Science.gov

Sample records for brunswick overhauls trauma

  1. 5. NEW BRUNSWICK STATION AND EASTON AVENUE BRIDGE NEW BRUNSWICK, ...

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

    5. NEW BRUNSWICK STATION AND EASTON AVENUE BRIDGE NEW BRUNSWICK, MIDDLESEX CO., NJ. Sec. 1401, MP 31.36. - Northeast Railroad Corridor, Amtrak Route between Pennsylvania/New Jersey & New Jersey/New York State Lines, Newark, Essex County, NJ

  2. 4. NEW BRUNSWICK STATION AND EASTON AVENUE BRIDGE. NEW BRUNSWICK, ...

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

    4. NEW BRUNSWICK STATION AND EASTON AVENUE BRIDGE. NEW BRUNSWICK, MIDDLESEX CO., NJ. Sec. 1401, MP 31.36. - Northeast Railroad Corridor, Amtrak Route between Pennsylvania/New Jersey & New Jersey/New York State Lines, Newark, Essex County, NJ

  3. 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.

  4. 76 FR 39259 - Establishment of Class E Airspace; Brunswick, ME

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-06

    ... Federal Aviation Administration 14 CFR Part 71 Establishment of Class E Airspace; Brunswick, ME AGENCY... establishes Class E airspace at Brunswick Executive Airport, Brunswick, ME. DATES: The effective date is moved...), establishes Class E airspace at Brunswick Executive Airport, Brunswick, ME. This action will move up...

  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. Delaying an Overhaul & Ship’s Equipment.

    DTIC Science & Technology

    1980-05-01

    M . On Pelh iiitqral Solutions of AD A0. 459 PP 176 the Schrodinger Equation Without Limiting Pry Felrx. Wendi. ’Correlates of letento,n -0 Prn- cedr...steaming rates per month to estimate increases in past steaming variables, equations (1) and (2) be- come 13 AC2 = -0.0126At (3a) AC3/C4 = 0.013RAt...3b) and T 12AC2 = -0.0126 E At = -0.98 (4a) At =1 T 1.2 AC3/C4 = 0.0138 At = 1.07 (4b) At=1 Using equation (4b), we estimate that if an overhaul were

  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 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.

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

    NASA Technical Reports Server (NTRS)

    Savage, M.; Lewicki, D. G.

    1989-01-01

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

  10. 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.

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

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

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

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

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

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

  13. 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…

  14. School Psychology in New Brunswick in 2016

    ERIC Educational Resources Information Center

    Mureika, Juanita

    2016-01-01

    School psychology in New Brunswick experienced a surge of growth and development in the early part of the 21st century; however, dwindling numbers and recent government initiatives are presenting serious challenges to our ability to continue to provide the quality tiered services that we want to offer to the school community.

  15. 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…

  16. Profile of New Brunswick Community College Students.

    ERIC Educational Resources Information Center

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

    In 1989, a profile was developed of the full-time students attending New Brunswick community colleges (NBCCs), using demographic data, and educational and labor force background information found in student records. Data for the profile were retrieved from the NBCC's Student Information System for the academic years 1985-86 through 1988-89,…

  17. 75 FR 8485 - Revocation of Class D and E Airspace; Brunswick, ME

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-25

    ... and E Airspace at Brunswick NAS Airport, Brunswick, ME, as the airport has closed and the associated... Brunswick NAS Airport in Brunswick, ME has closed in compliance with the 2005 Base Realignment and Closure... NAS Airport, Brunswick, ME. This rule will become effective on the date specified in the DATES...

  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. 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...

  20. 14 CFR 43.2 - Records of overhaul and rebuilding.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.2 Records of overhaul and rebuilding... required maintenance entry or form an aircraft, airframe, aircraft engine, propeller, appliance, or... maintenance entry or form an aircraft, airframe, aircraft engine, propeller, appliance, or component part...

  1. 14 CFR 43.2 - Records of overhaul and rebuilding.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.2 Records of overhaul and rebuilding... FR 9095, March 1, 2010. (a) No person may describe in any required maintenance entry or form an... of this chapter. (b) No person may describe in any required maintenance entry or form an...

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

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.2 Records of overhaul and rebuilding. (a) No person may describe in any required maintenance entry or form an aircraft, airframe, aircraft... may describe in any required maintenance entry or form an aircraft, airframe, aircraft...

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

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.2 Records of overhaul and rebuilding. (a) No person may describe in any required maintenance entry or form an aircraft, airframe, aircraft... may describe in any required maintenance entry or form an aircraft, airframe, aircraft...

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

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... MAINTENANCE, PREVENTIVE MAINTENANCE, REBUILDING, AND ALTERATION § 43.2 Records of overhaul and rebuilding. (a) No person may describe in any required maintenance entry or form an aircraft, airframe, aircraft... may describe in any required maintenance entry or form an aircraft, airframe, aircraft...

  5. 40 CFR 81.437 - New Brunswick, Canada.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false New Brunswick, Canada. 81.437 Section 81.437 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Visibility Is an Important Value § 81.437 New Brunswick, Canada. Table 1 Area name Acreage Public...

  6. The New Brunswick Writing Assessment Program: "The Language of Growth".

    ERIC Educational Resources Information Center

    Roberts, Bryan

    The New Brunswick Writing Assessment Program implemented in grades five, eight, and eleven in New Brunswick (Canada) public schools in 1978 is described in this report, which includes the specific assignments for each grade, a discussion of the general holistic scoring approach used, and characteristics of the responses at each grade, including…

  7. 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)

  8. 7. RARITAN AVENUE BRIDGE. NEW BRUNSWICK, MIDDLESEX CO., NJ. Sec. ...

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

    7. RARITAN AVENUE 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

  9. 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

  10. 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

  11. 6. RARITAN AVENUE BRIDGE. NEW BRUNSWICK, MIDDLESEX CO., NJ. Sec. ...

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

    6. RARITAN AVENUE 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

  12. 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

  13. 76 FR 36285 - Establishment of Class E Airspace; Brunswick, ME

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-22

    ..., Georgia 30320; telephone (404) 305-6364. SUPPLEMENTARY INFORMATION: History On March 18, 2011, the FAA... From 700 Feet or More Above the Surface of the Earth. * * * * * ANE ME E5 Brunswick, ME...

  14. Pockmarks in Passamaquoddy Bay, New Brunswick, Canada

    USGS Publications Warehouse

    Brothers, Laura; Legere, Christine; Hughes Clark, J.E.; Kelley, J.T.; Barnhardt, Walter; Andrews, Brian; Belknap, D.F.

    2016-01-01

    Pockmarks are seafloor depressions associated with fluid escape (Judd & Hovland 2007). They proliferate in the muddy seafloors of coastal Gulf of Maine and Bay of Fundy, where they are associated with shallow natural gas likely of biogenic origin (Ussler et al. 2003; Rogers et al. 2006; Wildish et al. 2008). In North America, shallow-water pockmark fields are not reported south of Long Island Sound, despite the abundance of gassy, muddy estuaries. The absence of pockmarks south of the limit of North American glaciation suggests that local and regional heterogeneities, possibly related to glacial or sea-level history or bedrock geology, influence pockmark field distribution. In shallow-water embayments, such as Passamaquoddy Bay, New Brunswick, pockmarks can be large (>200 m diameter) and number in the thousands.

  15. 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

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

    PubMed Central

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

    2012-01-01

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

  17. 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

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

    SciTech Connect

    Not Available

    1994-04-01

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

  19. 75 FR 57848 - Revocation of Class E Airspace, Brunswick, ME; and Establishment of Class E Airspace, Wiscasset, ME

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-23

    ...: Final rule. SUMMARY: This action removes Class E Airspace at Brunswick NAS, Brunswick, ME, as the..., Code of Federal Regulations (14 CFR) part 71 removes the Class E airspace at Brunswick NAS,...

  20. 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...

  1. 75 FR 69905 - Proposed Amendment of Class E Airspace; Brunswick Malcolm-McKinnon Airport, GA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-16

    ... Brunswick, GA, as the McKinnon NDB Non-Directional Beacon (NDB) has been decommissioned and new Standard... Class E airspace designated as surface areas. * * * * * ASO GA E2 Brunswick Malcolm-McKinnon Airport, GA... Airspace; Brunswick Malcolm- McKinnon Airport, GA AGENCY: Federal Aviation Administration (FAA),...

  2. 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.

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

    PubMed Central

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

    2012-01-01

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

  4. 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

  5. Lyme disease risk in dogs in New Brunswick

    PubMed Central

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

    2016-01-01

    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

  6. Educators and Visionaries: Women in Educational Administration in New Brunswick.

    ERIC Educational Resources Information Center

    Gill, Barbara A.

    A study was conducted during spring 1993 of 29 women educators in New Brunswick, Canada, who had either obtained a position or who were actively seeking a position in educational administration. About 25 percent of administrators in the Anglophone school system are women. The largest percentage of these women administrators are in rural school…

  7. History of Adult Vocational Education in New Brunswick.

    ERIC Educational Resources Information Center

    New Brunswick Dept. of Education, Fredericton (Canada).

    This paper traces the development of adult vocational education in New Brunswick from its beginning in 1918 to the present. Highlights summarize the adult vocational history before confederation and to World War I, when the first Vocational Education Act was passed in 1918. The paper then summarizes the events of World War I and the Depression…

  8. Public Attitudes toward Adult Education in New Brunswick: Research Proposal.

    ERIC Educational Resources Information Center

    Dyer, Linda

    In 1989, a province-wide survey was conducted to assess public opinion concerning adult education and the New Brunswick Community College System (NBCCS). A random sample of 800 respondents between the ages of 18 and 65 was surveyed regarding the quality of education, the quality of job-related education and training, experiences within the…

  9. Adenovirus Serotype 14 Infection, New Brunswick, Canada, 2011

    PubMed Central

    Garceau, Richard; Thibault, Louise; Oussedik, Youcef; Bastien, Nathalie; Li, Yan

    2013-01-01

    We describe 3 culture-proven cases of adenovirus serotype 14 infection in New Brunswick, Canada, during the summer of 2011. Strains isolated from severely ill patients were closely related to strains of a genomic variant, adenovirus 14p1, circulating in the United States and Ireland. Physicians in Canada should be aware of this emerging adenovirus. PMID:23260201

  10. 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

  11. 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

  12. 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

  13. 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

  14. New Coleoptera records from New Brunswick, Canada: Eucinetidae and Scirtidae

    PubMed Central

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

    2012-01-01

    Abstract We report two species of Eucinetidae, Nycteus oviformis (LeConte) and Nycteus punctulatus (LeConte), new to New Brunswick, Canada and confirm the presence of Nycteus testaceus (LeConte). Nycteus oviformis is newly recorded from the Maritime provinces. Additional locality data are provided for Eucinetus haemorrhoidalis (Germar) and Eucinetus morio LeConte. Five species of Scirtidae, Cyphon ruficollis (Say),Prionocyphon discoideus (Say), Sacodes pulchella (Guérin-Méneville), Elodes maculicollis Horn, and Sarabandus robustus (LeConte) are added to the New Brunswick faunal list. Sarabandus robustus is newly recorded from Canada; Cyphon ruficollis, Prionocyphon discoideus and Sacodes pulchella are new for the Maritime provinces. Collection and habitat data, and distribution maps are presented for these species. PMID:22539884

  15. 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.

  16. 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.

  17. 15 CFR 742.14 - Significant items: hot section technology for the development, production or overhaul of...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... or overhaul of commercial aircraft engines controlled under ECCN 9E003.a.1 through a.8, a.10, .h and..., production or overhaul of commercial aircraft engines controlled by ECCN 9E003a.1 through a.8, a.10, .h...

  18. 15 CFR 742.14 - Significant items: hot section technology for the development, production or overhaul of...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... or overhaul of commercial aircraft engines controlled under ECCN 9E003.a.1 through a.8, .h,.i and .j... or overhaul of commercial aircraft engines controlled by ECCN 9E003a.1 through a.8, .h,.i, and...

  19. 15 CFR 742.14 - Significant items: hot section technology for the development, production or overhaul of...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... or overhaul of commercial aircraft engines controlled under ECCN 9E003.a.1 through a.8, .h,.i and .j... or overhaul of commercial aircraft engines controlled by ECCN 9E003a.1 through a.8, .h,.i, and...

  20. 15 CFR 742.14 - Significant items: hot section technology for the development, production or overhaul of...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... or overhaul of commercial aircraft engines controlled under ECCN 9E003.a.1 through a.8, .h,.i and .j... or overhaul of commercial aircraft engines controlled by ECCN 9E003a.1 through a.8, .h,.i, and...

  1. Off to a Good Start: Report on the 1997-98 Beginning Teacher Induction Program in New Brunswick.

    ERIC Educational Resources Information Center

    Scott, Neil H.

    For the third consecutive year, New Brunswick's Department of Education, in cooperation with the New Brunswick Teacher Association (NBTA) and the University of New Brunswick, organized a Beginning Teacher Induction Program (BTIP) in all 12 anglophone school districts. In 1998, data were collected using surveys from beginning teachers, mentors,…

  2. 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

    ... Portion of the Cape Fear River in Brunswick and New Hanover Counties; No Discharge Zone Determination On... Brunswick and Pender Counties Coastal Waters and a portion of the Cape Fear River, as a No Discharge Zone... of the Cape Fear River in Brunswick and New Hanover Counties. The other saline waters of New...

  3. 76 FR 4148 - Notice of Opportunity for Public Comment on Surplus Property Release at Brunswick-Golden Isles...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-24

    ... Brunswick-Golden Isles Airport, Brunswick, GA AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice. SUMMARY: Under the provisions of Title 49, U.S.C. Section 47153(c), notice is being given that... adjacent to, but separated by a public roadway, Brunswick-Golden Isles Airport, be used for...

  4. 76 FR 30533 - Amendment of Class E Airspace; Brunswick Malcolm-McKinnon Airport, GA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-26

    ... Federal Aviation Administration 14 CFR Part 71 Amendment of Class E Airspace; Brunswick Malcolm-McKinnon... amends Class E airspace at Brunswick, GA. The McKinnon Non-Directional Beacon (NDB) has been decommissioned and new Standard Instrument Approach Procedures (SIAPs) have been developed for...

  5. 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.

  6. 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…

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

    ERIC Educational Resources Information Center

    EdSource, 2004

    2004-01-01

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

  8. 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…

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

    PubMed Central

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

    2012-01-01

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

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

    USGS Publications Warehouse

    Winger, Parley V.; Lasier, Peter J.; Geitner, Harvey

    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 μg/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 μg/g, and polychlorobiphenyl (PCB) concentrations ranged from 67 to 95 μg/g. On a molar basis, acid-volatile sulfide concentrations (20–45 μmol/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.

  11. 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.

  12. 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

  13. Childhood Trauma.

    ERIC Educational Resources Information Center

    Falasca, Tony; Caulfield, Thomas J.

    1999-01-01

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

  14. [Facial trauma and multiple trauma].

    PubMed

    Corre, Pierre; Arzul, Ludovic; Khonsari, Roman Hossein; Mercier, Jacques

    2013-09-01

    The human face contains the sense organs and is responsible for essential functions: swallowing, chewing, speech, breathing and communication. It is also and most importantly the seat of a person's identity. Multiple trauma adds a life-threatening dimension to the physical and psychological impact of a facial trauma.

  15. Method development study for APR cartridge evaluation in fire overhaul exposures.

    PubMed

    Anthony, T Renée; Joggerst, Philip; James, Leonard; Burgess, Jefferey L; Leonard, Stephen S; Shogren, Elizabeth S

    2007-11-01

    In the US, firefighters do not typically wear respiratory protection during overhaul activities, although fitting multi-gas or chemical, biological, radiological and nuclear cartridges to supplied air respirator facepieces has been proposed to reduce exposures. This work developed a method to evaluate the effectiveness of respirator cartridges in smoke that represents overhaul exposures to residential fires. Chamber and penetration concentrations were measured for 91 contaminants, including aldehydes, polynuclear aromatic hydrocarbons, hydrocarbons and methyl isothiocyanate, along with total and respirable particulates. These laboratory tests generated concentrations in the range of field-reported exposures from overhaul activities. With limited tests, no styrene, benzene, acrolein or particulates were detected in air filtered by the respirator cartridge, yet other compounds were detected penetrating the respirator. Because of the complexity of smoke, an exposure index was determined for challenge and filtered air to determine the relative risk of the aggregate exposure to respiratory irritants. The primary contributors to the irritant exposure index in air filtered by the respirator were formaldehyde and acetaldehyde, with total hydrocarbons contributing only 1% to the irritant index. Respirator cartridges were adequate to minimize firefighter exposures to aggregate respiratory irritants if the American Conference of Governmental Industrial Hygienists ceiling limit for formaldehyde is used (0.3 ppm) but not if National Institute for Occupational Safety and Health Recommended Exposure Limit (NIOSH REL) (0.1 ppm) is used, where three of five concentrations in filtered air exceeded the NIOSH REL. Respirator certification allows 1 ppm of formaldehyde to pass through it when challenged at 100 ppm, which may not adequately protect workers to current short-term exposure/ceiling limits. The method developed here recommends specific contaminants to measure in future work

  16. A Proposal for Improvement of Supply Support for Ship Overhauls in the Hellenic Navy

    DTIC Science & Technology

    1988-12-01

    necessary and identify by block number) FIELD GROUP . LSUBGROLP Hellenic Navy, Inventory model, Supply support, Ship overhaul 𔄃 ABSTRACT (Continue on...1T4A6L4X 5305MI’-AW4428 * 53T4U4-AA45 * 53,4Cr4A6445 5305-D-0h14931 ** 5305-00-051c0? * 51Th -cD174h056 ** 53D5-O-1744057 ** 53054D-2253839 ** 5356 51 ~1E

  17. 78 FR 41185 - Notice of Opportunity for Public Comment on Surplus Property Release at Brunswick Executive...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ...Under the provisions of Title 49, U.S.C. 47153(d), notice is being given that the FAA is considering a request from Midcoast Regional Redevelopment Authority to waive the surplus property requirements for approximately 3.47 acres of airport property located at Brunswick Executive Airport in Brunswick, ME. It has been determined through study and master planning that the subject parcel will not......

