Science.gov

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. Characterization of firefighter exposures during fire overhaul.

    PubMed

    Bolstad-Johnson, D M; Burgess, J L; Crutchfield, C D; Storment, S; Gerkin, R; Wilson, J R

    2000-01-01

    Previous studies have characterized firefighter exposures during fire suppression. However, minimal information is available regarding firefighter exposures during overhaul, when firefighters look for hidden fire inside attics, ceilings, and walls, often without respiratory protection. A comprehensive air monitoring study was conducted to characterize City of Phoenix firefighter exposures during the overhaul phase of 25 structure fires. Personal samples were collected for aldehydes; benzene; toluene; ethyl benzene; xylene; hydrochloric acid; polynuclear aromatic hydrocarbons (PNA); respirable dust; and hydrogen cyanide (HCN). Gas analyzers were employed to continuously monitor carbon monoxide (CO), HCN, nitrogen dioxide (NO2), and sulfur dioxide (SO2). Area samples were collected for asbestos, metals (Cd, Cr, Pb), and total dust. During overhaul the following exceeded published ceiling values: acrolein (American Conference of Governmental Industrial Hygienists [ACGIH] 0.1 ppm) at 1 fire; CO (National Institute for Occupational Safety and Health [NIOSH] 200 ppm) at 5 fires; formaldehyde (NIOSH 0.1 ppm) at 22 fires; and glutaraldehyde (ACGIH 0.05 ppm) at 5 fires. In addition, the following exceeded published short-term exposure limit values: benzene (NIOSH 1 ppm) at two fires, NO2 (NIOSH 1 ppm) at two fires, and SO2 (ACGIH 5 ppm) at five fires. On an additive effects basis, PNA concentrations exceeded the NIOSH recommended exposure limits (0.1 mg/M3) for coal tar pitch volatiles at two fires. Maximum concentrations of other sampled substances were below their respective permissible exposure limits. Initial 10-min average CO concentrations did not predict concentrations of other products of combustion. The results indicate that firefighters should use respiratory protection during overhaul. In addition, these findings suggest that CO should not be used as an indicator gas for other contaminants found in this atmosphere.

  5. Overhauling and Regulating Schools Set Up by Migrants: The Reason for Overhaul

    ERIC Educational Resources Information Center

    Jianzhong, Ding

    2004-01-01

    The article presents information on overhauling and regulating schools set up by migrants in the Pudong New District of China. As the number of migrants has risen sharply in the Pudong New District in recent years, so has the number of migrant children. An overall investigation of the fifty-nine schools set up by migrants was conducted and the…

  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. 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 ...

  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. 40 CFR 81.437 - New Brunswick, Canada.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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...

  10. 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...

  11. 40 CFR 81.437 - New Brunswick, Canada.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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...

  12. 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...

  13. 40 CFR 81.437 - New Brunswick, Canada.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 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...

  14. 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

  15. 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

  16. 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…

  17. 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…

  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.

  19. 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

  20. 14 CFR 21.337 - Performance of inspections and overhauls.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Performance of inspections and overhauls. 21.337 Section 21.337 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... domestic repair station. (c) An appropriately certificated foreign repair station having adequate...

  1. The NEA Supports Substantial Overhaul, Not Repeal, of NCLB

    ERIC Educational Resources Information Center

    Packer, Joel

    2007-01-01

    The National Education Association (NEA) agrees that No Child Left Behind (NCLB) Act is flawed but believes it can be salvaged. The association believes that several substantive changes that overhaul the statute would produce a far better result. The NEA is not alone in calling for fundamental changes in the law. A coalition of more than 129…

  2. 14 CFR 43.2 - Records of overhaul and rebuilding.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... aircraft, airframe, aircraft engine, propeller, appliance, or component part as being overhauled unless— (1... certificate, supplemental type certificate, or a material, part, process, or appliance approval under § 21.305..., airframe, aircraft engine, propeller, appliance, or component part as being rebuilt unless it has...

  3. 14 CFR 43.2 - Records of overhaul and rebuilding.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... engine, propeller, appliance, or component part as being overhauled unless— (1) Using methods, techniques... certificate, or a material, part, process, or appliance approval under part 21 of this chapter. (b) No person..., propeller, appliance, or component part as being rebuilt unless it has been disassembled, cleaned,...

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

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... engine, propeller, appliance, or component part as being overhauled unless— (1) Using methods, techniques... certificate, or a material, part, process, or appliance approval under part 21 of this chapter. (b) No person..., propeller, appliance, or component part as being rebuilt unless it has been disassembled, cleaned,...

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

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... engine, propeller, appliance, or component part as being overhauled unless— (1) Using methods, techniques... certificate, or a material, part, process, or appliance approval under part 21 of this chapter. (b) No person..., propeller, appliance, or component part as being rebuilt unless it has been disassembled, cleaned,...

  6. 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)

  7. 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)

  8. 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

  9. 9. Raritan River Bridge. New Brunswick, Middlesex Co., NJ. Sec. ...

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

    9. Raritan River Bridge. New Brunswick, Middlesex Co., NJ. Sec. 1401, MP 30.92. - Northeast Railroad Corridor, Amtrak Route between Pennsylvania/New Jersey & New Jersey/New York State Lines, Newark, Essex County, NJ

  10. 8. Raritan River Bridge. New Brunswick, Middlesex Co., NJ. Sec. ...

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

    8. Raritan River Bridge. New Brunswick, Middlesex Co., NJ. Sec. 1401, MP 30.92. - Northeast Railroad Corridor, Amtrak Route between Pennsylvania/New Jersey & New Jersey/New York State Lines, Newark, Essex County, NJ

  11. 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

  12. 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

  13. 15 CFR 742.14 - Significant items: hot section technology for the development, production or overhaul of...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... technology for the development, production or overhaul of commercial aircraft engines, components, and... development, production or overhaul of commercial aircraft engines, components, and systems. (a) License... or overhaul of commercial aircraft engines controlled under ECCN 9E003.a.1. through a.12., .f,...

  14. 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.

  15. 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.

  16. 77 FR 66875 - Brunswick Steam Electric Plant, Units 1 and 2

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-07

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Brunswick Steam Electric Plant, Units 1 and 2 AGENCY: Nuclear Regulatory Commission. ACTION... to Brunswick Steam Electric Plant, Units 1 and 2 (Brunswick). The petition is included in...

  17. 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

  18. 76 FR 36285 - Establishment of Class E Airspace; Brunswick, ME

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-22

    ... Executive Order 12866; (2) is not a ``significant rule'' under DOT Regulatory Policies and Procedures (44 FR...: Federal Aviation Administration (FAA), DOT. ACTION: Final rule. SUMMARY: This action establishes Class E... Approach Procedures developed for Brunswick Executive Airport. This enhances the safety and...

  19. 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

  20. 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

  1. Facial trauma

    MedlinePlus

    Kellman RM. Maxillofacial trauma. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . ... Facial trauma. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and ...

  2. Ear trauma.

    PubMed

    Eagles, Kylee; Fralich, Laura; Stevenson, J Herbert

    2013-04-01

    Understanding basic ear anatomy and function allows an examiner to quickly and accurately identify at-risk structures in patients with head and ear trauma. External ear trauma (ie, hematoma or laceration) should be promptly treated with appropriate injury-specific techniques. Tympanic membrane injuries have multiple mechanisms and can often be conservatively treated. Temporal bone fractures are a common cause of ear trauma and can be life threatening. Facial nerve injuries and hearing loss can occur in ear trauma.

  3. 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

  4. New Coleoptera records from New Brunswick, Canada: Cerambycidae

    PubMed Central

    Webster, Reginald P.; Sweeney, Jon D.; DeMerchant, Ian; Silk, Peter J.; Mayo, Peter

    2012-01-01

    Abstract Five species of Cerambycidae, Acmaeops discoideus (Haldeman), Anelaphus villosus (Fabricius), Phymatodes species (CNC sp. n. #1), Sarosesthes fulminans (Fabricius), and Urgleptus signatus (LeConte) are newly recorded for New Brunswick, Canada. All but Acmaeops villosus are new to the Maritime provinces. Phymatodes testaceus (Linnaeus) is removed from the faunal list of the province as a result of mislabeled specimens, records of Phymatodes maculicollis LeConte are presented confirming the presence of this species in New Brunswick, and the first recent records ofNeospondylis upiformis (Mannerheim) are presented. Additional records are given for the recently recorded Phymatodes aereus (Newman), indicating a wider distribution in the province. Collection data, habitat data, and distribution maps are presented for each species. PMID:22539899

  5. 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

  6. New Coleoptera records from New Brunswick, Canada: Dryopidae, Elmidae, Psephenidae, and Ptilodactylidae.

    PubMed

    Webster, Reginald P; Demerchant, Ian

    2012-01-01

    We report five new species records for New Brunswick, Canada from the Coleoptera families Dryopidae, Elimidae, Psephenidae, and Ptilodactylidae. Dryops viennensis (Heer) (Dryopidae) and Promoresia elegans (LeConte) (Elmidae) are added to the faunal list for New Brunswick and the Maritime provinces. Two Psephenidae species, Ectopria nervosa (Melsheimer) and Ectopria thoracica (Ziegler) are reported for the first time for New Brunswick, and the latter species is also new for the Maritime provinces. Anchytarsus bicolor (Melsheimer) and the family Ptilodactylidae are newly recorded for New Brunswick and the Maritime provinces. Collection, habitat data, and distribution maps are presented for all of these species.

  7. 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.

  8. 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.

  9. 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

  10. 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…

  11. 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…

  12. Salvage and Overhaul. Fire Service Certification Series. Unit FSCS-FF-15-81.

    ERIC Educational Resources Information Center

    Pribyl, Paul F.

    This training unit on salvage and overhaul is part of a 17-unit course package written to aid instructors in the development, teaching, and evaluation of fire fighters in the Wisconsin Fire Service Certification Series. The purpose stated for the 8-hour unit is to familiarize fire fighters with basic salvage cover operations and basic fundamentals…

  13. 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

  14. 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

  15. Breast cancer screening. First Nations communities in New Brunswick.

    PubMed Central

    Tatemichi, Sue; Miedema, Baukje; Leighton, Shelley

    2002-01-01

    OBJECTIVE: To determine use of breast cancer screening and barriers to screening among women in First Nations communities (FNCs). DESIGN: Structured, administered survey. SETTING: Five FNCs in New Brunswick. PARTICIPANTS: One hundred thirty-three (96%) of 138 eligible women between the ages of 50 and 69 years. INTERVENTIONS: After project objectives, methods, and expected outcomes were discussed with community health representatives, we administered a 32-item questionnaire on many aspects of breast cancer screening. MAIN OUTCOME MEASURES: Rate of use of mammography and other breast cancer screening methods, and barriers to screening. RESULTS: Some 65% of participants had had mammography screening within the previous 2 years. Having mammography at recommended intervals and clinical breast examinations (CBEs) yearly were significantly associated with having had a physician recommend the procedures (P < .001). A family history of breast cancer increased the odds of having a mammogram 2.6-fold (P < .05, 95% confidence interval [CI] 1.03 to 6.54). Rates of screening differed sharply by whether a family physician was physically practising in the community or not (P < .05, odds ratio 2.68, 95% CI 1.14 to 6.29). CONCLUSION: Women in FNCs in one health region in New Brunswick have mammography with the same frequency as off-reserve women. A family physician practising part time in the FNCs was instrumental in encouraging women to participate in breast cancer screening. PMID:12113195

  16. Upper Lower Cambrian depositional sequence in Avalonian New Brunswick

    USGS Publications Warehouse

    Landing, E.; Westrop, S.R.

    1996-01-01

    The Hanford Brook Formation (emended) is a thin (up to 42+ m), upper Lower Cambrian depositional sequence that is unconformably bounded by the lower Lower Cambrian (Random Formation) and the middle Middle Cambrian (Fossil Brook Member of the Chamberlain's Brook Formation). These stratigraphic relationships of the trilobite-bearing Hanford Brook Formation indicate deposition on the Avalonian marginal platform in the Saint John, New Brunswick, region and provide more evidence for a uniform, latest Precambrian-Cambrian epeirogenic history and cover sequence in Avalon. The Hanford Brook Formation is a deepening - shoaling sequence with (i) lower, transgressive sandstone deposited in episodically high-energy environments (St. Martins Member, new); (ii) highstand-regressive, dysaerobic mudstone - fine-grained sandstone with volcanic ashes (Somerset Street Member, new); and (iii) upper, regressive, planar and hummocky cross-stratified sandstone (Long Island Member, new). Trilobites are common in the distal Somerset Street Member, and ostracodes and brachiopods dominate the St. Martins and Long Island members. Condensation of the St. Martins Member and absence of the Long Island Member where the Random Formation and Fossil Brook Member are thinnest suggest onlap of the Hanford Brook and pronounced, sub-Middle Cambrian erosion across epeirogenically active blocks in southern New Brunswick.

  17. Toxicity of sediments and pore water from Brunswick Estuary, Georgia

    USGS Publications Warehouse

    Winger, P.V.; Lasier, P.J.; Geitner, H.

    1993-01-01

    A chlor-alkali plant in Brunswick, Georgia, USA, discharged >2 kg mercury/d into a tributary of the Turtle River-Brunswick Estuary from 1966 to 1971. Mercury concentrations in sediments collected in 1989 along the tributary near the chlor-alkali plant ranged from 1 to 27 ug/g (dry weight), with the highest concentrations found in surface (0?8 cm) sediments of subtidal zones in the vicinity of the discharge site. Toxicity screening in 1990 using Microtox? bioassays on pore water extracted on site from sediments collected at six stations distributed along the tributary indicated that pore water was highly toxic near the plant discharge. Ten-day toxicity tests on pore water from subsequent sediment samples collected near the plant discharge confirmed high toxicity to Hyalella azteca, and feeding activity was significantly reduced in whole-sediment tests. In addition to mercury in the sediments, other metals (chromium, lead, and zinc) exceeded 50 ug/g, and polychlorobiphenyl (PCB) concentrations ranged from 67 to 95 ug/g. On a molar basis, acid-volatile sulfide concentrations (20?45 umol/g) in the sediments exceeded the metal concentrations. Because acid-volatile sulfides bind with cationic metals and form metal sulfides, which are generally not bioavailable, toxicities shown by these sediments were attributed to the high concentrations of PCBs and possibly methylmercury.

  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. Acoustic trauma

    MedlinePlus

    Acoustic trauma is a common cause of sensory hearing loss . Damage to the hearing mechanisms within the inner ... Symptoms include: Partial hearing loss that most often involves ... The hearing loss may slowly get worse. Noises, ringing in ...

  20. 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.

  1. 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

  2. The evaluation of CBRN canisters for use by firefighters during overhaul.

    PubMed

    Currie, Jennifer; Caseman, Delayne; Anthony, T Renee

    2009-07-01

    Air-purifying respirators (APRs) have been proposed to provide an additional respiratory protection option for structural firefighters involved in overhaul operations and wildland firefighters, where particulate and aldehyde exposures have been documented. Previous studies (Anthony et al., 2007) developed test methods to evaluate APR cartridges and canisters for use in overhaul activities, where initial findings indicated that multi-gas cartridges may not be effective. This study evaluated the performance of three chemical, biological, radiological, and nuclear (CBRN) canisters (MSA, 3M, and Scott) and one multi-gas canister similar in appearance to CBRN canisters but without CBRN certification (3M FR-64040). Challenge concentrations typical of overhaul exposures were generated by combusting common household materials. Twelve tests were conducted, using random canister selection, where challenge air and air filtered by the canisters were tested. All tests examined penetration of CO; NO(2); SO(2); respirable dust; aldehydes, including formaldehyde, acrolein, and glutaraldehyde; and hydrogen cyanide. Six of the tests also investigated naphthalene, benzene, and hydrogen chloride, but challenge concentrations from the simulated overhaul smoke were near the limit of detection (LOD) and were two orders of magnitude below short-term or ceiling concentrations of concern and were eliminated from further study with the combustion materials used in this study. In all tests, an irritant index was computed to evaluate the aggregate penetration of contaminants in the smoke mixture, using 15- and 30-min occupational exposure limits as well as assessing individual penetrations. In all cases, the challenge concentration irritant index exceeded unity, ranging from 2.3 to 21. For all 12 tests, the APR canister reduced the overall irritant index to levels below unity, indicating that these canisters would provide protection for firefighters working in overhaul environments. However

  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. New Coleoptera records for New Brunswick, Canada: Kateretidae, Nitidulidae, Cerylonidae, Endomychidae, Coccinellidae, and Latridiidae.

    PubMed

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

    2012-01-01

    We report 20 new species records for the Coleoptera fauna in New Brunswick, Canada, five of which are new records for the Maritime provinces, including one species that is new for Canada. One species of Kateretidae, Kateretes pusillus (Thunberg) is newly recorded for New Brunswick and the Maritime provinces. Stelidota octomaculata (Say), Phenolia grossa (Fabricius), andCryptarcha strigatula Parsons of the family Nitidulidae are added to the faunal list of New Brunswick; the latter species is new to the Maritime provinces. Two species of Cerylonidae, Philothermus glabriculus LeConte and Cerylon unicolor (Ziegler), are reported for the first time for New Brunswick. Philothermus glabriculus is new for the Maritime provinces. Two species of Endomychidae, Hadromychus chandleri Bousquet and Leschen and Danae testacea (Ziegler) are newly recorded for New Brunswick. Three species of Coccinelidae, Stethorus punctum punctum (LeConte), Naemia seriata seriata Melsheimer, and Macronaemia episcopalis (Kirby) are added to the provincial list. Macronaemia episcopalis (Kirby) is a species new to the Maritime provinces. Nine species of Latridiidae, Cartodere nodifer (Westwood), Dienerella ruficollis (Marsham), Enicmus aterrimus Motschulsky, Enicmus fictus Fall, Encimus histrio Jay and Tomlin, Lathridius minutus (Linnaeus), Stephostethus productus Rosenhauer, Corticaria elongata (Gyllenhal), and Corticarina longipennis (LeConte) are newly recorded for New Brunswick. Stephostehus productus is newly recorded from Canada. Collection and habitat data are presented for all these species.

  5. Trauma Ultrasound.

    PubMed

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

    2015-10-01

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

  6. 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

  7. 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…

  8. Suspension trauma

    PubMed Central

    Lee, Caroline; Porter, Keith M

    2007-01-01

    Suspension trauma (also known as “harness‐induced pathology” or “orthostatic shock while suspended”) is the development of presyncopal symptoms and loss of consciousness if the human body is held motionless in a vertical position for a period of time. It has been described in experiments of personal fall protection, and has been implicated in causes of death in mountaineering accidents, but it seems neither to be widely known about nor to have been presented to the medical profession. This article highlights the potential existence of suspension trauma and suggests that more robust medical research using modern harnesses and healthy volunteers would be beneficial to assess whether this is purely a theoretical risk. PMID:17384373

  9. A model for successful research partnerships: a New Brunswick experience.

    PubMed

    Tamlyn, Karen; Creelman, Helen; Fisher, Garfield

    2002-01-01

    The purpose of this paper is to present an overview of a partnership model used to conduct a research study entitled "Needs of patients with cancer and their family members in New Brunswick Health Region 3 (NBHR3)" (Tamlyn-Leaman, Creelman, & Fisher, 1997). This partial replication study carried out by the three authors between 1995 and 1997 was a needs assessment, adapted with permission from previous work by Fitch, Vachon, Greenberg, Saltmarche, and Franssen (1993). In order to conduct a comprehensive needs assessment with limited resources, a partnership between academic, public, and private sectors was established. An illustration of this partnership is presented in the model entitled "A Client-Centred Partnership Model." The operations of this partnership, including the strengths, the perceived benefits, lessons learned by each partner, the barriers, and the process for conflict resolution, are described. A summary of the cancer care initiatives undertaken by NBHR3, which were influenced directly or indirectly by the recommendations from this study, is included. PMID:12271916

  10. 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

  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. 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.

  13. Asbestos exposure from the overhaul of a Pratt & Whitney R2800 engine.

    PubMed

    Mlynarek, S P; Van Orden, D R

    2012-11-01

    This study assessed the asbestos exposures of airplane piston engine mechanics while performing overhaul work on a Pratt & Whitney R2800 radial engine, with tools and practices in use since the time these engines were manufactured. Approximately 40% of the bulk samples collected during this test were found to contain chrysotile. Air samples were collected during the overhaul and were analyzed by phase contrast microscopy (PCM) and transmission electron microscopy (TEM). The average worker exposure during disassembly was 0.0272f/ml (PCM) and ranged from 0.0013 to 0.1240f/ml (PCM) during an average sample collection time of 188min. The average worker exposure during reassembly was 0.0198f/ml (PCM) and ranged from 0.0055 to 0.0913f/ml (PCM) during an average sample collection time of 222min. Only one worker sample (during reassembly) was found to contain asbestos at a concentration of 0.0012f/ml (PCME). Similar results should be found in other aircraft piston engines that use metal clad and non-friable asbestos gaskets, which are the current standard in aircraft piston engines.

  14. 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

    ... described either discharge into State approved waste treatment systems, or the waste is collected into a... AGENCY North Carolina Waters Along the Entire Length of Brunswick and Pender Counties and the Lower... Brunswick and Pender Counties Coastal Waters and a portion of the Cape Fear River, as a No Discharge...

  15. 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... Power Generation Corporation, has applied to renew its authority to transmit electric energy from the... Generation Corporation, to transmit electric energy from the United States to Canada as a power marketer...

  16. 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...

  17. 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

    ... COMMISSION Carolina Power & Light; Brunswick Steam Electric Plant, Units 1 and 2; Independent Spent Fuel... Licenses Nos. DPR-71 and DPR-62 for the Brunswick Steam Electric Plant (BSEP), Units 1 and 2, including the BSEP Independent Spent Fuel Storage Installation, currently held by Carolina Power & Light Company,...

  18. 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

    ... Waters of the Cape Fear River in Brunswick and New Hanover Counties No Discharge Zone Determination The... Counties, and the saline waters of the Cape Fear River in Brunswick and New Hanover Counties. The other... creeks, the Atlantic Intracoastal Waterway, Cape Fear River (up to Toomers Creek 34 15'36.61'' N 77...

  19. Public health assessment for petitioned public health assessment, Escambia Brunswick Wood (a/k/a Brunswick Wood Preserving), Brunswick, Glynn County, Georgia, Region 4. CERCLIS Number GAD981024466; Final report

    SciTech Connect

    1999-02-09

    Brunswick Wood Preserving (BWP) is in Brunswick, Glynn County, in eastern Georgia. Both owners of the site manufactured wooden poles and pilings, which were treated with creosote and solutions of pentachlorophenate. This activity, as well as improper storage and disposal practices, lead to the contamination of several environmental media with chromated copper arsenate (CCA), pentachlorophenol (PCP), polycyclic aromatic hydrocarbons (PAH`s), and dioxin. The site is categorized as an indeterminant public health hazard based upon data reviewed and observations made by ATSDR. This conclusion category was selected because the extent and magnitude of groundwater contamination and the extent of contamination in Burnett Creek have not been fully characterized. Data reviewed for this public health assessment does not indicate that exposure to chemicals at levels of concern is occurring.

