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Sample records for brunswick overhauls trauma

  1. States Strive to Overhaul Teacher Tenure

    ERIC Educational Resources Information Center

    Sawchuk, Stephen

    2010-01-01

    This article reports on how states strive to overhaul their teacher tenure policies. Over the past year, a handful of states have begun to overhaul their tenure-granting processes by increasing the number of years it takes teachers to win due process rights, and by trying to improve the evaluations that are supposed to guide determinations of…

  2. Trauma.

    PubMed

    Huisman, Thierry A G M; Poretti, Andrea

    2016-01-01

    Traumatic brain and spine injury (TBI/TSI) is a leading cause of death and lifelong disability in children. The biomechanical properties of the child's brain, skull, and spine, the size of the child, the age-specific activity pattern, and variance in trauma mechanisms result in a wide range of age-specific traumas and patterns of brain and spine injuries. A detailed knowledge about the various types of primary and secondary pediatric head and spine injuries is essential to better identify and understand pediatric TBI/TSI, which enhances sensitivity and specificity of diagnosis, will guide therapy, and may give important information about the prognosis. The purposes of this chapter are to: (1) discuss the unique epidemiology, mechanisms, and characteristics of TBI/TSI in children; (2) review the anatomic and functional imaging techniques that can be used to study common and rare pediatric TBI/TSI and their complications; (3) comprehensively review frequent primary and secondary brain injuries; and (4) to give a short overview of two special types of pediatric TBI/TSI: birth-related and nonaccidental injuries. PMID:27430465

  3. New Brunswick`s forestry sector. Forest report number 7

    SciTech Connect

    MacFarlane, D.D.; Simpson, C.M.

    1991-12-31

    The report presents data on the New Brunswick forestry industry, including forest land area, ownership, stock inventory, wood utilization, forest management expenditures, volume of roundwood production, silviculture activities, economic benefits from forest, fish, and wildlife, fuelwood consumption, Christmas tree production, maple syrup production, forest sector employment, salaries, income taxes from the industry, exports, and gross domestic product due to the forest sector.

  4. 14 CFR 43.2 - Records of overhaul and rebuilding.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Records of overhaul and rebuilding. 43.2 Section 43.2 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.2 Records of overhaul and...

  5. 14 CFR 43.2 - Records of overhaul and rebuilding.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Records of overhaul and rebuilding. 43.2 Section 43.2 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.2 Records of overhaul and...

  6. Transmission overhaul estimates for partial and full replacement at repair

    NASA Technical Reports Server (NTRS)

    Savage, M.; Lewicki, D. G.

    1991-01-01

    Timely transmission overhauls increase in-flight service reliability greater than the calculated design reliabilities of the individual aircraft transmission components. Although necessary for aircraft safety, transmission overhauls contribute significantly to aircraft expense. Predictions of a transmission's maintenance needs at the design stage should enable the development of more cost effective and reliable transmissions in the future. The frequency is estimated of overhaul along with the number of transmissions or components needed to support the overhaul schedule. Two methods based on the two parameter Weibull statistical distribution for component life are used to estimate the time between transmission overhauls. These methods predict transmission lives for maintenance schedules which repair the transmission with a complete system replacement or repair only failed components of the transmission. An example illustrates the methods.

  7. Transmission overhaul and replacement predictions using Weibull and renewal theory

    NASA Technical Reports Server (NTRS)

    Savage, M.; Lewicki, D. G.

    1989-01-01

    A method to estimate the frequency of transmission overhauls is presented. This method is based on the two-parameter Weibull statistical distribution for component life. A second method is presented to estimate the number of replacement components needed to support the transmission overhaul pattern. The second method is based on renewal theory. Confidence statistics are applied with both methods to improve the statistical estimate of sample behavior. A transmission example is also presented to illustrate the use of the methods. Transmission overhaul frequency and component replacement calculations are included in the example.

  8. Transmission overhaul and replacement predictions using Weibull and renewel theory

    NASA Technical Reports Server (NTRS)

    Savage, M.; Lewicki, D. G.

    1989-01-01

    A method to estimate the frequency of transmission overhauls is presented. This method is based on the two-parameter Weibull statistical distribution for component life. A second method is presented to estimate the number of replacement components needed to support the transmission overhaul pattern. The second method is based on renewal theory. Confidence statistics are applied with both methods to improve the statistical estimate of sample behavior. A transmission example is also presented to illustrate the use of the methods. Transmission overhaul frequency and component replacement calculations are included in the example.

  9. Libraries in New Brunswick: MedlinePlus

    MedlinePlus

    ... this page: https://medlineplus.gov/libraries/newbrunswick.html Libraries in New Brunswick To use the sharing features ... Fredericton Horizon Health Network (Fredericton Zone) Health Sciences Library P.O. Box 9000 Fredericton, NB E3B 5N5 ...

  10. 14 CFR 21.337 - Performance of inspections and overhauls.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... domestic repair station. (c) An appropriately certificated foreign repair station having adequate overhaul... the use of such foreign repair station. (d) The holder of an inspection authorization as provided in... manual as provided in Part 121 of this chapter....

  11. 18. MAINTENANCE SHOP, FIRST FLOOR, INTERIOR, ENGINE AND AIRPLANE OVERHAUL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. MAINTENANCE SHOP, FIRST FLOOR, INTERIOR, ENGINE AND AIRPLANE OVERHAUL AREAS; LOOKING EAST - Northwest Airways Hangar & Administration Building, 590 Bayfield Street, St. Paul Downtown Airport (Holman), Saint Paul, Ramsey County, MN

  12. 17. MAINTENANCE SHOP, FIRST FLOOR, INTERIOR, ENGINE AND AIRPLANE OVERHAUL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. MAINTENANCE SHOP, FIRST FLOOR, INTERIOR, ENGINE AND AIRPLANE OVERHAUL AREAS; LOOKING WEST. - Northwest Airways Hangar & Administration Building, 590 Bayfield Street, St. Paul Downtown Airport (Holman), Saint Paul, Ramsey County, MN

  13. 40 CFR 81.437 - New Brunswick, Canada.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Eastern Head Herring Cove Mainland New Brunswick* Point La Preau* Wolf Islands* Atlantic Ocean* Grand... Brunswick* Atlantic Ocean* Wolf Islands* Grand Manan Island* Sail Rock West Quoddy Head Lighthouse...

  14. 40 CFR 81.437 - New Brunswick, Canada.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Park Eastern Head Herring Cove Mainland New Brunswick* Point La Preau* Wolf Islands* Atlantic Ocean... Brunswick* Atlantic Ocean* Wolf Islands* Grand Manan Island* Sail Rock West Quoddy Head Lighthouse...

  15. 76 FR 39259 - Establishment of Class E Airspace; Brunswick, ME

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-06

    ... with the date July 25, 2011. Authority: 49 U.S.C. 106(g); 40103, 40113, 40120; E.O. 10854, 24 FR 9565... Federal Aviation Administration 14 CFR Part 71 Establishment of Class E Airspace; Brunswick, ME AGENCY... establishes Class E airspace at Brunswick Executive Airport, Brunswick, ME. DATES: The effective date is...

  16. Applications to New Brunswick Community Colleges.

    ERIC Educational Resources Information Center

    Brewer, Hope; Easterbrook-Nadeau, Pamela, Ed.

    In 1989, a study was conducted of applicants to training programs offered at community colleges in New Brunswick to determine the characteristics of applicants, their reasons for applying, their expectations of the program, and influences on their enrollment decisions. Applications and available training seats were examined over the 3-year period…

  17. New Brunswick. Reference Series No. 31.

    ERIC Educational Resources Information Center

    Department of External Affairs, Ottawa (Ontario).

    This booklet, one of a series featuring the Canadian provinces, presents a brief overview of New Brunswick and is suitable for teacher reference or student reading. Separate sections discuss cities and population, geography, history, politics, economy, manufacturing, forestry, agriculture, fisheries, mining, electricity, transportation, government…

  18. Assessment of potential asbestos exposures from jet engine overhaul work.

    PubMed

    Mlynarek, S P; Van Orden, D R

    2012-06-01

    Asbestos fibers have been used in a wide variety of products and numerous studies have shown that exposures from the use or manipulation of these products can vary widely. Jet engines contained various components (gaskets, clamps, o-rings and insulation) that contained asbestos that potentially could release airborne fibers during routine maintenance or during an engine overhaul. To evaluate the potential exposures to aircraft mechanics, a Pratt & Whitney JT3D jet engine was obtained and overhauled by experienced mechanics using tools and work practices similar to those used since the time this engine was manufactured. This study has demonstrated that the disturbance of asbestos-containing gaskets, o-rings, and other types of asbestos-containing components, while performing overhaul work to a jet engine produces very few airborne fibers, and that virtually none of these aerosolized fibers is asbestos. The overhaul work was observed to be dirty and oily. The exposures to the mechanics and bystanders were several orders of magnitude below OSHA exposure regulations, both current and historic. The data presented underscore the lack of risk to the health of persons conducting this work and to other persons in proximity to it from airborne asbestos. PMID:22401880

  19. New Brunswick Laboratory progress report, October 1990--September 1991

    SciTech Connect

    Not Available

    1992-03-01

    The mission of the New Brunswick Laboratory of the US Department of Energy (DOE) is to provide and maintain a nuclear material measurements and standards laboratory as a technical response to DOE's statutory responsibility to assure the safeguarding of nuclear materials. This report summarizes the mission-fulfilling activities of the New Brunswick Laboratory for the period of October 1990 through September 1991.

  20. New Brunswick Laboratory progress report, October 1991--September 1992

    SciTech Connect

    Bingham, C.D.

    1993-02-01

    The mission of the New Brunswick Laboratory of the US Department of Energy (DOE) Is to provide and maintain a nuclear material measurements and standards laboratory as a technical response to DOE's statutory responsibility to assure the safeguarding of nuclear materials. This report summarizes the mission-fulfilling activities of the New Brunswick Laboratory for the period of October 1991 through September 1992.

  1. Preparation and Execution of the GIS First Overhaul for Qinshan NPP Phase One

    SciTech Connect

    Kaihong Lou; Jiapeng Yan

    2006-07-01

    This paper addresses the necessity and feasibility of the first major overhaul on the GIS based on the analysis of the special conditions and the issues we confronted; After the comparison of various schemes, the optimized scheme is put forward; the paper also expounds the proper preparation and cautious practice which led to the hard but final accomplishment of the initial overhaul on the GIS; this article further explains the necessity of the major overhaul on the GIS through the disposal of abnormalities during the execution of this major overhaul. (authors)

  2. New Coleoptera records from New Brunswick, Canada: Tenebrionidae and Zopheridae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian; Bouchard, Patrice; Bousquet, Yves

    2012-01-01

    Abstract Thirteen species of Tenebrionidae are newly reported for New Brunswick, Canada. Paratenetus punctatus Spinola, Pseudocistela brevis (Say), Mycetochara foveata (LeConte), and Xylopinus aenescens LeConte are recorded for the first time from the Maritime provinces. Platydema excavatum (Say) is removed from the faunal list of New Brunswick, and the presence of Platydema americanum Laporte and Brullé for the province is confirmed. This brings the total number of species of Tenebrionidae known from New Brunswick to 42. Two species of Zopheridae, Bitoma crenata Fabricius and Synchita fuliginosa Melsheimer, are newly recorded for New Brunswick, bringing the number of species known from the province to four. Bitoma crenata is new to the Maritime provinces. Collection and habitat data are presented for these species. PMID:22539897

  3. Assessment of Core French: The New Brunswick Experience.

    ERIC Educational Resources Information Center

    Edwards, Viviane

    1985-01-01

    The development of an oral language proficiency rating scale for use in evaluating New Brunswick's junior and senior high school students' core French program achievement is described and discussed. (MSE)

  4. New Coleoptera records from New Brunswick, Canada: Mordellidae and Ripiphoridae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract Eleven species of Mordellidae are newly recorded for New Brunswick, Canada. Six of these, Falsomordellistena discolor (Melsheimer), Falsomordellistena pubescens (Fabricius), Mordellistena ornata (Melsheimer), Mordellaria undulata (Melsheimer), Tomoxia inclusa LeConte, and Yakuhananomia bidentata (Say)are new for the Maritime provinces. Falsomordellistena pubescens is new to Canada. Pelecotoma flavipes Melsheimer (family Ripiphoridae) is reported for the first time for New Brunswick and the Maritime provinces. Collection and habitat data are presented for all these species. PMID:22539896

  5. New Brunswick Laboratory progress report, October 1992--September 1993

    SciTech Connect

    Not Available

    1994-04-01

    The mission of the New Brunswick Laboratory of the US Department of Energy (DOE) is to provide and maintain a nuclear material measurements and standards laboratory as a technical response to DOE`s statutory responsibility to assure the safeguarding of nuclear materials. This report summarizes the mission-fulfilling activities of the New Brunswick Laboratory for the period of October 1992 through September 1993.

  6. New Coleoptera records from New Brunswick, Canada: Histeridae

    PubMed Central

    Webster, Reginald P.; Makepeace, Scott; DeMerchant, Ian; Sweeney, Jon D.

    2012-01-01

    Abstract Eighteen species of Histeridae are newly reported from New Brunswick, Canada. This brings the total number of species known from New Brunswick to 42. Seven of these species, Acritus exguus (Erichson), Euspilotus rossi (Wenzel), Hypocaccus fitchi (Marseul), Dendrophilus kiteleyi Bousquet and Laplante, Platysoma cylindricum (Paykull), Atholus sedecimstriatus (Say), and Margarinotus harrisii (Kirby) are recorded from the Maritime provinces for the first time. Collection and bionomic data are presented for these species. PMID:22539882

  7. New Coleoptera records from New Brunswick, Canada: Elateridae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract Twenty-two species of Elateridae are newly reported for New Brunswick, Canada. Negastrius exiguus (Randall) is removed from the faunal list and Agriotes pubescens Melsheimer is re-instated as a member of the New Brunswick fauna. Agriotes pubescens Melsheimer, Dalopius brevicornis W. J. Brown, Danosoma obtectum (Say) and Megapenthes solitarius Fall are newly reported for the Maritime provinces. Collection data, bionomic data, and distribution maps are presented for all these species. PMID:22539888

  8. New Brunswick Laboratory progress report, October 1990--September 1991

    SciTech Connect

    Not Available

    1992-03-01

    The mission of the New Brunswick Laboratory of the US Department of Energy (DOE) is to provide and maintain a nuclear material measurements and standards laboratory as a technical response to DOE`s statutory responsibility to assure the safeguarding of nuclear materials. This report summarizes the mission-fulfilling activities of the New Brunswick Laboratory for the period of October 1990 through September 1991.

  9. New Brunswick Laboratory progress report, October 1991--September 1992

    SciTech Connect

    Bingham, C.D.

    1993-02-01

    The mission of the New Brunswick Laboratory of the US Department of Energy (DOE) Is to provide and maintain a nuclear material measurements and standards laboratory as a technical response to DOE`s statutory responsibility to assure the safeguarding of nuclear materials. This report summarizes the mission-fulfilling activities of the New Brunswick Laboratory for the period of October 1991 through September 1992.

  10. Overhauling, updating and augmenting NASA spacelink electronic information system

    NASA Technical Reports Server (NTRS)

    Blake, Jean A.

    1991-01-01

    NASA/Spacelink is a collection of NASA information and educational materials stored on a computer at the MSFC. It is provided by the NASA Educational Affairs Division and is operated by the Education Branch of the Marshall Center Public Affairs Office. It is designed to communicate with a wide variety of computers and modems, especially those most commonly found in classrooms and homes. It was made available to the public in February, 1988. The system may be accessed by educators and the public over regular telephone lines. NASA/Spacelink is free except for the cost of long distance calls. Overhauling and updating Spacelink was done to refurbish NASA/Spacelink, a very valuable resource medium. Several new classroom activities and miscellaneous topics were edited and entered into Spacelink. One of the areas that received a major overhaul (under the guidance of Amos Crisp) was the SPINOFFS BENEFITS, the great benefits resulting from America's space explorations. The Spinoff Benefits include information on a variety of topics including agriculture, communication, the computer, consumer, energy, equipment and materials, food, health, home, industry, medicine, natural resources, public services, recreation, safety, sports, and transportation. In addition to the Space Program Spinoff Benefits, the following is a partial list of some of the material updated and introduced: Astronaut Biographies, Miscellaneous Aeronautics Classroom Activities, Miscellaneous Astronomy Classroom Activities, Miscellaneous Rocketry Classroom Activities, Miscellaneous Classroom Activities, NASA and Its Center, NASA Areas of Research, NASA Patents, Licensing, NASA Technology Transfer, Pictures from Space Classroom Activities, Status of Current NASA Projects, Using Art to Teach Science, and Word Puzzles for Use in the Classroom.

  11. Ninth-grade students' attitudes toward energy: A comparison between Maine and New Brunswick

    SciTech Connect

    Barrow, L.H.; Morrisey, J.T.

    1987-01-01

    The purpose of the study was to determine if there was any relationship between energy attitudes of ninth-grade students by gender and by their geographical location (Maine and New Brunswick). For general energy concerns, Maine students had a more positive attitude than New Brunswick students. Both Maine and New Brunswick females had a more positive attitude toward energy than males. Overall, Maine and New Brunswick students had a nonpositive attitude toward energy.

  12. 18. Yards & Docks Drawing 112,447 (463A1) (1931), 'Battery Overhaul ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. Yards & Docks Drawing 112,447 (463-A-1) (1931), 'Battery Overhaul Bldg., Acid Mixing Plant & Misc. Details' - Mare Island Naval Shipyard, Acid Mixing Facility, California Avenue & E Street, Vallejo, Solano County, CA

  13. New Coleoptera records from New Brunswick, Canada: Silvanidae and Laemophloeidae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; deMerchant, Ian

    2012-01-01

    Abstract One species of Silvanidae, Silvanus muticus Sharp, is newly recorded from New Brunswick, Canada and the Maritime provinces; Ahasverus longulus (Blatchley) is re-instated to the faunal list of the province, and we report the first recent provincial records of Dendrophagus cygnaei Mannerheim. Five species of Laemophloeidae (Charaphloeus convexulus (LeConte), Charaphloeus undescribed species (near adustus), Leptophloeus angustulus (LeConte), Placonotus zimmermanni (LeConte), and an undescribed Leptophloeus species) are added to the faunal list of New Brunswick. Collection data, bionomic data, and distribution maps are presented for all these species. PMID:22539892

  14. Checklist of the Coleoptera of New Brunswick, Canada

    PubMed Central

    Webster, Reginald P.

    2016-01-01

    Abstract All 3,062 species of Coleoptera from 92 families known to occur in New Brunswick, Canada, are recorded, along with their author(s) and year of publication using the most recent classification framework. Adventive and Holarctic species are indicated. There are 366 adventive species in the province, 12.0% of the total fauna. PMID:27110174

  15. 76 FR 42471 - Establishment of Class E Airspace; Brunswick, ME

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-19

    ... rule FR Doc 2011-16783, on page 39259 in the Federal Register of July 6, 2011 (76 FR 39259), make the... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Federal Aviation Administration 14 CFR Part 71 Establishment of Class E Airspace; Brunswick, ME...

  16. Lyme disease risk in dogs in New Brunswick.

    PubMed

    Bjurman, Natalie K; Bradet, Gina; Lloyd, Vett K

    2016-09-01

    This study assessed the seroprevalence of anti-Borrelia burgdorferi antibodies in New Brunswick dogs. Testing of 699 serum samples from dogs across the province revealed a 6% province-wide seropositivity, more than 6 times higher than that found in 2008. The rapid increase in seropositivity indicates increased Lyme disease risk to both canine and human health. PMID:27587892

  17. New Brunswick Francophone and Anglophone Student Attitudes and Outlooks

    ERIC Educational Resources Information Center

    Gleason, Thomas P.; Rankine, Fred C.

    1974-01-01

    Analyzes the impact of a wide reaching educational reform program on the attitudes and world outlook of a current generation of anglophone and francophone undergraduates in the province of New Brunswick, Canada, drawn from summaries of questionnaires and personal interviews in the students' mother tongue. (Author)

  18. Facial trauma

    MedlinePlus

    Maxillofacial injury; Midface trauma; Facial injury; LeFort injuries ... Kellman RM. Maxillofacial trauma. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: ...

  19. Facial trauma

    MedlinePlus

    Kellman RM. Maxillofacial trauma. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 23. Mayersak RJ. Facial trauma. In: Marx JA, Hockberger RS, ...

  20. Systemic trauma.

    PubMed

    Goldsmith, Rachel E; Martin, Christina Gamache; Smith, Carly Parnitzke

    2014-01-01

    Substantial theoretical, empirical, and clinical work examines trauma as it relates to individual victims and perpetrators. As trauma professionals, it is necessary to acknowledge facets of institutions, cultures, and communities that contribute to trauma and subsequent outcomes. Systemic trauma-contextual features of environments and institutions that give rise to trauma, maintain it, and impact posttraumatic responses-provides a framework for considering the full range of traumatic phenomena. The current issue of the Journal of Trauma & Dissociation is composed of articles that incorporate systemic approaches to trauma. This perspective extends conceptualizations of trauma to consider the influence of environments such as schools and universities, churches and other religious institutions, the military, workplace settings, hospitals, jails, and prisons; agencies and systems such as police, foster care, immigration, federal assistance, disaster management, and the media; conflicts involving war, torture, terrorism, and refugees; dynamics of racism, sexism, discrimination, bullying, and homophobia; and issues pertaining to conceptualizations, measurement, methodology, teaching, and intervention. Although it may be challenging to expand psychological and psychiatric paradigms of trauma, a systemic trauma perspective is necessary on both scientific and ethical grounds. Furthermore, a systemic trauma perspective reflects current approaches in the fields of global health, nursing, social work, and human rights. Empirical investigations and intervention science informed by this paradigm have the potential to advance scientific inquiry, lower the incidence of a broader range of traumatic experiences, and help to alleviate personal and societal suffering. PMID:24617751

  1. New Staphylinidae (Coleoptera) records with new collection data from New Brunswick and eastern Canada: Tachyporinae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract Twenty-three species of Tachyporinae are newly recorded from New Brunswick. This brings the total number of Tachyporinae known from the province to 70. Lordithon campbelli Schülke is newly recorded for Canada and we provide the first documented records of Tachinus addendus Horn and Tachinus frigidus Erichson for New Brunswick. Collection and habitat data are presented and discussed for each species. A list of Tachyporinae species currently known from the province of New Brunswick is presented. PMID:22577318

  2. New Brunswick Laboratory: Progress report, October 1993 through September 1994

    SciTech Connect

    1995-03-01

    The mission of the New Brunswick Laboratory of the US Department of Energy (DOE) is to serve as the National Certifying Authority for nuclear reference materials and to provide an independent Federal technical staff and laboratory resource performing nuclear material measurement, safeguards and non-proliferation functions in support of multiple program sponsors. During FY 94 New Brunswick Laboratory (NBL) completed development of a Strategic Plan which will aid in better defining performance oriented laboratory goals and objectives in each functional area consistent with the changing needs of the global nuclear community. This annual report describes accomplishments achieved in carrying out NBL`s assigned missions. Details of completed projects are reported in separate topical reports or as open-literature publications. Programs discussed here are: (1) safeguards assistance; (2) reference materials program; (3) measurement evaluation; (4) measurement services; and (5) measurement development.

  3. New Coleoptera records from New Brunswick, Canada: Megalopodidae and Chrysomelidae

    PubMed Central

    Webster, Reginald P.; LeSage, Laurent; DeMerchant, Ian

    2012-01-01

    Abstract Zeugophora varians Crotch and the family Megalopodidae are newly recorded for New Brunswick, Canada. Twenty-eight species of Chrysomelidae are newly recorded for New Brunswick, including Acalymma gouldi Barber, Altica knabii Blatchley, Altica rosae Woods, Altica woodsi Isely, Bassareus mammifer (Newman), Chrysolina marginata (Linnaeus), Chrysomela laurentia Brown, Crepidodera violacea Melsheimer, Cryptocephalus venustus Fabricius, Neohaemonia melsheimeri (Lacordaire), Neohaemonia nigricornis (Kirby), Pachybrachis bivittatus (Say), Pachybrachis m-nigrum (Melsheimer), Phyllobrotica limbata (Fabricius), Psylliodes affinis (Paykull), Odontota dorsalis (Thunberg), Ophraella communa (LeSage), Ophraella cribrata (LeConte), Ophraella notata (Fabricius), Systena hudsonias (Forster), Tricholochmaea ribicola (Brown), and Tricholochmaea rufosanguinea (Say), which are also newly recorded for the Maritime provinces. Collection data, habitat data, and distribution maps are presented for all these species. PMID:22539900

  4. [New Brunswick Tire Stewardship Board] annual report 1997

    SciTech Connect

    1998-12-01

    The Board`s mission is to administer a recycling program for tires in accordance with the Clean Environment Act. This report looks at the Board`s history and profile, composition, the trucking industry, the Atlantic Tire Dealers Association, and the New Brunswick Auto Dealers Association. Next, it looks at the Board`s relationship with Tire Recycling Atlantic Canada Corporation (TRACC), public relations and promotion, and administration. The report also examines financial surplus management and provides financial statements.

  5. New Brunswick Laboratory progress report, October 1994--September 1995

    SciTech Connect

    1996-03-01

    The mission of the New Brunswick Laboratory (NBL) of the A. S. Department of Energy (DOE) is to serve as the National Certifying Authority for nuclear reference materials and to provide an independent Federal technical staff and laboratory resource performing nuclear material measurement, safeguards, and non-proliferation functions in support of multiple program sponsors. This annual report describes accomplishments achieved in carrying out NBL`s assigned missions.

  6. Geriatric Trauma.

    PubMed

    Reske-Nielsen, Casper; Medzon, Ron

    2016-08-01

    Within the next 15 years, 1 in 5 Americans will be over age 65. $34 billion will be spent yearly on trauma care of this age group. This section covers situations in trauma unique to the geriatric population, who are often under-triaged and have significant injuries underestimated. Topics covered include age-related pathophysiological changes, underlying existing medical conditions and certain daily medications that increase the risk of serious injury in elderly trauma patients. Diagnostic evaluation of this group requires liberal testing, imaging, and a multidisciplinary team approach. Topics germane to geriatric trauma including hypothermia, elder abuse, and depression and suicide are also covered. PMID:27475011

  7. Building Political Will to Overhaul California's School Finance System. Forum Report

    ERIC Educational Resources Information Center

    EdSource, 2004

    2004-01-01

    Calls for changes in California's complex state-run school funding system, provided the backdrop for "Overhauling School Funding in California: The Push for Greater Adequacy, Equity, and Accountability," the EdSource 27th Annual Forum in March 2004. Participants discussed approaches for determining what would constitute adequate funding, reforms…

  8. 77 FR 29953 - Application of Buy America Waivers to Rolling Stock Overhauls and Rebuilds

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-21

    ... Federal Transit Administration 49 CFR Part 661 Application of Buy America Waivers to Rolling Stock... the application of the Federal Transit Administration's Buy America rules to procurements for the... America requirements to procurements for the overhaul and rebuilding of rolling stock. Until now,...

  9. Reflections on the Teacher Education System Overhaul (TESO) Program in Ethiopia: Promises, Pitfalls, and Propositions

    ERIC Educational Resources Information Center

    Mekonnen, Dawit M.

    2008-01-01

    In 2003 the Ethiopian education system experienced wide-ranging reform that touches every aspect of the system. This reform is called TESO (Teacher Education System Overhaul). Designed to address educational problems in Ethiopia, TESO introduced significant structural changes and promised to bring a "paradigm shift" in the Ethiopian educational…

  10. Vietnamese Leaders Discuss Overhaul of Higher Education During U.S. Visit

    ERIC Educational Resources Information Center

    Wasley, Paula

    2007-01-01

    At a June 2007 forum, Vietnam's president and minister of education outlined an ambitious plan to overhaul their country's troubled educational system, while a panel of American academics and scientists highlighted the importance of higher education to Vietnam's rapidly growing economy and suggested potential models for reform. Two decades after…

  11. Respiratory protection for firefighters--evaluation of CBRN canisters for use during overhaul.

    PubMed

    Jones, Leaton; Lutz, Eric A; Duncan, Michael; Burgess, Jefferey L

    2015-01-01

    In the United States, there are approximately 366,600 structural fires each year. After visible flames are extinguished, firefighters begin the overhaul stage of firefighting to smother remaining hot spots and initiate investigations. Typically during overhaul significant ambient concentrations of chemical contaminants remain. However, previous research suggests that the use of air purifying respirators (APR) fitted with chemical, biological, radiological, and nuclear (CBRN) canisters may reduce occupational respiratory exposures. This pilot study used large-scale prescribed burns of representative structural materials to perform simultaneous, side-by-side, filtering and service-life evaluations of commercially available CBRN filters. Three types of CBRN canisters and one cartridge were challenged in repetitive post live-fire overhaul exposure tests using a sampling manifold apparatus. At a flow rate of 80 L/min, nine tests were conducted in the breathing zone for three different exposure durations (0-15 min, 0-30 min, and 0-60 min). Fifty different chemicals were identified for evaluation and results indicate that 21 of the 50 chemicals tested were in the air of the overhaul environment. Respirable particles and formaldehyde were consistently present above the American Conference of Governmental Industrial Hygienists (ACGIH®) recommended exposure level (REL) and threshold limit ceiling value (TLVc), respectively. Each filter effectively reduced concentrations for respirable particulates below the maximum recommended level. Formaldehyde was reduced, but not consistently filtered below the TLVc. These results were consistent across all exposure durations. This study indicates that, regardless of brand, CBRN filters provide protection from the vast majority of particle and gas-phase contaminants. However, due to formaldehyde breakthrough, CBRN filters do not provide complete protection during firefighter overhaul. PMID:25738516

  12. 76 FR 45772 - Proposed Foreign-Trade Zone-Brunswick, ME; Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-01

    ... Foreign-Trade Zones Board Proposed Foreign-Trade Zone--Brunswick, ME; Application An application has been submitted to the Foreign-Trade Zones Board (the Board) by the Midcoast Regional Redevelopment Authority to establish a general-purpose foreign-trade zone at a site in Brunswick, Maine, adjacent to the Portland...

  13. 78 FR 12041 - Information on Surplus Land at Former Naval Air Station, Brunswick, ME

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-21

    ... 16, 2007 (72 FR 7624, FR Doc. E7-2762)). DATES: Effective February 7, 2013, by updating the acreage... Department of the Navy Information on Surplus Land at Former Naval Air Station, Brunswick, ME AGENCY... additional surplus property at the former Naval Air Station (NAS), Brunswick, ME, in accordance with...

  14. [Chest trauma].

    PubMed

    Freixinet Gilart, Jorge; Ramírez Gil, María Elena; Gallardo Valera, Gregorio; Moreno Casado, Paula

    2011-01-01

    Chest trauma is a frequent problem arising from lesions caused by domestic and occupational activities and especially road traffic accidents. These injuries can be analyzed from distinct points of view, ranging from consideration of the most severe injuries, especially in the context of multiple trauma, to the specific characteristics of blunt and open trauma. In the present article, these injuries are discussed according to the involvement of the various thoracic structures. Rib fractures are the most frequent chest injuries and their diagnosis and treatment is straightforward, although these injuries can be severe if more than three ribs are affected and when there is major associated morbidity. Lung contusion is the most common visceral lesion. These injuries are usually found in severe chest trauma and are often associated with other thoracic and intrathoracic lesions. Treatment is based on general support measures. Pleural complications, such as hemothorax and pneumothorax, are also frequent. Their diagnosis is also straightforward and treatment is based on pleural drainage. This article also analyzes other complex situations, notably airway trauma, which is usually very severe in blunt chest trauma and less severe and even suitable for conservative treatment in iatrogenic injury due to tracheal intubation. Rupture of the diaphragm usually causes a diaphragmatic hernia. Treatment is always surgical. Myocardial contusions should be suspected in anterior chest trauma and in sternal fractures. Treatment is conservative. Other chest injuries, such as those of the great thoracic and esophageal vessels, are less frequent but are especially severe. PMID:21640287

  15. Tailbone trauma

    MedlinePlus

    Choi SB, Cwinn AA. Pelvic trauma. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 55. Vora ...

  16. New Coleoptera records from New Brunswick, Canada: Geotrupidae and Scarabaeidae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract Two species of Geotrupidae, Geotrupes splendidus splendidus (Fabricius) and Odonteus liebecki (Wallis), are newly reported for New Brunswick, Canada. Twelve species of Scarabaeidae are added to the faunal list of the province, including Aegialia criddlei Brown, Caelius humeralis (Brown), Dialytellus dialytoides (Fall), Diapterna omissa (LeConte), Diapterna pinguis (Haldeman), Planolinoides aenictus (Cooper and Gordon), Stenotothorax badipes (Melsheimer), and Ataenius strigatus (Say), which are also newly recorded for the Maritime provinces. Collection data, habitat data, and distribution maps are presented for each species. PMID:22539883

  17. New Coleoptera records from New Brunswick, Canada: Buprestidae

    PubMed Central

    Webster, Reginald P.; DeMerchant, Ian

    2012-01-01

    Abstract Nine species of Buprestidae; Agrilus bilineatus (Weber), Agrilus crinicornis Horn, Agrilus obsoletoguttatus Gory, Agrilus putillus putillus Say, Brachys ovatus (Weber), Buprestis sulcicollis (LeConte), Chalcophora liberta (Germar), Phaenops aeneola (Melsheimer), and Taphrocerus gracilis (Say) are newly recorded for New Brunswick, Canada. Agrilus bilineatus, A. crinicornis, A. obsoletoguttatus,and B. ovatus are also newly reported for the Maritime provinces. Lindgren 12-funnel traps do not appear to be an effective tool for sampling the Bupresidae. Collection, habitat notes, and distribution maps are presented for each species. PMID:22539885

  18. New Coleoptera records from New Brunswick, Canada: Mycetophagidae, Tetratomidae, and Melandryidae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract We report 21 new species records for the Coleoptera fauna of New Brunswick, Canada, seven of which are new records for the Maritime provinces. Four species of Mycetophagidae (Litargus didesmus Say, Litargus tetrapilotus LeConte, Mycetophagus punctatus Say, and Mycetophagus quadriguttatus Müller) are newly reported for the province of New Brunswick. Litargus didesmus is newly recorded for the Maritime provinces. Seven species of Tetratomidae are added to the faunal list of New Brunswick: Eustrophus tomentosus Say, Penthe obliquata (Fabricius), and Tetratoma tessellata Melsheimer are new to New Brunswick: Hallomenus serricornis LeConte, Pisenus humeralis Kirby, Synstrophus repandus (Horn), and Tetratoma variegata Casey, which are newly recorded for New Brunswick and the Maritime provinces. Ten additional species of Melandryidae are reported from New Brunswick, of which Orchesia cultriformis Laliberté, Orchesia ovata Laliberté, Phloeotrya fusca (LeConte), Scotochroides antennatus Mank, Spilotus quadripustulatus (Melsheimer), Symphora flavicollis (Haldeman), Symphora rugosa (Haldeman), and Zilora hispida LeConte are new for the province, and Microscapha clavicornis LeConte and Zilora nuda Provancher are newly recorded for the Maritime provinces. In addition, we report numerous additional records for three species of Mycetophagidae and one species of Melandryidae previously recorded from New Brunswick that suggest these species are more widely distributed than previously known. Collection, habitat data, and distribution maps are presented for all these species. PMID:22539895

  19. Health assessment for Brunswick Naval Air Station, Brunswick, Cumberland County, Maine, Region 1. CERCLIS No. ME8170022018. Preliminary report

    SciTech Connect

    Not Available

    1989-04-10

    The Brunswick Naval Air Station (BWK) Site is listed by the U.S. Environmental Protection Agency (EPA) on the National Priorities List. The site is located in Brunswick (Cumberland County), Maine, and encompasses 7 waste areas within a 2-mile radius occupying 15 acres. Five of the seven sites were used to dispose various acids, caustics, and asbestos wastes. Preliminary on-site sampling results have identified various volatile organic compounds (VOCs) and heavy metals in groundwater. The site-related contaminants include: Chloroform, trichloroethylene, bis 2 ethylhexylphalate, lead, chromium, and mercury. On-site surface water contaminants identified include: total organics, chloroform, and chromium. Off-site surface water sampling results identified cadmium and mercury. The site is considered to be of potential public health concern because of the risk to human health caused by the possibility of human exposure to hazardous substances through direct contact and ingestion of contaminated groundwater, surface water, sediment and soil. Access to the waste areas inside the base should be restricted, if not already.

  20. Elderly trauma.

    PubMed

    Holleran, Renee Semonin

    2015-01-01

    Across the world, the population is aging. Adults 65 years and older make up one of the fastest growing segments of the US population. Trauma is a disease process that affects all age groups. The mortality and morbidity that result from an injury can be influenced by many factors including age, physical condition, and comorbidities. The management of the elderly trauma patient can present some unique challenges. This paper addresses the differences that occur in the management of elderly patient who has been injured. This paper also includes a discussion of how to prevent injury in the elderly. PMID:26039652

  1. Shock trauma.

    PubMed

    Trunkey, D D

    1984-09-01

    Trauma - accidental or intentional injury - is a major health and social problem. It is still the chief cause of death in people between the ages of 1 and 38 years. In the United States, the mortality due to trauma between the ages of 15 and 24 years increased by 13% from 1960 to 1978. During the same period, the mortality for people aged 25 to 64 years declined by 16%. Murders have increased from 8464 in 1960, to 26 000 in 1982. The overall death rate of American teenagers and young adults is 50% higher than that of their counterparts in Britain, Sweden and Japan. Trauma affects young, productive citizens, and the estimated costs for death, disability and loss of productivity exceed $230 million a day. The most tragic statistic is that at least 40% of the deaths are needless and preventable if better treatment and prevention programs were available. Trauma deaths that might be prevented are those due to motor vehicle accidents, homicide, burns, and alcohol and drug abuse. In this paper suggestions for prevention are made. They include improved crash worthiness of motor vehicles, revocation of drunk drivers' licences, use of devices that limit drunk drivers, increased tax on alcohol and random breathalyser tests, and the use of seat belts and motorcycle helmets. Control of hand-guns and burn characteristics of cigarettes could also reduce deaths. The problems and issues in trauma care can be divided into two broad categories: system and professional. System problems include prehospital care, in-hospital care, rehabilitation and prevention. Professional problems include education, research, economics, and quality.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6478325

  2. New Coleoptera records from New Brunswick, Canada: Dermestidae, Endecatomidae, Bostrichidae, and Ptinidae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian; Turgeon, Martin

    2012-01-01

    Abstract We report ten new species records for the Coleoptera fauna of New Brunswick, Canada from the families Dermestidae, Endecatomidae, Bostrichidae, and Ptinidae. Anthrenus fuscus Olivier and Anthrenus museorum (Linnaeus) of the family Dermestidae are newly recorded for New Brunswick. Endecatomus rugosus (Randall) and the family Endecatomidae are recorded for the first time for New Brunswick and the Maritime provinces. Two Bostrichidae, the adventive Dinoderus minutus (Fabricius) and the native Stephanopachys substriatus (Paykull), are newly recorded for the province. Five species of Ptinidae, the adventive Anobium punctatum (DeGeer) and Microbregma emarginatum emarginatum (Duftschmid), and the native Hadrobregmus notatus (Say), Ptilinus lobatus Casey, and Ptilinus ruficornis Say are added to the faunal list of New Brunswick. Collection data, habitat data, and distribution maps are presented for all these species. PMID:22539890

  3. New Coleoptera records from New Brunswick, Canada: Gyrinidae, Carabidae, and Dytiscidae

    PubMed Central

    Webster, Reginald P.; DeMerchant, Ian

    2012-01-01

    Abstract Dineutus assimilis Kirby and Dineutus discolor Aubé of the Family Gyrinidae are newly reported from New Brunswick, Canada. Four species of Carabidae, Agonum (Agonum) piceolum (LeConte), Bembidion (Pseudoperyphus) rufotinctum Chaudoir, Harpalus (Harpalus) opacipennis (Haldeman), and Pterostichus (Melanius) castor Goulet & Bousquet are newly reported from New Brunswick and the Maritime provinces, and one species of Dytiscidae, Liodessus noviaffinis Miller, is newly recorded for the province. Collection, habitat data, and distribution maps are presented for each species. PMID:22539881

  4. BCS theory has to be overhauled: Reassurance from numerical survival rate

    NASA Astrophysics Data System (ADS)

    Zheng, X. H.; Walmsley, D. G.

    2016-07-01

    The BCS theory has conceptual and numerical difficulties. We have previously overhauled it with a new scheme of phonon-mediated electron pairing that can be expressed analytically in terms of an empirical pairing survival rate factor, S(q) = 0 or 1/2, depending on phonon momentum, q. Now we evaluate S(q) numerically entirely from experimental data on normal state electrical resistivity and on superconducting tunnelling conductance. The empirical and numerical S(q) are reassuringly close in aluminium and lead and particularly so in two other cases, niobium and tantalum.

  5. Innovation Overhaul

    ERIC Educational Resources Information Center

    Zeiss, Tony

    2008-01-01

    Traditional community college CEOs who are experiencing an increased demand for services, as well as reduced funding, have a choice to make: They can worry and complain, or they can change their operating model. In this article, the author calls for CEOs to have a clear focus on how they operate their organizations. The author argues that it is…

  6. Penetrating trauma

    PubMed Central

    Kuhajda, Ivan; Zarogoulidis, Konstantinos; Kougioumtzi, Ioanna; Huang, Haidong; Li, Qiang; Dryllis, Georgios; Kioumis, Ioannis; Pitsiou, Georgia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Papaiwannou, Antonis; Lampaki, Sofia; Zaric, Bojan; Branislav, Perin; Dervelegas, Konstantinos; Porpodis, Konstantinos

    2014-01-01

    Pneumothorax occurs when air enters the pleural space. Currently there is increasing incidence of road traffic accidents, increasing awareness of healthcare leading to more advanced diagnostic procedures, and increasing number of admissions in intensive care units are responsible for traumatic (non iatrogenic and iatrogenic) pneumothorax. Pneumothorax has a clinical spectrum from asymptomatic patient to life-threatening situations. Diagnosis is usually made by clinical examination and imaging techniques. In our current work we focus on the treatment of penetrating trauma. PMID:25337403

  7. Penetrating trauma.

    PubMed

    Kuhajda, Ivan; Zarogoulidis, Konstantinos; Kougioumtzi, Ioanna; Huang, Haidong; Li, Qiang; Dryllis, Georgios; Kioumis, Ioannis; Pitsiou, Georgia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Papaiwannou, Antonis; Lampaki, Sofia; Zaric, Bojan; Branislav, Perin; Dervelegas, Konstantinos; Porpodis, Konstantinos; Zarogoulidis, Paul

    2014-10-01

    Pneumothorax occurs when air enters the pleural space. Currently there is increasing incidence of road traffic accidents, increasing awareness of healthcare leading to more advanced diagnostic procedures, and increasing number of admissions in intensive care units are responsible for traumatic (non iatrogenic and iatrogenic) pneumothorax. Pneumothorax has a clinical spectrum from asymptomatic patient to life-threatening situations. Diagnosis is usually made by clinical examination and imaging techniques. In our current work we focus on the treatment of penetrating trauma. PMID:25337403

  8. New Staphylinidae (Coleoptera) records with new collection data from New Brunswick, Canada: Omaliinae, Micropeplinae, Phloeocharinae, Olisthaerinae, and Habrocerinae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract Eleven species of Omaliinae are newly recorded from New Brunswick, bringing the total number of species known from the province to 32 described species. Supporting data are presented for the New Brunswick record of Geodromicus strictus (Fauvel) reported by Majka et al. (2011). Micropeplus browni Campbell, Micropeplus laticollis Mäklin (Micropeplinae), Charyhyphus picipennis (LeConte) (Phloeocharinae), Olisthaerus substriatus (Paykull) (Olisthaerinae), Habrocerus capillaricornis (Gravenhorst), Habrocerus magnus LeConte, and Habrocerus schwarzi Horn (Habrocerinae) are also newly recorded for New Brunswick. These are the first records of the latter four subfamilies from New Brunswick. Collection and bionomic data are presented for each species and discussed. PMID:22577316

  9. New Brunswick Laboratory progress report, October 1989--September 1990

    SciTech Connect

    Not Available

    1991-03-01

    The New Brunswick Laboratory (NBL) has been tasked by the DOE Office of Safeguards and Security, Defense Programs (OSS/DP) to assure the application of accurate and reliable measurement technology for the safeguarding of special nuclear materials. NBL is fulfilling its mission responsibilities by identifying the measurement and measurement-related needs of the nuclear material safeguards community and addressing them by means of activities in the following program areas: (1) reference and calibration materials, (2) measurement development, (3) measurement services, (4) measurement evaluation, (5) safeguards assessment, and (6) site-specific assistance. Highlights of each of these program areas are provided in this summary. This progress report is written as a part of NBL's technology transfer responsibilities, primarily for the use and benefit of the scientific personnel that perform safeguards-related measurements. Consequently, the report is technical in nature. Many of the reports of multi-year projects are fragmentary in that only partial results are reported. Separate topical reports are to be issued at the completion of many of these projects. 30 refs.

  10. The New Brunswick Laboratory Safeguards Measurement Evaluation Program

    SciTech Connect

    Cacic, C.G.; Trahey, N.M.; Zook, A.C.

    1987-07-01

    The New Brunswick Laboratory (NBL) has been tasked by the U.S. Department of Energy (DOE) Office of Safeguards and Security (OSS) to assess and evaluate the adequacy of measurement technology as applied to materials accounting in DOE nuclear facilities. The Safeguards Measurement Evaluation (SME) Program was developed as a means to monitor and evaluate the quality and effectiveness of accounting measurements by site, material balance area (MBA), or unit process. Phase I of the SME Program, initiated during 1985, involved evaluation of the primary accountability measurement methods at six DOE Defense Programs facilities: Savannah River Plant, Portsmouth Gaseous Diffusion Plant, Y-12 Plant, Rocky Flats Plant, Rockwell Hanford Operations, and NBL. Samples of uranyl nitrate solution, dried plutonium nitrates, and plutonium oxides were shipped to the participants for assay and isotopic abundance measurements. Resulting data are presented and evaluated as indicators of current state-of-the-practice accountability measurement methodology, deficiencies in materials accounting practices, and areas for possible assistance in upgrading measurement capabilities. Continuing expansion of the SME Program to include materials which are representative of specific accountability measurement points within the DOE complex is discussed.

  11. New Brunswick Laboratory. Progress report, October 1995--September 1996

    SciTech Connect

    1997-04-01

    Fiscal year (FY) 1996 was a very good year for New Brunswick Laboratory (NBL), whose major sponsor is the Office of Safeguards and Security (NN-51) in the US Department of Energy (DOE), Office of Nonproliferation and National Security, Office of Security Affairs. Several projects pertinent to the NBL mission were completed, and NBL`s interactions with partners and customers were encouraging. Among the partners with which NBL interacted in this report period were the International Atomic Energy Agency (IAEA), NN-51. Environmental Program Group of the DOE Chicago Operations Office, International Safeguards Project Office, Waste Isolation Pilot Plant (WIPP), Ukraine Working Group, Fissile Materials Assurance Working Group, National Institute of Standards and Technology (NIST), Nuclear Regulatory Commission (NRC), Institute for Reference Materials and Measurements (IRMM) in Belgium, Brazilian/Argentine Agency for Accounting and Control of Nuclear Materials (ABACC), Lockheed Idaho Technologies Company, and other DOE facilities and laboratories. NBL staff publications, participation in safeguards assistance and other nuclear programs, development of new reference materials, involvement in the updating and refinement of DOE documents, service in enhancing the science education of others, and other related activities enhanced NBL`s status among DOE laboratories and facilities. Noteworthy are the facts that NBL`s small inventory of nuclear materials is accurately accounted for, and, as in past years, its materials and human resources were used in peaceful nuclear activities worldwide.

  12. A study in animal ethics in New Brunswick.

    PubMed Central

    Schneider, B J

    2001-01-01

    Society uses animals in ever-increasing numbers and ways, providing ethical challenges. Decisions about animal use are guided by the social consensus ethic towards animals. Because there is no clear social consensus ethic, these decisions are difficult. Society's ethic is changing and a "new ethic" towards animals is emerging. This study addressed the need to better understand society's ethics towards animals. Qualitative research methodology (focus groups) was used to study 7 different animal-interest groups. Qualitative data analysis was computer-aided. The group ethical position towards animals of its own group interest was determined for each group. The animal welfare, companion animal, and veterinary groups took Rollin's Position, a position based on both the Utilitarian and the Rights Principles; the farmer and trapper groups the Utilitarian/Land Ethic position, a dual position based on actions producing the greatest amount of pleasure and the least amount of pain for the greatest number, and preserving the integrity, stability, and beauty of the biotic community; the hunter group the Utilitarian/Judeo-Christian position, a dual position based on actions producing the greatest amount of pleasure and the least amount of pain for the greatest number, and having dominion over animals; and the naturalist group took Rollin's Position/Land Ethic. All these groups perceived medium to extreme ethical responsibility towards animals of their own group's interest that are used by others. The study showed that the predicted "new ethic" towards animals is in New Brunswick society and it is Rollin's Position. PMID:11467182

  13. Transforming the New Brunswick Energy Hub: An Analysis on Renewable Energy

    NASA Astrophysics Data System (ADS)

    Gunter, Christopher

    This research examines the benefits and disadvantages of instituting a shift from fossil fuel dependence to renewable sources of energy in New Brunswick. The New Brunswick Energy Hub is a complex system acting under the mandate of the White Paper New Brunswick Energy Policy. In my research, I consider information derived from statistical indicators developed by Patlitzianas, Doukas, Kagiannas and Psarras (2008) and compare these findings to the efficacy of energy policies in Germany, Denmark and Spain. These countries are similar to New Brunswick in climate and organizational complexity (US Department of Commerce, 2009). Weighing the outcomes of this comparative study, I discuss my recommendations highlighting the environmental and economic benefits. My research investigates subsidies in each country that allowed them early economic and environmental advantages. Specific regional considerations, such as Denmark's trend of selling energy technology for profit over domestic applications, inform my conclusions. The future New Brunswick Energy Policy should focus on creating favorable conditions for renewable energy development to occur. Some proven conditions include infrastructure development subsidies and the development and annual review of a competitive open access transmission tariff. With the expiry of the current White Paper comes the necessity of this investigation, and the opportunity to address the growing financial and environmental concerns that many politicians and policy planners have failed to deal with in past policies.

  14. Overhaul, Inspection and Repair of Reciprocating Engines 1 (Course Outline), Aviation Mechanics (Power Plant): 9055.01.

    ERIC Educational Resources Information Center

    Dade County Public Schools, Miami, FL.

    The course outline has been prepared as a guide to help the trainee acquire the knowledge and skills associated with the overhaul, inspection, and repair of reciprocating engines. This course is the first of two and must be completed first. Successful completion of these courses and others will provide the trainee with the knowledge and skills…

  15. Overhaul, Inspection and Repair of Reciprocating Engines 2 (Course Outline), Aviation Mechanics (Power Plant): 9055.02.

    ERIC Educational Resources Information Center

    Dade County Public Schools, Miami, FL.

    The course outlined is the second of two designed to help a trainee acquire the knowledge and become proficient in the skills associated with the overhaul, inspection, and repair of reciprocating engines. The knowledge and skills are necessary to pass the Powerplant Theory and Maintenence section of the Federal Aviation Administration examination…

  16. Scheduling challenges. With overhauled Form 990, hospitals are being asked for more specifics on governance, pay, perks, subsidized care.

    PubMed

    Evans, Melanie

    2008-01-01

    With an expanded and overhauled Form 990, hospitals will find themselves digging up and reporting lots more details about executive pay and perks, governance policies, and how much subsidized care they provide. "We look at this as the first step," says the IRS' Theresa Pattara, left, who was project manager for the form's retooling. PMID:18271193

  17. 76 FR 8720 - Record of Decision for the Disposal and Reuse of Naval Air Station Brunswick, ME

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ... storm water management plan, as required by the Town of Brunswick. Sediment and Erosion Control: Redevelopment of NAS Brunswick has the potential to cause soil erosion. The developer will be required to utilize mitigation measures in accordance with Maine's Erosion and Sediment Control Law and...

  18. 78 FR 64207 - Application To Export Electric Energy; New Brunswick Energy Marketing Corporation (f/k/a New...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... Application To Export Electric Energy; New Brunswick Energy Marketing Corporation (f/k/a New Brunswick Power... 301(b) and 402(f) of the Department of Energy Organization Act (42 U.S.C. 7151(b), 7172(f)) and require authorization under section 202(e) of the Federal Power Act (16 U.S.C. 824a(e)). On December...

  19. 76 FR 18548 - North Carolina Waters Along the Entire Length of Brunswick and Pender Counties and the Lower...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-04

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY North Carolina Waters Along the Entire Length of Brunswick and Pender Counties and the Lower Portion of the Cape Fear River in Brunswick and New Hanover Counties; No Discharge Zone Determination On June 21, 2010, the Environmental...

  20. 75 FR 35024 - North Carolina Waters Along the Entire Length of Brunswick and Pender Counties and the Saline...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-21

    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY North Carolina Waters Along the Entire Length of Brunswick and Pender Counties and the Saline Waters of the Cape Fear River in Brunswick and New Hanover Counties No Discharge Zone Determination The Environmental Protection Agency (EPA), Region...

  1. 76 FR 4148 - Notice of Opportunity for Public Comment on Surplus Property Release at Brunswick-Golden Isles...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-24

    ..., Atlanta, GA 30337-2747. In addition, one copy of any comments submitted to the FAA must be mailed or... Manager, Atlanta Airports District Office, 1701 Columbia Ave., Campus Bldg, Ste. 2-260, Atlanta, GA 30337... Brunswick-Golden Isles Airport, Brunswick, GA AGENCY: Federal Aviation Administration (FAA), DOT....

  2. 75 FR 53197 - Restricted Area in Cape Fear River and Tributaries at Sunny Point Army Terminal, Brunswick County...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ... at Sunny Point Army Terminal, Brunswick County, NC AGENCY: U.S. Army Corps of Engineers, DoD. ACTION... Terminal, Brunswick County, North Carolina, by renaming the marker buoys and specifying the latitude and... Terminal. DATES: This rule is effective November 1, 2010 without further notice, unless the Corps...

  3. Partial Overhaul and Initial Parallel Optimization of KINETICS, a Coupled Dynamics and Chemistry Atmosphere Model

    NASA Technical Reports Server (NTRS)

    Nguyen, Howard; Willacy, Karen; Allen, Mark

    2012-01-01

    KINETICS is a coupled dynamics and chemistry atmosphere model that is data intensive and computationally demanding. The potential performance gain from using a supercomputer motivates the adaptation from a serial version to a parallelized one. Although the initial parallelization had been done, bottlenecks caused by an abundance of communication calls between processors led to an unfavorable drop in performance. Before starting on the parallel optimization process, a partial overhaul was required because a large emphasis was placed on streamlining the code for user convenience and revising the program to accommodate the new supercomputers at Caltech and JPL. After the first round of optimizations, the partial runtime was reduced by a factor of 23; however, performance gains are dependent on the size of the data, the number of processors requested, and the computer used.

  4. Ten years of the Three Gorges Dam: a call for policy overhaul

    NASA Astrophysics Data System (ADS)

    Yang, Xiankun; Lu, X. X.

    2013-12-01

    The Three Gorges Dam (TGD), the world’s largest source of ‘clean’ hydroelectric power (Shen and Xie 2004), has entered its tenth year after the first turbine went into operation in June 2003. The dam, with a generating capacity 20 times that of the United States’ Hoover Dam, has been hailed as a crucial part of a solution to China’s energy crisis. Despite great benefits, however, major concerns have been voiced over the disastrous environmental and social consequences of this massive engineering project (Stone 2011). In this paper, we review the benefits and impacts learned from the controversial megadam over the past decade and discuss perspective quests on policy overhaul for future environmental protection.