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

    PubMed

    Webster, Reginald P; Demerchant, Ian

    2012-01-01

    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.

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

    PubMed Central

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

    2012-01-01

    Abstract 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. PMID:22539894

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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

    ... 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 for... Application To Export Electric Energy; New Brunswick Energy Marketing Corporation (f/k/a New Brunswick...

  7. 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...

  8. 75 FR 53197 - Restricted Area in Cape Fear River and Tributaries at Sunny Point Army Terminal, Brunswick County...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

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

  9. 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.

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

    PubMed Central

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

    2012-01-01

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

  11. 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

  12. Chest trauma.

    PubMed

    Budassi, S A

    1978-09-01

    For any patient with obvious or suspected chest trauma, one must first assure an adequate airway and adequate ventilation. One should never hesitate to administer oxygen to a victim with a chest injury. The nurse should be concerned with adequate circulation--this may mean the administration of intravenous fluids, specifically volume expanders, via large-bore cannulae. Any obvious open chest wound should be sealed, and any fractures should be splinted. These patients should be rapidly transported to the nearest Emergency Department capable of handling this type of injury. The majority of patients who arrive in the Emergency Department following blunt or penetrating trauma should be considered to be in critical condition until proven otherwise. On presentation, it is essential to recognize those signs, symptoms, and laboratory values that identify the patient's condition as life-threatening. Simple recognition of these signs and symptoms and early appropriate intervention may alter an otherwise fatal outcome.

  13. 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

  14. 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.

  15. 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.

  16. 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

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

    PubMed

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

    2016-01-01

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

  18. Sexual Health Education at School and at Home: Attitudes and Experiences of New Brunswick Parents.

    ERIC Educational Resources Information Center

    Weaver, Angela D.; Byers, E. Sandra; Sears, Heather A.; Cohen, Jacqueline N.; Randall, Hilary E. S.

    2002-01-01

    Examined New Brunswick parents' attitudes toward sexual health education (SHE) at school and home. Surveys of parents with K-8 children indicated that most parents believed: SHE should be provided in the school and shared between home and school; SHE should begin in elementary or middle school; and a broad range of topics should be included. Most…

  19. 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

  20. Beginning Teacher Induction Program in New Brunswick, 1996-97 Report.

    ERIC Educational Resources Information Center

    Scott, Neil H.

    This report describes the Beginning Teacher Induction Program (BTIP) in 12 New Brunswick anglophone school districts during 1996-1997. Data come from beginning teachers, mentors, principals and district coordinators who participated in the BTIP and completed a survey. Half of the mentors attended a mentor training workshop, an increase from the…

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

    ERIC Educational Resources Information Center

    Patterson, Martha

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

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

    ERIC Educational Resources Information Center

    Marino, Michael P.; Crocco, Margaret Smith

    2012-01-01

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

  3. 76 FR 34105 - Carolina Power & Light Company, Brunswick Steam Electric Plant Units 1 and 2; Exemption

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-10

    ... COMMISSION Carolina Power & Light Company, Brunswick Steam Electric Plant Units 1 and 2; Exemption 1.0 Background Carolina Power & Light Company, et al. (the licensee), is the holder of Facility Operating License... Carolina Power & Light Company an exemption from the requirements of 10 CFR 26.205(c) and (d) for...

  4. 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

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Carolina Power & Light Company, Brunswick Steam Electric Plant, Units 1 and 2; Exemption 1.0 Background Carolina Power & Light Company (CP&L, the licensee) is the holder of Facility Operating...

  5. 75 FR 17898 - Foreign-Trade Zone 144-Brunswick, GA; Application for Expansion and Reorganization Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-08

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE Foreign-Trade Zones Board Foreign-Trade Zone 144--Brunswick, GA; Application for Expansion and Reorganization Under Alternative Site Framework An application has been submitted to the Foreign-Trade Zones...

  6. 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, citizenship,…

  7. 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…

  8. 40 CFR 81.91 - Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 18 2013-07-01 2013-07-01 false Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region. 81.91 Section 81.91 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality...

  9. 40 CFR 81.91 - Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 18 2012-07-01 2012-07-01 false Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region. 81.91 Section 81.91 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality...

  10. 40 CFR 81.91 - Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 18 2014-07-01 2014-07-01 false Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region. 81.91 Section 81.91 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality...

  11. 40 CFR 81.91 - Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region. 81.91 Section 81.91 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality...

  12. 40 CFR 81.91 - Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 17 2011-07-01 2011-07-01 false Jacksonville (Florida)-Brunswick (Georgia) Interstate Air Quality Control Region. 81.91 Section 81.91 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality...

  13. Proposal for the Implementation of the New Brunswick Virtual Campus. Final Version.

    ERIC Educational Resources Information Center

    McGreal, Rory

    This document outlines a proposal for the implementation of "The Virtual Campus" program in New Brunswick, a distributed online learning environment that will support the participation of all regions of the province and all sectors involved in learning and training. It also supports the development of multimedia courseware at all…

  14. 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.

  15. 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.

  16. 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.

  17. 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…

  18. Depot Acquisition Management and Engineering Support for Close-in Weapon System (CIWS) Phalanx Mk 15 and FCS Mk 92/Gun Mount Mk 75 Overhaul Programs.

    DTIC Science & Technology

    1980-12-01

    Corporation’s work in support of the Navy’d Designated Overhaul Activity planning & acquisition efforts for the Close- In Weapon program. The work was...in sup- port of the Navy’s Designated Overhaul Activity planning and acquisition efforts for the Close-In Weapon Program. The work was performed from... design agent/ in-service engineering agent and interface with other data and management reporting systems. Operational recommendations should include

  19. 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.

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

    PubMed

    Galloro, Vince

    2002-11-11

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

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

    NASA Astrophysics Data System (ADS)

    Gray, Janet

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

  2. The "Ethics Rupture" Summit, Fredericton, New Brunswick, Canada, October 25-28, 2012.

    PubMed

    van den Hoonaard, Will C

    2013-02-01

    This report explains the background of the "Ethics Rupture" Summit held in New Brunswick, Canada, October 2012, focusing on the disconnect between research-ethics policies and the nature and purpose of social-science research-an unintended "rupture" in ethics governance. Ethics is about human relationships, and the governance of ethics must reflect that fact rather than function as a bureaucratic, self-legitimating system of control. The themes that emerged from the Summit point to: structural problems with the current system; an undermining of the original, historical mission of some social-science disciplines; a discomfort with new methodologies; ethics committees and the well-being and education of social-science students; the possibilities of reform and renewal; and the next steps. Finally, the report refers in broad outlines to a "New Brunswick Declaration," which is currently being considered by participants of the Summit.

  3. China's refiners face massive overhaul, expansion to meet demand growth, new crude slate

    SciTech Connect

    Not Available

    1994-05-09

    China's refining industry has embarked on a massive overhaul and expansion to accommodate soaring domestic growth in refined products demand. Currently that growth in demand is being met by increasing imports of refined products, in recent years attaining triple digit growth rates and squeezing direly needed foreign exchange. The focus is on adding refining capacity of about 1.4 million b/d to the current capacity of about 3.2 million b/d by 2000. Priority for increasing capacity is being given to expanding existing refineries and participating in foreign joint venture grassroots refineries along China's booming coastal regions as well as hiking output. A major challenge for China's refineries is that country's reentry into the General Agreement on Tariffs and Trade (GATT), recently signed in Morocco by more than 100 nations. The accompanying reduction of tariffs on imported refined products will make it more difficult for China's marginal refineries to compete in the domestic market. The paper discusses imports and exports, LPG outlook, refining capacity, revamps needed, third party processing, China's first joint venture refinery, industry plans, and GATT challenges.

  4. Province-wide adenovirus type 3 outbreak with severe cases in New Brunswick

    PubMed Central

    Girouard, Gabriel; Garceau, Richard; Thibault, Louise; Bourque, Christine; Bastien, Nathalie; Li, Yan

    2011-01-01

    Adenovirus is a commonly isolated virus in clinical samples. Life-threatening infections, although rare, are described worldwide. An epidemic spread of an adenovirus type 3 strain occurred in the province of New Brunswick during the fall of 2008 to the winter of 2009; it resulted in three severely ill patients, with one fatality. Adenovirus should be considered as a cause of severe community-acquired viral pneumonia, especially when the influenza test is negative. PMID:22379488

  5. New paleomagnetic data from carboniferous volcanics and red beds from central New Brunswick

    NASA Astrophysics Data System (ADS)

    Seguin, Maurice K.; Singh, A.; Fyffe, L.

    1985-02-01

    It has long been argued, on the basis of paleomagnetic data derived from Devonian, Carboniferous and Permian lithological units from eastern North America that a sinistral megashear of Carboniferous age parallels and lies within the faults delimiting the Appalachian-Caledonian chains. Recent paleomagnetic studies in the northern Appalachians have cast doubt on the models of a Carboniferous offset. The geologic evidence suggests that only a small amount of dextral (and not sinistral) strike slip has occurred on faults which are parallel with pre-Acadian paleogeographic realms. The purpose of this paleomagnetic study is to test the validity of the proposed left-lateral motion at one of the sites of its presumed passage in central New Brunswick. Six sites (80 oriented specimens) in Carboniferous red beds and volcanics were collected on both sides of the Fredericton Fault and other parallel faults. After AF and thermal cleaning, the mean direction of magnetization is 158° + 38° the fold test is indecisive. The corresponding paleopole is 135°E, 21°N and the paleolatitude 20°S. The paleopole positions and paleolatitudes are not significantly different on either side of the Fredericton fault and no left-lateral motion was detected by paleomagnetic means. As no such motion was detected in south-central New Brunswick and Newfoundland, it is possible but unlikely that it took place in northern New Brunswick and in the western Gaspé Peninsula. This contribution is useful in discussing possible motions of Acadia.

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

    NASA Astrophysics Data System (ADS)

    Quartuch, Michael R.; Beckley, Thomas M.

    2014-01-01

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

  7. 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.

  8. 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

  9. 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

  10. Ocular trauma in otolaryngology.

    PubMed

    Govett, G S; Amedee, R G

    1992-05-01

    Otolaryngologists are commonly called upon to emergently evaluate blunt trauma to the facial skeleton. These injuries are occasionally associated with serious trauma to the orbital contents. This manuscript reviews these orbital injuries by considering the pertinent eye anatomy and the extensive examination usually performed by an ophthalmologist. Anterior and posterior segment injuries along with specific trauma to the optic nerve will also be discussed.

  11. 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…

  12. Military Sexual Trauma

    MedlinePlus

    Military Sexual Trauma What is military sexual trauma (MST)? Military sexual trauma, or MST, is the term used by VA to refer to experiences of sexual assault ... that a Veteran experienced during his or her military service. The definition used by the VA comes ...

  13. Helping Youth Overcome Trauma

    ERIC Educational Resources Information Center

    Chambers, Jamie C.

    2005-01-01

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

  14. 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.

  15. Trauma system development.

    PubMed

    Lendrum, R A; Lockey, D J

    2013-01-01

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

  16. 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

  17. Comparison of CMA joint statement on resuscitative interventions and New Brunswick hospital corporations' policies on end-of-life treatments.

    PubMed

    Poirier, N

    2000-01-01

    Why do most physicians have so much difficulty respecting the wishes of their terminally ill patients who refuse treatment? The normative pluralism model is introduced to answer this question. Comparative content analysis serves as the theoretical framework for evaluating the Canadian Medical Association Joint Statement on Resuscitative Interventions against the corresponding administrative policies of New Brunswick hospital corporations and relevant New Brunswick law. Despite protection afforded patients by law, fully 75% of New Brunswick hospital corporations' administrative policies permit physicians to ignore patients' expressed objection to treatments. The futility-of-treatment criteria in the CMA joint statement and in all provincial hospital corporations' policies authorize physicians to substitute their judgment for patients' expressed refusal of CPR. The author concludes that when medical professional norms conflict with the law, physicians tend to follow their professional normative order.

  18. Saltwater intrusion in the Floridan aquifer system near downtown Brunswick, Georgia, 1957–2015

    USGS Publications Warehouse

    Cherry, Gregory S.; Peck, Michael

    2017-02-16

    IntroductionThe Floridan aquifer system (FAS) consists of the Upper Floridan aquifer (UFA), an intervening confining unit of highly variable properties, and the Lower Floridan aquifer (LFA). The UFA and LFA are primarily composed of Paleocene- to Oligocene-age carbonate rocks that include, locally, Upper Cretaceous rocks. The FAS extends from coastal areas in southeastern South Carolina and continues southward and westward across the coastal plain of Georgia and Alabama, and underlies all of Florida. The thickness of the FAS varies from less than 100 feet (ft) in aquifer outcrop areas of South Carolina to about 1,700 ft near the city of Brunswick, Georgia.Locally, in southeastern Georgia and the Brunswick– Glynn County area, the UFA consists of an upper water-bearing zone (UWBZ) and a lower water-bearing zone (LWBZ), as identified by Wait and Gregg (1973), with aquifer test data indicating the upper zone has higher productivity than the lower zone. Near the city of Brunswick, the LFA is composed of two permeable zones: an early middle Eocene-age upper permeable zone (UPZ) and a highly permeable lower zone of limestone (LPZ) of Paleocene and Late Cretaceous age that includes a deeply buried, cavernous, saline water-bearing unit known as the Fernandina permeable zone. Maslia and Prowell (1990) inferred the presence of major northeast–southwest trending faults through the downtown Brunswick area based on structural analysis of geophysical data, northeastward elongation of the potentiometric surface of the UFA, and breaches in the local confining unit that influence the area of chloride contamination. Pronounced horizontal and vertical hydraulic head gradients, caused by pumping in the UFA, allow saline water from the FPZ to migrate upward into the UFA through this system of faults and conduits.Saltwater was first detected in the FAS in wells completed in the UFA near the southern part of the city of Brunswick in late 1957. By the 1970s, a plume of groundwater

  19. Stage 1: Expression of interest and consultation document for natural gas distribution in New Brunswick

    SciTech Connect

    1998-12-01

    The New Brunswick government intends to award a franchise to establish natural gas distribution in the province. To this end, the province wishes to invite bids from qualified entities to establish gas distribution facilities. The province will select the preferred bidder(s) through a two-stage competitive bidding process. This document details the province`s policy objectives, questions and issues to be addressed in stage 1 of the process, and the schedule for the process. Appendices include copies of relevant provincial statutes and regulations.

  20. 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

  1. Cooperative Education in the New Brunswick Community College System. Interim Report--Phase 1 = L'enseignement cooperatif dans le systeme du College communautaire du Nouveau-Brunswick. Rapport provisoire: phase 1.

    ERIC Educational Resources Information Center

    New Brunswick Labour Force Development Board, Fredericton.

    In an effort to improve cooperative education (CE) programs, or those which formally integrate academic studies with work experience, in the New Brunswick Community College System (Canada), a study was conducted to explore the current status and structure of existing CE programs and determine approaches for future program development. This report…

  2. About Military Sexual Trauma

    MedlinePlus Videos and Cool Tools

    ... out why Close About Military Sexual Trauma Veterans Health Administration Loading... Unsubscribe from Veterans Health Administration? Cancel Unsubscribe Working... Subscribe Subscribed Unsubscribe 12, ...

  3. 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

  4. 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

  5. A Research Report on New Brunswick School Drop-Outs in the Academic Year 1963-1964.

    ERIC Educational Resources Information Center

    Drummie, Mary A.

    This study of dropouts from New Brunswick (Canada) schools presents a description of dropout characteristics and makes a comparison with findings of the dropout profile from the preceding year. Six variables were found to be stable factors--sex, original language (French or English), end result of leaving school (work, school, or other), grade…

  6. Defense Infrastructure: DOD Used Available Guidance in Its Decision to Discontinue Commissary Operations at NAS Brunswick, but Criteria Needs Clarification

    DTIC Science & Technology

    2011-04-20

    cost of goods includes the invoice cost of the items plus an additional 1 percent for theft, spoilage , or damage to goods, known as “shrinkage.” DOD...integral element of the military pay and benefits package for active-duty personnel. DOD’s decision to discontinue commissary operations at NAS Brunswick

  7. 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

    ... roadways in the area. Storm Water Management: Storm water mitigation will be outlined by the developer in a storm water management plan, as required by the Town of Brunswick. Sediment and Erosion Control... transfer to address storm water management, Energy/LEED, and construction emissions requirements. The...

  8. 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

  9. 33 CFR 334.450 - Cape Fear River and tributaries at Sunny Point Army Terminal, Brunswick County, NC; restricted area.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  10. 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...

  11. 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...

  12. 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...

  13. 75 FR 53264 - Restricted Area in Cape Fear River and Tributaries at Sunny Point Army Terminal, Brunswick County...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

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

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-30

    ... COMMISSION Carolina Power & Light; Brunswick Steam Electric Plant, Units 1 and 2; Independent Spent Fuel... Resulting From the Proposed Merger Between Progress Energy, Inc. and Duke Energy Corporation, and... BSEP Independent Spent Fuel Storage Installation, currently held by Carolina Power & Light Company,...

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

    PubMed

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

    2016-01-01

    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.