  20. 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

  1. 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

  2. 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

  3. 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

  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. 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.

  6. 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

  7. 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

  8. 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...

  9. Summary of Ground-Water Data for Brunswick County, North Carolina, Water Year 2006

    USGS Publications Warehouse

    McSwain, Kristen Bukowski

    2008-01-01

    Ground-water availability in Brunswick County, North Carolina, has been monitored continuously since 2000 through the operation and maintenance of ground-water-level observation wells in the surficial, Castle Hayne, Peedee, and Black Creek aquifers of the North Atlantic Coastal Plain aquifer system. Ground-water-resource conditions for the Brunswick County area were determined by relating the period-of-record normal (25th to 75th percentile) monthly mean ground-water-level and precipitation data to median monthly mean ground-water levels and monthly sum of daily precipitation for water year 2006. Summaries of precipitation and ground-water conditions for the Brunswick County area and hydrographs and statistics of continuous ground-water levels collected during the 2006 water year are presented in this report. Ground-water resource conditions varied by aquifer and geographic location within Brunswick County. Water levels were normal in 3 of the 11 observation wells, above normal in 5, and below normal in the remaining 3 wells.

  10. Summary of Ground-Water Data for Brunswick County, North Carolina, Water Year 2007

    USGS Publications Warehouse

    McSwain, Kristen Bukowski

    2008-01-01

    Ground-water availability in Brunswick County, North Carolina, has been monitored continuously since 2000 through the operation and maintenance of ground-water-level observation wells in the surficial, Castle Hayne, Peedee, and Black Creek aquifers of the North Atlantic Coastal Plain aquifer system. Ground-water-resource conditions for the Brunswick County area were determined by relating the period-of-record normal (25th to 75th percentile) monthly mean groundwater- level and precipitation data to median monthly mean ground-water levels and monthly sum of daily precipitation for water year 2007. Summaries of precipitation and ground-water conditions for the Brunswick County area and hydrographs and statistics of continuous ground-water levels collected during the 2007 water year are presented in this report. Ground-water resource conditions varied by aquifer and geographic location within Brunswick County. Water levels were normal in 6 of the 11 observation wells, above normal in 1 well, and below normal in the remaining 4 wells.

  11. 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…

  12. 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…

  13. 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.

  14. 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,…

  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..., issued to Carolina Power & Light Company (CP&L, the licensee), for operation of the Brunswick...

  17. 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.

  18. 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.

  19. Trauma Facts for Educators

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2008

    2008-01-01

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

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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

  7. 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

  8. Summary and statistical analysis of precipitation and groundwater data for Brunswick County, North Carolina, Water Year 2008

    USGS Publications Warehouse

    McSwain, Kristen Bukowski; Strickland, A.G.

    2010-01-01

    Groundwater conditions in Brunswick County, North Carolina, have been monitored continuously since 2000 through the operation and maintenance of groundwater-level observation wells in the surficial, Castle Hayne, and Peedee aquifers of the North Atlantic Coastal Plain aquifer system. Groundwater-resource conditions for the Brunswick County area were evaluated by relating the normal range (25th to 75th percentile) monthly mean groundwater-level and precipitation data for water years 2001 to 2008 to median monthly mean groundwater levels and monthly sum of daily precipitation for water year 2008. Summaries of precipitation and groundwater conditions for the Brunswick County area and hydrographs and statistics of continuous groundwater levels collected during the 2008 water year are presented in this report. Groundwater levels varied by aquifer and geographic location within Brunswick County, but were influenced by drought conditions and groundwater withdrawals. Water levels were normal in two of the eight observation wells and below normal in the remaining six wells. Seasonal Kendall trend analysis performed on more than 9 years of monthly mean groundwater-level data collected in an observation well located within the Brunswick County well field indicated there is a strong downward trend, with water levels declining at a rate of about 2.2 feet per year.

  9. A Review of New Brunswick's Dedicated Notebook Research Project: One-to-One Computing--A Compelling Classroom-Change Intervention

    ERIC Educational Resources Information Center

    Milton, Penny

    2008-01-01

    The Canadian Education Association (CEA) was commissioned by Hewlett-Packard Canada to create a case study describing the development, implementation and outcomes of New Brunswick's Dedicated Notebook Research Project. The New Brunswick Department of Education designed its research project to assess impacts on teaching and learning of dedicated…

  10. 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

  11. 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

  12. Ventilation in chest trauma

    PubMed Central

    Richter, Torsten; Ragaller, Maximilian

    2011-01-01

    Chest trauma is one important factor for total morbidity and mortality in traumatized emergency patients. The complexity of injury in trauma patients makes it challenging to provide an optimal oxygenation while protecting the lung from further ventilator-induced injury to it. On the other hand, lung trauma needs to be treated on an individual basis, depending on the magnitude, location and type of lung or chest injury. Several aspects of ventilatory management in emergency patients are summarized herein and may give the clinician an overview of the treatment possibilities for chest trauma victims. PMID:21769213

  13. 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

  14. Treating childhood trauma.

    PubMed

    Terr, Lenore C

    2013-01-01

    This review begins with the question "What is childhood trauma?" Diagnosis is discussed next, and then the article focuses on treatment, using 3 basic principles-abreaction, context, and correction. Treatment modalities and complications are discussed, with case vignettes presented throughout to illustrate. Suggestions are provided for the psychiatrist to manage countertransference as trauma therapy proceeds.

  15. Physician recruitment in rural Canada: programs in New Brunswick, Newfoundland, and Nova Scotia.

    PubMed

    Reamy, J

    1994-01-01

    This paper examines programs used in the Atlantic provinces of New Brunswick, Newfoundland, and Nova Scotia to recruit and retain physicians in rural areas. The provinces have many similarities but have unique characteristics that have shaped recruitment methods. The total number of physicians in each province has grown at a faster rate than the population. Each has problems attracting physicians to underserved areas, although the magnitude of the problems vary. The data for this paper were gathered from documents available from various agencies in each province and a series of personal interviews conducted in the spring of 1993. The provinces have chosen different avenues in attempting to solve the maldistribution of physician resources, ranging from regulatory methods in New Brunswick to moves in Newfoundland to encourage graduates of the province's medical school to locate in the rural areas and lessen the dependence on foreign medical graduates. Nova Scotia, with fewer areas needing physicians, has been able to focus its efforts on selected locations. Reviewing the methods used in the three provinces provides an insight into the attempts to solve the shortage of physicians in rural areas.

  16. 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

  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. 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,…

  20. 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

    ... at Sunny Point Army Terminal, Brunswick County, NC; restricted area. 334.450 Section 334.450 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.450 Cape Fear River and tributaries at Sunny Point Army...

  1. 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

    ... Department of the Army, Corps of Engineers 33 CFR Part 334 Restricted Area in Cape Fear River and Tributaries at Sunny Point Army Terminal, Brunswick County, NC AGENCY: U.S. Army Corps of Engineers, DoD. ACTION: Proposed rule. SUMMARY: The U.S. Army requested that the U.S. Army Corps of Engineers (Corps) revise...

  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

    ... Department of the Army, Corps of Engineers 33 CFR Part 334 Restricted Area in Cape Fear River and Tributaries at Sunny Point Army Terminal, Brunswick County, NC AGENCY: U.S. Army Corps of Engineers, DoD. ACTION: Direct final rule. SUMMARY: The U.S. Army requested that the U.S. Army Corps of Engineers (Corps)...

  3. 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...

  4. 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...

  5. 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...

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. Nuances in pediatric trauma.

    PubMed

    Kenefake, Mary Ella; Swarm, Matthew; Walthall, Jennifer

    2013-08-01

    Pediatric trauma evaluation mimics adult stabilization in that it is best accomplished with a focused and systematic approach. Attention to developmental differences, anatomic and physiologic nuances, and patterns of injury equip emergency physicians to stabilize and manage pediatric injury.

  11. Acquired Cerebral Trauma: Epilogue.

    ERIC Educational Resources Information Center

    Bigler, Erin D., Ed.

    1988-01-01

    The article summarizes a series of articles concerning acquired cerebral trauma. Reviewed are technological advances, treatment, assessment, potential innovative therapies, long-term outcome, family impact of chronic brain injury, and prevention. (DB)

  12. Trauma-Informed Schools.

    PubMed

    Wiest-Stevenson, Courtney; Lee, Cindy

    2016-01-01

    Violence has impacted every aspect of daily life. These tragedies have shocked the world. This has resulted in school communities being fractured. Additionally, The National Survey of Children Exposed to Violence found that 60% of the children surveyed have been exposed to some form of trauma, either in or out of school. Traumatology research has shown most people respond to a wide range of traumatic events in similar ways. The common responses include traumatic responses, posttraumatic stress responses, and posttraumatic stress disorder (PTSD). In this article the authors outline the impact of trauma on children within school systems; discuss the mental health services schools are providing; present a trauma-informed school model; identifies tools which can be utilized in schools; and provide resources needed for a trauma-informed school, along with additional tools and resources. The authors discuss future recommendations for the community and schools as traumatic events continue to grow and impact a large number of children.

  13. Review of pancreatic trauma.

    PubMed Central

    Glancy, K E

    1989-01-01

    In reviewing the literature on pancreatic trauma (1,984 cases), I found that it resulted from penetrating trauma in 73% and blunt trauma in 27% of cases. Associated injuries were common (average 3.0 per patient). Increased mortality was associated with shotgun wounds, an increasing number of associated injuries, the proximity of the injury to the head of the pancreas, preoperative shock, and massive hemorrhage. High mortality was found for total pancreatectomy, duct reanastomosis, and lack of surgical treatment, with lower mortality for Roux-en-Y anastomoses, suture and drainage, distal pancreatectomy, and duodenal exclusion and diverticulization techniques. Most patients required drainage only. The preoperative diagnosis of pancreatic trauma is difficult, with the diagnosis usually made during surgical repair for associated injuries. Blood studies such as amylase levels, diagnostic peritoneal lavage, and plain radiographs are not reliable. Computed tomographic scanning may be superior, but data are limited. PMID:2669347

  14. 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.

  15. Quality of trauma care and trauma registries.

    PubMed

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

    2015-03-01

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

  16. Noninvasive ventilation in trauma

    PubMed Central

    Karcz, Marcin K; Papadakos, Peter J

    2015-01-01

    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

  17. 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

  18. 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.

  19. 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.

  20. 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

  1. 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).

  2. Trauma systems and the costs of trauma care.

    PubMed Central

    Goldfarb, M G; Bazzoli, G J; Coffey, R M

    1996-01-01

    OBJECTIVE. This study examines the cost of providing trauma services in trauma centers organized by publicly administered trauma systems, compared to hospitals not part of a formal trauma system. DATA SOURCES AND STUDY SETTING. Secondary administrative discharge abstracts for a national sample of severely injured trauma patients in 44 trauma centers and 60 matched control hospitals for the year 1987 were used. STUDY DESIGN. Retrospective univariate and multivariate analyses were conducted to examine the impact of formal trauma systems and trauma center designation on the costs of treating trauma patients. Key dependent variables included length of stay, charge per day per patient, and charge per hospital stay. Key impact variables were type of trauma system and level of trauma designation. Control variables included patient, hospital, and community characteristics. DATA COLLECTION/EXTRACTION METHODS. Data were selected for hospitals based on (1) a large national hospital discharge database, the Hospital Cost and Utilization Project, 1980-1987 (HCUP-2) and (2) a special survey of trauma systems and trauma designation undertaken by the Hospital Research and Educational Trust of the American Hospital Association. PRINCIPAL FINDINGS. The results show that publicly designated Level I trauma centers, which are the focal point of most trauma systems, have the highest charge per case, the highest average charge per day, and similar or longer average lengths of stay than other hospitals. These findings persist after controlling for patient injury and health status, and for demographic characteristics and hospital and community characteristics. CONCLUSIONS. Prior research shows that severely injured trauma patients have greater chances of survival when treated in specialized trauma centers. However, findings here should be of concern to the many states developing trauma systems since the high costs of Level I centers support limiting the number of centers designated at this

  3. Systemic inflammation after trauma.

    PubMed

    Lenz, Andreas; Franklin, Glen A; Cheadle, William G

    2007-12-01

    Trauma is still one of the main reasons for death among the population worldwide. Mortality occurring early after injury is due to "first hits", including severe organ injury, hypoxia, hypovolaemia or head trauma. Massive injury leads to activation of the immune system and the early inflammatory immune response after trauma has been defined as systemic inflammatory response syndrome (SIRS). "Second hits" such as infections, ischaemia/reperfusion or operations can further augment the pro-inflammatory immune response and have been correlated with the high morbidity and mortality in the latter times after trauma. SIRS can lead to tissue destruction in organs not originally affected by the initial trauma with subsequent development of multi-organ dysfunction (MOD). The initial pro-inflammatory response is followed by an anti-inflammatory response and can result in immune suppression with high risk of infection and sepsis. Trauma causes activation of nearly all components of the immune system. It activates the neuroendocrine system and local tissue destruction and accumulation of toxic byproducts of metabolic respiration leads to release of mediators. Extensive tissue injury may result in spillover of these mediators into the peripheral bloodstream to further maintain and augment the pro-inflammatory response. Hormones like ACTH, corticosteroids and catecholamines as well as cytokines, chemokines and alarmins play important roles in the initiation and persistence of the pro-inflammatory response after severe injury. The purpose of this review is therefore to describe the immunological events after trauma and to introduce important mediators and pathways of the inflammatory immune response.

  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.

  5. 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

  6. 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.

  7. Transfusion practices in trauma.

    PubMed

    Ramakrishnan, V Trichur; Cattamanchi, Srihari

    2014-09-01

    Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. Recent articles addressing the transfusion practises in trauma from 2000 to 2014 were identified and reviewed. Trauma induced consumption and dilution of clotting factors, acidosis and hypothermia in a severely injured patient commonly causes trauma-induced coagulopathy. Early infusion of blood products and early control of bleeding decreases trauma-induced coagulopathy. Hypothermia and dilutional coagulopathy are associated with infusion of large volumes of crystalloids. Hence, the predominant focus is on damage control resuscitation, which is a combination of permissive hypotension, haemorrhage control and haemostatic resuscitation. Massive transfusion protocols improve survival in severely injured patients. Early recognition that the patient will need massive blood transfusion will limit the use of crystalloids. Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs) and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets. Close monitoring of bleeding and point of care coagulation tests are employed, to allow goal-directed plasma, PRBCs and platelets transfusions, in order to decrease the risk of transfusion-related acute lung injury. PMID:25535424

  8. Transfusion practices in trauma

    PubMed Central

    Ramakrishnan, V Trichur; Cattamanchi, Srihari

    2014-01-01

    Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. Recent articles addressing the transfusion practises in trauma from 2000 to 2014 were identified and reviewed. Trauma induced consumption and dilution of clotting factors, acidosis and hypothermia in a severely injured patient commonly causes trauma-induced coagulopathy. Early infusion of blood products and early control of bleeding decreases trauma-induced coagulopathy. Hypothermia and dilutional coagulopathy are associated with infusion of large volumes of crystalloids. Hence, the predominant focus is on damage control resuscitation, which is a combination of permissive hypotension, haemorrhage control and haemostatic resuscitation. Massive transfusion protocols improve survival in severely injured patients. Early recognition that the patient will need massive blood transfusion will limit the use of crystalloids. Initially during resuscitation, fresh frozen plasma, packed red blood cells (PRBCs) and platelets should be transfused in the ratio of 1:1:1 in severely injured patients. Fresh whole blood can be an alternative in patients who need a transfusion of 1:1:1 thawed plasma, PRBCs and platelets. Close monitoring of bleeding and point of care coagulation tests are employed, to allow goal-directed plasma, PRBCs and platelets transfusions, in order to decrease the risk of transfusion-related acute lung injury. PMID:25535424

  9. 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

  10. Sonography of scrotal trauma.

    PubMed

    Rao, Meka Srinivasa; Arjun, Kalyanpur

    2012-10-01

    The purpose of this article is to depict the spectrum of scrotal injuries in blunt trauma. Scrotal injuries are not very common and are mostly due to blunt trauma from direct injury, sports injuries or motor vehicle accidents. To minimize complications and ensure testicular salvage, rapid and accurate diagnosis is necessary. High-resolution USG is the investigation of choice, as it is readily available, accurate and has been seen to improve outcomes. An understanding of and familiarity with the sonographic appearance of scrotal injuries on the part of the radiologist/sonographer is therefore of key importance. PMID:23833421

  11. 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…

  12. 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

  13. 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

  14. Trauma and the endocrine system.

    PubMed

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

    2010-12-01

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

  15. Pediatric spinal trauma.

    PubMed

    Huisman, Thierry A G M; Wagner, Matthias W; Bosemani, Thangamadhan; Tekes, Aylin; Poretti, Andrea

    2015-01-01

    Pediatric spinal trauma is unique. The developing pediatric spinal column and spinal cord deal with direct impact and indirect acceleration/deceleration or shear forces very different compared to adult patients. In addition children are exposed to different kind of traumas. Moreover, each age group has its unique patterns of injury. Familiarity with the normal developing spinal anatomy and kind of traumas is essential to correctly diagnose injury. Various imaging modalities can be used. Ultrasound is limited to the neonatal time period; plain radiography and computer tomography are typically used in the acute work-up and give highly detailed information about the osseous lesions. Magnetic resonance imaging is more sensitive for disco-ligamentous and spinal cord injuries. Depending on the clinical presentation and timing of trauma the various imaging modalities will be employed. In the current review article, a summary of the epidemiology and distribution of posttraumatic lesions is discussed in the context of the normal anatomical variations due to progressing development of the child. PMID:25512255

  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. Minimizing Promotion Trauma.

    ERIC Educational Resources Information Center

    Darling, LuAnn W.; McGrath, Loraine

    1983-01-01

    Nursing administrators can minimize promotion trauma and its unnecessary cost by building awareness of the transition process, clarifying roles and expectations, and attending to the promoted employee's needs. This article will help nursing administrators develop a concept of manager care combined with programs for orientation of new managers,…

  18. 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…

  19. Trauma induced myocardial infarction.

    PubMed

    Lolay, Georges A; Abdel-Latif, Ahmed K

    2016-01-15

    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.

  20. 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

  1. 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.

  2. 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.

  3. 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.

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

    PubMed

    Baker, Cynthia; Varma, Manju; Tanaka, Connie

    2009-03-01

    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, Canada, 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 3 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.

  5. 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.

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

    NASA Astrophysics Data System (ADS)

    van Staal, Cees R.; Ravenhurst, Casey E.; Winchester, John A.; Roddick, J. Chris; Langton, John P.

    1990-11-01

    A narrow belt of Late Ordovician-Early Silurian blueschist, at least 70 km long, separates an afochthonous 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 FeO/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 in a subduction complex formed during the closure of a wide Taconic back-arc basin in Late Ordovician-Silurian time.

  7. Survey of food-related waste management practises in New Brunswick health establishments.

    PubMed

    Robichaud, R; Cormier, A; Gaudet-Leblanc, C

    1995-01-01

    A survey was conducted jointly by Université de Moncton and the New Brunswick (N.B.) Department of Health and Community Services to generate information on waste management practises within health care institutions. The objectives of the survey were: 1) to identify the type of waste management methods in place in N.B. health establishments; 2) to identify the major difficulties associated with recycling food-related waste; 3) to study the attitudes and beliefs of food service managers toward waste management. Data were collected through a questionnaire mailed to food service managers. Results indicated that 86% of establishments were involved in waste reduction. There were no statistically significant differences in reduction practices between hospitals and nursing homes or between the size of these establishments (P = 0.11). The same applied for reutilization (P = 0.09) where 93% of the establishments were involved. Recycling was carried out in 64.8% of the establishments. Major obstacles to recycling included the lack of pickup services, the lack of storage space, and the absence of buyers for recyclable materials. The results of this survey will help in the formulation of policies, strategies, and recommendations for better protection of the environment.

  8. 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

  9. 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

  10. Training in Trauma Surgery

    PubMed Central

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

    2003-01-01

    Objective: To describe outcomes from a clinical trauma surgical education program that places the board-eligible/board-certified fellow in the role of the attending surgeon (fellow-in-exception [FIE]) during the latter half of a 2-year trauma/surgical critical care fellowship. Summary Background Data: National discussions have begun to explore the question of optimal methods for postresidency training in surgery. Few objective studies are available to evaluate current training models. Methods: We analyzed provider-specific data from both our trauma registry and performance improvement (PI) databases. In addition, we performed TRISS analysis when all data were available. Registry and PI data were analyzed as 2 groups (faculty trauma surgeons and FIEs) to determine experience, safety, and trends in errors. We also surveyed graduate fellows using a questionnaire that evaluated perceptions of training and experience on a 6-point Likert scale. Results: During a 4-year period 7,769 trauma patients were evaluated, of which 46.3% met criteria to be submitted to the PA Trauma Outcome Study (PTOS, ie, more severe injury). The faculty group saw 5,885 patients (2,720 PTOS); the FIE group saw 1,884 patients (879 PTOS). The groups were similar in respect to mechanism of injury (74% blunt; 26% penetrating both groups) and injury severity (mean ISS faculty 10.0; FIEs 9.5). When indexed to patient contacts, FIEs did more operations than the faculty group (28.4% versus 25.6%; P < 0.05). Death rates were similar between groups (faculty 10.5%; FIEs 10.0%). Analysis of deaths using PI and TRISS data failed to demonstrate differences between the groups. Analysis of provider-specific errors demonstrated a slightly higher rate for FIEs when compared with faculty when indexed to PTOS cases (4.1% versus 2.1%; P < 0.01). For both groups, errors in management were more common than errors in technique. Twenty-one (91%) of twenty-three surveys were returned. Fellows’ feelings of preparedness

  11. [Immunonutrition after trauma].

    PubMed

    Felbinger, T W; Sachs, M; Richter, H P

    2011-11-01

    Immunonutrition may be superior to standard clinical nutrition in specific clinical situations. After severe trauma, an enteral immuno-enhancing diet, enriched with arginine, omega-3 fatty acids, and nucleotides, decreases infectious complications. During acute respiratory distress syndrome, a continuous enteral diet with high-dose omega-3 fatty acids, gamma-linolenic acid, and antioxidants improved clinical outcome. Glutamine should be administered enterally or parenterally whenever total parenteral nutrition is indicated.

