracts, then full text) and extract data from included records. Numerical and narrative analyses will be presented by theme (biomechanical efficacy, clinical effectiveness, cost-effectiveness, workplace safety). Ethics and dissemination This scoping review responds to the information needs of healthcare decision-makers tasked with preventing fall-related injuries. This review will summarise evidence about compliant flooring as a potential intervention for preventing fall-related injuries in older adults and identify gaps in evidence and new avenues for research. Results will be especially useful in long-term care, but also applicable in acute care, assisted living and home care. We will disseminate the review's findings via open-access publications, conference presentations, a webinar, a Stakeholder Symposium and a Knowledge-to-Action Report. PMID:27531731
Møller Luef, Stefan; Lauritsen, Jens Martin; Faergemann, Christian
INTRODUCTION: The aim of this study was to examine the development in incidence rates and the severity of weapon-related physical interpersonal violence in Odense Municipality, Denmark from 1991 to 2009. METHODS: All victims of physical interpersonal violence with weapon-related injuries treated...... at the Emergency Department in the 1991-2009 period at Odense University Hospital, Denmark, and/or subjected to medico-legal autopsy at the Institute of Forensic Medicine in the 1991-2009 period at the University of Southern Denmark were included. Incidence rates were estimated following stratification by gender...... rate was 4.8 per 1,000 victims in males and 29.1 per 1,000 victims in females. More than half (57%) of the homicides were caused by lesions due to sharp weapons. CONCLUSION: Weapon-related injuries are rare in the Odense Municipality. The incidence rate of weapon-related violence did not increase...
Herring, Rachel; Betsy, Thom; Beccaria, Franca
The EMCDDA’s 10th scientific monograph, entitled Harm reduction: evidence, impacts and challenges provides a comprehensive overview of the harm reduction field. Part I of the monograph looks back at the emergence of harm reduction approaches and their diffusion, and explores the concept from diff...
Davies, Louise; Oliver, Chris
The aim of this study was to analyse statistically published data regarding the age related prevalence of aggression and self-injury in persons with intellectual disability. Studies including prevalence data for aggression and/or self-injury broken down by age band were identified and relative risk analyses conducted to generate indices of age…
Full Text Available Nonsuicidal self-injury (NSSI and suicidal behaviors, both important issues in adolescent health care, are frequently associated and possibly clinically related. Our objective was to explore the views of relations between nonsuicidal self-injury and suicidal behaviors during adolescence and young adulthood (11-25 years expressed in the scientific (medical and psychological literature. We adopted a textual approach to the process of synthesis to tell the story of the findings from the included studies. Our narrative systematic review of 64 articles found that they share the same risk factors. Integrated models envision nonsuicidal self-injury as a gateway enabling teens to acquire the capability for suicide. Because suicidal behavior short-circuits thought, it is difficult to conceive an intention to die during adolescents' acts of self-injury. Intention is constructed by the narrative of the act, influenced by numerous elements from the psychopathologic, cultural, religious, and philosophic context. Techniques of mentalizing-based treatments and work on the meaning that adolescents attribute to their behaviors might improve care.
Helgeson, Melvin D; Potter, Benjamin K; Burns, Travis C; Hayda, Roman A; Gajewski, Donald A
We studied patients with combat-related injuries that required delayed amputation at least 4 months after the initial injury due to dysfunction, persistent pain, and patient desires. Late amputations were performed 22 times in 22 patients (21 men, 1 woman) since 2003. Fourteen patients underwent transtibial amputation, 5 transfemoral amputations, 1 knee disarticulation, and 2 transradial amputations. The primary indications for late amputation were neurologic dysfunction in 6 patients, persistent or recurrent infection in 6, neurogenic pain in 3, non-neurogenic pain in 5, and a globally poor functional result in 2. Sixteen of 22 patients reported multiple indications for electing to undergo amputation, with an average of 2.1 specific indications per patient. At final clinical follow-up an average of 13 months after amputation, all patients reported subjectively improved function and reported that they would undergo amputation again under similar circumstances. When medically and functionally practicable, every effort is given to limb salvage following severe combat-related extremity injuries. There is no single risk factor that increases the likelihood of delayed amputation, but the combination of complex pain symptoms with neurologic dysfunction appears to increase the risk, particularly if the initial insult is a severe hindfoot injury or distal tibia fracture. With appropriately selected and counseled patients, elective late amputation results in a high degree of patient satisfaction and subjectively improved function.
Chan, Christie Wl; Eng, Janice J; Tator, Charles H; Krassioukov, Andrei
Despite the recognition of sports as a significant contributor in the etiology of spinal cord injury (SCI), no studies have systematically explored the epidemiology of SCI caused by sports. This paper aims to give a systematic overview of the epidemiology of sport-related spinal cord injury around the world. A systematic review was conducted to identify published literature reporting the epidemiology of SCI caused by sports. The literature search was conducted in MEDLINE/PubMed, CINAHL, EMBASE, PsycINFO and Sportdiscus with date limits 1980 through to July 2015. Data from 54 studies covering 25 countries was extracted and collated. Important findings include identification of 6 countries in which sports accounts for over 13% of SCI (highest to lowest: Russia, Fiji, New Zealand, Iceland, France and Canada); individual sports with high risk for SCI (diving, skiing, rugby, and horseback riding); and the most common level of injury for various sports (almost entirely cervical for hockey, skiing, diving and American football, while over half of horseback riding and snowboarding injuries are thoracic or lumbosacral). This paper identifies countries and sports with higher rates of sport-related SCIs where implementation of prevention programs and reporting systems to track SCI epidemiology may be helpful, and highlights gaps in our current knowledge for further investigation. The comparison of SCI occurrence for each sport across countries, as well as examination of the specific characteristics of SCI incurred for individual sports will assist in directing efforts for prevention.
Full Text Available Objectives: This case-control study aimed to investigate the predictors of return to work (RTW following work-related major forearm, wrist or hand injury at the preparation stage of return to work. Material and Methods: A total of 80 clients were recruited and divided into 2 groups depending on their readiness of RTW. The groups were compared with each other with regard to their demographics, compensation status, hand injury severity, health perception, and time off work (TOW using correlation coefficient. Predictors of RTW were measured by logistic regression analysis. Results: There were no significant differences in demographics and the severity of hand injury between 2 groups. Self-perceived physical functioning (p = 0.04, vitality (p = 0.01, mental health (p = 0.03 and TOW (p = 0.001 were significantly different between Action group and Preparation group. With binary logistic regression analysis, self-perceived vitality (odds ratio (OR = 1.041 and TOW (OR = 0.996 were shown to be strongly predictive of RTW at the preparation stage of return to work. Conclusions: This study has shown that shorter TOW and better self-perceived vitality could predict early readiness for RTW after major work-related forearm, wrist or hand injury.
Santaella-Tenorio, Julian; Cerdá, Magdalena; Villaveces, Andrés; Galea, Sandro
Firearms account for a substantial proportion of external causes of death, injury, and disability across the world. Legislation to regulate firearms has often been passed with the intent of reducing problems related to their use. However, lack of clarity around which interventions are effective remains a major challenge for policy development. Aiming to meet this challenge, we systematically reviewed studies exploring the associations between firearm-related laws and firearm homicides, suicides, and unintentional injuries/deaths. We restricted our search to studies published from 1950 to 2014. Evidence from 130 studies in 10 countries suggests that in certain nations the simultaneous implementation of laws targeting multiple firearms restrictions is associated with reductions in firearm deaths. Laws restricting the purchase of (e.g., background checks) and access to (e.g., safer storage) firearms are also associated with lower rates of intimate partner homicides and firearm unintentional deaths in children, respectively. Limitations of studies include challenges inherent to their ecological design, their execution, and the lack of robustness of findings to model specifications. High quality research on the association between the implementation or repeal of firearm legislation (rather than the evaluation of existing laws) and firearm injuries would lead to a better understanding of what interventions are likely to work given local contexts. This information is key to move this field forward and for the development of effective policies that may counteract the burden that firearm injuries pose on populations.
Grandclerc, Salome; De Labrouhe, Diane; Spodenkiewicz, Michel
Nonsuicidal self-injury (NSSI) and suicidal behaviors, both important issues in adolescent health care, are frequently associated and possibly clinically related. Our objective was to explore the views of relations between nonsuicidal self-injury and suicidal behaviors during adolescence and young adulthood (11–25 years) expressed in the scientific (medical and psychological) literature. We adopted a textual approach to the process of synthesis to tell the story of the findings from the included studies. Our narrative systematic review of 64 articles found that they share the same risk factors. Integrated models envision nonsuicidal self-injury as a gateway enabling teens to acquire the capability for suicide. Because suicidal behavior short-circuits thought, it is difficult to conceive an intention to die during adolescents' acts of self-injury. Intention is constructed by the narrative of the act, influenced by numerous elements from the psychopathologic, cultural, religious, and philosophic context. Techniques of mentalizing-based treatments and work on the meaning that adolescents attribute to their behaviors might improve care. PMID:27089157
The incidence of injury in combat sports has not been adequately reported although it is important to identify the nature and frequency of injuries prior to the implementation of prevention programs. This study compared injury rates treated in Hospital Emergency Departments between different combat sports of boxing, wrestling, and martial arts. A secondary objective described anatomic region and diagnosis of these injuries. Data were obtained on all boxing, wrestling, and martial arts-related injuries that were in the National Electronic Injury Surveillance System database and resulted in Emergency Department visits between 2002 and 2005. Pearson’s chi-square statistics were calculated to compare injury rates for each activity accounting for complex sample design. Martial arts had lower injury rates compared to boxing and wrestling for all diagnoses (pMartial arts have lower emergency department injury rates compared to boxing and wrestling. Wrestling has higher strains/sprains and dislocation injury rates compared to boxing. Combat sports do not appear to have higher injury rates compared to non-combat sports. PMID:24198705
Danny A. Young-Afat
Full Text Available Hand infections occurring after fishing and other marine-related activities may involve uncommon bacteria that are not susceptible to the conventional or empiric antibiotic therapy used to treat soft tissue infections. Therefore appropriate treatment is often delayed and could lead to severe hand damage. An illustrative case of fishing-related injury leading to complicated tenosynovitis and horseshoe abscess caused by Mycobacterium marinum and its treatment course is outlined. Laceration of the skin during boating is fairly common. Because of the rarity of some of the bacteria, referrals to the appropriate specialist including hand surgeons and infectious disease specialists should occur in early stages. M. marinum infections should always be considered in injuries related to seawater and fishing as this may lead to early appropriate treatment and prevent severe damage.
Kong, George Y X; Henderson, Robert H; Sandhu, Sukhpal S; Essex, Rohan W; Allen, Penelope J; Campbell, William G
Careful surgical management of traumatic wounds is important in open globe injury repair. This study examines the clinical outcomes following repair of open globe injuries with particular focus on wound-related issues. Retrospective, cohort study of consecutive open globe injuries presenting to a tertiary referral eye hospital from 1 January 2009 to 31 December 2011. A total of 267 eyes of 263 patients, mainly male (82.5%) with a mean age of 44.8 (range: 4-97) years. Average follow up was 6.9 months. All cases classified according to Ocular Trauma Classification Group. Visual outcomes, risk factors for and rates of postoperative complications and endophthalmitis. There were 83 globe ruptures, 182 penetrating and 2 perforating eye injuries, of which 43 cases had intraocular foreign body. Factors contributing to final visual acuity (VA) globe rupture (OR = 4.64, [1.99-10.8]), retinal detachment (OR = 3.40, [1.19-9.74]) and age ≥50 (OR = 2.45, [1.05-5.74]). Wound leak occurred in 44 eyes (16%). Of these, 18 (41%) proceeded to re-suturing. Factors contributing to wound leak were stellate-shaped wound (OR = 3.28, [1.39-7.73]) and delayed presentation (OR = 2.80, [1.02-7.71]). Ten eyes (3.7%) developed endophthalmitis. Factors associated with endophthalmitis were delayed presentation (OR = 8.91, [1.71-46.6]), microbial keratitis (OR = 12.5, [1.85-85.0]) and lens capsule breach (OR = 12.4, [1.85-83.1]). Wound leak is an important postoperative complication of open globe injury repair. Delayed presentation is an important risk factor for postoperative wound leak and endophthalmitis. Prompt and meticulous wound management of open globe injury may reduce these complications. © 2015 Royal Australian and New Zealand College of Ophthalmologists.