  5. Toxic trauma.

    PubMed

    Moles, T M; Baker, D J

    2001-01-01

    Hazardous materials (HAZMAT) carry many inherent dangers. Such materials are distributed widely in industrial and military sites. Toxic trauma (TT) denotes the complex of systemic and organ injury caused by toxic agents. Often, TT is associated with other injuries that also require the application of life-support techniques. Rapid onset of acute respiratory failure and consequent cardiovascular failure are of primary concern. Management of TT casualties is dependent upon the characteristics of the toxic agents involved and on the demographics surrounding the HAZMAT incident. Agents that can produce TT possess two pairs of salient characteristics: (1) causality (toxicity and latency), and (2) EMS system (persistency and transmissibility). Two characteristics of presentations are important: (1) incident presentation, and (2) casualty presentation. In addition, many of these agents complicate the processes associated with anaesthesia and must be dealt with. Failure of recognition of these factors may result in the development of respiratory distress syndromes and multiorgan system failure, or even death. PMID:11513285

  6. New Coleoptera records from New Brunswick, Canada: Trogossitidae, Cleridae, and Melyridae, with an addition to the fauna of Nova Scotia

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract Grynocharis quadrilineata (Melsheimer) and Tenebroides corticalis (Melsheimer) of the family Trogossitidae are newly recorded for New Brunswick, Canada. Additional records of the recently reported Calitys scabra (Thunberg)and Ostoma fraterna (Randall) are presented for the province. The record of Ostoma fraterna is the first recent record of this species from New Brunswick. Additional New Brunswick records of the thaneroclerine, Zenodosus sanguineus (Say), are given, indicting that this species is common and widespread in the province. One species of Cleridae, Cymatodera bicolor (Say),is newly reported from New Brunswick, and the adventive Thanasimus formicarius Linnaeus is newly recorded from Nova Scotia and the Maritime provinces. Attalus morulus (LeConte) and Dolichosoma foveicolle (Kirby), family Melyridae, are reported for the first time for New Brunswick and the Maritime provinces. Collection, habitat data, and distribution maps are presented for these species. PMID:22539891

  7. New Coleoptera records from New Brunswick, Canada: Sphindidae, Erotylidae, Monotomidae, and Cryptophagidae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract Two species of Sphindidae, Odontosphindus denticollis LeConteand Sphindus trinifer Casey, are reported for the first time for New Brunswick. Another species, Sphindus near americanus LeConte is reported from the province but may be an undescribed species, pending further study. Five species of Erotylidae are newly recorded for the province, including Tritoma humeralis Fabricius and Tritoma sanguinipennis (Say), which are new to the Maritime provinces. Three species of Monotomidae are added to the New Brunswick faunal list, including Pycnotomina cavicollis (Horn), which is newly recorded for the Maritime provinces. Six additional species of Cryptophagidae are reported for the province and the presence of Antherophagus convexulus LeContein New Brunswick is confirmed. Cryptophagus pilosus Gyllenhal and Myrmedophila americana (LeConte) are newly reported to the Maritime provinces. PMID:22539893

  8. Hydrogeology and ground-water quality of Brunswick County, North Carolina

    USGS Publications Warehouse

    Harden, Stephen L.; Fine, Jason M.; Spruill, Timothy B.

    2003-01-01

    Brunswick County is the southernmost coastal county in North Carolina and lies in the southeastern part of the Coastal Plain physiographic province. In this report, geologic, hydrologic, and chemical data were used to investigate and delineate the hydro-geologic framework and ground-water quality of Brunswick County. The major aquifers and their associated confining units delineated in the Brunswick County study area include, from youngest to oldest, the surficial, Castle Hayne, Peedee, Black Creek, upper Cape Fear, and lower Cape Fear aquifers. All of these aquifers, with the exception of the Castle Hayne aquifer, are located throughout Brunswick County. The Castle Hayne aquifer extends across only the southeastern part of the county. Based on available data, the Castle Hayne and Peedee confining units are missing in some areas of Brunswick County, which allows direct hydraulic contact between the surficial aquifer and underlying Castle Hayne or Peedee aquifers. The confining units for the Black Creek, upper Cape Fear, and lower Cape Fear aquifers appear to be continuous throughout Brunswick County. In examining the conceptual hydrologic system for Brunswick County, a generalized water budget was developed to better understand the natural processes, including precipitation, evapotranspiration, and stream runoff, that influence ground-water recharge to the shallow aquifer system in the county. In the generalized water budget, an estimated 11 inches per year of the average annual precipitation of 55 inches per year in Brunswick County is estimated to infiltrate and recharge the shallow aquifer system. Of the 11 inches per year that recharges the shallow system, about 1 inch per year is estimated to recharge the deeper aquifer system. The surficial aquifer in Brunswick County is an important source of water for domestic supply and irrigation. The Castle Hayne aquifer is the most productive aquifer and serves as the principal ground-water source of municipal supply

  9. New Staphylinidae (Coleoptera) records with new collection data from New Brunswick, Canada: Paederinae

    PubMed Central

    Webster, Reginald P.; DeMerchant, Ian

    2012-01-01

    Abstract We report 17 species of Paederinae new for New Brunswick, Canada. Ten of these species, Lathrobium othioides LeConte, Lathrobium amplipenne Casey, Lathrobium armatum Say, Lathrobium confusum LeConte, Lathrobium debile LeConte, Achenomorphus corticinus (Gravenhorst), Rugilus rufipes Germar, Homaeotarsus bicolor (Gravenhorst), Homaeotharsus cribratus (LeConte), and Homaeotarsus pallipes (Gravenhorst) are newly recorded for the Maritime provinces. This brings the total number of Paederinae recorded from New Brunswick to 36 species. Additional records are presented for the recently reported Lathrobium simile LeConte and Lathrobium washingtoni Casey. Collection and habitat data are presented for all species. PMID:22577324

  10. New Staphylinidae (Coleoptera) records with new collection data from New Brunswick, Canada: Oxyporinae

    PubMed Central

    Webster, Reginald P.; DeMerchant, Ian

    2012-01-01

    Abstract Five species of Oxyporinae: Oxyporus occipitalis Fauvel, Oxyporus quinquemaculatus LeConte, Oxyporus major Gravenhorst, Oxyporus rufipennis LeConte, and Oxyporus stygicus Say, are newly recorded from New Brunswick, bringing the number of Oxyporinae known from the province to eight. The first documented records from New Brunswick are provided for Oxyporus kiteleyi reported by Majka et al. (2011). Oxyporus occipitalis and Oxyporus major are newly reported for the Maritime provinces of Canada. Collection and habitat data are presented for all these species. PMID:22577323

  11. Automation of the New Brunswick Laboratory controlled-potential coulometric method for plutonium

    SciTech Connect

    Mitchell, W.G.; Troutman, D.; Lewis, K.

    1988-11-01

    The development and evolution of the automated coulometric analysis of plutonium at the New Brunswick Laboratory is described. The importance of maintaining electrical calibration of the analysis so that the results are traceable to the Faraday is discussed. The innovations which were necessary to achieve the desired accuracy and precision are explained. The experimental tests to qualify the instruments for use in sample analysis at New Brunswick Laboratory are detailed. Details of the calculations performed by the automated coulometer system are given in the Appendix. 21 refs., 16 figs., 4 tabs.

  12. Urine vanadium concentrations in workers overhauling an oil-fired boiler.

    PubMed

    Hauser, R; Elreedy, S; Ryan, P B; Christiani, D C

    1998-01-01

    Since fuel oil ash contains vanadium (V), the measurement of urinary levels of V may provide a biological marker in workers exposed to fuel oil ash. The usefulness of urine V samples as a biological monitoring tool ultimately depends on determining the appropriate time of sampling relative to when exposure occurs. Twenty boilermakers were studied during the overhaul of a large oil-fired boiler. A total of 117 urine samples were collected, 65 start-of-shift (S-O-S) and 52 end-of-shift (E-O-S) samples. Air V exposures were estimated with personal sampling devices and work history diaries. Air V concentrations ranged from 0.36 to 32.19 micrograms V/m3, with a mean +/- SD of 19.1 +/- 10.7, and a median of 18.5. On the first day of work on the overhaul, the V urine levels at the E-O-S (mean +/- SD were 1.53 +/- 0.53, median was 1.52 mg V/g creatinine) were significantly higher than those at the S-O-S (0.87 +/- 0.32, median was 0.83), P = 0.004. However, the V concentrations of the S-O-S urine samples on the last Monday of the study were not significantly different from the S-O-S urine levels on the previous Saturday, a time interval of about 38 hr between the end of exposure and sample collection. The Spearman correlation coefficient (r) between the S-O-S urine V and the workplace concentration of V dust during the previous day was r = 0.35. In summary, the results suggest a rapid initial clearance of V (elevating the E-O-S V concentration on the first day of work relative to the S-O-S concentration), followed by a slow clearance that is not complete 38 hr after the end of exposure, as evidenced by the Monday morning urine V concentrations. The Spearman correlations suggest that the S-O-S urine is preferred to the E-O-S urine for across-shift biological monitoring of V exposure. PMID:9408529

  13. Rural trauma management.

    PubMed

    Wayne, R

    1989-05-01

    Rural trauma is a major problem in the United States. Up to 70 percent of trauma fatalities occur in rural areas, even though 70 percent of the population live in urban areas. Over the past 3 decades, numerous studies have defined the concept of preventable trauma death in both rural and urban populations. With the development of a regional trauma care system in Oregon, preventable trauma mortality should decrease. An effort was made to improve the quality of trauma care in Clatsop County, Oregon, a community of 30,000 people with 2 small rural hospitals. To obtain this goal, four steps were taken: (1) physician and nurse education was improved, (2) trauma protocols promoting prompt resuscitation and stabilization of patients were established, (3) regular trauma case reviews were conducted, and (4) emergency medical technician and prehospital management were coordinated. This study reviews the trail from sporadic, uncoordinated rural trauma care to the designation process. PMID:2712202

  14. Ninth-Grade Students' Attitudes toward Energy: A Comparison between Maine and New Brunswick.

    ERIC Educational Resources Information Center

    Barrow, Lloyd H.; Morrisey, J. Thomas

    1987-01-01

    Reports on a study to compare the energy attitudes of ninth-grade students by gender and by their geographical location. Results indicated that students in Maine had more positive attitudes than those in New Brunswick, that females in both locations had more positive attitudes than males, but that, overall, all had nonpositive attitudes. (TW)

  15. The Ciidae (Coleoptera) of New Brunswick, Canada: New records and new synonyms

    PubMed Central

    Lopes-Andrade, Cristiano; Webster, Reginald P.; Webster, Vincent L.; Alderson, Chantelle A.; Hughes, Cory C.; Sweeney, Jon D.

    2016-01-01

    Abstract The Ciidae of New Brunswick, Canada are reviewed. Seventeen species are recorded for New Brunswick, including the following 10 species that are newly recorded for the province: Ceracis singularis (Dury), Ceracis thoracicornis (Ziegler), Cis angustus Hatch, Cis fuscipes Mellié, Cis horridulus Casey, Cis striatulus Mellié, Dolichocis laricinus (Mellié), Malacocis brevicollis (Casey), Orthocis punctatus (Mellié), and Plesiocis cribrum Casey. Additional locality data are provided for the following species previously known from the province: Cis americanus Mannerheim, Cis creberrimus Mellié, Cis levettei (Casey), Cis submicans Abeille de Perrin, Dolichocis manitoba Dury, Hadreule elongatula (Gyllenhal), and Octotemnus glabriculus (Gyllenhal). Seven synonyms are proposed here; Cis pistoria Casey with Cis submicans Abeille de Perrin; Cis fraternus Casey, Cis macilentus Casey and Cis striolatus Casey with Cis striatulus Mellié; Dolichocis indistinctus Hatch with Dolichocis laricinus (Mellié); and Octotemnus denudatus Casey and Octotemnus laevis Casey with Octotemnus glabriculus (Gyllenhal). Lindgren funnel traps provided the majority of specimens for 15 of the 17 species reported from New Brunswick and were the sole source of specimens for seven of the 10 species newly reported here, suggesting they are a very useful tool for sampling Ciidae in the forests of New Brunswick. PMID:27110172

  16. 75 FR 8753 - Carolina Power & Light Company, Brunswick Steam Electric Plant, Units 1 and 2; Environmental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-25

    ... part 73 as discussed in a Federal Register notice dated March 27, 2009 (74 FR 13967). There will be no... Requirements, 74 FR 13926, 13967 (March 27, 2009)). The licensee currently maintains a security system... COMMISSION Carolina Power & Light Company, Brunswick Steam Electric Plant, Units 1 and 2;...

  17. 75 FR 16871 - Carolina Power & Light Company, Brunswick Steam Electric Plant, Units 1 and 2; Exemption

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ... significant effect on the quality of the human environment (75 FR 8753, February 25, 2010). This exemption is... COMMISSION Carolina Power & Light Company, Brunswick Steam Electric Plant, Units 1 and 2; Exemption 1.0 Background Carolina Power & Light Company (CP&L, the licensee) is the holder of Facility Operating...

  18. Ground-Water Conditions and Studies in the Brunswick-Glynn County Area, Georgia, 2007

    USGS Publications Warehouse

    Cherry, Gregory S.; Clarke, John S.

    2008-01-01

    The Upper Floridan aquifer is contaminated with saltwater in a 2-square-mile area of downtown Brunswick, Georgia. This contamination has limited the development of the ground-water supply in the Glynn County area. Hydrologic, geologic, and water-quality data are needed to effectively manage water resources. Since 1959, the U.S. Geological Survey has conducted a cooperative water-resources program with the City of Brunswick to monitor and assess the effect of ground-water development on saltwater contamination of the Floridan aquifer system. The potential development of alternative sources of water in the Brunswick and surficial aquifer systems also is an important consideration in coastal areas. During calendar year 2007, the cooperative water-resources monitoring program included continuous water-level recording of 13 wells completed in the Floridan, Brunswick, and surficial aquifer systems; collecting water levels from 22 wells to map the potentiometric surface of the Upper Floridan aquifer during July and August 2007; and collecting and analyzing water samples from 76 wells to map chloride concentrations in the Upper Floridan aquifer during July and August 2007. In addition, work was initiated to refine an existing ground-water flow model for evaluation of water-management scenarios.

  19. 40 CFR 81.91 - Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (Georgia) Interstate Air Quality Control Region. 81.91 Section 81.91 Protection of Environment... (Georgia) Interstate Air Quality Control Region. The Jacksonville (Florida)-Brunswick (Georgia) Interstate... County, Suwannee County, Taylor County, Union County, Wakulla County. In the State of Georgia:...

  20. 40 CFR 81.91 - Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (Georgia) Interstate Air Quality Control Region. 81.91 Section 81.91 Protection of Environment... (Georgia) Interstate Air Quality Control Region. The Jacksonville (Florida)-Brunswick (Georgia) Interstate... County, Suwannee County, Taylor County, Union County, Wakulla County. In the State of Georgia:...

  1. 40 CFR 81.91 - Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... (Georgia) Interstate Air Quality Control Region. 81.91 Section 81.91 Protection of Environment... (Georgia) Interstate Air Quality Control Region. The Jacksonville (Florida)-Brunswick (Georgia) Interstate... County, Suwannee County, Taylor County, Union County, Wakulla County. In the State of Georgia:...

  2. 40 CFR 81.91 - Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... (Georgia) Interstate Air Quality Control Region. 81.91 Section 81.91 Protection of Environment... (Georgia) Interstate Air Quality Control Region. The Jacksonville (Florida)-Brunswick (Georgia) Interstate... County, Suwannee County, Taylor County, Union County, Wakulla County. In the State of Georgia:...

  3. 40 CFR 81.91 - Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (Georgia) Interstate Air Quality Control Region. 81.91 Section 81.91 Protection of Environment... (Georgia) Interstate Air Quality Control Region. The Jacksonville (Florida)-Brunswick (Georgia) Interstate... County, Suwannee County, Taylor County, Union County, Wakulla County. In the State of Georgia:...

  4. New Staphylinidae (Coleoptera) records with new collection data from New Brunswick, Canada: Pselaphinae

    PubMed Central

    Webster, Reginald P.; Chandler, Donald S.; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract Twenty species of Pselaphinae are newly recorded from New Brunswick, Canada. This brings the total number of species known from the province to 36. Thirteen of these species are newly recorded for the Maritime provinces of Canada. Dalmosella tenuis Casey and Brachygluta luniger (LeConte) are newly recorded for Canada. Collection and habitat data are presented for these species. PMID:22577317

  5. A Collision of Culture, Values, and Education Policy: Scrapping Early French Immersion in New Brunswick

    ERIC Educational Resources Information Center

    Cooke, Max

    2009-01-01

    A CBC New Brunswick Forum broadcast live on March 27, 2008, from Moncton's Capitol Theatre provided a cathartic moment for parents angry at Education Minister Kelly Lamrock, who was linked into the discussion via satellite from Fredericton. Two weeks earlier, Minister Lamrock had declared in a press release that bilingualism was changing from an…

  6. 76 FR 28481 - Carolina Power & Light Company; Brunswick Steam Electric Plant, Units 1 and 2; Environmental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-17

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Carolina Power & Light Company; Brunswick Steam Electric Plant, Units 1 and 2; Environmental Assessment and Finding of No Significant Impact The U.S. Nuclear Regulatory Commission (NRC) is considering issuance of an exemption, pursuant to Title...

  7. 77 FR 66875 - Brunswick Steam Electric Plant, Units 1 and 2

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-07

    ...The U.S. Nuclear Regulatory Commission (NRC or the Commission) is giving notice that by petition dated July 10, 2012, Mr. David Lochbaum (the petitioner) and two copetitioners on behalf of the North Carolina Waste Awareness & Reduction Network, the Nuclear Information and Resource Service, and the Union of Concerned Scientists have requested that the NRC take action with regard to Brunswick......

  8. Women's Access to Training in New Brunswick. Training Matters: Working Paper Series.

    ERIC Educational Resources Information Center

    McFarland, Joan

    A gender-based analysis of training that focuses on barriers to women because of changes in the availability of sponsorship leads to the conclusion that training programs for women in New Brunswick have been spotty at best. Women's training has occurred during the 1970s, 1980s, and 1990s under the aegis of the Canadian Manpower Training Program,…

  9. (New Brunswick Laboratory): Progress report for the period October 1985 through September 1986

    SciTech Connect

    Not Available

    1987-03-01

    This report summarizes the mission activities of the New Brunswick Laboratory (NBL) of the US Department of Energy (DOE). NBL's mission is to provide and maintain a nuclear material measurements and standards laboratory as a technical response to DOE's statutory responsibility to assure the safeguarding of nuclear materials.

  10. (New Brunswick Laboratory): Progress report for the period October 1986 through September 1987

    SciTech Connect

    Not Available

    1988-03-01

    This report summarizes the mission activities of the New Brunswick Laboratory (NBL) of the US Department of Energy (DOE). NBL's mission is to provide and maintain a nuclear material measurements and standards laboratory as a technical response to DOE's statutory responsibility to assure the safeguarding of nuclear materials.

  11. (Mission activities of New Brunswick Laboratory). Progress report, October 1983-September 1984

    SciTech Connect

    Not Available

    1985-04-01

    This report summarizes the mission activities of the New Brunswick Laboratory to provide and maintain a nuclear material standards and measurement laboratory in support of Federal programmatic responsibilities to assure the application of accurate and reliable measurement technology for the safeguarding of special nuclear materials. 20 refs., 6 figs., 28 tabs.

  12. New Brunswick Laboratory progress report for the period October 1988--September 1989

    SciTech Connect

    Not Available

    1990-04-01

    The mission of the New Brunswick Laboratory (NBL) of the US Department of Energy (DOE) is to provide and maintain a nuclear material measurements and standards laboratory as a technical response to DOE's statutory responsibility to assure the safeguarding of nuclear materials. This report summarizes the mission-fulfilling activities of NBL for the period October 1988 through September 1989.

  13. The University of New Brunswick's Renaissance College: Curricular Evolution and Assessment at the Faculty Level

    ERIC Educational Resources Information Center

    Zundel, Pierre; Mengel, Thomas

    2007-01-01

    The purpose of this chapter is to draw some general lessons on curricular evolution processes and practices at the faculty level emerging from the creation of Renaissance College at the University of New Brunswick and the implementation of its BPhil program. The authors proceed by induction, working from the specific case of Renaissance College to…

  14. The New Brunswick Graduate Follow-Up for the 1987 and 1988 Surveys.

    ERIC Educational Resources Information Center

    Patterson, Martha

    In 1987 and 1988, the New Brunswick (Canada) Department of Advanced Education and Training conducted follow-up surveys of graduates of full-time training programs to determine their labor market success. In 1987, of the 2,319 graduates surveyed, 1,574 (68%) responded, while in 1988, 1,578 (69%) of the 2,302 graduates surveyed responded. In both…

  15. Doing Local History: A Case Study of New Brunswick, New Jersey

    ERIC Educational Resources Information Center

    Marino, Michael P.; Crocco, Margaret Smith

    2012-01-01

    This article provides a methodology that teachers can use to incorporate themes and ideas related to local history in their classrooms. Using the city of New Brunswick, New Jersey as a case study, the article offers different approaches that allow local history to be connected to wider themes in American history. The focus here on a small,…

  16. The Ciidae (Coleoptera) of New Brunswick, Canada: New records and new synonyms.

    PubMed

    Lopes-Andrade, Cristiano; Webster, Reginald P; Webster, Vincent L; Alderson, Chantelle A; Hughes, Cory C; Sweeney, Jon D

    2016-01-01

    The Ciidae of New Brunswick, Canada are reviewed. Seventeen species are recorded for New Brunswick, including the following 10 species that are newly recorded for the province: Ceracis singularis (Dury), Ceracis thoracicornis (Ziegler), Cis angustus Hatch, Cis fuscipes Mellié, Cis horridulus Casey, Cis striatulus Mellié, Dolichocis laricinus (Mellié), Malacocis brevicollis (Casey), Orthocis punctatus (Mellié), and Plesiocis cribrum Casey. Additional locality data are provided for the following species previously known from the province: Cis americanus Mannerheim, Cis creberrimus Mellié, Cis levettei (Casey), Cis submicans Abeille de Perrin, Dolichocis manitoba Dury, Hadreule elongatula (Gyllenhal), and Octotemnus glabriculus (Gyllenhal). Seven synonyms are proposed here; Cis pistoria Casey with Cis submicans Abeille de Perrin; Cis fraternus Casey, Cis macilentus Casey and Cis striolatus Casey with Cis striatulus Mellié; Dolichocis indistinctus Hatch with Dolichocis laricinus (Mellié); and Octotemnus denudatus Casey and Octotemnus laevis Casey with Octotemnus glabriculus (Gyllenhal). Lindgren funnel traps provided the majority of specimens for 15 of the 17 species reported from New Brunswick and were the sole source of specimens for seven of the 10 species newly reported here, suggesting they are a very useful tool for sampling Ciidae in the forests of New Brunswick. PMID:27110172

  17. Relationship between trauma narratives and trauma pathology.

    PubMed

    Amir, N; Stafford, J; Freshman, M S; Foa, E B

    1998-04-01

    In this study we examined the relationship between posttrauma pathology and the level of articulation (complexity) in rape narratives recounted by victims shortly after the assault. Degree of articulation was operationalized as the reading level of the narrative as determined by a computer program. Shortly after the trauma, reading level was correlated with severity of anxiety but not with posttraumatic stress disorder (PTSD) symptoms. Degree of the narrative articulation shortly after the trauma, however, was related to severity of later PTSD. These results are consistent with the hypothesis that the less developed trauma narratives hinder recovery from trauma. PMID:9565923

  18. Stormy weather. Echoes of Columbia/HCA heard as Tenet overhauls management amid scrutiny of outliner payments and investor protests.

    PubMed

    Galloro, Vince

    2002-11-11

    What began as a small shower of questions quickly transformed into a storm of investor protest last week as Tenet Healthcare Corp. underwent a management overhaul and analysts asked questions about its fiscal future. Tenet's business strategy came under scrutiny because a large proportion of its Medicare revenue was generated by so-called outlier payments. Chairman and CEO Jeffrey Barbakow (left) says that's not how he wants to do business. PMID:12462882

  19. The impact of new and emerging technologies in the commercial aviation maintenance, repair, and overhaul industry a Delphi study

    NASA Astrophysics Data System (ADS)

    Gray, Janet

    Purpose. The purpose of this study was to identify new or emerging technological trends and events that are likely to occur between now and 2017 that will have an impact on the commercial aviation maintenance, repair, and overhaul (MRO) industry. Further, it was the purpose of this study to examine those technological trends and events believed to provide the greatest impact and, given the experts' analysis, identify the feasibility of implementation. Methodology. This descriptive study utilized the Delphi method with a panel of twenty-four experts comprised of practitioners, theorists, and futurists. A priority matrix was utilized to determine the impact and feasibility of trend and events. Findings. The experts identified fifty-three trends and events that will impact the commercial aviation maintenance, repair, and overhaul (MRO) industry. Analysis of the priority matrix revealed eighteen trends and events were of high priority and high feasibility. Conclusions. The responses from the expert panel were examined and the findings analyzed. The following are the conclusions constructed from the data provided by the Delphi panel of experts: (1) the need to respond to the demands of the maintenance, repair, and overhaul (MRO) industry such as down time, efficiency, cost, and environmental concerns by implementing new technology, (2) the demand to integrate and implement new technology as indicative of the priority matrix scoring high importance/high feasibility, (3) to proactively address the inadequate professional development in new technologies, and (4) the consensus reached by the panel of experts of importance and feasibility of implementation of new technologies encompass eighteen trends and events. Implications and recommendations for action. The implementation of new and emerging technological advances in the commercial aviation maintenance, repair, and overhaul (MRO) industry between now and 2017 will be dependent on the technologies' capacity to reduce

  20. Exposure to fuel-oil ash and welding emissions during the overhaul of an oil-fired boiler.

    PubMed

    Liu, Youcheng; Woodin, Mark A; Smith, Thomas J; Herrick, Robert F; Williams, Paige L; Hauser, Russ; Christiani, David C

    2005-09-01

    The health effects of exposure to vanadium in fuel-oil ash are not well described at levels ranging from 10 to 500 microg/m(3). As part of a larger occupational epidemiologic study that assessed these effects during the overhaul of a large oil-fired boiler, this study was designed to quantify boilermakers' exposures to fuel-oil ash particles, metals, and welding gases, and to identify determinants of these exposures. Personal exposure measurements were conducted on 18 boilermakers and 11 utility workers (referents) before and during a 3-week overhaul. Ash particles < 10 microm in diameter (PM(10), mg/m(3)) were sampled over full work shifts using a one-stage personal size selective sampler containing a polytetrafluoroethylene filter. Filters were digested using the Parr bomb method and analyzed for the metals vanadium (V), nickel (Ni), iron (Fe), chromium (Cr), cadmium (Cd), lead (Pb), manganese (Mn), and arsenic (As) by inductively coupled plasma mass spectrometry. Nitrogen dioxide (NO(2)) was measured with an Ogawa passive badge-type sampler and ozone (O(3)) with a personal active pump sampler.Time-weighted average (TWA) exposures were significantly higher (p < 0.05) for boilermakers than for utility workers for PM(10) (geometric mean: 0.47 vs. 0.13 mg/m(3)), V (8.9 vs. 1.4 microg/m(3)), Ni (7.4 vs. 1.8 microg/m(3)) and Fe (56.2 vs. 11.2 microg/m(3)). Exposures were affected by overhaul time periods, tasks, and work locations. No significant increases were found for O(3) or NO(2) for boilermakers or utility workers regardless of overhaul period or task group. Fuel-oil ash was a major contributor to boilermakers' exposure to PM(10) and metals. Vanadium concentrations sometimes exceeded the 2003 American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value. PMID:16048845

  1. Helping Youth Overcome Trauma

    ERIC Educational Resources Information Center

    Chambers, Jamie C.

    2005-01-01

    The effects of trauma can roll on unchecked like a spirit of death. In its path are strewn its once vibrant victims. Human bonds are rent asunder by the disgrace of trauma. These are the youngsters who have been verbally bashed, physically battered, sexually assaulted, and spiritually exploited. Other traumas of childhood neglect include: (1)…

  2. Computed tomography in trauma

    SciTech Connect

    Toombs, B.D.; Sandler, C.M.

    1987-01-01

    This book begins with a chapter dealing with the epidemiology and mechanisms of trauma. Trauma accounts for more lives lost in the United States than cancer and heart disease. The fact that 30%-40% of trauma-related deaths are caused by improper or delayed diagnoses or treatment emphasizes the importance of rapid and accurate methods to establish a diagnosis. Acute thoracic, abdominal, and pelvic trauma and their complications are discussed. A chapter on high-resolution CT of spinal and facial trauma and the role of three-dimensional reconstruction images is presented.

  3. Trauma system development.

    PubMed

    Lendrum, R A; Lockey, D J

    2013-01-01

    The word 'trauma' describes the disease entity resulting from physical injury. Trauma is one of the leading causes of death worldwide and deaths due to injury look set to increase. As early as the 1970s, it became evident that centralisation of resources and expertise could reduce the mortality rate from serious injury and that organisation of trauma care delivery into formal systems could improve outcome further. Internationally, trauma systems have evolved in various forms, with widespread reports of mortality and functional outcome benefits when major trauma management is delivered in this way. The management of major trauma in England is currently undergoing significant change. The London Trauma System began operating in April 2010 and others throughout England became operational this year. Similar systems exist internationally and continue to be developed. Anaesthetists have been and continue to be involved with all levels of trauma care delivery, from the provision of pre-hospital trauma and retrieval teams, through to chronic pain management and rehabilitation of patients back into society. This review examines the international development of major trauma care delivery and the components of a modern trauma system. PMID:23210554

  4. The right scan, for the right patient, at the right time: the reorganization of major trauma service provision in England and its implications for radiologists.

    PubMed

    Harvey, J J; West, A T H

    2013-09-01

    Major trauma services in England are currently undergoing a radical overhaul with the formation of regional trauma networks and designated major trauma centres (MTCs). Radiology is scheduled to play a key role within major trauma care both in terms of 24/7 access to whole body computed tomography (WBCT) and interventional radiology (IR) services, as well as providing immediate expert imaging guidance to the trauma team. This review examines the rationale behind trauma networks, as well as drawing attention to the new Royal College of Radiologists' standards for major trauma imaging. It attempts to address radiologists' understandable concerns about the inappropriate use of WBCT, radiation dose, and intravenous contrast medium risks. Reporting whole-body CT for trauma patients is difficult, covering multiple body regions, with great pressure to provide a rapid and accurate report to the trauma team. The benefits of standardized reports, dual-radiologist reporting, and the use of organ injury severity grading are explored to aid succinct communication of findings and further guide patient management. PMID:23453710

  5. Analysis of infectious laryngotracheitis virus isolates from Ontario and New Brunswick by the polymerase chain reaction.

    PubMed Central

    Alexander, H S; Key, D W; Nagy, E

    1998-01-01

    The polymerase chain reaction (PCR) was used to amplify DNA of infectious laryngotracheitis virus (ILTV) isolates obtained from field specimens. The examined 47 samples included 37 isolates representing 35 cases of infectious laryngotracheitis from Ontario and 10 isolates originating from 10 field cases in New Brunswick. The viruses were grown in either embryonated chicken eggs or cell culture, the DNA extracted and amplified using primers designed from the sequence information of a 1.1 kb BamHI fragment of the Ontario 1598 ILTV strain. Thirty-four of the Ontario isolates and all of the New Brunswick isolates were amplified successfully. This suggests that the selected primers would be useful for the majority of the isolates encountered in outbreaks of ILTV. Images Figure 1. Figure 2. PMID:9442943

  6. Carrots and Sticks: New Brunswick and Maine Forest Landowner Perceptions Toward Incentives and Regulations

    NASA Astrophysics Data System (ADS)

    Quartuch, Michael R.; Beckley, Thomas M.

    2014-01-01

    The governments of countries that allow private land ownership have two main tools to motivate landowner behavior: regulations and incentives. This research examines landowner preferences toward these policy tools and asks specifically: Do private forest landowners in New Brunswick and Maine believe that regulations and/or incentives are effective means to motivate responsible stewardship? Can landowners identify explicit regulations and policies that restrict property rights? Also, we were interested to see if any discernible differences existed between these adjacent jurisdictions from different countries, but that share similar forests and a similar settlement history. We identified and interviewed diverse landowners, recorded and transcribed our discussions, and analyzed the results using a grounded theory approach. Findings suggest that both New Brunswick and Maine participants are fairly comfortable with most regulations and many agreed that a combination of incentives and regulations are in fact useful. Furthermore, landowners in New Brunswick discussed non-monetary incentives as a mechanism to reward "good" stewardship; while Maine respondents articulated a degree of responsible stewardship that transcends a need to incentivize landowners. This study demonstrates that diverse landowners may be more comfortable with environmental regulations than previously understood and may be interested in non-monetary incentives.

  7. Carrots and sticks: New Brunswick and Maine forest landowner perceptions toward incentives and regulations.

    PubMed

    Quartuch, Michael R; Beckley, Thomas M

    2014-01-01

    The governments of countries that allow private land ownership have two main tools to motivate landowner behavior: regulations and incentives. This research examines landowner preferences toward these policy tools and asks specifically: Do private forest landowners in New Brunswick and Maine believe that regulations and/or incentives are effective means to motivate responsible stewardship? Can landowners identify explicit regulations and policies that restrict property rights? Also, we were interested to see if any discernible differences existed between these adjacent jurisdictions from different countries, but that share similar forests and a similar settlement history. We identified and interviewed diverse landowners, recorded and transcribed our discussions, and analyzed the results using a grounded theory approach. Findings suggest that both New Brunswick and Maine participants are fairly comfortable with most regulations and many agreed that a combination of incentives and regulations are in fact useful. Furthermore, landowners in New Brunswick discussed non-monetary incentives as a mechanism to reward "good" stewardship; while Maine respondents articulated a degree of responsible stewardship that transcends a need to incentivize landowners. This study demonstrates that diverse landowners may be more comfortable with environmental regulations than previously understood and may be interested in non-monetary incentives. PMID:24281917

  8. New Brunswick Site annual environmental report for calendar year 1991, New Brunswick, New Jersey. Formerly Utilized Sites Remedial Action Program (FUSRAP)

    SciTech Connect

    Not Available

    1992-09-01

    This document describes the environmental monitoring program at the New Brunswick Site (NBS) and surrounding area, implementation of the program, and monitoring results for 1991. The site, near New Brunswick,, New Jersey, is a 5.6-acre vacant, fenced, and grass-covered area. Environmental monitoring of NBS began in 1981 when the site was part of the US Department of Energy`s (DOE) Surplus Facilities Management Program. In 1990 responsibility for NBS was transferred to the Formerly Utilized Sites Remedial Action Program (FUSP.4P). FUSRAP is a DOE program to identify and decontaminate or otherwise control sites where residual radioactive materials remain from the,early years of the nation`s atomic energy program or from commercial operations causing conditions that Congress has authorized DOE to remedy. The environmental monitoring program at NBS includes sampling networks for radon and thoron in air; external gamma radiation exposure; and radium-226, radium-228, thorium-228, thorium-230, thorium-232, americium-241, cesium-137, plutonium-239, and total uranium in surface water, sediment, and groundwater. Several nonradiological parameters are also measured in groundwater, surface water, and sediments. Monitoring results are compared with applicable Environmental Protection Agency standards, DOE derived concentration guides, dose limits, and other requirements in DOE orders. Environmental standards are established to protect public health and the environment.

  9. Caring for Trauma Survivors.

    PubMed

    Antai-Otong, Deborah

    2016-06-01

    Although trauma exposure is common, few people develop acute and chronic psychiatric disorders. Those who develop posttraumatic stress disorder likely have coexisting psychiatric and physical disorders. Psychiatric nurses must be knowledgeable about trauma responses, implement evidence-based approaches to conduct assessments, and create safe environments for patients. Most researchers assert that trauma-focused cognitive-behavioral approaches demonstrate the most efficacious treatment outcomes. Integrated approaches, offer promising treatment options. This article provides an overview of clinical factors necessary to help the trauma survivor begin the process of healing and recovery and attain an optimal level of functioning. PMID:27229285

  10. Blunt thoracic trauma.

    PubMed

    Weyant, Michael J; Fullerton, David A

    2008-01-01

    Blunt thoracic trauma represents a significant portion of trauma admissions to hospitals in the United States. These injuries are encountered by physicians in many specialities such as emergency medicine, pediatrics, general surgery and thoracic surgery. Accurate diagnosis and treatment improves the chances of favorable outcomes and it is desirable for all treating physicians to have current knowledge of all aspects of blunt thoracic trauma. Cardiothoracic surgeons often treat the most severe forms of blunt thoracic injuries and we review the aspects of blunt thoracic trauma that are pertinent to the practicing cardiothoracic surgeon. PMID:18420123

  11. New Coleoptera records from New Brunswick, Canada: Stenotrachelidae, Oedemeridae, Meloidae, Myceteridae, Boridae, Pythidae, Pyrochroidae, Anthicidae, and Aderidae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract We report 19 new species records for the faunal list of Coleoptera in New Brunswick, Canada, six of which are new records for the Maritime provinces, and one of which is new Canadian record. We also provide the first recent records for five additional species in New Brunswick. One new species of Stenotrachelidae, Cephaloon ungulare LeConte, is added to the New Brunswick faunal list. Additional records are provided for Cephaloon lepturides Newman, as well the first recent record of Nematoplus collaris LeConte. Two species of Oedemeridae, Asclera puncticollis (Say) and Asclera ruficollis (Say), are newly reported for New Brunswick, and additional locality and bionomic data are provided for Calopus angustus LeConte and Ditylus caeruleus (Randall). The records of Ditylus caerulus are the first recent records for the province. Three species of Meloidae, Epicauta pestifera Werner, Lytta sayi LeConte, and Meloe augustcollis Say are reported the first time for New Brunswick; Epicauta pestifera is newly recorded in Canada. Lacconotus punctatus LeConte and the family Mycteridaeis newly recorded for New Brunswick. The first recent records of Borus unicolor Say (Boridae) are reported from the province. One new species of Pythidae, Pytho siedlitzi Blair, and the first recent records of Pytho niger Kirby are added to the faunal list of New Brunswick. Three species of Pyrochroidae are newly reported for the province, including Pedilus canaliculatus (LeConte) and Pedilus elegans (Hentz), which are new for the Maritime provinces. Five species of Anthicidae and the first recent record of Anthicus cervinus LaFerté-Sénectére are newly reported for New Brunswick. Anthicus melancholicus LaFerté-Sénectère, Sapintus pubescens (LaFerté-Sénectère), Notoxus bifasciatus (LeConte), and Stereopalpus rufipes Casey are new to the Maritime provinces faunal list. Ambyderus granularis (LeConte) is removed from the faunal list of the province. Three species of Aderidae, Vanonus

  12. New Coleoptera records from New Brunswick, Canada: Stenotrachelidae, Oedemeridae, Meloidae, Myceteridae, Boridae, Pythidae, Pyrochroidae, Anthicidae, and Aderidae.

    PubMed

    Webster, Reginald P; Sweeney, Jon D; Demerchant, Ian

    2012-01-01

    We report 19 new species records for the faunal list of Coleoptera in New Brunswick, Canada, six of which are new records for the Maritime provinces, and one of which is new Canadian record. We also provide the first recent records for five additional species in New Brunswick. One new species of Stenotrachelidae, Cephaloon ungulare LeConte, is added to the New Brunswick faunal list. Additional records are provided for Cephaloon lepturides Newman, as well the first recent record of Nematoplus collaris LeConte. Two species of Oedemeridae, Asclera puncticollis (Say) and Asclera ruficollis (Say), are newly reported for New Brunswick, and additional locality and bionomic data are provided for Calopus angustus LeConte and Ditylus caeruleus (Randall). The records of Ditylus caerulus are the first recent records for the province. Three species of Meloidae, Epicauta pestifera Werner, Lytta sayi LeConte, and Meloe augustcollis Say are reported the first time for New Brunswick; Epicauta pestifera is newly recorded in Canada. Lacconotus punctatus LeConte and the family Mycteridaeis newly recorded for New Brunswick. The first recent records of Borus unicolor Say (Boridae) are reported from the province. One new species of Pythidae, Pytho siedlitzi Blair, and the first recent records of Pytho niger Kirby are added to the faunal list of New Brunswick. Three species of Pyrochroidae are newly reported for the province, including Pedilus canaliculatus (LeConte) and Pedilus elegans (Hentz), which are new for the Maritime provinces. Five species of Anthicidae and the first recent record of Anthicus cervinus LaFerté-Sénectére are newly reported for New Brunswick. Anthicus melancholicus LaFerté-Sénectère, Sapintus pubescens (LaFerté-Sénectère), Notoxus bifasciatus (LeConte), and Stereopalpus rufipes Casey are new to the Maritime provinces faunal list. Ambyderus granularis (LeConte) is removed from the faunal list of the province. Three species of Aderidae, Vanonus huronicus

  13. New Staphylinidae (Coleoptera) records with new collection data from New Brunswick and an addition to the fauna of Quebec: Staphylininae

    PubMed Central

    Webster, Reginald P.; Smetana, Aleš; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract Forty-four species of Staphylininae are newly reported from New Brunswick, bringing the total number of species known from the province to 126. Quedius criddlei (Casey) is reported for the first time from Quebec. Bisnius cephalotes (Gravenhorst) is removed from the faunal list of New Brunswick due to a lack of supporting voucher specimens. Additional locality data are presented for seven species either recently recorded from the province or with few previous records and little habitat data. We provide the first documented records of Atrecus americanus (Casey), Quedius erythrogaster Mannerheim, Quedius labradorensis labradorensis Smetana, Quedius plagiatus (Mannerheim), and Neobisnius terminalis (LeConte) from New Brunswick. Collection and habitat data are presented and discussed for all species. PMID:22577325

  14. An evaluation of energy-absorbing guide rail terminals in New Brunswick

    NASA Astrophysics Data System (ADS)

    Esligar, Ryan W.

    2011-12-01

    Energy-absorbing guide rail terminals (EAGRTs) are a form of end treatment designed to absorb energy during a collision and prevent intrusion into the impacting vehicle. After several years of use in New Brunswick there is evidence to suggest these systems may not always perform as expected. This study was conducted to evaluate the real-world performance of EAGRT systems in collisions throughout the Province. A retrospective review of data for 103 collisions that occurred prior to the study was supplemented with an in-depth analysis and reconstruction of 18 collisions that occurred during the study. The study revealed that two types of EAGRTs are used in New Brunswick; the ET-Plus and the SKT-350. Between 2007 and 2010 approximately 80% of all EAGRT collisions were PDO, nearly 19% resulted in injuries, while one collision resulted in a fatality. In most cases the EAGRT absorbed a significant amount of energy (an average of 315 KJ per crash); however, there were several problems identified. It was determined that not all EAGRT systems are being installed in accordance with the manufacturer's guidelines. Intrusion into the vehicle was documented in three collisions. It was also discovered that many of the collision configurations were different than the NCHRP Report 350 tests. The major recommendations focused on installation and maintenance issues identified during the study. The study also revealed areas in need of further research. These areas include the feasibility of using the FLEAT system in New Brunswick, the installation of rumble strips on the median shoulder, and whether or not additional crash test configurations should be incorporated into NCHRP Report 350 or Project 22-14(2).

  15. Imaging of head trauma.

    PubMed

    Rincon, Sandra; Gupta, Rajiv; Ptak, Thomas

    2016-01-01

    Imaging is an indispensable part of the initial assessment and subsequent management of patients with head trauma. Initially, it is important for diagnosing the extent of injury and the prompt recognition of treatable injuries to reduce mortality. Subsequently, imaging is useful in following the sequelae of trauma. In this chapter, we review indications for neuroimaging and typical computed tomography (CT) and magnetic resonance imaging (MRI) protocols used in the evaluation of a patient with head trauma. We review the role of CT), the imaging modality of choice in the acute setting, and the role of MRI in the evaluation of patients with head trauma. We describe an organized and consistent approach to the interpretation of imaging of these patients. Important topics in head trauma, including fundamental concepts related to skull fractures, intracranial hemorrhage, parenchymal injury, penetrating trauma, cerebrovascular injuries, and secondary effects of trauma, are reviewed. The chapter concludes with advanced neuroimaging techniques for the evaluation of traumatic brain injury, including use of diffusion tensor imaging (DTI), functional MRI (fMRI), and MR spectroscopy (MRS), techniques which are still under development. PMID:27432678

  16. New records of Helophoridae, Hydrochidae, and Hydrophilidae (Coleoptera) from New Brunswick, Canada

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.

    2016-01-01

    Abstract The following three species of Helophoridae are newly recorded for New Brunswick, Canada: Helophorus (Kyphohelophorus) turberculatus Gyllenhal, Helophorus (Rhopaleloporus) oblongus LeConte, Helophorus (Rhopaleloporus) marginicollis Smetana. Hydrochus subcupreus Randall, family Hydrochidae, and the following 15 species of Hydrophilidae are newly reported for the province: Berosus fraternus LeConte, Berosus peregrinus (Herbst), Berosus sayi Hansen, Paracymus despectus (LeConte), Chaetarthria atra (LeConte), Cymbiodyta acuminata Fall, Cymbiodyta blanchardi Horn, Cymbiodyta minima Notman, Enochrus (Lumetus) hamiltoni Horn, Enochrus (Methydrus) consors (LeConte), Enochrus (Methydrus) consortus Green, Enochrus (Methydrus) pygmaeus nebulosus (Say), Cercyon (Cercyon) cinctus Smetana, Cercyon (Cercyon) herceus frigidus Smetana, Cercyon (Dicyrtocercyon) ustulatus (Preyssler). PMID:27110166

  17. The coagulopathy of trauma.

    PubMed

    Maegele, M

    2014-04-01

    Trauma is a leading cause of death, with uncontrolled hemorrhage and exsanguination being the primary causes of preventable deaths during the first 24 h following trauma. Death usually occurs quickly, typically within the first 6 h after injury. One out of four patients arriving at the Emergency Department after trauma is already in hemodynamic and hemostatic depletion. This early manifestation of hemostatic depletion is referred to as the coagulopathy of trauma, which may distinguished as: (i) acute traumatic coagulopathy (ATC) and (ii) iatrogenic coagulopathy (IC). The principle drivers of ATC have been characterized by tissue trauma, inflammation, hypoperfusion/shock, and the acute activation of the neurohumoral system. Hypoperfusion leads to an activation of protein C with cleavage of activated factors V and VIII and the inhibition of plasminogen activator inhibitor-1 (PAI-1), with subsequent fibrinolysis. Endothelial damage and activation results in Weibel-Palade body degradation and glycocalyx shedding associated with autoheparinization. In contrast, there is an IC which occurs secondary to uncritical volume therapy, leading to acidosis, hypothermia, and hemodilution. This coagulopathy may, then, be an integral part of the "vicious cycle" when combined with acidosis and hypothermia. The awareness of the specific pathophysiology and of the principle drivers underlying the coagulopathy of trauma by the treating physician is paramount. It has been shown that early recognition prompted by appropriate and aggressive management can correct coagulopathy, control bleeding, reduce blood product use, and improve outcome in severely injured patients. This paper summarizes: (i) the current concepts of the pathogenesis of the coagulopathy of trauma, including ATC and IC, (ii) the current strategies available for the early identification of patients at risk for coagulopathy and ongoing life-threatening hemorrhage after trauma, and (iii) the current and updated European

  18. Trauma and Mobile Radiography

    SciTech Connect

    Drafke, M.W.

    1989-01-01

    Trauma and Mobile Radiography focuses on the radiography of trauma patients and of patients confined to bed. This book offers students a foundation in the skills they need to produce quality radiograms without causing additional injury or pain to the patient. Features of this new book include: coverage of the basics of radiography and patient care, including monitoring of heavily sedated, immobile, and accident patients. Information on the injuries associated with certain types of accidents, and methods for dealing with these problems. Detailed explanation of the positioning of each anatomical area. A Quick Reference Card with information on evaluating, monitoring and radiographing trauma patients.

  19. Trauma program development.

    PubMed

    Althausen, Peter L

    2014-07-01

    The development of a strong trauma program is clearly one of the most important facets of successful business development. Several recent publications have demonstrated that well run trauma services can generate significant profits for both the hospital and the surgeons involved. There are many aspects to this task that require constant attention and insight. Top notch patient care, efficiency, and cost-effective resource utilization are all important components that must be addressed while providing adequate physician compensation within the bounds of hospital financial constraints and the encompassing legal issues. Each situation is different but many of the components are universal. This chapter addresses all aspects of trauma program development to provide the graduating fellow with the tools to create a new trauma program or improve an existing program in order to provide the best patient care while optimizing financial reward and improving care efficiency. PMID:24918830

  20. Basic trauma life support.

    PubMed

    Werman, H A; Nelson, R N; Campbell, J E; Fowler, R L; Gandy, P

    1987-11-01

    The impact of traumatic injuries on modern society in terms of morbidity, mortality, and economic cost is enormous. Studies have shown that both advanced life support skills and rapid stabilization and transport of the trauma victim have a beneficial effect on the patient's ultimate outcome. The Basic Trauma Life Support (BTLS) course was designed to provide pre-hospital care providers with the skills necessary to provide a thorough assessment, initial resuscitation, and rapid transportation of the trauma victim. Early studies suggest that the material is easily learned by prehospital care providers and that the on-scene time for trauma cases is reduced following training in BTLS. More widespread training in BTLS may have a significant effect on the mortality and morbidity associated with traumatic injuries. PMID:3662184

  1. Imaging of Abusive Trauma.

    PubMed

    Shekdar, Karuna

    2016-06-01

    "Shaken baby syndrome" is a term often used by the physicians and public to describe abusive trauma inflicted on infants and young children. Advances in the understanding of the mechanisms and the associated clinical spectrum of injury has lead us to modify our terminology and address it as "abusive trauma" (AT). Pediatric abusive head trauma is defined as an injury to the skull or intracranial contents of an infant or a young child (< 5 y age) due to inflicted blunt impact and/or violent shaking. This chapter focuses on the imaging aspects of childhood abusive trauma along with a brief description of the mechanism and pathophysiology of abusive injury. The diagnosis of AT is not always obvious, and abusive injuries in many infants may remain unrecognized. Pediatricians should be cognizant of AT since pediatricians play a crucial role in the diagnosis, management and prevention of AT. PMID:26882906

  2. Imaging in orbital trauma

    PubMed Central

    Lin, Ken Y.; Ngai, Philip; Echegoyen, Julio C.; Tao, Jeremiah P.

    2012-01-01

    Orbital trauma is one of the most common reasons for ophthalmology specialty consultation in the emergency department setting. We survey the literature from 1990 to present to describe the role of computed tomography (CT), magnetic resonance imaging (MRI) and their associated angiography in some of the most commonly encountered orbital trauma conditions. CT orbit can often detect certain types of foreign bodies, lens dislocation, ruptured globe, choroidal or retinal detachments, or cavernous sinus thrombosis and thus complement a bedside ophthalmic exam that can sometimes be limited in the setting of trauma. CT remains the workhorse for acute orbital trauma owing to its rapidity and ability to delineate bony abnormalities; however MRI remains an important modality in special circumstances such as soft tissue assessment or with organic foreign bodies. PMID:23961028

  3. Trauma registry reengineered.

    PubMed

    Wargo, Christina; Bolig, Nicole; Hixson, Heather; McWilliams, Nate; Rummerfield, Heather; Stratton, Elaine; Woodruff, Tracy

    2014-01-01

    A successful trauma registry balances accuracy of abstraction and timeliness of case submissions to achieve quality performance. Staffing to achieve quality performance is a challenge at times based on competitive institutional need. The aim of this performance improvement timing study was to identify trauma registry job responsibilities and redesign the responsibilities to create increased abstraction time and maintain accuracy of data abstraction. The outcome is measured by case submission rates with existing staffing and interrater reliability outcomes. PMID:25397337

  4. Penetrating extremity trauma.

    PubMed

    Ivatury, Rao R; Anand, Rahul; Ordonez, Carlos

    2015-06-01

    Penetrating extremity trauma (PET) usually becomes less important when present along with multiple truncal injuries. The middle eastern wars documented the terrible mortality and morbidity resulting from PET. Even in civilian trauma, PET can lead to significant morbidity and mortality. There are now well-established principles in the evaluation and management of vascular, bony, soft tissue, and neurologic lesions that will lead to a reduction of the poor outcomes. This review will summarize some of these recent concepts. PMID:25413177

  5. Noninvasive ventilation in trauma.

    PubMed

    Karcz, Marcin K; Papadakos, Peter J

    2015-02-01

    Trauma patients are a diverse population with heterogeneous needs for ventilatory support. This requirement depends mainly on the severity of their ventilatory dysfunction, degree of deterioration in gaseous exchange, any associated injuries, and the individual feasibility of potentially using a noninvasive ventilation approach. Noninvasive ventilation may reduce the need to intubate patients with trauma-related hypoxemia. It is well-known that these patients are at increased risk to develop hypoxemic respiratory failure which may or may not be associated with hypercapnia. Hypoxemia in these patients is due to ventilation perfusion mismatching and right to left shunt because of lung contusion, atelectasis, an inability to clear secretions as well as pneumothorax and/or hemothorax, all of which are common in trauma patients. Noninvasive ventilation has been tried in these patients in order to avoid the complications related to endotracheal intubation, mainly ventilator-associated pneumonia. The potential usefulness of noninvasive ventilation in the ventilatory management of trauma patients, though reported in various studies, has not been sufficiently investigated on a large scale. According to the British Thoracic Society guidelines, the indications and efficacy of noninvasive ventilation treatment in respiratory distress induced by trauma have thus far been inconsistent and merely received a low grade recommendation. In this review paper, we analyse and compare the results of various studies in which noninvasive ventilation was applied and discuss the role and efficacy of this ventilator modality in trauma. PMID:25685722

  6. Airway management in trauma.

    PubMed

    Langeron, O; Birenbaum, A; Amour, J

    2009-05-01

    Maintenance of a patent and prevention of aspiration are essential for the management of the trauma patient, that requires experienced physicians in airway control techniques. Difficulties of the airway control in the trauma setting are increased by the vital failures, the risk of aspiration, the potential cervical spine injury, the combative patient, and the obvious risk of difficult tracheal intubation related to specific injury related to the trauma. Endotracheal intubation remains the gold standard in trauma patient airway management and should be performed via the oral route with a rapid sequence induction and a manual in-line stabilization maneuver, to decrease the risks previously mentioned. Different techniques to control the airway in trauma patients are presented: improvement of the laryngoscopic vision, lighted stylet tracheal intubation, retrograde technique for orotracheal intubation, the laryngeal mask and the intubating laryngeal mask airways, the combitube and cricothyroidotomy. Management of the airway in trauma patients requires regular training in these techniques and the knowledge of complementary techniques allowing tracheal intubation or oxygenation to overcome difficult intubation and to prevent major complications as hypoxemia and aspiration. PMID:19412149

  7. New Brunswick nurses' views on nursing research, and factors influencing their research activities in clinical practice.

    PubMed

    Robichaud-Ekstrand, Sylvie

    2016-06-01

    New Brunswick became the first province in Canada to require a baccalaureate degree in nursing as the entry to practice, yet nursing research in hospital settings remains quite low. This study examined clinical nurses' views on nursing research, and identified some contributing factors to the research-practice gap. This descriptive, cross-sectional multicenter study involved 1081 nurses working in the Francophone Regional Health Authority in New Brunswick, Canada. Nurses were eager to identify nursing-care problems to improve patient care (92.9%), and to be involved in collecting data for nursing research studies (95.2%). However, without research supervision, few had engaged in basic research activities, such as formulating or refining research questions (24.5%), presenting at research conferences (6.9%), or changing their practice based on research findings (27.2%). Younger, more educated nurses, nurse managers, and educators participated more readily in research. Sharing research and clinical expertise, as well as infrastructures between academic and clinical institutions is the key to enduring successful patient-centered nursing research in clinical settings. Concrete actions are proposed to build clinical nursing research. PMID:26822438

  8. New Curculionoidea records from New Brunswick, Canada with an addition to the fauna of Nova Scotia

    PubMed Central

    Webster, Reginald P.; Anderson, Robert S.; Webster, Vincent L.; Alderson, Chantelle A.; Hughes, Cory C.; Sweeney, Jon D.