  12. 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

  13. 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

  14. Cervical spine trauma

    PubMed Central

    Torretti, Joel A; Sengupta, Dilip K

    2007-01-01

    Cervical spine trauma is a common problem with a wide range of severity from minor ligamentous injury to frank osteo-ligamentous instability with spinal cord injury. The emergent evaluation of patients at risk relies on standardized clinical and radiographic protocols to identify injuries; elucidate associated pathology; classify injuries; and predict instability, treatment and outcomes. The unique anatomy of each region of the cervical spine demands a review of each segment individually. This article examines both upper cervical spine injuries, as well as subaxial spine trauma. The purpose of this article is to provide a review of the broad topic of cervical spine trauma with reference to the classic literature, as well as to summarize all recently available literature on each topic. Identification of References for Inclusion: A Pubmed and Ovid search was performed for each topic in the review to identify recently published articles relevant to the review. In addition prior reviews and classic references were evaluated individually for inclusion of classic papers, classifications and previously unidentified references. PMID:21139776

  15. Imaging of laryngeal trauma.

    PubMed

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

    2014-01-01

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

  16. Imaging of laryngeal trauma.

    PubMed

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

    2014-01-01

    External laryngeal trauma is a rare but potentially life-threatening situation in the acutely injured patient. Trauma mechanism and magnitude, maximum focus of the applied force, and patient related factors, such as age and ossification of the laryngeal cartilages influence the spectrum of observed injuries. Their correct diagnosis and prompt management are paramount in order to avoid patient death or long-term impairment of breathing, swallowing and speaking. The current review provides a comprehensive approach to the radiologic interpretation of imaging studies performed in patients with suspected laryngeal injury. It describes the key anatomic structures that are relevant in laryngeal trauma and discusses the clinical role of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the acute emergency situation. The added value of two-dimensional multiplanar reconstructions (2D MPR), three-dimensional volume rendering (3D VR) and virtual endoscopy (VE) for the non-invasive evaluation of laryngeal injuries and for treatment planning is discussed. The clinical presentation, biomechanics of injury, diagnostic pitfalls and pearls, common and uncommon findings are reviewed with emphasis of fracture patterns, involvement of laryngeal joints, intra- and extralaryngeal soft tissue injuries, and complications seen in the acute emergency situation. The radiologic appearance of common and less common long-term sequelae, as well as treatment options are equally addressed. PMID:24238937

  17. The trauma team--a system of initial trauma care.

    PubMed Central

    Adedeji, O. A.; Driscoll, P. A.

    1996-01-01

    Trauma remains the leading cause of death under the age of 35 years. England and Wales lost 252,000 working years from accidental deaths, including poison, in 1992. In this country, preventable deaths from trauma are inappropriately high. In many hospitals there are not enough personnel; in the majority, there are no recognisable trauma care systems, which can reduce preventable deaths to a minimum. The appropriateness of trauma centres for this country is being assessed in Stoke-on-Trent, and a report is due out later this year. Even if the recommendation is made to establish such centres, it is unlikely that many will be set up. Consequently most hospitals will have to rely on their own resources to set up and run a trauma team. This type of trauma care system is the subject of this article. PMID:8977939

  18. 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.…

  19. 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

  20. 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

  1. 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.

  2. Global trauma: the great divide.

    PubMed

    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.

  3. 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

  4. 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).

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

    SciTech Connect

    Not Available

    1999-01-01

    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.

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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.

  11. 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

  12. Acute brain trauma.

    PubMed

    Martin, G T

    2016-01-01

    In the 20th century, the complications of head injuries were controlled but not eliminated. The wars of the 21st century turned attention to blast, the instant of impact and the primary injury of concussion. Computer calculations have established that in the first 5 milliseconds after the impact, four independent injuries on the brain are inflicted: 1) impact and its shockwave, 2) deceleration, 3) rotation and 4) skull deformity with vibration (or resonance). The recovery, pathology and symptoms after acute brain trauma have always been something of a puzzle. The variability of these four modes of injury, along with a variable reserve of neurones, explains some of this problem.

  13. 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.

  14. 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

  15. 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

  16. 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…

  17. 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

  18. Haemodynamic changes in trauma.

    PubMed

    Kirkman, E; Watts, S

    2014-08-01

    Trauma is the leading cause of death during the first four decades of life in the developed countries. Its haemodynamic response underpins the patient's initial ability to survive, and the response to treatment and subsequent morbidity and resolution. Trauma causes a number of insults including haemorrhage, tissue injury (nociception) and, predominantly, in military casualties, blast from explosions. This article discusses aspects of the haemodynamic responses to these insults and subsequent treatment. 'Simple' haemorrhage (blood loss without significant volume of tissue damage) causes a biphasic response: mean arterial blood pressure (MBP) is initially maintained by the baroreflex (tachycardia and increased vascular resistance, Phase 1), followed by a sudden decrease in MAP initiated by a second reflex (decrease in vascular resistance and bradycardia, Phase 2). Phase 2 may be protective. The response to tissue injury attenuates Phase 2 and may cause a deleterious haemodynamic redistribution that compromises blood flow to some vital organs. In contrast, thoracic blast exposure augments Phase 2 of the response to haemorrhage. However, hypoxaemia from lung injury limits the effectiveness of hypotensive resuscitation by augmenting the attendant shock state. An alternative strategy ('hybrid resuscitation') whereby tissue perfusion is increased after the first hour of hypotensive resuscitation by adopting a revised normotensive target may ameliorate these problems. Finally, morphine also attenuates Phase 2 of the response to haemorrhage in some, but not all, species and this is associated with poor outcome. The impact on human patients is currently unknown and is the subject of a current physiological investigation.

  19. 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…

  20. Neurosurgery: Skull Base Craniofacial Trauma.

    PubMed

    Donald, Paul J

    2016-10-01

    Much of craniofacial trauma involves the frontal sinuses. Because of its response to injury, the frontal sinus mucosa has an innate ability to develop mucoceles, and if infected, mucopyocoeles. This article presents a therapeutic algorithm for all forms of craniofacial trauma with concentration on the most severe injury-the through and through fracture and its surgical remediation. PMID:27648398

  1. 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.

  2. Maternal mortality due to trauma.

    PubMed

    Romero, Vivian Carolina; Pearlman, Mark

    2012-02-01

    Maternal mortality is an important indicator of adequacy of health care in our society. Improvements in the obstetric care system as well as advances in technology have contributed to reduction in maternal mortality rates. Trauma complicates up to 7% of all pregnancies and has emerged as the leading cause of maternal mortality, becoming a significant concern for the public health system. Maternal mortality secondary to trauma can often be prevented by coordinated medical care, but it is essential that caregivers recognize the unique situation of providing simultaneous care to 2 patients who have a complex physiologic relationship. Optimal management of the pregnant trauma victim requires a multidisciplinary team, where the obstetrician plays a central role. This review focuses on the incidence of maternal mortality due to trauma, the mechanisms involved in traumatic injury, the important anatomic and physiologic changes that may predispose to mortality due to trauma, and finally, preventive strategies that may decrease the incidence of traumatic maternal death.

  3. Mouthpart deformities and community composition of Chironomidae (Diptera) larvae downstream of metal mines in New Brunswick, Canada.

    PubMed

    Swansburg, Erin O; Fairchild, Wayne L; Fryer, Brian J; Ciborowski, Jan J H

    2002-12-01

    The effect of metal enrichment on chironomid communities was examined in streams receiving mine drainage from metal mining operations in New Brunswick, Canada. At five sites receiving mine drainage, metal concentrations were significantly (p < 0.05) elevated in water (Zn), periphyton (Cd, Co, Cu, and Zn), and chironomid tissue (Cu, Cd, and Zn) relative to five paired reference locations. Metal concentrations in chironomid larvae were significantly correlated with concentrations in both water and periphyton. Chironomid communities were severely affected at sites receiving mine drainage as demonstrated by reduced genera richness and altered community composition. Sites receiving mine drainage exhibited an increased abundance of metal-tolerant Orthocladiinae and a reduced abundance of metal-sensitive Tanytarsini relative to reference sites. The incidence of mentum deformities was significantly elevated at sites receiving mine drainage (1.43 +/- 0.24%), with the mean percentage approaching a doubling of that observed at reference sites (0.79 +/- 0.22%). Trace metal concentrations at mine-associated streams in New Brunswick significantly affected the benthic community and have the potential to alter the structure and function of these aquatic ecosystems. PMID:12463564

  4. 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.

  5. 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

  6. 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…

  7. 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

    ... at Sunny Point Army Terminal, Brunswick County, N.C.; restricted area. 334.450 Section 334.450 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.450 Cape Fear River and tributaries at Sunny Point Army...

  8. Validating Evapotranspiraiton Equations Using Bowen Ratio in New Brunswick, Maritime, Canada

    PubMed Central

    Xing, Zisheng; Chow, Lien; Meng, Fan-Rui; Rees, Herb W.; Stevens, Lionel; Monteith, John

    2008-01-01

    Three methods including the Penman-Monteith (PM), Priestley-Taylor (PT), and 1963 Penman equation (PE) for calculating daily reference evapotranspiration (ETo) were evaluated in the Maritime region of Canada with the data collected from 2004 to 2007. An automatically operated meteorological station located on the Potato Research Centre, Agriculture and Agri-Food Canada, Fredericton, New Brunswick, Canada, was used to collect required meteorological data for evapotranspiration modeling. A Bowen Ratio system (BR) was setup near the Environment Canada grade one weather station to provide evapotranspiration observations for the validation research of reference evapotranspiration models. The results showed that the prediction from each of the tested models had a certain degree of offset in comparison with the observations obtained by the BR method. All of the tested models slightly overestimated evapotranspiration compared to the BR system by 5-14%, depending on the method. However, the PM generated a better fit to the pooled dataset while the PT produced the best prediction for the 2007 validation dataset. The PM generated the best estimation of evapotranspiration for year 2004 during a inter-annual comparison. The BR revealed that the average daytime ET for the site was around 2.5 mm day-1(±0.1) averaged for Julian day 157-276 in 2004 to 2006 and possible condensation was 0.16 mm day-1 for the same period. Crop coefficient (Kc) varied with different models, for example, 0.42 for the PM, 0.44 for the PT, and 0.67 for the PE with a slight yearly variation. With this set of Kc values, a validation with additional dataset collected in 2007 indicated that all three equations achieved a good fit with observations using the above Kc values. The PT performed slightly better than the other two models. A single factor analysis did not show any statistically significant difference between predicted and measured ET. With a consideration of simplicity and application for scaling

  9. 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

  10. 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.

  11. Skiing and spinal trauma.

    PubMed

    Frymoyer, J W; Pope, M H; Kristiansen, T

    1982-07-01

    Spinal injury in skiers can either be acute or chronic. Acute spinal injury accounts for 3 to 3.6 per cent of all injuries occurring in Alpine skiing. Fewer acute injuries occur in cross-country skiing, and those that do usually are the result of a sudden, compressive force from a seated fall. The prevalence of chronic spinal trauma in skiing is unknown. Both cross-country and Alpine skiers appear to have greater complaints of mild to moderate low back pain as compared with their nonskiing counterparts. These differences may be the result of a complex interaction between recreational and occupational activities. Theoretical analyses suggest a risk for low-grade torsional injury to the Alpine skier's spine, whereas in cross-country skiing significant shear forces are applied to lumbar discs during the kick but not the double-poling phase.

  12. 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.

  13. Vascular emergencies in liver trauma.

    PubMed

    Taourel, P; Vernhet, H; Suau, A; Granier, C; Lopez, F M; Aufort, S

    2007-10-01

    The use of CT in the diagnosis and management of liver trauma is responsible for the shift from routine surgical versus non-surgical treatment in the management of traumatic liver injuries, even when they are of high grade. The main cause of complication and of death in liver trauma is related to vascular injury. The goal of this review focussed on the vascular complications of liver trauma is to describe the elementary lesions shown by CT in liver trauma including laceration, parenchymal hematoma and contusions, partial devascularisation, subcapsular hematomas, hemoperitoneum, active bleeding, pseudoaneurysm of the hepatic artery, bile leak, and periportal oedema, to illustrate the possible pitfalls in CT diagnosis of liver trauma and to underline the key-points which may absolutely be present in a CT report of liver trauma. Then we will remind the grading system based on the CT features and we will analyze the interest and limitations of such grading systems. Last we will discuss the diagnostic strategy at the early phase in patients with suspected liver trauma according to their clinical conditions and underline the conditions of arterial embolization, and then we will discuss the diagnosis strategy at the delayed phase according to the suspected complications. PMID:17851012

  14. Individual Differences in Trauma Disclosure

    PubMed Central

    Bedard-Gilligan, Michele; Jaeger, Jeff; Echiverri-Cohen, Aileen; Zoellner, Lori A.

    2011-01-01

    Background and Objectives Findings on disclosure and adjustment following traumatic events have been mixed. Better understanding of individual differences in disclosure may help us better understand reactions following trauma exposure. In particular, studying disclosure patterns for those with and without psychopathology and for different types of emotional experiences may help clarify the relationship between disclosure, event emotionality, trauma exposure, and PTSD. Methods In this study, 143 men and women with (n = 67) and without (n = 43) chronic PTSD and without trauma exposure (n = 33) provided information on disclosure for a traumatic/severe life event, a negative event, and a positive event. Results Individuals with PTSD reported greater difficulty disclosing their traumatic event compared to those with trauma exposure no PTSD and those with no-trauma exposure. However, individuals with PTSD reported disclosing the traumatic event a similar number of times and with similar levels of detail to those with trauma exposure but no PTSD. Both sexual and childhood trauma were associated with greater disclosure difficulty. Limitations Although control event types (positive, negative) were selected to control for the passage of time and for general disclosure style, they do not control for salience of the event and results may be limited by control events that were not highly salient. Conclusions The present findings point to a dynamic conceptualization of disclosure, suggesting that the differential difficulty of disclosing traumatic events seen in individuals with PTSD is not simply a function of the amount of disclosure or the amount of details provided. PMID:22080869

  15. Impact of trauma on children.

    PubMed

    Lubit, Roy; Rovine, Deborah; DeFrancisci, Lea; Eth, Spencer

    2003-03-01

    Millions of children are affected by physical and sexual abuse, natural and technological disasters, transportation accidents, invasive medical procedures, exposure to community violence, violence in the home, assault, and terrorism. Unfortunately, the emotional impact of exposure to trauma on children is often unappreciated and therefore untreated, and yet the impact of exposures to disaster and violence is profound and long-lasting. This article first briefly discusses the epidemiology of trauma in children, and then reviews the psychiatric and neurodevelopmental impact of trauma on children as well as the effects of trauma on children's emotional development. Trauma in children can lead to the development of posttraumatic stress disorder as well as to a variety of other psychiatric disorders, including depression, generalized anxiety disorder, panic attacks, borderline personality disorder, and substance abuse in adult survivors of trauma. Research has found that early exposure to stress and trauma causes physical effects on neurodevelopment which may lead to changes in the individual's long-term response to stress and vulnerability to psychiatric disorders. Exposure to trauma also affects children's ability to regulate, identify, and express emotions, and may have a negative effect on the individual's core identity and ability to relate to others. The authors also discuss what has been learned, based on recent experiences such as the World Trade Center catastrophe, about the role of television viewing in increasing the effects of traumatic events. The last section of the article provides guidance concerning the identification and clinical treatment of children and adolescents who are having emotional problems as a result of exposure to trauma.

  16. 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.

  17. 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…

  18. Management of midface maxillofacial trauma.

    PubMed

    Gentile, Michael A; Tellington, Andrew J; Burke, William J; Jaskolka, Michael S

    2013-03-01

    The management of midface trauma continues to challenge maxillofacial surgeons. The complex local anatomy and functional and cosmetic importance of the region make precise surgical correction and reconstruction essential to success.

  19. 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

  20. 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

  1. Trauma of the midface.

    PubMed

    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

  2. [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

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. 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

  8. Multiple Employment Training Programs. Major Overhaul Needed To Reduce Costs, Streamline the Bureaucracy, and Improve Results. Testimony before the Committee on Labor and Human Resources. U.S. Senate.

    ERIC Educational Resources Information Center

    Crawford, Clarence C.

    Research conducted by the General Accounting Office (GAO) indicates that the current system of multiple employment training programs requires major overhaul to reduce costs, streamline the bureaucracy, and improve results. The current system of 163 different federal employment training programs wastes resources and confuses and frustrates clients,…

  9. Exploring trauma associated appraisals in trauma survivors from collectivistic cultures.

    PubMed

    Engelbrecht, Alberta; Jobson, Laura

    2016-01-01

    Appraisals are a key feature in understanding an individual's experience; this is especially important when the experience is a traumatic one. However, research is diminutive when looking at the interaction between trauma appraisals and culture in relation to posttraumatic stress disorder using qualitative methodologies. This study explored cultural differences in perceptions and appraisals of trauma using three qualitative focus groups with community members (n = 11) from collectivistic cultures who had experienced a traumatic event and three qualitative individual key informant interviews with mental health practitioners (n = 3) routinely working with trauma survivors. Using template analysis, eight emergent themes were highlighted from the data sets [(1) trauma and adjustment; (2) cultural and social roles; (3) traumatised self; (4) relationships; (5) external attribution; (6) future; (7) education; (8) language] that potentially have significant consequences for posttrauma psychological adjustment and recovery. Cumulatively, while a number of themes are similar to that which is emphasised in current literature (e.g. damaged self, negative appraisals of the world, others, future) a number of themes were also resonant and warrant further scrutiny. For instance, the importance and interconnectedness of the group to the individual and the impact trauma has on this; the importance of social roles, cultural appropriateness and violations of cultural values and norms; findings and implications are discussed. PMID:27652138

  10. 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…

  11. Ventilatory strategies in trauma patients

    PubMed Central

    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

  12. 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

  13. Pancreatic trauma: A concise review

    PubMed Central

    Debi, Uma; Kaur, Ravinder; Prasad, Kaushal Kishor; Sinha, Saroj Kant; Sinha, Anindita; Singh, Kartar

    2013-01-01

    Traumatic injury to the pancreas is rare and difficult to diagnose. In contrast, traumatic injuries to the liver, spleen and kidney are common and are usually identified with ease by imaging modalities. Pancreatic injuries are usually subtle to identify by different diagnostic imaging modalities, and these injuries are often overlooked in cases with extensive multiorgan trauma. The most evident findings of pancreatic injury are post-traumatic pancreatitis with blood, edema, and soft tissue infiltration of the anterior pararenal space. The alterations of post-traumatic pancreatitis may not be visualized within several hours following trauma as they are time dependent. Delayed diagnoses of traumatic pancreatic injuries are associated with high morbidity and mortality. Imaging plays an important role in diagnosis of pancreatic injuries because early recognition of the disruption of the main pancreatic duct is important. We reviewed our experience with the use of various imaging modalities for diagnosis of blunt pancreatic trauma. PMID:24379625

  14. [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

  15. Trauma from a global perspective.

    PubMed

    Ray, Susan L

    2008-01-01

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

  16. 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…

  17. 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

  18. 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.

  19. 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 ...

  20. 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.

  1. [Japan Trauma Data Bank (JTDB) managed by Japan Trauma Care and Research (JTCR)].

    PubMed

    Yokota, Junichiro

    2016-02-01

    Japan Trauma Care and Research (JTCR) was founded for operating the trauma care education and research in 2005. Japan Advanced Trauma Evaluation and Care (JATEC) is an educational program of trauma care established by The Japanese Association for The Surgery of Trauma (JAST) and the Japanese Association of Acute Medicine (JAAM), managed by JTCR. The Japan Trauma Data Bank (JTDB) is the only database organization of Japan trauma registry that was also established by JAST and JAAM, and managed by JTCR. Registry data that is collected from the JTDB is compiled annually and disseminated in the forms of hospital benchmark reports, data quality reports, and research data sets.

  2. The role of the trauma nurse leader in a pediatric trauma center.

    PubMed

    Wurster, Lee Ann; Coffey, Carla; Haley, Kathy; Covert, Julia

    2009-01-01

    The trauma nurse leader role was developed by a group of trauma surgeons, hospital administrators, and emergency department and trauma leaders at Nationwide Children's Hospital who recognized the need for the development of a core group of nurses who provided expert trauma care. The intent was to provide an experienced group of nurses who could identify and resolve issues in the trauma room. Through increased education, exposure, mentoring, and professional development, the trauma nurse leader role has become an essential part of the specialized pediatric trauma care provided at Nationwide Children's Hospital.

  3. Coronary artery dissection after blunt chest trauma

    PubMed Central

    Shamsi, Fahad; Tai, Javed Majid; Bokhari, Saira

    2014-01-01

    Blunt thoracic trauma may result in cardiac injuries ranging from simple arrhythmias to fatal cardiac rupture. Coronary artery dissection culminating in acute myocardial infarction (AMI) is rare after blunt chest trauma. Here we report a case of a 37-year-old man who had an AMI secondary to coronary dissection resulting from blunt chest trauma after involvement in a physical fight. PMID:25246456

  4. 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…

  5. 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.

  6. 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…

  7. Addressing Trauma in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Giordano, Amanda L.; Prosek, Elizabeth A.; Stamman, Julia; Callahan, Molly M.; Loseu, Sahar; Bevly, Cynthia M.; Cross, Kaitlin; Woehler, Elliott S.; Calzada, Richard-Michael R.; Chadwell, Katie

    2016-01-01

    Trauma is prevalent among clients with substance abuse issues, yet addictions counselors' training in trauma approaches is limited. The purpose of the current article is to provide pertinent information regarding trauma treatment including the use of assessments, empirically supported clinical approaches, self-help groups and the risk of vicarious…

  8. 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…

  9. Skeletal trauma in child abuse.

    PubMed

    Swoboda, Sara L; Feldman, Kenneth W

    2013-11-01

    Fractures and other skeletal injuries are common in childhood. Most are the result of falls, motor vehicle accidents, and other forms of accidental trauma. However, skeletal trauma is present in a significant number of abused children. Age and developmental abilities are key components in raising clinical suspicion for child abuse. Children who are unable to provide their own history because of age or developmental delay require increased attention. Younger children are more likely to have abusive fractures, whereas accidental fractures increase with age and developmental abilities. The consequences of missing abuse are high because children returned to their homes without intervention are likely to face further abuse and have an increased mortality risk. Because of the potentially high cost of undiagnosed child abuse, diagnosis of a skeletal injury is incomplete without diagnosing its etiology. All health providers for children should be able to recognize patterns of skeletal injury secondary to abusive trauma and understand the process for initiating Child Protective Services (CPS) investigations when necessary. Although they can occur accidentally, fractures in nonmobile children should always increase the clinician's concern for abusive trauma. In light of the significant consequences for children when abuse is missed by a primary care provider, abuse should be on the differential diagnosis for all presenting childhood injuries.

  10. 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)

  11. 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…

  12. 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

  13. The Trauma-Sensitive Teacher

    ERIC Educational Resources Information Center

    Craig, Susan E.