Mahesh, E.; Puri, S.; Varma, V.; Madhyastha, P. R.; Bande, S.; Gurudev, K. C.
Pregnancy-related acute kidney injury (PRAKI) contributes to 3–7% of overall acute kidney injury (AKI) cases in Indian subcontinent. The aim of this study was to determine the outcomes of PRAKI and risk factors associated with renal injury and maternal mortality. One hundred and sixty-five patients with PRAKI, seen at M. S. Ramaiah Medical College between 2005 and 2014, were included in this, observational study. AKI was analyzed in terms of maximal stage of renal injury attained as per Risk, Injury, Failure, Loss of function, and End-stage renal disease (RIFLE) criteria. Outcomes included requirement for renal replacement therapy (RRT), maternal, and fetal mortality. Incidence of PRAKI was 1.56%, and the mean age of the study population was 25 years. Fifty percent of the patients were diagnosed with PRAKI during their first pregnancy. PRAKI was observed most commonly in the postpartum period (60%), followed by third trimester (32%); as per RIFLE criteria, failure was seen in 36% and injury in 34%. Thirty percent of cases required RRT. Sepsis (59%), pre-eclampsia, and eclampsia (56%) were the leading causes of PRAKI, while sepsis was the leading cause of maternal mortality. Maternal and fetal mortality were 20% and 22%, respectively. In univariate analysis, shock, hemorrhage requiring transfusion of >5 units packed red blood cells, oliguria, and “Loss” category of RIFLE were significantly associated with mortality. Majority of the patients (57%) required Intensive Care Unit care with a mean duration of admission at 7.3 days, and 75% was diagnosed with AKI at the time of admission. We report the lowest incidence of PRAKI in contemporary Indian literature. PRAKI was associated with high maternal and fetal mortality, with sepsis being the leading cause. No association was noted between mortality and initial stages of RIFLE criteria. PMID:28356662
Full Text Available Pregnancy-related acute kidney injury (PRAKI contributes to 3–7% of overall acute kidney injury (AKI cases in Indian subcontinent. The aim of this study was to determine the outcomes of PRAKI and risk factors associated with renal injury and maternal mortality. One hundred and sixty-five patients with PRAKI, seen at M. S. Ramaiah Medical College between 2005 and 2014, were included in this, observational study. AKI was analyzed in terms of maximal stage of renal injury attained as per Risk, Injury, Failure, Loss of function, and End-stage renal disease (RIFLE criteria. Outcomes included requirement for renal replacement therapy (RRT, maternal, and fetal mortality. Incidence of PRAKI was 1.56%, and the mean age of the study population was 25 years. Fifty percent of the patients were diagnosed with PRAKI during their first pregnancy. PRAKI was observed most commonly in the postpartum period (60%, followed by third trimester (32%; as per RIFLE criteria, failure was seen in 36% and injury in 34%. Thirty percent of cases required RRT. Sepsis (59%, pre-eclampsia, and eclampsia (56% were the leading causes of PRAKI, while sepsis was the leading cause of maternal mortality. Maternal and fetal mortality were 20% and 22%, respectively. In univariate analysis, shock, hemorrhage requiring transfusion of >5 units packed red blood cells, oliguria, and “Loss” category of RIFLE were significantly associated with mortality. Majority of the patients (57% required Intensive Care Unit care with a mean duration of admission at 7.3 days, and 75% was diagnosed with AKI at the time of admission. We report the lowest incidence of PRAKI in contemporary Indian literature. PRAKI was associated with high maternal and fetal mortality, with sepsis being the leading cause. No association was noted between mortality and initial stages of RIFLE criteria.
Background Although injuries related to sports and recreation represent a significant burden to children and youth, few studies have examined the descriptive epidemiology of sports-related injury since 2005, and some sports such as ringette have not been evaluated to date. The primary purpose of this study was to provide the descriptive epidemiology of sports-related injuries treated in emergency departments for children and youth aged 5 – 19. Methods A retrospective data analysis was performed using data from the Canadian Hospitals Injury Reporting and Prevention Program [CHIRPP] from fiscal years (April – March) 2007/08 to 2009/10. CHIRPP is a computerized information system designed by the Public Health Agency of Canada that collects information about injuries to people evaluated in emergency departments across 11 pediatric hospitals and 5 general hospitals in Canada. Thirteen sports or activities were analyzed (baseball, basketball, cycling, football, ice hockey, lacrosse, ringette, rugby, skiing, sledding, snowboarding, soccer, and volleyball). Descriptive statistics, including frequency by sport, age and sex, as well as the percent of concussions within each sport were calculated. Results Out of a total of 56, 691 reported sports and recreational injuries, soccer accounted for the largest proportion of injuries with 11,941 reported cases over the 3 year time period. Of these, approximately 30% were fractures. The 10 – 14 year age group reported the greatest proportion of injuries in 10 out of the 13 sports analyzed. In addition, males reported a greater number of overall injuries than females in 11 out of the 13 sports analyzed. The largest percentage of concussions was reported in ringette; these injuries accounted for 17.1% of overall injuries within this sport. Conclusions Injury prevention programs in Canada should focus on improving evidence-based programs to reduce the burden of injuries in all sports. PMID:24364875
Young, Liane; Bechara, Antoine; Tranel, Daniel; Damasio, Hanna; Hauser, Marc; Damasio, Antonio
Summary Moral judgments, whether delivered in ordinary experience or in the courtroom, depend on our ability to infer intentions. We forgive unintentional or accidental harms and condemn failed attempts to harm. Prior work demonstrates that patients with damage to the ventromedial prefrontal cortex (VMPC) deliver abnormal judgments in response to moral dilemmas, and that these patients are especially impaired in triggering emotional responses to inferred or abstract events (e.g., intentions), as opposed to real or actual outcomes. We therefore predicted that VMPC patients would deliver abnormal moral judgments of harmful intentions in the absence of harmful outcomes, as in failed attempts to harm. This prediction was confirmed in the current study: VMPC patients judged attempted harms including attempted murder as more morally permissible relative to controls. These results highlight the critical role of the VMPC in processing harmful intent for moral judgment. PMID:20346759
Kıvanç, Sertaç Argun; Akova Budak, Berna; Skrijelj, Emina; Tok Çevik, Mediha
To evaluate demographic characteristics and clinical outcomes of work-related open globe injuries in the most industrialized region of Turkey. The demographic and medical records of patients with work-related open globe injuries who presented to the ophthalmology or emergency departments with an official occupational accident report were retrospectively reviewed. Visual acuity categories were defined according to the World Health Organization. The injury types and zones of the open globes were classified according to Birmingham Eye Trauma Terminology System. Among 479 patients with work-related eye injuries in 5 years, there were 102 eyes of 101 patients with open globe injuries (21%). The mean age of the patients was 34.5±8.9 years with a mean follow-up of 12.5±12.6 months. The injuries peaked in June in the hour between 12:00 and 13:00. Eighty-six percent presented to emergency services within 12 hours after the injury. Twenty-two percent of the patients had been wearing protective eyewear at the time of injury. The open globe injuries were penetrating in 51%, intraocular foreign body in 40%, rupture in 7% and perforation in 2% of the eyes. The most frequent finding was traumatic cataract. Final visual acuity of 33.3% of patients was below 3/60. Seventy-eight percent of patients that had visual acuity worse than 6/18 at presentation had visual acuity of 6/18 or better at final visit. Sixty-three percent of eyes which had injuries involving all 3 zones resulted in phthisis bulbi, enucleation or evisceration. Work-related open globe injuries may have severe consequences such as visual impairment and blindness among the young male working population in industrialized areas. Nearly half of the occupational open globe injuries resulted in visual impairment and blindness.
Barker, Anna; Kamar, Jeannette; Tyndall, Tamara; Hill, Keith
This article is a report of a study of associations between occurrence of serious fall-related injuries and implementation of low-low beds at The Northern Hospital, Victoria, Australia. A 9-year evaluation at The Northern Hospital found an important reduction in fall-related injuries after the 6-PACK falls prevention program was implemented. Low-low beds are a key component of the 6-PACK that aims to decrease fall-related injuries. A retrospective cohort study. Retrospective audit of The Northern Hospital inpatients admitted between 1999-2009. Changes in serious fall-related injuries throughout the period and associations with available low-low beds were analysed using Poisson regression. During the observation of 356,158 inpatients, there were 3946 falls and 1005 fall-related injuries of which 60 (5·9%) were serious (55 fractures and five subdural haematomas). Serious fall-related injuries declined significantly throughout the period. When there was one low-low bed to nine or more standard beds there was no statistically significant decrease in serious fall-related injuries. An important reduction only occurred when there was one low-low bed to three standard beds. The 6-PACK program has been in place since 2002 at The Northern Hospital. Throughout this time serious fall-related injuries have decreased. There appears to be an association between serious fall-related injuries and the number of available low-low beds. Threshold numbers of these beds may be required to achieve optimal usability and effectiveness. A randomized controlled trial is required to give additional evidence for use of low-low beds for injury prevention in hospitals. © 2012 Blackwell Publishing Ltd.
Moffitt, Terrie E; Houts, Renate M; Belsky, Daniel W; Arseneault, Louise; Caspi, Avshalom
Objectives To test whether frequent bullying victimisation in childhood increases the likelihood of self harming in early adolescence, and to identify which bullied children are at highest risk of self harm. Design The Environmental Risk (E-Risk) longitudinal study of a nationally representative UK cohort of 1116 twin pairs born in 1994-95 (2232 children). Setting England and Wales, United Kingdom. Participants Children assessed at 5, 7, 10, and 12 years of age. Main outcome measures Relative risks of children’s self harming behaviour in the six months before their 12th birthday. Results Self harm data were available for 2141 children. Among children aged 12 who had self harmed (2.9%; n=62), more than half were victims of frequent bullying (56%; n=35). Exposure to frequent bullying predicted higher rates of self harm even after children’s pre-morbid emotional and behavioural problems, low IQ, and family environmental risks were taken into account (bullying victimisation reported by mother: adjusted relative risk 1.92, 95% confidence interval 1.18 to 3.12; bullying victimisation reported by child: 2.44, 1.36 to 4.40). Victimised twins were more likely to self harm than were their non-victimised twin sibling (bullying victimisation reported by mother: 13/162 v 3/162, ratio=4.3, 95% confidence interval 1.3 to 14.0; bullying victimisation reported by child: 12/144 v 7/144, ratio=1.7, 0.71 to 4.1). Compared with bullied children who did not self harm, bullied children who self harmed were distinguished by a family history of attempted/completed suicide, concurrent mental health problems, and a history of physical maltreatment by an adult. Conclusions Prevention of non-suicidal self injury in young adolescents should focus on helping bullied children to cope more appropriately with their distress. Programmes should target children who have additional mental health problems, have a family history of attempted/completed suicide, or have been maltreated by an adult
Kawai, Yoshiko; Nakao, Takafumi; Kunimura, Naoshi; Kohda, Yuka; Gemba, Munekazu
We investigated the involvement of reactive oxygen species (ROS) and intracellular calcium in nephrotoxicity related to an antitumor agent, cisplatin. In this study, we employed cultured renal epithelial cells (LLC-PK1). Cisplatin at 500 microM significantly increased the production of ROS 5 h and caused cell injury. This agent significantly increased the intracellular calcium level ([Ca2+]i) in a dose-dependent manner 1 h or more after exposure. DPPD (N,N'-diphenyl-p-phenylenediamine), an antioxidant, inhibited a cisplatin-related increase in active oxygen production and cell injury but did not inhibit an early increase in the [Ca2+]i level. An intracellular calcium-chelating compound BAPTA-AM (1,2-bis(O-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid tetra(acetoxymethyl) ester) inhibited an increase in ROS production and cell injury induced by cisplatin. Furthermore, BAPTA-AM suppressed the rise of [Ca2+]i level in 1 h after exposure; however, an extracellular calcium chelator EGTA and a calcium antagonist nicardipine did not inhibit the rise in [Ca2+]i level in the early phase. An NADPH oxidase inhibitor inhibited a cisplatin-related increase in ROS production and cell disorder. These results suggest that cisplatin-related calcium release from the site of intracellular calcium storage in the early phase causes oxidative stress in renal tubular epithelial cells. Cisplatin may increase the intracellular production of ROS via NADPH oxidase.
being less competent (Sawchyn, Mateer, & Suffi eld, 2005 ). Mild TBI has also been associated with greater emotional distress ( Leininger , Kreutzer...brain injury . Brain Injury , 23 , 83 – 91 . Leininger , B.E. , Kreutzer , J.S. , & Hill , M.R . ( 1991 ). Comparison of minor and severe
Allan, Charlotte L; Behrman, Sophie; Ebmeier, Klaus P
Self-harm is best defined as 'any act of self-poisoning or self-injury carried out by an individual irrespective of motivation'. With a 10.5% lifetime risk, self-reported self-harm is common in the community. Self-harm can occur at any age but is most common in young people. Prior self-harm is the key risk factor both for repeated self-harm and also for subsequent suicide. The presence of depressive symptoms predicts repeated self-harm, as does any history of psychiatric illness. Assessment of self-harm (actual or planned) should include: details of preplanning; final acts; the event itself; what happened afterwards; as well as broader psychosocial risk factors. Patients should be asked to reflect on the episode to consider whether they regret it, or whether they are likely to repeat it. Patients should be screened for depression, anxiety, psychosis and history of self-harm. Physical illness and substance misuse increase risk. Referral to secondary care community mental health teams should be considered for patients who present in primary care with a history of self-harm and a risk of repetition. Patients with continuing thoughts or serious intent of self-harm, where supportive or protective factors cannot be identified, may need urgent referral to secondary care. Prediction of further episodes of self-harm is difficult. Some clinicians may find the use of standardised rating scales, such as the SAD PERSONS scale, a useful way to identify patients who warrant referral and further assessment. The GP should provide long-term continuity of care, and maintain a holistic awareness of a patient's life events enabling discussion of the patient's emotional problems at an early stage with the aim of intervening before a crisis.