  16. Ultrasound in trauma.

    PubMed

    Rippey, James C R; Royse, Alistair G

    2009-09-01

    Point-of-care ultrasound is well suited for use in the emergency setting for assessment of the trauma patient. Currently, portable ultrasound machines with high-resolution imaging capability allow trauma patients to be imaged in the pre-hospital setting, emergency departments and operating theatres. In major trauma, ultrasound is used to diagnose life-threatening conditions and to prioritise and guide appropriate interventions. Assessment of the basic haemodynamic state is a very important part of ultrasound use in trauma, but is discussed in more detail elsewhere. Focussed assessment with sonography for Trauma (FAST) rapidly assesses for haemoperitoneum and haemopericardium, and the Extended FAST examination (EFAST) explores for haemothorax, pneumothorax and intravascular filling status. In regional trauma, ultrasound can be used to detect fractures, many vascular injuries, musculoskeletal injuries, testicular injuries and can assess foetal viability in pregnant trauma patients. Ultrasound can also be used at the bedside to guide procedures in trauma, including nerve blocks and vascular access. Importantly, these examinations are being performed by the treating physician in real time, allowing for immediate changes to management of the patient. Controversy remains in determining the best training to ensure competence in this user-dependent imaging modality.

  17. Thromboprophylaxis for trauma patients

    PubMed Central

    Lozano, Luis Manuel Barrera; Perel, Pablo; Ker, Katharine; Cirocchi, Roberto; Farinella, Eriberto; Morales, Carlos Hernando

    2014-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of thromboprophylaxis in trauma patients on mortality and incidence of DVT and PE. To compare the effects of different thromboprophylaxis interventions and their relative effects according to the type of trauma. PMID:25267908

  18. 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.

  19. Children and Facial Trauma

    MedlinePlus

    ... up after Facial trauma: A prospective study. Otolaryngol Head Neck Surg 1997: 117:72-75 Kim MK, Buchman ... trauma in children: An urban hospital’s experience. Otolaryngoly–Head Neck Surgery 2000: 123: 439-43 Patient Health Home ...

  20. Advances in forefoot trauma.

    PubMed

    Clements, J Randolph; Schopf, Robert

    2013-07-01

    Forefoot traumas, particularly involving the metatarsals, are commonly occurring injuries. There have been several advances in management of these injuries. These advances include updates in operative technique, internal fixation options, plating constructs, and external fixation. In addition, the advances of soft tissue management have improved outcomes. This article outlines these injuries and provides an update on techniques, principles, and understanding of managing forefoot trauma.

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

    USGS Publications Warehouse

    Fine, Jason M.; Cunningham, William L.

    2001-01-01

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

  2. Trauma: the seductive hypothesis.

    PubMed

    Reisner, Steven

    2003-01-01

    In much of contemporary culture, "trauma" signifies not so much terrible experience as a particular context for understanding and responding to a terrible experience. In therapy, in the media, and in international interventions, the traumatized are seen not simply as people who suffer and so are deserving of concern and aid; they are seen also as people who suffer for us, who are given special dispensation. They are treated with awe if they tell a certain kind of trauma story, and are ignored or vilified if they tell another. Trauma has become not simply a story of pain and its treatment, but a host of sub-stories involving the commodification of altruism, the justification of violence and revenge, the entry point into "true experience," and the place where voyeurism and witnessing intersect. Trauma is today the stuff not only of suffering but of fantasy. Historically, trauma theory and treatment have shown a tension, exemplified in the writings of Freud and Janet, between those who view trauma as formative and those who view it as exceptional. The latter view, that trauma confers exceptional status deserving of special privilege, has gained ground in recent years and has helped to shape the way charitable dollars are distributed, how the traumatized are presented in the media, how governments justify and carry out international responses to trauma, and how therapists attend to their traumatized patients. This response to trauma reflects an underlying, unarticulated belief system derived from narcissism; indeed, trauma has increasingly become the venue, in society and in treatment, where narcissism is permitted to prevail.

  3. 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.

  4. [Pediatric multiple trauma].

    PubMed

    Auner, B; Marzi, I

    2014-05-01

    Multiple trauma in children is rare so that even large trauma centers will only treat a small number of cases. Nevertheless, accidents are the most common cause of death in childhood whereby the causes are mostly traffic accidents and falls. Head trauma is the most common form of injury and the degree of severity is mostly decisive for the prognosis. Knowledge on possible causes of injury and injury patterns as well as consideration of anatomical and physiological characteristics are of great importance for treatment. The differences compared to adults are greater the younger the child is. Decompression and stopping bleeding are the main priorities before surgical fracture stabilization. The treatment of a severely injured child should be carried out by an interdisciplinary team in an approved trauma center with expertise in pediatrics. An inadequate primary assessment involves a high risk of early mortality. On the other hand children have a better prognosis than adults with comparable injuries.

  5. Military Sexual Trauma

    MedlinePlus

    ... Budget, & Performance VA Center for Innovation (VACI) Agency Financial Report (AFR) Budget Submission Recovery Act Resources Business ... Depression Military Sexual Trauma PTSD Schizophrenia Substance Use Suicide Prevention I am a... Returning Veteran Veteran in ...

  6. 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.

  7. Men and Sexual Trauma

    MedlinePlus

    ... are some symptoms related to sexual trauma in boys and men? Particularly when the assailant is a ... those who do not. Emotional Disorders Men and boys who have been sexually assaulted are more likely ...

  8. Thromboembolic Complications Following Trauma

    DTIC Science & Technology

    2009-12-01

    injury in blunt trauma.15,16 Of the 114 patients, 73 received either antiplatelet agents or anticoagulation , and none developed strokes. The remaining...41 patients were determined to have contraindications to anticoagu- lation and did not receive heparin or antiplatelet agents . Of these, 19 (46...continue to be exam- ined. As prohemostatic agents are being used more frequently in trauma, it is important to understand the natural history of

  9. 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.

  10. Hypothermia in trauma.

    PubMed

    Moffatt, Samuel Edwin

    2013-12-01

    Hypovolaemic shock that results through traumatically inflicted haemorrhage can have disastrous consequences for the victim. Initially the body can compensate for lost circulating volume, but as haemorrhage continues compensatory mechanisms fail and the patient's condition worsens significantly. Hypovolaemia results in the lethal triad, a combination of hypothermia, acidosis and coagulopathy, three factors that are interlinked and serve to worsen each other. The lethal triad is a form of vicious cycle, which unless broken will result in death. This report will focus on the role of hypothermia (a third of the lethal triad) in trauma, examining literature to assess how prehospital temperature control can impact on the trauma patient. Spontaneous hypothermia following trauma has severely deleterious consequences for the trauma victim; however, both active warming of patients and clinically induced hypothermia can produce particularly positive results and improve patient outcome. Possible coagulopathic side effects of clinically induced hypothermia may be corrected with topical haemostatic agents, with the benefits of an extended golden hour given by clinically induced hypothermia far outweighing these risks. Active warming of patients, to prevent spontaneous trauma induced hypothermia, is currently the only viable method currently available to improve patient outcome. This method is easy to implement requiring simple protocols and contributes significantly to interrupting the lethal triad. However, the future of trauma care appears to lie with clinically induced therapeutic hypothermia. This new treatment provides optimism that in the future the number of deaths resulting from catastrophic haemorrhaging may be significantly lessened.

  11. 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

  12. Trauma in pregnancy.

    PubMed

    Brown, Haywood L

    2009-07-01

    Acute traumatic injury during pregnancy is a significant contributor to maternal and fetal morbidity and mortality in the United States. Motor vehicle accidents are the leading cause of injury-related maternal death, followed by violence and assault. Lack of seat belts or other restraints increases the risks of both maternal and fetal morbidity and mortality. The American College of Obstetricians and Gynecologists recommends proper seat belt use by all pregnant women and screening for domestic abuse. Maternal injury and death from physical abuse is prevalent, and in some communities, homicide is a major cause of pregnancy-associated maternal death. Blunt trauma most often occurs as a result of motor vehicle accidents, whereas penetrating trauma results from gunshots or stabbings. Blunt trauma to the abdomen increases the risk for placental abruption, and direct fetal injury is more likely with penetrating trauma. Management strategies in acute maternal trauma must focus on a thorough assessment of the mother. A coordinated team effort that includes the obstetrician is essential to ensure optimal maternal and fetal outcomes. Imaging studies should not be delayed because of concerns of fetal radiation exposure, because the risk is minimal with usual imaging procedures, especially in mid-to-late pregnancy. The obstetrician should serve in a consultative role if nonobstetric surgical care is required and must also be prepared to intervene on behalf of the mother and the fetus if trauma care is compromised by the pregnancy. Perimortem cesarean delivery should be considered early in the resuscitation of a pregnant trauma victim, especially when fetal viability is a concern. Once the mother is stabilized in the emergency setting, she should be transported for appropriate maternal and fetal observation until both mother and fetus are clear of danger. It is essential that the clinician and staff maintain thorough and accurate documentation and recording of the chronology of

  13. Toxicological screening in trauma

    PubMed Central

    Carrigan, T; Field, H; Illingworth, R; Gaffney, P; Hamer, D

    2000-01-01

    Objectives—To determine the prevalence and patterns of alcohol and drug use in patients with major trauma. Methods—Consecutive trauma patient enrolment, 24 hours a day, was envisaged with anonymised patient data on gender, age band, and mechanism of injury collected. The study group had surplus plasma quantitatively analysed for ethanol concentration, and urine samples were initially screened, via immunoassay, for opiates, cannabinoids, amphetamines, benzodiazepines, cocaine, and methadone. Confirmation and specification of individual positive results was then performed using thin layer or gas-liquid chromatography. Drugs of treatment given in the resuscitation room, if subsequently detected in the urine samples, were excluded from the final results. Results—There were 116 eligible trauma patients assessed and treated in the resuscitation room over a six month period, of which 93 (80%) were enrolled. Altogether 27% of this trauma population had plasma ethanol concentrations greater than 80 mg/dl. There was a significantly higher prevalence of alcohol intoxication in the group not involved in a road traffic accident (RTA) compared with the group who were involved in a RTA. Initial screening of urine for drugs revealed a prevalence of 51%. After 12 exclusions due to iatrogenic administration of opiates, the final confirmed prevalence was 35% in this trauma population. The individual drug prevalence was 13% for cannabinoids, 11% for codeine, 8% for morphine, 6% for amphetamine, 6% for benzodiazepines, 3% for cocaine, 1% for dihydrocodeine, and 1% for methadone. Conclusions—There is a notable prevalence of drug and alcohol use in this British accident and emergency trauma population. A significantly higher prevalence for alcohol intoxication was found in the non-RTA group compared with the RTA group. The patterns of drug usage detected reflect local influences and less cocaine use is seen compared with American studies. The association between alcohol, drugs

  14. Physician characteristics and prescribing for elderly people in New Brunswick: relation to patient outcomes.

    PubMed Central

    Davidson, W; Molloy, D W; Bédard, M

    1995-01-01

    OBJECTIVE: To examine the relation between physician characteristics, prescribing behaviour and patient outcomes. DESIGN: Descriptive study linking four provincial databases. SETTING: New Brunswick. PARTICIPANTS: All 366 general practitioners (GPs) (accounting for 40% of all physicians with a general licence in New Brunswick) who ordered at least 200 prescriptions for elderly beneficiaries of the New Brunswick Prescription Drug Program and saw at least 20 elderly patients in an office setting between Apr. 1, 1990, and Mar. 31, 1991. Physicians with palliative care practices were excluded. OUTCOME MEASURES: GPs' personal, professional and practice characteristics, their prescribing patterns, and mortality, morbidity (number of days in hospital per patient) and hip-fracture rates among their elderly patients. RESULTS: Compared with the GPs who had a lower mortality rate, those with a higher mortality rate prescribed more drugs overall (p < 0.001), specifically antidepressants, bronchodilators, cholesterol-lowering agents, gastrointestinal drugs, neuroleptics and nonsteroidal anti-inflammatory drugs (NSAIDs). They also were more likely to be male (p < 0.01), had larger practices (p < 0.001), saw more patients per day (p < 0.05) and billed more per year (p < 0.001). Compared with the GPs who had a lower morbidity rate, those with a higher morbidity rate prescribed more drugs overall (p < 0.005), specifically bronchodilators, gastrointestinal drugs and NSAIDs. They also were more likely to be younger (p < 0.005) and male (p < 0.01), had fewer years in practice (p < 0.001), saw more patients per day (p < 0.05) and billed more per patient (p < 0.01). The GPs who had a higher hip-fracture rate prescribed more drugs overall (p < 0.001), notably antihypertensives, bronchodilators, cholesterol-lowering agents, gastrointestinal drugs and NSAIDs, than those who had a lower hip-fracture rate. They also had a larger practice (p < 0.001), practised more days per year (p < 0

  15. 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.

  16. Progress in Medicine: Compensation and medical negligence in India: Does the system need a quick fix or an overhaul?

    PubMed Central

    Chandra, Meghana S.; Math, Suresh Bada

    2016-01-01

    In a recent judgment on medical negligence, the Supreme Court awarded compensation amounting to Rs. 11 crore to a victim, which was to be paid by the doctors and the private hospital deemed responsible for the wrongful death of a patient. This landmark decision was by far the largest compensation award in the history of Indian medical negligence litigation. Hence, the process of calculating compensation for medical negligence has received great attention and debate, largely due to the impact that it is going to have on the practice of medicine within the country, in the near future. However, the method of calculation of compensation is unpredictable as it varies hugely across different cases, courts and tribunals resulting, in a loss of faith in the system, protracted litigation, and frequent appeals. With over 80% of India's healthcare being provided by the private sector, predictability and uniformity in the regulation of compensation in medical negligence would benefit the victims and the doctors concerned. A basic knowledge of how medical negligence compensation is calculated and adjudicated in the judicial courts of India will aid a doctor in planning his/her professional indemnity insurance, as well as in practicing his/her profession without undue worry about facing litigation for alleged medical negligence. This article addresses the merits and demerits of large compensation awards, and also discusses whether the system is broken, needs a quick fix, or a massive overhaul. PMID:27891021

  17. 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

  18. 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

  19. 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…

  20. A novel trauma model: naturally occurring canine trauma.

    PubMed

    Hall, Kelly E; Sharp, Claire R; Adams, Cynthia R; Beilman, Gregory

    2014-01-01

    In human trauma patients, most deaths result from hemorrhage and brain injury, whereas late deaths, although rare, are the result of multiple organ failure and sepsis. A variety of experimental animal models have been developed to investigate the pathophysiology of traumatic injury and evaluate novel interventions. Similar to other experimental models, these trauma models cannot recapitulate conditions of naturally occurring trauma, and therefore therapeutic interventions based on these models are often ineffective. Pet dogs with naturally occurring traumatic injury represent a promising translational model for human trauma that could be used to assess novel therapies. The purpose of this article was to review the naturally occurring canine trauma literature to highlight the similarities between canine and human trauma. The American College of Veterinary Emergency and Critical Care Veterinary Committee on Trauma has initiated the establishment of a national network of veterinary trauma centers to enhance uniform delivery of care to canine trauma patients. In addition, the Spontaneous Trauma in Animals Team, a multidisciplinary, multicenter group of researchers has created a clinical research infrastructure for carrying out large-scale clinical trials in canine trauma patients. Moving forward, these national resources can be utilized to facilitate multicenter prospective studies of canine trauma to evaluate therapies and interventions that have shown promise in experimental animal models, thus closing the critical gap in the translation of knowledge from experimental models to humans and increasing the likelihood of success in phases 1 and 2 human clinical trials.

  1. 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

  2. Tectonic control of Triassic sedimentation in southern New Brunswick: Local and regional implications

    NASA Astrophysics Data System (ADS)

    Nadon, G. C.; Middleton, G. V.

    1984-10-01

    Both regional and local tectonics controlled the sediment distribution in the Fundy half-graben during the Triassic. Locally, alluvial fans built out into the basin from the western boundary fault along what is now the south shore of New Brunswick. The alluvial fan red beds of the Honeycomb Point Formation are covered by fluvial conglomerates of the Quaco Formation, which in turn are buried by a resurgence of alluvial fan deposition represented by the Echo Cove Formation. Pollen recovered from the upper part of the Echo Cove Formation indicates that, regionally, the system of Triassic-Jurassic grabens along the eastern seaboard is composed of two separate graben systems; one stretching from South Carolina to Connecticut, the other from the Gulf of Maine to the southern Grand Banks. Initial graben formation began at the southern end of each system, followed by successive grabens opening toward the north. The areal distribution of both graben systems appears to have been controlled by four large transform-fault systems from the Middle Triassic through the Jurassic. The age and overall distribution of sediments within the Fundy Basin confirm the existence of a hot spot along the Kelvin Seamount chain and refines determination of the position and timing of the initial rifting that led to the formation of the present Atlantic Ocean.

  3. Participation and retention in the breast cancer screening program in New Brunswick Canada.

    PubMed

    McDonald, James Ted; Wang, Yunli; Liu, Zikuan

    2017-06-01

    New Brunswick (NB) Canada uses its breast cancer screening service program to assess the extent to which eligible NB women are complying with mammography guidelines. While many studies have investigated factors associated with participation in periodic breast cancer screening in Canada and elsewhere, most work has relied on self-reported surveys or smaller scale primary data collection. Using a longitudinal administrative dataset for NB over the period 1996-2011 of 255,789 eligible women aged 45-69, this study examined demographic, socioeconomic and geographic factors associated with initial participation in regular screening at age 50 and ongoing retention in the program. Logistic regression was used to examine correlates of initial screening, while rescreening participation was estimated using survival analysis accounting for rescreening episodes. Initial screening participation was lower for women born outside of NB, many women living farther away from screening centers, women in rural areas, and higher for married women. In contrast, retention was higher for rural women and women recently arrived in NB. For both participation and retention, regional disparities across health zone persisted after controlling for observable personal and locational factors. The analysis highlights important characteristics to be targeted to increase screening but also that how health zones operate their screening programs exerts a very significant effect on the use of screening services by eligible women. This offers lessons for the design and evaluation of any cancer screening program.