    2016-01-01

    Abstract This paper presents 27 new records of Curculionoidea for the province of New Brunswick, Canada, including three species new to Canada, and 12 adventive species, as follows: Eusphryrus walshii LeConte, Choragus harrisii LeConte (newly recorded for Canada), Choragus zimmermanni LeConte (newly recorded for Canada) (Anthribidae); Cimberis pallipennis (Blatchley) (Nemonychidae); Nanophyes marmoratus marmoratus (Goeze) (Brentidae); Procas lecontei Bedel (Brachyceridae); Anthonomus pusillus LeConte (newly recorded for Canada), Anthonomus (Cnemocyllus) pictus Blatchley, Archarius salicivorus (Paykull), Dorytomus hirtus LeConte, Ellescus bipunctatus (Linnaeus), Mecinus janthinus (Germar), Myrmex chevrolatii (Horn), Madarellus undulatus (Say), Microplontus campestris (Gyllenhal), Pelenomus waltoni (Boheman), Rhinoncus bruchoides (Herbst), Rhinoncus perpendicularis (Reich), Cossonus impressifrons Boheman, Cossonus pacificus Van Dyke, Rhyncolus knowltoni (Thatcher), Eubulus bisignatus (Say), Polydrusus cervinus (Linnaeus), Magdalis piceae Buchanan, Procryphalus mucronatus (LeConte), Ips grandicollis (Eichhoff), and Xyleborinus attenuatus (Blandford). Recent name changes in the genus Rhinoncus are applied to species known from New Brunswick. In addition, Orchestes alni (Linnaeus) is newly recorded from Nova Scotia. PMID:27110173

  9. Role of the statistician in the decommissioning of the New Brunswick Laboratory and other nuclear facilities

    SciTech Connect

    Gilbert, R.O.

    1980-12-01

    This report examines what the statistician can contribute to decommissioning operations, with particular emphasis on the New Brunswick Laboratory (NBL) currently scheduled for decommissioning beginning in FY81. In the opinion of the author, a professional statistician should be a full member of the planning team directing decommissioning operations at the New Brunswick Laboratory. This opinion is based in part on the familiarity with the valuable contributions made by statisticians toward the cleanup of transuranics in soil on the Enewetak Atoll. More generally, however, the professional statistician can help plan the decommissioning effort to help ensure that representative data are obtained, analyzed and, interpreted in appropriate ways so that RA decisions can be made with the required confidence. The statistician's contributions at the NBL could include providing guidance on the number and location of samples and in-situ measurements, analyzing and interpreting these data, designing a data management and documentation system, interfacing with the certification contractor's statistician, and assisting in writing documentation and final reports. In all cases, the statistician should work closely with the professional health physicist and others on the planning team in a closely coordinated effort of planning and data analysis.

  10. 33 CFR 334.450 - Cape Fear River and tributaries at Sunny Point Army Terminal, Brunswick County, NC; restricted area.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Cape Fear River and tributaries... AND RESTRICTED AREA REGULATIONS § 334.450 Cape Fear River and tributaries at Sunny Point Army Terminal, Brunswick County, NC; restricted area. (a) The area. That portion of Cape Fear River due west of the...

  11. 33 CFR 334.450 - Cape Fear River and tributaries at Sunny Point Army Terminal, Brunswick County, NC; restricted area.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Cape Fear River and tributaries... AND RESTRICTED AREA REGULATIONS § 334.450 Cape Fear River and tributaries at Sunny Point Army Terminal, Brunswick County, NC; restricted area. (a) The area. That portion of Cape Fear River due west of the...

  12. 33 CFR 334.450 - Cape Fear River and tributaries at Sunny Point Army Terminal, Brunswick County, NC; restricted area.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Cape Fear River and tributaries... AND RESTRICTED AREA REGULATIONS § 334.450 Cape Fear River and tributaries at Sunny Point Army Terminal, Brunswick County, NC; restricted area. (a) The area. That portion of Cape Fear River due west of the...

  13. 33 CFR 334.450 - Cape Fear River and tributaries at Sunny Point Army Terminal, Brunswick County, NC; restricted area.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Cape Fear River and tributaries... AND RESTRICTED AREA REGULATIONS § 334.450 Cape Fear River and tributaries at Sunny Point Army Terminal, Brunswick County, NC; restricted area. (a) The area. That portion of Cape Fear River due west of the...

  14. 76 FR 53970 - Carolina Power & Light; Brunswick Steam Electric Plant, Units 1 and 2; Independent Spent Fuel...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-30

    ... From the Federal Register Online via the Government Publishing Office ] NUCLEAR REGULATORY COMMISSION Carolina Power & Light; Brunswick Steam Electric Plant, Units 1 and 2; Independent Spent Fuel Storage Installation; Notice of Consideration of Approval of Application for Indirect License Transfers Resulting From the Proposed Merger...

  15. Political Partisanship, Bureaucratic Pragmatism and Acadian Nationalism: New Brunswick, Canada's 1920 History Textbook Controversy

    ERIC Educational Resources Information Center

    Helyar, Frances

    2014-01-01

    During a time of post-war sensitivity to Canadian nationalism and patriotism, public feeling was aroused in 1920 New Brunswick regarding a world history textbook with a new chapter about the First World War. The American author made no reference to Canada's war efforts. The subsequent public discussion focused on issues of patriotism,…

  16. Building a Strong Foundation for Teaching: The Fifth Annual Report of the Beginning Teacher Induction Program in New Brunswick.

    ERIC Educational Resources Information Center

    Scott, Neil H.

    This report describes the reactions of beginning teachers, mentors, principals, and district coordinators in 12 New Brunswick, Canada, school districts to a teacher induction program that paired beginning teachers with experienced mentor teachers over one school year. Questionnaires were sent to each of the four groups. All four groups strongly…

  17. New Staphylinidae (Coleoptera) records with new collection data from New Brunswick, Canada: Scaphidiinae, Piestinae, Osorinae, and Oxytelinae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract Nine species of Scaphidiinae are newly reported for New Brunswick, Canada, bringing the total number of species known from the province to 12. Scaphium castanipes Kirby, Baeocera inexspectata Löbl and Stephen, Baeocera securiforma (Cornell), Scaphisoma repandum Casey, and Toxidium gammaroides LeConte are reported for the first time from the Maritime provinces. Siagonum punctatum LeConte and Siagonum stacesmithi Hatch, and the subfamily Piestinae are reported for the first time from New Brunswick. The subfamily Osoriinae is reported for the first time from New Brunswick and the Maritime provinces based on the collection of three species: Clavilispinus prolixus (LeConte), Thoracophorus costalis (Erichson), and a Lispinodes species. The Lispinodes species is also newly recorded for Canada. Six species of Oxytelinae are newly recorded from New Brunswick, bringing the total number of species of this subfamily known to the province to 20. Apocellus sphaericollis (Say) and Platystethus americanus Erichson are new to the Maritime provinces. Additional locality and bionomic data are presented for Mitosynum vockerothi Campbell, and the male genitalia are illustrated for the first time. Collection and bionomic data are presented for all included species. PMID:22577322

  18. Inclusion on the Agenda in Four Different School Contexts in Canada (Ontario, Manitoba, New Brunswick and Quebec)

    ERIC Educational Resources Information Center

    Belanger, Nathalie; Gougeon, Nathalie A.

    2009-01-01

    Four case studies from four different Canadian provinces (Ontario, Manitoba, New Brunswick, and Quebec) are examined in order to better understand meanings given to an inclusive approach in education, as it is defined and experienced by the actors, practitioners, parents, and students. The data examined in this article come from a larger research…

  19. Further contributions to the Coleoptera fauna of New Brunswick with an addition to the fauna of Nova Scotia, Canada

    PubMed Central

    Webster, Reginald P.; Webster, Vincent L.; Alderson, Chantelle A.; Hughes, Cory C.; Sweeney, Jon D.

    2016-01-01

    Abstract This paper treats 134 new records of Coleoptera for the province of New Brunswick, Canada from the following 41 families: Gyrinidae, Carabidae, Dytiscidae, Histeridae, Leiodidae, Scarabaeidae, Scirtidae, Buprestidae, Elmidae, Limnichidae, Heteroceridae, Ptilodactylidae, Eucnemidae, Throscidae, Elateridae, Lampyridae, Cantharidae, Dermestidae, Bostrichidae, Ptinidae, Cleridae, Melyridae, Monotomidae, Cryptophagidae, Silvanidae, Laemophloeidae, Nitidulidae, Endomychidae, Coccinellidae, Corylophidae, Latridiidae, Tetratomidae, Melandryidae, Mordellidae, Tenebrionidae, Mycteridae, Pyrochroidae, Aderidae, Scraptiidae, Megalopodidae, and Chrysomelidae. Among these, the following four species are newly recorded from Canada: Dirrhagofarsus ernae Otto, Muona & McClarin (Eucnemidae), Athous equestris (LeConte) (Elateridae), Ernobius opicus Fall (Ptinidae), and Stelidota coenosa Erichson (Nitidulidae). The Family Limnichidae is newly reported for New Brunswick, and one species is added to the fauna of Nova Scotia. Stephostethus productus Rosenhauer (Latridiidae), Tetratoma (Abstrulia) variegata Casey (Tetratomidae), and Chauliognathus marginatus (Fabricius) (Cantharidae) are removed from the faunal list of New Brunswick, and additional records of Lacconotus punctatus LeConte (Mycteridae) are presented and discussed. Lindgren funnel traps provided specimens for 104 (78%) of the species and were the sole source of specimens for 89 (66%) of the species reported here, suggesting they are a very useful tool for sampling Coleoptera fauna in the forests of New Brunswick. PMID:27110171

  20. 75 FR 53264 - Restricted Area in Cape Fear River and Tributaries at Sunny Point Army Terminal, Brunswick County...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ... at Sunny Point Army Terminal, Brunswick County, NC AGENCY: U.S. Army Corps of Engineers, DoD. ACTION... regulation for the restricted area in the Cape Fear River and its tributaries at Sunny Point Army Terminal... facility, including vessels loading and offloading at the Sunny Point Army Terminal. In the ``Rules...

  1. Compilation of Water-Resources Data and Hydrogeologic Setting for Brunswick County, North Carolina, 1933-2000

    USGS Publications Warehouse

    Fine, Jason M.; Cunningham, William L.

    2001-01-01

    Water-resources data were compiled for Brunswick County, North Carolina, to describe the hydrologic conditions of the County. Hydrologic data collected by the U.S. Geological Survey as well as data collected by other governmental agencies and reviewed by the U.S. Geological Survey are presented. Data from four weather stations and two surface-water stations are summarized. Data also are presented for land use and land cover, soils, geology, hydrogeology, 12 continuously monitored ground-water wells, 73 periodically measured ground-water wells, and water-quality measurements from 39 ground-water wells. Mean monthly precipitation at the Longwood, Shallotte, Southport, and Wilmington Airport weather stations ranged from 2.19 to 7.94 inches for the periods of record, and mean monthly temperatures at the Longwood, Southport, and Wilmington Airport weather stations ranged from 43.4 to 80.1 degrees Fahrenheit for the periods of record. An evaluation of land-use and land-cover data for Brunswick County indicated that most of the County is either forested land (about 57 percent) or wetlands (about 29 percent). Cross sections are presented to illustrate the general hydrogeology beneath Brunswick County. Water-level data for Brunswick County indicate that water levels ranged from about 110 feet above mean sea level to about 22 feet below mean sea level. Chloride concentrations measured in aquifers in Brunswick County ranged from near 0 to 15,000 milligrams per liter. Chloride levels in the Black Creek and Cape Fear aquifers were measured at well above the potable limit for ground water of 250 milligrams per liter set by the U.S. Environmental Protection Agency for safe drinking water.

  2. Pitfalls in penetrating trauma.

    PubMed

    van Vugt, A B

    2003-08-01

    In Western Europe the most frequent cause of multiple injuries is blunt trauma. Only few of us have experience with penetrating trauma, without exception far less than in the USA or South-Africa. In Rotterdam, the Erasmus Medical Centre is a level I trauma centre, situated directly in the town centre. All penetrating traumas are directly presented to our emergency department by a well organized ambulance service supported by a mobile medical team if necessary. The delay with scoop and run principles is very short for these cases, resulting in severely injured reaching the hospital alive in increasing frequency. Although the basic principles of trauma care according to the guidelines of the Advanced Trauma Life Support (ATLS) (1-2) are the same for blunt and penetrating trauma with regard to priorities, diagnostics and primary therapy, there are some pitfalls in the strategy of management in penetrating trauma one should be aware of. Simple algorithms can be helpful, especially in case of limited experience (3). In case of life-saving procedures, the principles of Damage Control Surgery (DCS) must be followed (4-5). This approach is somewhat different from "traditional" surgical treatment. In the Ist phase prompt interventions by emergency thoracotomy and laparotomy are carried out, with only two goals to achieve: surgical control of haemorrhage and contamination. After temporary life-saving procedures, the 2nd phase is characterized by intensive care treatment, dealing with hypothermia, metabolic acidosis and clotting disturbances. Finally in the 3rd phase, within 6-24 hours, definitive surgical care takes place. In this overview, penetrating injuries of neck, thorax, abdomen and extremities will be outlined. Penetrating cranial injuries, as a neurosurgical emergency with poor prognosis, are not discussed. History and physical examination remain the corner stones of good medical praxis. In a work-up according to ATLS principles airway, breathing and circulation

  3. Classification of Liver Trauma

    PubMed Central

    Rizoli, Sandro B.; Brenneman, Frederick D.; Hanna, Sherif S.; Kahnamoui, Kamyar

    1996-01-01

    The classification of liver injuries is important for clinical practice, clinical research and quality assurance activities. The Organ Injury Scaling (OIS) Committee of the American Association for the Surgery of Trauma proposed the OIS for liver trauma in 1989. The purpose ofthe present study was to apply this scale to a cohort ofliver trauma patients managed at a single Canadian trauma centre from January 1987 to June 1992.170 study patients were identified and reviewed. The mean age was 30, with 69% male and a mean ISS of 33.90% had a blunt mechanism ofinjury. The 170 patients were categorized into the 60IS grades ofliver injury. The number of units of blood transfused, the magnitude of the operative treatment required, the liver-related complications and the liver-related mortality correlated well with the OIS grade. The OIS grade was unable to predict the need for laparotomy or the length of stay in hospital. We conclude that the OIS is a useful, practical and important tool for the categorization of liver injuries, and it may prove to be the universally accepted classification scheme in liver trauma. PMID:8809585

  4. Epidemiology of severe trauma.

    PubMed

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

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions. PMID:25241267

  5. Male genital trauma

    SciTech Connect

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

    1988-07-01

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

  6. Paediatric Blunt Torso Trauma

    PubMed Central

    Bhatti, Khalid M.; Taqi, Kadhim M.; Al-Harthy, Ahmed Z. S.; Hamid, Rana S.; Al-Balushi, Zainab N.; Sankhla, Dilip K.; Al-Qadhi, Hani A.

    2016-01-01

    Objectives: Trauma is the greatest cause of morbidity and mortality in paediatric/adolescent populations worldwide. This study aimed to describe trauma mechanisms, patterns and outcomes among children with blunt torso trauma admitted to the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. Methods: This retrospective single-centre study involved all children ≤12 years old with blunt torso trauma admitted for paediatric surgical care at SQUH between January 2009 and December 2013. Medical records were analysed to collect demographic and clinical data. Results: A total of 70 children were admitted with blunt torso trauma during the study period, including 39 (55.7%) male patients. The mean age was 5.19 ± 2.66 years. Of the cohort, 35 children (50.0%) received their injuries after having been hit by cars as pedestrians, while 19 (27.1%) were injured by falls, 12 (17.1%) during car accidents as passengers and four (5.7%) by falling heavy objects. According to computed tomography scans, thoracic injuries were most common (65.7%), followed by abdominal injuries (42.9%). The most commonly involved solid organs were the liver (15.7%) and spleen (11.4%). The majority of the patients were managed conservatively (92.9%) with a good outcome (74.3%). The mortality rate was 7.1%. Most deaths were due to multisystem involvement. Conclusion: Among children with blunt torso trauma admitted to SQUH, the main mechanism of injury was motor vehicle accidents. As a result, parental education and enforcement of infant car seat/child seat belt laws are recommended. Conservative management was the most successful approach. PMID:27226913

  7. Trauma-Focused CBT for Youth who Experience Ongoing Traumas

    PubMed Central

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

    2011-01-01

    Many youth experience ongoing trauma exposure, such as domestic or community violence. Clinicians often ask whether evidence-based treatments containing exposure components to reduce learned fear responses to historical trauma are appropriate for these youth. Essentially the question is, if youth are desensitized to their trauma experiences, will this in some way impair their responding to current or ongoing trauma? The paper addresses practical strategies for implementing one evidence-based treatment, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth with ongoing traumas. Collaboration with local therapists and families participating in TF-CBT community and international programs elucidated effective strategies for applying TF-CBT with these youth. These strategies included: 1) enhancing safety early in treatment; 2) effectively engaging parents who experience personal ongoing trauma; and 3) during the trauma narrative and processing component focusing on a) increasing parental awareness and acceptance of the extent of the youths’ ongoing trauma experiences; b) addressing youths’ maladaptive cognitions about ongoing traumas; and c) helping youth differentiate between real danger and generalized trauma reminders. Case examples illustrate how to use these strategies in diverse clinical situations. Through these strategies TF-CBT clinicians can effectively improve outcomes for youth experiencing ongoing traumas. PMID:21855140

  8. Trauma-Focused CBT for Youth Who Experience Ongoing Traumas

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.; Murray, Laura K.

    2011-01-01

    Many youth experience ongoing trauma exposure, such as domestic or community violence. Clinicians often ask whether evidence-based treatments containing exposure components to reduce learned fear responses to historical trauma are appropriate for these youth. Essentially the question is, if youth are desensitized to their trauma experiences, will…

  9. Assuring optimal trauma care: the role of trauma centre accreditation

    PubMed Central

    Simons, Richard; Kirkpatrick, Andrew

    2002-01-01

    Optimal care of the injured patient requires the delivery of appropriate, definitive care shortly after injury. Over the last 30 to 40 years, civilian trauma systems and trauma centres have been developed in the United States based on experience gained in military conflicts, particularly in Korea and Vietnam. A similar process is evolving in Canada. National trauma committees in the US and Canada have defined optimal resources to meet the goal of rapid, appropriate care in trauma centres. They have introduced programs (verification or accreditation) to externally audit trauma centre performance based on these guidelines. It is generally accepted that implementing trauma systems results in decreased preventable death and improved survival after trauma. What is less clear is the degree to which each facet of trauma system development contributes to this improvement. The relative importance of national performance guidelines and trauma centre audit as integral steps toward improved outcomes following injury are reviewed. Current Trauma Association of Canada guidelines for trauma centres are presented and the process of trauma centre accreditation is discussed. PMID:12174987

  10. The Scholarship of Teaching and Learning (SoTL) at Renaissance College (University of New Brunswick): A Case Study of SoTL at the Faculty Level

    ERIC Educational Resources Information Center

    Mengel, Thomas

    2016-01-01

    This chapter presents the case study of Renaissance College at the University of New Brunswick, discussing the faculty's achievements, challenges, and outlook for the future in the context of the scholarship of teaching and learning in Canada.

  11. Advances in prehospital trauma care

    PubMed Central

    Williamson, Kelvin; Ramesh, Ramaiah; Grabinsky, Andreas

    2011-01-01

    Prehospital trauma care developed over the last decades parallel in many countries. Most of the prehospital emergency medical systems relied on input or experiences from military medicine and were often modeled after the existing military procedures. Some systems were initially developed with the trauma patient in mind, while other systems were tailored for medical, especially cardiovascular, emergencies. The key components to successful prehospital trauma care are the well-known ABCs of trauma care: Airway, Breathing, Circulation. Establishing and securing the airway, ventilation, fluid resuscitation, and in addition, the quick transport to the best-suited trauma center represent the pillars of trauma care in the field. While ABC in trauma care has neither been challenged nor changed, new techniques, tools and procedures have been developed to make it easier for the prehospital provider to achieve these goals in the prehospital setting and thus improve the outcome of trauma patients. PMID:22096773

  12. Groundwater flow in the Brunswick/Glynn County area, Georgia, 2000-04

    USGS Publications Warehouse

    Cherry, Gregory S.

    2015-01-01

    Simulated potentiometric profiles for 2000 and 2004 were used to evaluate the potentiometric gradients in the upper water-bearing zone of the Upper Floridan aquifer (layer 7) near the chloride plume in the downtown Brunswick area. Four potentiometric profiles were constructed for 2000 to compare the simulated and observed water levels in 13 wells and were oriented outward from a primary well field. The simulated potentiometric gradients from the four profiles for 2000 ranged from 3.6 to 5.2 feet per mile (ft/mi) compared to observed values ranging from 4.1 to 5.6 ft/mi. The five potentiometric profiles constructed for 2004 allowed for a similar comparison using simulated and observed water levels in 18 wells. The simulated pote

  13. Learning through EC directive based SEA in spatial planning? Evidence from the Brunswick Region in Germany

    SciTech Connect

    Fischer, Thomas B.; Kidd, Sue; Jha-Thakur, Urmila; Gazzola, Paola; Peel, Deborah

    2009-11-15

    This paper presents results of an international comparative research project, funded by the UK Economic and Social Research Council (ESRC) and the Academy for Sustainable Communities (ASC) on the 'learning potential of appraisal (strategic environmental assessment - SEA) in spatial planning'. In this context, aspects of 'single-loop' and 'double-loop' learning, as well as of individual, organisational and social learning are discussed for emerging post-EC Directive German practice in the planning region (Zweckverband) of Brunswick (Braunschweig), focusing on four spatial plan SEAs from various administrative levels in the region. It is found that whilst SEA is able to lead to plan SEA specific knowledge acquisition, comprehension, application and analysis ('single-loop learning'), it is currently resulting only occasionally in wider synthesis and evaluation ('double-loop learning'). Furthermore, whilst there is evidence that individual and occasionally organisational learning may be enhanced through SEA, most notably in small municipalities, social learning appears to be happening only sporadically.

  14. Reconstructing the Avalon continent: Marginal to inner platform transition in the Cambrian of southern New Brunswick

    USGS Publications Warehouse

    Landing, E.

    1996-01-01

    A west to east, marginal to inner Avalonian platform transition, comparable to that in southeast Newfoundland and southern Britain, is present in the Cambrian of southern New Brunswick. The Saint John - Caton's Island - Hanford Brook area lay on the marginal platform, and its thick, uppermost Precambrian - lower Lower Cambrian is unconformably overlain by trilobite-bearing, upper Lower Cambrian. An inner platform remnant is preserved in the Cradle Brook outlier 60 km northeast of Saint John. In contrast to the marginal platform sequences, the Cradle Brook outlier has a very thin lower Lower Cambrian and has middle Lower Cambrian strata (Bonavista Group) not present on the marginal platform. The Cradle Brook Lower Cambrian closely resembles inner platform successions in eastern Massachusetts and Trinity and Placentia bays, southeast Newfoundland. A limestone with Camenella baltica Zone fossils on Cradle Brook seems to be the peritidal limestone cap of the subtrilobitic Lower Cambrian known in Avalonian North America (Fosters Point Formation) and England (Home Farm Member).

  15. Nurses' voice: influencing the restructuring of the New Brunswick healthcare system.

    PubMed

    Davidson, P; Rhéaume, A; Dykeman, M; Ericson, P; Duffett-Leger, L; Doucet, J

    2007-01-01

    Although nurses make up the largest group of professionals working in th healthcare field, they are often left out of the decisions that shape the restructuring of healthcare in Canada. A feminist philosophy guided this qualitative study, conducted in New Brunswick, to gain an in-depth knowledge of the impact of restructuring on nurses working in all types of healthcare facilities across the province. Sixty-five nurses were interviewed, and a number of themes, including "having a voice," emerged from the data. While many of the nurses interviewed reported that they were not invited to participate in decisions related to healthcare restructuring, others noted that when they did have an opportunity to participate, they were frequently not heard. However, a number of nurses also reported that they believed they had some influence and could continue to make a positive difference when they were asked to be involved at the outset of a change process. PMID:18303727

  16. Structured Sensory Trauma Interventions

    ERIC Educational Resources Information Center

    Steele, William; Kuban, Caelan

    2010-01-01

    This article features the National Institute of Trauma and Loss in Children (TLC), a program that has demonstrated via field testing, exploratory research, time series studies, and evidence-based research studies that its Structured Sensory Intervention for Traumatized Children, Adolescents, and Parents (SITCAP[R]) produces statistically…

  17. Pediatric head trauma

    PubMed Central

    Alexiou, George A; Sfakianos, George; Prodromou, Neofytos

    2011-01-01

    Head injury in children accounts for a large number of emergency department visits and hospital admissions. Falls are the most common type of injury, followed by motor-vehicle-related accidents. In the present study, we discuss the evaluation, neuroimaging and management of children with head trauma. Furthermore, we present the specific characteristics of each type of pediatric head injury. PMID:21887034

  18. Trauma Induced Myocardial Infarction

    PubMed Central

    Lolay, Georges A.; Abdel-Latef, Ahmed K.

    2016-01-01

    Chest Trauma in athletes is a common health problem. However, myocardial infarction secondary to coronary dissection in the setting of blunt chest trauma is extremely rare. We report a case of acute inferior wall myocardial infarction following blunt chest trauma. A 32-year-old male with no relevant medical problems was transferred to our medical center for retrosternal chest pain after being elbowed in the chest during a soccer game. Few seconds later, he started experiencing sharp retrosternal chest pain that was severe to that point where he called the emergency medical service. Upon arrival to the Trauma department patient was still complaining of chest pain. ECG demonstrated ST segment elevation in the inferior leads with reciprocal changes in the lateral leads all consistent with active ischemia. After rolling out Aortic dissection, patient was loaded with ASA, ticagerlor, heparin and was emergently taken to the cardiac catheterization lab. Coronary angiography demonstrated 100% thrombotic occlusion in the distal right coronary artery with TIMI 0 flow distally. After thrombus aspiration, a focal dissection was noted on the angiogram that was successfully stented. Two days after admission patient was discharged home. Echocardiography prior to discharge showed inferior wall akinesis, normal right ventricular systolic function and normal overall ejection fraction. PMID:26490501

  19. Early Childhood Trauma

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2010

    2010-01-01

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

  20. Imaging in spinal trauma.

    PubMed

    Van Goethem, Johan W M; Maes, Menno; Ozsarlak, Ozkan; van den Hauwe, Luc; Parizel, Paul M

    2005-03-01

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

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

    PubMed

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

    2016-01-01

    According to the National Trauma Institute (2015), trauma accounts for more than 180,000 deaths each year in the United States. Nurses play a significant role in the care of trauma patients and therefore need appropriate education and training (L. ). Although several courses exist for trauma education, many nurses have not received adequate education in trauma management (B. ; L. ). Trauma Tactics, a 2-day course that focuses on high-fidelity human patient simulation, was created to meet this educational need. This descriptive study was conducted retrospectively to assess the effectiveness of the Trauma Tactics course. Pre- and postsurveys, tests, and simulation performance were used to evaluate professional nurses who participated in Trauma Tactics over a 10-month period. Fifty-five nurses were included in the study. Pre- and postsurveys revealed an increase in overall confidence, test scores increased by an average of 2.5 points, and simulation performance scores increased by an average of 16 points. Trauma Tactics is a high-quality course that provides a valuable and impactful educational experience for nurses. Further research is needed to evaluate the long-term effects of Trauma Tactics and its impacts on quality of care and patient outcomes. PMID:27414143

  2. 78 FR 9771 - Notice of Opportunity for Public Comment on Surplus Property Release at Brunswick-Golden Isles...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-11

    ...Under the provisions of Title 49, U.S.C. 47153(c), notice is being given that the FAA is considering a request from the Glynn County Airport Commission to waive the requirement that a 0.739-acre parcel of surplus property, located on Glynn County airport owned and operated land adjacent to, but not contiguace with, Brunswick--Golden Isles Airport, be used for aeronautical...

  3. Needle Thoracotomy in Trauma.

    PubMed

    Rottenstreich, Misgav; Fay, Shmuel; Gendler, Sami; Klein, Yoram; Arkovitz, Marc; Rottenstreich, Amihai

    2015-12-01

    Tension pneumothorax is one of the leading causes of preventable death in trauma patients. Needle thoracotomy (NT) is the currently accepted first-line intervention but has not been well validated. In this review, we have critically discussed the evidence for NT procedure, re-examined the recommendations by the Advanced Trauma Life Support organization and investigated the safest and most effective way of NT. The current evidence to support the use of NT is limited. However, when used, it should be applied in the 2nd intercostal space at midclavicular line using a catheter length of at least 4.5 cm. Alternative measures should be studied for better prehospital management of tension pneumothorax. PMID:26633663

  4. Maxillofacial trauma scoring systems.

    PubMed

    Sahni, Vaibhav

    2016-07-01

    The changing complexity of maxillofacial fractures in recent years has created a situation where classical systems of classification of maxillofacial injuries fall short of defining trauma particularly that observed with high-velocity collisions where more than one region of the maxillofacial skeleton is affected. Trauma scoring systems designed specifically for the maxillofacial region are aimed to provide a more accurate assessment of the injury, its prognosis, the possible treatment outcomes, economics, length of hospital stay, and triage. The evolution and logic of such systems along with their merits and demerits are discussed. The author also proposes a new system to aid users in quickly and methodically choosing the system best suited to their needs without having to study a plethora of literature available in order to isolate their choice. PMID:26971084

  5. Substance Abuse and Trauma.

    PubMed

    Simmons, Shannon; Suárez, Liza

    2016-10-01

    There is a strong, bidirectional link between substance abuse and traumatic experiences. Teens with cooccurring substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) have significant functional and psychosocial impairment. Common neurobiological foundations point to the reinforcing cycle of trauma symptoms, substance withdrawal, and substance use. Treatment of teens with these issues should include a systemic and integrated approach to both the SUD and the PTSD. PMID:27613348

  6. Rethinking historical trauma.

    PubMed

    Kirmayer, Laurence J; Gone, Joseph P; Moses, Joshua

    2014-06-01

    Recent years have seen the rise of historical trauma as a construct to describe the impact of colonization, cultural suppression, and historical oppression of Indigenous peoples in North America (e.g., Native Americans in the United States, Aboriginal peoples in Canada). The discourses of psychiatry and psychology contribute to the conflation of disparate forms of violence by emphasizing presumptively universal aspects of trauma response. Many proponents of this construct have made explicit analogies to the Holocaust as a way to understand the transgenerational effects of genocide. However, the social, cultural, and psychological contexts of the Holocaust and of post-colonial Indigenous "survivance" differ in many striking ways. Indeed, the comparison suggests that the persistent suffering of Indigenous peoples in the Americas reflects not so much past trauma as ongoing structural violence. The comparative study of genocide and other forms of massive, organized violence can do much to illuminate both common mechanisms and distinctive features, and trace the looping effects from political processes to individual experience and back again. The ethics and pragmatics of individual and collective healing, restitution, resilience, and recovery can be understood in terms of the self-vindicating loops between politics, structural violence, public discourse, and embodied experience. PMID:24855142

  7. [The Trauma Network of the German Society for Trauma 2009].

    PubMed

    Kühne, C A; Mand, C; Sturm, J; Lackner, C K; Künzel, A; Siebert, H; Ruchholtz, S

    2009-10-01

    In 2009, 3 years after the foundation of the Trauma Network of the German Society for Trauma (TraumaNetzwerkD DGU), the majority of German hospitals participating in the treatment of seriously injured patients is registered in regional trauma networks (TNW). Currently there are 41 trauma networks with more than 660 hospitals in existence, 18 more are registered but are still in the planning phase. Each Federal State has an average of 39 trauma centres of different levels taking part in the treatment of seriously injured patients and every trauma network has an average catchment area of 8708 km(2). The most favourable geographical infrastructure conditions exist in Nordrhein-Westfalen, the least favourable in Sachsen-Anhalt and Mecklenburg-Vorpommern. A total of 95 hospitals have already fulfilled the first audit of the structural, personnel and qualitative requirements by the certification bodies. Examination of the check lists of 26 hospitals showed shortcomings in the clinical structure so that these hospitals must be rechecked after correction of the shortcomings. A total of 59 hospitals throughout Germany were successfully audited and only one failed to fulfil the requirements. Because of the varying sizes of the trauma networks there are differences in the areas covered by each trauma network and trauma centre. Concerning the process of certification and auditing (together with the company DIOcert) it could be seen that by careful examination of the check lists of each hospital unforeseen problems during the audit could be avoided. The following article will present the current state of development of the Trauma Network of the German Society for Trauma and describe the certification and auditing process. PMID:19756455

  8. Trauma in the geriatric population.

    PubMed

    Maxwell, Cathy A

    2015-06-01

    Injury in older adults is a looming public health crisis. This article provides a broad overview of geriatric trauma across the continuum of care. After a review of the epidemiology of geriatric trauma, optimal approaches to patient care are presented for triage and transport, trauma team activation and initial assessment, inpatient management, and injury prevention. Special emphasis is given to assessment of frailty, advanced care planning, and transitions of care. PMID:25981722

  9. Global trauma: the great divide

    PubMed Central

    Paniker, Jayanth; Graham, Simon Matthew; Harrison, James William

    2015-01-01

    Road trauma is an emergent global issue. There is huge disparity between the population affected by road trauma and the resource allocation. If the current trend continues, a predicted extra 5 million lives will be lost in this decade. This article aims to create an awareness of the scale of the problem of road trauma and the inequality in the resources available to address this problem. It also describes the responses from the international organisations and the orthopaedic community in dealing with this issue. The International Orthopaedic community has a unique opportunity and moral obligation to play a part in changing this trend of global trauma. PMID:27163075

  10. Post-Taconic blueschist suture in the northern Appalachians of northern New Brunswick, Canada

    SciTech Connect

    van Staal, C.R.; Ravenhurst, C.E.; Roddick, J.C. ); Winchester, J.A. ); Langton, J.P. )

    1990-11-01

    A narrow belt of Late Ordovician-Early Silurian blueschist, at least 70 km long, separates an allochthonous fragment of back-arc oceanic crust of the Middle Ordovician Fournier Group from underlying, rift-related volcanic rocks of the Middle Ordovician Tetagouche Group in northern New Brunswick, Canada. The basalts on both sides of the blueschist belt are predominantly metamorphosed to greenschist facies conditions. The blueschist belt is interpreted to be an out-of-sequence thrust zone that accommodated tectonic transport of higher pressure rocks on top of lower pressure rocks during post-peak blueschist facies metamorphism. The blueschists have higher Fe{sub 2}O{sub 3}/FeO ratios and total iron contents in comparison to otherwise chemically equivalent basalts of the Fournier and Tetagouche Groups that have been metamorphosed into greenschists. The blueschist belt was probably the site of channelized flow of oxidizing fluids during active deformation ina subduction complex formed during the closure of a wide Taconic back-arac basin in Late Ordovician-Silurian time.

  11. Further contributions to the longhorn beetle (Coleoptera, Cerambycidae) fauna of New Brunswick and Nova Scotia, Canada

    PubMed Central

    Webster, Reginald P.; Alderson, Chantelle A.; Webster, Vincent L.; CoryC. Hughes; Sweeney, Jon D.

    2016-01-01

    Abstract Sixteen species of Cerambycidae are newly recorded for New Brunswick, Canada; Arhopalus obsoletus (Randall), Atimia confusa confusa (Say), Callidium frigidum Casey, Phymatodes amoenus (Say), Phymatodes testaceus (Linnaeus), Neoclytus mucronatus mucronatus (Fabricius), Xylotrechus aceris Fisher, Xylotrechus sagittatus sagittatus (Germar), Tylonotus bimaculatus Haldeman, Lepturges angulatus (LeConte), Lepturges symmetricus (Haldeman), Urgleptes querci (Fitch), Oplosia nubila (LeConte), Eupogonius subarmatus (LeConte), Monochamus carolinensis (Olivier), and Pogonocherus parvulus LeConte. Urgleptes signatus (LeConte) and Urgleptes querci are newly recorded from Nova Scotia. All but two specimens were collected in 12-funnel Lindgren traps. Xylotrechus aceris, Tylonotus bimaculatus, Lepturges angulatus, Lepturges symmetricus, Urgleptes signatus (NS), and Pogonocherus parvulus were detected exclusively in traps deployed in the forest canopy, and most individuals of Oplosia nubila and Monochamus carolinensis were captured in canopy traps. Arhopalus obsoletus, Atimia confusa confusa, Callidium frigidum, Phymatodes testaceus, and Xylotrechus sagittatus sagittatus were captured almost exclusively in traps near (1 m above) the forest floor. These results highlight the importance of sampling both the understory and upper canopy when using traps for surveying diversity of Cerambycidae. PMID:26865818

  12. A teleseismic analysis of the New Brunswick earthquake of January 9, 1982.

    USGS Publications Warehouse

    Choy, G.L.; Boatwright, J.; Dewey, J.W.; Sipkin, S.A.

    1983-01-01

    The analysis of the New Brunswick earthquake of January 9, 1982, has important implications for the evaluation of seismic hazards in eastern North America. Although moderate in size (mb, 5.7), it was well-recorded teleseismically. Source characteristics of this earthquake have been determined from analysis of data that were digitally recorded by the Global Digital Seismography Network. From broadband displacement and velocity records of P waves, we have obtained a dynamic description of the rupture process as well as conventional static properties of the source. The depth of the hypocenter is estimated to be 9km from depth phases. The focal mechanism determined from the broadband data corresponds to predominantly thrust faulting. From the variation in the waveforms the direction of slip is inferred to be updip on a west dipping NNE striking fault plane. The steep dip of the inferred fault plane suggests that the earthquake occurred on a preexisting fault that was at one time a normal fault. From an inversion of body wave pulse durations, the estimated rupture length is 5.5km.-from Authors

  13. Ascidian depth zonation on sublittoral hard substrates off deer island, New Brunswick, Canada

    NASA Astrophysics Data System (ADS)

    Hatfield, C.; Logan, A.; Thomas, M. L. H.

    1992-02-01

    The upper surfaces of sublittoral hard substrates in the Deer Island region of the Bay of Fundy, New Brunswick, support diverse, depth-zoned epibenthic communities of which ascidians form a minor part. Their population density was quantitatively studied from photo-transects taken between mean low water (MLW) and 30 m depth at four sites off the Deer Island coast and from 30-140 m depth along two photo-transects in Head Harbour Passage. All photo-analyses were aided by collections from transect survey sites, wharf pilings and salmon cage floats, to yield a total of 15 ascidian species encountered. Ascidians were found at all depths at the four shallow sites. Halocynthia pyriformis and Boltenia ovifera are most common at depths of less than 20 m, while Aplidium pallidum, Didemnum albidum and other species exhibit a marked increase in abundance below this depth. Cluster analysis of ascidians shows an association between B. echinata and B. ovifera, which may reflect resource partitioning, and between A. pallidum-D. albidum and Molgula sp.— A. stellatum, the ecological significance of which are as yet unknown. The community in Head Harbour Passage is animal-dominated and in its deeper sections often shows three-dimensional bottom relief from horse mussel shells. D. albidum, the commonest ascidian, shows a close association with Modiolus modiolus, to which it is normally attached, suggesting that mussel beds may minimize the possibility of dislodgement and even confer a feeding advantage on this ascidian.

  14. Two phase deglaciation incorporating a late-stage readvance in the Brunswick, Maine area

    SciTech Connect

    Borelli, C.; Smity, P. . Dept. of Geoscience)

    1993-03-01

    Reinterpretation of late Wisconsinan glacial deposits indicate that retreat of the Laurentide ice margin occurred west of the marine limit in the Brunswick area. Marine transgression deposited the overlying Presumpscot Formation which locally contains organic rich, silty sand. A regionally extensive readvance deformed and truncated the uppermost glaciomarine sediments during the oceanic highstand. Striations and other ice flow indicators which are found underlying the Presumpscot Formation consistently trend NW-SE, while those found on exposed outcrops above the Presumpscot Formation dominantly trend NE-SW. These otherwise anomalous directional flow indicators support a late stage readvance of the ice sheet. Areally extensive, stratified, and locally imbricated outwash caps the glaciomarine sediments. Mineral composition of the basal outwash differs from the upper outwash sequences, supporting the readvance model by indicating different source areas. Multi-phase emergence characterized by terraced landforms caused a reworking and redeposition of sediment in a fluvial, tidally influenced environment. Localized eolian deposits record a late phase reworking of sediment.

  15. Sticks and stones: racism as experienced by adolescents in New Brunswick.

    PubMed

    Baker, C; Varma, M; Tanaka, C

    2001-12-01

    The purpose of the study was to describe both the nature of racism as experienced by adolescent self-described victims in the province of New Brunswick and their response to the perceived racist incidents. A qualitative methodology based on the constructivist paradigm was used. In-depth interviews were conducted with non-White adolescent victims of racism and with parents of victims. Although the study was initiated in response to an eruption of publicity about teenage racial violence, the findings indicate that racist incidents were not a new phenomenon for the participants. They described a low-key but long-term problem that had begun when they entered the public school system. Name-calling was by far the most common form of racism identified and it played a part in most of the other incidents described; dismissed as harmless by authority figures, it appeared to have long-term consequences for its targets. The participants' response to racism was found to have three phases: splintered universe, spiralling resistance, and disengagement. The results suggest that nurses working in the field of school health should address issues of racism among children and adolescents. PMID:11845626

  16. Respiratory protection for firefighters--Evaluation of CBRN canisters for use during overhaul II: In mask analyte sampling with integrated dynamic breathing machine.

    PubMed

    Jones, Leaton; Burgess, Jefferey L; Evans, Heath; Lutz, Eric A

    2016-01-01

    According to the National Fire Protection Association there were 487,500 structural fires in the U.S. in 2013. After visible flames are extinguished firefighters begin the overhaul stage where remaining hot spots are identified and further extinguished. During overhaul, a significant amount of potentially hazardous chemicals can remain in the ambient environment. Previous research suggests that the use of air purifying respirators fitted with chemical, biological, radiological, and nuclear (CBRN) canisters may reduce occupational exposure. This study used large scale burns of representative structural materials to perform side-by-side, filtering, and service-life evaluations of commercially available CBRN filters using two head forms fitted with full-face respirators and a dynamic breathing machine. Three types of CBRN canisters and one non-CBRN cartridge were challenged in repetitive post-fire environments. Tests were conducted with two different breathing volumes and rates for two sampling durations (0-15 min and 0-60 min). Fifty-five different chemicals were selected for evaluation and results indicate that 10 of the 55 chemicals were present in the post-fire overhaul ambient environment. Acetaldehyde and formaldehyde were found to be the only two chemicals detected post filter but were effectively filtered to below ACGIH TLVs. Counter to our prior published work using continuous flow filter evaluation, this study indicates that, regardless of brand, CBRN filters were effective at reducing concentrations of post-fire ambient chemicals to below occupational exposure limits. However, caution should be applied when using CBRN filters as the ambient formaldehyde level in the current study was 8.9 times lower than during the previous work. PMID:26554925

  17. Biomechanics of penetrating trauma.

    PubMed

    Yoganandan, N; Pintar, F A

    1997-01-01

    It is well known that injuries and deaths due to penetrating projectiles have become a national and an international epidemic in Western society. The application of biomedical engineering to solve day-to-day problems has produced considerable advances in safety and mitigation/prevention of trauma. The study of penetrating trauma has been largely in the military domain where war-time specific applications were advanced with the use of high-velocity weapons. With the velocity and weapon caliber in the civilian population at half or less compared with the military counterpart, wound ballistics is a largely different problem in today's trauma centers. The principal goal of the study of penetrating injuries in the civilian population is secondary prevention and optimized emergency care after occurrence. A thorough understanding of the dynamic biomechanics of penetrating injuries quantifies missile type, caliber, and velocity to hard and soft tissue damage. Such information leads to a comprehensive assessment of the acute and long-term treatment of patients with penetrating injuries. A review of the relevant military research applied to the civilian domain and presentation of new technology in the biomechanical study of these injuries offer foundation to this field. Relevant issues addressed in this review article include introduction of the military literature, the need for secondary prevention, environmental factors including projectile velocity and design, experimental studies with biological tissues and physical models, and mathematical simulations and analyses. Areas of advancement are identified that enables the pursuit of biomechanics research in order to arrive at better secondary prevention strategies. PMID:9719858

  18. Rural Trauma: Is Trauma Designation Associated with Better Hospital Outcomes?

    ERIC Educational Resources Information Center

    Bowman, Stephen M.; Zimmerman, Frederick J.; Sharar, Sam R.; Baker, Margaret W.; Martin, Diane P.

    2008-01-01

    Context: While trauma designation has been associated with lower risk of death in large urban settings, relatively little attention has been given to this issue in small rural hospitals. Purpose: To examine factors related to in-hospital mortality and delayed transfer in small rural hospitals with and without trauma designation. Methods: Analysis…

  19. Trauma-Focused CBT for Youth with Complex Trauma

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  20. Trauma-focused CBT for youth with complex trauma

    PubMed Central

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

    2013-01-01

    Objectives Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth with complex trauma. Methods TF-CBT treatment phases are described and modifications of timing, proportionality and application are described for youth with complex trauma. Practical applications include a) dedicating proportionally more of the model to the TF-CBT coping skills phase; b) implementing the TF-CBT Safety component early and often as needed throughout treatment; c) titrating gradual exposure more slowly as needed by individual youth; d) incorporating unifying trauma themes throughout treatment; and e) when indicated, extending the TF-CBT treatment consolidation and closure phase to include traumatic grief components and to generalize ongoing safety and trust. Results Recent data from youth with complex trauma support the use of the above TF-CBT strategies to successfully treat these youth. Conclusions The above practical strategies can be incorporated into TF-CBT to effectively treat youth with complex trauma. Practice implications Practical strategies include providing a longer coping skills phase which incorporates safety and appropriate gradual exposure; including relevant unifying themes; and allowing for an adequate treatment closure phase to enhance ongoing trust and safety. Through these strategies therapists can successfully apply TF-CBT for youth with complex trauma. PMID:22749612

  1. Radiology of skeletal trauma

    SciTech Connect

    Rogers, L.F.

    1982-01-01

    This 1000-page book contains over 1700 illustrations, is presented in two volumes and subdivided into 23 chapters. After brief chapters of Introduction and General Anatomy, a section on Skeletal Biomechanics is presented. The Epidemiology of Fractures chapter examines, among other things, the effects of age on the frequency and distribution of fractures. In the chapter on Classifications of Fractures, the author describes the character of traumatic forces such as angulating, torsional, avulsive, and compressive, and then relates these to the resultant fracture configurations. The Fracture Treatment chapter presents an overview of treatment principles. Other chapters deal with specific problems in pediatric trauma, fracture healing and nonhealing, and fracture complications.

  2. Management of Pediatric Trauma.

    PubMed

    2016-08-01

    Injury is still the number 1 killer of children ages 1 to 18 years in the United States (http://www.cdc.gov/nchs/fastats/children.htm). Children who sustain injuries with resulting disabilities incur significant costs not only for their health care but also for productivity lost to the economy. The families of children who survive childhood injury with disability face years of emotional and financial hardship, along with a significant societal burden. The entire process of managing childhood injury is enormously complex and varies by region. Only the comprehensive cooperation of a broadly diverse trauma team will have a significant effect on improving the care of injured children. PMID:27456509

  3. Proceedings of the 2007 Annual Meeting of the Canadian Mathematics Education Study Group = Actes de la Rencontre Annuelle 2007 du Groupe Canadien d'Etude en Didactique des Mathematiques (31st, Fredricton, New Brunswick, Canada, Jun 8-12, 2007)

    ERIC Educational Resources Information Center

    Liljedahl, Peter, Ed.

    2008-01-01

    This submission contains the Proceedings of the 2007 Annual Meeting of the Canadian Mathematics Education Study Group (CMESG), held at the University of New Brunswick in Fredricton, New Brunswick. The CMESG is a group of mathematicians and mathematics educators who meet annually to discuss mathematics education issues at all levels of learning.…

  4. NASA overhauls grant process

    NASA Astrophysics Data System (ADS)

    Simarski, Lynn Teo

    A university recently received a NASA grant so quickly that the recipients, used to a long wait for money even after a grant had been approved, assumed a mistake had been made. Such a story has been making the rounds since NASA began to refurbish the procedure by which it issues grants, speeding up and streamlining the process in response to suggestions from space scientists.One way NASA has measured success so far is how quickly it has cleared the decks of pending grants. The agency reduced the backlog from 572 grants on September 11 to zero by the end of the month, according to Don Bush, NASA's deputy assistant administrator for procurement. But that's just the beginning of changes Bush expects to be completed by March or April next year. The new procedures are first being tested out at headquarters, which issues over half of the agency's space science grants. NASA centers will also adopt the procedures after full approval.

  5. Management of Colorectal Trauma

    PubMed Central

    2011-01-01

    Although the treatment strategy for colorectal trauma has advanced during the last part of the twentieth century and the result has improved, compared to other injuries, problems, such as high septic complication rates and mortality rates, still exist, so standard management for colorectal trauma is still a controversial issue. For that reason, we designed this article to address current recommendations for management of colorectal injuries based on a review of literature. According to the reviewed data, although sufficient evidence exists for primary repair being the treatment of choice in most cases of nondestructive colon injuries, many surgeons are still concerned about anastomotic leakage or failure, and prefer to perform a diverting colostomy. Recently, some reports have shown that primary repair or resection and anastomosis, is better than a diverting colostomy even in cases of destructive colon injuries, but it has not fully established as the standard treatment. The same guideline as that for colonic injury is applied in cases of intraperitoneal rectal injuries, and, diversion, primary repair, and presacral drainage are regarded as the standards for the management of extraperitoneal rectal injuries. However, some reports state that primary repair without a diverting colostomy has benefit in the treatment of extraperitoneal rectal injury, and presacral drainage is still controversial. In conclusion, ideally an individual management strategy would be developed for each patient suffering from colorectal injury. To do this, an evidence-based treatment plan should be carefully developed. PMID:21980586

  6. Sexual Trauma, Spirituality, and Psychopathology

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  7. Coagulopathy after severe pediatric trauma.

    PubMed

    Christiaans, Sarah C; Duhachek-Stapelman, Amy L; Russell, Robert T; Lisco, Steven J; Kerby, Jeffrey D; Pittet, Jean-François

    2014-06-01

    Trauma remains the leading cause of morbidity and mortality in the United States among children aged 1 to 21 years. The most common cause of lethality in pediatric trauma is traumatic brain injury. Early coagulopathy has been commonly observed after severe trauma and is usually associated with severe hemorrhage and/or traumatic brain injury. In contrast to adult patients, massive bleeding is less common after pediatric trauma. The classical drivers of trauma-induced coagulopathy include hypothermia, acidosis, hemodilution, and consumption of coagulation factors secondary to local activation of the coagulation system after severe traumatic injury. Furthermore, there is also recent evidence for a distinct mechanism of trauma-induced coagulopathy that involves the activation of the anticoagulant protein C pathway. Whether this new mechanism of posttraumatic coagulopathy plays a role in children is still unknown. The goal of this review is to summarize the current knowledge on the incidence and potential mechanisms of coagulopathy after pediatric trauma and the role of rapid diagnostic tests for early identification of coagulopathy. Finally, we discuss different options for treating coagulopathy after severe pediatric trauma. PMID:24569507

  8. New Coleoptera records from New Brunswick, Canada: Anthribidae, Brentidae, Dryophthoridae, Brachyceridae, and Curculionidae, with additions to the fauna of Quebec, Nova Scotia and Prince Edward Island

    PubMed Central

    Webster, Reginald P.; Anderson, Robert S.; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract We report 63 species of Curculionoidea that are new to New Brunswick (three species of Anthribidae, four species of Brentidae, three species of Dryophthoridae, three species of Brachyceridae, 50 species of Curculionidae). Among these are 27 species (two Anthribidae, two Brenthidae, one Brachyceridae, 22 Curculionidae) that are also newly recorded for the Maritime provinces, and one species, Plesiobaris disjuncta Casey (Curculionidae) that is newly recorded for Canada from New Brunswick and Quebec. Bagous planatus LeConte is reinstated to the faunal list of New Brunswick. Two species of Curculionidae are newly recorded from Nova Scotia and the Maritime provinces, and two others are reported for the first time for Prince Edward Island. PMID:22539901

  9. Prehospital Trauma Care in Singapore.

    PubMed

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

    2015-01-01

    Prehospital emergency care in Singapore has taken shape over almost a century. What began as a hospital-based ambulance service intended to ferry medical cases was later complemented by an ambulance service under the Singapore Fire Brigade to transport trauma cases. The two ambulance services would later combine and come under the Singapore Civil Defence Force. The development of prehospital care systems in island city-state Singapore faces unique challenges as a result of its land area and population density. This article defines aspects of prehospital trauma care in Singapore. It outlines key historical milestones and current initiatives in service, training, and research. It makes propositions for the future direction of trauma care in Singapore. The progress Singapore has made given her circumstances may serve as lessons for the future development of prehospital trauma systems in similar environments. Key words: Singapore; trauma; prehospital emergency care; emergency medical services. PMID:25494913

  10. U.S. Geological Survey Georgia Water Science Center and City of Brunswick- Glynn County Cooperative Water Program-Summary of Activities, July 2005 through June 2006

    USGS Publications Warehouse

    Cherry, Gregory S.

    2007-01-01

    Since 1959, the U.S. Geological Survey has conducted a cooperative water resources program (CWP) with the City of Brunswick and Glynn County in the Brunswick, Georgia, area. Since the late 1950s, the salinity of ground water in the Upper Floridan aquifer near downtown Brunswick, Georgia, has been increasing, and its occurrence has been detected across an area of increasing size. Pumping of the Upper Floridan aquifer near downtown Brunswick has lowered water levels in the aquifer and resulted in an upward hydraulic gradient between the highly saline parts of the Lower Floridan aquifer and the normally fresh Upper Floridan aquifer. Saltwater likely enters the Upper Floridan aquifer through localized, vertically oriented conduits of relatively high permeability and moves laterally in response to the distribution of stresses within the aquifer. The Brunswick-Glynn County CWP for fiscal year 2006 includes the operation and maintenance of 12 continuous water-level recorders. In addition, water-level data were collected from 52 wells and water from 70 wells was analyzed for chloride concentration during June 2005. Geophysical logs were obtained from one well to assess whether the cause of elevated chloride concentration could be due to leaky well casing. A summary of the Georgia Department of Natural Resources, Environmental Protection Division (GaEPD) Georgia Coastal Sound Science Initiative (CSSI) activities that directly benefit the CWP-Brunswick-Glynn County is included in this report. The GaEPD CSSI is a program of scientific and feasibility studies to support development of a final strategy to protect the Upper Floridan aquifer from saltwater contamination. These data presented in this report are needed by State and local authorities to manage water resources effectively in the coastal area of Georgia.

  11. Penetrating abdominal trauma.

    PubMed

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  12. Cancer Institute of New Jersey: University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey. Environmental Assessment

    SciTech Connect

    Not Available

    1994-06-01

    The Department of Energy (DOE) proposes to authorize the University of Medicine and Dentistry of New Jersey to proceed with the design, construction, and equipping of the proposed Clinical Treatment and Research Facility of the University of New Jersey on the New Brunswick campus. The facility will provide for the integration of new and existing clinical outpatient cancer treatment with basic and clinical research to expedite the application of new discoveries in cancer treatment. Based on the analysis in the environmental assessment, DOE has determined that the proposed action is not a major Federal action significantly affecting the quality of the human environment within the meaning of the National Environmental Policy Act (NEPA).

  13. New Brunswick air quality monitoring results for the years 1996 and 1997. Technical report number T-9901

    SciTech Connect

    1999-11-01

    This report summarizes air quality monitoring data from New Brunswick during 1996 and 1997, with an emphasis on air quality assessment in relation to existing air quality standards and objectives. Introductory sections review provincial air quality legislation, national and provincial standards, other air quality criteria, sources and effects of regulated air pollutants, and air quality monitoring networks in the province. Results are presented by area, corporation, or network monitored, and are discussed and compared with data from centres in other parts of the world. Air pollutants monitored include nitrogen oxides, hydrogen sulphide, particulates, ozone, acid precipitation, carbon monoxide, and sulphur dioxide. Appendices include a glossary and detailed monthly monitoring results.