Stanhope J; Milanese S; Grimmer K
Jessica Stanhope,1 Steve Milanese,2 Karen Grimmer1 1International Centre for Allied Health Evidence, 2School of Health Sciences, University of South Australia, Adelaide, SA, Australia Background: This study aimed to determine the experiences of university classical woodwind students with playing-related injuries (PRIs), the impact of these PRIs, the management selected by students with PRIs, and the perceived effectiveness of this management. Materials and methods: All classical woodwind stu...
Kalb, Luther G; Vasa, Roma A; Ballard, Elizabeth D; Woods, Steven; Goldstein, Mitchell; Wilcox, Holly C
Several reports suggest children with autism spectrum disorder (ASD) are more likely to be seen for injury-related ED visits; however, no nationally representative study has examined this question. Using data from the 2008 Nationwide Emergency Department Sample, over a quarter of all visits among those with ASD were related to injury. In the multivariate analyses, the odds of an injury-related visit was 54 % greater among those with ASD compared to youth with intellectual disability (ID), but 48 % less compared to youth without ID or ASD. Compared to all other pediatric injury-visits in the US, visits among children with ASD were more likely to be due to self-inflicted injury and poisoning and were more likely to result in hospitalization (all p < 0.001).
Changma Fu; Zongsheng Yin; Defu Yu; Zuhua Yang
The neuropeptides, substance P and calcitonin gene-related peptide, have been shown to be involved in pain transmission and repair of sciatic nerve injury. A model of sciatic nerve defect was prepared by dissecting the sciatic nerve at the middle, left femur in female Sprague Dawley rats. The two ends of the nerve were encased in a silica gel tube. L5 dorsal root ganglia were harvested 7, 14 and 28 days post sciatic nerve injury for immunohistochemical staining. Results showed that substance P and cal-citonin gene-related peptide expression increased significantly in dorsal root ganglion of rats with sci-atic nerve injury. This increase peaked at 7 days, declined at 14 days, and reduced to normal levels by 28 days post injury. The findings indicate that the neuropeptides, substance P and calcitonin gene-related peptide, mainly increased in the early stages after sciatic nerve injury.
Xiao Fan; Li Zhang
Spinal cord injury is a disease of high incidence and low cure rate without any ideal treatment. Among the complex pathological reactions, the post-injury abnormal expressions of many genes may be an important one. Method of tonifying Qi and activating blood circulation, which is one of the most important treatments of spinal cord injury in Traditional Chinese Medicine and has been used extensively in clinic, is proved to be effective in the treatment of spinal cord injury. Recently, many scholars have carried out a lot of studies in this filed and acquired notable achievements. The essay concludes mechanisms of the regulation of method of tonifying Qi and activating blood circulation in the related gene expressions after spinal cord injury to provide new thoughts and new methods for the treatment and study of spinal cord injury.
Full Text Available Shaheen C Kavoussi,1 Martin D Slade,2 Seth W Meskin,1 Ron A Adelman11Department of Ophthalmology and Visual Science, 2Department of Occupational and Environmental Medicine, Yale University School of Medicine, New Haven, CT, USA Aim: We aimed to identify the characteristics and prognostic indicators of poor visual and anatomic outcome in pseudophakic patients with fall-related open-globe (OG injuries. We used a case series design, for a total of 26 patients.Methods: Charts of consecutive pseudophakic patients with fall-related OG injury at a single institution were reviewed. Demographics, ophthalmic history, circumstances of injury, initial best-corrected visual acuity (BCVA, examination findings, surgical interventions, and follow-up BCVA were tabulated for statistical analysis with unpaired t-tests and Fisher’s exact tests.Results: Nineteen patients (73% were women. Mean (± standard deviation age was 80.6±4.6 years (range: 61–97 years. Initial BCVA was <20/400 in 24 of 25 patients (96%. Mean ocular trauma score (OTS was 38.54±10.95. OTS was lower (P=0.0017, P<0.0001, and P=0.0240 and wound size was larger (P=0.0440, 0.0145, and 0.0026 in patients with final BCVA <20/40, <20/400, and phthisis at final follow-up, respectively; compared to patients with BCVA ≥20/40, 20/400, and no phthisis at final follow-up, respectively. Final BCVA <20/400 was associated with 360° subconjunctival hemorrhage (SCH, retinal detachment, and proliferative vitreoretinopathy (P=0.0498, 0.0181, and 0.0310, respectively. Total hyphema, intraocular lens (IOL damage, and IOL expulsion were associated with needing multiple surgical interventions (P=0.0345, P<0.0001, and P=0.0023, respectively.Conclusion: Large wound size, low OTS, 360° SCH, total hyphema, posterior injury, and IOL damage are common findings that are also prognostic of poor visual and anatomic outcome in pseudophakic patients with fall-related OG injuries. Ophthalmologists dealing primarily
Full Text Available While large mass mortality events (MMEs are well known for toothed whales, they have been rare in baleen whales due to their less gregarious behavior. Although in most cases the cause of mortality has not been conclusively identified, some baleen whale mortality events have been linked to bio-oceanographic conditions, such as harmful algal blooms (HABs. In Southern Chile, HABs can be triggered by the ocean–atmosphere phenomenon El Niño. The frequency of the strongest El Niño events is increasing due to climate change. In March 2015, by far the largest reported mass mortality of baleen whales took place in a gulf in Southern Chile. Here, we show that the synchronous death of at least 343, primarily sei whales can be attributed to HABs during a building El Niño. Although considered an oceanic species, the sei whales died while feeding near to shore in previously unknown large aggregations. This provides evidence of new feeding grounds for the species. The combination of older and newer remains of whales in the same area indicate that MMEs have occurred more than once in recent years. Large HABs and reports of marine mammal MMEs along the Northeast Pacific coast may indicate similar processes in both hemispheres. Increasing MMEs through HABs may become a serious concern in the conservation of endangered whale species.
Yue, John K; Winkler, Ethan A; Burke, John F; Chan, Andrew K; Dhall, Sanjay S; Berger, Mitchel S; Manley, Geoffrey T; Tarapore, Phiroz E
OBJECTIVE Traumatic brain injury (TBI) in children is a significant public health concern estimated to result in over 500,000 emergency department (ED) visits and more than 60,000 hospitalizations in the United States annually. Sports activities are one important mechanism leading to pediatric TBI. In this study, the authors characterize the demographics of sports-related TBI in the pediatric population and identify predictors of prolonged hospitalization and of increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from children (age 0-17 years) across 5 sports categories: fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged length of stay (LOS) in the hospital or intensive care unit (ICU), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α sports-related TBIs were recorded in the NTDB, and these injuries represented 11,614 incidents nationally after sample weighting. Fall or interpersonal contact events were the greatest contributors to sports-related TBI (47.4%). Mild TBI represented 87.1% of the injuries overall. Mean (± SEM) LOSs in the hospital and ICU were 2.68 ± 0.07 days and 2.73 ± 0.12 days, respectively. The overall mortality rate was 0.8%, and the prevalence of medical complications was 2.1% across all patients. Severities of head and extracranial injuries were significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Hypotension on admission to the ED was a significant predictor of failure to discharge to home (OR 0.05, 95% CI 0.03-0.07, p injury incurred during roller sports was independently associated with prolonged hospital LOS compared
Dual air bags will be required standard equipment in all new passenger cars sold in the United States beginning in 1997 and all light trucks sold in the United States in 1998 but are available now in many earlier-model vehicles. Air bags are designed to supplement the protection provided by safety belts in frontal crashes; when combined with lap and shoulder safety belts, air bags assist in preventing fatal and nonfatal injuries in motor-vehicle crashes. However, passenger-side air bags have been associated with injuries to children who, in almost all cases, were unrestrained or incorrectly restrained in the front seat. In 1993, approximately 1.4 million (0.8% of all vehicles registered) were equipped with passenger-side air bags, compared with an estimated 21.6 million vehicles (11.4% of all vehicles registered) in 1996 (National Highway Traffic Safety Administration [NHTSA], unpublished data, 1996). NHTSA, the National Transportation Safety Board (NTSB), and CDC collaborated with the American Academy of Pediatrics, the Children's Hospital of Philadelphia, The Air Bag Safety Campaign, the National Safety Council, the Brain Injury Association, the National Association of Governors Highway Safety Representatives, the National Association of Children's Hospitals and Related Institutions, and the Health Resources and Services Administration to examine crashes from the Special Crash Investigation Data File maintained by NHTSA, in which fatal injuries in children (aged air bags. This report presents the findings of this review, which indicate that during January 1993-November 1996, annual increases occurred for both the number of fatal injuries to children resulting from air-bag deployments and the proportion of dual air bag-equipped vehicles (Table 1).
Pamella Padilha BRITO
Full Text Available Introduction: The quality of prenatal care, childbirth and newborn are determinants of perinatal morbidity and mortality. The realization of a adequate prenatal care and skilled birth assistance would reduce the incidence of injuries and perinatal deaths that are largely preventable. Method: Descriptive and exploratory study of quantitative and qualitative nature. Interview and review of medical records of thirty mothers and newborns were made. The results were chart using the SPSS software, version 20.0, for processing and statistical analysis. We performed thematic analysis of interviews, and tabulated according to their frequencies, identifying the differences and similarities between data. Results: The most frequent perinatal injuries were prematurity (74.2%, Respiratory Distress (71%, Underweight (51.6%, Infection or Sepsis (41.9%, Perinatal Asphyxia (19.4% and Oligohydramnio (19.4%. These injuries were related to several factors such as inadequate prenatal care, with fewer than six prenatal consultations (70% and late onset (50%, and presence of maternal health problems such as: changes in amniotic fluid (50% and preterm labor (50%. The interviewees added other factors such as failures in the care professional (43%, failures in care and service (33%, difficulty of access (19% and breast self-care failures (16.6%. Conclusion: Stood out in this study the occurrence of perinatal injuries in children of mothers with stable socio-demographic profile and in term newborns as also the percentage of deaths (16.1%. The perinatal injuries and deaths could have been avoided with qualified prenatal care, childbirth and newborn care.
Full Text Available Abstract Background To prevent burn injuries it is vital to have sound information on predictors of its occurrence in different settings. Ardabil Province is the coldest province of Iran with high burden of burn injuries. The aim of this study was to determine the household related predictors of unintentional burns in Ardabil Province located at North-West of Iran. Methods The study was conducted through a hospital based case–control design. 239 burn victims as well as 246 hospital-based controls were enrolled. Both bivariate and multivariate analysis methods were used. Results Males comprised 55.2% of all the study subjects. Mean age of the participants was 21.8 years (95% CI: 19.17-24.4. The economic ability of the households was associated with risk of burn injuries. Multivariate conditional logistic regression results showed the following variables to be independent factors associated with burn injuries. Using non-conventional pipe-less air heaters instead of conventional piped kerosene- or gas-burning heaters (Odds ratio: 1.98, 95% CI: 1.1-3.6. Common use of picnic gas-stove for cooking at home (odds ratio = 1.6, 95%CI: 1–2.4. Using electric samovars instead of other types of samovars (Odds ratio = 0.3, 95% CI: 0.1-1. Using samovars lacking the national standard authorization mark (Odds ratio = 2.2, 95% CI: 1.4-3.6. Conclusion Using some types of specific heating or cooking appliances, and unsafe use of conventional appliances were major risk predictors of burn injuries in this population.