  4. Availability of nutrition screening parameters in New Brunswick hospitals and nursing homes.

    PubMed

    Caissie, Isabelle; Villalon, Lita; Carrier, Natalie; Laporte, Manon

    2012-01-01

    We explored the availability of parameters for a nutrition screening system among elderly people in New Brunswick (NB) health care facilities. Patients aged 65 or older were asked to participate in the study; each participant had been admitted to one of four hospitals or lived in one of six nursing homes. Availability of nutrition screening parameters (weight, height, weight change, serum albumin level, appetite, and food intake record) was assessed by auditing the participants' medical charts. When data were not available, the feasibility of obtaining them was determined. Additional data related to nutrition screening were also obtained. In total, 421 participants were recruited for the study: 140 (33.2%) who lived in nursing homes and 281 (66.8%) who were in hospitals. Parameters needed to conduct nutrition screening, such as weight upon admission, were available for 83.6% of participants; usual weight was available for 43.0%, height for 86.0%, and serum albumin level for 47.5%. Our findings show that basic parameters for nutrition screening are available, and that implementation of a nutrition screening system is feasible for patients in NB health care facilities.

  5. 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.

  6. 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.

  7. 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.

  8. [A participatory approach for the prevention of type 2 diabetes for francophone youth of New Brunswick].

    PubMed

    Villalon, Lita; Leclair, Cédée-Anne

    2004-01-01

    Diabetes, a serious public health problem, is on the rise, claiming millions of victims. A considerable body of research exists on diabetes, but the development of effective primary prevention strategies is just beginning. This article presents the results of a project, based on an innovative approach where health professionals and community groups have come together to address the issue. The purpose of the project is to develop an intervention strategy for the prevention of type 2 diabetes directed at young francophones living in a minority environment in New Brunswick and adapted to their needs. Qualitative data were gathered from two focus groups and submitted for a content analysis. The process was evaluated. The young francophones have identified the school environment as ideal for intervention. According to them, the intervention should be adapted to the age of the youths. For the 5-to-13-year-old group, the intervention should target healthy eating habits and physical activity whereas for the 14-to-18-year-old group, the emphasis should be on preventing diabetes. The youth and the professionals acquired a greater understanding of the problem of diabetes and its prevention. Youth can now proceed to action, with appropriate guidance. The experience and knowledge of the professionals contributed to the development of the strategy. A shortage of dietitians in public health to work in the area of the prevention of diabetes has been noted.

  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. Physician recruitment and retention in New Brunswick: a medical student perspective

    PubMed Central

    Giberson, Mariah; Murray, Joshua; Percy, Edward

    2016-01-01

    Background Physician recruitment and retention is a priority for many Canadian provinces. Each province is unique in terms of recruitment strategies and packages offered; however, little is known about how medical students evaluate these programs. The purpose of the current study was to determine which factors matter most to New Brunswick (NB) medical students when considering their location of future practice. Method A survey of NB medical students was conducted. Descriptive statistics were produced and a linear regression model was developed to study factors predictive of a student’s expressed willingness to practice in NB. Results 158 medical students completed the online survey, which is a response rate of 55%. Job availability and spouse’s ability to work in the province were ranked as the top factors in deciding where to practice. In the final regression model, factors predictive of an expressed desire to practice in NB include being female, living in NB prior to medical school, attending medical school at Université de Sherbrooke, participation in the NB Preceptorship program, and a desire to practice family medicine. Conclusions This study provides insight into what medical students consider when deciding where to practice. This research may be used to inform physician recruitment efforts and guide future research into medical education and policy. PMID:28344691

  11. A sublittoral hard substrate epibenthic community below 30 m in head harbour passage, New Brunswick, Canada

    NASA Astrophysics Data System (ADS)

    Logan, Alan

    1988-10-01

    A sublittoral hard substrate epibenthic community has been photographically sampled mainly between depths of 30 and 140 m along two transects in Head Harbour Passage, Bay of Fundy, New Brunswick. A diverse biota of sponges, hydroids, anemones, polychaetes, brachiopods, molluscs, arthropods, echinoderms and tunicates is present throughout the depth range, but is dominated, in terms of abundance, by tubularian and campanularian hydroids, the anemone Tealia felina and the bivalve Modiolus modiolus. Cluster analysis revealed 5-6 clusters from each transect, separable on the basis of minor biological, as well as abundance, differences in the main taxa, within the depth range sampled. Abundance-depth data from each transect indicate an absence of encrusting coralline algae below 30 m and a gradual reduction in abundance of the sea urchin Strongylocentrotus droebachiensis and the brachiopod Terebratulina septentrionalis with increasing depth. In contrast, there is a gradual, but significant, increase in the abundance of tubularian hydroids, Tealia felina and Modiolus modiolus, with increasing depth. This community below about 30 m in Head Harbour Passage is here designated the Tubularia-Tealia felina-Modiolus modiolus community and forms part of the circalittoral subzone, sharing a gradational boundary with the overlying Terebratulina septentrionalis community.

  12. 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.

  13. 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…

  14. Ultrasound in cardiac trauma.

    PubMed

    Saranteas, Theodosios; Mavrogenis, Andreas F; Mandila, Christina; Poularas, John; Panou, Fotios

    2017-04-01

    In the perioperative period, the emergency department or the intensive care unit accurate assessment of variable chest pain requires meticulous knowledge, diagnostic skills, and suitable usage of various diagnostic modalities. In addition, in polytrauma patients, cardiac injury including aortic dissection, pulmonary embolism, acute myocardial infarction, and pericardial effusion should be immediately revealed and treated. In these patients, arrhythmias, mainly tachycardia, cardiac murmurs, or hypotension must alert physicians to suspect cardiovascular trauma, which would potentially be life threatening. Ultrasound of the heart using transthoracic and transesophageal echocardiography are valuable diagnostic tools that can be used interchangeably in conjunction with other modalities such as the electrocardiogram and computed tomography for the diagnosis of cardiovascular abnormalities in trauma patients. Although ultrasound of the heart is often underused in the setting of trauma, it does have the advantages of being easily accessible, noninvasive, and rapid bedside assessment tool. This review article aims to analyze the potential cardiac injuries in trauma patients, and to provide an elaborate description of the role of echocardiography for their accurate diagnosis.

  15. 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…

  16. 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.…

  17. 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

  18. 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.

  19. 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).

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

    PubMed

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

    1996-12-01

    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.

  1. 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.

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

    SciTech Connect

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

    1983-03-01

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

  3. 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

  4. 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.

  5. Operation Brain Trauma Therapy

    DTIC Science & Technology

    2011-10-01

    OBTT consortium as the drug #2 for primary screening . Based on that same review , two doses were selected, namely 5000 or 10,000 IU/kg, by a single IV...in drug screening . This review article discusses a consortium called opera- tion brain trauma therapy (OBTT) that was recently established in attempt...consortium that identifies the most promising therapies and compares them across a spectrum of the state -of-the- art models and injury levels. The most

  6. 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.

  7. Trauma in pregnancy.

    PubMed

    Bremer, C; Cassata, L

    1986-12-01

    The pregnant woman is exposed to the same risks as the non-pregnant woman for sustaining a traumatic injury, but because of the multiple physiologic changes that occur during pregnancy, the assessment and treatment of such patients must be adapted accordingly. This article discusses these normal physiologic changes, their effect on response to trauma, and the comprehensive care of the patient using the nursing process.

  8. Endovascular Therapy in Trauma

    DTIC Science & Technology

    2014-11-23

    patients. The use of endovascu- lar techniques in trauma can be considered in three broad categories: (1) large- vessel repair (e.g. covered stent repair...2) mid- to small- vessel hemostasis (e.g. coils, plugs, and hemostatic agents), and (3) large- vessel balloon occlusion for resuscitation (e.g...a diagnostic contrast study (i.e. angiography), accomplish large- vessel occlusion, or render a therapy for vessel disruption and/or bleeding. Not

  9. 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.

  10. 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

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

    DTIC Science & Technology

    2015-12-01

    funding . The infrastructure/process is streamlined and efficient leading to the selection of research projects based on a solid scientific, peer review...National Trauma Institute (NTI) to build on the establishment of NTI as a national coordinating center for trauma research funding . In addition, a... research funding . 1. Requests for proposals (RFP) based on areas of scientific merit in trauma and emergency or critical care will be prepared and

  12. Trauma surgery: discipline in crisis.

    PubMed

    Green, Steven M

    2009-02-01

    Throughout the past quarter century, there have been slow but dramatic changes in the nature and practice of trauma surgery, and this field increasingly faces potent economic, logistic, political, and workforce challenges. Patients and emergency physicians have much to lose by this budding crisis in our partner discipline. This article reviews the specific issues confronting trauma surgery, their historical context, and the potential directions available to this discipline. Implications of these issues for emergency physicians and for trauma care overall are discussed.

  13. 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.

  14. NASA overhauls grant process

    NASA Astrophysics Data System (ADS)

    Simarski, Lynn Teo

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

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

    ERIC Educational Resources Information Center

    McFadden, Charles

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

  16. 33 CFR 334.450 - Cape Fear River and tributaries at Sunny Point Army Terminal, Brunswick County, N.C.; restricted...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  17. Student Recruitment and Retention in Small Colleges: Colleges of Pride, Determination, and Optimism. A Study of The Brunswick Foundation's Small College Program.

    ERIC Educational Resources Information Center

    Brunswick Foundation, Inc., Skokie, IL.

    Student recruitment and retention at small colleges are considered, and Brunswick Foundation's Small College Program is described. An overview considers problems of small colleges (those with enrollments of 2,000 and less), and the Foundations's approach to meeting the needs of small colleges. The Foundation's Small College Program, which provides…

  18. Acute brain trauma

    PubMed Central

    Martin, GT

    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. PMID:26688392

  19. 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.

  20. 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.

  1. 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

  2. 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…

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    PubMed

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

    2008-01-24

    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

  5. Geochemical Evolution of Induced Infiltration in a River-Recharged Aquifer System: Fredericton, New Brunswick, Canada

    NASA Astrophysics Data System (ADS)

    Al, T.; Amskold, L.

    2004-05-01

    The city of Fredericton, New Brunswick, Canada relies on groundwater from a glacial aquifer in the Saint John River valley. The aquifer is a semi-confined esker discontinuously overlain by clay/silt of glacio-lacustrine and/or marine origin. Recharge to the well field occurs partly from the adjacent river where a discontinuity in the confining layer allows for hydraulic connection with the river. It has been suggested that elevated Mn concentrations in the groundwater supply are related to reductive dissolution of Mn-oxide minerals in the aquifer as a result of the infiltration of dissolved organic carbon from the river. A detailed hydrogeochemical study has been conducted to investigate redox conditions along a flow path from the river bed to a nearby water-supply well. Aqueous geochemical data from multi-level piezometers along the flow path display variations in redox-sensitive solutes (O2, NO3, Mn, Fe, SO4 and HS) in space and time. The redox conditions cycle on a seasonal time scale, likely in response to temperature changes in the infiltrating river water. In the spring and early summer the conditions are relatively oxidizing with elevated concentrations of dissolved O2 and NO3, and low concentrations of Mn and Fe. Toward late summer, and into the fall, the system tends toward more reducing conditions, with concentrations of dissolved O2 and NO3 declining, and concentrations of Mn and Fe increasing. Localized zones of elevated HS concentrations suggest that SO4 reduction occurs, however, the seasonal trend toward reducing conditions is not manifest by a widespread decline in SO4 concentrations as it is for O2 and NO3. The data are generally consistent with trends that are expected based on thermodynamics, with O2 reduction followed by NO3, MnIV, FeIII and SO4 reduction, however, in some locations these respective redox zones are superimposed. The observed overlap of redox zones is likely attributable to a combination of variable reaction kinetics (probably

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

    USGS Publications Warehouse

    Morin, Roger H.; Senior, Lisa A.; Decker, Edward 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 is

  7. Trauma, narcissism and the two attractors in trauma.

    PubMed

    Gerzi, Shmuel

    2005-08-01

    In this paper, the author sets out to distinguish anew between two concepts that have become sorely entangled--'trauma' and 'narcissism'. Defining 'narcissism' in terms of an interaction between the selfobject and the self that maintains a protective shield, and 'trauma' as attacks on this protective shield, perpetrated by bad objects, he introduces two attractors present in trauma--'the hole attractor' and the structure enveloping it, 'the narcissistic envelope'. The hole attractor pulls the trauma patient, like a 'black hole', into a realm of emotional void, of hole object transference, devoid of memories and where often in an analyst's countertransference there are no reverberations of the trauma patient's experience. In the narcissistic envelope, on the other hand, motion, the life and death drive and fragments of memory do survive. Based on the author's own clinical experience with Holocaust survivors, and on secondary sources, the paper concludes with some clinical implications that take the two attractors into account.

  8. 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…

  9. Occlusal trauma--periodontal concerns.

    PubMed

    Hallmon, W W

    2001-10-01

    While there is evidence that suggests that occlusal trauma is a risk factor for periodontal destruction, there is no evidence that indicates that occlusal trauma will initiate periodontal destruction. Effective plaque control and compliance with periodontal maintenance recommendations are key and essential factors necessary to assure successful treatment and control of periodontal disease.

  10. 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.

  11. 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.

  12. Vascular trauma historical notes.

    PubMed

    Rich, Norman M

    2011-03-01

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

  13. Orthopedic trauma in pregnancy.

    PubMed

    Desai, Pratik; Suk, Michael

    2007-11-01

    Trauma sustained during pregnancy can trigger uncertainty and anxiety for patient and orthopedic surgeon alike. In particular, orthopedic-related injuries raise concerns about preoperative, intraoperative, and postoperative care. In this article, we review common concerns about radiation exposure, leukemia, pain management, anticoagulation, and anesthesia. One finding is that radiation risk is minimal when obtaining x-rays for operative planning, provided that the cumulative dose is within 5 rad. We also address safety concerns about patient positioning and staff radiation exposure. In addition, we found that most anesthetics used in pregnancy are category C (ie, safe). Perioperative opioid use for pain management is recommended with little risk. Regarding anticoagulation, low-molecular-weight heparin and fondaparinux are the safest choices. Last, pregnancy is not a contraindication to operative management of pelvic and acetabular fractures.

  14. 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.

  15. Penetrating neck traumas

    PubMed Central

    Kaczmarski, Jacek; Brzeziński, Daniel; Cieślik-Wolski, Bartosz; Kozak, Józef

    2014-01-01

    Aim of the study Aim of the study is to present our own experiences in the treatment of people suffering from penetrating neck traumas. Material and methods In the years 1996-2012, 10 patients with penetrating neck traumas were treated, including 3 women and 7 men. The patients’ age ranged from 16 to 55 (the average age being 40.7 years). In 9 cases the wound was caused by cutting or stabbing, while in one case it was inflicted by a gunshot. In 8 patients it was a single cut wound, while one patient suffered from 34 stab wounds to the neck, chest and stomach. Two cut wounds resulted from a suicide attempt. The remaining injuries were the result of a crime. Results All patients underwent immediate surgery, which involved revision of the neck wounds in 8 cases, one longitudinal sternotomy and one left-sided thoracotomy. The indications for surgery included increased subcutaneous emphysema in 5 patients, bleeding from the wound in 3 patients, and mediastinal hematoma in 2 patients. The damage assessed intraoperatively included tracheal damage in 6 patients, damage to carotid vessels in 3 patients, larynx in 2 patients, thoracic vessels in 2 patients, oesophagus in 1 patient and thyroid gland in 1 patient. In 9 patients, the treatment yielded positive results. The patient with a gunshot wound died during the surgery due to massive bleeding from the aorta. Conclusions In patients with penetrating neck wounds, early and rapid diagnostics allows one to determine the indications for surgery and prevent serious fatal complications. PMID:26336390

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

    PubMed

    van den Hoonaard, Will C

    2013-04-01

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

  17. 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.

  18. Superfund Record of Decision (EPA Region 2): South Brunswick, New Jersey (second remedial action), September 1987. Final report

    SciTech Connect

    Not Available

    1987-09-30

    The Browning-Ferris Industries South Brunswick Landfill (BFI) is a closed landfill in Middlesex County, New Jersey. The site is in close proximity to a brook that feeds into a public drinking water supply 10 miles downstream. For more than twenty years the site operated, under two separate owners, as a solid-waste landfill that received municipal refuse, pesticides, chemical wastes and hazardous wastes. The site was officially closed in December 1978. A site investigation revealed elevated levels of VOCs and iron in the ground water and surface water. The selected remedial action for the site includes onsite containment (leachate collection/treatment system, slurry wall, clay cap, gas venting system), which was initiated in May 1983 and completed on September 1985; and post-remedial ground water, surface and air monitoring.

  19. Pauciconfibula subsolana n. sp. (Monogenea: Microcotylidae) from Morone americana (Perciformes: Percichthyidae) collected in fresh water in New Brunswick, Canada.

    PubMed

    Chisholm, L A; Beverley-Burton, M; McAlpine, D F

    1991-12-01

    Pauciconfibula subsolana n. sp. (Monogenea: Microcotylidae) is proposed for parasites found on the inner surface of the operculum of Morone americana collected in the freshwater reaches of the Saint John River, near Mactaquac, New Brunswick. Pauciconfibula subsolana is differentiated from other species in the genus by the 2 posterolateral clamp sclerites, each of which is composed of 2 distinct sections, and by the absence of appendages on the eggs. An amended generic diagnosis is provided for Pauciconfibula. Pseudoaspinatrium Mamaev, 1986, is considered a junior synonym of Pauciconfibula Dillon and Hargis, 1965, and the species previously assigned to Pseudoaspinatrium are transferred to Pauciconfibula as Pauciconfibula euzeti (Ktari, 1971) n. comb., Pauciconfibula gallieni (Euzet and Ktari, 1971) n. comb., and Pauciconfibula pogoniae (MacCallum, 1913) n. comb.