  14. Mercury concentrations in seabird tissues from Machias Seal Island, New Brunswick, Canada.

    PubMed

    Bond, Alexander L; Diamond, Antony W

    2009-07-01

    Mercury is a pervasive environmental contaminant, the anthropogenic portion of which is increasing globally, and in northeastern North America in particular. Seabirds frequently are used as indicators of the marine environment, including mercury contamination. We analysed paired samples for total mercury (Hg) concentrations in feathers and blood from adult and chick, albumen, and lipid-free yolk of seven seabirds breeding on Machias Seal Island, New Brunswick, Canada - Arctic Tern (Sterna paradisaea), Atlantic Puffin (Fratercula arctica), Common Eider (Somateria mollissima), Common Murre (Uria aalge), Common Tern (Sterna hirundo), Leach's Storm-petrel (Oceanodroma leucorhoa), and Razorbill (Alca torda). We also used stable-isotope ratios of carbon (delta(13)C), and nitrogen (delta(15)N) to evaluate the relationship between carbon source and trophic position and mercury. We found high Hg concentrations across tissue types in Leach's Storm-petrels, and Razorbills, with lower concentrations in other species, the lowest being in Common Eiders. Storm-petrels prey on mesopelagic fish that accumulate mercury, and Razorbills feed on larger, older fish that bioaccumulate heavy metals. Biomagnification of Hg, or the increase in Hg concentration with trophic position as measured by delta(15)N, was significant and greater in albumen than other tissues, whereas in other tissues, delta(15)N explained little of the overall variation in Hg concentration. Hg concentrations in egg components are higher on Machias Seal Island than other sites globally and in the Gulf of Maine region, but only for some species. Further detailed investigations are required to determine the cause of this trend. PMID:19419752

  15. Association between ozone and asthma emergency department visits in Saint John, New Brunswick, Canada.

    PubMed Central

    Stieb, D M; Burnett, R T; Beveridge, R C; Brook, J R

    1996-01-01

    This study examines the relationship of asthma emergency department (ED) visits to daily concentrations of ozone and other air pollutants in Saint John, New Brunswick, Canada. Data on ED visits with a presenting complaint of asthma (n = 1987) were abstracted for the period 1984-1992 (May-September). Air pollution variables included ozone, sulfur dioxide, nitrogen dioxide, sulfate, and total suspended particulate (TSP); weather variables included temperature, humidex, dewpoint, and relative humidity. Daily ED visit frequencies were filtered to remove day of the week and long wave trends, and filtered values were regressed on air pollution and weather variables for the same day and the 3 previous days. The mean daily 1-hr maximum ozone concentration during the study period was 41.6 ppb. A positive, statistically significant (p < 0.05) association was observed between ozone and asthma ED visits 2 days later, and the strength of the association was greater in nonlinear models. The frequency of asthma ED visits was 33% higher (95% CI, 10-56%) when the daily 1-hr maximum ozone concentration exceeded 75 ppb (the 95th percentile). The ozone effect was not significantly influenced by the addition of weather or other pollutant variables into the model or by the exclusion of repeat ED visits. However, given the limited number of sampling days for sulfate and TSP, a particulate effect could not be ruled out. We detected a significant association between ozone and asthma ED visits, despite the vast majority of sampling days being below current U.S. and Canadian standards. Images Figure 1. A Figure 1. B Figure 2. Figure 3. PMID:9118879

  16. An Integrated RFID and Barcode Tagged Item Inventory System for Deployment at New Brunswick Laboratory

    SciTech Connect

    Younkin, James R; Kuhn, Michael J; Gradle, Colleen; Preston, Lynne; Thomas, Brigham B.; Laymance, Leesa K; Kuziel, Ron

    2012-01-01

    New Brunswick Laboratory (NBL) has a numerous inventory containing thousands of plutonium and uranium certified reference materials. The current manual inventory process is well established but is a lengthy process which requires significant oversight and double checking to ensure correctness. Oak Ridge National Laboratory has worked with NBL to develop and deploy a new inventory system which utilizes handheld computers with barcode scanners and radio frequency identification (RFID) readers termed the Tagged Item Inventory System (TIIS). Certified reference materials are identified by labels which incorporate RFID tags and barcodes. The label printing process and RFID tag association process are integrated into the main desktop software application. Software on the handheld computers syncs with software on designated desktop machines and the NBL inventory database to provide a seamless inventory process. This process includes: 1) identifying items to be inventoried, 2) downloading the current inventory information to the handheld computer, 3) using the handheld to read item and location labels, and 4) syncing the handheld computer with a designated desktop machine to analyze the results, print reports, etc. The security of this inventory software has been a major concern. Designated roles linked to authenticated logins are used to control access to the desktop software while password protection and badge verification are used to control access to the handheld computers. The overall system design and deployment at NBL will be presented. The performance of the system will also be discussed with respect to a small piece of the overall inventory. Future work includes performing a full inventory at NBL with the Tagged Item Inventory System and comparing performance, cost, and radiation exposures to the current manual inventory process.

  17. Development of site-specific soil cleanup criteria: New Brunswick Laboratory, New Jersey site

    SciTech Connect

    Veluri, V.R.; Moe, H.J.; Robinet, M.J.; Wynveen, R.A.

    1983-03-01

    The potential human exposure which results from the residual soil radioactivity at a decommissioned site is a prime concern during D and D projects. To estimate this exposure, a pathway analysis approach is often used to arrive at the residual soil radioactivity criteria. The development of such a criteria for the decommissioning of the New Brunswick Laboratory, New Jersey site is discussed. Contamination on this site was spotty and located in small soil pockets spread throughout the site area. Less than 1% of the relevant site area was contaminated. The major contaminants encountered at the site were /sup 239/Pu, /sup 241/Am, normal and natural uranium, and natural thorium. During the development of the pathway analysis to determine the site cleanup criteria, corrections for the inhomogeneity of the contamination were made. These correction factors and their effect upon the relevant pathway parameters are presented. Major pathways by which radioactive material may reach an individual are identified and patterns of use are specified (scenario). Each pathway is modeled to estimate the transfer parameters along the given pathway, such as soil to air to man, etc. The transfer parameters are then combined with dose rate conversion factors (ICRP 30 methodology) to obtain soil concentration to dose rate conversion factors (pCi/g/mrem/yr). For an appropriate choice of annual dose equivalent rate, one can then arrive at a value for the residual soil concentration. Pathway modeling, transfer parameters, and dose rate factors for the three major pathways; inhalation, ingestion and external exposure, which are important for the NBL site, are discussed.

  18. Arenig volcanic and sedimentary strata, central New Brunswick and eastern Maine

    USGS Publications Warehouse

    Poole, W.H.; Neuman, R.B.

    2002-01-01

    Arenig strata in the Napadogan area of the Miramichi Highlands of west-central New Brunswick are similar to those of the Lunksoos anti-clinorial area of eastern Maine. Strata from both areas were deposited in a volcanic back-arc setting upon Cambrian-Tremadoc, deep-water, turbiditic quartzose strata on the northwest-facing Gander margin of Gondwana. Tremadoc southeastward obduction of the Penobscot Arc, formed in the lapetus Ocean to the northwest of the margin, was followed by local uplift, rift faulting, erosion, and finally by local deposition of late Arenig gravel within the early stages of a subsiding back-arc basin that was related to a younger, northwest-facing, early Arenig-Llanvirn Popelogan Arc lying to the northwest. These strata became overlain by late Arenig marine felsic tuff, sandy and silty tuff and mudstone, coarse textured and many hundreds of metres thick in the Lunksoos area but much finer and only a few metres thick farther from the volcanic centres, in the Napadogan area. During Llanvirn, the strata became covered with deep-water, commonly manganiferous, ferruginous shale-chert in a basin shielded from currents carrying coarse detritus. Arenig strata of the Napadogan area probably developed to the southeast of the main rift-volcanism zone that perhaps extended between the Lunksoos and northeastern Miramichi Highlands during the Arenig. Brachiopods of the Celtic paleogeographic assemblage colonized newly formed shelves flanking islands along the zone. Shell beds developed upon fresh layers of ash in a nutrient-rich environment between episodes of volcanism. These Celtic brachiopods developed in cool waters of high southern latitudes off Gondwana, different from those on the Laurentian margin in warm waters of low southern latitudes.

  19. Vascular trauma historical notes.

    PubMed

    Rich, Norman M

    2011-03-01

    This article provides a brief historical review of treatment of vascular trauma. Although methods for ligation came into use in the second century, this knowledge was lost during the Dark Ages and did not come back until the Renaissance. Many advances in vascular surgery occurred during the Balkan Wars, World War I, and World War II, although without antibiotics and blood banking, the philosophy of life over limb still ruled. Documenting and repairing both arteries and veins became more common during the Korean and Vietnam conflicts. Increased documentation has revealed that the current conflicts have resulted in more arterial injuries than in previous wars, likely because of improved body armor, improvised explosive device attacks, tourniquet use, and improved medical evacuation time. This brief review emphasizes the great value of mentorship and the legacy of the management of arterial and venous injuries to be passed on. PMID:21502112

  20. [MUSCULOSKELETAL MARKERS, ARTHROPATY, TRAUMAS].

    PubMed

    Caldarini, Carla; Zavaroni, Federica; Benassi, Valentina

    2015-01-01

    The bone tissue remodeling due to strong physical/working activity is defined as ergonomic markers or MSM (Muscoloskeletal Stress Markers) (Capasso et al. 1999) and MOS (Markers of Occupational Stress). Among them we can find: enthesopaties, arthropaties, non metrical stress and traumas markers. In the present study, the analysis of these traits has been used to clarify habitual activity patterns of four imperial populations from Suburbium: Castel Malnome, Casal Bertone area Q, Via Padre Semeria e Quarto Cappello del Prete. The very high prevalence of activity-induced stress lesions occurred among the individuals of Castel Malnome and Casal Bertone area Q suggests that these groups were involved in strenuous occupations such as, respectively: the processing and storage of salt and the dyeing of textiles and hides discernible from the archaeological context. For the individuals of Via Padre Semeria and Quarto Cappello del Prete the alterations, instead, could be compatibles with agricultural work. PMID:27348990

  1. Lightweight Trauma Module - LTM

    NASA Technical Reports Server (NTRS)

    Hatfield, Thomas

    2008-01-01

    Current patient movement items (PMI) supporting the military's Critical Care Air Transport Team (CCATT) mission as well as the Crew Health Care System for space (CHeCS) have significant limitations: size, weight, battery duration, and dated clinical technology. The LTM is a small, 20 lb., system integrating diagnostic and therapeutic clinical capabilities along with onboard data management, communication services and automated care algorithms to meet new Aeromedical Evacuation requirements. The Lightweight Trauma Module is an Impact Instrumentation, Inc. project with strong Industry, DoD, NASA, and Academia partnerships aimed at developing the next generation of smart and rugged critical care tools for hazardous environments ranging from the battlefield to space exploration. The LTM is a combination ventilator/critical care monitor/therapeutic system with integrated automatic control systems. Additional capabilities are provided with small external modules.

  2. Trauma and religiousness.

    PubMed

    Gostečnik, Christian; Repič Slavič, Tanja; Lukek, Saša Poljak; Cvetek, Robert

    2014-06-01

    Victims of traumatic events who experience re-traumatization often develop a highly ambivalent relationship to God and all religiosity as extremely conflictual. On the one hand, they may choose to blame God for not having protected them, for having left them to feel so alone, for having been indifferent to them or they may even turn their wrath upon God, as the source of cruelty. Often though, the traumas experienced by individuals prompt them to turn to God and religion in search of help. This gives reason for the need of new and up-to-date research that can help elucidate why some people choose to seek help in religion and others turn away from it. PMID:23187617

  3. An ecological view of psychological trauma and trauma recovery.

    PubMed

    Harvey, M R

    1996-01-01

    This paper presents an ecological view of psychological trauma and trauma recovery. Individual differences in posttraumatic response and recovery are the result of complex interactions among person, event, and environmental factors. These interactions define the interrelationship of individual and community and together may foster or impede individual recovery. The ecological model proposes a multidimensional definition of trauma recovery and suggests that the efficacy of trauma-focused interventions depends on the degree to which they enhance the person-community relationship and achieve "ecological fit" within individually varied recovery contexts. In attending to the social, cultural and political context of victimization and acknowledging that survivors of traumatic experiences may recover without benefit of clinical intervention, the model highlights the phenomenon of resiliency, and the relevance of community intervention efforts. PMID:8750448

  4. Immunohistochemical alterations after muscle trauma.

    PubMed

    Fechner, G; Bajanowski, T; Brinkmann, B

    1993-01-01

    The proteins fibrin, fibrinogen, fibronectin and complement C5b-9 were investigated in mechanically damaged skeletal muscle. An accumulation of fibrin, fibrinogen and fibronectin could be observed immediately after intra-vital trauma in damaged fibre zones, later an accumulation at the torn edges of the fibres. The accumulation of complement C5b-9 began one hour after trauma. After post mortem trauma no positive reactions could be observed for any of the proteins. The degree of expression of these proteins can therefore be used to differentiate between vital and postmortem muscle damage as well as the estimation of wound age in the early antemortem time period. PMID:8431399

  5. Computed tomography in trauma: An atlas approach

    SciTech Connect

    Toombs, B.D.; Sandler, C.

    1986-01-01

    This book discussed computed tomography in trauma. The text is organized according to mechanism of injury and site of injury. In addition to CT, some correlation with other imaging modalities is included. Blunt trauma, penetrating trauma, complications and sequelae of trauma, and use of other modalities are covered.

  6. Secondary Trauma in Children and School Personnel

    ERIC Educational Resources Information Center

    Motta, Robert W.

    2012-01-01

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

  7. Derivation of guidelines for uranium residual radioactive material in soil at the New Brunswick Site, Middlesex County, New Jersey

    SciTech Connect

    Dunning, D.; Kamboj, S.; Nimmagadda, M.; Yu, C.

    1996-02-01

    Residual radioactive material guidelines for uranium in soil were derived for the New Brunswick Site, located in Middlesex County, New Jersey. This site has been designated for remedial action under the Formerly Utilized Sites Remedial Action Program of the US Department of Energy (DOE). Residual radioactive material guidelines for individual radionuclides of concern and total uranium were derived on the basis of the requirement that the 50-year committed effective dose equivalent to a hypothetical individual who lives or works in the immediate vicinity of the New Brunswick Site should not exceed a dose of 30 mrem/yr following remedial action for the current-use and likely future-use scenarios or a dose of 100 mrem/yr for less likely future-use scenarios. The DOE residual radioactive material guideline computer code, RESRAD, was used in this evaluation; RESRAD implements the methodology described in the DOE manual for establishing residual radioactive material guidelines. The guidelines derived in this report are intended to apply to the remediation of these remaining residual radioactive materials at the site. The primary radionuclides of concern in these remaining materials are expected to be radium-226 and, to a lesser extent, natural uranium and thorium. The DOE has established generic cleanup guidelines for radium and thorium in soil; however, cleanup guidelines for other radionuclides must be derived on a site-specific basis.

  8. Trauma and the wise baby.

    PubMed

    Kilborne, Benjamin

    2011-09-01

    This paper expands upon Ferenczi's concept of the wise baby and explores the dynamics of ignorance and compensatory ideals of wisdom as reactions to trauma and as manifestations of "double conscience," shame dynamics and Oedipal shame. Focusing on feelings of ignorance, of knowing and not knowing and their relation to trauma, the author elaborates on the dynamics of fantasies of wisdom, adumbrating implications for psychoanalytic technique. PMID:21818096

  9. Teaching SciencePlus: An Observational Survey of Science Teaching in New Brunswick and Novia Scotia, Grades 7, 8 and 9.

    ERIC Educational Resources Information Center

    McFadden, Charles

    After several years of curriculum writing workshops and field-testing of draft materials, involving approximately 150 teachers, the SciencePlus program was implemented in Nova Scotia and New Brunswick between 1986 and 1991. SciencePlus programs provide a shift from an overwhelming emphasis on fact-recall testing to a predominate emphasis on…

  10. Who Is Using What in the Public Schools: The Interrelationships among Alcohol, Drug and Tobacco Use by Adolescents in New Brunswick Classrooms.

    ERIC Educational Resources Information Center

    Grobe, Cary; Campbell, Elaine

    1990-01-01

    Attempted to discover patterns of alcohol, drug, and tobacco use among public school children in New Brunswick using Provincial School Drug Survey (PSDS), an existing large-scale assessment. Recoded variables in PSDS dataset to derive profiles of typical tobacco, cannabis, and alcohol users. Found increase in predictive accuracy of regression…

  11. 33 CFR 334.450 - Cape Fear River and tributaries at Sunny Point Army Terminal, Brunswick County, N.C.; restricted...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Cape Fear River and tributaries... AND RESTRICTED AREA REGULATIONS § 334.450 Cape Fear River and tributaries at Sunny Point Army Terminal, Brunswick County, N.C.; restricted area. (a) The area. That portion of Cape Fear River due west of the...

  12. Vascular trauma in civilian practice.

    PubMed Central

    Golledge, J.; Scriven, M. W.; Fligelstone, L. J.; Lane, I. F.

    1995-01-01

    Vascular trauma is associated with major morbidity and mortality, but little is known about its incidence or nature in Britain. A retrospective study of 36 patients requiring operative intervention for vascular trauma under one vascular surgeon over a 6-year period was undertaken. Twenty-four patients suffered iatrogenic trauma (median age 61 years); including cardiological intervention (19), radiological intervention (2), varicose vein surgery (1), umbilical vein catherisation (1) and isolated hyperthermic limb perfusion (1). There were 23 arterial and three venous injuries. Twelve patients had accidental trauma (median age 23 years). Three of the ten patients with blunt trauma were referred for vascular assessment before orthopaedic intervention, two after an on-table angiogram and five only after an initial orthopaedic procedure (range of delay 6 h to 10 days). Injuries were arterial in nine, venous in two and combined in one. Angiography was obtained in six patients, and in two patients with multiple upper limb fractures identified the site of injury when clinical localisation was difficult. A variety of vascular techniques were used to treat the injuries. Two patients died postoperatively and one underwent major limb amputation. Thirty-two (89%) remain free of vascular sequelae after a median follow-up of 48 months (range 3-72 months). Vascular trauma is uncommon in the United Kingdom. To repair the injuries a limited repertoire of vascular surgery techniques is needed. Therefore, vascular surgical assessment should be sought at an early stage to prevent major limb loss. PMID:8540659

  13. Complications of pediatric trauma.

    PubMed

    Czerwinski, S J

    1991-09-01

    MSOF is a life-threatening complication of trauma. The body is a dynamic interrelated group of systems that work together efficiently. Changes in one system generally have a widespread impact, and soon the entire system is changed. In children with MSOF, the normal equilibrium that is maintained between organ systems does not exist. Generalized disruption of organ functions occur, and the body attempts to compensate and regain its homeostasis. This activity will often benefit certain organs and harm others. If the disruption continues and compensation fails, organ dysfunction occurs and general chaos reigns. Medical and nursing interventions are directed toward supporting individual organ systems before failure occurs. Attempts to provide this support for one system can cause adverse effects to occur in other systems. Although this is a potential result of medical and nursing interventions, often there is no other choice. It is essential that nurses be aware of the systemic consequences of these interventions and carefully evaluate them. Although overall mortality rates are high, children have a better chance for survival than adults. Expert nursing assessments, interventions, and evaluations are essential to maximize this outcome. More research in the area of MSOF in children is necessary, with specific attention to nursing management and the effect on patient outcome. PMID:1883588

  14. [Major respiratory tract traumas].

    PubMed

    Petrov, D; Obretenov, E; Kalaĭdzhiev, G; Plochev, M; Kostadinov, D

    2002-01-01

    Between 1988 and 2000 a total of 33 patients with traumatic tracheobronchial lesions were diagnosed and treated. The trauma was penetrating in 7 (stab and gun-shot), blunt in 10 (car accidents, compression and falling from heights) and iatrogenic in 16 of them (postintubational--15, after foreign body extraction--1). The main clinical and radiological features were subcutaneous emphysema, hemoptysis, respiratory insufficiency, pneumomediastinum and pneumothorax. The diagnosis was confirmed in all patients by early fiberoptic bronchoscopy. "Watch and see" tactics with massive antibiotics therapy was followed in 4 (12%) patients. A surgical treatment was carried out in 29 (88%) patients as follows: simple repair--19 (58%), left pneumonectomy--2 (6%), tracheal resection and anastomosis "end to end"--2 (6%), tracheostomy--1 (3%), thoracocenthesis and drainage--3 (9%) and cervical mediastinotomy--2 (6%). The operative mortality was 9%. The cause of death in these 3 patients were associated brain and spinal cord injuries. In the rest of patients the early and long-term postoperative results were considered very good. PMID:12515032

  15. Abdominal trauma by ostrich

    PubMed Central

    Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

    2015-01-01

    Introduction Ostriches typically avoid humans in the wild, since they correctly assess humans as potential predators, and, if approached, often run away. However, ostriches may turn aggressive rather than run when threatened, especially when cornered, and may also attack when they feel the need to defend their offspring or territories. Presentation of case A 71-year-old male patient presented with intra abdominal injury sustained from being kicked in the abdominal wall by an ostrich. During laparotomy, were found free peritoneal effusion and perforation of the small intestine. Discussion The clinical history and physical examination are extremely important for diagnostic and therapeutic decision making. CT-scan is the most accurate exam for making diagnosis. Surgery is the treatment of choice, and is always indicated when there is injury to the hollow viscera. In general it is possible to suture the defect. Conclusion In cases of blunt abdominal trauma by animals is necessary to have a low threshold of suspicion for acute abdomen. PMID:25685344

  16. Trauma of the midface

    PubMed Central

    Kühnel, Thomas S.; Reichert, Torsten E.

    2015-01-01

    Fractures of the midface pose a serious medical problem as for their complexity, frequency and their socio-economic impact. Interdisciplinary approaches and up-to-date diagnostic and surgical techniques provide favorable results in the majority of cases though. Traffic accidents are the leading cause and male adults in their thirties are affected most often. Treatment algorithms for nasal bone fractures, maxillary and zygomatic fractures are widely agreed upon whereas trauma to the frontal sinus and the orbital apex are matter of current debate. Advances in endoscopic surgery and limitations of evidence based gain of knowledge are matters that are focused on in the corresponding chapter. As for the fractures of the frontal sinus a strong tendency towards minimized approaches can be seen. Obliteration and cranialization seem to decrease in numbers. Some critical remarks in terms of high dose methylprednisolone therapy for traumatic optic nerve injury seem to be appropriate. Intraoperative cone beam radiographs and preshaped titanium mesh implants for orbital reconstruction are new techniques and essential aspects in midface traumatology. Fractures of the anterior skull base with cerebrospinal fluid leaks show very promising results in endonasal endoscopic repair. PMID:26770280

  17. [Trauma of the midface].

    PubMed

    Kühnel, T S; Reichert, T E

    2015-03-01

    Fractures of the midface pose a serious medical problem as for their complexity, frequency and their socio-economic impact. Interdisciplinary approaches and up-to-date diagnostic and surgical techniques provide favorable results in the majority of cases though. Traffic accidents are the leading cause and male adults in their thirties are affected most often. Treatment algorithms for nasal bone fractures, maxillary and zygoma fractures are widely agreed upon whereas trauma to the frontal sinus and the orbital apex are matter of current debate. Advances in endoscopic surgery and limitations of evidence based gain of knowledge are matters that are focused on in the corresponding chapter. As for the fractures of the frontal sinus a strong tendency towards minimized approaches can be seen. Obliteration and cranialisation seem to decrease in numbers.Some critical remarks in terms of high dose methylprednisolone therapy for traumatic optic nerve injury seem to be appropriate.Intraoperative cone beam radiographs and preshaped titanium mesh implants for orbital reconstruction are new techniques and essential aspects in midface traumatology. Fractures of the anterior skull base with cerebrospinal fluid leaks show very promising results in endonasal endoscopic repair. PMID:25860490

  18. The Character of Sn (-W-Mo) Mineralizing Fluids, North Zone, Mount Pleasant, New Brunswick

    NASA Astrophysics Data System (ADS)

    Elmi Assadzadeh, G.; Samson, I. M.; Gagnon, J. E.

    2009-05-01

    Several major Sn deposits and minor W-Mo mineralization occur within hydrothermally altered breccias in the North Zone (NZ), Mount Pleasant, New Brunswick. The principal hydrothermal minerals, which either replace the host granites or have been precipitated in cavities and veins, are quartz, fluorite, topaz and chlorite. Previous studies carried out on the Endogranitic Tin Zone (ETZ), one of the mineralized zones in the NZ, have reported that cassiterite is associated with all stages of alteration, but mostly occurred during intense chloritization-topazification. Our studies indicate, however, that cassiterite principally occurs in association with fluorite as an open space filling, and that chlorite alteration was a later event. Wolframite is also associated with fluorite, and with topaz and arsenopyrite. Molybdenite occurs either in quartz veins or in veins associated with quartz-topaz greisen. Previous work on the Endogranitic Tin Zone (ETZ) indicated that primary fluid inclusions in quartz, topaz, and fluorite contain liquid + vapour ± halite, with trapping temperatures of less than ˜ 225°C and salinities of < 30 equiv wt % NaCl. In the Fire Tower Zone (FTZ), fluid inclusions associated with W-Mo mineralization are reported to be liquid + vapour ± solid inclusions, with the latter containing up to 6 daughter crystals, and which homogenize by halite disappearance at temperatures from 146 to 492°C, with salinities ranging from 30 to 60 equiv wt % NaCl. Our studies show that primary fluid inclusions in fluorite that is intimately associated with cassiterite have very complex solid phase assemblages at room temperature. These solids occupy up to ˜ 75 volume % of these inclusions, the remainder being a vapour bubble and liquid. At least 7 of the solids melt between 89 and 385°C, indicating that they are daughter minerals, and the inclusions homogenize to liquid by vapour disappearance at between 469 and 493°C. These complex fluid inclusions indicate that the

  19. Predicting water temperatures using a deterministic model: Application on Miramichi River catchments (New Brunswick, Canada)

    NASA Astrophysics Data System (ADS)

    Caissie, Daniel; Satish, Mysore G.; El-Jabi, Nassir

    2007-04-01

    SummaryWater temperature influences many physical, chemical and biological properties of rivers. It also influences the distribution of fish and many aquatic organisms within the river environment. Hence, a good understanding of the thermal regime of rivers is essential for effective management of fisheries and aquatic resources. This study deals with the modelling of river water temperature using a deterministic model. This model calculates the net heat flux at the water surface using meteorological conditions within the study area. The water temperature model was applied on two watercourses of different size and thermal characteristics, but within a similar meteorological region, i.e. the Little Southwest Miramichi River and Catamaran Brook (New Brunswick, Canada). Data from 1992 to 1994 were used to calibrate the model, while data from 1995 to 1999 were used for the model validation. Results showed equally good agreement between observed and predicted water temperatures during the calibration period for both rivers with a root-mean-square error (RMSE) of 1.49 °C for the Little Southwest Miramichi River compared to 1.51 °C for Catamaran brook. During the validation period, RMSEs were calculated at 1.55 °C for the Little Southwest Miramichi River and 1.61 °C for Catamaran Brook. Poorer model performances were generally observed early in the season (e.g. spring), especially for the Little Southwest Miramichi River due to the influence of snowmelt conditions, while late summer to autumn performances showed among the best results for both rivers. Late autumn performances were more variable in Catamaran Brook and presumably influenced by the groundwater, geothermal conditions and potentially riparian shading. The geothermal aspect was further investigated at Catamaran Brook (using 1998 data) and results revealed that although geothermal fluxes are present, they explained very little of the unexplained variability (<0.1 °C). Similar to previous studies, the net

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

    PubMed

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

    2016-05-01

    Child maltreatment is a serious public health concern, and its detrimental effects can be compounded by traumatic experiences associated with the child welfare (CW) system. Trauma-informed care (TIC) is a promising strategy for addressing traumatized children's needs, but research on the impact of TIC in CW is limited. This study examines initial findings of the Massachusetts Child Trauma Project, a statewide TIC initiative in the CW system and mental health network. After 1 year of implementation, Trauma-Informed Leadership Teams in CW offices emerged as key structures for TIC systems integration, and mental health providers' participation in evidence-based treatment (EBT) learning collaboratives was linked to improvements in trauma-informed individual and agency practices. After approximately 6 months of EBT treatment, children had fewer posttraumatic symptoms and behavior problems compared to baseline. Barriers to TIC that emerged included scarce resources for trauma-related work in the CW agency and few mental providers providing EBTs to young children. Future research might explore variations in TIC across service system components as well as the potential for differential effects across EBT models disseminated through TIC. PMID:26564909

  1. Liver trauma grading and biochemistry tests.

    PubMed

    Arslan, Gozde; Gemici, Aysegul Akdogan; Yirgin, Inci Kizildag; Gulsen, Esma; Inci, Ercan

    2013-10-01

    Among solid organ blunt traumas, the liver and spleen are mostly subject to injury. In addition, the liver is also commonly injured in penetrating traumas because of its size, location, and the ease of injury to the "Glisson Capsule". Several enzymes are known to be elevated following trauma. In our study, we evaluated the correlation between the levels of serum aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and gamma-glutamyl transpeptidase in 57 patients with blunt trauma to the liver and compared these values to the American Association for the Surgery of Trauma trauma grading system. Additionally, we compared the enzyme level elevations in these patients to the enzyme levels of 29 healthy subjects. As expected, we found significant elevations in enzyme levels of trauma patients compared to the control group. The calculated point estimates were not significantly different between grades 1 and 2 trauma. However, grade 3 trauma group showed a significant increase in enzyme levels. PMID:23793528

  2. Delta Alerts: Changing Outcomes in Geriatric Trauma.

    PubMed

    Wiles, Lynn L; Day, Mark D; Harris, LeAnna

    2016-01-01

    Geriatric trauma patients (GTPs) suffering minor injuries have suboptimal outcomes compared with younger populations. Patients 65 years or older account for 10% of all traumas but 28% of all trauma deaths. This trauma center established a third tier trauma alert specifically targeting GTPs at risk for poor outcomes. A Delta Alert is activated when GTPs suffer injuries that fall outside traditional trauma alert guidelines. Early identification and treatment of injuries and expedited referral to specialty groups have improved our GTPs' outcomes including decreased mortality and length of stay and increased percentage of GTPs who are discharged home. PMID:27414140

  3. Video recording of emergency department trauma resuscitations.

    PubMed

    Brown, Debra M

    2003-01-01

    Although hospitals are faced with the challenges of appropriately informing the public regarding health care and protecting the privacy of patients, a comprehensive policy concerning videotaping of trauma resuscitations can be developed to comply with regulatory bodies. Video recording of trauma team resuscitations can be utilized as an effective quality improvement tool to evaluate trauma team performance, psychomotor skills and techniques, and to identify educational needs related to specific trauma populations. Video recording of Trauma resuscitations is an effective tool for improving trauma team performance by educating clinical staff regarding roles and responsibilities. PMID:16265920

  4. The study of psychic trauma.

    PubMed

    Bacciagaluppi, Marco

    2011-01-01

    This article starts from the DSM definition of psychic trauma. A central source in this field is the 1992 book by Judith Herman. One line of investigation is the sexual abuse of women and children. In an early phase, both Janet and Freud described dissociation as a reaction to trauma. In 1897, Freud disputed the reality of sexual trauma, a position countered later by Ferenczi. In a later phase, this subject was investigated by the American feminist movement. Studies of physical abuse are then described, followed by mental abuse and neglect. Another line of investigation is combat neurosis. The two lines converged in the definition of PTSD and its incorporation into the DSM in 1980. The views on trauma of John Bowlby and Alice Miller are also discussed. The integration of the relational model in psychoanalysis with the trauma literature is presented. The most recent advances are located in neurobiology. The discussion makes a preliminary investigation of the remote causes of war and sexual violence. PMID:21902510

  5. Ventilatory strategies in trauma patients.

    PubMed

    Arora, Shubhangi; Singh, Preet Mohinder; Trikha, Anjan

    2014-01-01

    Lung injury in trauma patients can occur because of direct injury to lung or due to secondary effects of injury elsewhere for example fat embolism from a long bone fracture, or due to response to a systemic insult such as; acute respiratory distress syndrome (ARDS) secondary to sepsis or transfusion related lung injury. There are certain special situations like head injury where the primary culprit is not the lung, but the brain and the ventilator strategy is aimed at preserving the brain tissue and the respiratory system takes a second place. The present article aims to delineate the strategies addressing practical problems and challenges faced by intensivists dealing with trauma patients with or without healthy lungs. The lung protective strategies along with newer trends in ventilation are discussed. Ventilatory management for specific organ system trauma are highlighted and their physiological base is presented. PMID:24550626

  6. Management of Carotid Artery Trauma

    PubMed Central

    Lee, Thomas S.; Ducic, Yadranko; Gordin, Eli; Stroman, David

    2014-01-01

    With increased awareness and liberal screening of trauma patients with identified risk factors, recent case series demonstrate improved early diagnosis of carotid artery trauma before they become problematio. There remains a need for unified screening criteria for both intracranial and extracranial carotid trauma. In the absence of contraindications, antithrombotic agents should be considered in blunt carotid artery injuries, as there is a significant risk of progression of vessel injury with observation alone. Despite CTA being used as a common screening modality, it appears to lack sufficient sensitivity. DSA remains to be the gold standard in screening. Endovascular techniques are becoming more widely accepted as the primary surgical modality in the treatment of blunt extracranial carotid injuries and penetrating/blunt intracranial carotid lessions. Nonetheless, open surgical approaches are still needed for the treatment of penetrating extracranial carotid injuries and in patients with unfavorable lesions for endovascular intervention. PMID:25136406

  7. Trauma--the malignant epidemic.

    PubMed

    Muckart, D J

    1991-01-19

    Trauma is the commonest cause of death in children and young adults in the USA and the UK and the incidence of both accidental and non-accidental injury continues to increase. In the Western world more pre-retirement years of life are lost annually from trauma than malignant disease, heart disease, and AIDS combined, and by the beginning of the last decade injury deaths outnumbered deaths from all other causes combined in those under 35 years of age. In South Africa, although infectious diseases continue to exact their toll, a similar pattern is emerging. Alcohol and speed are responsible for the majority of motor vehicle accidents, while the increasing ownership of firearms directly parallels the homicide rates from these weapons. Stricter application of the legislation governing alcohol, driving and firearm control is required and a regionalised trauma care programme is desperately needed to contain this epidemic. PMID:1989097

  8. Transfusion medicine in trauma patients

    PubMed Central

    Murthi, Sarah B; Dutton, Richard P; Edelman, Bennett B; Scalea, Thomas M; Hess, John R

    2011-01-01

    Injured patients stress the transfusion service with frequent demands for uncrossmatched red cells and plasma, occasional requirements for large amounts of blood products and the need for new and better blood products. Transfusion services stress trauma centers with demands for strict accountability for individual blood component units and adherence to indications in a clinical field where research has been difficult, and guidance opinion-based. New data suggest that the most severely injured patients arrive at the trauma center already coagulopathic and that these patients benefit from prompt, specific, corrective treatment. This research is clarifying trauma system requirements for new blood products and blood-product usage patterns, but the inability to obtain informed consent from severely injured patients remains an obstacle to further research. PMID:21083009

  9. Fate of spinosad in litter and soils of a mixed conifer stand in the Acadian forest region of New Brunswick.

    PubMed

    Thompson, Dean G; Harris, Brenda J; Lanteigne, Leonard J; Buscarini, Teresa M; Chartrand, Derek T

    2002-02-13

    Spinosad is a natural insecticide, produced via fermentation culture of the actinomycete Saccharopolyspora spinosa, with potential use against a number of forest pests including spruce budworm (Choristoneura fumiferana [Clem]). Persistence of spinosad was determined in terrestrial fate experiments conducted within a semimature stand of black spruce (Picea mariana [Mill.]) and balsam fir (Abies balsamea [L]) in the Acadian forest region of New Brunswick, Canada. Results of experiments established under full coniferous canopy and in a canopy opening indicated that spinosad dissipated rapidly following hyperbolic kinetics in both litter and soils and was not susceptible to leaching. Time to 50% dissipation estimates for spinosyn A ranged from 2.0 to 12.4 days depending upon matrix and experimental conditions. Spinosyn D dissipated to levels below quantitation limits (0.02 microg/g of dry mass) within 7 days in all cases. Sporadic low-level detection of the demethylated metabolites suggested that parent compounds were degraded in situ. PMID:11829646

  10. The social and policy contexts of the New Brunswick Declaration on Research Ethics, Integrity, and Governance: a commentary.

    PubMed

    van den Hoonaard, Will C

    2013-04-01

    This paper explores the social and policy implications of the "New Brunswick Declaration on Research Ethics, Integrity, and Governance" developed at the Ethics Rupture Summit in Fredericton, N.B., Canada, October 2012. It discusses the Declaration and the Summit in relation to the usual criticism and analysis of research ethics regimes, and considers reasons why the immense prior literature has had little impact on regulatory bodies. Because the Declaration, like the Illinois White Paper, has quickly achieved considerable attention relative to most other such documents, and because much further deliberation has evolved since the Summit, we offer here a commentary on each of the eight principles contained in the Declaration in the hope of further stimulating discussion and consolidating the progress that now seems underway. PMID:23651934

  11. Paleoenvironmental and tectonostratigraphic evolution of the west Cumberland Basin of Nova Scotia and New Brunswick during the Upper Mississippian

    NASA Astrophysics Data System (ADS)

    McLeod, Jason R.

    2010-06-01

    The Cumberland Basin, which spans the provinces of Nova Scotia and New Brunswick, contains one of the most complete stratigraphic records of upper Mississippian (Visean -- Namurian) strata within the Maritimes Basin. The paleoenvironmental and tectonostratigraphic evolution of these units is here assessed, as well as lateral variations and stratigraphic relationships between upper Mississippian units in the western half of the basin. This exercise resulted in necessary petrographic and stratigraphic correlations across the study area, and several redundancies and inconsistencies in the pre-existing stratigraphic nomenclature were identified and informally amended based on equivalencies and precedence. Three source areas were identified in the west Cumberland Basin during the upper Mississippian, and a paleogeographic model was created for that interval based on geophysical, paleocurrent, provenance and facies distribution data.

  12. Using Net-Zero Energy Projects to Enable Sustainable Economic Redevelopment at the Former Brunswick Air Naval Base

    SciTech Connect

    Huffman, S.

    2011-10-01

    A Study Prepared in Partnership with the Environmental Protection Agency for the RE-Powering America's Land Initiative: Siting Renewable Energy on Potentially Contaminated Land and Mine Sites. The Brunswick Naval Air Station is a naval air facility and Environmental Protection Agency (EPA) Super Fund site that is being cleaned up, and closed down. The objective of this report is not only to look at the economics of individual renewable energy technologies, but also to look at the systemic benefits that can be gained when cost-effective renewable energy technologies are integrated with other systems and businesses in a community; thus multiplying the total monetary, employment, and quality-of-life benefits they can provide to a community.

  13. Fractured-aquifer hydrogeology from geophysical logs: Brunswick group and Lockatong Formation, Pennsylvania

    USGS Publications Warehouse

    Morin, R.H.; Senior, L.A.; Decker, E.R.

    2000-01-01

    The Brunswick Group and the underlying Lockatong Formation are composed of lithified Mesozoic sediments that constitute part of the Newark Basin in southeastern Pennsylvania. These fractured rocks form an important regional aquifer that consists of gradational sequences of shale, siltstone, and sandstone, with fluid transport occurring primarily in fractures. An extensive suite of geophysical logs was obtained in seven wells located at the borough of Lansdale, Pennsylvania, in order to better characterize the areal hydrogeologic system and provide guidelines for the refinement of numerical ground water models. Six of the seven wells are approximately 120 m deep and the seventh extends to a depth of 335 m. Temperature, fluid conductivity, and flowmeter logs are used to locate zones of fluid exchange and to quantify transmissivities. Electrical resistivity and natural gamma logs together yield detailed stratigraphic information, and digital acoustic televiewer data provide magnetically oriented images of the borehole wall from which almost 900 fractures are identified. Analyses of the geophysical data indicate that the aquifer penetrated by the deep well can be separated into two distinct structural domains, which may, in turn, reflect different mechanical responses to basin extension by different sedimentary units: 1. In the shallow zone (above 125 m), the dominant fracture population consists of gently dipping bedding plane partings that strike N46??E and dip to the northwest at about 11 degrees. Fluid flow is concentrated in the upper 80 m along these subhorizontal fractures, with transmissivities rapidly diminishing in magnitude with depth. 2. The zone below 125 m marks the appearance of numerous high-angle fractures that are orthogonal to the bedding planes, striking parallel but dipping steeply southeast at 77 degrees. This secondary set of fractures is associated with a fairly thick (approximately 60 m) high-resistivity, low-transmissivity sandstone unit that

  14. Sulfur Isotopic Composition and Behavior in Granitoid Intrusions, southwestern New Brunswick, Canada

    NASA Astrophysics Data System (ADS)

    Yang, X.; Lentz, D. R.

    2004-05-01

    Bulk sulfur isotopic composition and sulfur content were determined for 12 granitoid intrusions (48 samples) associated with various types of mineralization (e.g., Au, Sb-W-Mo-Au, W-Sn-In-Zn-Pb-Cu) and the pertinent wallrocks (7 samples), in southwestern New Brunswick, Canada. This data together with data from field relations, magnetic susceptibility, sulfide mineralogy, petrology, and geochemistry, were used to characterize these intrusions. Two distinct groups can be established, although both show some features of I-type grantiods: (1) a Late Devonian granitic series (GS) including the Mount Pleasant, True Hill, Beech Hill, Pleasant Ridge, Kedron, Sorrel Ridge granites, and (2) a Late Silurian to Early Devonian granodioritic to monzogranitic series (GMS) including the Magaguadavic, Bocabec, Utopia, Tower Hill, Evandale, and Lake George intrusions. The former occur along the northwestern flank of the Saint George Batholith as satellite plutons, and the later form parts of this batholith and the Pokiok Batholith to the north. The GS rocks show the attributes of evolved I-type with some A-type features, whereas the GMS rocks are either reduced I-type (ilmenite-series), or normal I-type (magnetite-series). Strong assimilation and contamination by local metasedimentary rocks lead to the Tower Hill granite resembling S-type, e.g., the presence of muscovite and garnet. The GS type rocks have δ 34S values between -7.1 and +13 per mil with bulk-S content ranging from 33 to 3434 ppm. The GMS type rocks have relatively narrower variation in δ 34S values (-4.4 to +7.3 per mil), but with larger ranges of bulk-S content (45 to 11100 ppm). The granite samples with S contents much higher than its solubility in felsic melts are interpreted to be affected either by local metasedimentary rocks or by late stage hydrothermal alteration. The metasedimentary rocks contain variable S contents (707 to 14000 ppm) with δ 34S values of -10.6 to 0.1 per mil. In terms of mass balance, a

  15. Vascular Injury in Orthopedic Trauma.

    PubMed

    Mavrogenis, Andreas F; Panagopoulos, George N; Kokkalis, Zinon T; Koulouvaris, Panayiotis; Megaloikonomos, Panayiotis D; Igoumenou, Vasilios; Mantas, George; Moulakakis, Konstantinos G; Sfyroeras, George S; Lazaris, Andreas; Soucacos, Panayotis N

    2016-07-01

    Vascular injury in orthopedic trauma is challenging. The risk to life and limb can be high, and clinical signs initially can be subtle. Recognition and management should be a critical skill for every orthopedic surgeon. There are 5 types of vascular injury: intimal injury (flaps, disruptions, or subintimal/intramural hematomas), complete wall defects with pseudoaneurysms or hemorrhage, complete transections with hemorrhage or occlusion, arteriovenous fistulas, and spasm. Intimal defects and subintimal hematomas with possible secondary occlusion are most commonly associated with blunt trauma, whereas wall defects, complete transections, and arteriovenous fistulas usually occur with penetrating trauma. Spasm can occur after either blunt or penetrating trauma to an extremity and is more common in young patients. Clinical presentation of vascular injury may not be straightforward. Physical examination can be misleading or initially unimpressive; a normal pulse examination may be present in 5% to 15% of patients with vascular injury. Detection and treatment of vascular injuries should take place within the context of the overall resuscitation of the patient according to the established principles of the Advanced Trauma Life Support (ATLS) protocols. Advances in the field, made mostly during times of war, have made limb salvage the rule rather than the exception. Teamwork, familiarity with the often subtle signs of vascular injuries, a high index of suspicion, effective communication, appropriate use of imaging modalities, sound knowledge of relevant technique, and sequence of surgical repairs are among the essential factors that will lead to a successful outcome. This article provides a comprehensive literature review on a subject that generates significant controversy and confusion among clinicians involved in the care of trauma patients. [Orthopedics. 2016; 39(4):249-259.]. PMID:27322172

  16. Long-term Monitoring Program Optimization for Chlorinated Volatile Organic Compound Plume, Naval Air Station Brunswick, Maine

    NASA Astrophysics Data System (ADS)

    Calderone, G. M.

    2006-12-01

    A long-term monitoring program was initiated in 1995 at 6 sites at NAS Brunswick, including 3 National Priorities List (Superfund) sites. Primary contaminants of concern include chlorinated volatile organic compounds, including tetrachloroethane, trichloroethene, and vinyl chloride, in addition to metals. More than 80 submersible pumping systems were installed to facilitate sample collection utilizing the low-flow sampling technique. Long-term monitoring of the groundwater is conducted to assess the effectiveness of remedial measures, and monitor changes in contaminant concentrations in the Eastern Plume Operable Unit. Long-term monitoring program activities include quarterly groundwater sampling and analysis at more than 90 wells across 6 sites; surface water, sediment, seep, and leachate sampling and analysis at 3 sites; landfill gas monitoring; well maintenance; engineering inspections of landfill covers and other sites or evidence of stressed vegetation; water level gauging; and treatment plant sampling and analysis. Significant cost savings were achieved by optimizing the sampling network and reducing sampling frequency from quarterly to semi- annual or annual sampling. As part of an ongoing optimization effort, a geostatistical assessment of the Eastern Plume was conducted at the Naval Air Station, Brunswick, Maine. The geostatistical assessment used 40 monitoring points and analytical data collected over 3 years. For this geostatistical assessment, EA developed and utilized a database of analytical results generated during 3 years of long-term monitoring which was linked to a Geographic Information System to enhance data visualization capacity. The Geographic Information System included themes for groundwater volatile organic compound concentration, groundwater flow directions, shallow and deep wells, and immediate access to point-specific analytical results. This statistical analysis has been used by the site decision-maker and its conclusions supported a

  17. Trauma-Informed or Trauma-Denied: Principles and Implementation of Trauma-Informed Services for Women

    ERIC Educational Resources Information Center

    Elliott, Denise E.; Bjelajac, Paula; Fallot, Roger D.; Markoff, Laurie S.; Reed, Beth Glover

    2005-01-01

    In this article, we attempt to bridge the gap between practice (service delivery) and philosophy (trauma theory, empowerment, and relational theory). Specifically, we identify 10 principles that define trauma-informed service, discuss the need for this type of service, and give some characteristics of trauma-informed services in eight different…

  18. Resuscitative thoracotomy in penetrating trauma.

    PubMed

    Fairfax, Lindsay M; Hsee, Li; Civil, Ian D

    2015-06-01

    The resuscitative thoracotomy (RT) is an important procedure in the management of penetrating trauma. As it is performed only in patients with peri-arrest physiology or overt cardiac arrest, survival is low. Experience is also quite variable depending on volume of penetrating trauma in a particular region. Survival ranges from 0% to as high as 89% depending on patient selection, available resources, and location of RT (operating or emergency rooms). In this article, published guidelines are reviewed as well as outcomes. Technical considerations of RT and well as proper training, personnel, and location are also discussed. PMID:25342073

  19. Component separation in abdominal trauma.

    PubMed

    Rawstorne, Edward; Smart, Christopher J; Fallis, Simon A; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and the fascia and skin closed successfully. Primary abdominal closure can be achieved in patients with penetrating abdominal trauma with the use of component separation and insertion of intra-abdominal biological mesh, where standard closure is not possible. PMID:24876334

  20. Acoustic trauma caused by lightning.

    PubMed

    Mora-Magaña, I; Collado-Corona, M A; Toral-Martiñòn, R; Cano, A

    1996-03-01

    Lesions produced by exposure to noise are frequent in everyday life. Injuries may be found in all systems of the human body, from the digestive to the endocrine, from the cardiovascular to the nervous system. Many organs may be damaged, the ear being one of them. It is known that noise produced by factories, airports, musical instruments and even toys can cause auditory loss. Noises in nature can also cause acoustic trauma. This report is the case history of acoustic trauma caused by lightning. The patient was studied with CAT scan, electroencephalogram, and brain mapping, impedance audiometry with tympanogram and acoustic reflex, audiometry and evoked otoacoustics emissions: distortion products and transients. PMID:8882110

  1. [Polyvagal theory and emotional trauma].

    PubMed

    Leikola, Anssi; Mäkelä, Jukka; Punkanen, Marko

    2016-01-01

    According to the polyvagal theory, the autonomic nervous system can, in deviation from the conventional theory, be divided in three distinct parts that are in hierarchical relationship with each other. The most-primitive autonomic control results in depression of vital functions, the more evolved one in fighting or escape and the most evolved one in social involvement. Practical application of the polyvagal theory has resulted in positive results above all in the treatment of emotional trauma. in Finland, therapy of complex trauma is founded on the theory of structural dissociation of the personality, which together with the polyvagal theory forms a practical frame of reference for psychotherapeutic work. PMID:27044181

  2. Thromboembolic Disease After Orthopedic Trauma.

    PubMed

    Whiting, Paul S; Jahangir, A Alex

    2016-04-01

    Orthopedic trauma results in systemic physiologic changes that predispose patients to venous thromboembolism (VTE). In the absence of prophylaxis, VTE incidence may be as high as 60%. Mechanical and pharmacologic thromboprophylaxis are effective in decreasing rates of VTE. Combined mechanical and pharmacologic thromboprophylaxis is more efficacious for decreasing VTE incidence than either regimen independently. If pharmacologic thromboprophylaxis is contraindicated, mechanical prophylaxis should be used. Patients with isolated lower extremity fractures who are ambulatory, or those with isolated upper extremity trauma, do not require pharmacologic prophylaxis in the absence of other VTE risk factors. PMID:26772942

  3. Management of ocular, orbital, and adnexal trauma

    SciTech Connect

    Spoor, T.C.; Nesi, F.A.

    1988-01-01

    This book contains 20 chapters. Some of the chapter titles are: The Ruptured Globe: Primary Care; Corneal Trauma, Endophthalmitis; Antibiotic Usage; Radiology of Orbital Trauma; Maxillofacial Fractures; Orbital Infections; and Basic Management of Soft Tissue Injury.

  4. Acoustic Trauma - Hearing Loss in Teenagers

    MedlinePlus

    ... Issues Listen Español Text Size Email Print Share Acoustic Trauma - Hearing Loss in Teenagers Page Content Article ... temporary or permanent hearing loss. This is called acoustic trauma. How loud is 85 decibels? Surprisingly, not ...

  5. Wet deposition monitoring and modelling in New Brunswick — An area dominated by wet deposition due to long-range transport

    NASA Astrophysics Data System (ADS)

    Davis, Claude S.

    Two wet deposition monitoring networks, the Coleson Cove Precipitation Monitoring Network (CCPMN) (12 stations) located in the Coleson Cove-Saint John area of south New Brunswick, and the Expanded New Brunswick Precipitation Monitoring Network (ENBPMN) (6 stations) covering the remainder of the province, were established in May 1988. The monitoring networks and a complementary modelling study were implemented to assess the relative contributions of local and distant sources to wet deposition in New Brunswick. Quality assurance/quality control activities for the networks included independent external audits, collocated samplers at one site and comparisons of weekly measurements at the ENBPMN sampler and the Canadian Air and Precipitation Monitoring Network (CAPMoN) sampler which makes daily measurements. The intercomparisons provided reassurance that the networks provided high quality data. Analysis of 2 years (June 1988-May 1990) data from the networks included routine statistical analyses for acid rain chemistry as well as analysis of 1 year of daily back trajectory data from Harcourt, New Brunswick. Three-day back trajectories determined at 12-h intervals from Harcourt on days with precipitatio showed that air masses originate mainly from regions in Quebec, Ontario and northeast U.S.A. which are known to have high sulphur oxide emissions. Some 18 trajectories were associated with 50% of the wet sulphate deposition and over 200 trajectories with 75% of the deposition in the 1-year period ending 31 May 1989. The MESOPUFF model, applied to an 800 km by 800 km domain that included the entire province of New Brunswick, was used to make predictions of wet sulphate and nitrate deposition at each of the wet deposition monitoring stations for a 2-year period, 1 June 1988-31 May 1990. Model predictions averaged over all receptors due to all sources in the model domain accounted for 7-25% of the measured seasonal average wet sulphate deposition and less than 3% of the

  6. TraumaSCAN: assessing penetrating trauma with geometric and probabilistic reasoning.

    PubMed Central

    Ogunyemi, O.; Clarke, J. R.; Webber, B.; Badler, N.

    2000-01-01

    This paper presents TraumaSCAN, a prototype computer system for assessing the effects of penetrating trauma to the chest and abdomen. TraumaSCAN combines geometric reasoning about potentially injured anatomic structures with (probabilistic) diagnostic reasoning about the consequences of these injuries. We also present results obtained from testing TraumaSCAN retrospectively on 26 actual gunshot wound cases. PMID:11079958

  7. How regional trauma systems improve outcomes.

    PubMed

    Cole, Elaine

    2015-10-01

    Management of severely injured patients is complex and requires organised, expert care. Regionalised trauma systems are relatively new in the UK and aim to deliver optimal, timely care to injured patients at the most appropriate location. This article discusses the drivers, organisation, processes and outcomes of regionalised trauma care. It also describes the challenges and benefits of working within a trauma system to enable emergency practitioners to reflect on their roles in contemporary trauma care. PMID:26451941

  8. Computed tomography in the evaluation of trauma

    SciTech Connect

    Federle, M.P.; Brant-Zawadzki, M.

    1982-01-01

    This book is intended to be the current standard for computed tomography in the evaluation of trauma. It summarizes two years of experience at San Francisco General Hospital. The book is organized into seven chapters, covering head, maxillofacial, laryngeal, spinal, chest, abdominal, acetabular, and pelvic trauma. Extremity trauma is not discussed.

  9. Helpers in Distress: Preventing Secondary Trauma

    ERIC Educational Resources Information Center

    Whitfield, Natasha; Kanter, Deborah

    2014-01-01

    Those in close contact with trauma survivors are themselves at risk for trauma (e.g., Bride, 2007; Figley, 1995). Family, friends, and professionals who bear witness to the emotional retelling and re-enacting of traumatic events can experience what is called "secondary trauma" (Elwood, Mott, Lohr, & Galovski, 2011). The literature…

  10. Facial nerve palsy due to birth trauma

    MedlinePlus

    Seventh cranial nerve palsy due to birth trauma ... these factors do not lead to facial nerve palsy or birth trauma. ... The most common form of facial nerve palsy due to birth trauma ... This part controls the muscles around the lips. The muscle ...

  11. Cultural Differences in Autobiographical Memory of Trauma

    ERIC Educational Resources Information Center

    Jobson, Laura; O'Kearney, Richard

    2006-01-01

    This study investigated cultural differences in autobiographical memory of trauma. Australian and Asian international students provided self-defining memories, narratives of everyday and trauma memories and self-reports assessing adjustment to the trauma. No cultural distinction was found in how Australian or Asian subjects remembered a personal…

  12. The management of liver trauma.

    PubMed Central

    Macfarlane, R.

    1985-01-01

    Despite advances in the management of liver trauma during the past 40 years, haemorrhage has remained the commonest cause of death. This article outlines the diversity of opinion between the desire to determine the extent of damage and resect devitalised tissue with its attendant risk of exacerbating haemorrhage, and the alternative of a more conservative approach. PMID:3895205

  13. Transforming Cultural Trauma into Resilience

    ERIC Educational Resources Information Center

    Brokenleg, Martin

    2012-01-01

    One of the biggest challenges facing Aboriginal populations increasingly is being called "intergenerational trauma." Restoring the cultural heritage is a central theme in the book, "Reclaiming Youth at Risk." That work describes the Circle of Courage model for positive development which blends Native child and youth care philosophy with research…

  14. Hypothermia and the trauma patient

    PubMed Central

    Kirkpatrick, Andrew W.; Chun, Rosaleen; Brown, Ross; Simons, Richard K.