Background To prevent burn injuries it is vital to have sound information on predictors of its occurrence in different settings. Ardabil Province is the coldest province of Iran with high burden of burn injuries. The aim of this study was to determine the household related predictors of unintentional burns in Ardabil Province located at North-West of Iran. Methods The study was conducted through a hospital based case–control design. 239 burn victims as well as 246 hospital-based controls were enrolled. Both bivariate and multivariate analysis methods were used. Results Males comprised 55.2% of all the study subjects. Mean age of the participants was 21.8 years (95% CI: 19.17-24.4). The economic ability of the households was associated with risk of burn injuries. Multivariate conditional logistic regression results showed the following variables to be independent factors associated with burn injuries. Using non-conventional pipe-less air heaters instead of conventional piped kerosene- or gas-burning heaters (Odds ratio: 1.98, 95% CI: 1.1-3.6). Common use of picnic gas-stove for cooking at home (odds ratio = 1.6, 95%CI: 1–2.4). Using electric samovars instead of other types of samovars (Odds ratio = 0.3, 95% CI: 0.1-1). Using samovars lacking the national standard authorization mark (Odds ratio = 2.2, 95% CI: 1.4-3.6). Conclusion Using some types of specific heating or cooking appliances, and unsafe use of conventional appliances were major risk predictors of burn injuries in this population. PMID:22571762
Sadeghi-Bazargani, Homayoun; Arshi, Shahnam; Mashoufi, Mehrnaz; Deljavan-anvari, Reza; Meshkini, Mohammad; Mohammadi, Reza
To prevent burn injuries it is vital to have sound information on predictors of its occurrence in different settings. Ardabil Province is the coldest province of Iran with high burden of burn injuries. The aim of this study was to determine the household related predictors of unintentional burns in Ardabil Province located at North-West of Iran. The study was conducted through a hospital based case-control design. 239 burn victims as well as 246 hospital-based controls were enrolled. Both bivariate and multivariate analysis methods were used. Males comprised 55.2% of all the study subjects. Mean age of the participants was 21.8 years (95% CI: 19.17-24.4). The economic ability of the households was associated with risk of burn injuries. Multivariate conditional logistic regression results showed the following variables to be independent factors associated with burn injuries. Using non-conventional pipe-less air heaters instead of conventional piped kerosene- or gas-burning heaters (Odds ratio: 1.98, 95% CI: 1.1-3.6). Common use of picnic gas-stove for cooking at home (odds ratio = 1.6, 95%CI: 1-2.4). Using electric samovars instead of other types of samovars (Odds ratio = 0.3, 95% CI: 0.1-1). Using samovars lacking the national standard authorization mark (Odds ratio = 2.2, 95% CI: 1.4-3.6). Using some types of specific heating or cooking appliances, and unsafe use of conventional appliances were major risk predictors of burn injuries in this population.
van Geel, Mitch; Goemans, Anouk; Vedder, Paul
Several studies suggest that there are relations between children's or adolescents' self-injurious behaviors and peer victimization. In the current study, a meta-analysis was performed to study the relations between non-suicidal self-injury and peer victimization. Non-suicidal self-injury focuses on self-injurious behaviors without suicidal intent, that result in immediate tissue damage and are not socially sanctioned within one's culture or for display. Using a meta-analysis, effect sizes of existing studies can be statistically summarized, and publication bias and moderators can be analyzed. The databases PsycINFO, MEDLINE, ERIC and ProQuest were searched for relevant articles. Articles were only included if they focused on children or adolescents, if they focused on non-clinical samples, and if they focused on self-injuring behaviors as opposed to thoughts or ideation. We found nine studies with fourteen independent samples and a total of 20,898 adolescents and children reporting on the relation between peer victimization and non-suicidal self-injury. Our analysis showed positive and significant relations between non-suicidal self-injury and peer victimization. Further analyses showed an absence of publication bias. Younger children that were victimized reported significantly more non-suicidal self-injury than older children. By preventing peer victimization we may potentially prevent non-suicidal self-injury in children and adolescents.
Bredeweg, Steef W.; Zijlstra, Sjouke; Bessem, Bram; Buist, Ida
Objectives There is no consensus on the aetiology and prevention of running-related injuries in runners. Preconditioning studies among different athlete populations show positive effects on the incidence of sports injuries. Hypothesis A 4-week preconditioning programme in novice runners will reduce
Vanlaar, Ward; Mainegra Hing, Marisela; Brown, Steve; McAteer, Heather; Crain, Jennifer; McFaull, Steven
The goals of this study were to analyze possible trends of fatal and serious injuries related to vulnerable road users in Canada (pedestrians, cyclists and motorcyclists) from 1990 to 2012 and the role of alcohol and drugs in these cases. Drugs have rarely been documented with respect to vulnerable road users. The Traffic Injury Research Foundation's National Fatality and Serious Injury Databases and the Public Health Agency of Canada's Canadian Hospitals Injury Reporting and Prevention Program databases were used. Numbers and rates of fatalities and serious injuries among vulnerable road users were analyzed and regression models were used to assess changes over time. The analyses show that while the absolute number of fatalities and the rate per 100,000 population among vulnerable road users may be decreasing, no such trends are apparent when looking at the proportions of these road user fatalities out of all motor-vehicle fatalities. The trend for the proportion of motorcyclist fatalities is significantly increasing (coef.=0.16, p<0.001). The elderly (76years or older) are overrepresented among pedestrian fatalities, and serious injuries (they represent 18.5% of all pedestrian fatalities but only 5.8% of the population), while those 15years or younger are overrepresented among cyclists (they represent 23.3% of cyclist fatalities but 19.5% of the population), and those 16 to 25years old are overrepresented among motorcyclists (27.2% of motorcyclists fatalities and 13.6% of population). Alcohol and drug use among fatally injured vulnerable road users were significant problems, especially among pedestrians. Among fatally injured pedestrians tested for alcohol and drugs, 39.7% and 43.4% tested positive, respectively. With the promotion of walking and cycling as forms of exercise and the popularity of motorcycling, the safety of vulnerable road users is an important issue. The results corroborate previous research and extend our understanding about the influence of
Rozenfeld, Michael; Peleg, Kobi; Givon, Adi; Kessel, Boris
When treating patients with stab injuries of the torso, clinicians often lack timely information about the degree and nature of internal organ damage. An externally observable sign significantly associated with characteristics of torso injuries may therefore be useful for practitioners. One such potential sign is the presence of wounds to the hands, sometimes sustained during victims' attempt to defend themselves during the violent altercation. Thus, the primary aim of this study was to evaluate the association between presence of upper extremity wounds and the severity of the thoracic and intra-abdominal injuries due to stabbing. This study was carried out retrospectively using data on 8714 patients with stabbing-related injuries from 19 trauma centers that participated in the Israeli National Trauma Registry (INTR) between January 1st1997 and December 31st 2013. Patients with wounds of upper extremities in addition to torso injuries (UE group) were compared to other patients with torso injuries (TO group) in terms of demographics, injury characteristics and clinical outcome. The compared groups were found to be homogeneous in terms of age and systolic blood pressure; the number of sustained torso injuries was also identical. The UE group comprised a slightly greater percentage of females, however both groups were predominantly male. Patients with upper extremity injuries had a lower proportion of internal organ damage (36% vs. 38.5%) and lower mortality (0.9% vs. 2%). The higher mortality of patients without upper extremity wounds remained significantly different even when adjusted by other epidemiological parameters (OR 2.46, 95% CI 1.33-5.08).The number of sustained upper extremity injuries was positively associated with deeper penetration of the torso by the stabbing instrument. Patients with stabbing-related upper extremity wounds had a significant survival advantage over patients without such injuries. However, a greater number of sustained upper extremity
Full Text Available The study aimed at evaluating the psychometric properties of the German version of the Self- Harm Inventory (SHI and examining the lifetime prevalence and correlates of self-harm in a representative German population sample (N = 2,507; age mean = 48.79, SD = 18.11; range 14 to 94 years; 55.5% women using the SHI. All participants answered the German SHI, the short form of the Barratt Impulsiveness Scale (BIS-15, the ultra-brief Patient Health Questionnaire for Depression and Anxiety (PHQ-4, and provided sociodemographic information. The one-factorial structure of the SHI was replicated using a confirmatory factor analysis. Internal consistency coefficients were sufficient and in line with previous studies. Almost half of the sample (49% acknowledged at least one self-harming behavior over the life-span, most frequently indirect forms of self-harm. The rate of participants who engaged in at least one SHI behavior was higher among men than women (51.6% vs. 46.9%, respectively, χ2 = 5.38, p = 0.020. Higher SHI scores were related to younger age, male gender, living alone, more symptoms of anxiety and depression (PHQ-4, higher impulsivity scores (BIS-15, and suffering from obesity grade 2. Women engaged more often in discreet forms of self-harm than men, e.g., preventing wounds from healing, exercising an injury, starving, and abusing laxatives. In terms of other indirect self-harming behaviors, men admitted more often driving recklessly, being promiscuous and losing a job on purpose, while women reported more frequently engaging in emotionally abusive relationships. With respect to direct self-harm, women were more likely to endorse suicide attempts and cutting, while men admitted more often head-banging. The findings suggest that self-harm constitutes a common problem. Future longitudinal studies are required to examine the natural course, sociodemographic and psychopathological risk factors, as well as possible time-trends of self-harming
Müller, Astrid; Claes, Laurence; Smits, Dirk; Brähler, Elmar; de Zwaan, Martina
The study aimed at evaluating the psychometric properties of the German version of the Self- Harm Inventory (SHI) and examining the lifetime prevalence and correlates of self-harm in a representative German population sample (N = 2,507; age mean = 48.79, SD = 18.11; range 14 to 94 years; 55.5% women) using the SHI. All participants answered the German SHI, the short form of the Barratt Impulsiveness Scale (BIS-15), the ultra-brief Patient Health Questionnaire for Depression and Anxiety (PHQ-4), and provided sociodemographic information. The one-factorial structure of the SHI was replicated using a confirmatory factor analysis. Internal consistency coefficients were sufficient and in line with previous studies. Almost half of the sample (49%) acknowledged at least one self-harming behavior over the life-span, most frequently indirect forms of self-harm. The rate of participants who engaged in at least one SHI behavior was higher among men than women (51.6% vs. 46.9%, respectively, χ2 = 5.38, p = 0.020). Higher SHI scores were related to younger age, male gender, living alone, more symptoms of anxiety and depression (PHQ-4), higher impulsivity scores (BIS-15), and suffering from obesity grade 2. Women engaged more often in discreet forms of self-harm than men, e.g., preventing wounds from healing, exercising an injury, starving, and abusing laxatives. In terms of other indirect self-harming behaviors, men admitted more often driving recklessly, being promiscuous and losing a job on purpose, while women reported more frequently engaging in emotionally abusive relationships. With respect to direct self-harm, women were more likely to endorse suicide attempts and cutting, while men admitted more often head-banging. The findings suggest that self-harm constitutes a common problem. Future longitudinal studies are required to examine the natural course, sociodemographic and psychopathological risk factors, as well as possible time-trends of self-harming behaviors in more
Zuckerman, Scott L; Prather, Colin T; Yengo-Kahn, Aaron M; Solomon, Gary S; Sills, Allen K; Bonfield, Christopher M
OBJECTIVE Arachnoid cysts (ACs) are congenital lesions bordered by an arachnoid membrane. Researchers have postulated that individuals with an AC demonstrate a higher rate of structural brain injury after trauma. Given the potential neurological consequences of a structural brain injury requiring neurosurgical intervention, the authors sought to perform a systematic review of sport-related structural-brain injury associated with ACs with a corresponding quantitative analysis. METHODS Titles and abstracts were searched systematically across the following databases: PubMed, Embase, CINAHL, and PsycINFO. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Peer-reviewed case reports, case series, or observational studies that reported a structural brain injury due to a sport or recreational activity (hereafter referred to as sport-related) with an associated AC were included. Patients were excluded if they did not have an AC, suffered a concussion without structural brain injury, or sustained the injury during a non-sport-related activity (e.g., fall, motor vehicle collision). Descriptive statistical analysis and time to presentation data were summarized. Univariate logistic regression models to assess predictors of neurological deficit, open craniotomy, and cystoperitoneal shunt were completed. RESULTS After an initial search of 994 original articles, 52 studies were found that reported 65 cases of sport-related structural brain injury associated with an AC. The median age at presentation was 16 years (range 4-75 years). Headache was the most common presenting symptom (98%), followed by nausea and vomiting in 49%. Thirteen patients (21%) presented with a neurological deficit, most commonly hemiparesis. Open craniotomy was the most common form of treatment (49%). Bur holes and cyst fenestration were performed in 29 (45%) and 31 (48%) patients, respectively. Seven patients (11%) received