  20. 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

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

    NASA Astrophysics Data System (ADS)

    Calderone, G. M.

    2006-12-01

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

  2. 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,…

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

    NASA Astrophysics Data System (ADS)

    Davis, Claude S.

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

  4. 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…

  5. Self-Harm and Trauma

    MedlinePlus

    ... Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research ( ... you are outside your body or yourself Reduce stress and tension Block upsetting memories and flashbacks Show ...

  6. Mental Findings in Trauma Victims

    PubMed Central

    CAN, İsmail Özgür; DEMİROĞLU UYANIKER, Zehra; ULAŞ, Halis; KARABAĞ, Gökmen; CİMİLLİ, Can; SALAÇİN, Serpil

    2013-01-01

    Introduction In medico-legal evaluation of trauma patients, the bio-psychological effects of the trauma and the severity of the injuries require to be evaluated. In this study, assuming the fact that psychiatric assessment is not taken into consideration in physical trauma cases, we planned to show the presence of psychological trauma in our medico-legally evaluated patients who presented with different types of traumas and to review the mental findings and diagnoses in trauma victims. Method We retrospectively analyzed the hospital records of 1975 patients aged 18 years or older who presented to the Department of Forensic Medicine at Dokuz Eylül University School of Medicine for medico-legal evaluation between 1999 and 2009. Psychiatric assessment was performed in 142 patients by the Department of Psychiatry. The data contained in medico-legal reports and patient records were then examined with respect to patients’ age, gender, nature of traumatic events, psychiatric diagnoses, descriptive characteristics of the patients, severity of trauma and past history of mental disorder and trauma experience. Results of the medicolegal evaluations were also analyzed. Result Of the 142 patients, 80 (56.3%) were female and their average age was 40.30±17.17 years. The most frequent traumatic events were traffic accidents (29.6%) and violence-related blunt force trauma (28.9%). When the distribution of the most common psychiatric diagnoses was examined, it was found that anxiety disorders were found in 69 cases (48.6%), adjustment disorders were found in 16 cases (11.3%) and mood disorders were found in 12 cases (8.5%). Among anxiety disorders, acute stress disorder (n=39) and post-traumatic stress disorder (PTSD) (n=27) were the most common ones. In 27 cases of the 142, it was determined that, psychiatric symptoms and findings did not meet the diagnostic criteria of any psychiatric disorder. Diagnosis of psychiatric disorder was not significantly related with traumatic

  7. Nasal septal trauma in children.

    PubMed

    Olsen, K D; Carpenter, R J; Kern, E B

    1979-07-01

    If the septal component of a nasal injury is adequately managed, usually the entire nasal injury will be well managed. Major or minor nasal trauma can cause cartilage fracture, deviation, dislocation, hematoma, or abscess formation, and the various associated sequelae, some of them life-threatening. A negative x-ray report should never be used as a substitute for a complete intranasal examination in any child with nasal trauma. Any nasal abnormality should be referred for immediate evaluation and treatment.

  8. 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…

  9. Review of Evaluative Mechanisms in the Departments of Advanced Education and Labour and Human Resources Development--New Brunswick = Examen des mecanismes d'evaluation au ministere de l'Enseignement superieur et du Travail et au ministere du Developpement des Ressources humaines du Nouveau-Brunswick.

    ERIC Educational Resources Information Center

    New Brunswick Labour Force Development Board, Fredericton.

    The evaluative mechanisms in the Department of Advanced Education and Labour and Department of Human Resources Development in the Canadian province of New Brunswick were reviewed. Data were gathered from the following: meetings with key staff in each department, briefing session for all key informants, 19 personal interviews, brief review of the…

  10. Renal Trauma: The Rugby Factor

    PubMed Central

    Freeman, Catherine M.; Kelly, Michael E.; Nason, Gregory J.; McGuire, Barry B.; Kilcoyne, Aoife; Ryan, John; Lennon, Gerald; Galvin, David; Quinlan, David; Mulvin, David

    2015-01-01

    Introduction Renal trauma accounts for 5% of all trauma cases. Rare mechanisms of injuries including sports participation are increasingly common. Rugby-related trauma poses a conundrum for physicians and players due to the absence of clear guidelines and a paucity of evidence. Our series highlights traumatic rugby-related renal injuries in our institution, and emphasize the need for international guidelines on management. Methods A retrospective review of all abdominal traumas between January 2006 and April 2013, specifically assessing for renal related trauma that were secondary to rugby injuries was performed. All patients' demographics, computerized tomography results, hematological and biochemical results and subsequent management were recorded. Results Five male patients presented with rugby-related injuries. Mean age was 21 years old. All patients were hemodynamically stable and managed conservatively in acute setting. One patient was detected to have an unknown pre-existing atrophic kidney that had been subsequently injured, and was booked for an elective nephrectomy an 8-week interval. Conclusion Rugby-related trauma has generated essential attention. This paper serves to highlight this type of injury and the need for defined guidelines on role of imaging and international consensus on timing of return to contact sport, in both professional and amateur settings. PMID:26889132

  11. Trauma and termination.

    PubMed

    Ferraro, F

    1995-02-01

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

  12. 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

  13. Deposition of organochlorine pesticides, PCBs (Aroclor 1268), and PBDEs in selected plant species from a Superfund Site at Brunswick, Georgia, USA.

    PubMed

    Sajwan, Kenneth S; Senthil Kumar, Kurunthachalam; Kelley, Sarah; Loganathan, Bommanna G

    2009-04-01

    Deposition of organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) were measured in Loblolly pine needles (Pinus taeda) collected in and around a Linden Chemicals and Plastics (LCP) Superfund Site at Brunswick, Georgia, USA. For the comparison, foliage of eastern red cedar (Juniperus virginiana) was also collected to monitor contaminant levels. This study revealed that concentrations of OCPs, PCBs and PBDEs ranged from 0.75-10, 3.4-15 to 0.05-3, ng/g wet wt, respectively in both plant species. Total OCPs concentrations in pine needles decreased from 10 to 2.3 ng/g; and total PCBs decreased from 28 to 9.3 ng/g between 1997 and 2006. To our knowledge, this is the first report on PBDEs concentrations in pine needles and red cedar foliage samples from the Superfund Site at Brunswick, Georgia, USA.

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

    PubMed

    Jones, Shelley L

    2015-08-01

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

  15. 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

  16. 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.

  17. Warfare facial trauma: who will treat?

    PubMed

    Holmes, D K

    1996-09-01

    Most of the facial trauma in the United States is treated in trauma centers in large urban or university medical centers, with limited trauma care taking place in our military medical treatment facilities. In many cases, active duty facial trauma surgeons may lack the current experience necessary for the optimal care of facial wounds of our inquired military personnel in the early stages of the conflict. Consequently, the skills of the reservist trauma surgeons who staff our civilian trauma centers and who care for facial trauma victims daily will be critical in caring for our wounded. These "trauma-current" reservists may act as a cadre of practiced surgeons to aid those with less experience. A plan for refresher training of active duty facial trauma surgeons is presented.

  18. Trauma Training and Workload: A National Survey.

    PubMed

    McSorley, K; Quinlan, J

    2015-09-01

    Trauma is a major source of mortality and morbidity throughout Ireland. Training in trauma is dependant on experience gained by trainees within specific posts. Trauma services are a topical issue at present with much discussion about delivery and restructuring. With this in mind we conducted an online survey of trainees in emergency medicine, orthopaedic and general surgery to assess current experience and opinions with regard to trauma. The survey was vetted and distributed by the relevant training bodies. 59(98.33%) respondents believed smaller units should be bypassed for major trauma and 55 (91.67%) believed that larger hospitals receiving major trauma should have a trauma theatre available 24-hours a day. 55 (91.67%) also foresaw themselves covering major trauma as consultants, consequently these trainees will be the consultants developing, moulding and working in this restructured trauma service.

  19. Peritraumatic dissociative experiences, trauma narratives, and trauma pathology.

    PubMed

    Zoellner, Lori A; Alvarez-Conrad, Jennifer; Foa, Edna B

    2002-02-01

    Peritraumatic dissociation, i.e., dissociation during or immediately after a traumatic event, has been associated with persistence of trauma-related pathology. Peritraumatic dissociation may interfere with encoding of traumatic memories and this style may impede recovery. This study examines this hypothesis by analyzing trauma narratives from 28 female sexual and nonsexual assault victims who reported either high or low peritraumatic dissociation. Participants were asked to recount their assault. Narratives were videotaped, transcribed, and coded. Narratives of individuals with high peritraumatic dissociation had higher grade levels and a trend toward lower reading ease than those with low peritraumatic dissociation. Both higher grade levels and lower reading ease of prethreat sections of trauma narratives were related to posttreatment reexperiencing and anxiety symptoms.

  20. Trauma, attachment, and intimate relationships.

    PubMed

    Zurbriggen, Eileen L; Gobin, Robyn L; Kaehler, Laura A

    2012-01-01

    Intimate relationships can both affect and be affected by trauma and its sequelae. This special issue highlights research on trauma, attachment, and intimate relationships. Several themes emerged. One theme is the exploration of the associations between a history of trauma and relational variables, with an emphasis on models using these variables as mediators. Given the significance of secure attachment for healthy relationships, it is not surprising that attachment emerges as another theme of this issue. Moreover, a key component of relationships is trust, and so a further theme of this issue is betrayal trauma (J. J. Freyd, 1996 ). As the work included in this special issue makes clear, intimate relationships of all types are important for the psychological health of those exposed to traumatic events. In order to best help trauma survivors and those close to them, it is imperative that research exploring these issues be presented to research communities, clinical practitioners, and the public in general. This special issue serves as one step toward that objective.

  1. Psychological care in trauma patients.

    PubMed

    Mohta, Medha; Sethi, A K; Tyagi, Asha; Mohta, Anup

    2003-01-01

    The clinician manages trauma patients in the emergency room, operation theatre, intensive care unit and trauma ward with an endeavour to provide best possible treatment for physical injuries. At the same time, it is equally important to give adequate attention to behavioural and psychological aspects associated with the event. Knowledge of the predisposing factors and their management helps the clinician to prevent or manage these psychological problems. Various causes of psychological disturbances in trauma patients have been highlighted. These include pain, the sudden and unexpected nature of events and the procedures and interventions necessary to resuscitate and stabilise the patient. The ICU and trauma ward environment, sleep and sensory deprivation, impact of injury on CNS, medications and associated pre-morbid conditions are also significant factors. Specific problems that concern the traumatised patients are helplessness, humiliation, threat to body image and mental symptoms. The patients react to these stressors by various defence mechanisms like conservation withdrawal, denial, regression, anger, anxiety and depression. Some of them develop delirium or even more severe problems like acute stress disorder or post-traumatic stress disorder. Physical, pharmacological or psychological interventions can be performed to prevent or minimise these problems in trauma patients. These include adequate pain relief, prevention of sensory and sleep deprivation, providing familiar surroundings, careful explanations and reassurance to the patient, psychotherapy and pharmacological treatment whenever required.

  2. Transfusion medicine in trauma patients

    PubMed Central

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

    2011-01-01

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

  3. Accidental hypothermia in severe trauma.

    PubMed

    Vardon, Fanny; Mrozek, Ségolène; Geeraerts, Thomas; Fourcade, Olivier

    2016-10-01

    Hypothermia, along with acidosis and coagulopathy, is part of the lethal triad that worsen the prognosis of severe trauma patients. While accidental hypothermia is easy to identify by a simple measurement, it is no less pernicious if it is not detected or treated in the initial phase of patient care. It is a multifactorial process and is a factor of mortality in severe trauma cases. The consequences of hypothermia are many: it modifies myocardial contractions and may induce arrhythmias; it contributes to trauma-induced coagulopathy; from an immunological point of view, it diminishes inflammatory response and increases the chance of pneumonia in the patient; it inhibits the elimination of anaesthetic drugs and can complicate the calculation of dosing requirements; and it leads to an over-estimation of coagulation factor activities. This review will detail the pathophysiological consequences of hypothermia, as well as the most recent principle recommendations in dealing with it.

  4. 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

  5. Vascular Injury in Orthopedic Trauma.

    PubMed

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

    2016-07-01

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

  6. Acoustic trauma caused by lightning.

    PubMed

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

    1996-03-01

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

  7. Male genital trauma in sports.

    PubMed

    Hunter, Stanley R; Lishnak, Timothy S; Powers, Andria M; Lisle, David K

    2013-04-01

    Male genital trauma is a rare but potentially serious sports injury. Although such an injury can occur by many different mechanisms, including falls, collisions, straddle injuries, kicks, and equipment malfunction, the clinical presentation is typically homogeneous, characterized by pain and swelling. Almost all sports-related male genital injury comes from blunt force trauma, with involvement of scrotal structures far more common than penile structures. Most injuries can be treated conservatively, but catastrophic testicular injury must first be ruled out. Despite being relatively uncommon compared with other sports injuries, more than half of all testicular injuries are sustained during sports.

  8. [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.

  9. Cruciform position for trauma resuscitation.

    PubMed

    Mitra, Biswadev; Fitzgerald, Mark C; Olaussen, Alexander; Thaveenthiran, Prasanthan; Bade-Boon, Jordan; Martin, Katherine; Smit, De Villiers; Cameron, Peter A

    2017-04-01

    Multiply injured patients represent a particularly demanding subgroup of trauma patients as they require urgent simultaneous clinical assessments using physical examination, ultrasound and invasive monitoring together with critical management, including tracheal intubation, thoracostomies and central venous access. Concurrent access to multiple body regions is essential to facilitate the concept of 'horizontal' resuscitation. The current positioning of trauma patient, with arms adducted, restricts this approach. Instead, the therapeutic cruciform positioning, with arms abducted at 90°, allows planning and performing of multiple life-saving interventions simultaneously. This positioning also provides a practical surgical field with improved sterility and procedural access.

  10. Facial nerve palsy due to birth trauma

    MedlinePlus

    Seventh cranial nerve palsy due to birth trauma; Facial palsy - birth trauma; Facial palsy - neonate; Facial palsy - infant ... infant's facial nerve is also called the seventh cranial nerve. It can be damaged just before or at ...

  11. Bioprospecting from marine sediments of New Brunswick, Canada: exploring the relationship between total bacterial diversity and actinobacteria diversity.

    PubMed

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

    2014-02-13

    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.

  12. Structural controls on groundwater flow in a fractured bedrock aquifer underlying an agricultural region of northwestern New Brunswick, Canada

    NASA Astrophysics Data System (ADS)

    DesRoches, Aaron; Danielescu, Serban; Butler, Karl

    2014-08-01

    A hydrogeological study was conducted in northwestern New Brunswick, Canada, to improve the predictability of fracture-dominated groundwater flow within folded bedrock composed of fine-grained turbidites. Borehole televiewer logging and outcrop mapping, integrated with hydraulic packer tests revealed enhanced hydraulic conductivity associated with northeasterly striking bedding-plane fractures formed during folding and flexural slip. These fractures impart azimuthal anisotropy to the aquifer because of moderately dipping fold limbs. High-angle fractures form a well-developed non-stratabound network, comprising two open fracture sets striking NNE parallel to the current direction of principal stress, and WNW parallel to the direction of principal stress that dominated during the Acadian orogeny. The subset of fractures showing significant oxidation, deemed most important to the groundwater flow system, is dominated by bedding-plane and high-angle fractures striking near-parallel to the maximum principal stress direction, resulting in extensional opening and enhanced hydraulic conductivities. An equivalent porous media model, incorporating anisotropy and varying hydraulic conductivity with depth, indicates that horizontal flow dominates the aquifer with relatively minor exchange between different model layers. These findings have implications for understanding flow directions in the Black Brook Watershed and elsewhere in the Matapédia Basin where fractures formed under similar stress conditions.

  13. 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.

  14. 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

  15. 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.

  16. 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…

  17. Pneumomediastinum, an unusual complication of facial trauma.

    PubMed

    Monksfield, Peter; Whiteside, Olivia; Jaffé, Susan; Steventon, Nick; Milford, Chris

    2005-05-01

    Pneumomediastinum is often an incidental finding following a blunt or penetrating trauma to the neck or chest. We report a rare case of pneumomediastinum following an isolated facial trauma that was diagnosed on imaging. We also review the clinical signs of this condition, its radiologic characteristics, and the 18 previously reported cases of pneumomediastinum following facial trauma.

  18. 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…

  19. Bladder trauma: multidetector computed tomography cystography.

    PubMed

    Ishak, Charbel; Kanth, Nalini

    2011-08-01

    Multidetector computed tomography (MDCT) cystography is rapidly becoming the most recommended study for evaluation of the bladder for suspected trauma. This article reviews the bladder trauma with emphasis on the application of MDCT cystography to traumatic bladder injuries using a pictorial essay based on images collected in our level I trauma center.

  20. 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…

  1. The management of liver trauma.

    PubMed Central

    Macfarlane, R.

    1985-01-01

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

  2. 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…

  3. 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,…

  4. 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)

  5. 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…

  6. The morbidity of trauma nephrectomy.

    PubMed

    Edwards, Norma M; Claridge, Jeffrey A; Forsythe, Raquel M; Weinberg, Jordan A; Croce, Martin A; Fabian, Timothy C

    2009-11-01

    Mortality has been shown to be high in patients after trauma nephrectomy (TN). However, there are little data regarding morbidity in survivors. The objective of this study was to determine the morbidity rates associated with TN with attention directed to renal failure (RF) and formation of intra-abdominal abscess (IAA). Patients who underwent TN over a 9-year period (1996 to 2004) were identified from the trauma registry. Records were reviewed for all complications after TN in patients surviving at least 48 hours. Eighty-nine patients were identified with TN; 61 per cent resulted after penetrating trauma. Overall mortality was 34 per cent. Seventy-one patients survived greater than 48 hours; 51 (72%) experienced at least one morbidity. There was no difference in morbidity rates between patients undergoing blunt trauma and those undergoing penetrating trama. Patients with morbidities were significantly older, more severely injured, and had higher mortality rates and longer hospital courses. Infectious complications were seen in 52 per cent, respiratory in 48 per cent, gastrointestinal in 30 per cent, coagulopathy in 25 per cent, and RF and IAA were each seen in 14 per cent of patients. Patients undergoing TN are severely injured with significant morbidity. The results from this study allow us to establish benchmarks to assess complication rates for patients who undergo TN, which can provide prognostic information and goals to improve patient outcomes.