    2016-01-01

    According to the National Center for Mental Health Promotion and Youth Violence Prevention, about one quarter of children in the United States will witness or experience a traumatic event before the age of four. In this article, Susan E. Craig explains how these early trauma histories prime a child's brain to expect certain experiences,…

  14. 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.

  15. 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.

  16. 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

  17. Trauma care systems in The Netherlands.

    PubMed

    ten Duis, Henk Jan; van der Werken, Chris

    2003-09-01

    In the late 1980s the Dutch trauma surgeons (Dutch Trauma Society) expressed their concern about the quality of care to the (multi) trauma patients, in the prehospital as well as the in-hospital setting. The following intensive debate with the public health inspectorate and the government became the start point for major improvements in teaching and training (a.o. ATLS), reorganization, regionalization and implementation in which all partners in trauma care were involved. The regionalization of ambulance care, the introduction of mobile medical teams, the availability of trauma helicopters, the categorization of hospitals, the designation of trauma centres, the given responsibility of these centres in the regionalization of trauma care will and already have resulted in an important quality improvement, not only of the individual organizations but for all of the entire chain of trauma care. It has become a major step forward in the philosophy: get the individual trauma patient at the right time at the right hospital. Besides, initiatives have been taken to design a nationwide trauma registration data base in which all in-hospital trauma patients will be included. However serious concerns remain: shortage of intensive care beds, the impossibility to use the helicopter service at night, the shortage in the number of mobile medical teams at night and the slowness in executions of agreements between contracting parties. Many of the remaining problems are a matter of money. Not only (para) medical partners and hospitals but for all government and insurance companies should take their responsibility in this.

  18. 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

  19. 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.

  20. Sea lice monitoring on Atlantic salmon farms in New Brunswick, Canada: comparing audit and farm staff counts.

    PubMed

    Elmoslemany, A; Whyte, S K; Revie, C W; Hammell, K L

    2013-03-01

    Sea lice audits were performed by the Atlantic Veterinary College on commercial aquaculture sites in New Brunswick, Canada, in 2011. Although the primary objective was to verify that farms were reporting similar lice counts to third-party counts, more detailed comparisons were made to identify when lice counts were more likely to differ between the audit team and farm employees. A total of 28 sea lice audits were conducted on 16 sites between June and December 2011. During each audit, 10 cages were evaluated per site where possible, with ten fish per cage being evaluated by an audit technician and a further ten by a farm employee. Data analysis included descriptive statistics of lice counts by stage and limits of agreement plots. A random effects negative binomial model that accounted for clustering of cages within sites was applied to assess the effect of counter type and season on lice counts by stage. The results indicate that farms counts were generally in agreement with audit counts. However, when the average counts for chalimus and preadult (male and female) and adult male lice stages were high, farm counters were more likely to report a lower value. Higher lice counts were observed during autumn compared to summer especially for the adult female stage. Finally, there was a significant clustering effect for site and cage, with most of the variation attributable to site.

  1. 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.

  2. 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.

  3. 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

  4. Are the paradigms in trauma disease changing?

    PubMed

    Alted López, E

    2015-01-01

    Despite an annual trauma mortality of 5 million people worldwide, resulting in countless physical disabilities and enormous expenses, there are no standardized guidelines on trauma organization and management. Over the last few decades there have been very notorious improvements in severe trauma care, though organizational and economical aspects such as research funding still need to be better engineered. Indeed, trauma lags behind other serious diseases in terms of research and organization. The rapid developments in trauma care have produced original models available for research projects, initial resuscitation protocols and radiological procedures such as CT for the initial management of trauma patients, among other advances. This progress underscores the need for a multidisciplinary approach to the initial management and follow-up of this complicated patient population, where intensivists play a major role in both the patient admission and subsequent care at the trauma unit.

  5. 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

  6. Snowmobile trauma: 10 years' experience at Manitoba's tertiary trauma centre

    PubMed Central

    Stewart, Rena L.; Black, G. Brian

    2004-01-01

    Introduction According to the literature, the increased recreational use of the snowmobile has resulted in an increasing number of musculoskeletal injuries. We wished to examine whether previously described risk factors continue to be associated with snowmobile trauma and to identify previously unrecognized risks and specific patterns of injury. Methods We carried out a chart review of all snowmobile-related injuries over a 10-year period at the Health Sciences Centre in Winnipeg, the only level 1 trauma centre serving the Province of Manitoba, with particular attention to the risk factors of suboptimal lighting, excessive speed and alcohol consumption. Results We identified 480 injuries in 294 patients, and 81 (27.6%) of these patients died. Collisions accounted for 72% of the injury mechanisms. Of the injuries sustained, 31% occurred on roads. Excessive speed was a risk factor in 54% of patients, suboptimal lighting in 86% and a blood alcohol level greater than 0.08 in 70%. Musculoskeletal injuries accounted for 57% of those recorded. There were also brachial plexus injuries (3%) and knee dislocations (2%). To our knowledge, this is the largest study detailing injury associated with recreational use of snowmobiles in Canada. Conclusions Because snowmobile trauma is caused principally by human errors, it is potentially preventable. Efforts aimed at prevention must focus on the driver, who controls the common risk factors. The danger of snowmobiling while intoxicated must be emphasized. Trail-side monitoring is likely to be ineffective, as the majority of accidents do not occur on designated snowmobile trails. PMID:15132460

  7. 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.

  8. Musculoskeletal trauma: the baseball bat.

    PubMed

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

    1992-11-01

    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.

  9. Computed tomography of pancreatic trauma

    SciTech Connect

    Jeffrey, R.B. Jr.; Federle, M.P.; Crass, R.A.

    1983-05-01

    In a review of over 300 CT scans of abdominal trauma, we encountered 13 patients with surgically proved pancreatic injuries. CT correctly diagnosed pancreatic fractures, contusions, or posttraumatic pseudocysts in 11 of these patients. There were two false positive and two false negative diagnoses. The CT diagnosis of pancreatic trauma may be difficult in selected patients who are scanned soon after injury. Acutely, the actual plane of a pancreatic fracture may be difficult to identify with CT, and the peripancreatic soft-tissue changes of traumatic pancreatitis are often subtle. Eight of 11 correctly diagnosed pancreatic injuries showed thickening of the left anterior renal fascia on CT scans. This sign should prompt a critical evaluation of the pancreas of the traumatized patient.

  10. 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

  11. 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

  12. 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

  13. 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

  14. Penetrating nontorso trauma: the extremities

    PubMed Central

    Ball, Chad G.

    2015-01-01

    Summary Similar to penetrating torso trauma, nontorso injuries have undergone a fascinating oscillation between invasive and noninvasive approaches. This article discusses an organized approach to the evaluation and initial treatment of penetrating extremity injuries based on regional anatomy and clinical examination. The approach is reliable, efficient and minimizes both delays in diagnosis and missed injuries. Outpatient follow-up is particularly important for patients with extremity injuries who are discharged home from the emergency department. PMID:26022152

  15. 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

  16. 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

  17. The spectrum of agricultural trauma.

    PubMed

    Cogbill, T H; Busch, H M

    1985-01-01

    During the past 6 years, 375 patients were hospitalized with injuries resulting from farm accidents. The mechanism of injury was farm animal in 135 patients (36%), tractor in 89 (24%), corn picker or auger in 57 (15%), power take-off in 29 (8%), other farm machinery in 50 (13%), and miscellaneous in 15 (4%). Injury severity score (ISS) of 25 or greater was calculated for 29 individuals (8%). Eleven groups of surgical subspecialists performed 539 procedures. Eight patients (2.1%) died as a result of their injuries. All eight deaths occurred after tractor accidents secondary to pelvic fractures, head and spinal cord injury, or blunt chest trauma. Thirty-nine patients (10%) were left with serious permanent disability. Unnecessary morbidity and mortality in many cases were attributed to excessive prehospital care times within a largely rural area. Better prevention by farmer education and the initiation of mandatory safety devices on agricultural equipment may lower the incidence of farm accidents. Major agricultural trauma is frequent and diverse and is optimally managed in a regional trauma center. PMID:4093573

  18. Radionuclide evaluation of lung trauma

    SciTech Connect

    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.

  19. Orthopaedic outcomes: combat and civilian trauma care.

    PubMed

    Rispoli, Damian M; Mackenzie, Ellen J

    2012-01-01

    Important advances have been made in the management of complex trauma through careful scientific analysis of outcomes. Outcomes analysis in combat extremity trauma is exemplified and highlighted by scholarly work in the treatment of catastrophic lower extremity trauma. The success of this line of research in civilian trauma is exemplified by the Lower Extremity Assessment Project (LEAP) study on the outcomes of civilian lower extremity trauma. This highly successful effort was followed by the Military Extremity Trauma Amputation/Limb Salvage (METALS) study. Current ongoing analysis of both the LEAP and METALS studies by the Major Extremity Trauma Research Consortium seeks to compare and contrast the similarities and differences of both studies and to advance evidence-based patient-centered care. The effects of psychological trauma on the injured individual underscore the global effect of severe trauma and the need for a multidisciplinary approach to trauma care. Statistical modeling is being used to analyze outcomes to further the ability to scientifically and definitively determine the best practices for patient care.

  20. Social contexts of trauma and healing.

    PubMed

    Ajdukovic, Dean

    2004-01-01

    The social contexts in which the mass trauma of thousands of people occur and in which their recovery should progress have qualities that distinguish it in important ways from individualised trauma in which a person is a victim of a violent attack, rape or a traffic accident. Organised violence, such as wars, oppression by dictatorships and massive terrorist attacks are extreme cases in which hundreds or thousands of people are exposed to trauma in a short period of time. As such, it has multiple consequences that extend beyond the affected individuals and the symptoms they suffer. Although the symptoms may be similar, the social contexts in which individual victimisation and exposure to organised violence happen are very different. The social milieu in which the survivors of individual trauma and survivors of mass trauma are embedded is likewise different, with important consequences for recovery. Understanding the social context of the trauma helps create the right social intervention for healing at social and personal levels.

  1. 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

  2. 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.

  3. The role of palliative care in trauma.

    PubMed

    Owens, Darrell

    2012-01-01

    Trauma remains a leading cause of morbidity and mortality in the United States. Despite the aggressive and heroic nature of trauma care, including trauma surgery, 10% to 20% of patients admitted to trauma intensive care units die. As the population continues to age, it is predicted that by 2050, approximately 40% of those experiencing traumatic injury will be older than 65 years. For multiple reasons, people in this age group who experience trauma are at greater risk for death. Palliative care is the specialty of health care that provides care for patients with serious, life-threatening, or life-limiting illness or injury, regardless of the stage of disease or treatment. The goal of palliative care is to reduce or alleviate suffering through expert pain and symptom management, as well as assistance with decision making. The integration of palliative and trauma care can assist and support patients and families through stressful, often life-changing times, regardless of the final outcome.

  4. 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

  5. Specific trauma subtypes improve the predictive validity of the Harvard Trauma Questionnaire in Iraqi refugees.

    PubMed

    Arnetz, Bengt B; Broadbridge, Carissa L; Jamil, Hikmet; Lumley, Mark A; Pole, Nnamdi; Barkho, Evone; Fakhouri, Monty; Talia, Yousif Rofa; Arnetz, Judith E

    2014-12-01

    Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10%, respectively) than did the cumulative trauma index (7 and 3%, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.

  6. 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

  7. 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.

  8. Changes in acid precipitation-related water chemistry of lakes from southwestern New Brunswick, Canada, 1986-2001.

    PubMed

    Pilgrim, W; Clair, T A; Choate, J; Hughes, R

    2003-01-01

    Between 1986 and 2001, thirty-nine lakes in southwestern New Brunswick in Atlantic Canada were surveyed for acid precipitation-related water quality changes. Most of the study lakes are located on granite bedrock and represent the most acid sensitive lakes in the province. Between 1987 and 1992, hydrogen ion deposition to the lake study area averaged 452 eq ha(-1) yr(-1), compared to 338 eq ha(-1) yr(-1) between 1993 and 2000, a 25% reduction. The lake chemistry data were evaluated by dividing the lakes into four clusters for each survey year based on their acid neutralizing capacity. Twenty percent of the lakes (cluster IV) had an average ANC of 40 microeq L(-1) or greater and maintained an average pH of greater than 6 over the duration of the study period. A pH of 6 or greater is considered a healthy benchmark for maintaining biodiversity. The remaining 31 lakes (clusters I to III) had an average ANC of less than 40 microeq L(-1) and maintained an average pH of less than 6. Other lake chemistry changes included a general decline in lake sulphate and colour over the duration of the survey period, followed by more recent improvements in calcium ion, pH and ANC, and notably higher but declining aluminum levels in lower ANC and pH lakes. Nitrate accounted for 37% of the acid deposition to the study area, however it was not detectable in the lakes. Although acid deposition has declined and these lakes are beginning to show signs of acid recovery, 80% of the study lakes remain acid sensitive having little buffering capacity with low calcium, pH and ANC.

  9. Ethical aspects of research on psychological trauma

    PubMed Central

    Stein, Dan J.; Herman, Allen; Kaminer, Debra; Rataemane, Solomon; Seedat, Soraya; Kessler, Ronald C.; Williams, David

    2000-01-01

    Research in the area of psychological trauma raises a number of complex ethical issues. These include questions about unjustified medicalization of suffering, retraumatization of survivors, the morality of also investigating perpetrators of trauma, and neglecting to provide appropriate intervention. We discuss some of these issues against the backdrop of a study of trauma in South Africa, and the recent work of the Truth and Reconciliation Commission in that country. PMID:22033592

  10. Enhancing trauma education worldwide through telemedicine

    PubMed Central

    2012-01-01

    Advances in information and communication technologies are changing the delivery of trauma care and education. Telemedicine is a tool that can be used to deliver expert trauma care and education anywhere in the world. Trauma is a rapidly-evolving field requiring access to readily available sources of information. Through videoconferencing, physicians can participate in continuing education activities such as Grand Rounds, seminars, conferences and journal clubs. Exemplary programs have shown promising outcomes of teleconferences such as enhanced learning, professional collaborations, and networking. This review introduces the concept of telemedicine for trauma education, and highlights efforts of programs that are utilizing telemedicine to unite institutions across the world. PMID:23531408

  11. 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.

  12. Red blood cell storage duration and trauma.

    PubMed

    Sparrow, Rosemary L

    2015-04-01

    Numerous retrospective clinical studies suggest that transfusion of longer stored red blood cells (RBCs) is associated with an independent risk of poorer outcomes for certain groups of patients, including trauma, intensive care, and cardiac surgery patients. Large multicenter randomized controlled trials are currently underway to address the concern about RBC storage duration. However, none of these randomized controlled trials focus specifically on trauma patients with hemorrhage. Major trauma, particularly due to road accidents, is the leading cause of critical injury in the younger-than-40-year-old age group. Severe bleeding associated with major trauma induces hemodynamic dysregulation that increases the risk of hypoxia, coagulopathy, and potentially multiorgan failure, which can be fatal. In major trauma, a multitude of stress-associated changes occur to the patient's RBCs, including morphological changes that increase cell rigidity and thereby alter blood flow hemodynamics, particularly in the microvascular vessels, and reduce RBC survival. Initial inflammatory responses induce deleterious cellular interactions, including endothelial activation, RBC adhesion, and erythrophagocytosis that are quickly followed by profound immunosuppressive responses. Stored RBCs exhibit similar biophysical characteristics to those of trauma-stressed RBCs. Whether transfusion of RBCs that exhibit storage lesion changes exacerbates the hemodynamic perturbations already active in the trauma patient is not known. This article reviews findings from several recent nonrandomized studies examining RBC storage duration and clinical outcomes in trauma patients. The rationale for further research on RBC storage duration in the trauma setting is provided.

  13. 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…

  14. Demography of penetrating cardiac trauma.

    PubMed Central

    Naughton, M J; Brissie, R M; Bessey, P Q; McEachern, M M; Donald, J M; Laws, H L

    1989-01-01

    All cases of penetrating cardiac trauma in 1985 and 1986 in Jefferson County, Alabama, where patients dying of penetrating trauma received autopsies, were retrospectively reviewed. All hospitals in the county plus the single coroner's office provided the records of the 72 patients comprising this study. Incidents occurred most often in the home or residence (70%) by a known assailant (83%) due to domestic/social disputes (73%). Frequency was greatest in the evening hours (73% between 6:00 PM and 3:00 AM), on weekends in spring and summer. Victims tended to be male (86%), black (72%), married (46%), blue collar workers (62%). There were 41 (57%) gunshot wounds, 3 (4%) shotgun wounds, and 28 (39%) stab wounds with an associated mortality rate of 97%, 100%, and 68%, respectively. Prehospital mortality rate (dead at the scene) was 54.2% (39/72), and death on arrival was 26.4% (19/72), for a combined pretreatment mortality rate of 80.6%. All patients who arrived with no vital signs died. Mortality appeared to be related to mechanism of injury, age, race, sex, vital signs on arrival, number and specific cardiac chambers injured, associated major vascular injury, hematocrit, and mode of transportation. Mortality was not related to caliber of weapon, ethanol level, transport time, time from arrival to operation, or transfusion requirements. There were only ten survivors (1 gunshot wound and 9 stab wounds), all of whom had ventricular injuries and no associated major vascular injuries. The ten survivors represented a 71.4% (10/14) salvage rate for those victims arriving with vital signs. Complications occurred in three patients. Hospitalization averaged 7.3 days in the survivors. Penetrating cardiac trauma remains a serious, socially linked disease with a high rate of mortality. Rapid transport, aggressive resuscitation and cardiorrhaphy remain the best treatment. PMID:2730180

  15. 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

  16. 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

  17. 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

  18. Surgical and Nonsurgical Treatment of Vascular Skull Base Trauma.

    PubMed

    Dahlin, Brian C; Waldau, Ben

    2016-10-01

    Vascular trauma is associated with blunt skull base fractures and penetrating injuries. We review the contemporary management of cranial vascular trauma, including blunt and penetrating cerebrovascular injury as well as refractory epistaxis from facial trauma. PMID:27648396

  19. [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.

  20. [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

  1. 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.

  2. 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

  3. Partner preferences among survivors of betrayal trauma.

    PubMed

    Gobin, Robyn L

    2012-01-01

    Betrayal trauma theory suggests that social and cognitive development may be affected by early trauma such that individuals develop survival strategies, particularly dissociation and lack of betrayal awareness, that may place them at risk for further victimization. Several experiences of victimization in the context of relationships predicated on trust and dependence may contribute to the development of relational schema whereby abuse is perceived as normal. The current exploratory study investigates interpersonal trauma as an early experience that might impact the traits that are desired in potential romantic partners. Participants in the current study were asked to rate the desirability of several characteristics in potential romantic partners. Although loyalty was desirable to most participants regardless of their trauma history, those who reported experiences of high betrayal trauma rated loyalty less desirable than those who reported experiences of traumas that were low and medium in betrayal. Participants who reported experiences of revictimization (defined as the experience of trauma perpetrated by a close other during 2 different developmental periods) differed from participants who only reported 1 experience of high betrayal trauma in their self-reported desire for a romantic partner who possessed the traits of sincerity and trustworthiness. Preference for a partner who uses the tactic of verbal aggression was also associated with revictimization status. These preliminary findings suggest that victimization perpetrated by close others may affect partner preferences.

  4. 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…

  5. The evolution of modern trauma care.

    PubMed

    Shackford, S R

    1995-04-01

    The implementation of trauma systems has decreased the incidence of preventable death following injury and improved the quality of trauma care. Further improvements in outcome are unlikely to result from conventional therapies. Future strategies must include renewed interest in prevention and abrogation of secondary injury by modification of clinical protocols and manipulation of the inflammatory response by using molecular technologies.

  6. 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

  7. 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…

  8. 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.

  9. 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…

  10. 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…

  11. 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…

  12. Troublesome triad: trauma, insomnia, and alcohol.

    PubMed

    Lande, R Gregory

    2012-01-01

    The objective of this study was to examine the relationships between combat related trauma, insomnia, and alcohol misuse. The author reviewed the standardized tests results from 39 active duty service members, all of whom had recent deployments to either Iraq or Afghanistan. The battery of self-test instruments assessed the effects of military trauma, anxiety, depression, alcohol use, and insomnia. Among the study subjects, the entire group reported significant sleep problems, with bedtime arousals impeding sleep initiation. Male subjects' reported an average AUDIT score of 8.62. Service members with higher trauma scores also reported greater misuse of alcohol. The high trauma scores also correlated with specific pre-sleep cognitive and somatic factors. The findings of this study lend support for the use of standardized instruments for assessing sleep problems, along with similar tests for trauma and substance misuse, which together should help identify high risk military patients. PMID:23244556

  13. 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

  14. 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

  15. Sports-related ocular trauma.

    PubMed

    Larrison, W I; Hersh, P S; Kunzweiler, T; Shingleton, B J

    1990-10-01

    A prospective evaluation of all patients presenting with a sports-related ocular injury during a 1-year (4-season) period was conducted. Of the 202 patients evaluated, 28 (13.8%) required hospitalization and 11 (5.6%) required intraocular surgery. Twenty-six patients (12.8%) sustained permanent ocular sequelae including seven (3.5%) who suffered visual loss. Basketball accounted for 28.7%, baseball/softball 19.8%, and racquetball 11.4% of all injuries. At the time of injury, 5.1% of patients had worn protective eye wear, whereas on follow-up only 31% had used eye protection. These results indicate that sports trauma remains a significant cause of ocular morbidity.

  16. 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

  17. Deep Vein Thrombosis Prophylaxis in Trauma Patients

    PubMed Central

    Toker, Serdar; Hak, David J.; Morgan, Steven J.

    2011-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism (PE) are known collectively as venous thromboembolism (VTE). Venous thromboembolic events are common and potentially life-threatening complications following trauma with an incidence of 5 to 63%. DVT prophylaxis is essential in the management of trauma patients. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Traditionally, pelvic and lower extremity fractures, head injury, and prolonged immobilization have been considered risk factors for VTE; however it is unclear which combination of risk factors defines a high-risk group. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC) filters. The available pharmacologic agents include low-dose heparin (LDH), low molecular weight heparin (LMWH), and factor Xa inhibitors. Mechanical prophylaxis methods include graduated compression stockings (GCSs), pneumatic compression devices (PCDs), and A-V foot pumps. IVCs are traditionally used in high risk patients in whom pharmacological prophylaxis is contraindicated. Both EAST and ACCP guidelines recommend primary use of LMWHs in trauma patients; however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients. PMID:22084663

  18. Changes in neuroticism following trauma exposure.

    PubMed

    Ogle, Christin M; Rubin, David C; Siegler, Ilene C

    2014-04-01

    Using longitudinal data, the present study examined change in midlife neuroticism following trauma exposure. Our primary analyses included 670 participants (M(age) = 60.55; 65.22% male, 99.70% Caucasian) who completed the NEO Personality Inventory at ages 42 and 50 and reported their lifetime exposure to traumatic events approximately 10 years later. No differences in pre- and post-trauma neuroticism scores were found among individuals who experienced all of their lifetime traumas in the interval between the personality assessments. Results were instead consistent with normative age-related declines in neuroticism throughout adulthood. Furthermore, longitudinal changes in neuroticism scores did not differ between individuals with and without histories of midlife trauma exposure. Examination of change in neuroticism following life-threatening traumas yielded a comparable pattern of results. Analysis of facet-level scores largely replicated findings from the domain scores. Overall, our findings suggest that neuroticism does not reliably change following exposure to traumatic events in middle adulthood. Supplemental analyses indicated that individuals exposed to life-threatening traumas in childhood or adolescence reported higher midlife neuroticism than individuals who experienced severe traumas in adulthood. Life-threatening traumatic events encountered early in life may have a more pronounced impact on adulthood personality than recent traumatic events.