    Hypothermia has profound effects on every system in the body, causing an overall slowing of enzymatic reactions and reduced metabolic requirements. Hypothermic, acutely injured patients with multisystem trauma have adverse outcomes when compared with normothermic control patients. Trauma patients are inherently predisposed to hypothermia from a variety of intrinsic and iatrogenic causes. Coagulation and cardiac sequelae are the most pertinent physiological concerns. Hypothermia and coagulopathy often mandate a simplified approach to complex surgical problems. A modification of traditional classification systems of hypothermia, applicable to trauma patients is suggested. There are few controlled investigations, but clinical opinion strongly supports the active prevention of hypothermia in the acutely traumatized patient. Preventive measures are simple and inexpensive, but the active reversal of hypothermia is much more complicated, often invasive and controversial. The ideal method of rewarming is unclear but must be individualized to the patient and is institution specific. An algorithm reflecting newer approaches to traumatic injury and technical advances in equipment and techniques is suggested. Conversely, hypothermia has selected clinical benefits when appropriately used in cases of trauma. Severe hypothermia has allowed remarkable survivals in the course of accidental circulatory arrest. The selective application of mild hypothermia in severe traumatic brain injury is an area with promise. Deliberate circulatory arrest with hypothermic cerebral protection has also been used for seemingly unrepairable injuries and is the focus of ongoing research. PMID:10526517

  15. Neuropathology of Acquired Cerebral Trauma.

    ERIC Educational Resources Information Center

    Bigler, Erin D.

    1987-01-01

    To help educators understand the cognitive and behavioral sequelae of cerebral injury, the neuropathology of traumatic brain injury and the main neuropathological features resulting from trauma-related brain damage are reviewed. A glossary with definitions of 37 neurological terms is appended. (Author/DB)

  16. Management of hemorrhage in trauma.

    PubMed

    Schöchl, Herbert; Grassetto, Alberto; Schlimp, Christoph J

    2013-08-01

    Hemorrhage remains one of the leading causes of trauma-related deaths. Uncontrolled diffuse microvascular bleeding in the course of initial care is common, potentially resulting in exsanguination. Early and aggressive hemostatic intervention increases survival and reduces the incidence of massive transfusion. Thus, timely diagnosis of the underlying coagulation disorders is mandatory. It has been shown that standard coagulation tests do not sufficiently characterize trauma-induced coagulopathy (TIC). This has led to increasing interest in alternatives, such as the viscoelastic test, to diagnose TIC and to provide the basis for a goal-directed hemostatic therapy. The concept of damage control resuscitation (DCR) has been introduced widely in trauma patients with severe bleeding. This strategy addresses important confounders of the coagulation process such as hemodilution, hypothermia, and acidosis; DCR is based on a damage control surgical approach, permissive hypotension, and improvement of hemostatic competence. Many studies have shown benefit in mortality when using high ratios of fresh frozen plasma (FFP) to red blood cells (RBC) as early treatment. However, there is increased awareness that coagulation factor concentrate could be beneficial in the treatment of trauma-induced coagulopathy. PMID:23910535

  17. Medicating Relational Trauma in Youth

    ERIC Educational Resources Information Center

    Foltz, Robert

    2008-01-01

    Children who have experienced relational trauma present a host of problems and are often diagnosed with psychiatric disorders and then medicated. But there is evidence that commonly used drugs interfere with oxytocin or vasopressin, the human trust and bonding hormones. Thus, psychotropic drugs may impair interpersonal relationships and impede…

  18. Transfusion management of trauma patients.

    PubMed

    Shaz, Beth H; Dente, Christopher J; Harris, Robert S; MacLeod, Jana B; Hillyer, Christopher D

    2009-06-01

    The management of massively transfused trauma patients has improved with a better understanding of trauma-induced coagulopathy, the limitations of crystalloid infusion, and the implementation of massive transfusion protocols (MTPs), which encompass transfusion management and other patient care needs to mitigate the "lethal triad" of acidosis, hypothermia, and coagulopathy. MTPs are currently changing in the United States and worldwide because of recent data showing that earlier and more aggressive transfusion intervention and resuscitation with blood components that approximate whole blood significantly decrease mortality. In this context, MTPs are a key element of "damage control resuscitation," which is defined as the systematic approach to major trauma that addresses the lethal triad mentioned above. MTPs using adequate volumes of plasma, and thus coagulation factors, improve patient outcome. The ideal amounts of plasma, platelet, cryoprecipitate and other coagulation factors given in MTPs in relationship to the red blood cell transfusion volume are not known precisely, but until prospective, randomized, clinical trials are performed and more clinical data are obtained, current data support a target ratio of plasma:red blood cell:platelet transfusions of 1:1:1. Future prospective clinical trials will allow continued improvement in MTPs and thus in the overall management of patients with trauma. PMID:19448199

  19. Quality Assurance for Consumers of Private Training Programs. Findings and Recommendations from the Consultation on the Regulation and Support of Training Providers in New Brunswick = Assurance de la qualite pour les consommateurs de programmes de formation du secteur prive. Resultats et recommandations a la suite des consultations relativement a la reglementation et au soutien des fournisseurs de cours de formation au Nouveau-Brunswick.

    ERIC Educational Resources Information Center

    New Brunswick Labour Force Development Board, Fredericton.

    Eighteen key individuals from the business, labor, and training sectors and other organizations concerned with the purchase of private training programs were consulted in an effort to determine the role of Canada's federal government and New Brunswick's provincial government in quality assurance for consumers of private training programs. There…

  20. Autotransfusion utilization in abdominal trauma.

    PubMed

    Smith, L A; Barker, D E; Burns, R P

    1997-01-01

    The purpose of this review is to investigate the utility of autotransfusion in trauma patients in the past 3 years. A retrospective review was conducted of the charts for whom the Haemonetics Cell Saver autotransfusion device (Haemonetics Corp., Natick, MA) was utilized between January 1, 1993, and December 31, 1995. The estimated blood loss and quantity of blood transfused were noted for abdominal trauma patients. Costs of autotransfusion were then compared to estimated blood bank costs for this group. The Haemonetics Cell Saver autotransfusion device was requested for 592 cases from January 1, 1993, to December 31, 1995. Nonorthopedic trauma cases comprised 25 per cent of all autotransfusion cases. One hundred twenty-six patients had isolated abdominal trauma and had a mean estimated blood loss of 4864 +/- 6070 cc. The average volume of intraoperatively salvaged autologous blood transfused (autotransfusion) per patient was 1547 +/- 2359 cc, or a bank blood equivalent of 6.9 units of packed red blood cells. The total cost of autotransfusion in these patients was $63,252.00. Had bank blood been used instead of salvaged autologous blood, the cost would have been $114,523.00; thus, autotransfusion resulted in a savings of $51,271.00. The use of salvaged autologous blood comprised 45 per cent of total blood transfused. On a case-by-case basis, 75 per cent of cases were cost-effective compared to blood bank costs for an equivalent transfusion. Transfusion of intraoperatively salvaged autologous blood (autotransfusion) is a cost-effective, efficient way to provide blood products to operative trauma patients. PMID:8985070

  1. The National Trauma Research Repository: Ushering in a New ERA of trauma research (Commentary).

    PubMed

    Smith, Sharon L; Price, Michelle A; Fabian, Timothy C; Jurkovich, Gregory J; Pruitt, Basil A; Stewart, Ronald M; Jenkins, Donald H

    2016-09-01

    Despite being the leading cause of death in the United States for individuals 46 years and younger and the primary cause of death among military service members, trauma care research has been underfunded for the last 50 years. Sustained federal funding for a coordinated national trauma clinical research program is required to advance the science of caring for the injured. The Department of Defense is committed to funding studies with military relevance; therefore, it cannot fund pediatric or geriatric trauma clinical trials. Currently, trauma clinical trials are often performed within a single site or a small group of trauma hospitals, and research data are not available for secondary analysis or sharing across studies. Data-sharing platforms encourage transfer of research data and knowledge between civilian and military researchers, reduce redundancy, and maximize limited research funding. In collaboration with the Department of Defense, trauma researchers formed the Coalition for National Trauma Research (CNTR) in 2014 to advance trauma research in a coordinated effort. CNTR's member organizations are the American Association for the Surgery of Trauma (AAST), the American College of Surgeons Committee on Trauma (ACS COT), the Eastern Association for the Surgery of Trauma (EAST), the Western Trauma Association (WTA), and the National Trauma Institute (NTI). CNTR advocates for sustained federal funding for a multidisciplinary national trauma research program to be conducted through a large clinical trials network and a national trauma research repository. The initial advocacy and research activities underway to accomplish these goals are presented. PMID:27496599

  2. Diabetes Case Management in Primary Care: The New Brunswick Experience and Expanding the Practice of the Certified Diabetes Educator Nurse into Primary Care.

    PubMed

    Jones, Shelley L

    2015-08-01

    The role of the outreach diabetes case manager in New Brunswick, Canada, was first developed in the Moncton Area of Horizon Health Network in response to a physician-identified gap between patients' diagnoses of diabetes and their attendance at the local diabetes education centre. This model of collaborative interprofessional practice increases support for primary care providers and people living with diabetes in that they are being provided the services of certified diabetes educators who can address knowledge gaps with respect to evidence-based guidelines and best practice, promote advancement of diabetes and chronic-disease management therapies and support adherence to treatment plans and self-management practices. This report chronicles a review of the implementation, expansion and evaluation of the outreach diabetes case manager model in the province of New Brunswick, Canada, along with the rationale for development of the role for registered nurses in other jurisdictions. PMID:25797113

  3. Nonpathologizing trauma interventions in abnormal psychology courses.

    PubMed

    Hoover, Stephanie M; Luchner, Andrew F; Pickett, Rachel F

    2016-01-01

    Because abnormal psychology courses presuppose a focus on pathological human functioning, nonpathologizing interventions within these classes are particularly powerful and can reach survivors, bystanders, and perpetrators. Interventions are needed to improve the social response to trauma on college campuses. By applying psychodynamic and feminist multicultural theory, instructors can deliver nonpathologizing interventions about trauma and trauma response within these classes. We recommend class-based interventions with the following aims: (a) intentionally using nonpathologizing language, (b) normalizing trauma responses, (c) subjectively defining trauma, (d) challenging secondary victimization, and (e) questioning the delineation of abnormal and normal. The recommendations promote implications for instructor self-reflection, therapy interventions, and future research. PMID:26460794

  4. The biology of trauma: implications for treatment.

    PubMed

    Solomon, Eldra P; Heide, Kathleen M

    2005-01-01

    During the past 20 years, the development of brain imaging techniques and new biochemical approaches has led to increased understanding of the biological effects of psychological trauma. New hypotheses have been generated about brain development and the roots of antisocial behavior. We now understand that psychological trauma disrupts homeostasis and can cause both short and long-term effects on many organs and systems of the body. Our expanding knowledge of the effects of trauma on the body has inspired new approaches to treating trauma survivors. Biologically informed therapy addresses the physiological effects of trauma, as well as cognitive distortions and maladaptive behaviors. The authors suggest that the most effective therapeutic innovation during the past 20 years for treating trauma survivors has been Eye Movement Desensitization and Reprocessing (EMDR), a therapeutic approach that focuses on resolving trauma using a combination of top-down (cognitive) and bottom-up (affect/body) processing. PMID:15618561

  5. Further contributions to the staphylinid fauna of New Brunswick, Canada, and the USA, with descriptions of two new Proteinus species (Coleoptera, Staphylinidae).

    PubMed

    Webster, Reginald P; Davies, Anthony E; Klimaszewski, Jan; Bourdon, Caroline

    2016-01-01

    This paper treats the discovery of new species and new records of Staphylinidae from the subfamilies Omaliinae, Proteininae, Tachyporinae, Oxytelinae, Scydmaeninae, Steninae, Euaesthetinae, Pseudopsinae, Paederinae, and Staphylininae for the province of New Brunswick and other provinces of Canada, and the USA. We report here two species new to science, three new North American records, nine new Canadian records, two new USA records, and 50 new provincial records. The following are the species new to science: Proteinus hughesi Webster & Davies, sp. n. and Proteinus sweeneyi Webster & Klimaszewski, sp. n. (Proteininae). Sepedophilus immaculatus (Stephens) and Carpelimus erichsoni (Sharp), Carpelimus mundus (Sharp) are newly recorded from North America. New Canadian records are as follows: Carpelimus difficilis (Casey), Carpelimus gracilis (Mannerheim), Carpelimus lacustris (Notman), Carpelimus probus (Casey), Carpelimus pusillus (Gravenhorst), Carpelimus rivularis (Motschulsky), Carpelimus spretus (Casey), Carpelimus weissi (Notman) (Oxytelinae), and Edaphus lederi Eppelsheim (Euaesthetinae). This is the first record of the genus Edaphus for Canada. Bledius basalis LeConte and Carpelimus obesus (Kiesenwetter) (Oxytelinae) are removed from the faunal list of New Brunswick. Proteinus acadiensis Klimaszewski and Proteinus pseudothomasi Klimaszewski are newly recorded from the USA and several provinces of Canada. Habitat data from New Brunswick are provided for most of the species treated in this contribution. PMID:27110167

  6. Further contributions to the staphylinid fauna of New Brunswick, Canada, and the USA, with descriptions of two new Proteinus species (Coleoptera, Staphylinidae)

    PubMed Central

    Webster, Reginald P.; Davies, Anthony E.; Klimaszewski, Jan; Bourdon, Caroline

    2016-01-01

    Abstract This paper treats the discovery of new species and new records of Staphylinidae from the subfamilies Omaliinae, Proteininae, Tachyporinae, Oxytelinae, Scydmaeninae, Steninae, Euaesthetinae, Pseudopsinae, Paederinae, and Staphylininae for the province of New Brunswick and other provinces of Canada, and the USA. We report here two species new to science, three new North American records, nine new Canadian records, two new USA records, and 50 new provincial records. The following are the species new to science: Proteinus hughesi Webster & Davies, sp. n. and Proteinus sweeneyi Webster & Klimaszewski, sp. n. (Proteininae). Sepedophilus immaculatus (Stephens) and Carpelimus erichsoni (Sharp), Carpelimus mundus (Sharp) are newly recorded from North America. New Canadian records are as follows: Carpelimus difficilis (Casey), Carpelimus gracilis (Mannerheim), Carpelimus lacustris (Notman), Carpelimus probus (Casey), Carpelimus pusillus (Gravenhorst), Carpelimus rivularis (Motschulsky), Carpelimus spretus (Casey), Carpelimus weissi (Notman) (Oxytelinae), and Edaphus lederi Eppelsheim (Euaesthetinae). This is the first record of the genus Edaphus for Canada. Bledius basalis LeConte and Carpelimus obesus (Kiesenwetter) (Oxytelinae) are removed from the faunal list of New Brunswick. Proteinus acadiensis Klimaszewski and Proteinus pseudothomasi Klimaszewski are newly recorded from the USA and several provinces of Canada. Habitat data from New Brunswick are provided for most of the species treated in this contribution. PMID:27110167

  7. New COCORP profiling in the southeastern United States. Part II: Brunswick and east coast magnetic anomalies, opening of the north-central Atlantic Ocean

    NASA Astrophysics Data System (ADS)

    Nelson, K. D.; McBride, J. H.; Arnow, J. A.; Oliver, J. E.; Brown, L. D.; Kaufman, S.

    1985-10-01

    New COCORP profiles on the coastal plain of Georgia and northern Florida support the hypothesis that the Brunswick anomaly marks a late Paleozoic suture. They do not support the alternate view that this anomaly is caused by a Mesozoic rift basin. The trend of the Brunswick anomaly relative to the Appalachian gravity gradient indicates that in westernmost Georgia and adjacent Alabama, African basement (Suwannee terrane) is in proximity to autochthonous North American basement (Grenville). Farther east one or more Paleozoic accreted terranes intervene between the North American and African sides of the orogen. Offshore, the Brunswick anomaly closely parallels the east coast magnetic anomaly. This relationship implies that the east coast magnetic anomaly marks not only the present continental/oceanic crustal transition but also the northward continuation of the late Paleozoic suture between North America and Africa. Transitional crust beneath the Carolina Trough, Baltimore Canyon trough, and correlative parts of the African Atlantic margin is thus likely to have formed within a preexisting suture zone. The dramatic change in character of the U.S. Atlantic margin southward from the Carolina Trough to the Blake Plateau probably reflects the fact that two different types of prerift crust are juxtaposed in this region. *And Department of Geological Sciences, Cornell University, Ithaca, New York 14853

  8. Trauma care systems in Spain.

    PubMed

    Queipo de Llano, E; Mantero Ruiz, A; Sanchez Vicioso, P; Bosca Crespo, A; Carpintero Avellaneda, J L; de la Torre Prado, M V

    2003-09-01

    Trauma care systems in Spain are provided by the Nacional Health Service in a decentralized way by the seventeen autonomous communities whose process of decentralization was completed in January 2002. Its organisation is similar in all of them. Public sector companies of sanitary emergencies look after the health of citizens in relation to medical and trauma emergencies with a wide range of up to date resources both technical and human. In the following piece there is a description of the emergency response teams divided into ground and air that are responsible for the on site care of the patients in coordination with other public services. They also elaborate the prehospital clinical history that is going to be a valuable piece of information for the teams that receive the patient in the Emergency Hospital Unit (EHU). From 1980 to 1996 the mortality rate per 10.000 vehicles and the deaths per 1.000 accidents dropped significantly: in 1980 6.4 and 96.19% and in 1996, 2.8 and 64.06% respectively. In the intrahospital organisation there are two differentiated areas to receive trauma patients the casualty department and the EHU. In the EHU the severe and multiple injured patients are treated by the emergency hospital doctors; first in the triage or resuscitation areas and after when stabilised they are passed too the observation area or to the Intensive Care Unit (ICU) and from there the EHU or ICU doctors call the appropriate specialists. There is a close collaboration and coordination between the orthopaedic surgeon the EHU doctors and the other specialists surgeons in order to comply with treatment prioritization protocols. Once the patient has been transferred an entire process of assistance continuity is developed based on interdisciplinary teams formed in the hospital from the services areas involved in trauma assistance and usually coordinated by the ICU doctors. There is also mentioned the assistance registry of trauma patients, the ICU professional training

  9. Musculoskeletal trauma: the baseball bat.

    PubMed Central

    Bryant, D. D.; Greenfield, R.; Martin, E.

    1992-01-01

    Between July 1987 and December 1990 in Washington, DC, 116 patients sustained 146 fractures and seven dislocations due to an assault with a baseball bat. The ulna was the most common site of trauma (61 fractures), followed by the hand (27 injuries) and the radius (14 injuries). Forty-two of the 146 fractures were significantly displaced and required open reduction and internal fixation to restore satisfactory alignment. Twenty-nine of the 146 fractures were open fractures. Treatment protocol for open fractures consisted of irrigation and debridement, antibiotic therapy, and bone stabilization with either internal or external fixation, or casting. Recognition of the severity of the soft tissue and bone damage is important in the management of musculoskeletal trauma secondary to the baseball bat. Images Figure 1 Figure 2 Figure 3 PMID:1460683

  10. Computer-assisted trauma surgery.

    PubMed

    Atesok, Kivanc; Schemitsch, Emil H

    2010-05-01

    Computer-assisted orthopaedic surgery (CAOS) is performed by digitizing the patient's anatomy, combining the images in a computerized system, and integrating the surgical instruments into the digitized image background. This allows the surgeon to navigate the surgical instruments and the bone in an improved, virtual visual environment. CAOS in traumatology is performed with images obtained by fluoroscopy, CT, or three-dimensional fluoroscopy. CAOS is used in basic trauma procedures for preoperative planning, fracture reduction, intramedullary nailing, percutaneous screw or plate fixation, and hardware or shrapnel removal. Potential benefits of CAOS include minimal invasiveness, increased accuracy, and decreased radiation exposure. Limitations include a significant learning curve, increased surgical time, requirements for special setup and equipment handling in the operating room, specialized technical support, and cost. Current evidence shows no advantage with CAOS in trauma cases compared with conventional methods. Prospective randomized trials and clinical outcomes are lacking. PMID:20435875

  11. Hypotensive Resuscitation among Trauma Patients

    PubMed Central

    Carrick, Matthew M.; Leonard, Jan; Slone, Denetta S.; Mains, Charles W.

    2016-01-01

    Hemorrhagic shock is a principal cause of death among trauma patients within the first 24 hours after injury. Optimal fluid resuscitation strategies have been examined for nearly a century, more recently with several randomized controlled trials. Hypotensive resuscitation, also called permissive hypotension, is a resuscitation strategy that uses limited fluids and blood products during the early stages of treatment for hemorrhagic shock. A lower-than-normal blood pressure is maintained until operative control of the bleeding can occur. The randomized controlled trials examining restricted fluid resuscitation have demonstrated that aggressive fluid resuscitation in the prehospital and hospital setting leads to more complications than hypotensive resuscitation, with disparate findings on the survival benefit. Since the populations studied in each randomized controlled trial are slightly different, as is the timing of intervention and targeted vitals, there is still a need for a large, multicenter trial that can examine the benefit of hypotensive resuscitation in both blunt and penetrating trauma patients. PMID:27595109

  12. Planned reoperation for severe trauma.

    PubMed Central

    Hirshberg, A; Mattox, K L

    1995-01-01

    OBJECTIVE: The authors review the physiologic basis, indications, techniques, and results of the planned reoperation approach to severe trauma. SUMMARY BACKGROUND DATA: Multivisceral trauma and exsanguinating hemorrhage lead to hypothermia, coagulopathy, and acidosis. Formal resections and reconstructions in these unstable patients often result in irreversible physiologic insult. A new surgical strategy addresses these physiologic concerns by staged control and repair of the injuries. METHOD: The authors review the literature. RESULTS: Indications for planned reoperation include avoidance of irreversible physiologic insult and inability to obtain direct hemostasis or formal abdominal closure. The three phases of the strategy include initial control, stabilization, and delayed reconstruction. Various techniques are used to obtain rapid temporary control of bleeding and hollow visceral spillage. Hypothermia, coagulopathy, and the abdominal compartment syndrome are major postoperative concerns. Definitive repair of the injuries is undertaken after stabilization. CONCLUSION: Planned reoperation offers a simple and effective alternative to the traditional surgical management of complex or multiple injuries in critically wounded patients. PMID:7618965

  13. Computed tomography of splenic trauma

    SciTech Connect

    Jeffrey, R.B.; Laing, F.C.; Federle, M.P.; Goodman, P.C.

    1981-12-01

    Fifty patients with abdominal trauma and possible splenic injury were evaluated by computed tomography (CT). CT correctly diagnosed 21 of 22 surgically proved traumatic sesions of the spleen (96%). Twenty-seven patients had no evidence of splenic injury. This was confirmed at operation in 1 patient and clinical follow-up in 26. There were one false negative and one false positive. In 5 patients (10%), CT demonstrated other clinically significant lesions, including hepatic or renal lacerations in 3 and large retroperitoneal hematomas in 2. In adolescents and adults, CT is an accurate, noninvasive method of rapidly diagnosing splenic trauma and associated injuries. Further experience is needed to assess its usefulness in evaluating splenic injuries in infants and small children.

  14. Musculoskeletal trauma service in Thailand.

    PubMed

    Mahaisavariya, Banchong

    2008-10-01

    Trauma is becoming a leading cause of death in most of the low-income and middle-income countries worldwide. The growing number of motor vehicles far surpasses the development and upkeep of the road and highway networks, traffic laws, and driver training and licensing. In Thailand, road traffic injuries have become the second leading cause of death and morbidity overall since 1990. The lack of improvement to existing roadways, implementation of traffic safety and ridership laws including seatbelt regulations, and poor emergency medical assistance support systems all contribute to these statistics. An insufficient number and inequitable distribution of healthcare professionals is also a national problem, especially at the district level. Prehospital care of trauma patients remains insufficient and improvements at the national level are suggested. PMID:18629597

  15. Conservative treatment of liver trauma.

    PubMed

    Andersson, R; Bengmark, S

    1990-01-01

    A marked change toward a more conservative approach in the treatment of abdominal trauma has been noted, especially during the last decade. This change in regimen was first seen in the handling of splenic trauma, initiated by pediatric surgeons. Later, the concept of conservative management was also introduced among adults and it is now widely accepted. Here, an almost mandatory splenectomy has been replaced by attempts at various forms of splenic salvage. The development followed an initial report by King and Shumacker in 1952 on an increased susceptibility to overwhelming sepsis in splenectomized children, findings which later also were demonstrated among adults. It has also been shown that the bleeding from intraparenchymal lesions with an intact splenic capsule or minor capsular tears frequently ceases spontaneously, hereby making nonoperative management possible in selective cases. PMID:2200210

  16. Hypotensive Resuscitation among Trauma Patients.

    PubMed

    Carrick, Matthew M; Leonard, Jan; Slone, Denetta S; Mains, Charles W; Bar-Or, David

    2016-01-01

    Hemorrhagic shock is a principal cause of death among trauma patients within the first 24 hours after injury. Optimal fluid resuscitation strategies have been examined for nearly a century, more recently with several randomized controlled trials. Hypotensive resuscitation, also called permissive hypotension, is a resuscitation strategy that uses limited fluids and blood products during the early stages of treatment for hemorrhagic shock. A lower-than-normal blood pressure is maintained until operative control of the bleeding can occur. The randomized controlled trials examining restricted fluid resuscitation have demonstrated that aggressive fluid resuscitation in the prehospital and hospital setting leads to more complications than hypotensive resuscitation, with disparate findings on the survival benefit. Since the populations studied in each randomized controlled trial are slightly different, as is the timing of intervention and targeted vitals, there is still a need for a large, multicenter trial that can examine the benefit of hypotensive resuscitation in both blunt and penetrating trauma patients. PMID:27595109

  17. [New observations on gut trauma].

    PubMed

    Staib, L; Henne-Bruns, D

    2005-10-01

    Abdominal trauma from blunt objects remains a challenge in clinical practice. The primary aims are quick recognition and reversal of life-threatening situations, rational use of the available diagnostic methods, and avoidance of unnecessary laparotomy. The majority of these injuries can now be treated conservatively, whereby interventional methods such as drainage inserts and embolisation are becoming increasingly favoured. Observation of the treatment course by an experienced surgeon is a must. In patients with complicated injuries, special attention must be paid to so-called missed injuries: traumata that may be overlooked such as small intestine and diaphragm ruptures. Aside from retaining organs and their function, the most important concern is damage control (for complex injuries) and laparotomy in the abdominal compartment, with the application of temporary laparotomy as needed. These methods are aimed at reducing mortality pre- and post-admittance. However, we still lack valid prognostic parameters to allow realistic estimation of survival following severe, blunt abdominal trauma. PMID:15843910

  18. Pearls of Mandibular Trauma Management

    PubMed Central

    Koshy, John C.; Feldman, Evan M.; Chike-Obi, Chuma J.; Bullocks, Jamal M.

    2010-01-01

    Mandibular trauma is a common problem seen by plastic surgeons. When fractures occur, they have the ability to affect the patient's occlusion significantly, cause infection, and lead to considerable pain. Interventions to prevent these sequelae require either closed or open forms of reduction and fixation. Physicians determining how to manage these injuries should take into consideration the nature of the injury, background information regarding the patient's health, and the patient's comorbidities. Whereas general principles guide the management of the majority of injuries, special consideration must be paid to the edentulous patient, complex and comminuted fractures, and pediatric patients. These topics are discussed in this article, with a special emphasis on pearls of mandibular trauma management. PMID:22550460

  19. Changing approach to psychological trauma.

    PubMed

    2016-07-01

    As the Battle of the Somme's anniversary looms and post-traumatic stress disorder continues to be an enduring issue for the armed forces, what lessons in treating mental illness can we learn from the first world war? Claire Chatterton, writing in Mental Health Practice, examines the changes to treating psychological trauma during the Somme by health professionals who had rarely worked with people experiencing mental health problems. PMID:27380708

  20. Current Epidemiology of Genitourinary Trauma

    PubMed Central

    McGeady, James B.; Breyer, Benjamin N.

    2013-01-01

    Synopsis This article reviews recent publications evaluating the current epidemiology of urologic trauma. It begins by providing a brief explanation of databases that have been recently used to study this patient population, then proceeds to discuss each genitourinary organ individually, discussing the most relevant and up to date information published for each one. The conclusion of the article briefly discusses possible future research and development areas pertaining to the topic. PMID:23905930

  1. Contemporary Management of Renal Trauma

    PubMed Central

    Shoobridge, Jennifer J; Corcoran, Niall M; Martin, Katherine A; Koukounaras, Jim; Royce, Peter L; Bultitude, Matthew F

    2011-01-01

    In the management of renal trauma, surgical exploration inevitably leads to nephrectomy in all but a few specialized centers. With current management options, the majority of hemodynamically stable patients with renal injuries can be successfully managed nonoperatively. Improved radiographic techniques and the development of a validated renal injury scoring system have led to improved staging of injury severity that is relatively easy to monitor. This article reviews a multidisciplinary approach to facilitate the care of patients with renal injury. PMID:21941463

  2. Trauma systems, shock, and resuscitation.

    PubMed

    Fallon, W F

    1993-01-01

    This review of early care covers issues pertaining to the analysis of system function, prehospital intravascular volume replacement, diagnosis of proximity vascular injury, the role of emergency thoracotomy, and the value of transesophageal echocardiography. The first six articles deal with various aspects of system function, from triage to analysis of outcome. The next series of articles reviews work in progress evaluating optimal fluid for resuscitation. Hypertonic saline and dextran combinations have been shown to restore vital signs better than isotonic solutions; they are safe, require smaller volumes, and may improve head injury outcome. Danger lies in the restoration of perfusion without hemorrhage control. Two articles on emergency thoracotomy review the indications and outcome in blunt and penetrating trauma. Survival in blunt trauma is virtually zero. An article and two editorials summarize state of the art for diagnosis and treatment of proximity vascular injury. Two articles describe the potential use of the new technique of transesophageal echocardiography. This new modality has not formed a solid indication at present and can be considered investigational in trauma care. PMID:7584006

  3. Radionuclide evaluation of lung trauma.

    PubMed

    Lull, R J; Tatum, J L; Sugerman, H J; Hartshorne, M F; Boll, D A; Kaplan, K A

    1983-07-01

    Nuclear medicine imaging procedures can play a significant role in evaluating the pulmonary complications that are seen in trauma patients. A quantitative method for measuring increased pulmonary capillary permeability that uses Tc-99m HSA allows early diagnosis of acute respiratory distress syndrome (ARDS) and accurately differentiates this condition from pneumonia or cardiogenic pulmonary edema. This technique may be of great value in following the response to therapy. The use of 133Xe to diagnose inhalation injury remains an important diagnostic tool, particularly at hospitals with specialized burn units. Regional decreases in ventilation-perfusion images reliably localize aspirated foreign bodies. Radionuclide techniques that are used to demonstrate gastropulmonary aspiration remain controversial and require further clinical evaluation. Pulmonary perfusion imaging, although nonspecific, may provide the earliest clue for correct diagnosis of fat embolism, air embolism, contusion, or laceration. Furthermore, the possibility of perfusion abnormality due to these uncommon conditions must be remembered whenever trauma patients are evaluated for pulmonary thromboembolism with scintigraphy. Occasionally, liver or spleen scintigraphy may be the most appropriate procedure when penetrating chest trauma also involves these subdiaphragmatic organs. PMID:6226097

  4. Joseph Beuys: trauma and catharsis.

    PubMed

    Ottomann, C; Stollwerck, P L; Maier, H; Gatty, I; Muehlberger, T

    2010-12-01

    Joseph Beuys was one of the most significant artists of the 20th century. He was a gunner and radio operator in the German Air Force during World War II, and was severely injured several times. In March 1943 he had a life-changing experience after the dive bomber he was assigned to crashed in the Crimean peninsula. This trauma influenced Beuys' entire artistic career, and is known in art history as the 'Tartar Legend' or 'Tartar Myth'. Profoundly affected by the crash, the severe trauma, the near-death experience and his rescue, which he perceived as a "rebirth", Beuys no longer saw himself, other people or society as a whole in the same way as previously. With his new consciousness, he ignored boundaries and created visions whereby all mankind could experience the healing he had undergone. Beuys did not bring society far enough for the turning point towards "the healing of the world" to be visible, yet today it is important to keep his work alive as a record of his extraordinary strength, which arose from trauma and severe injury, and was carried by a passionate commitment to mankind and to life itself. PMID:21393290

  5. The Role of Cumulative Trauma, Betrayal, and Appraisals in Understanding Trauma Symptomatology.

    PubMed

    Martin, Christina Gamache; Cromer, Lisa Demarni; Deprince, Anne P; Freyd, Jennifer J

    2013-03-01

    Poor psychological outcomes are common among trauma survivors, yet not all survivors experience adverse sequelae. The current study examined links between cumulative trauma exposure as a function of the level of betrayal (measured by the relational closeness of the survivor and the perpetrator), trauma appraisals, gender, and trauma symptoms. Participants were 273 college students who reported experiencing at least one traumatic event on a trauma checklist. Three cumulative indices were constructed to assess the number of different types of traumas experienced that were low (LBTs), moderate (MBTs), or high in betrayal (HBTs). Greater trauma exposure was related to more symptoms of depression, dissociation, and PTSD, with exposure to HBTs contributing the most. Women were more likely to experience HBTs than men, but there were no gender differences in trauma-related symptoms. Appraisals of trauma were predictive of trauma-related symptoms over and above the effects explained by cumulative trauma at each level of betrayal. The survivor's relationship with the perpetrator, the effect of cumulative trauma, and their combined impact on trauma symptomatology are discussed. PMID:23542882

  6. Thyroid crisis in the maxillofacial trauma patient.

    PubMed

    Weinstock, Robert J; Lewis, Tashorn; Miller, Jared; Clarkson, Earl I

    2014-11-01

    Thyroid crisis, also known as thyroid storm, is a rare complication of thyrotoxicosis that results in a hypermetabolic and hyperadrenergic state. This condition requires prompt recognition and treatment because the mortality from thyroid crisis approaches 30%. Thyrotoxicosis alone will usually not progress to thyroid crisis. Thyroid crisis will typically be precipitated by some concomitant event such as infection, iodine-containing contrast agents, medications such as amiodarone, pregnancy, or surgery. Trauma is a rare precipitator of thyroid crisis. Several published studies have reported thyroid crisis resulting from blunt or penetrating neck trauma. Significant systemic trauma, such as motor vehicle accidents, has also been reported to precipitate thyroid crisis. It is very unusual for minor trauma to precipitate thyroid crisis. In the present study, we report the case of a patient who had incurred relatively minor maxillofacial trauma and developed thyroid crisis 2 weeks after the initial trauma. PMID:25085805

  7. Assessing sexual trauma histories in homeless women.

    PubMed

    Weinrich, Sally; Hardin, Sally; Glaser, Dale; Barger, Mary; Bormann, Jill; Lizarraga, Cabiria; Terry, Micheal; Criscenzo, Jeeni; Allard, Carolyn B

    2016-01-01

    Almost 1 out of every 3 homeless women (32%) in the United States, United Kingdom, and Australia has experienced childhood sexual trauma. We assessed lifetime sexual trauma histories among 29 homeless women from three Southern California community sites: one residential safe house and two safe parking areas. More than half of the women (54%) reported a history of sexual trauma. That rate was higher (86%) among women living at the safe home than among women staying at the safe parking sites (only 42%). All four of the women who had served in the military reported having experienced military sexual trauma. The high percentages of sexual trauma found in homeless women highlight the need for effective interventions for sexual trauma. PMID:26583457

  8. Primary and secondary skeletal blast trauma.

    PubMed

    Christensen, Angi M; Smith, Victoria A; Ramos, Vanessa; Shegogue, Candie; Whitworth, Mark

    2012-01-01

    This study examines primary (resulting from blast wave) and secondary (resulting from disintegrated, penetrating fragments) blast trauma to the skeleton. Eleven pigs were exposed to semi-controlled blast events of varying explosive type, charge size, and distance, including some cases with shrapnel. Skeletal trauma was found to be extensive, presenting as complex, comminuted fractures with numerous small, displaced bone splinters and fragments. Traumatic amputation of the limbs and cranium was also observed. Fractures were concentrated in areas nearer the blast, but there was generally no identifiable point of impact. Fractures were more random in appearance and widespread than those typically associated with gunshot or blunt force injury events. These patterns appear to be uniquely associated with blast trauma and may therefore assist forensic anthropologists and other forensic examiners in the interpretation of skeletal trauma by enabling them to differentiate between blast trauma and trauma resulting from some other cause. PMID:21981586

  9. Prehospital advanced trauma life support for critical blunt trauma victims.

    PubMed

    Cwinn, A A; Pons, P T; Moore, E E; Marx, J A; Honigman, B; Dinerman, N

    1987-04-01

    The ability of paramedics to deliver advanced trauma life support (ATLS) in an expedient fashion for victims of trauma has been strongly challenged. In this study, the records of 114 consecutive victims of blunt trauma who underwent laparotomy or thoracotomy were reviewed. Prehospital care was rendered by paramedics operating under strict protocols. The mean response time (minutes +/- SEM) to the scene was 5.6 +/- 0.27. On-scene time was 13.9 +/- 0.62. The time to return to the hospital was 8.0 +/- 0.4. On-scene time included assessing hazards at the scene, patient extrication, spine immobilization (n = 98), application of oxygen (n = 94), measurement of vital signs (n = 114), splinting of 59 limbs, and the following ATLS procedures: endotracheal intubation (n = 31), IV access (n = 106), ECG monitoring (n = 69), procurement of blood for tests including type and cross (n = 58), and application of a pneumatic antishock garment (PASG) (n = 31). On-scene times were analyzed according to the number of ATLS procedures performed: insertion of one IV line (n = 46), 14.8 +/- 1.03 minutes; two IV lines (n = 28), 13.4 +/- 0.92; one IV line plus intubation (n = 7), 14.0 +/- 2.94; two IV lines plus intubation (n = 9), 17.0 +/- 2.38; and two IV lines plus intubation plus PASG (n = 13), 12.4 +/- 1.36. Of the 161 IV attempts, 94% were completed successfully. Of 36 attempts at endotracheal intubation, 89% were successful.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3826807

  10. Rapid Risk Evaluation (ER2) Using MS Excel Spreadsheet: a Case Study of Fredericton (new Brunswick, Canada)

    NASA Astrophysics Data System (ADS)

    McGrath, H.; Stefanakis, E.; Nastev, M.

    2016-06-01

    Conventional knowledge of the flood hazard alone (extent and frequency) is not sufficient for informed decision-making. The public safety community needs tools and guidance to adequately undertake flood hazard risk assessment in order to estimate respective damages and social and economic losses. While many complex computer models have been developed for flood risk assessment, they require highly trained personnel to prepare the necessary input (hazard, inventory of the built environment, and vulnerabilities) and analyze model outputs. As such, tools which utilize open-source software or are built within popular desktop software programs are appealing alternatives. The recently developed Rapid Risk Evaluation (ER2) application runs scenario based loss assessment analyses in a Microsoft Excel spreadsheet. User input is limited to a handful of intuitive drop-down menus utilized to describe the building type, age, occupancy and the expected water level. In anticipation of local depth damage curves and other needed vulnerability parameters, those from the U.S. FEMA's Hazus-Flood software have been imported and temporarily accessed in conjunction with user input to display exposure and estimated economic losses related to the structure and the content of the building. Building types and occupancies representative of those most exposed to flooding in Fredericton (New Brunswick) were introduced and test flood scenarios were run. The algorithm was successfully validated against results from the Hazus-Flood model for the same building types and flood depths.

  11. Bioprospecting from Marine Sediments of New Brunswick, Canada: Exploring the Relationship between Total Bacterial Diversity and Actinobacteria Diversity

    PubMed Central

    Duncan, Katherine; Haltli, Bradley; Gill, Krista A.; Kerr, Russell G.

    2014-01-01

    Actinomycetes are an important resource for the discovery of natural products with therapeutic properties. Bioprospecting for actinomycetes typically proceeds without a priori knowledge of the bacterial diversity present in sampled habitats. In this study, we endeavored to determine if overall bacterial diversity in marine sediments, as determined by 16S rDNA amplicon pyrosequencing, could be correlated with culturable actinomycete diversity, and thus serve as a powerful tool in guiding future bioprospecting efforts. Overall bacterial diversity was investigated in eight marine sediments from four sites in New Brunswick, Canada, resulting in over 44,000 high quality sequences (x = 5610 per sample). Analysis revealed all sites exhibited significant diversity (H’ = 5.4 to 6.7). Furthermore, statistical analysis of species level bacterial communities (D = 0.03) indicated community composition varied according to site and was strongly influenced by sediment physiochemical composition. In contrast, cultured actinomycetes (n = 466, 98.3% Streptomyces) were ubiquitously distributed among all sites and distribution was not influenced by sediment composition, suggesting that the biogeography of culturable actinomycetes does not correlate with overall bacterial diversity in the samples examined. These actinomycetes provide a resource for future secondary metabolite discovery, as exemplified by the antimicrobial activity observed from preliminary investigation. PMID:24531187

  12. Multiple modes of water quality impairment by fecal contamination in a rapidly developing coastal area: southwest Brunswick County, North Carolina.

    PubMed

    Cahoon, Lawrence B; Hales, Jason C; Carey, Erin S; Loucaides, Socratis; Rowland, Kevin R; Toothman, Byron R

    2016-02-01

    Fecal contamination of surface waters is a significant problem, particularly in rapidly developing coastal watersheds. Data from a water quality monitoring program in southwest Brunswick County, North Carolina, gathered in support of a regional wastewater and stormwater management program were used to examine likely modes and sources of fecal contamination. Sampling was conducted at 42 locations at 3-4-week intervals between 1996 and 2003, including streams, ponds, and estuarine waters in a variety of land use settings. Expected fecal sources included human wastewater systems (on-site and central), stormwater runoff, and direct deposition by animals. Fecal coliform levels were positively associated with rainfall measures, but frequent high fecal coliform concentrations at times of no rain indicated other modes of contamination as well. Fecal coliform levels were also positively associated with silicate levels, a groundwater source signal, indicating that flux of fecal-contaminated groundwater was a mode of contamination, potentially elevating FC levels in impacted waters independent of stormwater runoff. Fecal contamination by failing septic or sewer systems at many locations was significant and in addition to effects of stormwater runoff. Rainfall was also linked to fecal contamination by central sewage treatment system failures. These results highlight the importance of considering multiple modes of water pollution and different ways in which human activities cause water quality degradation. Management of water quality in coastal regions must therefore recognize diverse drivers of fecal contamination to surface waters. PMID:26769702

  13. High-angle reverse faulting in northern New Brunswick, Canada, and its implications for fluid pressure levels

    NASA Astrophysics Data System (ADS)

    Sibson, Richard H.

    The 1982 Miramichi earthquake sequence in northern New Brunswick included four shocks in the magnitude range, 5.7 > m, > 5.0, and extensive aftershock activity. Rupturing occurred within granitic terrain on a pair of NNE—SSW-striking, opposite-facing, high-angle reverse faults which converge at the mainshock focal depth of ≈7 km. It seems probable that the earthquake sequence involved the reactivation under horizontal compression of an existing set of steep normal faults, perhaps derived from Mesozoic rifting of the Atlantic continental margin. The symmetry of the V-shaped profile of faults in WNW—ESE section suggests that the maximum principal compressive stress (σ 1) during reactivation was subhorizontal and the least principal stress (σ 3) was subvertical, so that the reactivation angle between σ 1 and the faults corresponded to the 50-65° dip of the faults. Stress analysis of the conditions for frictional reactivation of existing cohesionless faults shows that pore-fluid pressures approaching or exceeding lithostatic values are required for reshear at such high reactivation angles, with the implication that the earthquake sequence was triggered by locally elevated fluid pressure. While the source and composition of the inferred high pressure fluids are uncertain, a mixed H 2O—CO 2 fluid of mantle origin seems most likely.

  14. Comparison of clast and matrix dispersal in till: Charlo-Atholville area, north-central New Brunswick

    USGS Publications Warehouse

    Dickson, M.L.; Broster, B.E.; Parkhill, M.A.

    2004-01-01

    Striations and dispersal patterns for till clasts and matrix geochemistry are used to define flow directions of glacial transport across an area of about 800km2 in the Charlo-Atholville area of north-central New Brunswick. A total of 170 clast samples and 328 till matrix samples collected for geochemical analysis across the region, were analyzed for a total of 39 elements. Major lithologic contacts used here to delineate till clast provenance were based on recent bedrock mapping. Eleven known mineral occurrences and a gossan are used to define point source targets for matrix geochemical dispersal trains and to estimate probable distance and direction of transport from unknown sources. Clast trains are traceable for distances of approximately 10 km, whereas till geochemical dispersal patterns are commonly lost within 5 km of transport. Most dispersal patterns reflect more than a single direction of glacial transport. These data indicate that a single till sheet, 1-4 m thick, was deposited as the dominant ice-flow direction fluctuated between southeastward, eastward, and northward over the study area. Directions of early flow represent changes in ice sheet dominance, first from the northwest and then from the west. Locally, eastward and northward flow represent the maximum erosive phases. The last directions of flow are likely due to late glacial ice sheet drawdown towards the valley outlet at Baie des Chaleurs.

  15. Health-hazard evaluation report No. HETA 87-402-2145, LCP Chemicals and Plastics, Inc. , Brunswick, Georgia

    SciTech Connect

    Reh, C.M.; Deitchman, S.D.; Moss, C.E.

    1991-10-01

    In response to a request from the International Chemical Workers Union Local 716, an evaluation was made of possible worker exposure to mercury (7439976), chlorine (7782505) and hydrochloric-acid (7647010) at LCP Chemicals and Plastics, Inc. (SIC-2812, SIC-2819), Brunswick, Georgia. This was a chlor-alkali facility which employed about 124 production workers. The main products were chlorine gas, sodium-hydroxide, and sodium-hypochlorite. Air sampling at the site revealed concentrations of hydrochloric-acid and chlorine which were above the recommended limits. All samples analyzed for mercury had concentrations above the recommended limits of 50 micrograms/cubic meter (microg/cu m). Six of 29 personal samples for mercury had concentrations above the 50microg/cu m limit with the average mercury exposure concentration for all 29 cell room workers participating in the survey being 31.7microg/cu m. Exposure to magnetic fields was below the recommended ceiling limits. The authors conclude that a health hazard existed from exposure to mercury and chlorine in the cell rooms. A health hazard existed in the acid burners area from hydrochloric-acid. The authors recommend measures to lower the exposure of workers to mercury, chlorine, and hydrochloric-acid.

  16. Trends in trauma: a rural experience.

    PubMed

    Gupta, Gaurav C; Golhar, K B; Mehta, V K; Swapnil, D

    2014-08-01

    In last 20 years a progressive increase in the cases of road traffic accidents is seen in the institution. In this study efforts have been made to study epidemiology of trauma & how to help the trauma victims in a better way. To study the changing trends in incidence & presentation of trauma victims. To recommend preventive measures based on the analysis. The present study was carried out in MGIMS, Sewagram, Wardha from 2001 to 2003. For this study which is retrospective and prospective, a total of 986 cases of surgical trauma were studied. Present study showed that in this rural area accidents account for maximum trauma admissions & major trauma only in 20 %. Out of 986 patients, 78.8 % required repair of wounds, 3.8 % required exploratory laparotomy and 16.3 % had orthopedic interventions. Overall mortality rate was 2.9 %. It was found that general care in wards was good in terms of trauma results of rural areas. These results may vary when compared with specialized trauma centers in cities; however after a period of few years cost effectiveness of trauma centers in terms of benefits needs an assessment*. PMID:25278648

  17. Advanced technologies in trauma critical care management.

    PubMed

    Cannon, Jeremy W; Chung, Kevin K; King, David R

    2012-08-01

    Care of critically injured patients has evolved over the 50 years since Shoemaker established one of the first trauma units at Cook County Hospital in 1962. Modern trauma intensive care units offer a high nurse-to-patient ratio, physicians and midlevel providers who manage the patients, and technologically advanced monitors and therapeutic devices designed to optimize the care of patients. This article describes advances that have transformed trauma critical care, including bedside ultrasonography, novel patient monitoring techniques, extracorporeal support, and negative pressure dressings. It also discusses how to evaluate the safety and efficacy of future advances in trauma critical care. PMID:22850154

  18. Childhood traumas: an outline and overview.

    PubMed

    Terr, L C

    1991-01-01

    Childhood psychic trauma appears to be a crucial etiological factor in the development of a number of serious disorders both in childhood and in adulthood. Like childhood rheumatic fever, psychic trauma sets a number of different problems into motion, any of which may lead to a definable mental condition. The author suggests four characteristics related to childhood trauma that appear to last for long periods of life, no matter what diagnosis the patient eventually receives. These are visualized or otherwise repeatedly perceived memories of the traumatic event, repetitive behaviors, trauma-specific fears, and changed attitudes about people, life, and the future. She divides childhood trauma into two basic types and defines the findings that can be used to characterize each of these types. Type I trauma includes full, detailed memories, "omens," and misperceptions. Type II trauma includes denial and numbing, self-hypnosis and dissociation, and rage. Crossover conditions often occur after sudden, shocking deaths or accidents that leave children handicapped. In these instances, characteristics of both type I and type II childhood traumas exist side by side. There may be considerable sadness. Each finding of childhood trauma discussed by the author is illustrated with one or two case examples. PMID:1824611

  19. Trauma therapy for death row families.

    PubMed

    Long, Walter C

    2011-01-01

    The family members of death row inmates undergo unique suffering that includes disenfranchised grief and intense psychological trauma. In Texas, where executions occur at a rate of 1 every 2 weeks, this class of trauma victims presumably is large, a fact that should generate public mental health concern. Yet the class remains virtually unknown to the therapeutic community. Very little has been done to address the trauma healing needs of death row families. This theoretical paper proposes that structural therapy designed to reengage attachment relationships and reempower family members' innate resources to emotionally regulate one another may provide one of the most effective means of helping this population survive trauma. PMID:21967176

  20. Trauma Exposure and Posttraumatic Symptoms in Hawaii

    PubMed Central

    Klest, Bridget; Freyd, Jennifer J.; Foynes, Melissa Ming

    2013-01-01

    Eight-hundred thirty-three members of an ethnically diverse longitudinal cohort study in Hawaii were surveyed about their personal exposure to several types of traumatic events, socioeconomic resources, and mental health symptoms. Results replicated findings from prior research that while men and women are exposed to similar rates of trauma overall, women report more exposure to traumas high in betrayal (HB), while men report exposure to more traumas lower in betrayal (LB). Trauma exposure was predictive of mental health symptoms, with neglect, household dysfunction, and HB traumas predicting symptoms of depression, anxiety, PTSD, dissociation, and sleep disturbance, and LB traumas predicting PTSD and dissociation symptoms. Native Hawaiian ethnicity and poorer socioeconomic status were predictive of greater trauma exposure and symptoms. Results suggest that more inclusive definitions of trauma are important for gender equity, and that ethnic group variation in symptoms is better explained by factors such as differential trauma exposure and economic and social status differences, rather than minority status per se. PMID:24660048

  1. Expanding Trauma through Space and Time: Mapping the Rhetorical Strategies of Trauma Carrier Groups

    ERIC Educational Resources Information Center

    Degloma, Thomas

    2009-01-01

    In this article, I detail two rhetorical strategies that trauma carrier groups--including social movement organizations, professional mental health associations, and patient advocacy groups--use to expand the relevance of trauma and Post-Traumatic Stress Disorder (PTSD) through space and time: the social transmission of trauma and the social…

  2. The trauma of a recession.

    PubMed

    Murphy, S M; Kieran, I; Shaughnessy, M O

    2011-09-01

    Employment in construction in Ireland fell by 10% from nearly 282,000 in the second quarter of 2007 to 255,000 in the same period of 2008. Our study looks at the differences in soft tissue upper limb trauma dynamics of a pre- and post-recession Ireland. Construction accounted for 330 patients (27%) of all hand injuries in 2006, but only 18 (3%) in 2009. Our data shows a significant drop in hand injuries related to the construction industry, and more home/DIY cases and deliberate self-harm presenting in their stead. PMID:21431394

  3. Interactive work place trauma (IWPT).

    PubMed

    Shewchuk, Muriel

    2005-06-01

    Tragically, horizontal violence and bullying behaviour being master minded by nursing colleagues is firmly entrenched in many perioperative environments--just like a serious pathological bacteria. Interactive Workplace Trauma (IWPT) is ugly, mean, destructive, demoralizing and counterproductive to efficient, effective patient care and positive staff performance. Get educated and use astute observations to ensure you clearly understand what is occurring. Make sure the staff feel safe and have the appropriate, necessary protection to deal with unacceptable conduct. Deal effectively with the bullies. Remember if it is not documented, it didn't happen! PMID:16092572

  4. Blunt abdominal trauma in children.

    PubMed

    Tepas, J J

    1993-06-01

    The growing popularity of nonoperative treatment of children with splenic injuries has seduced some physicians into a false sense of security regarding care of the injured child. Although it has been established that hemodynamically stable children with splenic, hepatic, and even renal injuries can safely be treated "expectantly," this concept cannot be applied indiscriminately. Accurate diagnosis and effective care of the child with blunt abdominal trauma is an exercise of clinical precision that demands attention to detail and thorough evaluation. This review addresses this process in light of recent advances in diagnostic imaging and in consideration of recent reports analyzing different protocols for therapeutic decision making. PMID:8374651

  5. Taser-Related Testicular Trauma.

    PubMed

    Theisen, Katherine; Slater, Rick; Hale, Nathan

    2016-02-01

    The Thomas A. Swift's Electric Rifle (Taser) is an electrical weapon designed as a nonlethal means to subdue violent or fleeing subjects. Several reports have been published on the safety and efficacy of, as well as injury profile from, police Tasers. Documented urologic involvement is rare. The sequela of an electrical current from a Taser gun to the testis in regard to both short- and long-term functions is unknown. Herein we present a case of penetrating trauma to the scrotum from a Taser dart. PMID:26592466

  6. Trauma, soul murder, and change.

    PubMed

    Shengold, Leonard

    2011-01-01

    The author discusses trauma, particularly in relation to childhood events, as well as one of its possible sequelae, soul murder (Shengold 1989, 1999). Negative interactions with parental figures can have long-term implications for the developing child, sometimes persisting into adulthood, and yet even the most loving parents cannot always behave toward the child in an optimal manner. The profound effect of change on the human psyche is also discussed, and two clinical vignettes are presented to illustrate the author's points. PMID:21388002

  7. Experimental Trauma Models: An Update

    PubMed Central

    Frink, Michael; Andruszkow, Hagen; Zeckey, Christian; Krettek, Christian; Hildebrand, Frank

    2011-01-01

    Treatment of polytrauma patients remains a medical as well as socioeconomic challenge. Although diagnostics and therapy improved during the last decades, multiple injuries are still the major cause of fatalities in patients below 45 years of age. Organ dysfunction and organ failure are major complications in patients with major injuries and contribute to mortality during the clinical course. Profound understanding of the systemic pathophysiological response is crucial for innovative therapeutic approaches. Therefore, experimental studies in various animal models are necessary. This review is aimed at providing detailed information of common trauma models in small as well as in large animals. PMID:21331361

  8. Trauma and Violence in Autism.

    PubMed

    Westphal, Alexander

    2016-06-01

    Comorbidities of autism spectrum disorder are discussed as an introduction to the argument that, although ASD may modify presentation, it does not confer any protection against other disorder, including the negative effects of trauma (e.g., posttraumatic stress disorder). Dr. Im's hypotheses are discussed, and a case example of childhood disintegrative disorder (CDD) is raised to give clinical support to his hypotheses. CDD is a rare form of ASD that is defined by late onset, a traumatic prodrome, onset of behaviors including some with similarities to PTSD, and aggression. PMID:27236175

  9. Heterotopic Ossification in Orthopaedic Trauma

    PubMed Central

    Nauth, Aaron; Giles, Erica; Potter, Benjamin K.; Nesti, Leon J.; O’Brien, Frederick P.; Bosse, Michael J.; Anglen, Jeffrey O.; Mehta, Samir; Ahn, Jaimo; Miclau, Theodore; Schemitsch, Emil H.