  7. 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

  8. 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.

  9. The family of the trauma victim.

    PubMed

    Solursh, D S

    1990-03-01

    Emergency room and trauma unit work offers unique challenges to the nurse, both professionally and personally. One of these challenges is understanding and dealing with the behavior of victims' families. Some of the factors that impact on the behavior of families include (1) the sudden and unpredictable nature of trauma; (2) the nature of the relationship of the specific family member and the trauma victim; (3) the issues of responsibility, anger, and guilt; (4) religious beliefs; and (5) trauma sequelae. The development of organ and tissue donor programs and of psychotraumatology as ways to help ease the plight of trauma victims' families are also discussed.

  10. The biology of trauma: implications for treatment.

    PubMed

    Solomon, Eldra P; Heide, Kathleen M

    2005-01-01

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

  11. The Focused Assessment With Sonography For Trauma (FAST) Examination And Pelvic Trauma: Indications And Limitations.

    PubMed

    Shaukat, Nadia Maria; Copeli, Nikolai; Desai, Poonam

    2016-03-01

    Pelvic trauma accounts for only 3% of all skeletal injuries but may have mortality as high as 45% in cases of severe trauma. Significant high-grade-mechanism trauma to the pelvis must always take the abdomen into consideration for evaluation. The focused assessment with sonography for trauma (FAST) examination has been shown to be a valuable tool in assessing the unstable trauma patient with blunt abdominal injury, though its diagnostic utility is much less well-defined than in primary pelvic trauma. This systematic review explores the utility and limitations of the FAST examination in patients with blunt pelvic trauma and discusses the timing for the examination during the trauma survey. Newer techniques for emergency department management of the unstable trauma patient are also addressed.

  12. A proposed algorithm for multimodal liver trauma management from a surgical trauma audit in a western European trauma center.

    PubMed

    Di Saverio, S; Sibilio, A; Coniglio, C; Bianchi, E; Biscardi, A; Villani, S; Gordini, G; Tugnoli, G

    2014-11-01

    Management of liver trauma is challenging and may vary widely given the heterogeneity of liver injuries' anatomical configuration, the hemodynamic status, the settings and resources available. Perhaps the use of non-operative management (NOM) may have potential drawbacks and the role of damage control surgery (DCS) and angioembolization represents a major evolving concept.1 Most severe liver trauma in polytrauma patients accounts for a significant morbidity and mortality. Major liver trauma with extensive parenchymal injury and uncontrollable bleeding is therefore a challenge for the trauma team. However a safe and effective surgical hemostasis and a carefully planned multidisciplinary approach can improve the outcome of severe liver trauma. The technique of perihepatic packing, according to DCS approach, is often required to achieve fast, early and effective control of hemorrhage in the highest grades of liver trauma and in unstable patients. A systematic and standardized technique of perihepatic packing may contribute to improve hemostatic efficacy and overall outcomes if wisely combined in a stepwise "sandwich" multimodal approach. DCS philosophy evolved alongside with damage control resuscitation (DCR) in the management of trauma patients, requiring close interaction between surgery and resuscitation. Therefore, as a result of a combined surgical and critical care clinical audit activity in our western European trauma center, a practical algorithm for multimodal sequential management of liver trauma has been developed based on a historical cohort of 253 liver trauma patients and subsequently validated on a prospective cohort of 135 patients in the period 2010-2013.

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

    PubMed

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

    2016-01-01

    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 Dinaraea

  14. 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

  15. 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.

  16. 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

  17. 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

  18. Planned reoperation for severe trauma.

    PubMed Central

    Hirshberg, A; Mattox, K L

    1995-01-01

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

  19. Effective teamwork in trauma management.

    PubMed

    Frakes, Patricia; Neely, Iain; Tudoe, Robert

    2009-12-01

    The emergency department (ED) education team at the Queen's Medical Centre, Nottingham, has developed a process to promote effective teamwork in major trauma management. To introduce this process to ED staff, the team developed a multiprofessional education and training programme. This article describes the development process, explains how and why it was undertaken, and provides details of the education and training programme. It also highlights the challenges met by the education team during implementation.

  20. Transfusion Practice in Military Trauma

    DTIC Science & Technology

    2008-01-01

    15 patients including several who were shot, others who were severely injured in other ways and four who ultimately died. Despite the small number...their most profound social consequences in the loss of young adults from the working population. Injury is the most common cause of the loss of years...who have an injury severity score of > 15 and must have a trauma surgeon, anaesthesiologist, orthopaedic surgeon, thoracic surgeon and neurosurgeon

  1. Fibrinogen Metabolic Responses to Trauma

    DTIC Science & Technology

    2009-01-13

    intravascular coagulation (DIC), and thrombotic complications [8,10-12]. Based on the limited data avail- able at present, changes in fibrinogen...water at 4°C [48]. Temperature of 32°C was used based on the fact that 100% mortality was observed when the temperature in trauma patients dropped...study. The amount of fibrinogen transfused was calculated based on fibrinogen amount within each blood product, such as fresh whole blood

  2. 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

  3. Establishing Standards for Trauma Nursing Education: The Central Ohio Trauma System's Approach.

    PubMed

    Haley, Kathy; Martin, Stacey; Kilgore, Jane; Lang, Carrie; Rozzell, Monica; Coffey, Carla; Eley, Scott; Light, Andrea; Hubartt, Jeff; Kovach, Sherri; Deppe, Sharon

    Trauma nursing requires mastering a highly specialized body of knowledge. Expert nursing care is expected to be offered throughout the hospital continuum, yet identifying the necessary broad-based objectives for nurses working within this continuum has often been difficult to define. Trauma nurse leaders and educators from 7 central and southeastern Ohio trauma centers and 1 regional trauma organization convened to establish an approach to standardizing trauma nursing education from a regional perspective. Forty-two trauma nursing educational objectives were identified. The Delphi method was used to narrow the list to 3 learning objectives to serve as the framework for a regional trauma nursing education guideline. Although numerous trauma nursing educational needs were identified across the continuum of care, a lack of clearly defined standards exists. Recognizing and understanding the educational preparation and defined standards required for nurses providing optimal trauma care are vital for a positive impact on patient outcomes. This regional trauma nursing education guideline is a novel model and can be used to assist trauma care leaders in standardizing trauma education within their hospital, region, or state. The use of this model may also lead to the identification of gaps within trauma educational systems.

  4. The Trauma Collaborative Care Study (TCCS).

    PubMed

    Wegener, Stephen T; Pollak, Andrew N; Frey, Katherine P; Hymes, Robert A; Archer, Kristin R; Jones, Clifford B; Seymour, Rachel B; OʼToole, Robert V; Castillo, Renan C; Huang, Yanjie; Scharfstein, Daniel O; MacKenzie, Ellen J

    2017-04-01

    Previous research suggests that the care provided to trauma patients could be improved by including early screening and management of emotional distress and psychological comorbidity. The Trauma Collaborative Care (TCC) program, which is based on the principles of well-established models of collaborative care, was designed to address this gap in trauma center care. This article describes the TCC program and the design of a multicenter study to evaluate its effectiveness for improving patient outcomes after major, high-energy orthopaedic trauma at level 1 trauma centers. The TCC program was evaluated by comparing outcomes of patients treated at 6 intervention sites (n = 481) with 6 trauma centers where care was delivered as usual (control sites, n = 419). Compared with standard treatment alone, it is hypothesized that access to the TCC program plus standard treatment will result in lower rates of poor patient-reported function, depression, and posttraumatic stress disorder.

  5. 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.

  6. Thyroid crisis in the maxillofacial trauma patient.

    PubMed

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

    2014-11-01

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

  7. 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.

  8. The SCID PTSD module's trauma screen: validity with two samples in detecting trauma history.

    PubMed

    Elhai, Jon D; Franklin, C Laurel; Gray, Matt J

    2008-01-01

    We investigated the posttraumatic stress disorder (PTSD) module's trauma screen of the Structured Clinical Interview for DSM-IV (SCID), a single-item traumatic event history query. Compared to the Stressful Life Events Screening Questionnaire (SLESQ), the SCID trauma screen was 76% sensitive in identifying trauma histories in 199 medical patients (correctly ruling out 67%) but only 66% sensitive in 253 college students (ruling out 87%). A modified, more behaviorally specific SCID trauma screen (M-SCID) yielded poorer results in identifying trauma among 245 additional college students. Based on probable PTSD diagnoses (PTSD Symptom Scale), using the SCID screen instead of the SLESQ, 3% (M-SCID screen) to 11-14% (standard SCID) of PTSD cases were missed due to not having a trauma history. Our results lend support to previous research establishing the SCID trauma screen as a useful screening device in settings where a more comprehensive trauma screen is not possible.

  9. WSES classification and guidelines for liver trauma.

    PubMed

    Coccolini, Federico; Catena, Fausto; Moore, Ernest E; Ivatury, Rao; Biffl, Walter; Peitzman, Andrew; Coimbra, Raul; Rizoli, Sandro; Kluger, Yoram; Abu-Zidan, Fikri M; Ceresoli, Marco; Montori, Giulia; Sartelli, Massimo; Weber, Dieter; Fraga, Gustavo; Naidoo, Noel; Moore, Frederick A; Zanini, Nicola; Ansaloni, Luca

    2016-01-01

    The severity of liver injuries has been universally classified according to the American Association for the Surgery of Trauma (AAST) grading scale. In determining the optimal treatment strategy, however, the haemodynamic status and associated injuries should be considered. Thus the management of liver trauma is ultimately based on the anatomy of the injury and the physiology of the patient. This paper presents the World Society of Emergency Surgery (WSES) classification of liver trauma and the management Guidelines.

  10. [First aid and management of multiple trauma: in-hospital trauma care].

    PubMed

    Boschin, Matthias; Vordemvenne, Thomas

    2012-11-01

    Injuries remain the leading cause of death in children and young adults. Management of multiple trauma patients has improved in recent years by quality initiatives (trauma network, S3 guideline "Polytrauma"). On this basis, strong links with preclinical management, structured treatment algorithms, training standards (ATLS®), clear diagnostic rules and an established risk- and quality management are the important factors of a modern emergency room trauma care. We describe the organizational components that lead to successful management of trauma in hospital.

  11. Trauma Exposure and Posttraumatic Symptoms in Hawaii

    PubMed Central

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

    2013-01-01

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

  12. Association of Selected Teaching Conditions with Reported Instructional Pratices: From a Survey of New Brunswick and Nova Scotia Grades 7, 8 and 9 Science Teachers. Research Report Number 4.

    ERIC Educational Resources Information Center

    McFadden, Charles P.

    A survey of grade 7, 8 and 9 science teachers in New Brunswick and Nova Scotia was conducted as part of a research program to determine the consequences for teaching and learning of the recent introduction of the SciencePlus program developed by the Atlantic Science Curriculum Project and the need for further curriculum and professional…

  13. Crustal thickness and Vp/Vs estimates near the Brunswick magnetic anomaly using receiver functions from the SESAME array

    NASA Astrophysics Data System (ADS)

    Parker, E. H.; Hawman, R. B.; Fischer, K. M.; Wagner, L. S.

    2012-12-01

    The Southeastern Suture of the Appalachian Margin Experiment (SESAME) is designed to investigate lithospheric dynamics associated with the Paleozoic collision between the Suwanee terrane and Laurentia as well as subsequent Mesozoic rifting and passive margin formation. So far, we have deployed 63 broadband instruments along two N-S trending profiles across Georgia and northern Florida. A third NW-trending profile consisting of 19 stations extends across accreted terranes of the southern Appalachians from Augusta, GA to eastern TN. The N-S profiles are intended to provide constraints on variations in crustal structure across the Brunswick magnetic anomaly (BMA), a prominent magnetic low coinciding with south-dipping crustal-scale seismic reflectors evident on COCORP profiles in south Georgia. The seismic reflectivity is likely a consequence of suturing, but the BMA has been interpreted as an edge effect related to collision as well as an effect of mafic magmatism south of the suture zone. H-k stacking using 10 teleseismic receiver functions from station W27, located ~50-km north of the suture on the western N-S profile, suggests a crustal thickness (H) of 42-44 km and average crustal Vp/Vs (k) of 1.73-1.80. These estimates are in agreement with previous well-constrained stacking results from USNSN station GOGA, located ~70-km to the northeast, that suggest a crustal thickness of 41-43 km and average Vp/Vs 1.72-1.76. The proposed suture zone itself lies beneath sediments of the Atlantic Coastal Plain, and receiver functions from stations in this region appear to be strongly affected by high-amplitude reverberations within the sedimentary column. Therefore, preliminary H-k stacking results from stations directly over the BMA may be unreliable. However, receiver functions from station W23 near the Inner Piedmont-Coastal Plain boundary (near the north, up-dip end of the suture zone) display variations in Ps delay time and amplitude with event back-azimuth. Receiver

  14. REE-SIO2 Systematics in Mor Gabbros and Associated Plagiogranites from the Fournier Oceanic Fragment, New Brunswick, Canada

    NASA Astrophysics Data System (ADS)

    Brophy, J. G.

    2010-12-01

    Seawater influx into hot, dry MOR gabbro can initiate hydration-induced melting and the generation of intermediate to felsic partial melts collectively referred to as plagiogranite. In a recent modeling study, Brophy (2009) suggested that the REE abundances of partial melts generated in this fashion should be characterized by unique patterns of REE-SiO2 variation. Specifically, REE abundances (modeled as enrichment factors, Cl/Co) should show a positive correlation with increasing SiO2 up to around 60 wt. % followed by a steady decrease in abundance as liquid SiO2 increases to around 76%. For liquids of around 55% SiO2 the degree of enrichment is around 2 for all of the REE. However, Cl/Co in the intermediate liquids of around 60 % SiO2 steadily decreases from ~5 for La to ~3 for Yb. Simarlarly, Cl/Co in the high SiO2 liquids of around 76% SiO2 decrease from ~3 for La to ~1 for Yb. If these model predictions are correct, the REE-SiO2 systematics of any naturally occurring suite of plagiogranite and MOR gabbro could be used to assess a partial melting as opposed to crystal fractionation origin. To test the model predictions, a suite of MOR gabbros and intrusive veins of plagiogranite were collected from the Fournier Oceanic Fragment, a middle Ordovician ophiolite sequence located along the northern shore of New Brunswick, and the type exposure for plagiogranites generated by hydration-induced MOR gabbro melting (Flagler and Spray, 1991). The MOR gabbros range from 48 to 55 % SiO2 while the intrusive plagiogranites range from 57 to 78 % SiO2 (anhydrous basis). When REE abundances are plotted against whole rock SiO2 they show all of the model features described above, though the absolute abundances require an initial gabbroic source rock that is more enriched in the REE than the host gabbros themselves. This correspondence between modeled and observed REE- SiO2 variations confirms the model predictions of Brophy (2009) and suggests that REE- SiO2 systematics represent

  15. Imaging of Urinary System Trauma.

    PubMed

    Gross, Joel A; Lehnert, Bruce E; Linnau, Ken F; Voelzke, Bryan B; Sandstrom, Claire K

    2015-07-01

    Computed tomography (CT) imaging of the kidney, ureter, and bladder permit accurate and prompt diagnosis or exclusion of traumatic injuries, without the need to move the patient to the fluoroscopy suite. Real-time review of imaging permits selective delayed imaging, reducing time on the scanner and radiation dose for patients who do not require delays. Modifying imaging parameters to obtain thicker slices and noisier images permits detection of contrast extravasation from the kidneys, ureters, and bladder, while reducing radiation dose on the delayed or cystographic imaging. The American Association for the Surgery of Trauma grading system is discussed, along with challenges and limitations.

  16. [Thoracic drainage in trauma emergencies].

    PubMed

    Bergaminelli, C; De Angelis, P; Gauthier, P; Salzano, A; Vecchio, G

    1999-10-01

    A group of 191 cases of emergency tube thoracostomy for acute trauma reviewed retrospectively from March 1993 to March 1998 is reported. Of this group 169 were men and 22 were women. Their ages ranged from 16 to 73 years. The causes were as follows: 89 cases (46%) road accident; 33 cases (17%) accidental trauma; 33 cases (17%) someone else violence (assault, gunshot or stab wound); 15 cases (8%) work accident; 11 cases (6%) domestic accident and 5 cases (3%) iatrogenic trauma. In 32 patients a diagnosis of pneumothorax was made (2 tension, 11 for penetrating chest injuries, 19 after blunt trauma). In 2 cases of tension pneumothorax and in 3 cases of open pneumothorax a chest tube (24-28 Fr) in the third space in the mid-clavicular line was introduced. In the other patients it was decided to place a chest tube in the mid-axillary line in the fifth intercostal space to drain pneumothorax. Only in 7 cases suction was necessary. Fifty-four hemothorax (3 bilateral) were treated in 11 cases using thoracentesis, while the remaining cases were treated using the insertion of multiple drainage holes in the intercostal space (fifth in the mid-axillary line directed inferiorly and posteriorly). One hundred and three were the cases of hemopneumothorax: 24 of them received 2 chest tubes, the first (20-26 Fr) apically in the second intercostal space in the mid-clavicular line, the second (32-38 Fr) in the fifth intercostal space in the mid-axillary line. All the other cases were treated using a single thoracostomy. In 14 cases suction was applied. Two cases of chylothorax resolved by a large tube positioned in the chest (fifth intercostal space in the mid-axillary line) with a constant negative pressure were also observed. Duration of tube drainage ranged from 4 and 18 days, with an average of 11 days. Five infections of thoracostomy site and 1 empyema resolved by rethoracotomy were observed. Moreover, there were 3 complications: 2 subcutaneous placements and 1 little laceration

  17. Trauma Management of the Auricle.

    PubMed

    Steffen, Armin; Frenzel, Henning

    2015-08-01

    Smaller injuries of the auricle, such as lacerations without tissue loss, have more or less standardized treatment protocols that require thorough wound closure of each affected layer. Even extended lacerations of larger parts of the ear quite often heal with only minor irregularities. New in vivo diagnostic tools have aided the understanding of this outstanding "skin flap behavior." At the other end of the trauma severity spectrum are partial or complete amputations of the ear. Here, the debate has become more intense over the last decade. There were numerous reports of successful microvascular reattachments in the 1990s. Consequently, pocket methods and their variations have received increasing attention because the results seem to be convincing. Nevertheless, the pressure damage due to banking larger parts of the elastic cartilage in the mastoid region is tremendous, and the tissue for secondary reconstruction is severely injured. Particularly in cases of acute trauma with relevant concomitant injuries to the patient and in cases in which the amputated area is in a critical state, direct wound closure is a straightforward and safe option. Subsequent thoughtfully planned secondary reconstruction using ear or rib cartilage, or even allogenous material as an ear framework, can achieve excellent aesthetic results.