  19. Black-white disparities in blunt trauma.

    PubMed Central

    Goins, W. A.; Rodriguez, A.; Dunham, C. M.; Shankar, B. S.

    1993-01-01

    To uncover causes of increased mortality rates in black accident victims, patterns of injury and access to trauma care were compared between black and white patients. Over a 41-month period (February 1985 to June 1988), 2120 white and 468 black patients, each with an Injury Severity Score (ISS) > 14 as a result of blunt trauma, were admitted to a Level I regional trauma center, part of a statewide trauma system. Blacks were significantly older and more of them had premorbid illnesses. Although vehicular crashes accounted for the majority of injuries in both groups, blacks had significantly more injuries resulting from falls, pedestrian accidents, and assaults. Whereas 70.6% of whites were transported from the scene and 73% were transported by helicopter, 52.7% of blacks were transported from the scene and 44% by helicopter. Blacks made up 18% of the study group and accounted for 20% of deaths (mortality rate 17.3% for blacks and 14.9% for whites). Mortality was significantly increased for black patients admitted with a Glasgow Coma Scale (GCS) score > or = 13. Private medical insurance, available for 46.3% of black patients, accounted for 78% of payments for all trauma admissions. Increased mortality of black trauma patients may be related to risk factors (age, premorbid illness), increased rates of pedestrian accidents and falls, and disparities in access to Level I trauma centers. PMID:8371282

  20. Deep vein thrombosis prophylaxis in trauma patients.

    PubMed

    Toker, Serdar; Hak, David J; Morgan, Steven J

    2011-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism (PE) are known collectively as venous thromboembolism (VTE). Venous thromboembolic events are common and potentially life-threatening complications following trauma with an incidence of 5 to 63%. DVT prophylaxis is essential in the management of trauma patients. Currently, the optimal VTE prophylaxis strategy for trauma patients is unknown. Traditionally, pelvic and lower extremity fractures, head injury, and prolonged immobilization have been considered risk factors for VTE; however it is unclear which combination of risk factors defines a high-risk group. Modalities available for trauma patient thromboprophylaxis are classified into pharmacologic anticoagulation, mechanical prophylaxis, and inferior vena cava (IVC) filters. The available pharmacologic agents include low-dose heparin (LDH), low molecular weight heparin (LMWH), and factor Xa inhibitors. Mechanical prophylaxis methods include graduated compression stockings (GCSs), pneumatic compression devices (PCDs), and A-V foot pumps. IVCs are traditionally used in high risk patients in whom pharmacological prophylaxis is contraindicated. Both EAST and ACCP guidelines recommend primary use of LMWHs in trauma patients; however there are still controversies regarding the definitive VTE prophylaxis in trauma patients. Large randomized prospective clinical studies would be required to provide level I evidence to define the optimal VTE prophylaxis in trauma patients.

  1. 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

  2. Chest wall, lung, and pleural space trauma.

    PubMed

    Miller, Lisa A

    2006-03-01

    Chest radiographs frequently underestimate the severity and extent of chest trauma and, in some cases, fail to detect the presence of injury. CT is more sensitive than chest radiography in the detection of pulmonary, pleural, and osseous abnormalities in the patient who has chest trauma. With the advent of multidetector CT (MDCT), high-quality multiplanar reformations are obtained easily and add to the diagnostic capabilities of MDCT. This article reviews the radiographic and CT findings of chest wall, pleural, and pulmonary injuries that are seen in the patient who has experienced blunt thoracic trauma.

  3. Emotional intelligence--essential for trauma nursing.

    PubMed

    Holbery, Natalie

    2015-01-01

    Patients and their relatives are increasingly considered partners in health and social care decision-making. Numerous political drivers in the UK reflect a commitment to this partnership and to improving the experience of patients and relatives in emergency care environments. As a Lecturer/Practitioner in Emergency Care I recently experienced the London Trauma System as a relative. My dual perspective, as nurse and relative, allowed me to identify a gap in the quality of care akin to emotional intelligence. This paper aims to raise awareness of emotional intelligence (EI), highlight its importance in trauma care and contribute to the development of this concept in trauma nursing and education across the globe.

  4. Primary Inadequate Management of Dental Trauma.

    PubMed

    Agrafioti, Anastasia; Tsatsoulis, Ioannis N; Papanakou-Tzanetaki, Styliani I; Kontakiotis, Evangelos G

    2016-07-01

    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. PMID:27630967

  5. Trauma Management of the Pregnant Patient.

    PubMed

    Lucia, Amie; Dantoni, Susan E

    2016-01-01

    Trauma continues to be a leading cause of nonobstetric maternal and fetal mortality worldwide. Caring for the pregnant trauma patient requires a systematic and multidisciplinary approach. It is important to understand the anatomic and physiologic changes that occur during pregnancy. Accepted trauma guidelines for imaging and interventions should generally not be deviated from just because a patient is pregnant. Focus should be placed on injury prevention and education of at risk patients to decrease the morbidity and mortality associated with traumatic injuries in pregnant patients.

  6. 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. PMID:27630967

  7. 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.

  8. 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…

  9. 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

  10. 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

  11. Age of Trauma Onset and HPA Axis Dysregulation Among Trauma-Exposed Youth.

    PubMed

    Kuhlman, Kate Ryan; Vargas, Ivan; Geiss, Elisa G; Lopez-Duran, Nestor L

    2015-12-01

    The hypothalamic-pituitary-adrenal axis (HPA axis) is a pathway through which childhood trauma may increase risk for negative health outcomes. The HPA axis is sensitive to stress throughout development; however, few studies have examined whether timing of exposure to childhood trauma is related to differences in later HPA axis functioning. Therefore, we examined the association between age of first trauma and HPA axis functioning among adolescents, and whether these associations varied by sex. Parents of 97 youth (aged 9-16 years) completed the Early Trauma Inventory (ETI), and youth completed the Socially-Evaluated Cold-Pressor Task (SECPT). We measured salivary cortisol response to the SECPT, the cortisol awakening response, and diurnal regulation at home across 2 consecutive weekdays. Exposure to trauma during infancy related to delayed cortisol recovery from peak responses to acute stress, d = 0.23 to 0.42. Timing of trauma exposure related to diverging patterns of diurnal cortisol regulation for males, d = 0.55, and females, d = 0.57. Therefore, the HPA axis may be susceptible to developing acute stress dysregulation when exposed to trauma during infancy, whereas the consequences within circadian cortisol regulation may occur in the context of later trauma exposure and vary by sex. Further investigations are warranted to characterize HPA axis sensitivity to exposure to childhood trauma across child development.

  12. 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.

  13. [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

  14. Debunking myths about trauma and memory.

    PubMed

    McNally, Richard J

    2005-11-01

    How trauma victims remember--or forget--their most horrific experiences lies at the heart of the most bitter controversy in psychiatry and psychology in recent times. Whereas experts maintain that traumatic events--those experienced as overwhelmingly terrifying at the time of their occurrence--are remembered all too well, traumatic amnesia theorists disagree. Although these theorists acknowledge that trauma is often seemingly engraved on memory, they nevertheless maintain that a significant minority of survivors are incapable of remembering their trauma, thanks to mechanisms of either dissociation or repression. Unfortunately, the evidence they adduce in support of the concept of traumatic dissociative amnesia fails to support their claims. The purpose of this review is to dispel confusions and debunk myths regarding trauma and memory.

  15. 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 ...

  16. 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

  17. 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

  18. Representing the group's cultural trauma online.

    PubMed

    Lazar, Alon; Litvak Hirsch, Tal

    2012-02-01

    The case of the Holocaust as a cultural trauma in the Jewish-Israeli context can serve as an example of how younger members of collectives use the Internet as a platform on which to commemorate a trauma. This study explored their willingness to establish an Internet site for the purpose of commemorating the Holocaust as well as the materials and messages to be included. The results suggest that the younger members of a collective who live in a cultural atmosphere colored by the memory of a cultural trauma view online commemoration as an appropriate base from which to keep its memory alive, that audio-visual materials more so than textual ones are the preferred modes of representation, and that online commemoration is intended to provide a kaleidoscopic view of the trauma by focusing on the personal stories of both those who survived and those who perished.

  19. 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.

  20. Plasma arginine correlations in trauma and sepsis.

    PubMed

    Chiarla, C; Giovannini, I; Siegel, J H

    2006-02-01

    Arginine (ARG) is an amino acid (AA) with unique properties and with a key-role in the metabolic, immune and reparative response to trauma and sepsis. This study has been performed to characterize the correlations between plasma levels of ARG, of other AA and of multiple metabolic variables in trauma and sepsis. Two-hundred and sixty-three plasma amino-acidograms with a large series of additional biochemical and blood variables were obtained consecutively in 9 trauma patients who developed sepsis, undergoing total parenteral nutrition with dextrose, fat and a mixed AA solution containing 10.4% arginine. ARG was low soon after trauma, then it increased with increasing distance from trauma and with the development of sepsis. ARG was also directly related to the AA infusion rate (AAIR) and for any given AAIR, was lower after trauma than after the development of sepsis. ARG was also related directly to the plasma levels of most of the other AA, the best correlation being that with lysine (r(2) = 0.81, p < 0.001). These correlations were often shifted downwards (showing lower ARG for any given level of the other AA) in measurements performed after trauma, compared to those performed after development of sepsis; this effect was more pronounced for the correlations with branched chain AA. Correlations between ARG and non-AA variables were not particularly relevant. The best simultaneous correlates of ARG, among variables involved in plasma ARG availability, were citrulline level, AAIR and urinary 3-methylhistidine excretion (accounting for the effect of endogenous proteolysis) (multiple r(2) = 0.70, p < 0.001). Plasma ornithine (ORN), the AA more specifically linked to ARG metabolism, correlated with AAIR better than ARG and, for any given AAIR, was lower after trauma than after the development of sepsis. Correlations of ORN with other AA levels were poorer than those found for ARG, however ORN was directly related to white blood cell and platelet count, fibrinogen

  1. [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

  2. 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

  3. Selective arterial embolisation for hepatic trauma.

    PubMed Central

    Pain, J. A.; Heaton, N. D.; Karani, J. B.; Howard, E. R.

    1991-01-01

    The technique of selective arterial embolisation for patients presenting with major hepatic trauma is described. We have used this technique successfully in four patients, three of whom had continued bleeding after emergency laparotomy. It can abolish localised intrahepatic arterial haemorrhage and arteriovenous shunting. Selective embolisation may prove to be a useful technique in reducing the mortality of major hepatic trauma. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 PMID:2042900

  4. 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.

  5. Ultrasound of epigastric injuries after blunt trauma.

    PubMed

    Foley, L C; Teele, R L

    1979-04-01

    Blunt trauma to the epigastrum may result in a retroperitoneal hematoma involving the head of the pancreas and descending duodenum. Secondary effects include obstruction of the gastric outlet, obstruction of the biliary tree, and extrinsic compression of the inferior vena cava. Four patients with epigastric trauma were reviewed who had been examined by ultrasound of the abdomen. Ultrasound showed the extent of the retroperitoneal hematoma, its effect on contiguous organs, and was helpful in clinical management.

  6. 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...

  7. 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

  8. 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

  9. Complications of tube thoracostomy in trauma

    PubMed Central

    Bailey, R

    2000-01-01

    Objective—To assess the complication rate of tube thoracostomy in trauma. To consider whether this rate is high enough to support a selective reduction in the indications for tube thoracostomy in trauma. Methods—A retrospective case series of all trauma patients who underwent tube thoracostomy during a 12 month period at a large UK teaching hospital with an accident and emergency (A&E) department seeing in excess of 125 000 new patients/year. These patients were identified using the hospital audit department computerised retrieval system supplemented by a hand search of both the data collected for the Major Trauma Outcome Study and the A&E admission unit log book. The notes were assessed with regard to the incidence of complications, which were divided into insertional, infective, and positional. Results—Fifty seven chest drains were placed in 47 patients over the 12 month period. Seven patients who died within 48 hours of drain insertion were excluded. The commonest indications for tube thoracostomy were pneumothorax (54%) and haemothorax (20%); 90% of tubes were placed as a result of blunt trauma. The overall complication rate of the procedure was 30%. There were no insertional complications and only one (2%) major complication, which was empyema thoracis. Conclusion—This study reveals no persuasive evidence to support a selective reduction in the indications for tube thoracostomy in trauma. A larger study to confirm or refute these findings must be performed before any change in established safe practice. PMID:10718232

  10. 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

  11. Otolith function in patients with head trauma.

    PubMed

    Lee, Jong Dae; Park, Moo Kyun; Lee, Byung Don; Park, Ji Yun; Lee, Tae Kyung; Sung, Ki-Bum

    2011-10-01

    This study evaluates the otolith function of patients with head trauma, postulating that otolith dysfunction is a cause of nonspecific dizziness after head trauma. We prospectively enrolled 28 patients referred within 3 months after head trauma between March 2007 and December 2009. Pure tone audiometry, caloric testing and otolith function tests, including cervical vestibular evoked myogenic potential (cVEMP) and subjective visual vertical (SVV) tests, were performed on all patients. The relationship between otolith function and otologic symptoms was analyzed. Of the 28 patients with head trauma, 18 complained of dizziness and 12 experienced hearing loss, including 6 patients who complained of both. On defining otolith dysfunction as an abnormal cVEMP or abnormal SVV, a significant difference in otolith dysfunction existed between the groups with and without dizziness [72 (13/18) vs. 20% (2/10)]. In contrast, no significant difference in otolith dysfunction was detected between the abnormal and normal hearing groups. A significant number of the patients who complained of nonspecific dizziness after trauma had abnormal otolith function. After trauma, when patients complain of dizziness, vestibular function tests, including otolith function tests, should be considered.

  12. 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.

  13. 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

  14. Resilience, trauma, context, and culture.

    PubMed

    Ungar, Michael

    2013-07-01

    This article reviews the relationship between factors associated with resilience, and aspects of the individual's social ecology (environment) that promote and protect against the negative impact of exposure to traumatic events. It is shown that the Environment × Individual interactions related to resilience can be understood using three principles: (1) Resilience is not as much an individual construct as it is a quality of the environment and its capacity to facilitate growth (nurture trumps nature); (2) resilience looks both the same and different within and between populations, with the mechanisms that predict positive growth sensitive to individual, contextual, and cultural variation (differential impact); and (3) the impact that any single factor has on resilience differs by the amount of risk exposure, with the mechanisms that protect against the impact of trauma showing contextual and cultural specificity for particular individuals (cultural variation). A definition of resilience is provided that highlights the need for environments to facilitate the navigations and negotiations of individuals for the resources they need to cope with adversity. The relative nature of resilience is discussed, emphasizing that resilience can manifest as either prosocial behaviors or pathological adaptation depending on the quality of the environment. PMID:23645297

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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

  20. 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…

  1. 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

  2. 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

  3. 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…

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

    PubMed Central

    Mauritz, Maria W.; Goossens, Peter J. J.; Draijer, Nel; van Achterberg, Theo

    2013-01-01

    Background Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. Objective To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. Methods We conducted a systematic review of four databases (1980–2010) and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders. Results Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25–72%), sexual abuse 37% (range 24–49%), and posttraumatic stress disorder (PTSD) 30% (range 20–47%). Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI. Conclusions Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI. PMID:23577228

  5. 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

  6. 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…

  7. Leading in times of trauma.

    PubMed

    Dutton, Jane E; Frost, Peter J; Worline, Monica C; Lilius, Jacoba M; Kanov, Jason M

    2002-01-01

    An employee is diagnosed with cancer or loses a family member unexpectedly. An earthquake destroys an entire section of a city, leaving hundreds dead, injured, or homeless. At time like these, managerial handbooks fail us. After all, leaders can't eliminate personal suffering, nor can they ask employees who are dealing with these crises to check their emotions at the door. But compassionate leadership can facilitate personal as well as organizational healing. Based on research the authors have conducted at the University of Michigan and the University of British Columbia's CompassionLab, this article describes what leaders can do to foster organizational compassion in times of trauma. They recount real-world examples, including a story of personal tragedy at Newsweek, natural disasters that affected Macy's and Malden Mills, and the events of September 11, 2001. During times of collective pain and confusion, compassionate leaders take some form of public action, however small, that is intended to ease people's pain and inspire others to act. By openly demonstrating their own humanity, executives can unleash a compassionate response throughout the whole company, increasing bonds among employees and attachments to the organization. The authors say compassionate leaders uniformly provide two things: a "context for meaning"--creating an environment in which people can freely express and discuss how they feel--and a "context for action"--creating an environment in which those who experience or witness pain can find ways to alleviate their own and others' suffering. A leader's competence in demonstrating and fostering compassion is vital, the authors conclude, to nourishing the very humanity that can make people--and organizations--great. PMID:12964467

  8. Leading in times of trauma.

    PubMed

    Dutton, Jane E; Frost, Peter J; Worline, Monica C; Lilius, Jacoba M; Kanov, Jason M

    2002-01-01

    An employee is diagnosed with cancer or loses a family member unexpectedly. An earthquake destroys an entire section of a city, leaving hundreds dead, injured, or homeless. At time like these, managerial handbooks fail us. After all, leaders can't eliminate personal suffering, nor can they ask employees who are dealing with these crises to check their emotions at the door. But compassionate leadership can facilitate personal as well as organizational healing. Based on research the authors have conducted at the University of Michigan and the University of British Columbia's CompassionLab, this article describes what leaders can do to foster organizational compassion in times of trauma. They recount real-world examples, including a story of personal tragedy at Newsweek, natural disasters that affected Macy's and Malden Mills, and the events of September 11, 2001. During times of collective pain and confusion, compassionate leaders take some form of public action, however small, that is intended to ease people's pain and inspire others to act. By openly demonstrating their own humanity, executives can unleash a compassionate response throughout the whole company, increasing bonds among employees and attachments to the organization. The authors say compassionate leaders uniformly provide two things: a "context for meaning"--creating an environment in which people can freely express and discuss how they feel--and a "context for action"--creating an environment in which those who experience or witness pain can find ways to alleviate their own and others' suffering. A leader's competence in demonstrating and fostering compassion is vital, the authors conclude, to nourishing the very humanity that can make people--and organizations--great.

  9. 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

  10. 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

  11. Does spontaneous genital tract trauma impact postpartum sexual function?

    PubMed Central

    Rogers, Rebecca G.; Borders, Noelle; Leeman, Lawrence M.; Albers, Leah L.

    2009-01-01

    Changes in sexual function are common in postpartum women. In this comparative, descriptive study, a prospective cohort of midwifery patients consented to documentation of genital trauma at birth and assessment of sexual function three months postpartum. The impact of spontaneous genital trauma on postpartum sexual function was the focus of the study. Trauma was categorized into minor trauma (no trauma or 1st degree perineal or other trauma that was not sutured) or major trauma (2nd, 3rd, or 4th degree lacerations or any trauma that required suturing). Women who underwent episiotomy or operative delivery were excluded. Fifty eight percent (326/565) of enrolled women gave sexual function data; of those, 276 (85%) reported sexual activity since delivery. Seventy percent (193) of women sustained minor trauma and 30% (83) sustained major trauma. Sexually active women completed the Intimate Relationship Scale (IRS), a 12 item questionnaire validated as a measure of postpartum sexual function. Both trauma groups were equally likely to be sexually active. Total IRS scores did not differ between trauma groups nor did complaints of dyspareunia. However, for two items, significant differences were demonstrated: women with major trauma reported less desire to be held, touched, and stroked by their partner than women with minor trauma, and women who required perineal suturing reported lower IRS scores than women who did not require suturing. PMID:19249654

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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.

  17. [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

  18. 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

  19. The challenges of developing a trauma system for Indigenous people.

    PubMed

    Plani, Frank; Carson, Phil

    2008-12-01

    Trauma systems have been shown to provide the best trauma care for injured patients. A trauma system developed for Indigenous people should take into account many factors including geographical remoteness and cultural diversity. Indigenous people suffer from a significant intentional and non-intentional burden of injury, often greater than non-Indigenous populations, and a public health approach in dealing with trauma can be adopted. This includes transport issues, prevention and control of intentional violence, cultural sensitization of health providers, community emergency responses, community rehabilitation and improving resilience. The ultimate aim is to decrease the trauma burden through a trauma system with which indigenous people can fully identify.

  20. Maxillofacial trauma resulting from terror in Israel.

    PubMed

    Ringler, Doron; Einy, Shmuel; Giveon, Adi; Goldstein, Liab; Peleg, Kobi

    2007-01-01

    During a 33 month period, maxillofacial injuries resulting from terrorist attacks in Israel were compared with non-terror trauma maxillofacial injuries. Files of patients hospitalized from October 1, 2000 to June 30, 2003 were obtained from the Israel National Trauma Registry. Data were evaluated and compared with a hospitalized non-terror related trauma population within the same period. A literature survey was also conducted. Terror casualties totaled 1,811. In 493 patients with facial injuries, 322 had soft facial tissue injuries (excluding eyes and ears), and 104 had hard tissue injuries of the maxillofacial complex. A significantly higher prevalence was found in terror casualties (explosions and gunshots) compared with non-terror related casualties. Most suffered multiple injuries. Maxillofacial terror casualties experience a unique epidemiology, with more severe injuries and higher prevalence of soft and hard tissue injuries. Preparedness and awareness to the unique pattern of injuries are needed when terrorists strike.

  1. 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

  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.

