Pattern of road traffic injuries: one year hospital-based study in Western Nepal

Road traffic injuries and deaths caused by motor vehicles is a growing public health problem all over the world. Inter-country or regional differences in the pattern of injury by road users have significant implications in determining prevention policies. The present study was conducted to evaluate the pattern of injuries in 217 hospitalized trauma patients admitted during 1 year, 2003. The majority of the injuries (54%) involved motorcycles. The highest incidence amongst the male population was in the age group of 16 – 30 years. Head and face injuries and injuries to the lower limbs comprised 58.1% and 50.7% of all injuries respectively. The bones of the lower limbs were most commonly fractured. To conclude, the traffic casualties of motorcyclists and pedestrians are considered a major problem and the preventive measures to reduce these transport-related injuries are discussed in this study.     

腹部外伤合并颅脑创伤男性患者早期血清孕酮的临床意义

目的对比腹部外伤合并颅脑创伤男性患者与单纯腹部外伤男性患者的血清孕酮值,探讨其临床变化意义。方法收入我院2013年1月至11月急诊外科收治的急性腹部创伤男性患者116例,分成腹部外伤合并颅脑损伤组及单纯性腹部外伤组,并以ISS(创伤严重度评分)分值评价创伤患者机体损伤的严重程度。另选40例健康成年男性为对照组。于伤后后12、24、36、48h行放射免疫双抗体沉淀法测定血清孕酮水平,并进行数据比较。结果两组患者均随腹部外伤的ISS评分增高,早期血清孕酮值相比对照组越高(P<0.05)。但合并颅脑损伤组在相同ISS评分、相同时间点下早期血清孕酮值相比非颅脑损伤患者有明显升高,具有统计学意义(P<0.05)。结论血清孕酮在急性颅脑损伤中可作为一种特异性临床指标,指示患者的脑功能损伤严重程度,提供一定的基础临床资料。     

Trends in helmet use by motorcycle riders in the decades following the repeal of mandatory helmet laws

Several US states repealed universal motorcycle helmet laws in the 1990s and 2000s. The purpose of this study was to examine national trends in helmet use among adult trauma patients with motorcycle-related injuries. We hypothesized that motorcycle helmet use declined over time. We retrospectively analyzed the National Trauma Data Bank's National Sample Program for 2003–2010. We also obtained data on US motorcycle fatalities reported in the Fatality Analysis Reporting System and population data from the U.S. Census Bureau to calculate motorcycle-related fatality rates over time. A total of 255,914 patients met inclusion criteria, of whom 148,524 (58%) were helmeted. During the study period, helmet use increased from 56% in 2003 to 60% in 2010 (p < 0.001). However, motorcycle-related fatality rates also increased in states with and without universal helmet laws. Nationally, rates of helmet use have increased. However, fatalities due to motorcycle crashes have also increased during the same period.     

Investigating a potential hazard of carbonated drinks bottles

In response to concern over the risk of injury from caps missiling from carbonated drinks bottles during opening, a multi-disciplinary study was undertaken to identify the technical and ergonomic factors involved in this potential hazard. The specific conditions causing missiling were identified and an ergonomics approach was used to assess the likelihood of this combination of mainly behavioural factors. It was found that under ‘normal’ conditions, caps are unlikely to missile, suggesting that the risk from this product is low. Strength data collected in this study suggested that caps were applied with too great a torque for some users – particularly children and the elderly – to be able to open carbonated drinks bottles easily. User trials and a field study of naturalistic behaviour suggested that ‘tools’ are used to open bottles and some users may turn the caps the wrong way during opening, which together with an increase in temperature were the main factors likely to cause missiling.     

Prehospital trauma care evolution,practice and controversies: need for a review

Abstract

Modern medicine and surgery is historically very recent, and most interventions that are so commonly done in a hospital now are only 60 to 70?years old. Understanding of emergency care of the injured is more recent; however, for the sake of temporal convenience trauma care has become compartmentalized into phases: first aid, bystander care, prehospital care, emergency care, definitive levels of care and rehabilitation. The injured patient’s body physiology is changing continuously from the time of the impact at the injury site.. The outcome of trauma is dependent not only on what is done in the prehospital phase but also on hospital care and rehabilitation. Our understanding of the changes and the response to interventions in a trauma patient has been evolving over the years. This paper discusses the need to review recent advances in our understanding of the care process and how we need to improve it and how there is a pressing need to generate valid evidence on what we do in emergency care.     

‘RESILIENCE’ IN ORGANIZATIONAL ACTORS AND REARTICULATING ‘VOICE’: Towards a humanistic critique of New Public Management

Assumptions of resilience are frequently made about organizational actors, both by scholars and practitioners. It is argued that resilience is unlikely to be the usual outcome from the trauma routinely confronted in organizational life. It is suggested that ‘assumptions’ of resilience stem from either a reification of what is perceived to be a highly desirable trait in organizational actors or a lack of acknowledgement of what, if recognized, would be regarded as an ‘unthinkable’ aspect of organizational life. Managers are unlikely to recognize and admit that the pain they inflict on others in the name of efficiency, organizational down-sizing and out-sourcing will contribute to long-term changes in organizational actors. It is also likely that, while coping skills and resources may be sufficient to equip individuals for the myriad problems they routinely face, even the ‘successful’ actor may not remain unscathed. Some of the negative organizational outcomes of this unthinking ‘assumption’ of resilience are canvassed and suggestions are made as to what strategies may ameliorate the situation. A rearticulation of actors' ‘voice’ in formal organization, at a time of a hegemonic dominance of economic rationalism, is especially overdue.     

Estimating the South African trauma caseload

A survey of medical superintendents revealed that an estimated 1.5 million trauma cases presented to South Africa's 356 secondary and tertiary level hospitals in 1999. Injury rates for traffic, violence and other injuries showed considerable inter-provincial variation, with violence accounting for more than half of the trauma caseload. This type of survey is a simple low cost alternative for monitoring injury patterns and supplementing burden of disease and injury costing studies.     

Trauma's effects on shopper choice confusion: The role of psychological hardiness and retailer strategies as mitigating factors

Retailers must understand how trauma influences the consumer shopping journey and identify ways to mitigate any potential adverse effects. Two studies were conducted to explore trauma in the retail environment. First, a conceptual model was tested using structural equation modeling (SEM) based on survey data collected from 324 participants. Findings indicate that consumers who report previously experiencing traumatic events feel anxiety while shopping in retail environments, negatively influencing their ability to make purchase decisions. This outcome is due to challenges in adequately assessing stressful environmental stimuli and developing positive coping mechanisms. Consumer propensity for psychological hardiness was found to moderate this relationship. Next, a follow-up qualitative study from 110 consumers who reported experiencing instances of trauma identified potential ways for retailers to help consumers who have experienced trauma feel more comfortable in shopping environments. These findings extend research on trauma and consumer shopping behavior by identifying its impacts on choice confusion and stress appraisal and suggesting how retailers can support shoppers through a trauma-informed approach.