    2012-01-01

    Heterotopic ossification (HO) can be defined as the pathological formation of bone in extra-skeletal tissues. There has been a substantial amount of recent research on the pathophysiology, prophylaxis and treatment of HO and traumatic conditions associated with the development of HO. This research has advanced our understanding of this disease and helped to clarify evidence-based approaches to both the prophylaxis and treatment of HO. This article reviews the literature on these topics with a focus on their application in orthopaedic trauma. PMID:23010648

  10. A Challenging Penetrating Trauma Case.

    PubMed

    Snoek, Seetal; Butson, Benjamin; Wittenberg, Mark

    2016-01-01

    We present the prehospital management of a 23-year-old Australian Aboriginal man with an isolated knife stab wound to the posterior right chest. The lead author attended to the prehospital management of this young man during tenure as a registrar in retrieval medicine for CareFlight Medical Services (CMS) in North Queensland, Australia. The case is noteworthy because it involved a combination of a life-threatening injury with a superimposed iatrogenic injury. The case will be of interest to physicians and clinicians in prehospital medicine as well as those in low-volume emergency departments or facilities in which major trauma may present infrequently. PMID:27021676

  11. Vicarious Trauma Among Sexual Assault Nurse Examiners.

    PubMed

    Raunick, Cara Berg; Lindell, Deborah F; Morris, Diana Lynn; Backman, Theresa

    2015-01-01

    Vicarious trauma (VT), the phenomenon of changes in cognition and worldview that result from empathic response and repeated exposure to narratives of trauma, is a risk for helping professionals. This descriptive, correlational study sought to examine levels of VT among sexual assault nurse examiners (SANEs) as compared with other women's health nurses. It also explored whether levels of VT are different for nurses who have experienced primary trauma alone, VT alone, or both personal trauma and VT. VT was assessed through an anonymous online survey using the nurses' total scores on the Trauma and Attachment Belief Scale. Trauma and Attachment Belief Scale scores were significantly higher for SANEs (M = 178.5, SD = 42.6) than for women's health nurses (M = 168.1, SD = 41.4; p = 0.025), indicating higher levels of trauma-related cognitive disruption in the SANE group. Scores were also significantly higher for both groups with personal trauma histories at the p < 0.05 level compared with the women's health nurses with no personal history. SANEs who had no personal history of trauma did not differ significantly from either group of nurses who did, suggesting that VT from working as an SANE is associated with levels of cognitive disruption similar to oneself having experienced trauma. Nurses should be aware of this phenomenon and its sequelae when choosing to pursue the specialty of sexual assault nursing. Hospitals and other organizations employing SANEs should also be aware of VT and provide a support system with resources in place to mitigate these effects. Future research should further explore effects of primary trauma versus VT, clinical manifestations and significance of varying levels of VT, and interventions and strategies for dealing with VT. PMID:26226351

  12. [Trauma scores: reproducibility and reliability].

    PubMed

    Waydhas, C; Nast-Kolb, D; Trupka, A; Kerim-Sade, C; Kanz, G; Zoller, J; Schweiberer, L

    1992-02-01

    The inter-rater reliability of the Injury Severity Score (ISS) and the Polytraumaschlüssel (PTS) [multiple trauma code] was studied using diagnosis sheets filled in for 107 multiple injured patients. The scoring was performed by eight physicians with different levels of qualification. The scores for individual patients varied widely depending on the scorer, with extremes differing from the mean by about 80% and 70% for the ISS and PTS, respectively. The mean ISS and PTS for the whole study population also varied significantly between the scorers (P less than 0.0001, one-way analysis of variance). Raters with experience in trauma scoring calculated significantly higher scores (P less than 0.01, t-test) Neither the ISS nor the PTS seem reliable enough to describe injury severity in an individual patient. Treatment decisions must not be based on such grounds. Even for larger groups, caution must be exercised in comparison of different populations of multiple traumatized patients. PMID:1570531

  13. Management of temporal bone trauma.

    PubMed

    Patel, Alpen; Groppo, Eli

    2010-06-01

    The temporal bones are paired structures located on the lateral aspects of the skull and contribute to the skull base. Trauma is usually the result of blunt head injury and can result in damage to the brain and meninges, the middle and internal ear, and the facial nerve. Complications can include intracranial hemorrhage, cerebral contusion, CSF leak and meningitis, hearing loss, vertigo, and facial paralysis. To prevent these complications, diagnosis followed by appropriate medical and surgical management is critical. Diagnosis relies primarily on physical signs and symptoms as well as radiographic imaging. Emergent intervention is required in situations involving herniation of the brain into the middle ear cavity or hemorrhage of the intratemporal carotid artery. Patients with declining facial nerve function are candidates for early surgical intervention. Conductive hearing loss can be corrected surgically as an elective procedure, while sensorineural hearing loss carries a poor prognosis, regardless of management approach. Children generally recover from temporal bone trauma with fewer complications than adults and experience a markedly lower incidence of facial nerve paralysis. PMID:22110824

  14. Imaging following acute knee trauma.

    PubMed

    Kijowski, R; Roemer, F; Englund, M; Tiderius, C J; Swärd, P; Frobell, R B

    2014-10-01

    Joint injury has been recognized as a potent risk factor for the onset of osteoarthritis. The vast majority of studies using imaging technology for longitudinal assessment of patients following joint injury have focused on the injured knee joint, specifically in patients with anterior cruciate ligament injury and meniscus tears where a high risk for rapid onset of post-traumatic osteoarthritis is well known. Although there are many imaging modalities under constant development, magnetic resonance (MR) imaging is the most important instrument for longitudinal monitoring after joint injury. MR imaging is sensitive for detecting early cartilage degeneration and can evaluate other joint structures including the menisci, bone marrow, tendons, and ligaments which can be sources of pain following acute injury. In this review, focusing on imaging following acute knee trauma, several studies were identified with promising short-term results of osseous and soft tissue changes after joint injury. However, studies connecting these promising short-term results to the development of osteoarthritis were limited which is likely due to the long follow-up periods needed to document the radiographic and clinical onset of the disease. Thus, it is recommended that additional high quality longitudinal studies with extended follow-up periods be performed to further investigate the long-term consequences of the early osseous and soft tissue changes identified on MR imaging after acute knee trauma. PMID:25278054

  15. Imaging patients with cardiac trauma.

    PubMed

    Restrepo, Carlos S; Gutierrez, Fernando R; Marmol-Velez, Juan A; Ocazionez, Daniel; Martinez-Jimenez, Santiago

    2012-01-01

    In the United States, trauma is the leading cause of death among those who are 1-44 years old, with cardiovascular injuries representing the second most common cause of traumatic death after central nervous system injuries. Evaluation of trauma patients with suspected cardiac injury may be complex and include electrocardiography, measurement of cardiac biomarkers, and imaging examinations. Contrast material-enhanced computed tomography (CT) has become one of the most valuable imaging tools available for evaluating hemodynamically stable patients with suspected cardiac injury. The presence of hemopericardium, with or without cardiac tamponade, is one of the most significant findings of cardiac injury. Other complications that result from blunt cardiac injury, such as pericardial rupture and cardiac herniation, may be readily depicted at multidetector CT. Assessment of patients with cardiac injuries, particularly those with penetrating injuries, is a challenging and time-critical matter, with clinical and imaging findings having complementary roles in the formation of an accurate diagnosis. Patients who are hemodynamically stable, particularly those with penetrating cardiac injuries, also may benefit from a timely imaging examination. In addition to chest radiography, other available modalities such as transthoracic and transesophageal echocardiography, nuclear medicine, and magnetic resonance imaging may play a role in selected cases. PMID:22582351

  16. [Update: blast and explosion trauma].

    PubMed

    van de Weyer, P S; Praetorius, M; Tisch, M

    2011-08-01

    In recent decades, acoustic shock and explosion traumas have increased in frequency in the general population. Beside the use of fireworks and firearms, airbag ignitions and explosions caused by terror or suicidal acts are also relevant. Depending on duration and strength of the sound pressure affecting the human ear, isolated inner ear damage or additional ear drum perforation and interruption of the middle ear ossicle chain can result. By means of otoscopy, pure tone audiometry, measurement of otoacoustic emissions, and other neurootological examinations, the severity of the trauma can be determined. With prompt and adequate therapy, permanent hearing loss can be minimized. In particular, the measurement of otoacoustic emissions allows conclusions to be made on the functionality of the outer hair cells which are damaged first in most cases. Histological investigations on noise-exposed cochleas show extensive damage to the outer hair cells in the frequency range between 1.0 and 4.0 kHz, which correlates well with audiometric measurements. PMID:21769579

  17. Orbital emphysema following remote skull trauma.

    PubMed

    Brown, S M; Lissner, G

    1995-06-01

    In an unusual case of orbital emphysema following nose blowing, a reliable patient history and examination demonstrated no direct trauma to the orbit. Blunt posterior skull trauma was sustained several hours before the development of the orbital emphysema. A "seismic" transmittal of force to the orbital walls is postulated. PMID:7654620

  18. Imaging of orthopedic trauma and surgery

    SciTech Connect

    Berquist, T.H.

    1986-01-01

    This book discusses imaging of orthopedia trauma and surgery. A review of the pertinent anatomy, mechanism of injury, and radiology and orthopedic classification is provided for each topic discussed. The book employs recent advances in technique and focuses on adult skeletal trauma, and joint replacement.

  19. Trauma-Informed Forensic Child Maltreatment Investigations

    ERIC Educational Resources Information Center

    Pence, Donna M.

    2011-01-01

    Trauma-informed child welfare systems (CWSs) are the focus of several recent national and state initiatives. Since 2005 social work publications have focused on systemic and practice changes within CW which seek to identify and reduce trauma to children and families experiencing child maltreatment or other distressing events, as well as to the…

  20. Healing Trauma, Building Resilience: SITCAP in Action

    ERIC Educational Resources Information Center

    Steele, William; Kuban, Caelan

    2014-01-01

    Childhood trauma is marked by an overwhelming sense of terror and powerlessness. Loss of loving relationships is yet another type of trauma that produces the pain of sadness and grief. The resulting symptoms only reflect the neurological, biological, and emotional coping systems mobilized in the struggle to survive. These young people need new…

  1. Trauma among Street-Involved Youth

    ERIC Educational Resources Information Center

    Bender, Kimberly A.; Thompson, Sanna J.; Ferguson, Kristin M.; Yoder, Jamie R.; Kern, Leah

    2014-01-01

    Previous research documents that street-involved youth experience rates of trauma and posttraumatic stress disorder (PTSD) that are significantly higher than their housed counterparts. Trauma and PTSD are of particular concern for homeless youth as they can negatively affect youths' ability to function adaptively and to transition off the…

  2. Dental and General Trauma in Team Handball.

    PubMed

    Petrović, Mateja; Kühl, Sebastian; Šlaj, Martina; Connert, Thomas; Filippi, Andreas

    2016-01-01

    Handball has developed into a much faster and high-impact sport over the past few years because of rule changes. Fast sports with close body contact are especially prone to orofacial trauma. Handball belongs to a category of sports with medium risk for dental trauma. Even so, there is only little literature on this subject. The aim of this study was to examine the prevalence and the type of injuries, especially the occurrence of orofacial trauma, habits of wearing mouthguards, as well as degree of familiarity with the tooth rescue box. For this purpose, 77.1% (n=542/703) of all top athletes and coaches from the two highest Swiss leagues (National League A and National League B), namely 507 professional players and 35 coaches, were personally interviewed using a standardized questionnaire. 19.7% (n=100/507) of the players experienced dental trauma in their handball careers, with 40.8% (n=51/125) crown fractures being the most frequent by far. In spite of the relatively high risk of lip or dental trauma, only 5.7% (n=29/507) of the players wear mouthguards. The results of this study show that dental trauma is common among Swiss handball players. In spite of the high risk of dental trauma, the mouthguard as prevention is not adequately known, and correct procedure following dental trauma is rarely known at all. PMID:27622524

  3. Tips for Teachers during Times of Trauma.

    ERIC Educational Resources Information Center

    Adkins, Myrna Ann; Harper, Eric

    This guide for teachers in times of trauma was updated after the events of September 11, 2001--the terrorist attacks on the World Trade Center and the Pentagon. These traumatic events could cause refugees to experience trauma or become re-traumatized. For many refugees, their English-as-a-Second-Language (ESL) programs are the places where they…

  4. Impact of Trauma on Attenuated Psychotic Symptoms

    PubMed Central

    Falukozi, Erin; Addington, Jean

    2012-01-01

    Evidence that trauma may play a role in the development of a psychotic illness has lead researchers to investigate the relationship between trauma and the content of attenuated psychotic symptoms. Participants in this study were considered to be at clinical high risk for developing psychosis by meeting criteria for attenuated positive symptom syndrome based on the Structured Interview for Prodromal Syndromes. Trained raters used a specifically designed codebook to identify content in the vignettes of 45 participants. Various types of trauma that had occurred before age 16 were assessed, where participants who endorsed more types of trauma were considered to have experienced a greater amount of trauma. Spearman rank correlations revealed significant positive relationships between increased trauma and feeling watched or followed (rho=0.38, p<0.05) and false beliefs of status or power (rho=0.31, p<0.04). Significant negative relationships were observed between increased trauma and hearing nonnegative voices (rho=−0.39, p<0.01) as well as having unusual negative thoughts surrounding the self (rho=−0.31, p<0.05). Although this was a small sample, these findings support the possibility of a meaningful relationship between experiences of trauma and the content of attenuated positive symptoms. PMID:23155365

  5. The Biology of Trauma: Implications for Treatment

    ERIC Educational Resources Information Center

    Solomon, Eldra P.; Heide, Kathleen M.

    2005-01-01

    During the past 20 years, the development of brain imaging techniques and new biochemical approaches has led to increased understanding of the biological effects of psychological trauma. New hypotheses have been generated about brain development and the roots of antisocial behavior. We now understand that psychological trauma disrupts homeostasis…

  6. The Wounded Self in Trauma Treatment.

    PubMed

    Kluft, Richard P

    2016-07-01

    The potential role of hypnosis in the treatment of trauma is both venerable and underappreciated. This article underscores the importance of the wounded-self concept by proposing a Kohutian perspective complimentary to the cognitively-driven model of Alladin (2014a, 2014b) discussed elsewhere in this issue. It explores selected topics that demonstrate (1) the importance of considering the wounds to the sense of self experienced by trauma victims and their implications for individualization of treatment in planning a psychotherapy; (2) the possibility of enhancing access to memories using shame alleviating techniques with minimal suggestive properties; (3) the use of hypnosis to facilitate less disruptive processing of traumatic materials; and (4) the importance of hypnosis in enhancing the safety of the trauma patient between sessions. Absent contraindications, the circumspect use of hypnosis as a facilitator of trauma treatment deserves consideration for inclusion in the mainstream of contemporary trauma treatment. PMID:27196011

  7. Acritarchs in Cambrian and Lower Ordovician Rocks of Nova Scotia and New Brunswick, Canada: New Constraints on Correlations and Paleogeography

    NASA Astrophysics Data System (ADS)

    Palacios, T.; Jensen, S.; Barr, S. M.; White, C. E.; Miller, R. F.

    2009-05-01

    Most of 200 samples collected from Avalonian Cambrian and Lower Ordovician sequences in Nova Scotia and New Brunswick, as well as age-equivalent units in the Meguma terrane of southern Nova Scotia, have yielded acritarchs. Preliminary results show that they include taxa not reported previously from western Avalonia (Newfoundland), and indicate revised stratigraphical ranges for several taxa, thus increasing potential for stratigraphic comparisons and regional and global correlations, in particular to Baltica and northern Gondwana. Well-preserved material was obtained from the upper part of the MacLean Brook Formation (early Furongian) in the Mira River area of southeastern Cape Breton Island, including Petaloferidium lacrimiferum, Stelliferidium albanii and S. magnum and the first record in western Avalonia of Pirea orbicularis, a species which permits precise correlation to Baltica and northern Gondwana. Acritarchs from the MacNeil Formation in the Mira River area include Cristallinium randomense and Stelliferidium cortinulum. These findings suggest that any stratigraphic gap between the MacLean Brook Formation and the overlying MacNeil Formation is smaller than previously interpreted. In New Brunswick, the classic Lower to Middle Cambrian Hanford Brook section yielded acritarchs throughout the sequence. The upper half of the Ratcliffe Brook Formation (Early Cambrian) contains Archaeodiscina umbonulata and abundant Skiagia ornata, S. orbiculare and S. scottica. This assemblage of acritarchs has a global first appearance generally thought to be close in time to the rise of trilobites, potentially in conflict with the established view that all of the Ratcliffe Brook Formation is pre-trilobitic. The upper part of the Hanford Brook Formation yielded well- preserved material of Comasphaeridium silesiense, Heliosphaeridium notatum, Eliasum llaniscum and Liepania plana, taxa with a first appearance close to the base of the Middle Cambrian. Further studies of the Hanford

  8. Grand Junction/New Brunswick Laboratory interlaboratory measurement program. Part I. Evaluation. Part II. Methods manual. [National Uranium Resources Evaluation (NURE)

    SciTech Connect

    Trahey, N.M.; Voeks, A.M.; Soriano, M.D.

    1982-09-01

    This interlaboratory measurement program was conducted to provide a reference data base for comparison of measurements performed using various measurement methods under the National Uranium Resources Evaluation (NURE) Program. The design of the program also included an evaluation of the accuracies of the measurement methods used by the participating laboratories in measuring New Brunswick Laboratory Reference Materials (RMs) 101-A through 110-A, the low level uranium and thorium samples distributed in the program. Finally, consensus values for these RMs, based on participants measurement data, were calculated.

  9. Further contributions to the Aleocharinae (Coleoptera, Staphylinidae) fauna of New Brunswick and Canada including descriptions of 27 new species

    PubMed Central

    Webster, Reginald P.; Klimaszewski, Jan; Bourdon, Caroline; Sweeney, Jon D.; Hughes, Cory C.; Labrecque, Myriam

    2016-01-01

    Abstract This paper treats the discovery of new species and new records of aleocharine beetles for the province of New Brunswick. We report here 27 species new to science, one new North American record, six new Canadian records, and 29 new provincial records. The following are the new species: Acrotona brachyoptera Klimaszewski & Webster, sp. n., Acrotona sphagnorum Klimaszewski & Webster, sp. n., Atheta (Dimetrota) alphacrenuliventris Klimaszewski & Webster, sp. n., Atheta (Dimetrota) chartersensis Klimaszewski & Webster, sp. n., Atheta (Dimetrota) cranberriensis Klimaszewski & Webster, sp. n., Atheta (Dimetrota) bubo Klimaszewski & Webster, sp. n., Atheta (Dimetrota) mcalpinei Klimaszewski & Webster, sp. n., Atheta (Dimetrota) makepeacei Klimaszewski & Webster, sp. n., Atheta (Dimetrota) giguereae Klimaszewski & Webster, sp. n., Atheta (Dimetrota) petitcapensis Klimaszewski & Webster, sp. n., Atheta (sensu lato) pseudoschistoglossa Klimaszewski & Webster, sp. n., Atheta (sensu lato) sphagnicola Klimaszewski & Webster, sp. n., Atheta (sensu lato) thujae Klimaszewski & Webster, sp. n., Atheta (Pseudota) pseudoklagesi Klimaszewski & Webster, sp. n., Philhygra atypicalis Klimaszewski & Webster, sp. n., Schistoglossa (Schistoglossa) pelletieri Klimaszewski & Webster, sp. n., Thamiaraea corverae Klimaszewski & Webster, sp. n., Thamiaraea claydeni Klimaszewski & Webster, sp. n., Pleurotobia bourdonae Klimaszewski & Webster, sp. n., Pleurotobia brunswickensis Klimaszewski & Webster, sp. n., Agaricomorpha vincenti Klimaszewski & Webster, sp. n., Gyrophaena (Gyrophaena) aldersonae Klimaszewski & Webster, sp. n., Oligota polyporicola Klimaszewski & Webster, sp. n., Oligota sevogle Klimaszewski & Webster, sp. n., Hylota cryptica Klimaszewski & Webster, sp. n., Oxypoda sunpokeana Klimaszewski & Webster, sp. n., and Phloeopora gilbertae Klimaszewski & Webster, sp. n. The spermatheca of Dinaraea curtipenis Klimaszewski & Webster, Dinaraea longipenis Klimaszewski & Webster, and

  10. Petrogenetic evolution of Late Paleozoic rhyolites of the Harvey Group, southwestern New Brunswick (Canada) hosting uranium mineralization

    NASA Astrophysics Data System (ADS)

    Dostal, J.; van Hengstum, T. R.; Shellnutt, J. G.; Hanley, J. J.

    2016-06-01

    The 360 Ma subaerial felsic volcanic and volcaniclastic rocks of the Harvey Group form a belt about 15 km long and 3 km wide in southwestern New Brunswick (Canada) that has been correlated with parts of the Mount Pleasant caldera complex, the site of a significant polymetallic (tin, tungsten, molybdenum, indium and bismuth) deposit. The Harvey volcanic rocks are highly fractionated peraluminous within-plate F-rich rhyolites, which host uranium mineralization. The rocks were modified by late-magmatic and post-magmatic processes. A comparison of the composition of whole rocks and melt inclusions in the quartz phenocrysts shows that some trace elements, including U, were affected by the post-magmatic processes. Their flat REE patterns accompanied by distinct negative Eu anomalies are typical of highly evolved F-rich leucogranites and rhyolites. Nd isotopic ratios (ɛNd(360) = +0.6 to -1.0) are similar to those of the felsic rocks of the Mount Pleasant complex. The Harvey rhyolites were generated by extensive fractional crystallization of andesites of the Mount Pleasant caldera. The melt evolved at the apex of the magma chamber where volatile elements become concentrated. The Harvey rhyolite (with melt inclusions containing ~20 ppm U) had the potential to develop a significant U mineralization. The erupted glassy rhyolite is a favorable U source rock amendable to leaching by post-magmatic hydrothermal and meteoric water. The high Th/U ratios in the Harvey volcanic rocks compared to the low ratios in the U-rich melt inclusions is indicative of such a process.

  11. The effect of ion-exchange purification on the determination of plutonium at the New Brunswick Laboratory

    SciTech Connect

    Mitchell, W.G.; Spaletto, M.I.; Lewis, K.; Soriano, M.D.; Smith, M.W.

    1990-07-01

    The method of plutonium (Pu) determination at the Brunswick Laboratory (NBL) consists of a combination of ion-exchange purification followed by controlled-potential coulometric analysis (IE/CPC). The present report's purpose is to quantify any detectable Pu loss occurring in the ion-exchange (IE) purification step which would cause a negative bias in the NBL method for Pu analysis. The magnitude of any such loss would be contained within the reproducibility (0.05%) of the IE/CPC method which utilizes a state-of-the-art autocoulometer developed at NBL. When the NBL IE/CPC method is used for Pu analysis, any loss in ion-exchange purification (<0.05%) is confounded with the repeatability of the ion-exchange and the precision of the CPC analysis technique (<0.05%). Consequently, to detect a bias in the IE/CPC method due to the IE alone using the IE/CPC method itself requires that many randomized analyses on a single material be performed over time and that statistical analysis of the data be performed. The initial approach described in this report to quantify any IE loss was an independent method, Isotope Dilution Mass Spectrometry; however, the number of analyses performed was insufficient to assign a statistically significant value to the IE loss (<0.02% of 10 mg samples of Pu). The second method used for quantifying any IE loss of Pu was multiple ion exchanges of the same Pu aliquant; the small number of analyses possible per individual IE together with the column-to-column variability over multiple ion exchanges prevented statistical detection of any loss of <0.05%. 12 refs.

  12. Management of blunt hepatic trauma.

    PubMed

    Letoublon, C; Amariutei, A; Taton, N; Lacaze, L; Abba, J; Risse, O; Arvieux, C

    2016-08-01

    For the last 20 years, nonoperative management (NOM) of blunt hepatic trauma (BHT) has been the initial policy whenever this is possible (80% of cases), i.e., in all cases where the hemodynamic status does not demand emergency laparotomy. NOM relies upon the coexistence of three highly effective treatment modalities: radiology with contrast-enhanced computerized tomography (CT) and hepatic arterial embolization, intensive care surveillance, and finally delayed surgery (DS). DS is not a failure of NOM management but rather an integral part of the surgical strategy. When imposed by hemodynamic instability, the immediate surgical option has seen its effectiveness transformed by development of the concept of abbreviated (damage control) laparotomy and wide application of the method of perihepatic packing (PHP). The effectiveness of these two conservative and cautious strategies for initial management is evidenced by current experience, but the management of secondary events that may arise with the most severe grades of injury must be both rapid and effective. PMID:27519150

  13. Blunt pancreatic trauma: A persistent diagnostic conundrum?

    PubMed Central

    Kumar, Atin; Panda, Ananya; Gamanagatti, Shivanand

    2016-01-01

    Blunt pancreatic trauma is an uncommon injury but has high morbidity and mortality. In modern era of trauma care, pancreatic trauma remains a persistent challenge to radiologists and surgeons alike. Early detection of pancreatic trauma is essential to prevent subsequent complications. However early pancreatic injury is often subtle on computed tomography (CT) and can be missed unless specifically looked for. Signs of pancreatic injury on CT include laceration, transection, bulky pancreas, heterogeneous enhancement, peripancreatic fluid and signs of pancreatitis. Pan-creatic ductal injury is a vital decision-making parameter as ductal injury is an indication for laparotomy. While lacerations involving more than half of pancreatic parenchyma are suggestive of ductal injury on CT, ductal injuries can be directly assessed on magnetic resonance imaging (MRI) or encoscopic retrograde cholangio-pancreatography. Pancreatic trauma also shows temporal evolution with increase in extent of injury with time. Hence early CT scans may underestimate the extent of injures and sequential imaging with CT or MRI is important in pancreatic trauma. Sequential imaging is also needed for successful non-operative management of pancreatic injury. Accurate early detection on initial CT and adopting a multimodality and sequential imaging strategy can improve outcome in pancreatic trauma. PMID:26981225

  14. Addressing childhood trauma in a developmental context

    PubMed Central

    Gregorowski, Claire; Seedat, Soraya

    2013-01-01

    With the anticipated publication of the DSM-5 in May 2013, much reflection and work has been done on reviewing existing psychiatric nomenclature including, but not limited to the field of traumatic exposure. Traditionally, understanding of the psychiatric and psychological effects of trauma have been developed from studies with adults and then applied to trauma-exposed children with some modifications. While this is an important step to understanding the sequelae of trauma in children and adolescents, the adverse developmental effects of traumatic exposures on the rapidly evolving neurological, physical, social and psychological capacities of children calls for a developmentally sensitive framework for understanding, assessing and treating trauma-exposed children. The importance of early attachment relationships in infancy and childhood means that severely disrupted early caregiving relationships may have far-reaching and lifelong developmental consequences and can therefore be considered traumatic. Given the high rates of violence and trauma exposure of South African children and adolescents, the need for a developmentally based understanding of the effects of trauma on child and adolescent mental health becomes even more pronounced. In this paper, we draw on theoretical perspectives to provide a practical, clinically driven approach to the management of developmental trauma. PMID:25104963

  15. Abusive head trauma: past, present, and future.

    PubMed

    Narang, Sandeep; Clarke, Jennifer

    2014-12-01

    Abusive head trauma has a robust and interesting scientific history. Recently, the American Academy of Pediatrics has endorsed a change in terminology to a term that is more general in describing the vast array of abusive mechanisms that can result in pediatric head injury. Simply defined, abusive head trauma is "child physical abuse that results in injury to the head or brain." Abusive head trauma is a relatively common cause of childhood neurotrauma, with an estimated incidence of 16 to 33 cases per 100,000 children per year in the first 2 years of life. Clinical findings are variable; AHT should be considered in all children with neurologic signs and symptoms, especially if no or only mild trauma is described. Subdural and retinal hemorrhages are the most common findings. The current best evidence-based literature has identified some features--apnea and severe retinal hemorrhages--that reliably discriminate abusive from accidental injury. Longitudinal studies of outcomes in abusive head trauma patients demonstrate that approximately one-third of the children are severely disabled, one third of them are moderately disabled, and one third have no or only mild symptoms. Abusive head trauma cases are complex cases that require a rigorous, multidisciplinary team approach. The clinician can establish this diagnosis with confidence if he/she maintains a high index of suspicion for the diagnosis, has knowledge of the signs, symptoms, and risk factors of abusive head trauma, and reasonably excludes other etiologies on the differential diagnosis. PMID:25316728

  16. Blunt pancreatic trauma: A persistent diagnostic conundrum?

    PubMed

    Kumar, Atin; Panda, Ananya; Gamanagatti, Shivanand

    2016-02-28

    Blunt pancreatic trauma is an uncommon injury but has high morbidity and mortality. In modern era of trauma care, pancreatic trauma remains a persistent challenge to radiologists and surgeons alike. Early detection of pancreatic trauma is essential to prevent subsequent complications. However early pancreatic injury is often subtle on computed tomography (CT) and can be missed unless specifically looked for. Signs of pancreatic injury on CT include laceration, transection, bulky pancreas, heterogeneous enhancement, peripancreatic fluid and signs of pancreatitis. Pan-creatic ductal injury is a vital decision-making parameter as ductal injury is an indication for laparotomy. While lacerations involving more than half of pancreatic parenchyma are suggestive of ductal injury on CT, ductal injuries can be directly assessed on magnetic resonance imaging (MRI) or encoscopic retrograde cholangio-pancreatography. Pancreatic trauma also shows temporal evolution with increase in extent of injury with time. Hence early CT scans may underestimate the extent of injures and sequential imaging with CT or MRI is important in pancreatic trauma. Sequential imaging is also needed for successful non-operative management of pancreatic injury. Accurate early detection on initial CT and adopting a multimodality and sequential imaging strategy can improve outcome in pancreatic trauma. PMID:26981225

  17. Patterns of Errors Contributing to Trauma Mortality

    PubMed Central

    Gruen, Russell L.; Jurkovich, Gregory J.; McIntyre, Lisa K.; Foy, Hugh M.; Maier, Ronald V.

    2006-01-01

    Objective: To identify patterns of errors contributing to inpatient trauma deaths. Methods: All inpatient trauma deaths at a high-volume level I trauma center from 1996 to 2004 inclusive were audited. Data were collected with daily trauma registry chart abstraction, weekly morbidity and mortality reports, hospital quality assurance reports, and annual trauma registry analyses of risk of death using TRISS and HARM methodology. Deaths that met criteria for low to medium probability of mortality or those with quality of care concerns were analyzed for errors and then subjected to 3-stage peer review at weekly departmental, monthly hospital, and annual regional forums. Patterns of errors were constructed from the compiled longitudinal data. Results: In 9 years, there were 44,401 trauma patient admissions and 2594 deaths (5.8%), of which 601 met low to medium mortality risks. Sixty-four patients (0.14% admissions, 2.47% deaths) had recognized errors in care that contributed to their death. Important error patterns included: failure to successfully intubate, secure or protect an airway (16%), delayed operative or angiographic control of acute abdominal/pelvic hemorrhage (16%), delayed intervention for ongoing intrathoracic hemorrhage (9%), inadequate DVT or gastrointestinal prophylaxis (9%), lengthy initial operative procedures rather than damage control surgery in unstable patients (8%), over-resuscitation with fluids (5%), and complications of feeding tubes (5%). Resulting data-directed institutional and regional trauma system policy changes have demonstrably reduced the incidence of associated error-related deaths. Conclusions: Preventable deaths will occur even in mature trauma systems. This review has identified error patterns that are likely common in all trauma systems, and for which policy interventions can be effectively targeted. PMID:16926563

  18. Nd isotopic and trace element constraints on the source of Silurian-Devonian mafic lavas in the Chaleur Bay Synclinorium of New Brunswick (Canada): Tectonic implications

    NASA Astrophysics Data System (ADS)

    Dostal, Jaroslav; Keppie, J. Duncan; Wilson, Reginald A.

    2016-06-01

    Upper Silurian to Lower Devonian volcanic rocks of the Gander Zone, from the northern mainland Appalachians of northern New Brunswick, occur in the Chaleur Bay Synclinorium which forms the southeastern part of the Middle Paleozoic Matapedia cover sequence. These rocks, which are parts of shallow marine to subaerial sequences (Dalhousie, Dickie Cove and Tobique groups), were erupted in a continental rift environment between ca. 422 and 407 Ma. The volcanic rocks are mostly bimodal with mafic types corresponding predominantly to continental tholeiites inferred to be generated by partial melting of subcontinental lithospheric mantle (SCLM). The mafic rocks of all three groups have age-corrected ɛNd values ranging from + 3.4 to + 5.3, and depleted model mantle ages ranging from 0.65 to 0.95 Ma that are interpreted to represent mantle enrichment ages associated with ancient Neoproterozoic subduction. This Neoproterozoic SCLM shows no contributions from juvenile Silurian mantle, suggesting that rifting was of limited extent and did not result in the replacement of the old SCLM by upwelling juvenile asthenosphere beneath the rift. These Nd isotopic data do not support the generation of the volcanic rocks by slab break-off, which would have likely introduced a juvenile asthenospheric mantle source for some of the Silurian-Devonian basaltic rocks. The ranges in ɛNd values and depleted mantle ages in northern New Brunswick are similar to those recorded in penecontemporaneous mafic lavas in Avalonia suggesting that the Neoproterozoic SCLM was common to both Avalonia and Ganderia.

  19. Vascular Radiology in Trauma: A Review

    SciTech Connect

    Nicholson, Anthony A.

    2004-03-15

    It's been 30 years since an endovascular technique to control traumatic hemorrhage was first described. Despite major technical advances in both diagnostic and therapeutic technology, and a great deal of experience since then, endovascular techniques are rarely considered as part of frontline management for vascular trauma. This review considers the literature and calls for better planning and implementation of diagnostic and image=guided therapeutic facilities. Endovascular techniques should be an essential part of vascular trauma management along with endovascular specialists, partners in trauma teams.

  20. Primary Inadequate Management of Dental Trauma

    PubMed Central

    Agrafioti, Anastasia; Tsatsoulis, Ioannis N.; Papanakou-Tzanetaki, Styliani I.

    2016-01-01

    Tooth fractures are common complications due to trauma in the oral cavity. Tooth fragments and foreign bodies may be embedded in soft tissues as a result of dentofacial trauma and go unnoticed in emergency situations. The inadequate management of such cases may lead to complications, such as foreign-body reaction and scarring. This report describes two cases with dental fragments embedded in the lower lip, which went unnoticed until the patients presented later for completely different treatments and emphasizes the importance of clinical and radiographic examination of soft tissues, even in cases that present late for dental trauma management.

  1. Trauma, healing and the reconstruction of truth.

    PubMed

    Mucci, Clara

    2014-03-01

    The author analyzes recent developments in trauma theory, made necessary especially after the massive psychic traumas following World War II and the Shoah. The theories of Freud and Ferenczi are analyzed, especially, their different views of reality and their clinical attitude. When working with survivors of any trauma (from incest to genocide) it is necessary to reconstruct the historical details as carefully as possible, with the appropriate timing. Psychoanalysis is therefore viewed as an ethical and political practice similar to testimony, allowing the reconstruction of truth within the community and interrupting the cycle of the death instinct from one generation to the next. PMID:24603171

  2. Physical Trauma as an Etiological Agent in Mental Retardation.

    ERIC Educational Resources Information Center

    Angle, Carol R., Ed.; Bering, Edgar A., Jr., Ed.

    The conference on Physical Trauma as a Cause of Mental Retardation dealt with two major areas of etiological concern - postnatal and perinatal trauma. Following two introductory statements on the problem of and issues related to mental retardation (MR) after early trauma to the brain, five papers on the epidemiology of head trauma cover…

  3. A National Study of Trauma Level Designation and Renal Trauma Outcomes

    PubMed Central

    Hotaling, James M.; Wang, Jin; Sorensen, Mathew D.; Rivara, Frederick P.; Gore, John L.; Jurkovich, Jerry; McClung, Christopher D.; Wessells, Hunter; Voelzke, Bryan B.

    2012-01-01

    Purpose We examined the initial management of renal trauma and assessed patterns of management based on hospital trauma level designation. Materials and Methods The National Trauma Data Bank is a comprehensive trauma registry with records from hospitals in the United States and Puerto Rico. Renal injuries treated at a member hospital from 2002 to 2007 were identified. We classified initial management as expectant, minimally invasive (angiography, embolization, ureteral stent or nephrostomy) or open surgical management based on ICD-9 procedure codes. The primary outcome was use of secondary therapies. Results Of 3,247,955 trauma injuries in the National Trauma Data Bank 9,002 were renal injuries (0.3%). High grade injuries demonstrated significantly higher rates of definitive success with the first urological intervention at level I trauma centers vs other trauma centers (minimally invasive 52% vs 26%, p <0.001), and were more likely treated successfully with conservative management (89% vs 82%, p <0.001). When adjusting for other known indices of injury severity, and examining low and high grade injuries, level I trauma centers were 90% more likely to offer an initial trial of conservative management (OR 1.90; 95% CI 1.19, 3.05) and had a 30% lower chance of patients requiring multiple procedures (OR 0.70; 95% CI 0.52, 0.95). Conclusions Following multivariate analysis conservative therapy was more common at level I trauma centers despite the patient population being more severely injured. Initial intervention strategies were also more definitive at level I trauma centers, providing additional support for tiered delivery of trauma care. PMID:22177171

  4. Transforming US Army trauma care: an evidence-based review of the trauma literature.

    PubMed

    Remick, Kyle N; Dickerson, James A; Nessen, Shawn C; Rush, Robert M; Beilman, Greg J

    2010-01-01

    The US Army has been charged to transform to meet the demands of current and anticipated near-future combat needs, covering a full spectrum of military operations. The US Army combat trauma care system was created to deliver combat casualty care in a variety of situations and has been adapted to meet the needs of such care in both Operations Enduring Freedom and Iraqi Freedom. Questions related to our current system include the use and positioning of medical evacuation assets, the type of training for our trauma care providers, the positioning of these providers in proximity to the battlefield, and the type of units most suited to the wide variety of medical operations required of today's military medical team. The review was performed to evaluate available information in light of anticipated future needs to ensure preparedness. We reviewed trauma literature regarding the areas of civilian trauma systems, military trauma systems, presurgical trauma care, medical evacuation times, and the medical evacuation system. Among the conclusions drawn from the reviewed data include the following: regional trauma systems improve outcomes in significantly-injured patients; rural trauma care as part of a trauma system yields improved results compared to nontrauma hospitals and comparable results to those at a higher level center; and delivery of advanced trauma life support care has the potential to extend the period of time of safe medical evacuation to surgical capabilities. These lessons are used to discuss components of an improved system of trauma care, flexible for the varied needs of modern battlefield trauma and adaptable to provide support for anticipated future conflicts. PMID:21181650

  5. The incidence, spectrum and outcome of paediatric trauma managed by the Pietermaritzburg Metropolitan Trauma Service

    PubMed Central

    Manchev, V; Bruce, JL; Oosthuizen, GV; Laing, GL

    2015-01-01

    Introduction The Pietermaritzburg Metropolitan Trauma Service (PMTS) has run a systematic quality improvement programme since 2006. A key component included the development and implementation of an effective surveillance system in the form of an electronic surgical registry (ESR). This study used data from the ESR to review the incidence, spectrum and outcome of paediatric trauma in Pietermaritzburg, South Africa. Methods The ESR was reviewed, and all cases of paediatric trauma managed between 1 January 2012 and 30 July 2014 were retrieved for analysis. Results During the study period, 1,041 paediatric trauma patients (724 male, 69.5%) were managed by the PMTS, averaging a monthly admission of 36. The mean age was 10.9 years (standard deviation: 5.4 years). The mechanism of injury (MOI) was blunt trauma in 753 patients (72.3%) and penetrating trauma in 170 (16.3%). Pedestrian vehicle collisions accounted for 21% of cases and motor vehicle collisions for a further 11%. Intentional trauma accounted for 282 patients (27.1%) and self-inflicted trauma for 14 cases (1.3%). Ninety patients admitted to the intensive care unit and fifty-one required high dependency unit admission. There were 17 deaths, equating to an in-hospital mortality rate of 1.7%. A total of 172 children died on the scene of an incident. There were 35 road traffic related deaths, 26 suicides by hanging, 27 deaths from blunt assault and 23 deaths from penetrating assault. The overall mortality rate for paediatric trauma was 18.2%. Conclusions The ESR has proved to be an effective surveillance system and has enabled the accurate quantification of the burden of paediatric trauma in Pietermaritzburg. This has improved our understanding of the mechanisms and patterns of injury, and has identified a high incidence of intentional and penetrating trauma as well as road traffic collisions. These data can be used to guide strategies to reduce the burden of paediatric trauma in our environment. PMID:26263934

  6. The counselor's trauma as counseling motivation: vulnerability or stress inoculation?

    PubMed

    Jenkins, Sharon Rae; Mitchell, Jessica L; Baird, Stephanie; Whitfield, Sarah Roby; Meyer, Heather Lynn

    2011-08-01

    Should counselors with interpersonal trauma histories work with similarly traumatized clients? How does the work affect them? Current research is inconsistent. This study examines 101 sexual assault and domestic violence counselors' recalled motivations for trauma work, their reported subjective personal changes, and their secondary and vicarious trauma symptoms and burnout. Counselors motivated by interpersonal trauma report both more symptoms and positive changes (including dealing with their own trauma). Those seeking personal meaning report becoming more hypervigilant and self-isolating. Those saying they learned from clients rate symptoms lower, suggesting stress inoculation. Supervisors of trauma counselors should facilitate learning from clients separately from processing the counselor's trauma. PMID:20956440

  7. The trauma film paradigm as an experimental psychopathology model of psychological trauma: intrusive memories and beyond.

    PubMed

    James, Ella L; Lau-Zhu, Alex; Clark, Ian A; Visser, Renée M; Hagenaars, Muriel A; Holmes, Emily A

    2016-07-01

    A better understanding of psychological trauma is fundamental to clinical psychology. Following traumatic event(s), a clinically significant number of people develop symptoms, including those of Acute Stress Disorder and/or Post Traumatic Stress Disorder. The trauma film paradigm offers an experimental psychopathology model to study both exposure and reactions to psychological trauma, including the hallmark symptom of intrusive memories. We reviewed 74 articles that have used this paradigm since the earliest review (Holmes & Bourne, 2008) until July 2014. Highlighting the different stages of trauma processing, i.e. pre-, peri- and post-trauma, the studies are divided according to manipulations before, during and after film viewing, for experimental as well as correlational designs. While the majority of studies focussed on the frequency of intrusive memories, other reactions to trauma were also modelled. We discuss the strengths and weaknesses of the trauma film paradigm as an experimental psychopathology model of trauma, consider ethical issues, and suggest future directions. By understanding the basic mechanisms underlying trauma symptom development, we can begin to translate findings from the laboratory to the clinic, test innovative science-driven interventions, and in the future reduce the debilitating effects of psychopathology following stressful and/or traumatic events. PMID:27289421

  8. Trauma-induced insomnia: A novel model for trauma and sleep research.

    PubMed

    Sinha, Smit S

    2016-02-01

    Traumatic events have been increasingly recognized as important precipitants of clinically significant insomnia. Trauma is an extreme form of stressful life event that generates a sustained neurobiological response triggering the onset and maintenance of insomnia. Trauma may disrupt the normal sleep-wake regulatory mechanism by sensitizing the central nervous system's arousal centers, leading to pronounced central and physiological hyperarousal. The central concept of hyperarousal has been linked to both the pathogenesis of insomnia and to the neurobiological changes in the aftermath of traumatic events, and may be a neurobiological commonality underlying trauma and insomnia. This paper presents evidence for trauma-induced insomnia and advances a model of it as an important nosological and neurobiological entity. Trauma-induced insomnia may occur in the absence of full-blown posttraumatic stress disorder (PTSD), and may also be a precursor of subsequent PTSD development. Converging lines of evidence from the neuroscience of insomnia with the neurobiology and psychophysiology of stress, fear, trauma and PTSD will be integrated to advance understanding of the condition. Preclinical and clinical stress and fear paradigms have informed the neurobiological pathways mediating the production of insomnia by trauma. Elucidating the underlying neurobiological substrates can establish novel biological markers to identify persons at risk for the condition, and help optimize treatment of the trauma-insomnia interface. Early identification and treatment of trauma-induced insomnia may prevent the development of PTSD, as well as other important sequelae such as depression, substance dependence, and other medical conditions. PMID:26140870

  9. Popliteal vasculature injuries in paediatric trauma patients.

    PubMed

    Jones, S A; Roberts, D C; Clarke, N M P

    2012-10-01

    Popliteal-artery injuries in the paediatric-trauma patient are uncommon, difficult to diagnose and with prolonged ischaemia lead to substantial complications. We report three cases of popliteal-vasculature injury in paediatric-trauma patients with diverse mechanisms of injury: blunt trauma, penetrating injury and a Salter-Harris I fracture. We present a range of the significant sequelae that can result from paediatric popliteal-artery injury, both physically and psychologically. It is imperative that clinicians have a high index of suspicion when confronted with paediatric patients with trauma around the knee and that popliteal-vasculature injuries are diagnosed early. If insufficiencies are detected, further imaging should be considered, but surgical exploration should not be delayed in the presence of ischaemia. PMID:22776610

  10. [Who is who revisited: spinal trauma].

    PubMed

    Schueller, G

    2010-12-01

    The ideal classification of spinal trauma does not yet exist, primarily because the combination of morphological, biomechanical and clinical parameters in one single nomenclature has proved impossible. For radiologists and surgeons who work closely together, only a few classifications of injury patterns have been shown to be useful enough to provide rapid and stable therapy decisions. Many classifications are too complex to be practical for day-to-day practice, such as the Magerl classification, which has been adopted by the Arbeitsgemeinschaft für Osteosynthesefragen (AO). Not least because of this classification difficulty, eponyms and synonyms are widely used to describe trauma of the spine, comparable to the number of terms used to describe fractures of the upper and lower limbs. The members of trauma teams should be aware of the definitions of these terms as well as the strengths and limitations of the existing classifications of spinal trauma. PMID:20967415

  11. Rural Emergency Medical Services (EMS) and Trauma

    MedlinePlus

    ... completed a verification visit. Are there statistics and data on trauma related deaths and nonfatal injuries treated ... Insurance Institute for Highway Safety and Highway Loss Data Institute’s Urban/Rural Comparison 2013 , characteristics of fatal ...

  12. Nasal trauma: Primary reconstruction with open rhinoplasty.

    PubMed

    Konstantinidis, I; Malliari, H; Metaxas, S

    2011-01-01

    Due to the prominent location of the nose, the most common facial traumas are nasal injuries. Although nasal traumas usually require staged intervention at a later period of time, in selected cases, primary reconstruction can be effective. A 20-year-old man who was referred from the emergency department with nasal trauma is presented. He reported a fall after feeling unsteady, which caused a direct nasal injury. Clinical examination revealed septal fracture with obstruction of the left nasal cavity and deformity of the nasal pyramid (inverted V deformity). The patient also had a complete dissection of the columella skin. Epistaxis was self-limited, and an open rhinoplasty procedure was decided because the trauma occurred 1 h before admission and there was no significant edema. Surgical intervention included septal reconstruction combined with restoration of the nasal pyramid and columella. One month later, the patient had patent nasal airways, and he was satisfied with the aesthetic result. PMID:22942663

  13. Nasal trauma: Primary reconstruction with open rhinoplasty

    PubMed Central

    Konstantinidis, I; Malliari, H; Metaxas, S

    2011-01-01

    Due to the prominent location of the nose, the most common facial traumas are nasal injuries. Although nasal traumas usually require staged intervention at a later period of time, in selected cases, primary reconstruction can be effective. A 20-year-old man who was referred from the emergency department with nasal trauma is presented. He reported a fall after feeling unsteady, which caused a direct nasal injury. Clinical examination revealed septal fracture with obstruction of the left nasal cavity and deformity of the nasal pyramid (inverted V deformity). The patient also had a complete dissection of the columella skin. Epistaxis was self-limited, and an open rhinoplasty procedure was decided because the trauma occurred 1 h before admission and there was no significant edema. Surgical intervention included septal reconstruction combined with restoration of the nasal pyramid and columella. One month later, the patient had patent nasal airways, and he was satisfied with the aesthetic result. PMID:22942663

  14. Anorectal trauma. Medicolegal and forensic aspects.

    PubMed

    Eckert, W G; Katchis, S

    1989-03-01

    A review of both deliberate and accidental anorectal trauma is presented. The mechanisms and types of injuries as well as the complications are discussed. Injuries resulting from sexual assaults are discussed in detail. PMID:2648809

  15. Global access to literature on trauma.

    PubMed

    Noordin, Shahryar; Wright, James G; Howard, Andrew W

    2008-10-01

    The trauma pandemic disproportionately kills and maims citizens of low-income countries although the immediate cause of the trauma is often an industrial export of a high income country, such as a motor vehicle. Addressing the trauma pandemic in low-income countries requires access to relevant research information regarding prevention and treatment of injuries. Such information is also generally produced in high income countries. We explored various means of making scientific information available to low-income country surgeons using the internet. If orthopaedic surgeons want to maximize their global impact, they should focus on writing about trauma questions relevant to their colleagues in low-income countries and ensuring these same colleagues have access to the literature. PMID:18663552

  16. Hardware Removal in Craniomaxillofacial Trauma

    PubMed Central

    Cahill, Thomas J.; Gandhi, Rikesh; Allori, Alexander C.; Marcus, Jeffrey R.; Powers, David; Erdmann, Detlev; Hollenbeck, Scott T.; Levinson, Howard

    2015-01-01

    Background Craniomaxillofacial (CMF) fractures are typically treated with open reduction and internal fixation. Open reduction and internal fixation can be complicated by hardware exposure or infection. The literature often does not differentiate between these 2 entities; so for this study, we have considered all hardware exposures as hardware infections. Approximately 5% of adults with CMF trauma are thought to develop hardware infections. Management consists of either removing the hardware versus leaving it in situ. The optimal approach has not been investigated. Thus, a systematic review of the literature was undertaken and a resultant evidence-based approach to the treatment and management of CMF hardware infections was devised. Materials and Methods A comprehensive search of journal articles was performed in parallel using MEDLINE, Web of Science, and ScienceDirect electronic databases. Keywords and phrases used were maxillofacial injuries; facial bones; wounds and injuries; fracture fixation, internal; wound infection; and infection. Our search yielded 529 articles. To focus on CMF fractures with hardware infections, the full text of English-language articles was reviewed to identify articles focusing on the evaluation and management of infected hardware in CMF trauma. Each article’s reference list was manually reviewed and citation analysis performed to identify articles missed by the search strategy. There were 259 articles that met the full inclusion criteria and form the basis of this systematic review. The articles were rated based on the level of evidence. There were 81 grade II articles included in the meta-analysis. Result Our meta-analysis revealed that 7503 patients were treated with hardware for CMF fractures in the 81 grade II articles. Hardware infection occurred in 510 (6.8%) of these patients. Of those infections, hardware removal occurred in 264 (51.8%) patients; hardware was left in place in 166 (32.6%) patients; and in 80 (15.6%) cases

  17. Classification and management of mild head trauma

    PubMed Central

    Andrade, Almir F; Paiva, Wellingson S; Soares, Matheus S; De Amorim, Robson LO; Tavares, Wagner M; Teixeira, Manoel J

    2011-01-01

    Mild head trauma had been defined in patients with direct impact or deceleration effect admitted with a Glasgow Coma Scale score of 13–15. It is one of the most frequent causes of morbidity in emergency medicine. Although common, several controversies persist about its clinical management. In this paper, we describe the Brazilian guidelines for mild head trauma, based on a critical review of the relevant literature. PMID:21475628

  18. Trauma imaging in the thorax and abdomen

    SciTech Connect

    Rosenberger, A.; Adler, O.

    1987-01-01

    This book thoroughly covers the radiologic diagnosis of traumatic injuries of the thorax and abdomen with special consideration given to the physical principles governing blunt, blast, and penetrating trauma and to the pathophysiology which they cause. The clinical experience forming the major data base for this book is drawn from the Ramban Medical Center in Haifa, Israel, the major trauma center for the Middle East wars.

  19. The development of pneumobilia after blunt trauma

    PubMed Central

    Okan, İsmail; Tali, Servet; Özsoy, Zeki; Deniz, Çağlar; Acu, Berat; Yenidoğan, Erdinç; Kayaoğlu, Hüseyin Ayhan; Şahin, Mustafa

    2016-01-01

    Pneumobilia is the detection of gas within the biliary system. It usually develops after bilioenteric anastomosis, percutaneous or endoscopic biliary interventions, infections and abscesses. The treatment is surgical, especially in cases with no prior interventions to the biliary system. The development of pneumobilia is quite rare after blunt trauma. Therefore, both the diagnosis and management are challenging for surgeons. Herein, we present the diagnosis and conservative management of a patient with pneumobilia after blunt trauma. PMID:27528818

  20. Management of trauma to supporting dental structures.

    PubMed

    Elias, Husam; Baur, Dale A

    2009-10-01

    Teeth, periodontium, and supporting alveolar bone are frequently involved in trauma and account for approximately 15% of all emergency room visits. The cause of the dentoalveolar trauma varies in different demographics but generally results from falls, playground accidents, domestic violence, bicycle accidents, motor vehicle accidents, assaults, altercations, and sports injuries. Dentoalveolar injuries should be considered an emergency situation because successful management of the injury requires proper diagnosis and treatment within a limited time to achieve better outcomes. PMID:19958905

  1. Self-report may underestimate trauma intrusions.

    PubMed

    Takarangi, Melanie K T; Strange, Deryn; Lindsay, D Stephen

    2014-07-01

    Research examining maladaptive responses to trauma routinely relies on spontaneous self-report to index intrusive thoughts, which assumes people accurately recognize and report their intrusive thoughts. However, "mind-wandering" research reveals people are not always meta-aware of their thought content: they often fail to notice shifts in their attention. In two experiments, we exposed subjects to trauma films, then instructed them to report intrusive thoughts during an unrelated reading task. Intermittently, we asked whether they were thinking about the trauma. As expected, subjects often spontaneously reported intrusive thoughts. However, they were also "caught" engaging in unreported trauma-oriented thoughts. The presence and frequency of intermittent probes did not influence self-caught intrusions. Both self-caught and probe-caught intrusions were related to an existing tendency toward intrusive cognition, film-related distress, and thought suppression attempts. Our data suggest people may lack meta-awareness of trauma-related thoughts, which has implications for theory, research and treatment relating to trauma-related psychopathology. PMID:24993526

  2. Demystifying damage control in musculoskeletal trauma.

    PubMed

    Bates, P; Parker, P; McFadyen, I; Pallister, I

    2016-05-01

    Trauma care has evolved rapidly over the past decade. The benefits of operative fracture management in major trauma patients are well recognised. Concerns over early total care arose when applied broadly. The burden of additional surgical trauma could constitute a second hit, fuelling the inflammatory response and precipitating a decline into acute respiratory distress syndrome, sepsis and multiple organ dysfunction syndrome. Temporary external fixation aimed to deliver the benefits of fracture stabilisation without the risk of major surgery. This damage control orthopaedics approach was advocated for those in extremis and a poorly defined borderline group. An increasing understanding of the physiological response to major trauma means there is now a need to refine our treatment options. A number of large scale retrospective reviews indicate that early definitive fracture fixation is beneficial in the majority of major trauma patients. It is recommended that patients are selected appropriately on the basis of their response to resuscitation. The hope is that this approach (dubbed 'safe definitive fracture surgery' or 'early appropriate care') will herald an era when care is individualised for each patient and their circumstances. The novel Damage Control in Orthopaedic Trauma Surgery course at The Royal College of Surgeons of England aims to equip senior surgeons with the insights and mindset necessary to contribute to this key decision making process as well as also the technical skills to provide damage control interventions when needed, relying on the improved techniques of damage control resuscitation and advances in the understanding of early appropriate care. PMID:27023640

  3. Trauma management: Chernobyl in Belarus and Ukraine.

    PubMed

    Zhukova, Ekatherina

    2016-06-01

    Although the Chernobyl nuclear disaster happened in the Soviet Union in 1986, we still do not know how the most affected states - Ukraine and Belarus - have managed this tragedy since independence. Drawing on the concept of cultural trauma, this article compares Chernobyl narratives in Belarus and Ukraine over the past 28 years. It shows that national narratives of Chernobyl differ, representing the varying ways in which the state overcomes trauma. Our understanding of post-communist transformations can be improved by analysing trauma management narratives and their importance for new national identity construction. These narratives also bring new insights to our vision of cultural trauma by linking it to ontological insecurity. The article demonstrates how the state can become an arena of trauma process as it commands material and symbolic resources to deal with trauma. In general, it contributes to a better understanding of how the same traumatic event can become a source of solidarity in one community, but a source of hostility in another. PMID:27191056

  4. "Stuttering" after minor head trauma.