Inpatient falls are the most common adverse events that occur in a hospital, and about 3 to 10% of falls result in serious injuries such as bone fractures and intracranial haemorrhages. We previously reported that bone fractures and intracranial haemorrhages were two major fall-related injuries and that risk assessment score for osteoporotic bone fracture was significantly associated not only with bone fractures after falls but also with intracranial haemorrhage after falls. Based on the results, we tried to establish a risk assessment tool for predicting fall-related severe injuries in a hospital. Possible risk factors related to fall-related serious injuries were extracted from data on inpatients that were admitted to a tertiary-care university hospital by using multivariate Cox’ s regression analysis and multiple logistic regression analysis. We found that fall risk score and fracture risk score were the two significant factors, and we constructed models to predict fall-related severe injuries incorporating these factors. When the prediction model was applied to another independent dataset, the constructed model could detect patients with fall-related severe injuries efficiently. The new assessment system could identify patients prone to severe injuries after falls in a reproducible fashion. PMID:25168984
Full Text Available Abstract Background While child maltreatment is recognised as a global problem, solid epidemiological data on the prevalence of child maltreatment and risk factors associated with child maltreatment is lacking in Australia and internationally. There have been recent calls for action to improve the evidence-base capturing and describing child abuse, particularly those data captured within the health sector. This paper describes the quantity of documentation of maltreatment risk factors in injury-related paediatric hospitalisations in Queensland, Australia. Methods This study involved a retrospective medical record review, text extraction and coding methodology to assess the quantity of documentation of risk factors and the subsequent utility of data in hospital records for describing child maltreatment and data linkage to Child Protection Service (CPS. Results There were 433 children in the maltreatment group and 462 in the unintentional injury group for whom medical records could be reviewed. Almost 93% of the maltreatment code sample, but only 11% of the unintentional injury sample had documentation identified indicating the presence of any of 20 risk factors. In the maltreatment group the most commonly documented risk factor was history of abuse (41%. In those with an unintentional injury, the most commonly documented risk factor was alcohol abuse of the child or family (3%. More than 93% of the maltreatment sample also linked to a child protection record. Of concern are the 16% of those children who linked to child protection who did not have documented risk factors in the medical record. Conclusion Given the importance of the medical record as a source of information about children presenting to hospital for treatment and as a potential source of evidence for legal action the lack of documentation is of concern. The details surrounding the injury admission and consideration of any maltreatment related risk factors, both identifying their
Mentrikoski, Janelle M; Duncan, Christina L; Melanson, Andrea; Louden, Emily; Allgier, Allison; Michaud, Linda; Rinaldi, Robert
Owing to the possible visible nature and functional impairments associated with neonatal brachial plexus injuries (NBPI), the current study investigated the relations of injury severity, social support, and coping strategies to social difficulties and self-concept in youth with NBPI. 88 children (aged 10-17 years) with NBPI and their parent(s) were recruited from a national organization and two brachial plexus clinics. Participants completed a variety of questionnaires during their scheduled clinic visits. More social support from classmates was associated with better self-concept and fewer social difficulties. Less frequent use of negative coping strategies was associated with better self-concept and fewer social difficulties and was a significant moderator of the relation between injury severity and self-concept. Clinicians who work with children with NBPI should consider peer support and coping strategies when promoting the psychosocial functioning of these youth. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: email@example.com.
Shults, Ruth A; West, Bethany A; Rudd, Rose A; Helmkamp, James C
To estimate the numbers and rates of all-terrain vehicle (ATV)-related nonfatal injuries among riders aged ≤ 15 years treated in hospital emergency departments (EDs) in the United States during 2001-2010. National Electronic Injury Surveillance System-All Injury Program data for 2001-2010 were analyzed. Numbers and rates of injuries were examined by age group, gender, primary body part injured, diagnosis, and hospital admission status. During 2001-2010, an estimated 361,161 ATV riders aged ≤ 15 years were treated in EDs for ATV-related injuries. The injury rate peaked at 67 per 100,000 children in 2004 and then declined to 42 per 100,000 children by 2010. The annualized injury rate for boys was double that of girls (73 vs 37 per 100,000). Children aged 11 to 15 years accounted for two-thirds of all ED visits and hospitalizations. Fractures accounted for 28% of ED visits and 45% of hospitalizations. The reasons for the decline in ATV-related injuries among young riders are not well understood but might be related to the economic recession of the mid-2000s and decreased sales of new ATVs. Although many states have regulations governing children's use of ATVs, their effectiveness in reducing injuries is unclear. Broader use of known effective safety measures, including prohibiting children aged ≤ 15 years from riding adult-sized ATVs, always wearing a helmet while riding, not riding on paved roads, and not riding as or carrying a passenger could additionally reduce ATV-related injuries among children. Last, more research to better understand ATV crash dynamics might lead to safer designs for ATVs.
LI-PING LI; SHENG WANG
Currently, China is in short of thorough and systemic data concerning the patterns and incidence of injuries and related deaths. Guangdong Province as one of the economically advanced areas in China is faced with a relatively serious injury problem, and investigation of this problem in this Province will provide valuable information for other provinces and areas in this Country, as well as scientific basis for policy making for injury prevention and control. Methods Analyses are based on the computerized hospital discharge data collected from 322 hospitals in Guangdong Province between 1997 and 2001. Diagnoses are coded according to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). Results The total hospitalization rate related with injuries increased year by year from 1997 to 2001. The ratio of case-fatality has a decline trend for all injury inpatients, who were mainly caused by motor vehicle accidents, unintentional falls, puncture and cut by machine and others. The constituent ratio of death among patients caused by motor vehicle accidents accounted for 56.13% among the total deaths, which ranked as the first place. The direct medical cost also had an increased trend. Conclusions Data on injuries requiring hospitalization can be used to design and target more effective injury prevention programs. Injury prevention would decrease human sufferings, disability, and associated economic losses.
In Australia, both common and statutory law allows compensation for negligently occasioned recognised psychiatric injury, but distinguishes between pure mental harm and consequential mental harm. This column briefly discusses the concept of pure "mental harm" and the major Australian cases relating to defendants' liability to third parties for causing them pure mental harm (Jaensch v Coffey (1984) 155 CLR 549; Tame v New South Wales; Annetts v Australian Stations Pty Ltd (2002) 211 CLR 317; Sullivan v Moody (2001) 207 CLR 562; and Gifford v Strang Patrick Stevedoring Pty Ltd (2003) 214 CLR 269). The analysis focuses on judicial approaches to determining liability in these cases, especially causation. Lack of guiding principles and precise tests for attribution of liability are illustrated by Kemp v Lyell McEwin Health Service (2006) 96 SASR 192. This case is analysed first in the context of common law, and then in the light of the reform legislation contained in the Civil Liability Act 1936 (SA) and similar provisions in other jurisdictions.
McHugh, E E
This paper outlines the preventive health strategic measures that are currently in place and it endeavours to consider how improvements can be made to our national preventive strategy with the goal of reducing alcohol-related facial injuries. It is based on a review of the literature sourced through PubMed, Ovid Medline and the Cochrane database. The main findings are that increased funding, legislative amendment and media involvement are key to improving the work of the health services in their struggle to limit the ever increasing alcohol-related incidents that are experienced by society today.
Sanchez-Marquez, A.; Gil-Garcia, M.; Valls, C.; Narvaez-Garcia, J.; Andia-Navarro, E.; Pozuelo-Segura, O. [Inst. de Diagnostic per la Imatge (IDI), Hospital Duran i Reynals, Barcelona (Spain); Portabella-Blavia, F. [Servei de Cirurgia Ortopedica i Traumatologia, Ciutat Sanitaria i Univ., Barcelona (Spain)
Sports-related injuries of the lower extremity are frequent. Before magnetic resonance (MR) imaging was available, ultrasound, radionuclide scintigraphy and computed tomography were used to evaluate muscle trauma. Although relatively inexpensive, these imaging modalities are limited by their low specificity. The high degree of soft tissue contrast and multiplanar capability of MR imaging, allow direct visualization as well as characterization of traumatic muscle lesions. This pictorial review highlights the spectrum of traumatic muscle lesions on MRI, with emphasis on its typical appearances. (orig.) With 12 figs., 12 refs.
Roudsari, Bahman; Psoter, Kevin J; Mack, Christopher; Vavilala, Monica S; Jarvik, Jeffrey G
The purpose of our study was to evaluate the burden of alcohol-related injuries on a radiology department at a level 1 trauma center. We linked the trauma registry (2005-2009) of Harborview Medical Center to billing department data and extracted patient demographic and injury-related characteristics and the radiology services provided. Multivariate negative binomial analysis was used to evaluate the association between blood alcohol concentration (BAC) and CT and MRI utilization rates. A total of 125,776 CT and 4681 MRI examinations were performed on 27,274 patients during the study period. Higher BAC was generally associated with higher utilization rates for all types of CT even after adjusting for potential confounding variables. Compared with patients with a BAC of 0, the greatest increases in utilization were observed in individuals with a BAC of 240 mg/dL or more for head CT (incidence rate ratio [IRR], 1.43; 95% CI, 1.32-1.54), cervical spine (IRR, 1.45; 95% CI, 1.32-1.58), and maxillofacial (IRR, 1.66; 95% CI, 1.42-1.95), with no increase observed for MRI. This association was more prominent in less severely injured patients with utilization rates for head CT (IRR, 1.83; 95% CI, 1.56-2.13), abdomen (IRR, 1.46; 95% CI, 1.32-1.63), and thorax (IRR, 1.57; 95% CI, 1.30-1.89) in individuals with a BAC of 240 mg/dL or more compared with those with a BAC of 0. Higher BAC was associated with increased CT utilization for most body region-specific CT scans and was more strongly associated in patients with less severe injuries. Any guideline that could potentially decrease unnecessary imaging for patients with alcohol-involved injuries would represent a cost-saving strategy.
Chercos, Daniel Haile; Berhanu, Demeke
Work injury is an important cause of morbidity and mortality, much of these work injuries burden can be found in industry required heavy manual work such as, agriculture and fishers. Hence; agriculture is consistently cited as one of the most hazardous industry in the world. The objective of this study isto assess the magnitude and associated factors of work related injury among Saudi Star Agro Industry workers in Gambella region, South West Ethiopia. An institutional based cross-sectional study design was conducted on Saudi Star Agro Industry located in Gambella region, from February - June 2014 on 449 randomly selected workers who arestratifiedby working department. Anobservation checklist, factory clinical records and a structured interview questioner were used as a data collection tools. The prevalence of work related injury was 36.7%. Marital status [AOR;1.69, 95%; CI;(1.1-2.7)], service year [AOR;1.9,95%; CI;(1.17-3.1)], working more than 48 h per week [AOR;9.87, 95%; CI;(5.95-16.28)],safety training [AOR;3.38, 95%;CI;1.14-9.98)], regular health checkup [AOR; 12.29, 95%; CI (9-51.35)] and usage of personal protective equipment [AOR; 2.36, 95%; CI; (1.06-5.25)] were significant factors for the occurrence of work related injury. The prevalence of work related injury was high. Working hours, safety training and regular health checkup increases the risk of work related injury.