  18. Imaging following acute knee trauma.

    PubMed

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

    2014-10-01

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

  19. Dental and General Trauma in Team Handball.

    PubMed

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

    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.

  20. Anabolic steroid accelerated multicompartment syndrome following trauma

    PubMed Central

    Bahia, H; Platt, A; Hart, N; Baguley, P

    2000-01-01

    The case is reported of a 23 year old male body builder who was involved in a road traffic accident after taking anabolic steroids. The resulting trauma caused a severe life threatening acute multicompartment syndrome resulting in the need for urgent multiple fasciotomies. Key Words: anabolic steroids; body builder; trauma; multicompartment syndrome PMID:10953907

  1. Major trauma in Australia: a regional analysis.

    PubMed

    Cameron, P; Dziukas, L; Hadj, A; Clark, P; Hooper, S

    1995-09-01

    This study was undertaken to evaluate the frequency, distribution, cause, pattern, and outcome of patients suffering from major trauma in the State of Victoria over a 1-year period. No previous study in Australia has attempted a comprehensive regional analysis of major trauma. All major trauma admissions resulting from blunt, penetrating, and burns injury were identified, and data collected from emergency departments and intensive care log books at 25 major metropolitan and rural hospitals from the January 3, 1992 to February 28, 1993 by onsite data collectors. The total number of patients admitted into the study was 2,944. There were 1,076 major trauma cases with an Injury Severity Score greater than 15 in a population of 4.2 million people. The type of injury was predominantly blunt (87.5%), with only a small percentage of penetrating injuries (6.4%) and burns (6%). Major trauma in pediatric cases is less common (132 cases). The most common causes of injury were road transport (56%) and falls (22%). The overall outcome of the group was favorable when compared with the Major Trauma Outcome Study group (Z = 1.4, M = 0.93, W = 0.52). There was an unexpectedly low number of patients suffering from major trauma. Outcome using Trauma and Injury Severity Score methodology was favorable when compared with North America.

  2. 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 streets.…

  3. 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…

  4. Trauma-Focused Training Program for Teachers

    ERIC Educational Resources Information Center

    Davis, Marilyn Diane

    2016-01-01

    Teachers have reported that they have difficulty providing support to traumatized children and youth because of a lack of training in how to identify and respond to the needs of these children. The program, "Amazing Help Skills for Teachers to Unmask Trauma in Children and Youth" (AHSUM), is a trauma-focused training program, designed…

  5. 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…

  6. 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…

  7. 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…

  8. [Modern concepts of trauma care and multiple trauma management in oral and maxillofacial region].

    PubMed

    Tan, Yinghui

    2015-06-01

    Multiple trauma management requires the application of modem trauma care theories. Optimal treatment results can be achieved by reinforcing cooperation and stipulating a treatment plan together with other disciplines. Based on modem theories in trauma care and our understanding of the theoretical points, this paper analyzes the injury assessment strategies and methods in oral and maxillofacial multiple trauma management. Moreover, this paper discusses operating time and other influencing factors as well as proposed definitive surgical timing and indications in comprehensive management of oral and maxillofacial multiple trauma patients associated with injuries in other body parts. We hope that this paper can help stomatological physicians deepen their understanding of modem trauma care theories and improve their capacity and results in the treatment of oral and maxillofacial multiple trauma.

  9. OOSTT: a Resource for Analyzing the Organizational Structures of Trauma Centers and Trauma Systems

    PubMed Central

    Utecht, Joseph; Judkins, John; Otte, J. Neil; Colvin, Terra; Rogers, Nicholas; Rose, Robert; Alvi, Maria; Hicks, Amanda; Ball, Jane; Bowman, Stephen M.; Maxson, Robert T.; Nabaweesi, Rosemary; Pradhan, Rohit; Sanddal, Nels D.; Tudoreanu, M. Eduard; Winchell, Robert J.; Brochhausen, Mathias

    2017-01-01

    Organizational structures of healthcare organizations has increasingly become a focus of medical research. In the CAFÉ project we aim to provide a web-service enabling ontology-driven comparison of the organizational characteristics of trauma centers and trauma systems. Trauma remains one of the biggest challenges to healthcare systems worldwide. Research has demonstrated that coordinated efforts like trauma systems and trauma centers are key components of addressing this challenge. Evaluation and comparison of these organizations is essential. However, this research challenge is frequently compounded by the lack of a shared terminology and the lack of effective information technology solutions for assessing and comparing these organizations. In this paper we present the Ontology of Organizational Structures of Trauma systems and Trauma centers (OOSTT) that provides the ontological foundation to CAFÉ's web-based questionnaire infrastructure. We present the usage of the ontology in relation to the questionnaire and provide the methods that were used to create the ontology. PMID:28217041

  10. Marine trauma, envenomations, and intoxications.

    PubMed

    Brown, C K; Shepherd, S M

    1992-05-01

    When humans encounter marine creatures a variety of maladies may occur, ranging from dermatitis to life-threatening trauma, allergy, envenomations, or intoxications. The emergency physician should be prepared to recognize quickly and address appropriately the potential life threats, which are primarily neurologic, respiratory, and cardiovascular. A high degree of suspicion for these illnesses is needed. Intoxications may be especially confusing. Although most of the syndromes are self-limited and treatment supportive, time is of the essence if neuromuscular paralysis, hypotension, or respiratory compromise is present. Much folklore exists regarding detection and prevention of these entities and should be regarded as such. The last several decades have seen a marked increase in our knowledge base regarding these fascinating envenomations and intoxications. Research in the next several decades probably will produce a variety of diagnostic and therapeutic tools, which will further our understanding of, and ability to specifically manage, these syndromes.

  11. Trauma from occlusion. Restorative concerns.

    PubMed

    Neff, P

    1995-04-01

    Trauma from occlusion and restorative concerns may affect the tooth itself, the supporting structures inside and around the tooth's immediate structures, and the total articulating system, which includes the neuromuscular system, the temporomandibular joints, and other systems such as the impairment of hearing or vision and many other peripheral conditions. A thorough examination and a differential diagnosis procedure is essential to restore the health of the articulating system and reverse peripheral condition. This includes the ability to restore the individual tooth in its best anatomic position as a complement to the articulating system using all individual disciplines of dentistry in the finest abilities of treatment and the ability to share and distinguish the possible parafunctional habits and the need for behavioral understanding, support, and management to limit or lessen the wear and destruction of the individual tissues and to restore a healthier physical support.

  12. 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

  13. [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.

  14. Public health assessment for JIS Landfill, South Brunswick, Middlesex County, New Jersey, Region 2. Cerclis No. NJD97400998. addendum. Final report

    SciTech Connect

    1995-08-25

    The Jones Industrial Services (JIS) Landfill site is an approximately eleven acre landfill located on a 24 acre site in South Brunswick Town, Middlesex County, New Jersey. The landfill records document that sludges, solvents, pesticides, and industrial wastes, some of which are toxic and/or hazardous substances were accepted at the landfill from the 1960`s through the early 1970`s. On-site and off-site soil and groundwater is contaminated with volatile organic compounds (VOCs), petroleum hydrocarbons, polychlorinated biphenyls, pesticides, and heavy metals. The landfill may have posed a public health hazard in the past, since the site information indicates that human exposure to volatile organic compounds (VOCs) and metals in domestic drinking water wells may have occurred. However, available data do not indicate that humans are presently being exposed to contaminants at levels expected to cause adverse health effects.

  15. Trauma-related Therapeutic Procedures at Shohada Trauma Center in Tabriz

    PubMed Central

    Sadeghi-Bazargani, Homayoun; Azami-Aghdash, Saber; Ziapour, Behrad; Deljavan, Reza

    2013-01-01

    Background To decrease the burden of injuries it is essential to have an overview of trauma patterns and its management at regional trauma centers. Objectives The aim of this study was to investigate some patterns of trauma and trauma-related therapeutic interventions at our trauma center. Materials and Methods In a cross-sectional study, 19530 trauma cases admitted to the emergency department and hospital wards of Shohada University Hospital during 2007-2008 were assessed. Results Of the 19530 trauma cases, 14960(76.7%) were males. Mean (SD) of age was 31(19.9) years. The elderly aged 65 and above, comprised 10% (1953) of the participants; while 44 were infants. Falls and traffic injuries were the most common cause of injuries among trauma patients. Most of the mortalities were men comprising 74% of the 57 deaths. Reduction of fractures and dislocations were the most common types of operations among trauma patients. Conclusions Young men form the target group for possible interventions to decrease the burden of trauma following falls and traffic accidents. PMID:24350134

  16. Characterization of blunt chest trauma in a long-term porcine model of severe multiple trauma

    PubMed Central

    Horst, K.; Simon, T. P.; Pfeifer, R.; Teuben, M.; Almahmoud, K.; Zhi, Q.; Santos, S. Aguiar; Wembers, C. Castelar; Leonhardt, S.; Heussen, N.; Störmann, P.; Auner, B.; Relja, B.; Marzi, I.; Haug, A. T.; van Griensven, M.; Kalbitz, M.; Huber-Lang, M.; Tolba, R.; Reiss, L. K.; Uhlig, S.; Marx, G.; Pape, H. C.; Hildebrand, F.

    2016-01-01

    Chest trauma has a significant relevance on outcome after severe trauma. Clinically, impaired lung function typically occurs within 72 hours after trauma. However, the underlying pathophysiological mechanisms are still not fully elucidated. Therefore, we aimed to establish an experimental long-term model to investigate physiological, morphologic and inflammatory changes, after severe trauma. Male pigs (sus scrofa) sustained severe trauma (including unilateral chest trauma, femur fracture, liver laceration and hemorrhagic shock). Additionally, non-injured animals served as sham controls. Chest trauma resulted in severe lung damage on both CT and histological analyses. Furthermore, severe inflammation with a systemic increase of IL-6 (p = 0.0305) and a local increase of IL-8 in BAL (p = 0.0009) was observed. The pO2/FiO2 ratio in trauma animals decreased over the observation period (p < 0.0001) but not in the sham group (p = 0.2967). Electrical Impedance Tomography (EIT) revealed differences between the traumatized and healthy lung (p < 0.0001). In conclusion, a clinically relevant, long-term model of blunt chest trauma with concomitant injuries has been developed. This reproducible model allows to examine local and systemic consequences of trauma and is valid for investigation of potential diagnostic or therapeutic options. In this context, EIT might represent a radiation-free method for bedside diagnostics. PMID:28000769

  17. 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...

  18. 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

  19. 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.

  20. 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

  1. Evaluating Wetland Mapping Techniques for New Brunswick Using Landsat-5 TM, ALOS-Palsar and Radarsat-2 Dual-Polarized Images

    NASA Astrophysics Data System (ADS)

    LaRocque, A.; Leblon, B.; Bourgeau-Chavez, L. L.; McCarty, J. L.; Mordini, M.; French, N. H. F.; Landon, A.; Woodward, R.; Huntington, T. G.; Camill, P.

    2014-12-01

    This study evaluates the use of dual-polarized (HH, HV) RADARSAT-2 C-band and ALOS-PALSAR L-band SAR images with LANDSAT-5 TM and a digital elevation model (DEM) for mapping wetland areas in New Brunswick. The resulting maps were compared to GPS field data that were collected in 2012 as well as to two wetland maps currently in use by the Province of New Brunswick, namely the Department of Natural Resources (DNR) wetland map and the forested wetland classes of the DNR forest map (called hereafter "DNR forested wetland map"). Overall the Random Forests classifier gave better classification accuracies than the maximum likelihood classifier. The comparison with the 146 wetland ground truth sites shows that 73.3% are correctly identified using the LANDSAT-5 TM classified image. For the SAR-based classified images, the number of correctly identified wetland ground truth sites is higher when the image acquired during the flooding is considered, the difference being higher with the ALOS-PALSAR images than with the RADARSAT-2 images. The number of correctly identified ground truth wetland sites is the highest when both the ALOS-PALSAR images and RADARSAT-2 images are used (98.6%). This percentage is well above the one obtained with the DNR wetland and forested wetland maps (44.5%). For both SAR-based classifications, the majority of the misidentifications are due to wetlands not being classified in the right wetland class and very few are wetland sites being classified as a non-wetland class. For the DNR maps, about half of the misclassifications are field-validated wetlands that are not mapped as wetland on the DNR maps, the remaining half are wetland sites classified in the wrong wetland class.

  2. Patterns of Errors Contributing to Trauma Mortality

    PubMed Central

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

    2006-01-01

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

  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. Trauma advanced practice nurses: implementing the role.

    PubMed

    Martin, Kathleen D; Molitor-Kirsch, Shirley; Elgart, Heidi; Ruffolo, Daria C; Sicoutris, Corinna; Meredith, Denise

    2004-01-01

    The need for advanced practice nurses (APN) has expanded over the past several decades as a result of the changing healthcare environment. Increased patient acuity and decreased resident work hours have lead to a need for additional clinical expertise at the bedside. APNs are becoming an integral part of the acute care delivery team in many trauma programs and intensive care units. To date little has been published regarding the role of the APN in Trauma Centers. This article outlines the wide variety of responsibilities and services provided by a select group of nurse practitioners who work in trauma centers throughout the United States.

  5. The dedicated orthopedic trauma operating room.

    PubMed

    Min, William; Wolinsky, Philip R

    2011-08-01

    The development and implementation of a dedicated orthopedic trauma operating room (OTOR) that is used for the treatment of orthopedic trauma patients has changed and improved the practice of orthopedic trauma surgery. Advantages noted with OTOR implementation include improvements in morbidity and complication rates, enhancements in the professional and personal lifestyles of the on-call surgeon, and increased physician recruitment and retention in orthopedic traumatology. However, the inappropriate use of the OTOR, which can waste valuable resources and delay the treatment of emergent cases, must be monitored and avoided.

  6. Functional Endoscopic Surgery After Facial Trauma.

    PubMed

    Petrocelli, Marzia; Sbordone, Carolina; Salzano, Giovanni; Cassandro, Francesco Maria; Chiarella, Giuseppe; Scarpa, Alfonso; Romano, Antonio; Iaconetta, Giorgio; Califano, Luigi; Cassandro, Ettore

    2017-02-16

    The present study describes 3 patients of previous facial trauma who have subsequently been treated with functional endoscopic sinus surgery. The authors want pay attention on the possible correlation between facial trauma and sinusitis. Such fractures can be the cause of onset of paranasal sinusitis or of worsening of a previous sinusitis. The correlation between these 2 pathologies could be due to the fact that facial fractures concern the anatomic structures of paranasal sinuses. The damage to these structures during the facial trauma and tissue regeneration after injury or surgical treatment subverts the anatomy and function of the sinuses in a basically compromised situation.

  7. Migration, Trauma, PTSD: A Gender Study in Morrison's Jazz

    ERIC Educational Resources Information Center

    Motlagh, Leila Tafreshi; Yahya, Wan Roselezam Wan

    2014-01-01

    Toni Morrison is an acknowledged master of trauma literature, however trauma theory and a gender response to trauma remain largely unaccounted for her migration literature, specifically "Jazz" (1992). In her novel, two migrant women are affected by the same trauma, a crime of passion. But they choose different reactions and coping…

  8. The growth and development of a level II trauma center.

    PubMed

    Webster, Arvie M

    2007-01-01

    Attaining verification as a Level II Trauma Center requires dedication, flexibility, and continuous education. This article contains the history, birth, and growth of a Level II Trauma Center through a trauma resource clinician's experiences. It is intended to share the thoughts, processes, and technological advances of establishing a Level II Trauma Center.

  9. 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…

  10. Fibrinogen depletion in trauma: early, easy to estimate and central to trauma-induced coagulopathy

    PubMed Central

    2013-01-01

    Fibrinogen is fundamental to hemostasis and falls rapidly in trauma hemorrhage, although levels are not routinely measured in the acute bleeding episode. Prompt identification of critically low levels of fibrinogen and early supplementation has the potential to correct trauma-induced coagulation and improve outcomes. Early estimation of hypofibrinogenemia is possible using surrogate markers of shock and hemorrhage; for example, hemoglobin and base excess. Rapid replacement with fibrinogen concentrate or cryoprecipitate should be considered a clinical priority in major trauma hemorrhage. PMID:24063404

  11. Fibrinogen depletion in trauma: early, easy to estimate and central to trauma-induced coagulopathy.

    PubMed

    Davenport, Ross; Brohi, Karim

    2013-09-24

    Fibrinogen is fundamental to hemostasis and falls rapidly in trauma hemorrhage, although levels are not routinely measured in the acute bleeding episode. Prompt identification of critically low levels of fibrinogen and early supplementation has the potential to correct trauma-induced coagulation and improve outcomes. Early estimation of hypofibrinogenemia is possible using surrogate markers of shock and hemorrhage; for example, hemoglobin and base excess. Rapid replacement with fibrinogen concentrate or cryoprecipitate should be considered a clinical priority in major trauma hemorrhage.