  3. 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

  4. Psychological issues in acquired facial trauma

    PubMed Central

    De Sousa, Avinash

    2010-01-01

    The face is a vital component of one’s personality and body image. There are a vast number of variables that influence recovery and rehabilitation from acquired facial trauma many of which are psychological in nature. The present paper presents the various psychological issues one comes across in facial trauma patients. These may range from body image issues to post-traumatic stress disorder symptoms accompanied by anxiety and depression. Issues related to facial and body image affecting social life and general quality of life are vital and the plastic surgeon should be aware of such issues and competent to deal with them in patients and families. PMID:21217982

  5. Gelatin colloids in the resuscitation of trauma.

    PubMed

    Whitfield, C

    2006-12-01

    To date, the specific role of gelatins in trauma resuscitation remains under-investigated. Their adverse affects are well described and relate principally to the provocation of allergic responses whilst their influence upon haemostasis is relatively benign in comparison to the other colloids. However, their benefits are only sparsely documented and the evidence to choose one gelatin over another virtually non-existent. As knowledge of the microcirculatory dysfunction inherent in the shocked state increases, the role of the gelatins in trauma resuscitation is being increasing sidelined by other colloids--notably the starches. Their role beyond a basic resuscitation tool is now uncertain.

  6. 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.

  7. Evaluation d'une approche pedagogique respectant les facons d'apprendre des filles en sciences et en TIC en 9e annee au Nouveau-Brunswick

    NASA Astrophysics Data System (ADS)

    Lirette-Pitre, Nicole T.

    2009-07-01

    La reussite scolaire des filles les amene de plus en plus a poursuivre une formation postsecondaire et a exercer des professions qui demandent un haut niveau de connaissances et d'expertise scientifique. Toutefois, les filles demeurent toujours tres peu nombreuses a envisager une carriere en sciences (chimie et physique), en ingenierie ou en TIC (technologie d'information et de la communication), soit une carriere reliee a la nouvelle economie. Pour plusieurs filles, les sciences et les TIC ne sont pas des matieres scolaires qu'elles trouvent interessantes meme si elles y reussissent tres bien. Ces filles admettent que leurs experiences d'apprentissage en sciences et en TIC ne leur ont pas permis de developper un interet ni de se sentir confiante en leurs habiletes a reussir dans ces matieres. Par consequent, peu de filles choisissent de poursuivre leurs etudes postsecondaires dans ces disciplines. La theorie sociocognitive du choix carriere a ete choisie comme modele theorique pour mieux comprendre quelles variables entrent en jeu lorsque les filles choisissent leur carriere. Notre etude a pour objet la conception et l'evaluation de l'efficacite d'un materiel pedagogique concu specifiquement pour ameliorer les experiences d'apprentissage en sciences et en TIC des filles de 9e annee au Nouveau-Brunswick. L'approche pedagogique privilegiee dans notre materiel a mis en oeuvre des strategies pedagogiques issues des meilleures pratiques que nous avons identifiees et qui visaient particulierement l'augmentation du sentiment d'auto-efficacite et de l'interet des filles pour ces disciplines. Ce materiel disponible par Internet a l'adresse http://www.umoncton.ca/lirettn/scientic est directement en lien avec le programme d'etudes en sciences de la nature de 9e annee du Nouveau-Brunswick. L'evaluation de l'efficacite de notre materiel pedagogique a ete faite selon deux grandes etapes methodologiques: 1) l'evaluation de l'utilisabilite et de la convivialite du materiel et 2

  8. Can Trauma Trigger Violent Crime in Mentally Ill?

    MedlinePlus

    ... gov/news/fullstory_159859.html Can Trauma Trigger Violent Crime in Mentally Ill? Short-term risk was ... events are more likely to engage in a violent crime in the week following the trauma, a ...

  9. 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.

  10. 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

  11. 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…

  12. 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…

  13. 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…

  14. 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…

  15. 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…

  16. 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.

  17. 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…

  18. 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.

  19. 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…

  20. 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…

  1. Spiritual Challenges to Children Facing Violent Trauma.

    ERIC Educational Resources Information Center

    Garbarino, James; Bedard, Claire

    1996-01-01

    Reviews research dealing with the intersection of the developmental psychology of trauma and spirituality. Examines the role of religion in spiritual development and asserts the need to study life paths of violent youth to see role of spirituality in preventing social problems. Uses research with street children and children in war zones. (BGC)

  2. 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…

  3. 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…

  4. 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…

  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. 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…

  7. 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…

  8. [Pediatric trauma life support and cardiopulmonary resuscitation].

    PubMed

    Domínguez Sampedro, P; de Lucas García, N; Balcells Ramírez, J; Martínez Ibáñez, V

    2002-06-01

    Accidents are the most frequent cause of mortality among children older than one year. Thus, the need to proceed to cardiopulmonary resuscitation (CPR) during the early phases of trauma life support (TLS) is always a possibility. Trauma is a special situation in CPR: expected problems (i.e., hemorrhage, pneumo-hemothorax, hypothermia, and difficult intubation and vascular access), specific therapeutic actions (i.e., helmet retrieval and cervical spine immobilization), and exceptions to standard CPR guidelines (i.e., contraindication for the head tilt-chin lift manoeuvre) can arise. Therefore, TLS and CPR interventions must be appropriately integrated. TLS is considered a method (much like CPR). It combines organization and leadership with competent, structured and timely actions. Appropriate intervention within the first few moments ("platinum half-hour" and " golden hour") and first day ("silver day") is essential. As in CPR, two modalities can be distinguished: basic TLS (on the scene, without technical resources) and advanced TLS (with resources). The acronym PAA summarizes basic TLS: Protect-Alert-Aid. The advanced TLS sequence includes the following: primary survey and initial stabilization, secondary survey, triage, transport, and definitive care. The main objective of the primary survey and initial stabilization phase is the identification and treatment of injuries with immediate potential to cause death. CPR in the context of TLS should be adapted to the special features of trauma. Particular attention should be paid to the cervical spine. While not specific for trauma care, the early and generous administration of oxygen should be emphasized.

  9. Genital trauma in children and adolescents.

    PubMed

    Merritt, Diane F

    2008-06-01

    Traumatic wounds of the female genitalia include accidental straddle injuries or impalement, chemical or thermal burns, insufflation injuries, blunt trauma, or crush injuries. Children and adolescents may be victims of rape, sexual abuse, and female genital mutilation. Information is provided on epidemiology, pathophysiology, and management. Treatment guidelines are offered using the best evidence available, and recommendations are provided when data are limited.

  10. [Computer tomography of retroperitoneal trauma (author's transl)].

    PubMed

    Fischedick, A R; Müller, R P; Kramps, H; Cramer, B

    1982-01-01

    Computer tomography changes after retroperitoneal trauma are described on the basis of 19 patients seen by the authors. It appears that this method is superior to conventional techniques, both as a screening method and for carrying out follow-ups. The indications for angiography are thereby reduced.

  11. Essential Thrombocytosis Following Multiple Psychic Traumas.

    PubMed

    Sadr Mohammadi, Rezvan; Mahdian, Mehrdad; Bidaki, Reza; Mostafavi, Seyed-Ali

    2014-01-01

    The associations between exposure to traumatic events and psychiatric disorders such as posttraumatic stress disorder (PTSD), depression, and anxiety have been established. It is important that clinicians notice to this phenomenon and avoid from inappropriate interpretations and additional laboratory tests. Here, a case of 45-year-old man with Essential thrombocytosis developed after multiple psychic traumas was introduced.

  12. Trauma and Adult Learning. ERIC Digest.

    ERIC Educational Resources Information Center

    Kerka, Sandra

    Adult learning can be challenging and traumatic events can exacerbate the process. Symptoms such as difficulty beginning new tasks, fear of risk taking, eroded self-esteem, or inability to concentrate can be evidence of past or current trauma and may be manifested by a learner missing class, avoiding tests, or behaving inappropriately during class…

  13. 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…

  14. 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…

  15. Trauma sonography for use in microgravity.

    PubMed

    Kirkpatrick, Andrew W; Jones, Jeffrey A; Sargsyan, Ashot; Hamilton, Douglas R; Melton, Shannon; Beck, George; Nicolau, Savvas; Campbell, Mark; Dulchavsky, Scott

    2007-04-01

    Sonography is the only medical imaging modality aboard the ISS, and is likely to remain the leading imaging modality in future human spaceflight programs. While trauma sonography (TS) has been well recognized for terrestrial trauma settings, the technique had to be evaluated for suitability in spaceflight prior to adopting it as an operational capability. The authors found the following four-phased evaluative approach applicable to this task: 1) identifying standard or novel terrestrial techniques for potential use in space medicine; 2) developing and testing these techniques with suggested modifications on the ground (1 G) either in clinical settings or in animal models, as appropriate; 3) evaluating and refining the techniques in parabolic flight (0 G); and 4) validating and implementing for clinical use in space. In Phase I of the TS project, expert opinion and literature review suggested TS to be a potential screening tool for trauma in space. In Phase II, animal models were developed and tested in ground studies, and clinical studies were carried out in collaborating trauma centers. In Phase III, animal models were flight-tested in the NASA KC-135 Reduced Gravity Laboratory. Preliminary results of the first three phases demonstrated the potential clinical utility of TS in microgravity. Phase IV studies have begun to address crew training issues, onboard imaging protocols, and data transfer procedures necessary to offer the modified TS technique for space use.

  16. 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

  17. 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

  18. [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.

  19. [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

  20. Optimal use of blood in trauma patients

    PubMed Central

    Holcomb, John B.; Spinella, Philip C.

    2011-01-01

    Injury is rapidly becoming the leading cause of death worldwide, and uncontrolled hemorrhage is the leading cause of potentially preventable death. In addition to crystalloid and/or colloid based resuscitation, severely injured trauma patients are routinely transfused RBCs, plasma, platelets, and in some centers either cryoprecipitate or fibrinogen concentrates or whole blood. Optimal timing and quantity of these products in the treatment of hypothermic, coagulopathic and acidotic trauma patients is unclear. The immediate availability of these components is important, as most hemorrhagic deaths occur within the first 3–6 h of patient arrival. While there are strongly held opinions and longstanding traditions in their use, there are little data within which to logically guide resuscitation therapy. Many current recommendations are based on euvolemic elective surgery patients and incorporate laboratory data parameters not widely available in the first few minutes after patient arrival. Finally, blood components themselves have evolved over the last 30 years, with great attention paid to product safety and inventory management, yet there are surprisingly limited clinical outcome data describing the long term effects of these changes, or how the components have improved clinical outcomes compared to whole blood therapy. When focused on survival of the rapidly bleeding trauma patient, it is unclear if current component therapy is equivalent to whole blood transfusion. In fact data from the current war in Iraq and Afghanistan suggest otherwise. All of these factors have contributed to the current situation, whereby blood component therapy is highly variable and not driven by long term patient outcomes. This review will address the issues raised above and describe recent trauma patient outcome data utilizing predetermined plasma:platelet:RBC transfusion ratios and an ongoing prospective observational trauma transfusion study. PMID:20074980

  1. Morbid obesity impacts mortality in blunt trauma.

    PubMed

    Christmas, A Britton; Reynolds, Jennifer; Wilson, Ashley K; Franklin, Glen A; Miller, Frank B; Richardson, J David; Rodriguez, Jorge L

    2007-11-01

    Twenty-six per cent of adults in the Unites States are obese and trauma remains a major cause of death. We assessed the impact of morbid obesity on mortality in patients with blunt trauma. We reviewed the records of patients with a body mass index 40 kg/m2 or greater injured by blunt trauma from 1993 to 2003 and compared them with a 4:1 control population with a normal body mass index and matched for sex and constellation of injuries. For comparison, patients were categorized by Injury Severity Score 9 or less or Injury Severity Score 10 or greater. Student t test and chi2 were used for statistical analysis. P < 0.05 was considered significant. One hundred seven morbidly obese patients were identified and compared with 458 control subjects with a normal body mass index and matched for sex and constellation of injuries. Although the morbidly obese patients were found to be significantly younger, those who incurred multiorgan injury experienced a significantly longer hospital length of stay and displayed a greater than fourfold increase in mortality when compared with the control subjects. Furthermore, the number of morbidly obese patients admitted over the 10-year period significantly increased by fourfold (0.4% to 1.5%). Over the last decade, there has been a significant increase in morbidly obese patients cared for in our trauma center. Although these patients were significantly younger with a similar Glasgow Coma Score as that of the control population, morbid obesity significantly increased mortality when the injury from blunt trauma transitioned from a single to a multiorgan injury.

  2. Cirrhosis and trauma: a deadly duo.

    PubMed

    Christmas, A Britton; Wilson, Ashley K; Franklin, Glen A; Miller, Frank B; Richardson, J David; Rodriguez, Jorge L

    2005-12-01

    It has been previously reported that trauma patients with cirrhosis undergoing emergency abdominal operations exhibit a fourfold increase in mortality independent of their Child's classification. We undertook this review to assess the impact of cirrhosis on trauma patients. We reviewed the records of patients from 1993 to 2003 with documented hepatic cirrhosis and compared them to a 2:1 control population without hepatic cirrhosis and matched for age, sex, Injury Severity Score (ISS), and Glasgow Coma Score (GCS). Demographic, severity of injury, and outcome data were recorded. Student's t test and X2 were used for statistical analysis and a P < 0.05 was significant. Sixty-one patients had documented cirrhosis and were compared to 156 matched controls. Comparing the two groups demonstrates there was no difference in age, ISS, or GCS. Intensive care stay, hospital length of stay, blood requirements in the first 24 hours postinjury, and mortality (33% vs 1%) was significantly greater in the trauma patients with cirrhosis. Fifty-five per cent of deaths in the cirrhosis group was due to sepsis, and, as the Child's class increases, so does the mortality (Child's A, 15%; B, 37%; and C, 63%). In 64 per cent of cirrhotics without an emergent abdominal operation, mortality was 21 per cent. In the 36 per cent of cirrhotics who had emergent abdominal operation, mortality was 55 per cent. Hepatic cirrhosis in trauma patients, regardless of severity of injury or the need for an abdominal intervention, is a poor prognostic indicator. The necessity of an abdominal operative intervention further amplifies this effect. Trauma and cirrhosis is, in fact, a deadly duo.

  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.

  4. Comparison of humus and till as prospecting material in areas of thick overburden and multiple ice-flow events: An example from northeastern New Brunswick

    USGS Publications Warehouse

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

    2009-01-01

    Thirty-nine elements in humus and till matrix were compared at 109 sites overlying Ag-As-Cu-Mo-Pb-Zn mineralized occurrences in northeastern New Brunswick to assess humus for anomaly identification. Humus element concentrations were not consistently correlative with maximum or minimum concentrations found in the underlying till or bedrock. The humus demonstrated significantly higher mean elemental concentrations than the till for six specific elements: 9 times greater for Mn, 6 times greater for Cd, 5 times greater for Ag and Pb, 3 times greater for Hg, and double the concentration of Zn. Spatial dispersal patterns for these elements were much larger for humus content than that exhibited by the till matrix analysis, but did not delineate a point source. For elements in till, the highest concentrations were commonly found directly overlying the underlying mineralized bedrock source or within one km down-glacier of the source. The complexity of the humus geochemical patterns is attributed to the effects of post-glacial biogenic, down-slope hydrodynamic and solifluction modification of dispersed mineralization in the underlying till, and the greater capacity of humus to adsorb cations and form complexes with some elements, relative to the till matrix. Humus sampling in areas of glaciated terrain is considered to be mostly valuable for reconnaissance exploration as elements can be spatially dispersed over a much larger area than that found in the till or underlying bedrock. ?? 2009 Elsevier B.V. All rights reserved.

  5. [Difficulties in the assessment of trauma-related disorders].

    PubMed

    Gronau, W; Meyer-Lindenberg, A; Dreßing, H

    2015-03-01

    Assessment of trauma disorders is becoming increasingly important. A major problem here is that trauma disorders are extremely heterogeneous. Moreover, they are often associated with comorbid disorders, such as borderline personality disorder. The valid diagnostic systems ICD-10 and DSM-5 poorly represent trauma disorders. The so-called complex post-traumatic stress disorder or DESNOS (disorders of extreme stress not otherwise specified) are listed .in either of the ICD-10 or DSM-5. The distinctiveness is not generally scientifically accepted. In addition, the assessment of trauma disorders is complicated because there are often multiple traumas of varying degrees of severity.

  6. 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

  7. [Difficulties in the assessment of trauma-related disorders].

    PubMed

    Gronau, W; Meyer-Lindenberg, A; Dreßing, H

    2015-03-01

    Assessment of trauma disorders is becoming increasingly important. A major problem here is that trauma disorders are extremely heterogeneous. Moreover, they are often associated with comorbid disorders, such as borderline personality disorder. The valid diagnostic systems ICD-10 and DSM-5 poorly represent trauma disorders. The so-called complex post-traumatic stress disorder or DESNOS (disorders of extreme stress not otherwise specified) are listed .in either of the ICD-10 or DSM-5. The distinctiveness is not generally scientifically accepted. In addition, the assessment of trauma disorders is complicated because there are often multiple traumas of varying degrees of severity. PMID:25971145

  8. 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

  9. 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.

  10. Seduction trauma: representation, deferred action, and pathogenic development.

    PubMed

    Blum, H P

    1996-01-01

    Seduction trauma refers to a range of phenomena currently described under the rubric of child abuse. Freud elucidated the fantasy distortion and elaboration of traumatic experience and retained the importance of actual trauma. Psychic trauma is associated with the alteration of self and object representations and ensuing new identifications, e.g., with victim and aggressor. The "deferred action" of psychic trauma is an antiquated concept and psychic trauma has immediate effects as well as far reaching developmental consequences. Prior trauma predisposes to later traumatic vulnerability and to trauma linked to phase specific unconscious conflict. The pathogenesis of child sex abuse and the enactment of oedipal incest extends before and after the oedipal phase, is often associated with other forms of abuse, and has a history of pathogenic parent-child relationship.

  11. 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

  12. 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

  13. Sexuality attitudes: the impact of trauma.

    PubMed

    Broman, Clifford L

    2003-11-01

    This study examines the relationship between traumatic events and attitudes toward sexuality. Our results show that suffering trauma is related to more accepting attitudes concerning sexuality. Generally, people who suffer negative events, many of which are traumatic, are more likely to see both pornography and having a homosexual friend or family member as acceptable. Traumatic events that are sex-related or related to other physical assault proved to be most significant in the prediction of sexuality attitudes for women only. The results are specified by gender: Trauma predicts attitudes toward pornography for women but not for men, and traumatic events are associated with attitudes concerning homosexuality for women. These results are discussed in light of the previous research, and suggestions for future research made.

  14. Perinatal loss, trauma, and dream reports.

    PubMed

    Kroth, Jerry; Garcia, Marylynne; Hallgren, Michelle; LeGrue, Emilyann; Ross, Maureen; Scalise, Juliana

    2004-06-01

    This study investigated correlations among dream characteristics and measures of trauma and perinatal bereavement as reported by women who have experienced perinatal loss. 37 women who had experienced perinatal loss were randomly selected from a perinatal support group and administered the Impact of Event Scale, the Perinatal Grief Scale, and the KJP Dream Inventory. Scores on the Impact of Events Scale (IES) correlated with Emotional Pain (.41), Despair (.37), Dreams of Death (.31), Dreams of Water (-.29), and Dreams of Being Famous (-.36). Subjects who reported higher Social Support and Emotional Expressiveness throughout their trauma showed lower scores on IES Total scores (-.52), Despair (-.62), and reported dreaming more in color (.41). Results are discussed in terms of the hypothesized role dreams may play in the grief-recovery process. PMID:15217043

  15. 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

  16. 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

  17. 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

  18. Aeromonas hydrophilia infections after penetrating foot trauma.

    PubMed

    Larka, Ulla-Britt; Ulett, Dane; Garrison, Thomas; Rockett, Matthew S

    2003-01-01

    The bacterium Aeromonas hydrophila is an anaerobic gram-negative bacillus commonly found in natural bodies of water and can cause infection in patients who suffer water-associated trauma or in immunocompromised hosts. The authors present 5 cases of penetrating wound trauma that did not involve any aquatic environment and developed rapidly forming infections. All patients presented with severe pain, cellulitis, ascending lymphangitis, fever, and pain on range of motion of the joint near the traumatic site. Presentation of clinical symptoms mimicked that of a septic joint or of severe streptococcal infection. All patients required surgical incision and drainage, intravenous and oral antibiotics using levofloxacin or bactrim, and local wound care. Results from cultures taken intraoperatively showed only A hydrophilia in every case. Resolution of symptoms occurred rapidly after surgery, and clinical resolution was seen within 72 hours. Each patient healed uneventfully and returned to preinjury status.

  19. 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.

  20. 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

  1. Epidural hematoma after minor oral trauma.

    PubMed

    Rice, J O; Walters, C; Olson, R E; Pearson, D

    1976-07-01

    A case report was presented in which a 15-year-old boy was beaten about the head with a baseball bat. Intraoral trauma and facial lacerations were repaired. Since results of the neurological examination were within normal limits, the patient was discharged. The next day, the patient became lethargic; however, the patient's mother did not bring the patient back to the hospital until the routine postoperative visit. At that time, the patient had right hemiparesis, was unable to speak, and was clearly obtunded. A carotid angiogram disclosed a left venous epidural hematoma in the parietal area. A craniotomy was performed with good results. The importance of follow-up neurologic examinations in cases of trauma to the face and head is stressed.

  2. 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.

  3. Atrial-caval shunting (ACS) after trauma.

    PubMed

    Kudsk, K A; Sheldon, G F; Lim, R C

    1982-02-01

    Since 1968 the atrial-caval shunt (ACS), along with inflow occlusion at the porta hepatis, has been used at San Francisco General Hospital in 18 trauma patients to control massive hemorrhage from the inferior vena cava, hepatic veins, or liver. Thirteen patients died from irreversible shock. Five patients survived their initial injuries; one of them died 45 days later from the complications of shock and sepsis. No patients survived who sustained blunt trauma and were admitted in cardiac arrest. Only one of ten patients with BP less than 70 mm Hg after resuscitation survived, whereas four of eight with BP greater than 70 mm Hg survived. ACS was used to control caval injuries in seven patients (one survivor), severe hepatic parenchymal fractures in four patients (two survivors), and combined hepatic and caval injuries in seven patients (two survivors). Survivors had an average of 5.75 associated injuries; nonsurvivors had 3.8. No complications of ACS occurred in the surviving patients.

  4. 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

  5. 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

  6. [Role of surgery in closed abdominal trauma].

    PubMed

    Panis, Y; Charbit, L; Valleur, P

    1997-05-01

    Over the past twenty years, nonoperative management has increasingly been recommended for the care of patients with blunt abdominal trauma. Emergency laparotomy remains the rule in patients with hemodynamic instability or in those with peritonitis due to intestinal perforation. Surgical treatment of liver and splenic lesions tends to be more conservative. After assessment of the lesions by computed tomography, nonoperative management in intensive care unit is allowed in the majority of patients. PMID:9208689

  7. 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

  8. Innovations in military handling of facial trauma.

    PubMed

    Faulkner, Jeffrey A; Ferguson, Earl E

    2009-01-01

    As the military medical treatment facilities of Operation Iraqi Freedom have transitioned from make-shift tent facilities to more formal fixed facilities, the capability to deliver more complex care has markedly improved. Using case presentations, the authors illustrate the integration of advances in surgical technology in managing complex and devastating craniofacial trauma at the 332nd Air Force Theater Hospital in Balad Iraq during Operation Iraqi Freedom 2006. PMID:19164991

  9. 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

  10. 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

  11. [Management of psychological trauma in primary care].