Ginwalla, Rashna; Rhee, Peter; Friese, Randall; Green, Donald J; Gries, Lynn; Joseph, Bellal; Kulvatunyou, Narong; Lubin, Dafney; O'Keeffe, Terence; Vercruysse, Gary; Wynne, Julie; Tang, Andrew
Senate Bill 1108 (SB-1108) allows adult citizens to carry concealed weapons without a permit and without completion of a training course. It is unclear whether the law creates a "deterrent factor" to criminals or whether it escalates gun-related violence. We hypothesized that the enactment of SB-1108 resulted in an increase in gun-related injuries and deaths (GRIDs) in southern Arizona. We performed a retrospective cohort study spanning 24 months before (prelaw) and after (postlaw) SB-1108. We collected injury and death data and overall crime and accident trends. Injured patients were dichotomized based on whether their injuries were intentional (iGRIDs) or accidental (aGRIDs). The primary outcome was any GRID. To determine proportional differences in GRIDs between the two periods, we performed χ analyses. For each subgroup, we calculated relative risk (RR). The number of national and state background checks for firearms purchases increased in the postlaw period (national and state p guns had an 11% increased risk of being injured or killed by a firearm (p = 0.036) The proportion of iGRIDs to overall city violent crime remained the same during the two periods (9.74% prelaw vs. 10.36% postlaw; RR, 1.06; 95% confidence interval, 0.96-1.17). However, in the postlaw period, the proportion of gun-related homicides increased by 27% after SB-1108 (RR, 1.27; 95% confidence interval, 1.02-1.58). Both nationally and statewide, firearm purchases increased after the passage of SB-1108. Although the proportion of iGRIDs to overall city violent crime remained the same, the proportion of gun-related homicides increased. Liberalization of gun access is associated with an increase in fatalities from guns. Epidemiologic study, level III.
score for upper and lower extremities was 84% and 86.6%; negative predictive values were calculated as 95.45% and 90.2%, respectively. Conclusion: MESS is not predictive in combat related extremity injuries especially if between a score of 6–8. Limb ischemia and presence or absence of shock can be used in initial decision-making for amputation.
Gilyoma Japhet M
Full Text Available Abstract Background Animal related injuries are a major but neglected emerging public health problem and contribute significantly to high morbidity and mortality worldwide. No prospective studies have been done on animal related injuries in our setting. This study was conducted to determine the management patterns and outcome of animal related injuries and their social impact on public health policy in the region. Methods This was a descriptive prospective study of animal related injury patients that presented to Bugando Medical Centre between September 2007 and August 2011. Statistical data analysis was done using SPSS computer software version 17.0. Results A total of 452 (8.3% animal-related injury patients were studied. The modal age group was 21-30 years. The male to female ratio was 2.1:1. Dog-bites (61.1% were the most common injuries. Musculoskeletal (71.7% region was the most frequent body region injured. Soft tissue injuries (92.5% and fractures (49.1% were the most common type of injuries sustained. Only 140 (31.0% patients were hospitalized and most of them (97.1% were treated surgically. Wound debridement was the most common procedure performed in 91.2% of patients. Postoperative complication rate was 15.9%, the commonest being surgical site infections (SSI in 55.1% of patients. SSI was significantly associated with late presentation and open fractures (P Conclusion Animal related injuries constitute a major public health problem in our setting and commonly affect the young adult male in their economically productive age-group. Measures towards prevention and proper treatment and follow up are important in order to reduce morbidity and mortality resulting from this form of trauma
Tinetti, Mary E; McAvay, Gail J; Fried, Terri R; Allore, Heather G; Salmon, Joanna C; Foody, Joanne M; Bianco, Luann; Ginter, Sandra; Fraenkel, Liana
To determine the priority that older adults with coexisting hypertension and fall risk give to optimizing cardiovascular outcomes versus fall- and medication symptom-related outcomes. Interview. Community. One hundred twenty-three cognitively intact persons aged 70 and older with hypertension and fall risk. Discrete choice task was used to elicit the relative importance placed on reducing the risk of three outcomes: cardiovascular events, serious fall injuries, and medication symptoms. Risk estimates with and without antihypertensive medications were obtained from the literature. Participants chose between 11 pairs of options that displayed lower risks for one or two outcomes and a higher risk for the other outcome(s), versus the reverse. Results were used to calculate relative importance scores for the three outcomes. These scores, which sum to 100, reflect the relative priority participants placed on the difference between the risk estimates of each outcome. Sixty-two participants (50.4%) placed greater importance on reducing risk of cardiovascular events than reducing risk of the combination of fall injuries and medication symptoms; 61 participants did the converse. A lower percentage of participants with chronic obstructive pulmonary disease (P=.02), unsteadiness (P=.02), functional dependency (P=.04), lower cognition (P=.02) and depressive symptoms (P=.03) prioritized cardiovascular outcomes over fall injuries and medication symptoms than did participants without these characteristics. Interindividual variability in the face of competing outcomes supports individualizing decision-making to individual priorities. In the current example, this may mean forgoing antihypertensive medications or compromising on blood pressure reduction for some individuals.
Luef, Stefan Møller; Lauritsen, Jens Martin; Faergemann, Christian
The aim of this study was to examine the development in incidence rates and the severity of weapon-related physical interpersonal violence in Odense Municipality, Denmark from 1991 to 2009. All victims of physical interpersonal violence with weapon-related injuries treated at the Emergency Department in the 1991-2009 period at Odense University Hospital, Denmark, and/or subjected to medico-legal autopsy at the Institute of Forensic Medicine in the 1991-2009 period at the University of Southern Denmark were included. Incidence rates were estimated following stratification by gender and age. The development in the incident rates was examined. Overall, 2,957 victims were included. The overall incidence rate was 8.5 per 10,000 population/year (14.6 and 2.7 for males and females, respectively). The rates did not change significantly in the study period. Most victims were injured with bottles/glass and blunt weapons (44.8% versus 28.2%), whereas 24% were injured with sharp weapons and 3% with firearms. Most lesions were sustained to the head/neck (56.1%) and to the upper limbs (26.2%). A total of 182 (6.1%) victims had lesions that were considered severe. The mortality rate was 4.8 per 1,000 victims in males and 29.1 per 1,000 victims in females. More than half (57%) of the homicides were caused by lesions due to sharp weapons. Weapon-related injuries are rare in the Odense Municipality. The incidence rate of weapon-related violence did not increase in the study period. Additionally, no evidence of an increased proportion of severe injuries was found. Women had a seven-fold higher mortality than males. none. not relevant.
Tinetti, Mary E.; McAvay, Gail J.; Fried, Terri R.; Allore, Heather G.; Salmon, JoAnna C.; Foody, Joanne M.; Bianco, Luann; Ginter, Sandra; Fraenkel, Liana
OBJECTIVES To determine the priority that older adults with coexisting hypertension and fall risk give to optimizing cardiovascular outcomes versus fall- and medication symptom-related outcomes. DESIGN Interview. SETTING Community. PARTICIPANTS One hundred twenty-three cognitively intact persons aged 70 and older with hypertension and fall risk. MEASUREMENTS Discrete choice task was used to elicit the relative importance placed on reducing the risk of three outcomes: cardiovascular events, serious fall injuries, and medication symptoms. Risk estimates with and without antihypertensive medications were obtained from the literature. Participants chose between 11 pairs of options that displayed lower risks for one or two outcomes and a higher risk for the other outcome(s), versus the reverse. Results were used to calculate relative importance scores for the three outcomes. These scores, which sum to 100, reflect the relative priority participants placed on the difference between the risk estimates of each outcome. RESULTS Sixty-two participants (50.4%) placed greater importance on reducing risk of cardiovascular events than reducing risk of the combination of fall injuries and medication symptoms; 61 participants did the converse. A lower percentage of participants with chronic obstructive pulmonary disease (P =.02), unsteadiness (P =.02), functional dependency (P =.04), lower cognition (P =.02) and depressive symptoms (P =.03) prioritized cardiovascular outcomes over fall injuries and medication symptoms than did participants without these characteristics. CONCLUSION Interindividual variability in the face of competing outcomes supports individualizing decision-making to individual priorities. In the current example, this may mean forgoing antihypertensive medications or compromising on blood pressure reduction for some individuals. PMID:18662210
Chambers, I R; Jones, P A; Lo, T Y M; Forsyth, R J; Fulton, B; Andrews, P J D; Mendelow, A D; Minns, R A
Background The principal strategy for managing head injury is to reduce the frequency and severity of secondary brain insults from intracranial pressure (ICP) and cerebral perfusion pressure (CPP), and hence improve outcome. Precise critical threshold levels have not been determined in head injured children. Objective To create a novel pressure–time index (PTI) measuring both duration and amplitude of insult, and then employ it to determine critical insult thresholds of ICP and CPP in children. Methods Prospective, observational, physiologically based study from Edinburgh and Newcastle, using patient monitored blood pressure, ICP, and CPP time series data. The PTI for ICP and CPP for 81 children, using theoretical values derived from physiological norms, was varied systematically to derive critical insult thresholds which delineate Glasgow outcome scale categories. Results The PTI for CPP had a very high predictive value for outcome (receiver operating characteristic analyses: area under curve = 0.957 and 0.890 for mortality and favourable outcome, respectively) and was more predictive than for ICP. Initial physiological values most accurately predicted favourable outcome. The CPP critical threshold values determined for children aged 2–6, 7–10, and 11–15 years were 48, 54, and 58 mm Hg. respectively. Conclusions The PTI is the first substantive paediatric index of total ICP and CPP following head injury. The insult thresholds generated are identical to age related physiological values. Management guidelines for paediatric head injuries should take account of these CPP thresholds to titrate appropriate pressor therapy. PMID:16103043
Feng, Wei; Gong, Qinghai; Liu, Kui; Li, Hui
The purpose of this study was to explore the epidemiological features of common unintentional injury-related behaviours and to identify possible factors that lead to these unsafe behaviours among adolescents. A representative sample of 10,806 students was recruited from 77 schools by using the two-stage stratified random sampling method. All participants took a self-administered questionnaires and data were analysed to estimate the prevalence of unintentional injury-related behaviours and to identify the influential factors for these behaviours. The prevalence of unsafe swimming, jaywalking, illegal bicycling and not wearing a seat belt was 6.35%, 33.08%, 18.10% and 15.73%, respectively. The proportion of students who had two, three or four unintentional injury-related behaviours was 14.59%, 4.27% and 0.57%, respectively. Multiple regression analysis showed that male adolescents, living in an urban area and attending a vocational-technical school might contribute to the occurrence of four unintentional injury-related behaviours. In addition, the marital status of parents and father with a college degree or above were negatively associated with the adolescent's behaviour of not wearing a seat belt. Considering diverse epidemiological characteristics of unintentional injury-related behaviours among adolescents, targeted interventions such as enhancing self-protection capabilities and strengthening safety consciousness by family, school and related departments should be implemented to lower the occurrence of unintentional injury-related behaviours.
Acute subdural haematoma (ASDH) is one of the conditions most strongly associated with severe brain injury. Reports prior to 1980 describe overall mortality rates for acute subdural haematomas (SDH\\'s) ranging from 40% to 90% with poor outcomes observed in all age groups. Recently, improved results have been reported with rapid diagnosis and surgical treatment. The elderly are predisposed to bleeding due to normal cerebral atrophy related to aging, stretching the bridging veins from the dura. Prognosis in ASDH is associated with age, time from injury to treatment, presence of pupillary abnormalities, Glasgow Coma Score (GCS) or motor score on admission, immediate coma or lucid interval, computerized tomography findings (haematoma volume, degree of midline shift, associated intradural lesion, compression of basal cisterns), post-operative intracranial pressure and type of surgery. Advancing age is known to be a determinant of outcome in head injury. We present the results of a retrospective study carried out in Beaumont Hospital, Dublin, Ireland\\'s national neurosurgical centre. The aim of our study was to examine the impact of age on outcome in patients with ASDH following severe head injury. Only cases with acute subdural haematoma requiring surgical evacuation were recruited. Mortality was significantly higher in older patients (50% above 70 years, 25.6% between 40 and 70 years and 26% below 40 years). Overall poor outcome (defined as Glasgow outcome scores 3-5) was also higher in older patients; 74.1% above 70 years, 48% between 40 and 70 years and 30% below 40 years. Poor outcome in traumatic acute subdural haematoma is higher in elderly patients even after surgical intervention.