    PubMed

    Strasberg, Stephen; Johnson, Elizabeth J; Parry, Thomas

    2016-03-01

    Traumatic brain injury (TBI) is defined as impairment in brain function as a result of mechanical force. It is classified based on clinical findings using the Glasgow Coma Scale (GCS). Mild TBI is defined as GCS 14-15; moderate, 9-13; and severe, 3-8. Patients with the same TBI classification may have very different underlying pathology. In moderate to severe TBI, the primary pathology may include contusions, hemorrhage, diffuse axonal injury, direct cellular damage, "tearing and shearing of the tissues, loss of the blood-brain barrier, disruption of the neurochemical homeostasis and loss of the electrochemical function". Although the primary pathology associated with mild TBI may be milder versions of the same pathology associated with moderate and severe TBI, it is generally a metabolic injury. However, it is reported that 15% of patients with mild TBI and a GCS score of 14 or 15 will have an intracranial lesion; less than 1% of these require neurosurgical intervention. Although patients with mild TBI may have intracranial lesions, it is rare that the presenting and only physical examination finding is an isolated neurologic finding. Here we present a case of isolated head trauma with a single physical examination finding--expressive aphasia. PMID:26371830

  5. Neuroimaging in repetitive brain trauma

    PubMed Central

    2014-01-01

    Sports-related concussions are one of the major causes of mild traumatic brain injury. Although most patients recover completely within days to weeks, those who experience repetitive brain trauma (RBT) may be at risk for developing a condition known as chronic traumatic encephalopathy (CTE). While this condition is most commonly observed in athletes who experience repetitive concussive and/or subconcussive blows to the head, such as boxers, football players, or hockey players, CTE may also affect soldiers on active duty. Currently, the only means by which to diagnose CTE is by the presence of phosphorylated tau aggregations post-mortem. Non-invasive neuroimaging, however, may allow early diagnosis as well as improve our understanding of the underlying pathophysiology of RBT. The purpose of this article is to review advanced neuroimaging methods used to investigate RBT, including diffusion tensor imaging, magnetic resonance spectroscopy, functional magnetic resonance imaging, susceptibility weighted imaging, and positron emission tomography. While there is a considerable literature using these methods in brain injury in general, the focus of this review is on RBT and those subject populations currently known to be susceptible to RBT, namely athletes and soldiers. Further, while direct detection of CTE in vivo has not yet been achieved, all of the methods described in this review provide insight into RBT and will likely lead to a better characterization (diagnosis), in vivo, of CTE than measures of self-report. PMID:25031630

  6. Thyroid function after thermal trauma.

    PubMed

    Smeds, S; Kågedal, B; Liedén, G; Liljedahl, S O

    1981-01-01

    The thyroid function was analyzed for 4-6 weeks in a prospective study of 12 thermally injured patients. The burn size range was 15-90%. Serum concentrations of 3,5,3'-triidothyronine (T3) was suppressed and 3,3',5'-triidothyronine (rT3) was increased. The ratio T3/rT3 was subnormal on the third day after the trauma and normalized after 3 weeks. Thyroxine and the free T4-index were within the normal range. The free T3-index were within the normal range. The TSH concentration was initially low but slowly increasing during the period of study. The concentration of the thyroxine-binding globulin (TBG) varied within the normal range. The T3 resin uptake test varied inversely with the TBG concentration. The concentration of thyroxine-binding prealbumin (TBPA) was subnormal. A control experiment excluded possible interference on the hormone concentrations of administered donor blood and plasma. It is concluded that the thyroid hormones are not responsible for the posttraumatic hypermetabolism in burn injury. The present findings further indicate a depletion of metabolically active thyroid hormones at the cellular level after burn injury. PMID:6803354

  7. Animal Models of Head Trauma

    PubMed Central

    Cernak, Ibolja

    2005-01-01

    Summary: Animal models of traumatic brain injury (TBI) are used to elucidate primary and secondary sequelae underlying human head injury in an effort to identify potential neuroprotective therapies for developing and adult brains. The choice of experimental model depends upon both the research goal and underlying objectives. The intrinsic ability to study injury-induced changes in behavior, physiology, metabolism, the blood/tissue interface, the blood brain barrier, and/or inflammatory- and immune-mediated responses, makes in vivo TBI models essential for neurotrauma research. Whereas human TBI is a highly complex multifactorial disorder, animal trauma models tend to replicate only single factors involved in the pathobiology of head injury using genetically well-defined inbred animals of a single sex. Although such an experimental approach is helpful to delineate key injury mechanisms, the simplicity and hence inability of animal models to reflect the complexity of clinical head injury may underlie the discrepancy between preclinical and clinical trials of neuroprotective therapeutics. Thus, a search continues for new animal models, which would more closely mimic the highly heterogeneous nature of human TBI, and address key factors in treatment optimization. PMID:16389305

  8. Regional Anesthesia in Trauma Medicine

    PubMed Central

    Wu, Janice J.; Lollo, Loreto; Grabinsky, Andreas

    2011-01-01

    Regional anesthesia is an established method to provide analgesia for patients in the operating room and during the postoperative phase. While regional anesthesia offers unique advantages, as shown by the recent military experience, it is not commonly utilized in the prehospital or emergency department setting. Most often, regional anesthesia techniques for traumatized patients are first utilized in the operating room for procedural anesthesia or for postoperative pain control. While infiltration or single nerve block procedures are often used by surgeons or emergency medicine physicians in the preoperative phase, more advanced techniques such as plexus block procedures or regional catheter placements are more commonly performed by anesthesiologists for surgery or postoperative pain control. These regional techniques offer advantages over intravenous anesthesia, not just in the perioperative phase but also in the acute phase of traumatized patients and during the initial transport of injured patients. Anesthesiologists have extensive experience with regional techniques and are able to introduce regional anesthesia into settings outside the operating room and in the early treatment phases of trauma patients. PMID:22162684

  9. Trauma management incorporating focused assessment with computed tomography in trauma (FACTT) - potential effect on survival

    PubMed Central

    2010-01-01

    Background Immediate recognition of life-threatening conditions and injuries is the key to trauma management. To date, the impact of focused assessment with computed tomography in trauma (FACTT) has not been formally assessed. We aimed to find out whether the concept of using FACTT during primary trauma survey has a negative or positive effect on survival. Methods In a retrospective, multicentre study, we compared our time management and probability of survival (Ps) in major trauma patients who received FACTT during trauma resuscitation with the trauma registry of the German Trauma Society (DGU). FACTT is defined as whole-body computed tomography (WBCT) during primary trauma survey. We determined the probability of survival according to the Trauma and Injury Severity Score (TRISS), the Revised Injury Severity Classification score (RISC) and the standardized mortality ratio (SMR). Results We analysed 4.817 patients from the DGU database from 2002 until 2004, 160 (3.3%) were from our trauma centre at the Ludwig-Maximilians-University (LMU) and 4.657 (96.7%) from the DGU group. 73.2% were male with a mean age of 42.5 years, a mean ISS of 29.8. 96.2% had suffered from blunt trauma. Time from admission to FAST (focused assessment with sonography for trauma)(4.3 vs. 8.7 min), chest x-ray (8.1 vs. 16.0 min) and whole-body CT (20.7 vs. 36.6 min) was shorter at the LMU compared to the other trauma centres (p < 0.001). SMR calculated by TRISS was 0.74 (CI95% 0.40-1.08) for the LMU (p = 0.24) and 0.92 (CI95% 0.84-1.01) for the DGU group (p = 0.10). RISC methodology revealed a SMR of 0.69 (95%CI 0.47-0.92) for the LMU (p = 0.043) and 1.00 (95%CI 0.94-1.06) for the DGU group (p = 0.88). Conclusion Trauma management incorporating FACTT enhances a rapid response to life-threatening problems and enables a comprehensive assessment of the severity of each relevant injury. Due to its speed and accuracy, FACTT during primary trauma survey supports rapid decision-making and may

  10. Evaluating initial spine trauma response: injury time to trauma center in PA, USA.

    PubMed

    Harrop, James S; Ghobrial, George M; Chitale, Rohan; Krespan, Kelly; Odorizzi, Laura; Fried, Tristan; Maltenfort, Mitchell; Cohen, Murray; Vaccaro, Alexander

    2014-10-01

    Historical perceptions regarding the severity of traumatic spinal cord injury has led to considerable disparity in triage to tertiary care centers. This article retrospectively reviews a large regional trauma database to analyze whether the diagnosis of spinal trauma affected patient transfer timing and patterns. The Pennsylvania Trauma database was retrospectively reviewed. All acute trauma patient entries for level I and II centers were categorized for diagnosis, mechanism, and location of injury, analyzing transportation modality and its influence on time of arrival. A total of 1162 trauma patients were identified (1014 blunt injuries, 135 penetrating injuries and 12 other) with a mean transport time of 3.9 hours and a majority of patients arriving within 7 hours (>75%). Spine trauma patients had the longest mean arrival time (5.2 hours) compared to blunt trauma (4.2 hours), cranial neurologic injuries (4.35 hours), and penetrating injuries (2.13 hours, p<0.0001). There was a statistically significant correlation between earlier arrivals and both cranial trauma (p=0.0085) and penetrating trauma (p<0.0001). The fastest modality was a fire rescue (0.93 hours) or police (0.63 hours) vehicle with Philadelphia County (1.1 hour) having the quickest arrival times. Most trauma patients arrived to a specialty center within 7 hours of injury. However subsets analysis revealed that spine trauma patients had the greatest transit times. Present research trials for spinal cord injuries suggest earlier intervention may lead to improved recovery. Therefore, it is important to focus on improvement of the transportation triage system for traumatic spinal patients. PMID:24932590

  11. Potentially perilous pedagogies: teaching trauma is not the same as trauma-informed teaching.

    PubMed

    Carello, Janice; Butler, Lisa D

    2014-01-01

    This article explores why and how trauma theory and research are currently used in higher education in nonclinical courses such as literature, women's studies, film, education, anthropology, cultural studies, composition, and creative writing. In these contexts, traumatic material is presented not only indirectly in the form of texts and films that depict traumatic events but also directly in the form of what is most commonly referred to in nonclinical disciplines as trauma studies, cultural trauma studies, and critical trauma studies. Within these areas of study, some instructors promote potentially risky pedagogical practices involving trauma exposure or disclosure despite indications that these may be having deleterious effects. After examining the published rationales for such methods, we argue that given the high rates of trauma histories (66%-85%), posttraumatic stress disorder (9%-12%), and other past event-related distress among college students, student risk of retraumatization and secondary traumatization should be decreased rather than increased. To this end, we propose that a trauma-informed approach to pedagogy-one that recognizes these risks and prioritizes student emotional safety in learning-is essential, particularly in classes in which trauma theories or traumatic experiences are taught or disclosed. PMID:24313321

  12. Trauma Focused CBT for Children with Co-Occurring Trauma and Behavior Problems

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Berliner, Lucy; Mannarino, Anthony

    2010-01-01

    Objective: Childhood trauma impacts multiple domains of functioning including behavior. Traumatized children commonly have behavioral problems that therapists must effectively evaluate and manage in the context of providing trauma-focused treatment. This manuscript describes practical strategies for managing behavior problems in the context of…

  13. Trauma Adapted Family Connections: Reducing Developmental and Complex Trauma Symptomatology to Prevent Child Abuse and Neglect

    ERIC Educational Resources Information Center

    Collins, Kathryn S.; Strieder, Frederick H.; DePanfilis, Diane; Tabor, Maureen; Clarkson Freeman, Pamela A.; Linde, Linnea; Greenberg, Patty

    2011-01-01

    Families living in urban poverty, enduring chronic and complex traumatic stress, and having difficulty meeting their children's basic needs have significant child maltreatment risk factors. There is a paucity of family focused, trauma-informed evidence-based interventions aimed to alleviate trauma symptomatology, strengthen family functioning, and…

  14. The role of trauma scoring in developing trauma clinical governance in the Defence Medical Services

    PubMed Central

    Russell, R. J.; Hodgetts, T. J.; McLeod, J.; Starkey, K.; Mahoney, P.; Harrison, K.; Bell, E.

    2011-01-01

    This paper discusses mathematical models of expressing severity of injury and probability of survival following trauma and their use in establishing clinical governance of a trauma system. There are five sections: (i) Historical overview of scoring systems—anatomical, physiological and combined systems and the advantages and disadvantages of each. (ii) Definitions used in official statistics—definitions of ‘killed in action’ and other categories and the importance of casualty reporting rates and comparison across conflicts and nationalities. (iii) Current scoring systems and clinical governance—clinical governance of the trauma system in the Defence Medical Services (DMS) by using trauma scoring models to analyse injury and clinical patterns. (iv) Unexpected outcomes—unexpected outcomes focus clinical governance tools. Unexpected survivors signify good practice to be promulgated. Unexpected deaths pick up areas of weakness to be addressed. Seventy-five clinically validated unexpected survivors were identified over 2 years during contemporary combat operations. (v) Future developments—can the trauma scoring methods be improved? Trauma scoring systems use linear approaches and have significant weaknesses. Trauma and its treatment is a complex system. Nonlinear methods need to be investigated to determine whether these will produce a better approach to the analysis of the survival from major trauma. PMID:21149354

  15. The Aftermath of Road Trauma: Survivors' Perceptions of Trauma and Growth

    ERIC Educational Resources Information Center

    Harms, Louise; Talbot, Michelle

    2007-01-01

    For many survivors of serious road trauma, the physical and psychological consequences are complex and lifelong. The longer-term psychosocial recovery experience for survivors, however, is rarely documented in the social work literature. This article reports on findings from a study of road trauma recovery experiences. The findings are presented…

  16. Geriatric Trauma: A Radiologist's Guide to Imaging Trauma Patients Aged 65 Years and Older.

    PubMed

    Sadro, Claudia T; Sandstrom, Claire K; Verma, Nupur; Gunn, Martin L

    2015-01-01

    Radiologists play an important role in evaluation of geriatric trauma patients. Geriatric patients have injury patterns that differ markedly from those seen in younger adults and are susceptible to serious injury from minor trauma. The spectrum of trauma in geriatric patients includes head and spine injury, chest and rib trauma, blunt abdominal injury, pelvic fractures, and extremity fractures. Clinical evaluation of geriatric trauma patients is difficult because of overall frailty, comorbid illness, and medication effects. Specific attention should be focused on the effects of medications in this population, including anticoagulants, steroids, and bisphosphonates. Radiologists should use age-appropriate algorithms for radiography, computed tomography (CT), and magnetic resonance imaging of geriatric trauma patients and follow guidelines for intravenous contrast agent administration in elderly patients with impaired renal function. Because there is less concern about risk for cancer with use of ionizing radiation in this age group, CT is the primary imaging modality used in the setting of geriatric trauma. Clinical examples are provided from the authors' experience at a trauma center where geriatric patients who have sustained major and minor injuries are treated daily. PMID:26065932

  17. Trauma Deserts: Distance From a Trauma Center, Transport Times, and Mortality From Gunshot Wounds in Chicago

    PubMed Central

    Sharp, Douglas; Unger, Erin; Straus, David; Brasel, Karen; Hsia, Renee; Esposito, Thomas

    2013-01-01

    Objectives. We examined whether urban patients who suffered gunshot wounds (GSWs) farther from a trauma center would have longer transport times and higher mortality. Methods. We used the Illinois State Trauma Registry (1999–2009). Scene address data for Chicago-area GSWs was geocoded to calculate distance to the nearest trauma center and compare prehospital transport times. We used multivariate regression to calculate the effect on mortality of being shot more than 5 miles from a trauma center. Results. Of 11 744 GSW patients during the study period, 4782 were shot more than 5 miles from a trauma center. Mean transport time and unadjusted mortality were higher for these patients (P < .001 for both). In a multivariate model, suffering a GSW more than 5 miles from a trauma center was associated with an increased risk of death (odds ratio = 1.23; 95% confidence interval = 1.02, 1.47; P = .03). Conclusions. Relative “trauma deserts” with decreased access to immediate care were found in certain areas of Chicago and adversely affected mortality from GSWs. These results may inform decisions about trauma systems planning and funding. PMID:23597339

  18. Time distortion between "conceptual" and "preconceptual" traumas.

    PubMed

    López-Corvo, Rafael E

    2013-04-01

    Two forms of traumas are considered in this paper: "preconceptual" and "conceptual"; the former is ubiquitous and the latter, accidental. Preconceptual traumas represent "preconceptions" that take place during the first years of life, when there is not a mind capable of containing and endowing them with a sensible meaning, as distinguished from "conceptual traumas," which occur at a time when there is a mind already, which fails to contain the traumatic facts. There is always a continuous emotional entanglement between conceptual and preconceptual traumas. Preconceptual traumas are a consequence of the discrepancy present between the natural helplessness of the child and the supremacy of the parents. They split the mind in two opposite states that continuously interact: the "traumatized" and the "nontraumatized." The "traumatized state" is a consequence of the preconceptual trauma that takes place during the first years of life, which repeats compulsively and continuously. The "nontraumatized state," on the other hand, represents the mental development that will normally take place from birth to adulthood. All existing forms of psychopathology are always traumatic. The traumatized state is always minutely split and continuously projected everywhere, together with the part of the mind that contains it. A clinical case is considered in order to investigate how preconceptual traumas obstruct the possibility of dealing with the ensuing emotions that a true and violent threat of death can produce. Intense feelings linked to the phenomenology of early traumatic events obscured the true facts of the condition present at the time of the patient's analysis. Some aspects related to death and the death drive are examined prior to the clinical material. PMID:23566007

  19. Pain management in trauma: A review study

    PubMed Central

    Ahmadi, Alireza; Bazargan-Hejazi, Shahrzad; Heidari Zadie, Zahra; Euasobhon, Pramote; Ketumarn, Penkae; Karbasfrushan, Ali; Amini-Saman, Javad; Mohammadi, Reza

    2016-01-01

    Abstract: Background: Pain in trauma has a role similar to the double-edged sword. On the one hand, pain is a good indicator to determine the severity and type of injury. On the other hand, pain can induce sever complications and it may lead to further deterioration of the patient. Therefore, knowing how to manage pain in trauma patients is an important part of systemic approach in trauma. The aim of this manuscript is to provide information about pain management in trauma in the Emergency Room settings. Methods: In this review we searched among electronic and manual documents covering a 15-yr period between 2000 and 2016. Our electronic search included Pub Med, Google scholar, Web of Science, and Cochrane databases. We looked for articles in English and in peer-reviewed journals using the following keywords: acute pain management, trauma, emergency room and injury. Results: More than 3200 documents were identified. After screening based on the study inclusion criteria, 560 studies that had direct linkage to the study aim were considered for evaluation based World Health Organization (WHO) pain ladder chart. Conclusions: To provide adequate pain management in trauma patients require: adequate assessment of age-specific pharmacologic pain management; identification of adequate analgesic to relieve moderate to severe pain; cognizance of serious adverse effects of pain medications and weighting medications against their benefits, and regularly reassessing patients and reevaluating their pain management regimen. Patient-centered trauma care will also require having knowledge of barriers to pain management and discussing them with the patient and his/her family to identify solutions. PMID:27414816

  20. Risk factors for the development of psychopathology following trauma.

    PubMed

    Sayed, Sehrish; Iacoviello, Brian M; Charney, Dennis S

    2015-08-01

    Traumatic experiences can lead to a range of mental health problems with posttraumatic stress disorder (PTSD) leading as the most documented disorder following trauma. Epidemiological research has found the rate of exposure to trauma to far outweigh the prevalence of PTSD. Indicating that most people do not develop PTSD following a traumatic event, this phenomenon has led to an interest in evaluating risk factors to determine who develops PTSD. Risk factors for the development of psychopathology following trauma exposure fall into three categories: pre-trauma, peri-trauma and post-trauma factors. Pre-trauma factors can include age, gender, race/ethnicity, education, prior psychopathology, and neurobiological factors. Peri-trauma factors can include the duration/severity of trauma experience and the perception that the trauma has ended. Post-trauma factors can include access to needed resources, social support, specific cognitive patterns, and physical activity. To date, several important risk factors have been found to impact the risk of developing PTSD including gender, age, education, IQ, race and ethnicity, sexual orientation, pre-trauma psychopathology, prior trauma exposure, familial psychiatric history, and neurobiological factors. This article outlines the state of research findings on pretraumatic, peritraumatic, and posttraumatic risk factors for the development of PTSD and associated psychopathology following trauma. PMID:26206108

  1. ACR Appropriateness Criteria Head Trauma.

    PubMed

    Shetty, Vilaas S; Reis, Martin N; Aulino, Joseph M; Berger, Kevin L; Broder, Joshua; Choudhri, Asim F; Kendi, A Tuba; Kessler, Marcus M; Kirsch, Claudia F; Luttrull, Michael D; Mechtler, Laszlo L; Prall, J Adair; Raksin, Patricia B; Roth, Christopher J; Sharma, Aseem; West, O Clark; Wintermark, Max; Cornelius, Rebecca S; Bykowski, Julie

    2016-06-01

    Neuroimaging plays an important role in the management of head trauma. Several guidelines have been published for identifying which patients can avoid neuroimaging. Noncontrast head CT is the most appropriate initial examination in patients with minor or mild acute closed head injury who require neuroimaging as well as patients with moderate to severe acute closed head injury. In short-term follow-up neuroimaging of acute traumatic brain injury, CT and MRI may have complementary roles. In subacute to chronic traumatic brain injury, MRI is the most appropriate initial examination, though CT may have a complementary role in select circumstances. Advanced neuroimaging techniques are areas of active research but are not considered routine clinical practice at this time. In suspected intracranial vascular injury, CT angiography or venography or MR angiography or venography is the most appropriate imaging study. In suspected posttraumatic cerebrospinal fluid leak, high-resolution noncontrast skull base CT is the most appropriate initial imaging study to identify the source, with cisternography reserved for problem solving. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:27262056

  2. Disaster preparedness of Canadian trauma centres: the perspective of medical directors of trauma

    PubMed Central

    Gomez, David; Haas, Barbara; Ahmed, Najma; Tien, Homer; Nathens, Avery

    2011-01-01

    Background Owing to their constant readiness to treat injured patients, trauma centres are essential to regional responses to mass casualty incidents (MCIs). Reviews of recent MCIs suggest that trauma centre preparedness has frequently been limited. We set out to evaluate Canadian trauma centre preparedness and the extent of their integration into a regional response to MCIs. Methods We conducted a survey of Canadian level-1 trauma centres (n = 29) to characterize their existing disaster-response plans and to identify areas where pre-paredness could be improved. The survey was directed to the medical director of trauma at each centre. Descriptive statistics were used to analyze responses. Results Twenty-three (79%) trauma centres in 5 provinces responded. Whereas most (83%) reported the presence of a committee dedicated to disaster preparedness, only half of the medical directors of trauma were members of these committees. Almost half (43%) the institutions had not run any disaster drill in the previous 2 years. Only 70% of trauma centres used communications assets designed to function during MCIs. Additionally, more than half of the trauma directors (59%) did not know if their institutions had the ability to sustain operations for at least 72 hours during MCIs. Conclusion The results of this study suggest important opportunities to better prepare Canadian trauma centers to respond to an MCI. The main areas identified for potential improvement include the need for the standardization of MCI planning and response at a regional level and the implementation of strategies such as stockpiling of resources and novel communication strategies to avoid functional collapse during an MCI. PMID:21251427

  3. Evaluating trauma center process performance in an integrated trauma system with registry data

    PubMed Central

    Moore, Lynne; Lavoie, André; Sirois, Marie-Josée; Amini, Rachid; Belcaïd, Amina; Sampalis, John S

    2013-01-01

    Background: The evaluation of trauma center performance implies the use of indicators that evaluate clinical processes. Despite the availability of routinely collected clinical data in most trauma systems, quality improvement efforts are often limited to hospital-based audit of adverse patient outcomes. Objective: To identify and evaluate a series of process performance indicators (PPI) that can be calculated using routinely collected trauma registry data. Materials and Methods: PPI were identified using a review of published literature, trauma system documentation, and expert consensus. Data from the 59 trauma centers of the Quebec trauma system (1999, 2006; N = 99,444) were used to calculate estimates of conformity to each PPI for each trauma center. Outliers were identified by comparing each center to the global mean. PPI were evaluated in terms of discrimination (between-center variance), construct validity (correlation with designation level and patient volume), and forecasting (correlation over time). Results: Fifteen PPI were retained. Global proportions of conformity ranged between 6% for reduction of a major dislocation within 1 h and 97% for therapeutic laparotomy. Between-center variance was statistically significant for 13 PPI. Five PPI were significantly associated with designation level, 7 were associated with volume, and 11 were correlated over time. Conclusion: In our trauma system, results suggest that a series of 15 PPI supported by literature review or expert opinion can be calculated using routinely collected trauma registry data. We have provided evidence of their discrimination, construct validity, and forecasting properties. The between-center variance observed in this study highlights the importance of evaluating process performance in integrated trauma systems. PMID:23723617

  4. Trauma teams and time to early management during in situ trauma team training

    PubMed Central

    Härgestam, Maria; Lindkvist, Marie; Jacobsson, Maritha; Brulin, Christine

    2016-01-01

    Objectives To investigate the association between the time taken to make a decision to go to surgery and gender, ethnicity, years in profession, experience of trauma team training, experience of structured trauma courses and trauma in the trauma team, as well as use of closed-loop communication and leadership styles during trauma team training. Design In situ trauma team training. The patient simulator was preprogrammed to represent a severely injured patient (injury severity score: 25) suffering from hypovolemia due to external trauma. Setting An emergency room in an urban Scandinavian level one trauma centre. Participants A total of 96 participants were divided into 16 trauma teams. Each team consisted of six team members: one surgeon/emergency physician (designated team leader), one anaesthesiologist, one registered nurse anaesthetist, one registered nurse from the emergency department, one enrolled nurse from the emergency department and one enrolled nurse from the operating theatre. Primary outcome HRs with CIs (95% CI) for the time taken to make a decision to go to surgery was computed from a Cox proportional hazards model. Results Three variables remained significant in the final model. Closed-loop communication initiated by the team leader increased the chance of a decision to go to surgery (HR: 3.88; CI 1.02 to 14.69). Only 8 of the 16 teams made the decision to go to surgery within the timeframe of the trauma team training. Conversely, call-outs and closed-loop communication initiated by the team members significantly decreased the chance of a decision to go to surgery, (HR: 0.82; CI 0.71 to 0.96, and HR: 0.23; CI 0.08 to 0.71, respectively). Conclusions Closed-loop communication initiated by the leader appears to be beneficial for teamwork. In contrast, a high number of call-outs and closed-loop communication initiated by team members might lead to a communication overload. PMID:26826152

  5. New Staphylinidae (Coleoptera) records with new collection data from New Brunswick, and an addition to the fauna of Quebec, Canada: Aleocharinae

    PubMed Central

    Webster, Reginald P.; Klimaszewski, Jan; Sweeney, Jon D.; DeMerchant, Ian

    2012-01-01

    Abstract Thirty-eight species of Aleocharinae are newly reported from New Brunswick, bringing the total number of species known from the province to 216. Thirty-one of these species are newly recorded for the Maritime provinces, and four of them, Phloeopora oregona Casey, Gyrophaena michigana Seevers, Gyrophaena wisconsinica Seevers, and Tomoglossa decora (Casey), are newly recorded for Canada. Tomoglossa constitutes a new generic record for Canada. Collection and habitat data for all these species are presented and discussed. Color habitus, median lobe of the aedeagus, and male tergite and sternite 8 images are presented for the first time for Phloeopora oregona, and references to illustrations are provided for all other species included in this paper. A color habitus image is presented for Tomoglossa decora. PMID:22577319

  6. [The influence of minority sociolinguistic context on home support for seniors in a rural devitalized area: the case of Acadieville New Brunswick].

    PubMed

    Simard, Majella; Dupuis-Blanchard, Suzanne; Villalon, Lita; Gould, Odette; Éthier, Sophie; Gibbons, Caroline

    2015-06-01

    New Brunswick is one of the provinces most affected by the aging of the population. Moreover, aging at home in Francophone minority communities is a major challenge in rural areas. The goal of this paper is to identify the main advantages and disadvantages of aging at home and to expose organizational strategies deployed by seniors and their families in order to promote aging in place. The case study is the method of analysis that we have recommended. Our methodology is based on content analysis of 13 semi-structured interviews with seniors and their children. The results show that family and community support, resourcefulness and resiliency, the practice of leisure activities as well as the living environment are among the principal means used by older adults to promote aging at home. PMID:25792029

  7. Management of chest trauma: a review.

    PubMed

    Adebonojo, S A

    1993-01-01

    The incidence of chest trauma has increased significantly since the turn of the century especially in developed countries where rapid means of transportation has become part of daily life. Although gunshot wounds (GSWs) were the commonest causes of chest trauma in wartime, road traffic accidents (RTAs) have become the scourge of peacetime and modern civilization. Chest trauma is more common in males during the 2nd to the 5th decades of life with an average age of 40 years reducing their life expectancy by another 40 years at the most productive and active period of their lives. Despite improvement in ambulance service and rapid mobilization of victims from the scene of accident, about 10% of chest injured patients will die on the spot and another 5% die within an hour of reaching the hospital. Of the remaining 85%, five percent will require emergency thoracotomy for various reasons while 80% will respond to resuscitative measures and tube thoracostomy drainage alone. The primary aims in the management of chest trauma are prompt restoration of normal cardiorespiratory functions, control of haemorrhage, treatment of associated injuries and prevention of sepsis. Although the overall survival rate of trauma has improved in recent years, deaths are often due to airway obstruction, exsanguinating haemorrhage, flail chest, tension pneumothorax, cardiac tamponade and associated intracranial, intraabdominal and skeletal injuries. PMID:8398932

  8. Multidetector CT of blunt abdominal trauma.

    PubMed

    Soto, Jorge A; Anderson, Stephan W

    2012-12-01

    The morbidity, mortality, and economic costs resulting from trauma in general, and blunt abdominal trauma in particular, are substantial. The "panscan" (computed tomographic [CT] examination of the head, neck, chest, abdomen, and pelvis) has become an essential element in the early evaluation and decision-making algorithm for hemodynamically stable patients who sustained abdominal trauma. CT has virtually replaced diagnostic peritoneal lavage for the detection of important injuries. Over the past decade, substantial hardware and software developments in CT technology, especially the introduction and refinement of multidetector scanners, have expanded the versatility of CT for examination of the polytrauma patient in multiple facets: higher spatial resolution, faster image acquisition and reconstruction, and improved patient safety (optimization of radiation delivery methods). In this article, the authors review the elements of multidetector CT technique that are currently relevant for evaluating blunt abdominal trauma and describe the most important CT signs of trauma in the various organs. Because conservative nonsurgical therapy is preferred for all but the most severe injuries affecting the solid viscera, the authors emphasize the CT findings that are indications for direct therapeutic intervention. PMID:23175542

  9. Survival probability in patients with liver trauma.

    PubMed

    Buci, Skender; Kukeli, Agim

    2016-08-01

    Purpose - The purpose of this paper is to assess the survival probability among patients with liver trauma injury using the anatomical and psychological scores of conditions, characteristics and treatment modes. Design/methodology/approach - A logistic model is used to estimate 173 patients' survival probability. Data are taken from patient records. Only emergency room patients admitted to University Hospital of Trauma (former Military Hospital) in Tirana are included. Data are recorded anonymously, preserving the patients' privacy. Findings - When correctly predicted, the logistic models show that survival probability varies from 70.5 percent up to 95.4 percent. The degree of trauma injury, trauma with liver and other organs, total days the patient was hospitalized, and treatment method (conservative vs intervention) are statistically important in explaining survival probability. Practical implications - The study gives patients, their relatives and physicians ample and sound information they can use to predict survival chances, the best treatment and resource management. Originality/value - This study, which has not been done previously, explores survival probability, success probability for conservative and non-conservative treatment, and success probability for single vs multiple injuries from liver trauma. PMID:27477933

  10. The cost and compensability of trauma patients.

    PubMed

    Curtis, Kate; Dickson, Cara; Black, Deborah; Nau, Thomas

    2009-02-01

    Injury in Australia was responsible for 400 000 hospitalisations in 2002. This study aimed to examine the direct costs of trauma patients in a Level 1 trauma centre and determine the compensability of those patients. Data on all admitted patients (206) filling trauma criteria were collected prospectively over a 3-month period (November 2006 to January 2007). A 10-question survey was completed on each patient to record mechanism of injury, third party private health insurance or workers compensation, and direct costs were also obtained. 30% of trauma admissions had an injury severity score (ISS)> 15 (n = 62; median ISS =9; range, 1-56). Median length of stay was 3 days (range, 1-126). Almost half (47%) of the patients were involved in road trauma, and 29% in falls. More than half (53.4%) were eligible for compensation (21.8% of patients had full hospital health insurance cover, 21.4% third party insurance and 9.2% workers compensation). The mechanism of injury with the highest median cost per patient was assault, followed by pedal cyclists, pedestrians then motor vehicle collisions. PMID:19203337

  11. Blunt Force Trauma in Veterinary Forensic Pathology.

    PubMed

    Ressel, L; Hetzel, U; Ricci, E

    2016-09-01

    Veterinary pathologists commonly encounter lesions of blunt trauma. The development of lesions is affected by the object's mass, velocity, size, shape, and angle of impact and by the plasticity and mobility of the impacted organ. Scrape, impact, and pattern abrasions cause localized epidermal loss and sometimes broken hairs and implanted foreign material. Contusions are best identified after reflecting the skin, and must be differentiated from coagulopathies and livor mortis. Lacerations-traumatic tissue tears-may have irregular margins, bridging by more resilient tissue, deviation of the wound tail, crushed hairs, and unilateral abrasion. Hanging or choking can cause circumferential cervical abrasions, contusions and rupture of hairs, hyoid bone fractures, and congestion of the head. Other special forms of blunt trauma include fractured nails, pressure sores, and dog bites. Ocular blunt trauma causes extraocular and intraocular hemorrhages, proptosis, or retinal detachment. The thoracic viscera are relatively protected from blunt trauma but may develop hemorrhages in intercostal muscles, rib fractures, pulmonary or cardiac contusions or lacerations with subsequent hemothorax, pneumothorax, or cardiac arrhythmia. The abdominal wall is resilient and moveable, yet the liver and spleen are susceptible to traumatic laceration or rupture. Whereas extravasation of blood can occur after death, evidence of vital injury includes leukocyte infiltration, erythrophagocytosis, hemosiderin, reparative lesions of fibroblast proliferation, myocyte regeneration in muscle, and callus formation in bone. Understanding these processes aids in the diagnosis of blunt force trauma including estimation of the age of resulting injuries. PMID:27381403

  12. Reconstruction after pancreatic trauma by pancreaticogastrostomy

    PubMed Central

    Martín, Gonzalo Martín; Morillas, Patricia Jiménez; Pino, José C. Rodríguez; Canis, José M. Morón; Argenté, Francesc X. González

    2015-01-01

    Introduction Pancreatic lesions are very infrequent after closed abdominal trauma (5% of cases) with a complication rate that affects 30–40% of patients, and a mortality rate that can reach 39%. In our experience, closed abdominal traumatisms occurring at typical popular horse-riding festivals in our region constitute a high risk of pancreatic trauma. The purpose of the present paper is to raise awareness about our experience in the diagnosis and treatment of pancreatic lesions secondary to closed abdominal traumatism. Presentation of case We present the clinical cases of two young patients who, after suffering blunt abdominal trauma secondary to the impact of a horse during the celebration of typical horse-riding festival, were diagnosed with pancreatic trauma type III. The treatment was surgical in both cases and consisted in performing a pancreaticogastric anastomosis with preservation of the distal pancreas and spleen. The postoperative period was uneventful and, at present, both patients are asymptomatic. Discussion Signs and symptoms caused by pancreatic lesion are unspecific and difficult to objectify. With some limitations CT is the imaging test of choice for diagnosis and staging in the acute phase. The Wirsung section is indication for surgical treatment. The most extended surgical procedure in these cases is the resection of pancreatic body, tail, and spleen. Conclusion The identification of a pancreatic injury after closed abdominal trauma requires a high suspicion based on the injury mechanism. A safer option may be the distal pancreatic preservation with pancreaticogastric anastomosis in grade III lesions with healthy pancreatic tissue. PMID:25744560

  13. [Long-term survival after severe trauma].

    PubMed

    Mutschler, W; Mutschler, M; Graw, M; Lefering, R

    2016-07-01

    Long-term survival after severe trauma is rarely addressed in German trauma journals although knowledge of life expectancy and identification of factors contributing to increased mortality are important for lifetime care management, development of service models, and targeting health promotion and prevention interventions. As reliable data in Germany are lacking, we compiled data mainly from the USA and Australia to describe life expectancy, risk factors, and predictors of outcome in patients experiencing traumatic spinal cord injury, traumatic brain injury, and polytrauma. Two years after trauma, life expectancy in all three categories was significantly lower than that of the general population. It depends strongly on severity of disability, age, and gender and is quantifiable. Whereas improvements in medical care have led to a marked decline in short-term mortality, surprisingly long-term survival in severe trauma has not changed over the past 30 years. Therefore, there is need to intensify long-term trauma patient care and to find new strategies to limit primary damage. PMID:27342106

  14. [Multiple trauma and the management structure].

    PubMed

    Sturm, J

    1999-01-01

    The implementation of Quality Management Procedures is necessary in evaluating the treatment of multiple trauma-patients. The development of standards in structures of the trauma management system is the first step to insure quality (appraisal of structure). But the amount of investment in the trauma system structure is limited by 1. The resources available, 2. The efficacy of the applied resources, i.e. the principle of diminishing returns of investment. Centralization of care in Level I Trauma Centers is not realistic in every situation. Transport time can be too long and exceed the critical "golden hour". Review of current data indicates that in approximately 50% of the time, helicopter transport is not possible due to weather, geography, or other limiting factors. This leads to a fragmented transport system, often necessitating extensive transport times, resulting in less than optimal patient outcomes. In order to optimize quality, the following needs to be done: Assessment of process: 1. Realistic algorithms or protocols for primary transport must be developed. 2. Agreements must be reached between designated regional hospitals. 3. Treatment algorithms or protocols which address the different care levels, must be developed by a committee of clinical experts. 4. Quality management procedures must be implemented to monitor the quality of care delivered. Assessments of outcomes: 1. Outcome data must be reviewed on an ongoing basis to determine if changes must be made in the system design or the transportation & clinical algorithms/protocols. 2. Such outcome data should be gathered by means of a Trauma Registry. PMID:10612209

  15. Mexico to New Brunswick

    NASA Video Gallery

    This video was taken by the crew of Expedition 30 onboard the International Space Station. The sequence of shots was taken January 30, 2012 from 06:13:36 to 06:23:09 GMT, on a pass from northern Me...

  16. [Mesenteric trauma: management in austere environments].

    PubMed

    Peycru, T; Biance, N; Avaro, J P; Savoie, P H; Tardat, E; Balandraud, P

    2006-04-01

    Mesenteric trauma, i.e., injuries located in the bowel or organs supplied by the superior mesenteric artery, can be life-threatening. The incidence of these lesions is low. Most occur as result of blunt and penetrating abdominal trauma due mainly to gunshot wounds or road accidents. Management of these serious injuries can be challenging in the military field hospitals. The major problem in austere environment is the unavailabiity of computerized axial and other tools gene rally used for diagnosis. As an alternative to tomography diagnostic peritoneal lavage can be used with a high sensitivity for the detection of mesenteric trauma. The second difficulty is technical. General surgeons without vasular training or supplies must prepared to suspect and reonstuct lesions of the superior mesenteric available resources. PMID:16775948

  17. Psychologic trauma, posttraumatic stress disorder, and dermatology.

    PubMed

    Gupta, Madhulika A; Lanius, Ruth A; Van der Kolk, Bessel A

    2005-10-01

    Psychologic trauma refers to events (such as sexual assault, major earthquake, or plane crashes) that overwhelm an individual's capacity to cope. Psychologic trauma can result in chronic and recurring dermatologic symptoms that persist after the trauma subsides. Examples are cutaneous sensory flashbacks (which may be fragments of the sensory component of the traumatic experience), autonomic hyperarousal (with symptoms such as profuse sweating or flare-up of an underlying stress-reactive dermatosis), conversion symptoms (such as numbness, pain, or other medically unexplained cutaneous symptoms), and cutaneous self-injury (manifesting in many forms, including trichotillomania, dermatitis artefacta, and neurotic excoriations--tension-reducing behaviors in patients who have posttraumatic stress disorder). PMID:16112441

  18. Early management of ballistic hand trauma.

    PubMed

    Eardley, W G P; Stewart, M P M

    2010-02-01

    Complex hand wounds are an unfortunate consequence of conflict. Increased battlefield survival rates have resulted in an evolving range of ballistic hand trauma encountered by deployed surgical teams, requiring increased knowledge and understanding of these injuries. In the civilian setting, the combined threats of gun crime and acts of terrorism warrant appreciation for such injury among all surgeons. Surgeons often have to relearn the management of ballistic hand trauma and other aspects of war surgery under difficult circumstances because the experiences of their predecessors may be forgotten. Current evidence regarding these injuries is scarce. Ballistic hand trauma is rarely isolated. The demand on surgical resources from combat injury is significant, and it is imperative that a phased strategy be followed in this setting. Minimal, accurate débridement and decompression with early stability are crucial. Delayed primary closure and an awareness of future reconstructive options are fundamental. PMID:20118328

  19. Leukotrienes as mediators in tissue trauma

    SciTech Connect

    Denzlinger, C.; Rapp, S.; Hagmann, W.; Keppler, D.

    1985-10-18

    A significant increase in the production of cysteinyl leukotrienes was observed after mechanical or thermal trauma in the anesthesized rat. The amount of biliary N-acetyl-leukotriene E4, which represents a suitable indicator for blood plasma leukotrienes, was used as a measure of leukotriene generation. Cysteinyl leukotrienes were rapidly eliminated from blood plasma into bile where N-acetyl-leukotriene E4 was the major metabolite. Leukotrienes were at a much lower concentration in blood plasma than in bile and differed in the pattern of metabolites. The detected amounts of leukotrienes were sufficient to induce known phenomena associated with trauma, such as tissue edema and circulatory and respiratory dysfunction. Increased leukotriene generation appears to play an important role in the pathophysiology of tissue trauma.

  20. Trauma Survival Margin Analysis: A Dissection of Trauma Center Performance through Initial Lactate.

    PubMed

    Kassar, Odette M; Eklund, Erik A; Barnhardt, William F; Napoli, Nicolas J; Barnes, Laura E; Young, Jeffrey S

    2016-07-01

    Measurement of trauma center performance presently relies on W-score calculation and comparison to national data sets. A limitation to this practice is a skewing of the W score, as it determines overall performance of a trauma population that is often heavily weighted by patients of low acuity. The University of Virginia relative mortality metric (RMM) was formulated to provide higher resolution in identifying areas of performance improvement within subpopulations of a trauma center using traditional Trauma Injury Severity Score methodology. Lactic acidosis has been established as a risk factor for mortality in the setting of trauma. This study aims to compare survival margin, defined as the area between actual and predicted mortality curves, in patients with either normal or elevated initial lactate. W score and RMM were calculated and compared in these cohorts. Whereas the W score suggested increased survival within the high initial lactate group, the RMM demonstrated the expected finding of increased survival margin in the normal lactate cohort. The RMM is a potentially valuable tool for trauma centers to monitor and improve performance. In addition, these findings validate the use of lactate as a triage and risk adjustment tool in the trauma setting. PMID:27457866

  1. Trauma care and referral patterns in Rwanda: implications for trauma system development

    PubMed Central

    Ntakiyiruta, Georges; Wong, Evan G.; Rousseau, Mathieu C.; Ruhungande, Landouald; Kushner, Adam L.; Liberman, Alexander S.; Khwaja, Kosar; Dakermandji, Marc; Wilson, Marnie; Razek, Tarek; Kyamanywa, Patrick; Deckelbaum, Dan L.

    2016-01-01

    Background Trauma remains a leading cause of death worldwide. The development of trauma systems in low-resource settings may be of benefit. The objective of this study was to describe operative procedures performed for trauma at a tertiary care facility in Kigali, Rwanda, and to evaluate geographical variations and referral patterns of trauma care. Methods We retrospectively reviewed all prospectively collected operative cases performed at the largest referral hospital in Rwanda, the Centre Hospitalier Universitaire de Kigali (CHUK), between June 1 and Dec. 1, 2011, for injury-related diagnoses. We used the Pearson χ2 and Fisher exact tests to compare cases arising from within Kigali to those transferred from other provinces. Geospatial analyses were also performed to further elucidate transfer patterns. Results Over the 6-month study period, 2758 surgical interventions were performed at the CHUK. Of these, 653 (23.7%) were for trauma. Most patients resided outside of Kigali city, with 337 (58.0%) patients transferred from other provinces and 244 (42.0%) from within Kigali. Most trauma procedures were orthopedic (489 [84.2%]), although general surgery procedures represented a higher proportion of trauma surgeries in patients from other provinces than in patients from within Kigali (28 of 337 [8.3%] v. 10 of 244 [4.1%]). Conclusion To our knowledge, this is the first study to highlight geographical variations in access to trauma care in a low-income country and the first description of trauma procedures at a referral centre in Rwanda. Future efforts should focus on maturing prehospital and interfacility transport systems, strengthening district hospitals and further supporting referral institutions. PMID:26812407

  2. National Trauma Database (NTrD)--improving trauma care: first year report.

    PubMed

    Sabariah, F J; Ramesh, N; Mahathar, A W

    2008-09-01

    The first Malaysian National Trauma Database was launched in May 2006 with five tertiary referral centres to determine the fundamental data on major trauma, subsequently to evaluate the major trauma management and to come up with guidelines for improved trauma care. A prospective study, using standardized and validated questionnaires, was carried out from May 2006 till April 2007 for all cases admitted and referred to the participating hospitals. During the one year period, 123,916 trauma patients were registered, of which 933 (0.75%) were classified as major trauma. Patients with blunt injury made up for 83.9% of cases and RTA accounted for 72.6% of injuries with 64.9% involving motorcyclist and pillion rider. 42.8% had severe head injury with an admission Glasgow Coma Scale (GCS) of 3-8 and the Revised Trauma Score (RTS) of 5-6 were recorded in 28.8% of patients. The distribution of Injury Severity Score (ISS) showed that 42.9% of cases were in the range of 16-24. Only 1.9% and 6.3% of the patients were reviewed by the Emergency Physician and Surgeon respectively. Patients with admission systolic blood pressure of less than 90 mmHg had a death rate of 54.6%. Patients with severe head injury (GCS < 9), 45.1% died while 79% patients with moderate head injury survived. There were more survivors within the higher RTS range compared to the lower RTS. Patients with direct admission accounted for 52.3% of survivors and there were 61.7% survivors for referred cases. In conclusion, NTrD first report has successfully demonstrated its significance in giving essential data on major trauma in Malaysia, however further expansion of the study may reflect more comprehensive trauma database in this country. PMID:19227673

  3. Assessment of maxillofacial trauma in emergency department

    PubMed Central

    2014-01-01

    Introduction The incidence and epidemiological causes of maxillofacial (MF) trauma varies widely. The objective of this study is to point out maxillofacial trauma patients’ epidemiological properties and trauma patterns with simultaneous injuries in different areas of the body that may help emergency physicians to deliver more accurate diagnosis and decisions. Methods In this study we analyze etiology and pattern of MF trauma and coexisting injuries if any, in patients whose maxillofacial CT scans was obtained in a three year period, retrospectively. Results 754 patients included in the study consisting of 73.7% male and 26.3% female, and the male-to-female ratio was 2.8:1. Mean age was 40.3 ± 17.2 years with a range of 18 to 97. 57.4% of the patients were between the ages of 18–39 years and predominantly male. Above 60 years of age, referrals were mostly woman. The most common cause of injuries were violence, accounting for 39.7% of the sample, followed by falls 27.9% and road traffic accidents 27.2%. The primary cause of injuries were violence between ages 20 and 49 and falls after 50. Bone fractures found in 56,0% of individuals. Of the total of 701 fractured bones in 422 patients the most frequent was maxillary bone 28,0% followed by nasal bone 25,3%, zygoma 20,2%, mandible 8,4%, frontal bone 8,1% and nasoethmoidoorbital bone 3,1%. Fractures to maxillary bone were uppermost in each age group. 8, 9% of the patients had brain injury and only frontal fractures is significantly associated to TBI (p < 0.05) if coexisting facial bone fracture occurred. Male gender has statistically stronger association for suffering TBI than female (p < 0, 05). Most common cause of TBI in MF trauma patients was violence (47, 8%). 158 of the 754 patients had consumed alcohol before trauma. No statistically significant data were revealed between alcohol consumption gender and presence of fracture. Violence is statistically significant (p < 0.05) in these

  4. Coronary Thrombosis without Dissection following Blunt Trauma

    PubMed Central

    Sibel, Michael; Thomas, Peter; Burt, Francis; Cipolla, James; Puleo, Peter; Baker, Keith

    2016-01-01

    Blunt trauma to the chest resulting in coronary thrombosis and ST elevation myocardial infarction (STEMI) is a rare but well-described occurrence in adults. Angiography in such cases has generally disclosed complete epicardial coronary occlusion with thrombus, indistinguishable from the findings commonly found in spontaneous plaque rupture due to atherosclerotic disease. In all previously reported cases in which coronary interrogation with intravascular ultrasound (IVUS) was performed in association with acute revascularization, coronary artery dissection was implicated as the etiology of coronary thrombosis. We present the first case report of blunt trauma-associated coronary thrombosis without underlying atherosclerosis or coronary dissection, as documented by IVUS imaging. PMID:27006836

  5. Penetrating Trauma to the Parotid Gland.

    PubMed

    Tisch, Matthias; Maier, Susanne; Maier, Heinz

    2015-08-01

    Penetrating trauma to the parotid gland may present unique challenges especially when Stensen duct, neurovascular structures, and/or collateral organs are involved. Especially ballistic injuries caused by high-velocity projectiles or fragments of grenades and improvised explosive devices are often associated with massive tissue damage and a high risk of infections and other posttraumatic complications. Because penetrating parotid trauma is not very common, only limited information on the primary treatment of such injuries is available. This article gives a short overview about actual aspects on diagnosis and treatment strategies especially focusing on ballistic parotid injuries. PMID:26372712

  6. Anorectal avulsion: an exceptional rectal trauma.

    PubMed

    Ibn Majdoub Hassani, Karim; Ait Laalim, Said; Benjelloun, El Bachir; Toughrai, Imane; Mazaz, Khalid

    2013-01-01

    Anorectal avulsion is an exceptional rectal trauma in which the anus and sphincter no longer join the perineum and are pulled upward. As a result, they ventrally follow levator ani muscles. We present a rare case of a 29-years old patient who was admitted in a pelvic trauma context; presenting a complete complex anorectal avulsion. The treatment included a primary repair of the rectum and a diverting colostomy so as to prevent sepsis. Closure of the protective sigmoidostomy was performed seven months after the accident and the evolution was marked by an anal stenosis requiring iterative dilatations. PMID:24094142

  7. Contemporary management of blunt aortic trauma.

    PubMed

    Dubose, J J; Azizzadeh, A; Estrera, A L; Safi, H J

    2015-10-01

    Blunt thoracic aortic injury (BTAI) remains a common cause of death following blunt mechanisms of trauma. Among patients who survive to reach hospital care, significant advances in diagnosis and treatment afford previously unattainable survival. The Society for Vascular Surgery (SVS) guidelines provide current best-evidence suggestions for treatment of BTAI. However, several key areas of controversy regarding optimal BTAI care remain. These include the refinement of selection criteria, timing for treatment and the need for long-term follow-up data. In addition, the advent of the Aortic Trauma Foundation (ATF) represents an important development in collaborative research in this field. PMID:25868973

  8. Scoring systems of severity in patients with multiple trauma.

    PubMed

    Rapsang, Amy Grace; Shyam, Devajit Chowlek

    2015-04-01

    Trauma is a major cause of morbidity and mortality; hence severity scales are important adjuncts to trauma care in order to characterize the nature and extent of injury. Trauma scoring models can assist with triage and help in evaluation and prediction of prognosis in order to organise and improve trauma systems. Given the wide variety of scoring instruments available to assess the injured patient, it is imperative that the choice of the severity score accurately match the application. Even though trauma scores are not the key elements of trauma treatment, they are however, an essential part of improvement in triage decisions and in identifying patients with unexpected outcomes. This article provides the reader with a compendium of trauma severity scales along with their predicted death rate calculation, which can be adopted in order to improve decision making, trauma care, research and in comparative analyses in quality assessment. PMID:25015031

  9. A Key to Success: Building an Internal Trauma Education Program.

    PubMed

    Pirrung, Joan Marie

    2016-01-01

    Developing an internal education program that specifically meets the needs of your trauma center's nurses is fundamentally an optimal method in educating. This article offers an overview of an internally developed trauma educational series that was created for novice and experienced nurses who work in a Level 1 trauma center. PMID:27414147

  10. Trauma, Binge Eating, and the "Strong Black Woman"

    ERIC Educational Resources Information Center

    Harrington, Ellen F.; Crowther, Janis H.; Shipherd, Jillian C.

    2010-01-01

    Objective: The primary goal of this study was to test a culturally specific model of binge eating in African American female trauma survivors, investigating potential mechanisms through which trauma exposure and distress were related to binge eating symptomatology. Method: Participants were 179 African American female trauma survivors who…

  11. Multidimensional Model of Trauma and Correlated Antisocial Personality Disorder

    ERIC Educational Resources Information Center

    Martens, Willem H. J.

    2005-01-01

    Many studies have revealed an important relationship between psychosocial trauma and antisocial personality disorder. A multidimensional model is presented which describes the psychopathological route from trauma to antisocial development. A case report is also included that can illustrate the etiological process from trauma to severe antisocial…

  12. A Framework for Treating Cumulative Trauma with Art Therapy

    ERIC Educational Resources Information Center

    Naff, Kristina

    2014-01-01

    Cumulative trauma is relatively undocumented in art therapy practice, although there is growing evidence that art therapy provides distinct benefits for resolving various traumas. This qualitative study proposes an art therapy treatment framework for cumulative trauma derived from semi-structured interviews with three art therapists and artistic…

  13. Predictors of Trauma-Related Symptoms among Runaway Adolescents

    ERIC Educational Resources Information Center

    McCarthy, Michael D.; Thompson, Sanna J.

    2010-01-01

    Little is known about trauma-related symptoms among runaway adolescents. Precocious departure from familial homes often exposes youth to traumatic victimization. This study examined the extent to which runaway adolescents present trauma symptomotology and assessed factors that predict trauma symptoms. Participants (N = 350) were 12-18 years of age…

  14. Teaching with Awareness: The Hidden Effects of Trauma on Learning

    ERIC Educational Resources Information Center

    Sitler, Helen Collins

    2009-01-01

    Educators are often unaware of the effects of psychological trauma on learners. Through the examples of two students, a fifth grader and a first-year college student, the author explores the intersections between trauma and learning and discusses how teachers might mitigate the effects of trauma in their classrooms.