    PubMed

    Figueroa, Rodrigo A; Cortés, Paula F; Accatino, Luigi; Sorensen, Richard

    2016-05-01

    Exposure to traumatic events is frequent in the general population and psychiatric sequelae such as post-traumatic stress disorders are common. The symptoms of psychiatric sequelae after trauma are vague, with multiple psychological and physical symptoms, which can confuse the health care professional. This paper seeks to facilitate the work in primary care, providing practical information about the diagnosis, initial management and referral of patients who have suffered traumatic experiences. Some early interventions and treatments are suggested. PMID:27552016

  12. 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

  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. 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

  15. [Contusion-suction trauma after globe injuries].

    PubMed

    Kroll, P; Stoll, W; Kirchhoff, E

    1983-06-01

    An analysis of ball injuries treated during the last 3 years at Münster University Eye Hospital revealed a difference in the kind of traumata caused by air-filled balls and by solid, inelastic balls. The pathomechanism of a "contusion-suction trauma" is discussed; this would offer a satisfactory explanation not only for injuries of the anterior segment, but also for retinal changes at the outer periphery and the posterior pole.

  16. 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.

  17. A comprehensive analysis of craniofacial trauma.

    PubMed

    Hussain, K; Wijetunge, D B; Grubnic, S; Jackson, I T

    1994-01-01

    A review of the literature identified a need for a prospective study of the complete range of craniofacial trauma. The aims of this study were to determine the incidence, etiology, and mechanisms of craniofacial and associated injuries, enabling a greater understanding of their range and magnitude. Nine hundred fifty consecutive patients seen at an urban university hospital with any degree of craniofacial trauma were prospectively investigated. Craniofacial trauma was found to be very common at all ages. The causes were directly related to age, sex, and alcohol consumption, and determine the type and severity of injury. The commonest cause of soft-tissue injury was falls, whereas that of fractures was interpersonal violence. Falls accounted for most of the injuries in children and the elderly, whereas interpersonal violence was mainly responsible for those occurring in patients aged 15 to 50 years. Interpersonal violence mostly involved young male adults: fights occurring mainly between strangers who had consumed excessive amounts of alcohol. Women were usually assaulted by assailants known to them, their partners. Pedestrians showed a propensity to sustain cranial fractures, whereas motor vehicle occupants tended to sustain midfacial fractures and bicyclists mandibular fractures. Pedestrians incurred the severest injuries of all road users, and a significant proportion of road user collisions involved bicyclists. Sports were responsible for a significant proportion of craniofacial injuries in youths and young adults. Craniofacial soft-tissue injuries overall occurred most frequently on the forehead, nose, lips, and chin, and a method for their classification is proposed. The commonest craniofacial fracture was that of the nasal bones (45%), followed by cranial bones (24%), mandible (13%), zygoma (13%), orbital blow-out (3%), and maxilla (2%). The incidence of craniofacial trauma can be greatly reduced by improvements in interior home design, school education in

  18. Reduced heart rate responding to trauma reliving in trauma survivors with PTSD: correlates and consequences.

    PubMed

    Halligan, Sarah L; Michael, Tanja; Wilhelm, Frank H; Clark, David M; Ehlers, Anke

    2006-10-01

    The authors investigated whether heart rate (HR) responses to voluntary recall of trauma memories (a) are related to posttraumatic stress disorder (PTSD), and (b) predict recovery 6 months later. Sixty-two assault survivors completed a recall task modeled on imaginal reliving in the initial weeks postassault. Possible cognitive modulators of HR responsivity were assessed; dissociation, rumination, trauma memory disorganization. Individuals with PTSD showed a reduced HR response to reliving compared to those without PTSD, but reported greater distress. Notably, higher HR response but not self-reported distress during reliving predicted greater symptom reduction at follow-up in participants with PTSD. Engagement in rumination was the only cognitive factor that predicted lower HR response. The data are in contrast to studies using trauma reminders to trigger memories, which have found greater physiological reactivity in PTSD. The authors' observations are consistent with models of PTSD that highlight differences between cued or stimulus-driven retrieval and intentional trauma recall, and with E. B. Foa and M. J. Kozak's (1986) hypothesis that full activation of trauma memories facilitates emotional processing. PMID:17075909

  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. Gluteal Compartment Syndrome Secondary to Pelvic Trauma

    PubMed Central

    Taype Zamboni, Danilo E. R.; Carabelli, Guido S.; Barla, Jorge D.; Sancineto, Carlos F.

    2016-01-01

    Gluteal compartment syndrome (GCS) is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death. PMID:27579205

  1. Aspects of abuse: abusive head trauma.

    PubMed

    Hinds, Tanya; Shalaby-Rana, Eglal; Jackson, Allison M; Khademian, Zarir

    2015-03-01

    Abusive Head Trauma (AHT) is a form of child physical abuse that involves inflicted injury to the brain and its associated structures. Abusive Head Trauma, colloquially called Shaken Baby Syndrome, is the most common cause of serious or fatal brain injuries in children aged 2 years and younger. The American Academy of Pediatrics recommends the term Abusive Head Trauma, as opposed to Shaken Baby Syndrome, as the former term encompasses multiple forms of inflicted head injury (inertial, contact, and hypoxic-ischemic) and a range of clinical presentations and radiologic findings and their sequelae. Children diagnosed with AHT are 5 times more likely to die compared with accidentally head-injured children, yet signs and symptoms are not always obvious, and therefore the diagnosis can be overlooked. Therefore, the American Academy of Pediatrics has tasked pediatricians with knowing how and when to begin an evaluation of children with signs and symptoms that could possibly be due to AHT. Overall, a detailed history of present illness and medical history, recognition of physical and radiological findings, and careful interpretation of retinal pathology are important aspects of formulating the differential diagnoses and increasing or decreasing the index of suspicion for AHT.

  2. Gluteal Compartment Syndrome Secondary to Pelvic Trauma.

    PubMed

    Diaz Dilernia, Fernando; Zaidenberg, Ezequiel E; Gamsie, Sebastian; Taype Zamboni, Danilo E R; Carabelli, Guido S; Barla, Jorge D; Sancineto, Carlos F

    2016-01-01

    Gluteal compartment syndrome (GCS) is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death. PMID:27579205

  3. Pediatric pancreatic trauma: trending toward nonoperative management?

    PubMed

    Cuenca, Alex G; Islam, Saleem

    2012-11-01

    Pancreatic trauma is rare in children and optimal care has not been defined. We undertook this study to review the cumulative experience from three centers. After obtaining Institutional Review Board approval at each site, the trauma registries of three institutions were searched for pancreatic injuries. The charts were reviewed and data pertaining to demographics, hospital course, and outcome were obtained and analyzed. During the study period, a total of 79 pancreatic injuries were noted. The most common mechanism of injury was motor vehicle crash (44%) followed by child abuse (11%) and bicycle crashes (11%). Computed tomographic (CT) scans were obtained in 95 per cent with peripancreatic fluid the most common finding. Median Injury Severity Score (ISS) was 9, whereas median organ injury score was 2, and a higher grade correlated with need for operation (P = 0.001). Pancreatic operations were performed in 32 patients, whereas nonoperative management was noted in 47 cases. We noted no differences in length of stay, age, ISS, or initial blood pressure in operative versus nonoperatively managed cases. Pancreatic injuries were rare in children with trauma. CT scans were the most common method of diagnosis. Nonoperative management appeared to be safe and was more common, especially for the lower grade injuries.

  4. Disability evaluation in acoustic blast trauma

    PubMed Central

    Raju, Ganesan

    2015-01-01

    Introduction: Acoustic blast trauma is different from Noise induced hearing loss. Blast trauma can damage the tympanic membrane, ossicles and cochlea singly or in combination. It produces immediate severe hearing loss and may be associated with tinnitus and vestibular symptoms. Hearing loss recovers spontaneously in many cases but may be permanent in 30-55% cases. Thirteen patients working in an explosive manufacturing unit in Andhra Pradesh were exposed to blast trauma at work place. All these workers complained of immediate hearing loss and were subjected to audiological investigations. Methods: Initial evaluation showed a severe sensorineural type of hearing loss 10 of the 13 cases (77%). They were referred to our Medical board for disability evaluation after 2-3 years of initial injury. Pure tone audiometry indicated severe hearing loss in 12 of 13 cases (92%) that was not correlating clinically. Re-evaluation with Acoustic reflex and ABR (BERA) tests were done and permanent disability was evaluated with the results of these investigations. Observations: No significant hearing loss was found in most patients and these patients had minimal disability. Conclusion: Objective hearing tests should be carried out after one year or more before evaluation of permanent disability. PMID:26957811

  5. Short report of an unusual ballistic trauma

    PubMed Central

    Inchingolo, Francesco; Tatullo, Marco; Marrelli, Massimo; Inchingolo, Alessio D.; Pinto, Giorgia; Inchingolo, Angelo M.; Dipalma, Gianna

    2011-01-01

    INTRODUCTION Portable firearms have a relevant medico-legal interest, being a major cause of injury. Bullet entry wounds generally have a particular appearance, including contusion, skin introflection, and simple or excoriated ecchymosis. The skin wound is typically a hole with frayed margins, whose diameter is smaller than that of the bullet. PRESENTATION OF CASE We report the case of a 19-year-old man with ballistic trauma. Examination of the patient's lesions indicated that the bullet had entered from the left mandibular parasymphysis, creating a small hole without the typical bullet wipe and blackening. Subsequently, the bullet seemed to have fractured the left chin region immediately below the lower alveolar process, and it finally stopped in the submandibular area in the suprahyoid region of the neck. DISCUSSION This case is peculiar because the distinctive features of a firearm injury were absent; the lack of bleeding and edema made the case difficult to interpret without additional diagnostic investigations. CONCLUSION Ballistic trauma can manifest in different ways; therefore, internal trauma should be suspected even in the absence of clear external signs. This case report shows how an unusual bullet entry hole can mask quite serious injuries. PMID:22096751

  6. The neonatal nurse's role in preventing abusive head trauma.

    PubMed

    Allen, Kimberly A

    2014-10-01

    Abusive head trauma in infants occurs in 24.6 to 39.8 per 100,000 infants in developed countries. Abusive head trauma refers to any type of intentional head trauma an infant sustains, as a result of an injury to the skull or intracranial contents from a blunt force and/or violent shaking. The clinical question was: what evidence-based interventions have been implemented by neonatal nurses to prevent abusive head trauma in infants? PubMed was searched to obtain English language publications from 2005 to May 2014 for interventions focused on preventing abusive head trauma using the key term "shaken baby syndrome." A total of 10 studies were identified that met the inclusion criteria. All of the interventions targeted prevention of abusive head trauma with information about abusive head trauma/shaken baby syndrome and the "normal" infant crying behaviors. Interventions taught parents why infants cried, how to calm the infants, ways to cope with inconsolable infants, and how to develop a plan for what to do if they could not cope anymore. Parents who participated in the interventions were consistently able to explain the information and tell others about the dangers of shaking infants compared to the control parents. Only 2 studies calculated the preintervention abusive head trauma rate and the postintervention frequency of abusive head trauma. Each found significant differences in abusive head trauma.

  7. Nonoperative management of pediatric blunt hepatic trauma.

    PubMed

    Leone, R J; Hammond, J S

    2001-02-01

    The purpose of this study was to examine the effect of operative versus nonoperative management of blunt hepatic trauma in children including transfusion practices. We reviewed the experience at our American College of Surgeons-verified Level I trauma center with pediatric commitment over a 5-year period. Children < or = 16 years of age suffering blunt liver injury as documented on admission CT scan were included in the study. Liver injuries identified on CT scan were classified according to the American Association for the Surgery of Trauma's Organ Injury Scaling system. All data are presented as mean +/- standard error. One case of pediatric liver trauma not identified on CT was excluded (prehospital cardiopulmonary resuscitation). Twenty-seven patients were included [age 9.3 +/- 1.0 years (range 3-16)]. Mechanisms of injury included motor vehicle crash (14), pedestrian struck by motor vehicle (7), bicycle crash (4), fall from height (1), and pedestrian struck by falling object (1). Trauma Score was 11.5 +/- 0.3. Distribution of Liver Injury Grade was as follows: grade I, 13; grade II, 9; grade III, 3; grade IV, 2; and grade V, 0. All five patients who underwent operative management had multiple organ injuries; three had concomitant splenic injury requiring operative repair; the remaining two had small bowel injury requiring repair. Hepatorrhaphy did not correlate with severity of liver injury: grade I, n = 1; II, n = 2; III, n = 1; and IV, n = 1. Three operated patients received blood transfusions. Twenty-two patients were managed with nonoperative treatment, of these only one required blood transfusion. No patients in the study died, three were transferred to subacute rehabilitation, one was transferred to another hospital, and 23 were discharged home. Our findings indicate that a majority of children with blunt hepatic injury as documented on CT scan can be managed with nonoperative treatment, and few require blood transfusions. Patients with multiple organ

  8. Orofacial trauma in Brazilian basketball players and level of information concerning trauma and mouthguards.

    PubMed

    Frontera, Renata Reis; Zanin, Luciane; Ambrosano, Glaucia Maria Bovi; Flório, Flávia Martão

    2011-06-01

    Orofacial injuries are increasingly considered a public health problem in high impact sports. The purposes of this study were: to assess orofacial trauma (OT) history in basketball players, in relation to wearing mouthguards (MG), facial types, presence of mouth breathing and player's position in the game, also to check athletes' level of knowledge about trauma and MGs. Questionnaires were given to category A-1 adult athletes registered in 2006/07 in the State of São Paulo and Brazilian Basketball Confederation Championships, and National Team members. Of the total sample (n=388), 50% of athletes sustained orofacial injuries; dental trauma accounted for 69.7%, with emphasis on maxillary central incisors, followed by soft tissue (60.8%), in which lip injuries were the most prevalent. No relationship was found between trauma history and player's position (P=0.19), facial type (P=0.97), presence of mouth breathing (P=0.98), but there was statistically significant association between the prevalence of OT and lack of MG use (P≤0.0001). Of all the athletes affected, only 1% wore a MG at the time of the trauma, 26.5% did not know about the MGs and 10.6% did not know their functions. When trauma occurred, 79.6% replied one must look for the tooth at the accident site, 50% knew it must be stored in liquid, as replantation was possible (62.3%) and 75.8% believed elapsed time could influence prognosis. Basketball is a high impact sport with high prevalence of OT, particularly maxillary central incisor and lip injuries, but athletes did not use MGs. There should be more educational campaigns to inform players about orofacial injuries and their prevention in Brazilian basketball. PMID:21496201

  9. Orofacial trauma in Brazilian basketball players and level of information concerning trauma and mouthguards.

    PubMed

    Frontera, Renata Reis; Zanin, Luciane; Ambrosano, Glaucia Maria Bovi; Flório, Flávia Martão

    2011-06-01

    Orofacial injuries are increasingly considered a public health problem in high impact sports. The purposes of this study were: to assess orofacial trauma (OT) history in basketball players, in relation to wearing mouthguards (MG), facial types, presence of mouth breathing and player's position in the game, also to check athletes' level of knowledge about trauma and MGs. Questionnaires were given to category A-1 adult athletes registered in 2006/07 in the State of São Paulo and Brazilian Basketball Confederation Championships, and National Team members. Of the total sample (n=388), 50% of athletes sustained orofacial injuries; dental trauma accounted for 69.7%, with emphasis on maxillary central incisors, followed by soft tissue (60.8%), in which lip injuries were the most prevalent. No relationship was found between trauma history and player's position (P=0.19), facial type (P=0.97), presence of mouth breathing (P=0.98), but there was statistically significant association between the prevalence of OT and lack of MG use (P≤0.0001). Of all the athletes affected, only 1% wore a MG at the time of the trauma, 26.5% did not know about the MGs and 10.6% did not know their functions. When trauma occurred, 79.6% replied one must look for the tooth at the accident site, 50% knew it must be stored in liquid, as replantation was possible (62.3%) and 75.8% believed elapsed time could influence prognosis. Basketball is a high impact sport with high prevalence of OT, particularly maxillary central incisor and lip injuries, but athletes did not use MGs. There should be more educational campaigns to inform players about orofacial injuries and their prevention in Brazilian basketball.

  10. Fish and seafood availability in markets in the Baie des Chaleurs region, New Brunswick, Canada: a heavy metal contamination baseline study.

    PubMed

    Fraser, Marc; Surette, Céline; Vaillancourt, Cathy

    2013-02-01

    The consumption of halieutic products has many health benefits. However, their contaminants loads need to be addressed to better understand the risk from consuming these products. The aquatic biota from the Baie des Chaleurs in New Brunswick is contaminated by cadmium, zinc and lead. In spite of this, no study has examined the heavy metal concentrations in commercial halieutic products sold in this Canadian region. The objective of this pilot study was to characterize the species and origin of fish and seafood sold in the Baie des Chaleurs region by using an ecosystemic approach. Additionally, a baseline picture of the heavy metal levels found in these products has been determined. In 2008, interviews were carried out in markets located in the Baie des Chaleurs area. Species that were identified as the most purchased were then bought for analysis. Samples were freeze-dried and homogenized before nitric acid digestions. Aluminum, copper, cadmium, iron, manganese, and zinc concentrations were determined by inductively coupled plasma optical emission spectrometry. Results show that 36 % of seafood species sold in markets were caught in the Baie des Chaleurs. Lobsters, shrimps, scallops and oysters are the most purchased species regardless of the season. High amounts of cadmium exceeding tolerable daily intake are found in lobster hepatopancreas and can cause deleterious effects on health, in particular in vulnerable populations such as children and heavy consumers. The ecosystemic approach to health used in this pilot study shows the feasibility of an exhaustive study on the exposure of coastal population to heavy metal from fish and seafood consumption and the source of halieutic products sold in markets. PMID:22961483

  11. Sedimentary fabrics of the macrotidal, mud-dominated, inner estuary to fluvio-tidal transition zone, Petitcodiac River estuary, New Brunswick, Canada

    NASA Astrophysics Data System (ADS)

    Shchepetkina, Alina; Gingras, Murray K.; Zonneveld, John-Paul; Pemberton, S. George

    2016-03-01

    The study provides a detailed description of mud-dominated sedimentary fabrics and their application for the rock record within the inner estuary to the fluvial zone of the Petitcodiac River estuary, New Brunswick, Canada. Sedimentological characteristics and facies distributions of the clay- and silt-rich deposits are reported. The inner estuary is characterized by thick accumulations of interbedded silt and silty clay on intertidal banks that flank the tidally influenced channel. The most common sedimentary structures observed are parallel and wavy lamination, small-scale soft-sediment deformation with microfaults, and clay and silt current ripples. The tidal channel contains sandy silt and clayey silt with planar lamination, massive and convolute bedding. The fluvio-tidal transition zone is represented by interbedded trough cross-stratified sand and gravel beds with planar laminated to massive silty mud. The riverine, non-tidal reach of the estuary is characterized by massive, planar tabular and trough cross-stratified gravel-bed deposits. The absence of bioturbation within the inner estuary to the fluvio-tidal transition zone can be explained by the following factors: low water salinities (0-5 ppt), amplified tide and current speeds, and high concentrations of flocculated material in the water body. Notably, downstream in the middle and outer estuary, bioturbation is seasonally pervasive: in those locales the sedimentary conditions are similar, but salinity is higher. In this study, the sedimentological (i.e., grain size, bedding characters, sedimentary structures) differences between the tidal estuary and the fluvial setting are substantial, and those changes occur over only a few hundred meters. This suggests that the widely used concept of an extensive fluvio-tidal transition zone and its depositional character may not be a geographically significant component of fluvial or estuary deposits, which can go unnoticed in the study of the ancient rocks.

  12. Developing and Organizing a Trauma System and Mass Casualty Management: Some Useful Observations from the Israeli Trauma Model

    PubMed Central

    Borgohain, B; Khonglah, T

    2013-01-01

    A trauma system is a chain of arrangements and preparedness to provide quality response to injured from the site of injury to the appropriate hospital for the full range of care. Israel has a unique trauma system developed from the experience gained in peace and in war. The system is designed to fit the state's current health system, which is different from the European and American systems. An effective trauma system may potentially manage mass casualty incidence better. The aim of this paper is to discuss learning points to develop a trauma system based on the Israeli trauma model. After participating in a course on developing a trauma system organized by a top Israeli trauma center, a literature search on the topic on the Internet was done using relevant key words like trauma system and disaster management in Israel using the Google search engine in the pubmed, open access journals and websites of trauma organizations. Israel has a unique trauma system of organizing and managing an emergency event, characterized by a central national organization responsible for management, coordination and ongoing quality control. Because of its unique geopolitical situation, the armed forces has a significant role in the system. Investing adequate resources on continuous education, manpower training, motivation, team-work and creation of public volunteers through advocacy is important for capacity building to develop a trauma system. Wisdom, motivation and pragmatism of the Israeli model may be useful to streamline work in skeletal trauma services of developing countries having fewer resources to bring consistency and acceptable standards in trauma care. PMID:23634336

  13. The infantile psychic trauma from us to Freud: pure trauma, retroactivity and reconstruction.

    PubMed

    Baranger, M; Baranger, W; Mom, J M

    1988-01-01

    In the works of Freud, the concept of childhood psychic trauma evolves in the direction of increasing complexity. The authors maintain that this expansion corresponds to a new conception of retroactive temporality (Nachträglich), which is precisely the one we use in the analytic process of reconstruction and historicization from the present toward the past. We are thus led to differentiate the extreme form of the unassimilable 'pure' Trauma, nearly pure death drive, from the retroactively historicized forms which are reintegrated into the continuity of a vital flow of time that we 'invent' in analytic work. PMID:3403149

  14. The infantile psychic trauma from us to Freud: pure trauma, retroactivity and reconstruction.

    PubMed

    Baranger, M; Baranger, W; Mom, J M

    1988-01-01

    In the works of Freud, the concept of childhood psychic trauma evolves in the direction of increasing complexity. The authors maintain that this expansion corresponds to a new conception of retroactive temporality (Nachträglich), which is precisely the one we use in the analytic process of reconstruction and historicization from the present toward the past. We are thus led to differentiate the extreme form of the unassimilable 'pure' Trauma, nearly pure death drive, from the retroactively historicized forms which are reintegrated into the continuity of a vital flow of time that we 'invent' in analytic work.