Full Text Available Introduction: Behavior pattern influences the risk of unintentional injuries. This study was conducted to identify the pattern of household unsafe behavior in different socioeconomic strata, in Pune city, India. Materials and Method: Population-based, cross-sectional study. Behaviors influencing the risk of burn, poisoning, drowning, and road traffic injuries were questioned from 200 randomly selected households. Results: Nearly 28% of the households did not have a separate kitchen, 37.5% cooked at the ground level, 33.5% used a kerosene pressure stove, 12% used unprotected open fire as a source of warmth in winter, and 34.5% stored inflammable substances at home. Ninety one percent of the households reported storing poisonous chemicals in places that could not be locked. In 68.3% of the households with children below five years, these chemicals were kept in places accessible to children. Nearly 21% of the individuals, who could swim, did so in unsafe places and 25.2% of them were not trained in swimming. In 35.5% of the households, children used streets as playgrounds. Among all two-wheeled vehicle riders, 35.6% reported not having a helmet and 57.7% of those who had a helmet did not use it regularly. Socioeconomic status was strongly associated with the unsafe behaviors related to burns, drowning, and road traffic injuries. Conclusion: The study identifies the sociocultural and behavioral factors leading to unsafe behaviors, placing individuals at risk of unintentional injuries, which can be used as a first step toward prevention.
Selekman, Matthew D.
Approximately 14 to 17 percent of adolescents today self-harm, deliberately cutting, burning, or bruising themselves. Most self-harming adolescents use the behavior as a coping strategy to get immediate relief from emotional distress or other stressors in their lives. Stressors include fitting in with peers, activity and homework overload, fears…
Vanderlei, Franciele Marques; Bastos, Fabio Nascimento; Tsutsumi, Gustavo Yuki Cantalejo; Vanderlei, Luiz Carlos Marques; Netto Júnior, Jayme; Pastre, Carlos Marcelo
The participation of young in volleyball is becoming increasingly common, and this increased involvement raises concerns about the risk of installation of sports injuries. Therefore, the objectives the study were identify the characteristics of sports injuries in young volleyball players and associate anthropometric and training variables with contributing factors for injuries. A total of 522 volleyball players participating in the High School Olympic Games of the State of São Paulo (Brazil) were interviewed. A reported condition inquiry was used to gather information on injuries, such as anatomic site affected, mechanism and moment of injury, as well as personal and training data. The level of significance was set at 5%. A 19% frequency of injuries was found. Higher age, weight, height, body mass index and training duration values were associated with the occurrence of injuries. The most affected anatomic site was the ankle/foot complex (45 injuries, 36.3%). Direct contact and contactless mechanisms were the main causes of injuries (61 injuries; 49.2% and 48 injuries; 38.7%, respectively). Training was the moment in which most injuries occurred (93 injuries; 75%), independently of personal and training characteristics. Injuries affected the ankle/foot complex with a greater frequency. Direct contact and contactless mechanisms were the most frequently reported and injuries occurred mainly during training sessions. Personal and training characteristics were contributing factors for the occurrence of injuries.
Mamotte, Nicole; Wassenaar, Douglas; Singh, Nivedhna
Concern has been voiced in the research ethics literature that under U.S. federal regulations U.S. sponsors, particularly the NIH, are not required to provide compensation for the treatment of research-related injury for trial participants or to allow grant funds to be used by investigators for appropriate insurance. This is problematic in developing country contexts because most participants are unlikely to have health insurance, resulting in overburdened and under-resourced health systems in many developing countries being responsible for providing care and treatment for research-related injury. This study provides preliminary insight into how respondent principal investigators of NIH-sponsored HIV/AIDS clinical trials in Africa and African research ethics committees deal with compensation for research-related injury. The majority of PIs surveyed provided free treatment for research-related injury, but few provided other forms of financial reparation to participants. The study also found that half of the PIs surveyed indicated that NIH funds were used for compensation, highlighting a contradiction between literature and practice. The majority of REC chairs surveyed indicated that their RECs routinely reviewed compensation plans for research-related injury and that their ethics application forms specifically requested information on compensation. Findings from one southern African country revealed that NIH funds were not used to provide treatment and/or financial reparation for research-related injury. Instead, PIs from this country relied on the government or the individual research participant (and/or their medical aid/health insurer) to cover the costs of research-related injury. The findings are discussed in the light of the recent (December 2011) U.S. Presidential Commission for the Study of Bioethics report which recommends that research participants are morally entitled to compensation for research-related injury.
Full Text Available Whether traumatic brain injury (TBI is causally related to substance related disorder (SRD is still debatable, especially in persons with no history of mental disorders at the time of injury. This study analyzed data in the Taiwan National Health Insurance Research Database for 19,109 patients aged ≥18 years who had been diagnosed with TBI during 2000–2010. An additional 19,109 randomly selected age and gender matched patients without TBI (1 : 1 ratio were enrolled in the control group. The relationship between TBI and SRD was estimated with Cox proportional hazard regression models. During the follow-up period, SRD developed in 340 patients in the TBI group and in 118 patients in the control group. After controlling for covariates, the overall incidence of SRD was 3.62-fold higher in the TBI group compared to the control group. Additionally, patients in the severe TBI subgroup were 9.01 times more likely to have SRD compared to controls. Notably, patients in the TBI group were prone to alcohol related disorders. The data in this study indicate that TBI is significantly associated with the subsequent risk of SRD. Physicians treating patients with TBI should be alert to this association to prevent the occurrence of adverse events.
Weigel, M M; Armijos, R X; Beltran, O
Migrant and seasonal farmworkers are at high risk for musculoskeletal and other occupational injuries. Although persons aged 40-80 years account for 40 % of all US farmworkers and as many as 50 % in certain regions, little is known about their occupational health issues. The current study examined work-related persistent musculoskeletal injuries (PMIs) and their association with clinical and functional indicators of disability and health-related quality of life (HRQOL) in 177 middle-aged and elderly US-Mexico border farmworkers. At interview, 68 % reported current PMI pain; 51 % had pain at multiple sites. PMI pain was associated with increased shoulder, knee, and lower extremity dysfunction and reduced HRQOL scores. However, fewer than 25 % of injured participants received any conventional medical treatment. The study results indicated that work-related PMIs, especially multiple PMIs, caused significant functional impairment, disability, and poorer HRQOL, adversely affecting the ability of the aging farmworkers to perform work, self-care, and other daily activities.
Wu, Chieh-Hsin; Tsai, Tai-Hsin; Zhang, Zi-Hao; Liu, Wei; Wu, Ming-Kung; Chang, Chih-Hui; Kuo, Keng-Liang
Whether traumatic brain injury (TBI) is causally related to substance related disorder (SRD) is still debatable, especially in persons with no history of mental disorders at the time of injury. This study analyzed data in the Taiwan National Health Insurance Research Database for 19,109 patients aged ≥18 years who had been diagnosed with TBI during 2000–2010. An additional 19,109 randomly selected age and gender matched patients without TBI (1 : 1 ratio) were enrolled in the control group. The relationship between TBI and SRD was estimated with Cox proportional hazard regression models. During the follow-up period, SRD developed in 340 patients in the TBI group and in 118 patients in the control group. After controlling for covariates, the overall incidence of SRD was 3.62-fold higher in the TBI group compared to the control group. Additionally, patients in the severe TBI subgroup were 9.01 times more likely to have SRD compared to controls. Notably, patients in the TBI group were prone to alcohol related disorders. The data in this study indicate that TBI is significantly associated with the subsequent risk of SRD. Physicians treating patients with TBI should be alert to this association to prevent the occurrence of adverse events.
Ziyab, Ali H; Akhtar, Saeed
Road traffic injuries (RTIs), disabilities and deaths are recognised as a major public health problem worldwide. This study aimed to quantify the magnitude and the trends of RTI-related fatal and non-fatal injuries in Kuwait for the period 2000-2009. Data on road traffic crashes and related events (i.e., fatal and non-fatal minor and severe injuries) were obtained from police records, and the population data were sought from Ministry of Interior, Kuwait. From 2000 to 2009, 11,591 non-fatal RTIs and 3891 RTIs-related deaths occurred in Kuwait. Non-fatal severe RTIs accounted for 28.2% of the total non-fatal RTIs. Of the 2945 RTI-related deaths that occurred from 2003 to 2009, majority were amongst males (87.3%) and in the age range of 20-59 years (70.8%). The mean (SD) annual mortality rates for the 10-year study period (2000-2009) were 14 (1) per 100,000 population and 36 (2) per 100,000 registered vehicles. From 2000 to 2009, population-based and registered vehicle-based overall RTI-related crude mortality rates decreased by 20% and 29%, respectively. However, Poisson regression analyses showed that the overall slightly decreasing trends were statistically non-significant both for population-based crude mortality rate (trend coefficient=-0.016; p(trend)=0.587) and registered vehicle-based crude mortality rate (trend coefficient=-0.024; p(trend)=0.192). Furthermore, the trend in population-based age-adjusted RTI-related mortality rate for 2003-2009 was also statistically non-significant (trend coefficient=-0.050; p(trend)=0.284). For non-fatal severe RTIs, the overall mean (SD) annual rates per 100,000 population and 100,000 registered vehicles were 44 (23) and 113 (60) with corresponding total reduction of 61% and 66% from 2000 to 2009. The overall declining trends in minor and severe RTI rates (both population based and registered vehicles based) were statistically significant (p(trend)<0.001). Despite declined minor and severe RTI rates, the RTI-related crude
Meghoo, Colin A; Dennis, James W; Tuman, Caroline; Fang, Raymond
specificity of 97.2% in diagnosing cervical vascular injury. Penetrating cervical wounds from war-related blast trauma are associated with potentially life-threatening vascular injuries. The presenting physical examination, availability of CT/CTA, local surgical expertise, and tactical combat situation all contribute to surgical decision making in these patients. In patients without hard signs of vascular trauma and a normal CT/CTA of the neck, there is no evidence to support mandatory surgical neck explorations or further immediate diagnostic studies to exclude cervical vascular injury. Published by Mosby, Inc.
Full Text Available The practice of body art (or body decoration has its cultural roots and origins, associated with regional beliefs and rit‑ uals, and is met on all the continents. Can a tattoo – when approached in the understanding of risk behaviour – be regarded as one of autoaggression forms, being a substitute for the purposeful act of self‑harm? An evaluation of tattooing as a substitute for purposeful self‑harm. An analysis of correlations between tattooing and self‑harming in a group of subjects presenting both features. A self‑answer questionnaire, used as a study tool, included a self‑harm and a tattooing section. Questions in the former part had their counterparts in the latter part, what facilitated a compar‑ ative analysis. A study group included 79 subjects with tattoo. Out of that group, tattooed subjects with, at least, one purposeful self‑harm episode in history were isolated, with 56% of females and 44% of males. The analysis was carried out on the percent of subjects from the study group, who reported their sensations, following purposeful self‑harm and tattooing. Differences were observed, regarding the feeling of relief, satisfaction, guilt and impulsiveness in the undertak‑ en actions among the subjects with both features. Tattooing is a risk behaviour and coexists with other risk behaviours, such as risk drinking. Subjects with more than one self‑harm episode in history, presented – beside tattoo – also more invasive forms of body art, e.g., scarification. Even if the obtained results did not attain statistical significance (for the low number of subjects in the study group, we may conclude – although with some caution – about a dissimilar per‑ ception of the roles, played by tattoo and self‑harm in life of those with both features. A thesis may then be implied that tattoo does not fulfil the same function as self‑harm in subjects with both features.