  15. Impact of advanced technologies on rural trauma care

    NASA Astrophysics Data System (ADS)

    McGrane, Michael J.; Gainor, Dia; Buttrey, Jan M.; Taska, John D.; Pierce, Gregg E.; Wolff, Barack

    1994-03-01

    The high incidence of traumatic injury and death is significant among the western, rural United States. A number of characteristics and factors contribute to this concern, among them extremes in population, distance, terrain, and resources. Opportunity exists to apply current and future advanced technology to impact trauma prevention, communication, emergency response, trauma system support and monitor trauma outcome.

  16. Overview of Diagnosis and Treatment of Psychological Trauma in Children.

    ERIC Educational Resources Information Center

    Munson, Carlton E.

    1995-01-01

    Provides comprehensive definition of psychological trauma and offers guidance to practitioners who are increasingly needed to treat traumatized children. Key therapy considerations are organized around the role of dissociation and repetition compulsion in trauma. Presents treatments in connection with aloneness of trauma experience, dream and…

  17. Are we prepared for high standards of trauma care?

    PubMed

    2016-09-01

    For some years emergency nurses have speculated about what a competent standard of emergency nursing should look like. This is particularly important when managing complex trauma cases. The Trauma Quality Improvement Network System (TQuINS) was created to assess whether trauma care is safe and carried out by practitioners proficient in dealing with complex cases (analysis, page 8 ). PMID:27615325

  18. Role of Appraisals in Expressed Anger after Trauma

    ERIC Educational Resources Information Center

    Whiting, Diane; Bryant, Richard A.

    2007-01-01

    Anger is a common problem in trauma-exposed individuals. This study investigated factors that contribute to post-traumatic anger in civilian trauma survivors. Fifty-one trauma-exposed individuals were assessed for expressed anger, post-traumatic stress disorder (PTSD), daily hassles, maladaptive cognitions and blame. PTSD and non-PTSD participants…

  19. Perioperative management of pediatric trauma patients

    PubMed Central

    Ivashkov, Yulia; Bhananker, Sanjay M

    2012-01-01

    Pediatric trauma presents significant challenges to the anesthesia provider. This review describes the current trends in perioperative anesthetic management, including airway management, choice of anesthesia agents, and fluid administration. The review is based on the PubMed search of literature on perioperative care of severely injured children. PMID:23181208

  20. Treating Survivors of War Trauma and Torture.

    ERIC Educational Resources Information Center

    Hanscom, Karen L.

    2001-01-01

    Proposes a mental health treatment model for survivors of torture and war trauma, presenting principles underlying such treatment and a developmental view of such abuse. Describes a Guatemalan project that uses the model to train village women to treat survivors in their communities and a U.S. torture treatment program that treats survivors…

  1. Trauma in Early Childhood: A Neglected Population

    ERIC Educational Resources Information Center

    De Young, Alexandra C.; Kenardy, Justin A.; Cobham, Vanessa E.

    2011-01-01

    Infants, toddlers and preschoolers are a high risk group for exposure to trauma. Young children are also vulnerable to experiencing adverse outcomes as they are undergoing a rapid developmental period, have limited coping skills and are strongly dependent on their primary caregiver to protect them physically and emotionally. However, although…

  2. LSCI in Trauma-Informed Care

    ERIC Educational Resources Information Center

    Fecser, Frank A.

    2014-01-01

    There is increasing awareness that many children who present behavioral challenges have experienced relational trauma. These youngsters are not well served by traditional interventions in schools, treatment settings, and communities. Adults responsible for these young people often get drawn into conflict cycles and coercive interventions that only…

  3. Understanding and Addressing Early Childhood Trauma

    ERIC Educational Resources Information Center

    Garro, Adrienne; Brandwein, David; Calafiore, Tara; Rittenhouse, Nicolette

    2011-01-01

    The notion that development influences children's responses to traumatic stress is not novel. Chronological age and maturity level interact with environmental factors to mediate responses to trauma. Clinicians and researchers have confirmed that children can experience the full range of traumatic stress reactions seen in adults, and many youth…

  4. Healing the Hidden Wounds of Racial Trauma

    ERIC Educational Resources Information Center

    Hardy, Kenneth V.

    2013-01-01

    This article examines racial trauma and highlights strategies for healing and transformation to support the disproportionate number of children and youth of color who fail in school and become trapped in the pipelines of treatment, social service, and justice systems. The difficulty in meeting the needs of these children and youth is failing to…

  5. Advanced Trauma Life Support aboard RFA Argus.

    PubMed

    Greenslade, G L; Taylor, R H

    1992-01-01

    The Advanced Trauma Life Support (ATLS) system was adopted for casualty reception and resuscitation. ATLS permitted well-informed triage decisions to be made, coupled with appropriate initial, possibly life-saving, treatment. The training given on board has continued to benefit patients treated by ex-Argus staff in their peacetime roles. PMID:1453364

  6. Biomedical Techniques for Post Head Trauma Victims.

    ERIC Educational Resources Information Center

    Doney, Judith V.

    The nature and effects of head trauma are discussed. Among the most common deficits noted are impaired cognition, difficulties in oral and written communication, sensory problems, and marked personality changes. Suggestions are offered for dealing with each type of deficit, such as using alarm clocks and other tools to remind the individual about…

  7. Tetanus after blunt lawn mower trauma

    PubMed Central

    Normand, Camilla; Fostervold, Aasmund; Haarr, Elin; Skontorp, Marie; Berg, Åse

    2015-01-01

    A patient presented with tetanus ten days after blunt trauma with a lawn mower. Our case describes the diagnosis and treatment of this patient with an infectious disease commonly seen in the developing world but rarely seen in the developed world. PMID:26793459

  8. Teamwork improvement in emergency trauma departments

    PubMed Central

    Khademian, Zahra; Sharif, Farkhondeh; Tabei, Seyed Ziaadin; Bolandparvaz, Shahram; Abbaszadeh, Abbas; Abbasi, Hamid Reza

    2013-01-01

    Background: Interprofessional teamwork is considered as the key to improve the quality of patient management in critical settings such as trauma emergency departments, but it is not fully conceptualized in these areas to guide practice. The aim of this article is to explore interprofessional teamwork and its improvement strategies in trauma emergency departments. Materials and Methods: Participants of this qualitative study consisted of 11 nurses and 6 supervisors recruited from the emergency departments of a newly established trauma center using purposive sampling. Data were generated using two focus group and six in-depth individual interviews, and analyzed using qualitative content analysis. Results: Interprofessional teamwork attributes and improvement strategies were emerged in three main themes related to team, context, and goal. These were categorized as the effective presence of team members, role definition in team framework, managerial and physical context, effective patient management, and overcoming competing goals Conclusions: Interprofessional teamwork in trauma emergency departments is explained as interdependence of team, context, and goal; so, it may be improved by strengthening these themes. The findings also provide a basis to evaluate, teach, and do research on teamwork. PMID:24403932

  9. Trauma Exposure and the Social Work Practicum

    ERIC Educational Resources Information Center

    Didham, Steve; Dromgole, Laura; Csiernik, Rick; Karley, Mary Lou; Hurley, Dermot

    2011-01-01

    In this study, 58 undergraduate and graduate students at 1 Canadian school of social work voluntarily completed a survey at the conclusion of their academic year consisting of open- and closed-ended questions intended to examine their exposure to trauma during the course of their field practice. The authors discovered that the majority of students…

  10. Cognitive Behavioral Intervention for Trauma in Schools

    ERIC Educational Resources Information Center

    Jaycox, Lisa H.; Kataoka, Sheryl H.; Stein, Bradley D.; Langley, Audra K.; Wong, Marleen

    2012-01-01

    Developed out a community participatory research partnership with schools, the Cognitive-Behavioral Intervention for Trauma in Schools Program is a targeted intervention for school children who have experienced a traumatic or violent event and have symptoms of posttraumatic stress disorder. This article describes the original development of the…

  11. Trauma as a shibboleth in psychoanalysis?

    PubMed

    Sacerdoti, G; Semi, A A

    1989-01-01

    The authors consider that the subject of trauma is a good example of how metapsychological constructs (in this case, in particular, the economic or quantitative point of view) originated as essential working hypotheses necessitated by clinical observation. These conceptualizations may help us to understand what finds expression in processes that are sensed as affects (als Affekte der Empfindung bemerkbar werden) either by the patient or by the analyst. In the case of trauma (in analysis), an object-relations approach is not only compatible (Balint) with metapsychology but seems to be positively implicit in a correct interpretation of the latter. Two clinical vignettes are given as evidence for this assumption. They illustrate an irruption of stimuli through the protective shield (Reizschutz) of the analytic field, initiated by the patient and the analyst respectively. For the purpose of grasping and working through such situations--thus helping the patient to fill the gap (Ablösung) between the quota of affect (Affektbetrag) and the idea (Vorstellung)--it is very useful for the analyst to refer to the concept of trauma, either in the narrow or in the broad sense proposed by Freud. For this reason, the authors believe that the concept of trauma is a shibboleth of psychoanalysis. PMID:2737835

  12. Effective Bullying-Trauma Intervention Technique

    ERIC Educational Resources Information Center

    Pierce, Kenneth L.

    2010-01-01

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

  13. Trauma in pregnancy: assessment, management, and prevention.

    PubMed

    Murphy, Neil J; Quinlan, Jeffrey D

    2014-11-15

    Trauma complicates one in 12 pregnancies, and is the leading nonobstetric cause of death among pregnant women. The most common traumatic injuries are motor vehicle crashes, assaults, falls, and intimate partner violence. Nine out of 10 traumatic injuries during pregnancy are classified as minor, yet 60% to 70% of fetal losses after trauma are a result of minor injuries. In minor trauma, four to 24 hours of tocodynamometric monitoring is recommended. Ultrasonography has low sensitivity, but high specificity, for placental abruption. The Kleihauer-Betke test should be performed after major trauma to determine the degree of fetomaternal hemorrhage, regardless of Rh status. To improve the effectiveness of cardiopulmonary resuscitation, clinicians should perform left lateral uterine displacement by tilting the whole maternal body 25 to 30 degrees. Unique aspects of advanced cardiac life support include early intubation, removal of all uterine and fetal monitors, and performance of perimortem cesarean delivery. Proper seat belt use reduces the risk of maternal and fetal injuries in motor vehicle crashes. The lap belt should be placed as low as possible under the protuberant portion of the abdomen and the shoulder belt positioned off to the side of the uterus, between the breasts and over the midportion of the clavicle. All women of childbearing age should be routinely screened for intimate partner violence. PMID:25403036

  14. Lower limb trauma: primary treatment and reconstruction.

    PubMed Central

    Godfrey, A. M.

    1989-01-01

    The requirements of lower limb trauma reconstruction are discussed with comment on the availability of plastic surgery services. The significance of early efficient soft tissue management is stressed and a plea is made for better cooperation between plastic and orthopaedic surgery in both training and practice. Images fig. 1 PMID:2589787

  15. Monocyte-related immunopathologies in trauma patients.

    PubMed

    Laudanski, Krzysztof; Wyczechowska, Dorota

    2005-01-01

    Mechanical trauma is one of the most important causes of morbidity in the developed world. The response of the immune system to mechanical insult is of paramount importance for the patient's recovery. Shortly after trauma, the indiscriminate systemic inflammatory response syndrome (SIRS) is mediated by circulating monocytes (M Øs) and other innate immunity components. Then acquired immunity, limited to the offending pathogen and the site of injury, gradually preponderates. SIRS is followed by the compensatory anti-inflammatory response syndrome (CARS), where the initial inflammatory response is quenched by anti-inflammatory mediators. This precisely regulated process of immune system activation in response to trauma can be easily deviated, resulting in multiorgan failure (MOF) and increased mortality. Excessive activation of inflammatory M Øs in the SIRS phase, premature or exorbitant CARS, a predominance of macrophages (Macs) in the blood stream and peripheral tissues, as well as a depletion of dendritic cells are often seen in trauma patients and contribute to the development of MOF. Here we explore several mechanisms of pathological MØ; activation in patients with severe mechanical traumatic injury without accompanying sepsis. PMID:16088316

  16. Play Therapy for Severe Psychological Trauma. [Videotape

    ERIC Educational Resources Information Center

    Gil, Eliana

    In this 36-minute educational video, a play and family therapist elucidates the nature of trauma, how to recognize it clinically, and how to manage its powerful effects upon children's development with the use of specific play materials and techniques. With a reenacted clinical interview, footage from an actual play therapy session, and a detailed…

  17. Young Children and Trauma: Intervention and Treatment

    ERIC Educational Resources Information Center

    Osofsky, Joy D., Ed.

    2004-01-01

    Recent years have seen significant advances in knowledge about the effects of exposure to psychological trauma on young children from birth to age 5. This volume brings together leading experts to address practical considerations in working with traumatized young children and their caregivers. State-of-the-art assessment and treatment approaches…

  18. Training nurses and technologists for trauma surgery.

    PubMed

    Ross, Cynthia

    2006-01-01

    Getting assigned to a trauma for the first time is still stressful for perioperative staff members. However, viewing the video/DVD does seem to help overcome some of the inherent anxiety. In addition, encouraging new or inexperienced staff nurses and technologists to participate on trauma cases with more seasoned staff also seems to alleviate some of those fears. Saying "let's make believe it's an emergency" and setting up quickly for a scheduled case will keep those skills current. Having staff members utilize "what if" scenarios tends to keep them thinking and anticipating. Prioritizing and reviewing all the case actions will allow nurses and technologists to perform these actions/skills in an emergency without even thinking. Although specific internal injuries a trauma patient will have cannot always be predicted, the perioperative staff members must still use their basic training to be ready for anything that comes through the doors to surgery. Making a video seemed like an overwhelming task at first, but the team sought out guidance and support from appropriate resources (videographer, surgeons, etc) in order to collaborate effectively, and the result was a great educational product. The Staff Development team continues to present inservices that are specialty or case specific. The "trauma" aspect of these presentations is also always included to reinforce the topics that were brought out in the video. PMID:17263102

  19. Trauma-informed cognitive remediation group therapy.

    PubMed

    Spei, Ekaterini; Muenzenmaier, Kristina; Conan, Mara; Battaglia, Joseph

    2014-07-01

    This brief report presents the rationale for the importance of integrating trauma therapy with cognitive remediation in order to enhance both component interventions in the treatment of serious mental illness. It describes a general format that allows the above integration and suggests that future studies should investigate the efficacy of the proposed group design. PMID:24911229

  20. September 11: Children's Responses to Trauma.

    ERIC Educational Resources Information Center

    Berson, Michael J.; Berson, Ilene R.

    2002-01-01

    Teachers can help children deal with confusing emotions during times of crisis by listening to them and creating a comfortable environment. This paper explains what teachers can do in the aftermath of the attacks of September 11th, 2001, focusing on the impact of trauma, how children of different ages react and cope, safety and the future, and…

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

    PubMed Central

    2010-01-01

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

  2. Alcohol abusive use increases facial trauma?

    PubMed Central

    Soares-Carneiro, Suzana-Célia-de-Aguiar; Matos da-Silva, Gessyca-Suielly-Melo; de-Barros-Caldas, Luciano-Cruz; Porto, Gabriela-Granja; Leal, Jefferson-Figueiredo; Catunda, Ivson

    2016-01-01

    Background Trauma is among the main death causes and morbidity in the world and is often related to the use of alcohol and its abuse has reached massive proportions, no matter if the country is developed or not, being considered as public health problem. Since there are very few randomized and prospective studies in literature about the association of facial trauma and the use of alcohol, this study aims to investigate the impact of alcohol use in facial trauma. Material and Methods This was a prospective and cross sectional study, involving facial trauma patients attended at Oral Maxillofacial Surgery Division of a State Hospital. Variables included patient´s profile, trauma etiology, facial region involved, type of injury and treatment and days of hospitalization. AUDIT test was applied to identify risks and damages of alcohol use and chemical dependence. Absolute distribution, uni and mutilvaried percentages were made for data evaluation. Pearson´s qui-squared and Fisher´s Exact tests were also used. Results One hundred patients were evaluated. The patient´s mean age was 33.50 years-old, 48% had between 17 and 29 years old, 28% had 30 to 39, and 24% 40 or more. Most of them were male (86%). The most frequent etiology was traffic accident (57%), the extraoral area was most committed (62%), the most frequent type of injury was fractures (78%) and the most affected bone was the mandible (36%). More than half of the patients (53%) had surgical treatment. 38% had their discharge from hospital right after the first attendance. The AUDIT most frequent answer was “moderate use” (46%) and use at risk (39%). There was significant difference between the use of alcohol (AUDIT) and hematoma (0.003) and number of days of hospitalization (p=0.005). Conclusions In this study it was not observed association between alcohol consumption using the AUDIT and trauma etiology, but patient victims of traffic accidents were classified as with risk in the scale. Most of the

  3. Grief and trauma intervention for children after disaster: exploring coping skills versus trauma narration.

    PubMed

    Salloum, Alison; Overstreet, Stacy

    2012-03-01

    This study evaluated the differential effects of the Grief and Trauma Intervention (GTI) with coping skills and trauma narrative processing (CN) and coping skills only (C). Seventy African American children (6-12 years old) were randomly assigned to GTI-CN or GTI-C. Both treatments consisted of a manualized 11-session intervention and a parent meeting. Measures of trauma exposure, posttraumatic stress symptoms, depression, traumatic grief, global distress, social support, and parent reported behavioral problems were administered at pre, post, 3 and 12 months post intervention. In general, children in both treatment groups demonstrated significant improvements in distress related symptoms and social support, which, with the exception of externalizing symptoms for GTI-C, were maintained up to 12 months post intervention. Results suggest that building coping skills without the structured trauma narrative may be a viable intervention to achieve symptom relief in children experiencing trauma-related distress. However, it may be that highly distressed children experience more symptom relief with coping skills plus narrative processing than with coping skills alone. More research on the differential effects of coping skills and trauma narration on child distress and adaptive functioning outcomes is needed. PMID:22317753

  4. Improving outcome in severe trauma: trauma systems and initial management: intubation, ventilation and resuscitation.

    PubMed

    Harris, Tim; Davenport, Ross; Hurst, Tom; Jones, Jonathan

    2012-10-01

    Severe trauma is an increasing global problem mainly affecting fit and healthy younger adults. Improvements in the entire pathway of trauma care have led to improvements in outcome. Development of a regional trauma system based around a trauma centre is associated with a 15-50% reduction in mortality. Trauma teams led by senior doctors provide better care. Although intuitively advantageous, the involvement of doctors in the pre-hospital care of trauma patients currently lacks clear evidence of benefit. Poor airway management is consistently identified as a cause of avoidable morbidity and mortality. Rapid sequence induction/intubation is frequently indicated but the ideal drugs have yet to be identified. The benefits of cricoid pressure are not clear cut. Dogmas in the management of pneumothoraces have been challenged: chest x-ray has a role in the diagnosis of tension pneumothoraces, needle aspiration may be ineffective, and small pneumothoraces can be managed conservatively. Identification of significant haemorrhage can be difficult and specific early resuscitation goals are not easily definable. A hypotensive approach may limit further bleeding but could worsen significant brain injury. The ideal initial resuscitation fluid remains controversial. In appropriately selected patients early aggressive blood product resuscitation is beneficial. Hypothermia can exacerbate bleeding and the benefit in traumatic brain injury is not adequately studied for firm recommendations. PMID:23014941

  5. [Memory and trauma impact: a development approach].

    PubMed

    Moura, Maria; Estrada, José

    2010-01-01

    The purpose of this article is to review the main neuroanatomic structures and the neurotransmission process involved at memory. Memory is dynamic based on the reunion of aspects of neuronal activation, in a process based on the individual experiences. It will be described the importance of limbic regions and their interaction during processing, codification and consolidation of a memory - each one related with neuronal rebuild. Further the authors describe the memory types known (explicit and implicit memories); the characteristics and their progress during normal development. It will be addressed other issues like child amnesia, retrieval and trauma. Forgetting is one of the essential features at explicit memory. Many studies describe a U inverted effect at memories with emotional value. Events with moderate or elevated emotional intensity are printed as important (by limbic structures like amygdala and orbito-frontal cortex) being more easily recorded. If the experience is very intense the explicit memory codification processing at hippocampus will be inhibited and as a consequence also does the retrieval. Meanwhile the implicit memory will remain and may constitute pathologic memories. The psychological trauma blocks the explicit memory processing which will jeopardize the cortical consolidation of the traumatic experience. Focus on trauma an important question is memory precision and the impact of trauma, on a neurophysiologic and psychopathologic way. Trauma and stress aren't inoffensive because their presence will induce pathological neuronal rebuilding (myelination, synapse formation, neurogenesis) at main memory structures like amygdala or hippocampus. When the nature of the changes is irreversible the explicit memory processing, learning and Psychiatry syndromes may arouse, for example: Mood and Anxiety disorders (including Posttraumatic Stress Disorder); Personality Disorders; Dissociative disorders; Psychosis. PMID:20654262

  6. Outcomes following liver trauma in equestrian accidents

    PubMed Central

    2014-01-01

    Background Equestrian sports are common outdoor activities that may carry a risk of liver injury. Due to the relative infrequency of equestrian accidents the injury patterns and outcomes associated with liver trauma in these patients have not been well characterized. Methods We examined our experience of the management of equestrian liver trauma in our regional hepatopancreaticobiliary unit at a tertiary referral center. The medical records of patients who sustained liver trauma secondary to equestrian activities were analysed for parameters such as demographic data, liver function tests, patterns of injury, radiological findings, the need for intervention and outcomes. Results 20 patients sustained liver trauma after falling from or being kicked by a horse. The majority of patients were haemodynamically stable on admission. Alanine transaminase (ALT) levels were elevated in all patients and right-sided rib fractures were a frequently associated finding. CT demonstrated laceration of the liver in 12 patients, contusion in 3 and subcapsular haematoma in 2. The right lobe of the liver was most commonly affected. Only two patients required laparotomy and liver resection; the remaining 18 were successfully managed conservatively. Conclusions The risk of liver injury following a horse kick or falling off a horse should not be overlooked. Early CT imaging is advised in these patients, particularly in the presence of high ALT levels and concomitant chest injuries such as rib fractures. Despite significant liver trauma, conservative management in the form of close observation, ideally in a high-dependency setting, is often sufficient. Laparotomy is only rarely warranted and associated with a significantly higher risk of post-operative bile leaks. PMID:25177363

  7. Penetrating Trauma to the Ureter, Bladder, and Urethra

    PubMed Central

    Zaid, Uwais B.; Bayne, David B.; Harris, Catherine R.; Alwaal, Amjad; McAninch, Jack W.; Breyer, Benjamin N.

    2015-01-01

    We describe the epidemiology, diagnosis, and management of adult civilian penetrating trauma to the ureter, bladder, and urethra. Trauma is a significant source of death and morbidity. Genitourinary injuries are present in 10% of penetrating trauma cases. Prompt recognition and appropriate management of genitourinary injuries, which are often masked or overlooked due to concomitant injuries, is essential to minimize morbidity. Penetrating trauma most commonly results from gunshot wounds or stab wounds. Compared to blunt trauma, these typically require surgical exploration. An understanding of anatomy and a high index of suspicion are necessary for prompt recognition of genitourinary injuries. PMID:26623247

  8. Relational trauma in the context of intimate partner violence.

    PubMed

    Lannert, Brittany K; Garcia, Antonia M; Smagur, Kathryn E; Yalch, Matthew M; Levendosky, Alytia A; Bogat, G Anne; Lonstein, Joseph S

    2014-12-01

    The relational model of trauma (Scheeringa & Zeanah, 2001) proposes that infants' trauma symptoms may be influenced by their mothers' trauma symptoms and disruptions in caregiving behavior, although the mechanisms by which this occurs are less well understood. In this research, we examined the direct and indirect effects of a traumatic event (maternal intimate partner violence [IPV]), maternal trauma symptoms, and impaired (harsh and neglectful) parenting on infant trauma symptoms in a sample of mother-infant dyads (N=182) using structural equation modeling. Mothers completed questionnaires on IPV experienced during pregnancy and the child's first year of life, their past-month trauma symptoms, their child's past-month trauma symptoms, and their parenting behaviors. Results indicated that the effects of prenatal IPV on infant trauma symptoms were partially mediated by maternal trauma symptoms, and the relationship between maternal and infant trauma symptoms was fully mediated by neglectful parenting. Postnatal IPV did not affect maternal or infant trauma symptoms. Findings support the application of the relational model to IPV-exposed mother-infant dyads, with regard to IPV experienced during pregnancy, and help identify potential foci of intervention for professionals working with mothers and children. PMID:25455216

  9. 'Not just little adults' - a pediatric trauma primer.

    PubMed

    Overly, Frank L; Wills, Hale; Valente, Jonathan H

    2014-01-01

    This article describes pediatric trauma care and specifically how a pediatric trauma center, like Hasbro Children's Hospital, provides specialized care to this patient population. The authors review unique aspects of pediatric trauma patients broken down into anatomy and physiology, including Airway and Respiratory, Cardiovascular Response to Hemorrhage, Spine Injuries, Traumatic Brain Injuries, Thoracic Injuries and Blunt Abdominal Trauma. They review certain current recommendations for evaluation and management of these pediatric patients. The authors also briefly review the topic of Child Abuse/Non-accidental Trauma in pediatric patients. Although Pediatric Trauma is a very broad topic, the goal of this article is to act as a primer and describe certain characteristics and management recommendations unique to the pediatric trauma patient. PMID:24400309

  10. Suicide by blunt head trauma - Two cases with striking similarities.

    PubMed

    Park, Hyejin; Lee, Bongwoo; Yoon, Connie

    2015-10-01

    There have been several forensic pathological studies on the distinction between falls from height and homicidal blows in blunt head trauma, but few studies have focused on suicidal blows. Self-inflicted blunt head trauma is usually a part of a complex suicide with more than one suicidal method applied. Actually, no reports on suicide indicate blunt head trauma to be the singular cause of death in recent publications. Cases with self-inflicted blunt trauma are often challenging for those involved in the investigation because they are confronted with findings that are also found in homicides. A refined guideline to differentiate suicidal blows from homicidal blows in blunt head trauma allows for a more accurate representation of the events surrounding death. This paper presents two cases of suicide by self-inflicted blunt head trauma in which blunt head trauma from repeatedly hitting the decedent's head with a hammer was considered to be the only cause of death. PMID:26304757

  11. Penetrating trauma to the facial skeleton by pickaxe - case report.

    PubMed

    Neskoromna-Jędrzejczak, Aneta; Bogusiak, Katarzyna; Przygoński, Aleksander; Timler, Dariusz

    2016-01-01

    Number of deaths related with injuries suffered as a result of experienced traumas is increasing. Penetrating traumas of the facial skeleton occur relatively rarely and much more often concern rather children than adults. Epidemiology relating this kind of trauma differs depending on the region of the world. In Poland, gunshot injuries as well as traumas caused by explosions of firecrackers or fireworks amount only to a slight percentage among all facial skeleton traumas, and the most common reason for penetrating traumas lies in accidents or assault with the use of sharp, narrow and long objects that easily enter bones of the facial skeleton. The present study reported the case of 50-year-old man who suffered from trauma of the facial skeleton, which resulted from foreign body (pickaxe) penetration into the subtemporal area, zygomatic arch and the right orbital cavity. The surgical treatment method and final outcome was presented and discussed. PMID:27096775

  12. A Closer Examination of Sexual Trauma During Deployment: Not all Sexual Traumas are Associated with Suicidal Ideation.

    PubMed

    Monteith, Lindsey L; Menefee, Deleene S; Forster, Jeri E; Bahraini, Nazanin H

    2016-02-01

    Military personnel can be exposed to a wide range of sexual trauma while deployed, including sexual harassment and sexual assault. We examined whether different types of sexual trauma during deployment associated with recent suicidal ideation among previously deployed OEF/OIF/OND veterans admitted to trauma-focused treatment (n = 199). More severe forms of sexual trauma (e.g., sexual assault) were significantly and positively associated with suicidal ideation. In contrast, sexual trauma involving verbal remarks (e.g., sexual harassment) was not associated with suicidal ideation. Our findings suggest that sexual harassment and sexual assault during deployment may be differentially associated with suicidal ideation. PMID:26096625

  13. Complement Activation in Trauma Patients Alters Platelet Function.

    PubMed

    Atefi, Gelareh; Aisiku, Omozuanvbo; Shapiro, Nathan; Hauser, Carl; Dalle Lucca, Jurandir; Flaumenhaft, Robert; Tsokos, George C

    2016-09-01

    Trauma remains the main cause of death for both civilians and those in uniform. Trauma-associated coagulopathy is a complex process involving inflammation, coagulation, and platelet dysfunction. It is unknown whether activation of complement, which occurs invariably in trauma patients, is involved in the expression of trauma-associated coagulopathy. We designed a prospective study in which we enrolled 40 trauma patients and 30 healthy donors upon arrival to the emergency department of BIDMC. Platelets from healthy individuals were incubated with sera from trauma patients and their responsiveness to a thrombin receptor-activating peptide was measured using aggregometry. Complement deposition on platelets from trauma patients was measured by flow cytometry. Normal platelets displayed hypoactivity after incubation with trauma sera even though exposure to trauma sera resulted in increased agonist-induced calcium flux. Depletion of complement from sera further blocked activation of hypoactive platelets. Conversely, complement activation increased aggregation of platelets. Platelets from trauma patients were found to have significantly higher amounts of C3a and C4d on their surface compared with platelets from controls. Depletion of complement (C4d, C3a) reversed the ability of trauma sera to augment agonist-induced calcium flux in donor platelets. Our data indicate that complement enhances platelet aggregation. Despite its complement content, trauma sera render platelets hypoactive and complement depletion further blocks activation of hypoactive platelets. The defect in platelet activation induced by trauma sera is distal to receptor activation since agonist-induced Ca2+ flux is elevated in the presence of trauma sera owing to complement deposition. PMID:27355402

  14. Trauma research in Qatar: a literature review and discussion of progress after establishment of a trauma research centre.

    PubMed

    El-Menyar, A; Asim, M; Zarour, A; Abdelrahman, H; Peralta, R; Parchani, A; Al-Thani, H

    2016-11-01

    A structured research programme is one of the main pillars of a trauma care system. Despite the high rate of injury-related mortalities, especially road traffic accidents, in Qatar, little consideration has been given to research in trauma. This review aimed to analyse research publications on the subject of trauma published from Qatar and to discuss the progress of clinical research in Qatar and the Gulf Cooperation Council countries with special emphasis on trauma research. A literature search using PubMed and Google Scholar search engines located 757 English-language articles within the fields of internal medicine, surgery and trauma originating from Qatar between the years 1993 and 2013. A steep increase in the number of trauma publications since 2010 could be linked to the setting up of a trauma research centre in Qatar in 2011. We believe that establishing a research unit has made a major impact on research productivity, which ultimately benefits health care. PMID:26857718

  15. Survivors of early childhood trauma: evaluating a two-dimensional diagnostic model of the impact of trauma and neglect

    PubMed Central

    Wildschut, Marleen; Langeland, Willemien; Smit, Jan H.; Draijer, Nel

    2014-01-01

    Background A two-dimensional diagnostic model for (complex) trauma-related and personality disorders has been proposed to assess the severity and prognosis of the impact of early childhood trauma and emotional neglect. An important question that awaits empirical examination is whether a distinction between trauma-related disorders and personality disorders reflects reality when focusing on survivors of early childhood trauma. And, is a continuum of trauma diagnoses a correct assumption and, if yes, what does it look like? Objective We describe the design of a cross-sectional cohort study evaluating this two-dimensional model of the impact of trauma and neglect. To provide the rationale of our study objectives, we review the existing literature on the impact of early childhood trauma and neglect on trauma-related disorders and personality disorders. Aims of the study are to: (1) quantify the two-dimensional model and test the relation with trauma and neglect; and (2) compare the two study groups. Method A total of 200 consecutive patients referred to two specific treatment programs (100 from a personality disorder program and 100 from a trauma-related disorder program) in the north of Holland will be included. Data are collected at the start of treatment. The assessments include all DSM-5 trauma-related and personality disorders, and general psychiatric symptoms, trauma history, and perceived emotional neglect. Discussion The results will provide an evaluation of the model and an improvement of the understanding of the relationship between trauma-related disorders and personality disorders and early childhood trauma and emotional neglect. This may improve both diagnostic as well as indication procedures. We will discuss possible strengths and limitations of the design. PMID:24711888

  16. Oesophageal trauma: incidence, diagnosis, and management.

    PubMed Central

    Triggiani, E; Belsey, R

    1977-01-01

    The clinical manifestations, diagnosis, and surgical treatment of 110 cases of oesophageal trauma, admitted under the care of one surgical team between 1949 and 1973, are reviewed. The importance of early diagnosis and an aggressive surgical approach in the management of a potentially lethal situation are stressed. In our opinion, spontaneous rupture of the oesophagus, instrumental perforation, open and closed traumatic lesions, and postoperative anastomotic leaks are, as far as diagnosis and management are concerned, different aspects of the same desperate surgical problem. Oesophageal trauma is accompanied by a high morbidity and mortality rate if diagnosis and treatment are delayed. Perforations of the cervical oesophagus may be treated conservatively. Intrathoracic perforations demand an aggressive surgical appraoch; only exteriorisation followed by reconstruction at a later date offers a reasonable chance to save the life of the patient and ultimately restore continuity. PMID:882938

  17. Historical and Current Trends in Colon Trauma

    PubMed Central

    Causey, Marlin Wayne; Rivadeneira, David E.; Steele, Scott R.

    2012-01-01

    The authors discuss the evolution of the evaluation and management of colonic trauma, as well as the debate regarding primary repair versus fecal diversion. Their evidence-based review covers diagnosis, management, surgical approaches, and perioperative care of patients with colon-related trauma. The management of traumatic colon injuries has evolved significantly over the past 50 years; here the authors describe a practical approach to the treatment and management of traumatic injuries to the colon based on the most current research. However, management of traumatic colon injuries remains a challenge and continues to be associated with significant morbidity. Familiarity with the different methods to the approach and management of colonic injuries will allow surgeons to minimize unnecessary complications and mortality. PMID:24294119

  18. Developing psychological services following facial trauma.

    PubMed

    Choudhury-Peters, Deba; Dain, Vicky

    2016-01-01

    Adults presenting to oral and maxillofacial surgery services are at high risk of psychological morbidity. Research by the Institute of Psychotrauma and the centre for oral and maxillofacial surgery trauma clinic at the Royal London hospital (2015) demonstrated nearly 40% of patients met diagnostic criteria for either depression, post traumatic stress disorder (PTSD), anxiety, alcohol misuse, or substance misuse, or were presenting with facial appearance distress. Most facial injury patients were not receiving mental health assessment or treatment, and the maxillofacial team did not have direct access to psychological services. Based on these research findings, an innovative one-year pilot psychology service was designed and implemented within the facial trauma clinic. The project addressed this need by offering collaborative medical and psychological care for all facial injury patients. The project provided brief screening, assessment, and early psychological intervention. The medical team were trained to better recognise and respond to psychological distress. PMID:27493750

  19. Computer-assisted trauma care prototype.

    PubMed

    Holzman, T G; Griffith, A; Hunter, W G; Allen, T; Simpson, R J

    1995-01-01

    Each year, civilian accidental injury results in 150,000 deaths and 400,000 permanent disabilities in the United States alone. The timely creation of and access to dynamically updated trauma patient information at the point of injury is critical to improving the state of care. Such information is often non-existent, incomplete, or inaccurate, resulting in less than adequate treatment by medics and the loss of precious time by medical personnel at the hospital or battalion aid station as they attempt to reassess and treat the patient. The Trauma Care Information Management System (TCIMS) is a prototype system for facilitating information flow and patient processing decisions in the difficult circumstances of civilian and military trauma care activities. The program is jointly supported by the United States Advanced Research Projects Agency (ARPA) and a consortium of universities, medical centers, and private companies. The authors' focus has been the human-computer interface for the system. We are attempting to make TCIMS powerful in the functions it delivers to its users in the field while also making it easy to understand and operate. To develop such a usable system, an approach known as user-centered design is being followed. Medical personnel themselves are collaborating with the authors in its needs analysis, design, and evaluation. Specifically, the prototype being demonstrated was designed through observation of actual civilian trauma care episodes, military trauma care exercises onboard a hospital ship, interviews with civilian and military trauma care providers, repeated evaluation of evolving prototypes by potential users, and study of the literature on trauma care and human factors engineering. This presentation at MedInfo '95 is still another avenue for soliciting guidance from medical information system experts and users. The outcome of this process is a system that provides the functions trauma care personnel desire in a manner that can be easily and

  20. Biology, childhood trauma, and murder: rethinking justice.

    PubMed

    Heide, Kathleen M; Solomon, Eldra P

    2006-01-01

    This article reviews recent findings in the developmental neurophysiology of children subjected to psychological trauma. Studies link extreme neglect and abuse with long-term changes in the nervous and endocrine systems. A growing body of research literature indicates that individuals with severe trauma histories are at higher risk of behaving violently than those without such histories. This article links these two research areas by discussing how severe and protracted child abuse and/or neglect can lead to biological changes, putting these individuals at greater risk for committing homicide and other forms of violence than those without child maltreatment histories. The implications of these biological findings for forensic evaluations are discussed. Based on new understanding of the effects of child maltreatment, the authors invite law and mental health professionals to rethink their notions of justice and offender accountability, and they challenge policymakers to allocate funds for research into effective treatment and for service delivery. PMID:16516292

  1. Burial at Srebrenica: linking place and trauma.

    PubMed

    Pollack, Craig Evan

    2003-02-01

    Five years after the massacre at Srebrenica in Bosnia-Herzegovina, survivors were faced with the decision: where did they want their loved ones buried? This report explores the reasons for their choice in qualitative interviews with 37 survivors of the massacre and 22 key informants performed over the summer 2000. Survivors wanted the loved ones buried at Potocari, a site just outside of Srebrenica, because it represented the site of ultimate horror, was connected to their sense of home, and underscored the various power relationships. The data points to the importance of place for health. Trauma, as it occurs in particular locations, breaks the sense of attachment to a particular place. Restoring the physical and social environment through burial and memorials mitigates the consequences of the trauma. The burial at Potocari provides a window into the mourning, politics, and recovery after mass violence. PMID:12560012

  2. Effects of dental trauma on the pulp.

    PubMed

    Love, R M

    1997-05-01

    Infection of the root canal system following dental trauma induces pulp and periapical disease and prevents healing of previously healthy pulp. A clinical goal in treating trauma is the maintenance of pulp vitality, and clinicians should be aware of factors that influence pulp healing. The learning objective of this article is to review the factors and techniques that influence pulp vitality and examine the influence pulp has on the healing of adjacent tissues. The potential routes for bacterial infection of the root canal system are discussed, with the clinical crown as the primary portal of entry. Uncomplicated and complicated crown fractures, as well as the crown-root and root fractures, are reviewed. Complications in pulp healing include canal obliteration, disturbed root development, apexogenesis, apexification, and the various forms of resorption. PMID:9550069

  3. Pain and emotional processing in psychological trauma.

    PubMed

    Walter, Steffen; Leissner, Nicole; Jerg-Bretzke, Lucia; Hrabal, Vladimir; Traue, Harald C

    2010-09-01

    Extreme psychological and physical traumas cause dramatic symptom patterns which are insufficiently described by the psychiatric diagnostic criteria of post traumatic stress disorders (PTSD). Additionally, due to the neurobiological proximity and similarity of processing mechanisms of physical and psychological pain stimulation and extremely negative emotions, the patients often suffer from persistent pains even after the somatic healing process is completed. Epidemiological studies confirm the joint occurrence of pain and PTSD. The close relationship and the etiological and behavioral similarities of both disorders have led to the development of joined vulnerability and mutual maintenance models. The particular suffering of patients with PTSD due to chronic pain necessitates pain-therapeutic interventions. On the other hand, in chronic pain patients, the etiological role of severe traumas should be considered. PMID:20856194

  4. The major traumas in youth football.

    PubMed

    Volpi, P; Pozzoni, R; Galli, M

    2003-11-01

    For 4 years we followed a group of football players in the youth division of a professional club, ranging in age from 9 to 19 years, and analyzed the major injuries, i.e., those which required them to be sidelined for at least 4 weeks. We observed 23 sprains, 16 fractures, 16 cases of osteochondrosis, 7 muscle lesions, 6 cases of groin pain (athletic pubalgia), and 4 tendonopathies. The most frequent sites were the knee (n=30) and the ankle (n=11); the trauma factor was predominant (65.2%) with respect to overuse; noncontact traumas were more numerous (63.8%) than those resulting from contrast. Of a total 72 cases 8 regarded goalkeepers, and the remaining 64 cases were distributed among the other positions. As regards the age categories we detected a prevalence of osteochondrosis, traumatic detachments, and some fractures in the younger players, while in the older athletes we observed more sprains, muscle lesions, and tendonopathies. PMID:14618321

  5. Digital subtraction angiography in extremity trauma

    SciTech Connect

    Goodman, P.C.; Jeffrey, R.B. Jr.; Brant-Zawadzki, M.

    1984-10-01

    Digital subtraction angiography (DSA) may have considerable impact on the work-up of patients who have suffered trauma. The angiographic evaluation of vascular injuries can be accomplished rapidly and with minimal catheter use and manipulation, which is particularly important for those critically ill patients who have significant immobility because of multiple fractures. The authors retrospectively reviewed the digital subtraction angiograms in 50 consecutive cases of extremity trauma. The quality of the images in 44 of these permitted a confident diagnosis, the accuracy of which was confirmed by surgical or clinical follow-up. DSA reduces the time required to perform the procedure, the amount of contrast material injected, patient discomfort, and film cost. Its major disadvantage is the limited field size of the image intensifier.

  6. Myocardial contusion following nonfatal blunt chest trauma

    SciTech Connect

    Kumar, S.A.; Puri, V.K.; Mittal, V.K.; Cortez, J.

    1983-04-01

    Currently available diagnostic techniques for myocardial contusion following blunt chest trauma were evaluated. We investigated 30 patients prospectively over a period of 1 year for the presence of myocardial contusion. Among the 30 patients, eight were found to have myocardial contusion on the basis of abnormal electrocardiograms, elevated creatine phosphokinase MB fraction (CPK-MB), and positive myocardial scan. Myocardial scan was positive in seven of eight patients (87.5%). CPK-MB fraction was elevated in four of eight patients (50%). Definitive electrocardiographic changes were seen in only two of eight patients (25%). It appears that myocardial scan using technetium pyrophosphate and CPK-MB fraction determinations are the most reliable aids in diagnosis of myocardial contusion following blunt chest trauma.

  7. Induced hypothermia for trauma-related ARDS

    PubMed Central

    Dhillon, Gagandeep; Gopal, Palepu B.; Kamat, Akshata S.; Mulavisala, K.P.

    2015-01-01

    We report a case of 27-year-old male with lung contusions related acute respiratory distress syndrome (ARDS) managed by ARDSNet guidelines and additional hypothermia. On 4th day, post trauma partial pressure of oxygen dropped to 38 mm of mercury (Hg), not improving even on high positive end-expiratory pressure of 18 cm water (H2O), inverse ratio ventilation and fraction of inspired oxygen of 1. Extracorporeal membrane oxygenation was ruled out due to the risk of hemorrhage from trauma sites. Thereafter, hypothermia along with muscle paralysis was considered to reduce total body oxygen consumption. Patient's condition improved under hypothermia, and he was extubated and taken up for fracture fixation surgeries and discharged later in stable condition. PMID:26195862

  8. Developing psychological services following facial trauma

    PubMed Central

    Choudhury-Peters, Deba; Dain, Vicky

    2016-01-01

    Adults presenting to oral and maxillofacial surgery services are at high risk of psychological morbidity. Research by the Institute of Psychotrauma and the centre for oral and maxillofacial surgery trauma clinic at the Royal London hospital (2015) demonstrated nearly 40% of patients met diagnostic criteria for either depression, post traumatic stress disorder (PTSD), anxiety, alcohol misuse, or substance misuse, or were presenting with facial appearance distress. Most facial injury patients were not receiving mental health assessment or treatment, and the maxillofacial team did not have direct access to psychological services. Based on these research findings, an innovative one-year pilot psychology service was designed and implemented within the facial trauma clinic. The project addressed this need by offering collaborative medical and psychological care for all facial injury patients. The project provided brief screening, assessment, and early psychological intervention. The medical team were trained to better recognise and respond to psychological distress. PMID:27493750

  9. Review article: Maxillofacial emergencies: Maxillofacial trauma.

    PubMed

    DeAngelis, Adrian F; Barrowman, Roland A; Harrod, Richard; Nastri, Alf L

    2014-12-01

    Fractures of the facial skeleton are a common reason for patients to present to EDs and general medical practice in Australia. Trauma to the maxillofacial region can lead to airway obstruction, intracranial injuries, loss of vision or long term cosmetic and functional deficits. This article focuses on the emergency assessment, triage and non-specialist management of traumatic injuries of the orbit and facial skeleton. PMID:25292416

  10. Trauma pain – a military perspective

    PubMed Central

    Wyldbore, Mark

    2013-01-01

    This paper outlines the system developed by the United Kingdom’s Defence Medical Services to manage the pain associated with combat trauma from the point of wounding, through repatriation back home to rehabilitation and eventual discharge from the Forces, whenever that may be. The system is founded upon the principles of integration and sustainability and this article includes discussion of both clinical and non-clinical components. PMID:26516503

  11. Facial trauma in a softball player.

    PubMed

    Patterson, Brian L; Anan, Thomas

    2003-12-01

    Facial trauma frequently results in fracture of the facial bones. A blowout fracture involves the eye orbit and usually transpires when the object hitting the eye (eg, baseball, softball, fist, elbow) is larger than the orbit itself. The mechanism of injury will provide the physician with a clue to the diagnosis. Prompt recognition of any significant complications, proper imaging, and referral to an ophthalmology specialist are usually required. Facial reconstruction by a plastic surgeon may also be necessary. PMID:20086450

  12. Early trauma and narcissism-autism bipolarity.

    PubMed

    de Cesarei, Anna Oliva

    2005-06-01

    The analyst makes a series of considerations taken--a posteriori--from the analysis of a small number of patients. These patients have saved themselves from an early narcissistic catastrophe by developing precocious mental processes, while affective relationships rudimentarily repeat the impact with the original trauma. Primitive defences, essentially denial and vertical splitting, dissociate the tear in the psyche and structure a 'narcissism-autism bipolarity', revealed in aspects of the character which oblige the patient to automatically repeat a single matrix of experience. In therapy, it is necessary to construct a 'first time of the trauma', by finding and linking threads of the primary relationship and strengthening them in the analytic relationship. This reconstruction of the background, a screen to project what had originally been rejected, is the prerequisite for coming out, in deferred action, from the hold of the pathological identifications. The author dedicates particular attention to the undifferentiated background, the nature-environment torn by the trauma, and to the need to reconstruct this fabric of experience in the analytical relationship, as a fundamental element to the recomposition of the dissociated nuclei. In the clinical case, the analyst describes in particular how the analyst's words encounter an unbridgeable gap, a failure in the capacity for representation when opening the autistic nucleus. Through a regression lasting for about a year, a patient was able to live the experience of 'primitive agonies' and that of an unbearable helplessness and, at the same time, was able to feel how the analyst supported her sense of existence. Subsequently, the patient was able to give shape, through visual images, to deep states of being and start the process of metabolising and symbolising the trauma. PMID:16096069

  13. CT of trauma to the abnormal kidney

    SciTech Connect

    Rhyner, P.; Federle, M.P.; Jeffrey, R.B.

    1984-04-01

    Traumatic injuries to already abnormal kidneys are difficult to assess by excretory urography and clinical evaluation. Bleeding and urinary extravasation may accompany minor trauma; conversely, underlying tumors, perirenal hemorrhage, and extravasation may be missed on urography. Computed tomography (CT) was performed in eight cases including three neoplasms, one adult polycystic disease, one simple renal cyst, two hydronephrotic kidneys, and one horseshoe kidney. CT provided specific and clinically useful information in each case that was not apparent on excretory urography.

  14. Immunonutrition in patients after multiple trauma.

    PubMed

    Bastian, L; Weimann, A

    2002-01-01

    Severe trauma threatens the life of the victim, both directly and indirectly via immunological dysregulation during the subsequent clinical course. Inflammatory or infectious episodes may complicate the clinical course and ultimately result in sepsis and multiple organ failure, which have mortality rates of up to 80%. Immunomodulatory intervention aims to ameliorate the early hyperinflammatory phase (systemic inflammatory response syndrome, SIRS) to avoid the development of sepsis. One of the immunomodulation strategies is enteral feeding supplemented with specific nutrients, such as glutamine, n-3-polyunsaturated fatty acids, and nucleotides ('immunonutrition'), because changes in the GALT (gut-associated lymphoid tissue) immune response may contribute to intestinal dysfunction and increase susceptibility to post injury gut-derived sepsis. In a prospective, randomized, double-blind, controlled study in twenty-nine patients suffering severe trauma we were able to show that immunonutrition (arginine, n-3-fatty acids, and nucleotides) significantly reduces the number of SIRS days per patient, and also lowers the multiple organ failure (MOF) score on day 3 and days 8-11 (P<0.05). Other studies have reported a reduction in septic complications and MOF rates, shortened hospital stay, and reduction in the use of antibiotics in patients randomized to the immune-enhancing diet. This improved clinical outcome was reflected in a reduction in hospital costs. In the recovery period after trauma (1-72 h after injury) a limitation of the inflammatory response of immunocompetent cells must be achieved as quickly as possible (<72 h). The only strategy available to clinicians caring for trauma patients is immunonutrition, and this should be strongly considered as a rational approach improving immune function and reducing septic complications in critically ill or injured patients. PMID:11895149

  15. Redesigning the response to patients with trauma.

    PubMed

    Edwards, Carla; Seggie, Julie; Murphy, Margaret

    2012-06-01

    In 2008, a multidisciplinary team of nurses, doctors, clerical staff, a social worker and paramedic at Westmead Hospital, Sydney, New South Wales, began a project to redesign the composition and practice of the hospital's trauma team. This article describes the process involved and explains why staff collaboration, the involvement of stakeholders and the sponsorship of the hospital executive team were crucial to the success of the project. These principles can be transferred to other hospitals. PMID:22876507

  16. Reno Orthopaedic Trauma Fellowship business curriculum.

    PubMed

    Althausen, Peter L; Bray, Timothy J; Hill, Austin D

    2014-07-01

    The Reno Orthopaedic Center (ROC) Trauma Fellowship business curriculum is designed to provide the fellow with a graduate level business practicum and research experience. The time commitments in a typical 12-month trauma fellowship are significant, rendering a traditional didactic master's in business administration difficult to complete during this short time. An organized, structured, practical business education can provide the trauma leaders of tomorrow with the knowledge and experience required to effectively navigate the convoluted and constantly changing healthcare system. The underlying principle throughout the curriculum is to provide the fellow with the practical knowledge to participate in cost-efficient improvements in healthcare delivery. Through the ROC Trauma Fellowship business curriculum, the fellow will learn that delivering healthcare in a manner that provides better outcomes for equal or lower costs is not only possible but a professional and ethical responsibility. However, instilling these values without providing actionable knowledge and programs would be insufficient and ineffective. For this reason, the core of the curriculum is based on individual teaching sessions with a wide array of hospital and private practice administrators. In addition, each section is equipped with a suggested reading list to maximize the learning experience. Upon completion of the curriculum, the fellow should be able to: (1) Participate in strategic planning at both the hospital and practice level based on analysis of financial and clinical data, (2) Understand the function of healthcare systems at both a macro and micro level, (3) Possess the knowledge and skills to be strong leaders and effective communicators in the business lexicon of healthcare, (4) Be a partner and innovator in the improvement of the delivery of orthopaedic services, (5) Combine scientific and strategic viewpoints to provide an evidence-based strategy for improving quality of care in a

  17. [Abusive head trauma: report of a case].

    PubMed

    Grana, M; Nazar, M; de Luca, S; Casalini, E; Eyheremendy, E

    2015-01-01

    The abusive head trauma is a form of child abuse. The most frequent injuries are intracranial lesions, such as subdural hematoma, as well as retinal hemorrhages, usually without other external injuries. Due to its complexity, this problem requires a multidisciplinary medical team, where the role of the radiologist is important, since there are multiple diagnostic methods that are complementary in order to arrive at the correct diagnosis. PMID:24853831

  18. Implementing a perpetual anesthesia setup standardized for the trauma room in a level I trauma center.

    PubMed

    Faircloth, Amanda C; Ford, Mary B

    2013-02-01

    The trauma room in a level I trauma center is a dynamic environment that provides little room for error. Significant variability can exist if anesthesia providers set up the room differently. Standardization provides a system that is consistent, reliable, and cost-effective. This study examines the process of creating and implementing a standardized anesthesia setup in the trauma room of a level I trauma center. As a result of this study, the medication cart and airway setups have been standardized. Providers are encouraged to only draw up medications that will be immediately used and to ensure that prefilled syringes have been incorporated into the pharmacy formulary. Using the EZ Endo prestyleted endotracheal tube (ETT) vs a regular ETT with stylet has yielded an annual cost savings of $2,673. Ensuring that items such as an esophageal temperature probe, humidifier, and nasogastric tube are available but unopened has provided a savings of $1,989.25 per year. The reservoir bag has been changed to a latex-free bag, and 3 central line kits including an arterial line kit are routinely stocked. An ultrasound machine dedicated for central line access, GlideScope, rapid fluid infuser, and Airtraq laryngoscope have all been incorporated into the permanent setup in the trauma room. PMID:23513323

  19. Developing Orthopaedic Trauma Capacity in Uganda: Considerations From the Uganda Sustainable Trauma Orthopaedic Program.

    PubMed

    OʼHara, Nathan N; OʼBrien, Peter J; Blachut, Piotr A

    2015-10-01

    Uganda, like many low-income countries, has a tremendous volume of orthopaedic trauma injuries. The Uganda Sustainable Trauma Orthopaedic Program (USTOP) is a partnership between the University of British Columbia and Makerere University that was initiated in 2007 to reduce the consequences of neglected orthopaedic trauma in Uganda. USTOP works with local collaborators to build orthopaedic trauma capacity through clinical training, skills workshops, system support, technology development, and research. USTOP has maintained a multidisciplinary approach to training, involving colleagues in anaesthesia, nursing, rehabilitation, and sterile reprocessing. Since the program's inception, the number of trained orthopaedic surgeons practicing in Uganda has more than doubled. Many of these newly trained surgeons provide clinical care in the previously underserved regional hospitals. The program has also worked with collaborators to develop several technologies aimed at reducing the cost of providing orthopaedic care without compromising quality. As orthopaedic trauma capacity in Uganda advances, USTOP strives to continually evolve and provide relevant support to colleagues in Uganda. PMID:26356209

  20. Outcome analysis of management of liver trauma: A 10-year experience at a trauma center

    PubMed Central

    She, Wong Hoi; Cheung, Tan To; Dai, Wing Chiu; Tsang, Simon H Y; Chan, Albert C Y; Tong, Daniel K H; Leung, Gilberto K K; Lo, Chung Mau

    2016-01-01

    AIM: To review the outcomes of liver trauma in patients with hepatic injuries only and in patients with associated injuries outside the liver. METHODS: Data of liver trauma patients presented to our center from January 2003 to October 2013 were reviewed. The patients were divided into two groups. Group 1 consisted of patients who had hepatic injuries only. Group 2 consisted of patients who also had associated injuries outside the liver. RESULTS: Seven (30.4%) patients in group 1 and 10 (28.6%) patients in group 2 received non-operative management; the rest underwent operation. Blunt trauma occurred in 82.8% (48/58) of the patients and penetrative trauma in 17.2% (10/58). A higher injury severity score (ISS) was observed in group 2 (median 45 vs 25, P < 0.0001). More patients in group 1 were hemodynamically stable (65.2% vs 37.1%, P = 0.036). Other parameters were comparable between groups. Group 1 had better 30-d survival (91.3% vs 71.4%, P = 0.045). On multivariate analysis using the logistic regression model, ISS was found to be associated with mortality (P = 0.004, hazard ratio = 1.035, 95%CI: 1.011-1.060). CONCLUSION: Liver trauma patients with multiple injuries are relatively unstable on presentation. Despite a higher ISS in group 2, non-operative management was possible for selected patients. Associated injuries outside the liver usually account for morbidity and mortality. PMID:27239257