  15. The Genesis of a Trauma Performance Improvement Plan.

    PubMed

    Pidgeon, Kristopher

    2015-01-01

    The purpose of this article is to assist the trauma medical and program director with developing a performance improvement and patients safety plan (PIPS), which is a required component of a successful trauma verification process by the American College of Surgeons. This article will review trauma quality standards and will describe in detail the required elements of a successful trauma center's performance improvement plan including a written comprehensive plan that outlines the mission and vision of the PIPS Program, authority of the PIPS Program, PIPS Program Committee reporting structure to the other hospital committees, list of required PIPS multidisciplinary team members, the operational components of the utilized data management system (trauma registry), list of indicators/audit filters, levels of review, peer determinations, corrective action plan with implementation, event resolution, and reevaluation. Strategies to develop a successful trauma performance improvement plan are presented.

  16. Optimizing the use of blood products in trauma care.

    PubMed

    Hess, John R; Hiippala, Seppo

    2005-01-01

    Blood transfusion has been used to treat the injured since the US Civil War. Now, it saves the lives of tens of thousands of injured patients each year. However, not everyone who receives blood benefits, and some recipients are injured by the transfusion itself. Effective blood therapy in trauma management requires an integration of information from diverse sources, including data relating to trauma and blood use epidemiology, medical systems management, and clinical care. Issues of current clinical concern in highly developed trauma systems include how to manage massive transfusion events, how to limit blood use and so minimize exposure to transfusion risks, how to integrate new hemorrhage control modalities, and how to deal with blood shortages. Less developed trauma systems are primarily concerned with speeding transport to specialized facilities and assembling trauma center resources. This article reviews the factors that effect blood use in urgent trauma care. PMID:16221314

  17. Long-term sequelae following blunt thoracic trauma.

    PubMed

    Yeo, T P

    2001-01-01

    People experiencing blunt thoracic trauma may sustain multiple rib fractures, flail chest, cardiac or pulmonary contusions, injury to the great vessels, sternal fractures, clavicular fractures, neck injuries, and lacerations of the liver and/or spleen. Long-term sequelae from blunt chest trauma include chest wall deformities, persistent dyspnea, and cardiac, neurologic, or esophageal complications. Chronic pain, depression, and loss of functional status are also frequent components of recovery from trauma. PMID:12025303

  18. Trauma surgery associations and societies: which organizations match your goals?

    PubMed Central

    2014-01-01

    This focused summary is a multi-institutional, multi-national, and multi-generational project designed to briefly summarize current academic trauma societies for both trainees and faculty alike. The co-authorship is composed of former and/or current presidents from most major trauma organizations. It has particular relevance to trainees and/or recent graduates attempting to navigate the multitude of available trauma organizations. PMID:24955111

  19. Combined Gastric and Duodenal Perforation Through Blunt Abdominal Trauma

    PubMed Central

    Kaur, Adarshpal; Singla, Archan Lal; Kumar, Ashwani; Yadav, Manish

    2015-01-01

    Blunt abdominal traumas are uncommonly encountered despite their high prevalence, and injuries to the organ like duodenum are relatively uncommon (occurring in only 3%-5% of abdominal injuries) because of its retroperitoneal location. Duodenal injury combined with gastric perforation from a single abdominal trauma impact is rarely heard. The aim of this case report is to present a rare case of blunt abdominal trauma with combined gastric and duodenal injuries. PMID:25738037

  20. Childhood Trauma and Its Relation to Chronic Depression in Adulthood

    PubMed Central

    Negele, Alexa; Kaufhold, Johannes; Kallenbach, Lisa; Leuzinger-Bohleber, Marianne

    2015-01-01

    There is a large consensus indicating that childhood trauma is significantly involved in the development of depression. The aim of this study was to examine the prevalence of retrospectively recalled childhood trauma in chronically depressed patients and to investigate a more specific relationship between trauma type and depression. We further asked for the influence of multiple experiences of childhood trauma on the vulnerability to a chronic course of depression in adulthood. 349 chronically depressed patients of the German LAC Depression Study completed the Childhood Trauma Questionnaire, a self-report measure of traumatic experiences in childhood. 75.6% of the chronically depressed patients reported clinically significant histories of childhood trauma. 37% of the chronically depressed patients reported multiple childhood traumatization. Experiences of multiple trauma also led to significantly more severe depressive symptoms. Stepwise multiple regression analysis suggested that childhood emotional abuse and sexual abuse were significantly associated with a higher symptom severity in chronically depressed adults. Yet, expanding the regression model for multiple exposures showed that multiplicity was the only remaining significant predictor for symptom severity in chronically depressed patients. Clinical implications suggest a precise assessment of childhood trauma in chronically depressed patients with a focus on emotional abuse, sexual abuse, and multiple exposures to childhood trauma. This trial is registered with registration number ISRCTN91956346. PMID:26693349

  1. Trauma in war and political persecution: expanding the concept.

    PubMed

    Hernández, Pilar

    2002-01-01

    A contextual understanding of the concept of trauma is proposed through a study of its meaning in a Latin American context facing war and political repression. This article explores the contributions of narrative and liberation psychology to understanding politically based trauma. It critiques the relationship between the concept of trauma and the diagnosis of posttraumatic stress disorder. It analyzes how Colombian human rights activists make sense of the political persecution and trauma in their work. The author argues that the kind of experiences that these activists have endured go beyond the category of stress and can best be understood as traumatic within the context of the current medium-intensity war in Colombia.

  2. Trauma on rural roads: the role of a peripheral hospital.

    PubMed

    Street, J T; Winter, D; Buckley, S; Nicholson, P; Twomey, A

    1999-06-01

    Road accident trauma is a leading cause of death and serious morbidity among healthy young adults in the developed world. The Irish Republic has the third worst road safety record in the EU. In studying the unique demographics of rural road accidents, our aim was to provide information essential to the future development of trauma care in Ireland. Our figures highlight the inadequacies of data received by the National Roads Authority, illustrate the resource impact of road trauma on a peripheral hospital, and demonstrate the need for similar studies in the rationalisation of trauma care as we approach the next millennium.

  3. Colloid cyst mimicking intracranial hemorrhage after head trauma.

    PubMed

    Buyukkaya, Ayla; Buyukkaya, Ramazan; Özel, Mehmet Ali; Sarıtas, Ayhan

    2015-02-01

    Trauma patients consist vast majority of the patients who admit to emergency department, and most of them have a head trauma. A 58-year-old patient was taken to emergency department with head trauma, and a hyperdense lesion neighboring to third ventricle was detected. A diagnosis of colloid cyst was made in the patient who was being followed up for hemorrhage. In patients with head trauma, colloid cyst may easly be confused with intracranial hemorrhage due to hyperdensity. The aim of this report is to emphasize the importance of clinical thinking in the differential diagnosis of hyperdense lesion on computed tomography imaging of a patient with head injury.

  4. Preceding trauma in childhood hematogenous bone and joint infections.

    PubMed

    Pääkkönen, Markus; Kallio, Markku J T; Lankinen, Petteri; Peltola, Heikki; Kallio, Pentti E

    2014-03-01

    Preceding trauma may play a role in the etiology and pathogenesis of hematogenous bone and joint infections. Among 345 children with an acute hematogenous bone and/or joint infection, 20% reported trauma during a 2-week period leading to infection. Blunt impact, bruises, or excoriations were commonly reported. The rate was similar to that in the general pediatric population obtained from the literature. In the study group, patients with and without trauma were similar in age, serum C-reactive protein and erythrocyte sedimentation rate, length of hospitalization, and late sequelae. Preceding minor trauma did not prove to be significant as an etiological or as a prognostic factor.

  5. Taking a History of Childhood Trauma in Psychotherapy

    PubMed Central

    SAPORTA, JOSÉ A.; GANS, JEROME S.

    1995-01-01

    The authors examine the process of taking an initial history of childhood abuse and trauma in psychodynamic psychotherapy. In exploring the advantages, complexities, and potential complications of this practice, they hope to heighten the sensitivities of clinicians taking trauma histories. Emphasis on the need to be active in eliciting important historical material is balanced with discussion of concepts that can help therapists avoid interpersonal dynamics that reenact and perpetuate the traumas the therapy seeks to treat. Ensuring optimal psychotherapeutic treatment for patients who have experienced childhood trauma requires attention to the following concepts: a safe holding environment, destabilization, compliance, the repetition compulsion, and projective identification. PMID:22700250

  6. An expanding role for cardiopulmonary bypass in trauma

    PubMed Central

    Chughtai, Talat S.; Gilardino, Miroslav S.; Fleiszer, David M.; Evans, David C.; Brown, Rea A.; Mulder, David S.

    2002-01-01

    Objectives To analyze experience at the McGill University Health Centre with cardiopulmonary bypass (CPB) in trauma, complemented by a review of the literature to define its role globally and outline indications for its expanded use in trauma management. Data sources All available published English-language articles from peer reviewed journals, located using the MEDLINE database. Chapters from relevant, current textbooks were also utilized. Study selection Nine relevant case reports, original articles or reviews pertaining to the use of CPB in trauma. Data extraction Original data as well as authors’ opinions pertinent to the application of CPB to trauma were extracted, incorporated and appropriately referenced in our review. Data synthesis Overall mortality in the selected series of CPB used in the trauma setting was 44.4%. Four of 5 survivors had CPB instituted early (first procedure in operative management) whereas 3 of 4 deaths involved late institution of CPB. Conclusions Although CPB has traditionally been used in the setting of cardiac trauma alone, a better understanding of its potential benefit in noncardiac injuries will likely make for improved outcomes in the increasingly diverse number of severely injured patients seen in trauma centres today. Further studies by other trauma centres will allow for standardized indications for the use of CPB in trauma. PMID:11939667

  7. Survival in trauma victims with pulmonary contusion.

    PubMed

    Stellin, G

    1991-12-01

    The author evaluated 203 consecutive patients with severe chest trauma admitted to the trauma center between 1985 and 1989. The goal was to identify risk factors that play a significant role in mortality of patients with pulmonary contusion. There were 160 men and 43 women. The average was 33 years (range 2 to 92 years); 178 patients were younger than 60 years and 25 were older. There were 183 motor vehicle or motorcycle accidents, five gun shot wounds, one stab wound, five falls from height, three industrial accidents, one altercation, and five other undetermined causes. One hundred and fifty-nine patients survived; 44 died (22%). Their injury severity scores averaged 27 (range 9 to 59) for the survivors and 43.5 (range 17 to 75) for the nonsurvivors. Fifty-seven per cent of the patients required mechanical ventilation. The average time on the ventilator was 4.4 days (range 1 to 47 days) for the survivors and 14.2 days for the nonsurvivors (range 1 to 126 days). Of the patients less than 60 years old, 34 (20%) died, but 10 (40%) of the 25 patients older than 60 years died. Average blood loss was 1,047 cc (range 0 to 14,300 cc), but the difference was not statistically significant between survivors and nonsurvivors in the authors' series. Injuries to the central nervous system were present in 80 (40%) of the patients and were associated with death in 30 (68%) of the cases. Age, severity of injury, associated head trauma, and shock were the most important factors affecting survival in the authors' patients with pulmonary contusion. PMID:1746794

  8. Control of road trauma epidemic in Australia.

    PubMed Central

    McDermott, F.

    1978-01-01

    This lecture discusses initiatives taken by the Road Trauma Committee of the Royal Australasian College of Surgeons to reduce fatality and injury on Australian roads. In 1970 the Road Trauma Committee and the communications media initiated a national campaign in support of legislation for the compulsory wearing of seat belts. Public ignorance and Parliamentary inertia were countered. Victoria became the first State in the Western world to introduce this legislation. All other Australian States followed. Significant and marked reductions in fatality and injury were achieved and have been maintained. Recognising alcohol as the single most important cause of serious road crashes and injuries in Australia, the committee advocated legislation for compulsory blood alcohol tests on all adult road crash casualties. In 1973-74 legislation was enacted in South Australia and Victoria and in 1976 in Queensland. Results show that more than one-quarter of driver casualties have alcohol concentrations above the legal limit of 0.05 g%. Half of these exceed 0.15 g%. On the other hand less than 3% of the general driving population exceed the legal limit. Further advocacy led in 1976 to the enactment of random roadside breath-test legislation in Victoria. The majority of Australian convicted drinking drivers have alcohol-related social problems. A quarter incur reconvictions. The conventional penal approach has failed. At present the Road Trauma Committee is campaigning for compulsory medical assessment of convicted drinking drivers. Reissue of a driving licence would be dependent upon evidence of re-education and/or rehabilitation. Pilot re-education programmes have been shown to lessen recidivism markedly. Prevention of drink-driving behaviour is the major strategy. The tactics entail deterence, improved secondary-school and driver education, and the implementation of a national policy for control of alcohol abuse. PMID:718071

  9. Primitive mechanisms of trauma response: an evolutionary perspective on trauma-related disorders.

    PubMed

    Baldwin, David V

    2013-09-01

    The symptoms we identify and the behaviors we recognize as defenses define which symptoms we see as trauma-related. Early conceptions of trauma-related disorders focused on physical signs of distress while current ones emphasize mental symptoms, but traumatizing experiences evoke psychobiological reactions. An evolutionary perspective presumes that psychophysical reactions to traumatizing events evolved to ensure survival. This theoretical review examines several primitive mechanisms (e.g., sensitization and dissolution) associated with responses to diverse stressors, from danger to life-threat. Some rapidly acquired symptoms form without conscious awareness because severe stresses can dysregulate mental and physical components within systems ensuring survival. Varied defensive options engage specialized and enduring psychophysical reactions; this allows for more adaptive responses to diverse threats. Thus, parasympathetically mediated defense states such as freeze or collapse increase trauma-related symptom variability. Comorbidity and symptom variability confuse those expecting mental rather than psychophysical responses to trauma, and active (sympathetically mediated flight and fight) rather than immobility defenses. Healthcare implications for stress research, clinical practice and diagnostic nosology stem from the broader evolutionary view.

  10. Advanced trauma and life support principles: an audit of their application in a rural trauma centre.

    PubMed

    Calleary, J G; el-Nazir, A K; el-Sadig, O; Carolan, P E; Joyce, W P

    1999-01-01

    In December of 1995 a system of trauma care based on Advanced Trauma Life Support (ATLS) principles was instituted to assess the impact of such principles on trauma care in a rural general hospital setting. This audit reviews the results over a 2 yr period to December 1997. All patients admitted with major trauma (i.e. with life threatening or potentially life threatening injuries) to Cavan General Hospital (CGH) were eligible for inclusion. This numbered 70 patients admitted (for at least 3 days), or who were transferred after resuscitation and stabilization as well as inpatient deaths. Twenty-seven patients who died prior to admission are also reviewed. The endpoints assessed were death, disability and survival 3 months post-accident. Based on injury severity scores 7 per cent of cases suffered fatal non-survivable injury, 20-30 per cent had very serious injury with an overall mortality rate of 17 per cent. The predicted mortality rate was 30 per cent. One-third had their full treatment at CGH with a 76 per cent survival rate. The other two-thirds were transferred for specialist intervention with an overall survival of 80 per cent, a disability rate of 16 per cent and a mortality rate of 4 per cent. No patient died during transportation. PMID:10422385

  11. Cultural Differences in the Relationship between Intrusions and Trauma Narratives Using the Trauma Film Paradigm

    PubMed Central

    Jobson, Laura; Dalgleish, Tim

    2014-01-01

    Two studies explored the influence of culture on the relationship between British and East Asian adults’ autobiographical remembering of trauma film material and associated intrusions. Participants were shown aversive film clips to elicit intrusive images. Then participants provided a post-film narrative of the film content (only Study 1). In both studies, participants reported intrusive images for the film in an intrusion diary during the week after viewing. On returning the diary, participants provided a narrative of the film (delayed). The trauma film narratives were scored for memory-content variables. It was found that for British participants, higher levels of autonomous orientation (i.e. expressions of autonomy and self-determination) and self-focus in the delayed narratives were correlated significantly with fewer intrusions. For the East Asian group, lower levels of autonomous orientation and greater focus on others were correlated significantly with fewer intrusions. Additionally, Study 2 found that by removing the post-film narrative task there was a significant increase in the number of intrusions relative to Study 1, suggesting that the opportunity to develop a narrative resulted in fewer intrusions. These findings suggest that the greater the integration and contextualization of the trauma memory, and the more the trauma memory reflects culturally appropriate remembering, the fewer the intrusions. PMID:25203300

  12. Cultural differences in the relationship between intrusions and trauma narratives using the trauma film paradigm.

    PubMed

    Jobson, Laura; Dalgleish, Tim

    2014-01-01

    Two studies explored the influence of culture on the relationship between British and East Asian adults' autobiographical remembering of trauma film material and associated intrusions. Participants were shown aversive film clips to elicit intrusive images. Then participants provided a post-film narrative of the film content (only Study 1). In both studies, participants reported intrusive images for the film in an intrusion diary during the week after viewing. On returning the diary, participants provided a narrative of the film (delayed). The trauma film narratives were scored for memory-content variables. It was found that for British participants, higher levels of autonomous orientation (i.e. expressions of autonomy and self-determination) and self-focus in the delayed narratives were correlated significantly with fewer intrusions. For the East Asian group, lower levels of autonomous orientation and greater focus on others were correlated significantly with fewer intrusions. Additionally, Study 2 found that by removing the post-film narrative task there was a significant increase in the number of intrusions relative to Study 1, suggesting that the opportunity to develop a narrative resulted in fewer intrusions. These findings suggest that the greater the integration and contextualization of the trauma memory, and the more the trauma memory reflects culturally appropriate remembering, the fewer the intrusions.

  13. Transdiaphragmatic Intercostal Herniation following Blunt Trauma

    PubMed Central

    Sarkar, Debkumar; Warta, Melissa; Solomon, Jason

    2012-01-01

    Intercostal herniation is very rarely and sporadically reported in the literature. Intercostal hernia can occur following blunt trauma and may be associated with rib fractures. We present a case of a patient who presented with rib fractures, diaphragmatic rupture, and intrathoracic herniation of abdominal contents with subsequent herniation of both lung and abdominal contents through an intercostal defect. The patient was successfully treated with primary surgical repair of the diaphragm and intercostal hernia. The presentation, pathophysiology, and management of this rare clinical entity are discussed. PMID:23198242

  14. Segmental Renal Infarction due to Blunt Trauma

    PubMed Central

    Alevizopoulos, Aristeidis; Hamilton, Lauren; Stratu, Natalia; Rix, Gerald

    2016-01-01

    Segmental renal infarction is a rare situation which has been reported so far in the form of case reports. It's caused usually by cardiac conditions, such as atrial fibrillation, and systemic diseases (e.g. systemic lupus erythematous). We are presenting a case of a 31 year old healthy male, who sustained a left segmental renal infarction, following a motorbike accident. We report his presentation, management and outcome. We also review the literature in search of the optimal diagnostic and treatment pathway. To our knowledge, this is the first report of segmental renal infarction due to blunt trauma. PMID:27175338

  15. Leadership and Teamwork in Trauma and Resuscitation

    PubMed Central

    Ford, Kelsey; Menchine, Michael; Burner, Elizabeth; Arora, Sanjay; Inaba, Kenji; Demetriades, Demetrios; Yersin, Bertrand

    2016-01-01

    Introduction Leadership skills are described by the American College of Surgeons’ Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders. Methods We searched the PubMed database using the keywords “leadership” and then either “trauma” or “resuscitation” as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders. Results We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching

  16. Trauma: Conventional radiologic study in spine injury

    SciTech Connect

    Dosch, J.

    1985-01-01

    This book includes a discussion of the anatomy of the spinal cord and descriptions of methods for tailored radiologic investigation of spine trauma. Most of the text is devoted to the analysis and classification of spinal injury by radiologic signs and mode of injury. The author addresses injury to the entire spine but emphasizes the cervical spine. Plain radiography and conventional tomography are the only imaging methods discussed. The author stresses the active role of the attending radiologist in directing every phase of the x-ray study. Many subtle variations in patient positioning plus beam direction and angulation are described.

  17. Odontogenic maxillary sinusitis obscured by midfacial trauma.

    PubMed

    Simuntis, Regimantas; Kubilius, Ričardas; Ryškienė, Silvija; Vaitkus, Saulius

    2015-01-01

    We present a case of odontogenic maxillary sinusitis whose sinonasal symptomatology was thought to be the consequence of a previous midfacial trauma. The patient was admitted to the Clinic of Oral and Maxillofacial Surgery after more than 10 years of exacerbations of sinonasal symptoms, which began to plague soon after a facial contusion. We decided to perform CT of paranasal sinuses, and despite the absence dental symptomatology, the dental origin of sinusitis was discovered. The majority of sinonasal symptoms resolved after appropriate dental treatment, and there was no need for nasal or sinus surgery.

  18. Bone SPECT/CT in skeletal trauma.

    PubMed

    Scharf, Stephen C

    2015-01-01

    The utility of radionuclide bone scanning in skeletal trauma has been greatly enhanced over the last decade by hybrid technology merging multislice CT with SPECT that can take advantage of CT-based correction of attenuation and scatter. The resulting images have been particularly helpful in giving us new insights into the evaluation of foot and ankle injuries and vertebral pathology both before and after surgery. The physiological information and anatomical detail allow a better understanding of the causes of patients' pain and have proven to be particularly useful in planning surgical intervention.

  19. Psychodrama groups for girls coping with trauma.

    PubMed

    Carbonell, D M; Parteleno-Barehmi, C

    1999-07-01

    This study evaluated the effectiveness of psychodrama groups with traumatized middle-school girls. Comparisons of treatment and control group members' pre- and postintervention adjustment revealed significant decreases in group participants' self-reported difficulties in withdrawn behavior and anxiety/depression. Interviews with the participants reinforced the value of psychodrama group participation in the resolution of trauma and in increasing a sense of competence and self-efficacy. A brief outline of the group structure and a description of the process offer examples that illustrate the practice methodology and provide guidance for conducting psychodrama groups with vulnerable populations. Concerns with safety and containment are addressed.

  20. [Isolated chest trauma in elderly patients].

    PubMed

    Yersin, Bertrand; Carron, Pierre-Nicolas; Pasquier, Mathieu; Zingg, Tobias

    2015-08-12

    In elderly patients, a blunt trauma of the chest is associated with a significant risk of complications and mortality. The number of ribs fractures (≥ 4), the presence of bilateral rib fractures, of a pulmonary contusion, of existent comorbidities or acute extra-thoracic traumatic lesions, and lastly the severity of thoracic pain, are indeed important risk factors of complications and mortality. Their presence may require hospitalization of the patient. When complications do occur, they are represented by alveolar hypoventilation, pulmonary atelectasia and broncho-pulmonary infections. When hospitalization is required, it may allow for the specific treatment of thoracic pain, including locoregional anesthesia techniques. PMID:26449103