WU, Hui; ZHANG, Fang; CHENG, Wenhong; LIN, Ying; WANG, Qian
Background Those injured in accidents commonly have strong emotional reactions to their situation. However, despite the large number of patients who are admitted to general hospitals each year for orthopedic injuries due to an accident, research focusing on psychological disorders due to these injuries is lacking. Objective To investigate the presentation and factors related to depression and acute anxiety among inpatients being treated for injury on a Trauma Orthopedics Unit. Methods 323 patients with orthopedic trauma were evaluated using the Injury Severity Score (ISS), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD). Results In this study, a total of 323 inpatients (213 males and 110 females) had a mean (sd) age of 44.3 (13.2) years old. Mean (sd) time in the hospital was 11.1 (5.7) days with a range of 2 to 40 days. Among these patients, 299 had mild trauma, 20 had moderate trauma, and 4 had severe trauma. Patients had a mean (sd) score of 8.1 (4.9) with a range of 1 to 38. The top three most reported symptoms from the HAMA were sleep disorder, gastrointestinal symptoms and anxiety. The top three most reported symptoms from the HAMD were sleep disorder, depression and anxiety. Non-conditional logistic regression analysis showed that being female (anxiety: OR=2.738, 95%CI=1.511-4.962; depression: OR=2.622, 95%CI=1.504-4.570) and duration of hospitalization (anxiety: OR=1.091, 95%CI=1.040-1.145; depression: OR=1.093, 95%CI=1.044-1.144) were risk factors for anxiety and depression among these orthopedic trauma patients. Conclusion The main acute symptoms of anxiety and depression in these orthopedic trauma inpatients were sleep disorder, gastrointestinal symptoms, anxious mood and depressed mood. Female patients had stronger emotional reactions to injuries than males. Persistent anxiety and depression symptoms were associated with the duration of hospitalization. All these suggest the need for early psychological assessment and intervention for
Full Text Available In this study, it was aimed to examine the deaths related to the firearm injuries during childhood in Konya and the information such as demographic aspects of the cases, the types of the firearms, origin, and the region of injury, place of case, place of death, shooting distance, and the owner of the firearm. With this purpose, the cases which were autopsied by Konya Branch of Forensic Medicine Council and by forensic medicine expert in the districts of Konya between 1999 and 2007 were retrospectively examined. Among 985 death cases at the age of 18 and under; 50 (5.1% were determined to occur as a result of firearm injuries. The ages of the cases changed between 1 and 18 and the average age was 14.6 + 3.9 (median: 16. 34 cases (68% were boys while 16 (32% of them were girls. The rate of boys to girls was 2.1:1. The origin was suicide in 20 cases (40%, accident in 17 cases (34% and 13 cases (26% was murder. Shotguns were used in 33 cases (66% and handguns were use in 17 cases (34%. Only head was injured in 27 cases (54% while only abdominal region was injured in 10 cases (20%. 29 (70% of firearm injuries took place at home. 35 cases (70% died at crime scene and 3 of them (6% died on the way to hospital. In 24 cases (48% the shooting was performed adjacently or from a close distant, the shooting were performed from nearby in 11 cases (22% while 15 shooting cases (30% were performed from a long distance. In 24 (48% cases, the gun belonged to the victim’s father. As a result, it was seen that keeping the firearms at homes in the increasing rates would end up with deaths during the childhood age. We think it is necessary and useful for people to avoid from keeping firearms at home or other living quarters, keep them in higher places or under strong locking when they have to since they could lead to suicide or accident originated injuries or deaths if the children easily access to the firearms. Key words: Child, firearm, death, forensic medicine
Al Mofleh Ibrahim
Full Text Available A large proportion of the population all over the world consumes acetylsalicylic acid (ASA: aspirin or other nonsteroidal, antiinflammatory drugs (NSAIDs. This is associated with a considerable morbidity and mortality. Elderly patients, patients with prior history of peptic ulcer disease (PUD or its complications, those who require high doses of NSAIDs and those undergoing concomitant therapy with corticosteroids or anticoagulants, are at particularly high risk of developing gastroduodenal injuries and related adverse reactions. Gastroduodenal mucosal injuries induced by NSAIDs vary from subtle microscopic to gross macroscopic changes including ulcers. These injuries are induced by both topical and systemic actions of NSAIDs. Inhibition of gastroduodenal cyclooxygenase (COX enzyme by NSAIDs is considered to be a major pathogenetic factor. Reactive oxygen species (ROS appear also to play a significant role in the pathogenesis of mucosal injury. Withdrawal of NSAIDs is preferably the first therapeutic option; however, it is not feasible in the majority of patients. Therefore, several drugs including antisecretory drugs (ASDs-proton pump inhibitors and Histamine-2 receptor antagonists and misoprostol, a prostaglandin analog are used for the prevention and treatment of NSAID-induced gastroduodenal injuries. Among ASDs, proton pump inhibitors (PPIs are the most commonly used drugs. The antiulcerogenic effect of PPIs is similar to that of misoprostol and superior to standard doses of histamine-2 receptor antagonists (H2-RAs. The adverse effects of m,isoprostol such as diarrhea, abdominal pain, nausea, flatulence, headache, dyspepsia, vomiting, constipation, abortifacient and teratogenicity limit its general use. Aside from their antisecretory action, PPIs also possess an antioxidative effect. PPI maintenance is recommended in chronic NSAID treatment in those with an increased risk of complications and is more effective than Helicobacter pylori
Spikman, Jacoba M.; Timmerman, Marieke E.; Milders, Maarten V.; Veenstra, Wencke S.; van der Naalt, Joukje
Impairments in social behavior are frequently found in moderate to severe traumatic brain injury (TBI) patients and are associated with an unfavorable outcome with regard to return to work and social reintegration. Neuropsychological tests measuring aspects of social cognition are thought to be sens
Full Text Available In Europe, all countries regularly recognise mental disorders as workplace accidents (mainly post-traumatic stress disorders. However, there has been little emphasis on this emerging issue in Italy. Our discussion focuses on a recent case report regarding an employee who was affected by an acute anxiety disorder after a common workplace conflict with a coworker. Given that prolonged and unresolved relationship conflicts may result in more extreme forms of conflict known as workplace bullying, relationship conflicts should be minimised or prevented as early as possible. These conflicts can also lead to acute stress disorders, particularly in workers who are at-risk for stress disorders. To prevent psychological work-related injuries, occupational stakeholders should use assessments for work-related stress as a framework for addressing all organisational risk factors that are related to workplace relationships and conflict.
Williams, S T B; Power, D
A search of the UK Department of Trade and Industry's Home and Leisure Accident database found 16,003 emergency hospital attendances in 2000-2002 following accidents with tools. The hand was the site of injury in 9535 cases (60%). The tool most commonly involved was a Stanley knife, causing as many hand injuries (21%) as all power tools combined. The power tools most frequently causing hand injury were circular saws (28% of power tool injuries), hedge trimmers (21%) and electric drills (17%). Compared to injuries from manual tools, power tool hand injuries were more than twice as likely to be referred to specialists and three times more likely to be admitted to hospital. Specialist referral/admission most commonly occurred following hand injury from mowers (51% admitted/referred), routers (50%) and circular saws (48%). The rate for manual blade injuries was 14%. Missed diagnoses following manual blade injuries may stem from comparatively low rates of specialist assessment.
Full Text Available Jessica Stanhope,1 Steve Milanese,2 Karen Grimmer1 1International Centre for Allied Health Evidence, 2School of Health Sciences, University of South Australia, Adelaide, SA, Australia Background: This study aimed to determine the experiences of university classical woodwind students with playing-related injuries (PRIs, the impact of these PRIs, the management selected by students with PRIs, and the perceived effectiveness of this management. Materials and methods: All classical woodwind students enrolled in vocational education training or undergraduate courses at a university were sent an email with a link to an online survey. Only those aged 18 years and older were eligible. The survey obtained data regarding demographic information, details of PRI experienced (location, if they lasted for more than 3 months, and if they were current, and the impact of these, as well as the types of management strategies tried and their perceived effectiveness. Data were analyzed using descriptive statistics, and comments were reported descriptively. Results: Fourteen students returned the survey; however, one of these only completed the questions regarding demographics, and was therefore excluded. A total of 62% of participants reported having experienced a PRI. Common locations for PRI were the wrist/hand/fingers, lower back, and neck. Reducing practice time by half and missing playing commitments were the most commonly reported consequences of PRIs. Playing-related management strategies were most frequently trialed, with these and passive nonplaying-related strategies perceived to be the most effective. Conclusion: PRIs are common in this population, with a range of consequences reported. While it is encouraging that students had tried and found effective playing-related management strategies, active nonplaying-related strategies should be encouraged, particularly in preference to passive nonplaying-related strategies. This was a small-scale study, and the
Løberg, Magnus; Lousdal, Mette Lise; Bretthauer, Michael; Kalager, Mette
Mammography screening for breast cancer is widely available in many countries. Initially praised as a universal achievement to improve women's health and to reduce the burden of breast cancer, the benefits and harms of mammography screening have been debated heatedly in the past years. This review discusses the benefits and harms of mammography screening in light of findings from randomized trials and from more recent observational studies performed in the era of modern diagnostics and treatment. The main benefit of mammography screening is reduction of breast-cancer related death. Relative reductions vary from about 15 to 25% in randomized trials to more recent estimates of 13 to 17% in meta-analyses of observational studies. Using UK population data of 2007, for 1,000 women invited to biennial mammography screening for 20 years from age 50, 2 to 3 women are prevented from dying of breast cancer. All-cause mortality is unchanged. Overdiagnosis of breast cancer is the main harm of mammography screening. Based on recent estimates from the United States, the relative amount of overdiagnosis (including ductal carcinoma in situ and invasive cancer) is 31%. This results in 15 women overdiagnosed for every 1,000 women invited to biennial mammography screening for 20 years from age 50. Women should be unpassionately informed about the benefits and harms of mammography screening using absolute effect sizes in a comprehensible fashion. In an era of limited health care resources, screening services need to be scrutinized and compared with each other with regard to effectiveness, cost-effectiveness and harms.
目的 对诸城市2010年居民损伤和中毒死亡情况进行流行病学分析,为政府制定科学的防治对策提供依据.方法 统计分析诸城市2010年居民损伤和中毒死亡的死亡率、构成比及性别比.结果 2010年诸城市居民损伤和中毒死亡率为52.07/10万,占死亡总数的7.73%,居死因顺位的第五位;男性高于女性,性别比值为2.41.损伤和中毒死亡的前三位是运输事故、故意自害、意外淹溺和沉没,占84.68%.30～59岁死亡人数最多,占54.79%.结论 损伤和中毒是诸城市居民主要致死原因之一,以青壮年为主,应引起足够重视.%Objective To analyze poisoning and injury-related deaths among residents and exptore measures for mortality prevention. Methods The 2010 data of mortality registration and surveillance were used to analyze the characteristics and role of poisoning and injury-related deaths in general in Zhucheng, Shandong. Results The incidence rate of poisoning and injury-related deaths was 52. 07/ lakh in 2010 among urban residents, which was the fifth cause of deaths. The cases of poisoning and injury-related mortality accounted for 7. 73% of total deaths. The ratio of odds was 2. 41 to 1 for men to women (P<0. 05). The top three causes of poisoning and injury-related deaths were transport accidents, intentional self-harm and accidental drowning, which accounted for 84. 68% of the total cases. The residents aged 30-59 years had 54. 79% of poisoning and injury-related deaths. Conclusion Middle-aged male urban residents are at high risk of poisoning and injury-related deaths. Additional attention should be given to driving behavior and poison control.
Lippa, Sara M; Pastorek, Nicholas J; Benge, Jared F; Thornton, G Matthew
Blast injury is common in current warfare, but little is known about the effects of blast-related mild traumatic brain injury (mTBI). Profile analyses were conducted investigating differences in self-reported postconcussive (PC) symptoms in 339 veteran outpatients with mTBI histories reporting current symptoms based on mechanism of injury (blast only, nonblast only, or both blast and nonblast), number of blast injuries, and distance from the blast. Veterans with any blast-related mTBI history were younger and reported higher posttraumatic stress symptoms than veterans with nonblast-related mTBI histories, with a marginally significant difference in posttraumatic stress symptom report between veterans reporting blast-related mTBI only and those reporting nonblast-related mTBI. The groups did not differ in terms of PC symptom severity or PC symptom cluster profiles. Among veterans with blast-related mTBI histories, PC symptom report did not vary by number of blast-related mTBIs or proximity to blast. Overall, posttraumatic stress symptoms accounted for a substantial portion of variance in PC symptom report. In veteran outpatients with remote mTBI histories who have enduring symptom complaints related to the mTBI, mechanism of injury did not clearly contribute to differential PC symptom severity or PC symptom cluster profile. Proximal rather than distal factors may be important intervention targets in returning symptomatic veterans with mTBI histories.
Jasmeet P. Hayes
Full Text Available Blast-related traumatic brain injury (TBI has been a common injury among returning troops due to the widespread use of improvised explosive devices in the Iraq and Afghanistan Wars. As most of the TBIs sustained are in the mild range, brain changes may not be detected by standard clinical imaging techniques such as CT. Furthermore, the functional significance of these types of injuries is currently being debated. However, accumulating evidence suggests that diffusion tensor imaging (DTI is sensitive to subtle white matter abnormalities and may be especially useful in detecting mild TBI (mTBI. The primary aim of this study was to use DTI to characterize the nature of white matter abnormalities following blast-related mTBI, and in particular, examine the extent to which mTBI-related white matter abnormalities are region-specific or spatially heterogeneous. In addition, we examined whether mTBI with loss of consciousness (LOC was associated with more extensive white matter abnormality than mTBI without LOC, as well as the potential moderating effect of number of blast exposures. A se