  12. 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.

  13. Electronic documentation of trauma resuscitations at a level 1 pediatric trauma center.

    PubMed

    Wurster, Lee Ann; Groner, Jonathan I; Hoffman, Jeffrey

    2012-01-01

    Although many hospitals across the country have implemented an electronic medical record (EMR) for inpatient care, very few have successfully implemented an EMR for trauma resuscitations. Although there is evidence that the EMR improves patient safety, increases access to all care providers, increases workflow efficiency, and minimizes time spent on documenting thereby improving nursing care, the fast paced, complex nature of trauma resuscitations makes it difficult to implement such a system for trauma documentation. With the support of multiple disciplines with a variety of clinical knowledge, this article describes the design process that has led us to successful development and implementation of an EMR for documentation of trauma resuscitations.

  14. 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.

  15. [Duodenal perforation after blunt abdominal trauma].

    PubMed

    Schneider, R; Moebius, C; Thelen, A; Jonas, S

    2009-12-01

    Duodenal perforation after a blunt abdominal trauma is a rare emergency situation that can result in life-threatening complications. We report on a woman who had a perforation of the duodenum after a supposed mild blunt abdominal trauma. Unremarkable at the initial presentation, the patient presented with acute abdominal pain and a retroperitoneal abscess five days after the initial trauma. The duodenal repair was performed with a Roux-Y anastomosis. Difficulties in diagnosis are very common, but the early recognition of the rupture is essential. The contrast-enhanced CT scan is the gold standard for diagnosis. Surgical management depends on the severity of the trauma and must be chosen on an individual basis.

  16. 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

  17. Late-presenting complications after splenic trauma.

    PubMed

    Freiwald, Sandra

    2010-01-01

    Since the 1970s, the management of blunt splenic trauma has evolved from almost exclusive surgical management to selective use of nonsurgical management in hemodynamically stable patients. Understanding of the spleen's immunologic importance in protection against overwhelming postsplenectomy infection led to development first of surgical techniques for splenic salvage and later to protocols for nonsurgical management of adults with blunt splenic injury. The evolution of nonsurgical management has resulted in new patterns of postsplenic trauma complications.This article describes a pancreatic pseudocyst, one of several described delayed complications of nonsurgical management of blunt splenic trauma. Along with missed splenic injury and delayed rupture, the development of a splenic pseudocyst represents challenges for any multidisciplinary team involved in trauma care. Detection and management of these complications is discussed, as is postsplenectomy vaccination and return to activity.

  18. Sexual Trauma: Women Veterans Health Care

    MedlinePlus

    ... United States reported experiencing an attempted or completed rape at some time in their lives. Sexual violence, ... the CDC .* Military Sexual Trauma VA refers to sexual assault or repeated, threatening sexual harassment during military service ...

  19. Pelvic trauma: WSES classification and guidelines.

    PubMed

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

    2017-01-01

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

  20. 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

  1. Complex trauma of the foot.

    PubMed

    Zwipp, H; Dahlen, C; Randt, T; Gavlik, J M

    1997-12-01

    Following complex foot injuries (incidence up to 52 %) in the multiply-injured patient the ultimate goal remains the same as for all significant foot injuries: the restoration of a painless, stable and plantigrade foot to avoid corrective procedures with moderate results. In the case of a complex trauma of the foot (5 point-score) - e. g. a crush injury - primary amputation in the multiply-injured patient (PTS 3-4) is indicated. Limb salvage (PTS 1-2) depends on the intraoperative aspect during the second look (within 24-48 hours after injury): the debridement has to be radical, the selection of amputation level should be at the most distal point compatible with tissue viability and wound healing. A free tissue transfer should be done early if necessary. Single lesions presenting with a compartment syndrome need an immediate dorsal fasciotomy, in the case of a multiply-injured patient as soon as possible. Open fractures are reduced following radical debridement and temporarily stabilized with K-wires and/or tibiotarsal transfixation with an external fixateur until the definitive ORIF. Dislocation-fractures of the talus type 3 and 4 according to Hawkins' classification need open reduction and internal fixation by screws (titan). Open fractures of the calcaneus are stabilized temporarily by a medial external fixateur after debridement until the definitive treatment. If there is a compartment syndrome an immediate dermatofasciotomy is essential. Like closed, calcanear fractures in multiply-injured patients dislocation-fractures of the Chopart's joint need immediate open reduction only if it is an open fracture or associated with a compartment syndrome. The incidence of a compartment syndrome in the case of dislocation fractures of the Lisfranc's joint is high and therefore a dorsal dermatofasciotomy without delay is critical. Open reduction and internal fixation are achieved either by 1.8 mm K-wires or 3.5 mm cortical screws. To avoid further soft tissue damage a

  2. [Complex trauma of the foot].

    PubMed

    Zwipp, H; Dahlen, C; Randt, T; Gavlik, J M

    1997-12-01

    Following complex foot injuries (incidence up to 52%) in the multiply-injured patient the ultimate goal remains the same as for all significant foot injuries: the restoration of a painless, stable and plantigrade foot to avoid corrective procedures with moderate results. In the case of a complex trauma of the foot (5 point-score)--e.g. a crush injury--primary amputation in the multiply-injured patient (PTS 3-4) is indicated. Limb salvage (PTS 1-2) depends on the intraoperative aspect during the second look (within 24-48 hours after injury): the debridement has to be radical, the selection of amputation level should be at the most distal point compatible with tissue viability and wound healing. A free tissue transfer should be done early if necessary. Single lesions presenting with a compartment syndrome need an immediate dorsal fasciotomy, in the case of a multiply-injured patient as soon as possible. Open fractures are reduced following radical debridement and temporarily stabilized with K-wires and/or tibiotarsal transfixation with an external fixateur until the definitive ORIF. Dislocation-fractures of the talus type 3 and 4 according to Hawkins' classification need open reduction and internal fixation by screws (titan). Open fractures of the calcaneus are stabilized temporarily by a medial external fixateur after debridement until the definitive treatment. If there is a compartment syndrome an immediate dermatofasciotomy is essential. Like closed, calcanear fractures in multiply-injured patients dislocation-fractures of the Chopart's joint need immediate open reduction only if it is an open fracture or associated with a compartment syndrome. The incidence of a compartment syndrome in the case of dislocation fractures of the Lisfranc's joint is high and therefore a dorsal dermatofasciotomy without delay is critical. Open reduction and internal fixation are achieved either by 1.8 mm K-wires or 3.5 mm cortical screws. To avoid further soft tissue damage a delayed

  3. Whats the story? Information needs of trauma teams.

    PubMed

    Sarcevic, Aleksandra; Burd, Randall S

    2008-11-06

    This paper reports on information needs of trauma teams based on an ethnographic study in an urban teaching hospital. We focus on questions posed by trauma team members during ten trauma events. We identify major categories of questions, as well as information seekers and providers. In addition to categories known from other critical care settings, we found categories unique to trauma settings. Based on these findings, we discuss implications for information technology support for trauma teams.

  4. Advanced Technologies in Trauma Critical Care Management

    DTIC Science & Technology

    2012-01-01

    Development Program. The authors have nothing to disclose. a Division of Trauma and Acute Care Surgery , San Antonio Military Medical Center, 3551 Roger Brooke...Drive, Fort Sam Houston, San Antonio, TX 78234, USA; b Department of Surgery , Uniformed Services University of the Health Sciences, Bethesda, MD...Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Suite 810

  5. Temporal variation in major trauma admissions

    PubMed Central

    Kieffer, WKM; Michalik, DV; Gallagher, K; McFadyen, I; Bernard, J; Rogers, BA

    2016-01-01

    Introduction Trauma is a significant cause of morbidity and mortality in the UK. Since the inception of the trauma networks, little is known of the temporal pattern of trauma admissions. Methods Trauma Audit and Research Network data for 1 April 2011 to 31 March 2013 were collated from two large major trauma centres (MTCs) in the South East of England: Brighton and Sussex University Hospitals NHS Trust (BSUH) and St George's University Hospitals NHS Foundation Trust (SGU). The number of admissions and the injury severity score by time of admission, by weekdays versus weekend and by month/season were analysed. Results There were 1,223 admissions at BSUH and 1,241 at SGU. There was significant variation by time of admission; there were more admissions in the afternoons (BSUH p<0.001) and evenings (SGU p<0.001). There were proportionally more admissions at the weekends than on weekdays (BSUH p<0.001, SGU p=0.028). There was significant seasonal variation in admissions at BSUH (p<0.001) with more admissions in summer and autumn. No significant seasonal variation was observed at SGU (p=0.543). Conclusions The temporal patterns observed were different for each MTC with important implications for resource planning of trauma care. This study identified differing needs for different MTCs and resource planning should be individualised to the network. PMID:26741676

  6. The impact of trauma on neutrophil function.

    PubMed

    Hazeldine, Jon; Hampson, Peter; Lord, Janet M

    2014-12-01

    A well described consequence of traumatic injury is immune dysregulation, where an initial increase in immune activity is followed by a period of immune depression, the latter leaving hospitalised trauma patients at an increased risk of nosocomial infections. Here, we discuss the emerging role of the neutrophil, the most abundant leucocyte in human circulation and the first line of defence against microbial challenge, in the initiation and propagation of the inflammatory response to trauma. We review the findings of the most recent studies to have investigated the impact of trauma on neutrophil function and discuss how alterations in neutrophil biology are being investigated as potential biomarkers by which to predict the outcome of hospitalised trauma patients. Furthermore, with trauma-induced changes in neutrophil biology linked to the development of such post-traumatic complications as multiple organ failure and acute respiratory distress syndrome, we highlight an area of research within the field of trauma immunology that is gaining considerable interest: the manipulation of neutrophil function as a means by which to potentially improve patient outcome.

  7. Cost factors in Canadian pediatric trauma

    PubMed Central

    Dueck, Andrew; Poenaru, Dan; Pichora, David R.

    2001-01-01

    Objectives To estimate the costs of Canadian pediatric trauma and identify cost predictors. Design A chart review. Setting A regional trauma centre. Study material The charts of all 221 children who suffered traumatic injuries with an Injury Severity Score (ISS) of 4 or more seen over 6 years at a regional trauma centre. Main outcome measures Patient data, injury data, all hospital-based costs, excluding nursing, food and medication costs. Results Mean (and standard deviation) patient age was 12.8 (5) years. Sixty percent were boys. Motor vehicle accidents (MVAs) accounted for 71% of the injuries, followed by falls (11%). The mean (and SD) total cost of care was Can$7582 (Can$12 370), and the cost of media was Can$2666. Total cost correlated directly with age (r = 0.29, p < 0.001) and Injury Severity Score (ISS) (r = 0.34, p < 0.001) and inversely with the Pediatric Trauma Score (PTS) (r = −0.20, p = 0.003). The presence of extremity injuries correlated significantly with total cost (r = 0.22, p = 0.001) and PTS (r = −0.25, p < 0.001) but not with the ISS. Logistic regression analysis identified runk injury, ISS and PTS as the main determinants of survival. Conclusions The cost of pediatric trauma in Canada can be predicted from admission data and trauma scores. The cost of extremity injuries is significant and can be predicted by the PTS but not the ISS. PMID:11308233

  8. Improving trauma care in Trinidad and Tobago.

    PubMed

    Adam, R; Stedman, M; Winn, J; Howard, M; Williams, J I; Ali, J

    1994-06-01

    Identification of trauma as a major cause of morbidity and mortality in Trinidad and Tobago prompted the establishment of a training programme aimed at improving trauma care in this developing country. An Advanced Trauma Life Support (ATLS) programme for physicians, funded through the Canadian International Development Agency resulted in a statistically significant improvement of in-hospital trauma patient outcome at the Port-of-Spain General Hospital (observed to expected mortality ratio of 3.16 pre-ATLS compared to 1.94 post-ATLS). A recent analysis of all motor vehicle injuries for a shorter period did not confirm this positive impact of the ATLS programme, primarily because a large number of these patients died in the pre-hospital period. Pre-hospital trauma care therefore required urgent attention to complement the positive in-hospital impact of the ATLS programme. A second training programme (the Pre-Hospital Trauma Life Support or PHTLS) for paramedical personnel was thus instituted in 1990. Over 250 physicians have been trained in the ATLS programme and to date over 100 paramedical personnel have been trained in the PHTLS programme. Attempts have also been made to equip the ambulances with more appropriate resuscitative devices in order to improve pre-hospital care. The combination of the PHTLS and the ATLS programme should result in further improvement in the care of patients sustaining major injuries in Trinidad and Tobago.

  9. 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.

  10. Initial evaluation of the "Trauma surgery course"

    PubMed Central

    Tugnoli, Gregorio; Ribaldi, Sergio; Casali, Marco; Calderale, Stefano M; Coletti, Massimo; Alifano, Marco; Parri, Sergio N Forti; Villani, Silvia; Biscardi, Andrea; Giordano, M Chiara; Baldoni, Franco

    2006-01-01

    Background The consequence of the low rate of penetrating injuries in Europe and the increase in non-operative management of blunt trauma is a decrease in surgeons' confidence in managing traumatic injuries has led to the need for new didactic tools. The aim of this retrospective study was to present the Corso di Chirurgia del Politrauma (Trauma Surgery Course), developed as a model for teaching operative trauma techniques, and assess its efficacy. Method the two-day course consisted of theoretical lectures and practical experience on large-sized swine. Data of the first 126 participants were collected and analyzed. Results All of the 126 general surgeons who had participated in the course judged it to be an efficient model to improve knowledge about the surgical treatment of trauma. Conclusion A two-day course, focusing on trauma surgery, with lectures and life-like operation situations, represents a model for simulated training and can be useful to improve surgeons' confidence in managing trauma patients. Cooperation between organizers of similar initiatives would be beneficial and could lead to standardizing and improving such courses. PMID:16759403

  11. Impact of Sexual Trauma on HIV Care Engagement: Perspectives of Female Patients with Trauma Histories in Cape Town, South Africa.

    PubMed

    Watt, Melissa H; Dennis, Alexis C; Choi, Karmel W; Ciya, Nonceba; Joska, John A; Robertson, Corne; Sikkema, Kathleen J

    2016-11-19

    South African women have disproportionately high rates of both sexual trauma and HIV. To understand how sexual trauma impacts HIV care engagement, we conducted in-depth qualitative interviews with 15 HIV-infected women with sexual trauma histories, recruited from a public clinic in Cape Town. Interviews explored trauma narratives, coping behaviors and care engagement, and transcripts were analyzed using a constant comparison method. Participants reported multiple and complex traumas across their lifetimes. Sexual trauma hindered HIV care engagement, especially immediately following HIV diagnosis, and there were indications that sexual trauma may interfere with future care engagement, via traumatic stress symptoms including avoidance. Disclosure of sexual trauma was limited; no women had disclosed to an HIV provider. Routine screening for sexual trauma in HIV care settings may help to identify individuals at risk of poor care engagement. Efficacious treatments are needed to address the psychological and behavioral sequelae of trauma.

  12. 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.

  13. Depersonalization, mindfulness, and childhood trauma.

    PubMed

    Michal, Matthias; Beutel, Manfred E; Jordan, Jochen; Zimmermann, Michael; Wolters, Susanne; Heidenreich, Thomas

    2007-08-01

    Depersonalization (DP), i.e., feelings of being detached from one's own mental processes or body, can be considered as a form of mental escape from the full experience of reality. This mental escape is thought to be etiologically linked with maltreatment during childhood. The detached state of consciousness in DP contrasts with certain aspects of mindfulness, a state of consciousness characterized by being in touch with the present moment. Against this background, the present article investigates potential connections between DP severity, mindfulness, and childhood trauma in a mixed sample of nonpatients and chronic nonmalignant pain patients. We found a strong inverse correlation between DP severity and mindfulness in both samples, which persisted after partialing out general psychological distress. In the nonpatient sample, we additionally found significant correlations between emotional maltreatment on the one hand and DP severity (positive) and mindfulness (negative) on the other. We conclude that the results first argue for an antithetical relationship between DP and certain aspects of mindfulness and thus encourage future studies on mindfulness-based interventions for DP and second throw light on potential developmental factors contributing to mindfulness.

  14. Neuroimaging in repetitive brain trauma

    PubMed Central

    2014-01-01

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

  15. Neuroimaging in repetitive brain trauma.

    PubMed

    Ng, Thomas Sc; Lin, Alexander P; Koerte, Inga K; Pasternak, Ofer; Liao, Huijun; Merugumala, Sai; Bouix, Sylvain; Shenton, Martha E

    2014-01-01

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

  16. 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…

  17. 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…

  18. 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

  19. 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

  20. 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.

  1. 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…

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

    PubMed

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

    2011-01-27

    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.

  3. 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

  4. Trauma adapted family connections: reducing developmental and complex trauma symptomatology to prevent child abuse and neglect.

    PubMed

    Collins, Kathryn S; Strieder, Frederick H; DePanfilis, Diane; Tabor, Maureen; Freeman, Pamela A Clarkson; 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 prevent child abuse and neglect. Trauma Adapted Family Connections (TA-FC) is a manualized trauma-focused practice rooted in the principles of Family Connections (FC), an evidence supported preventive intervention developed to address the glaring gap in services for this specific, growing, and underserved population. This paper describes the science based development of TA-FC, its phases and essential components, which are based on theories of attachment, neglect, trauma, and family interaction within a comprehensive community-based family focused intervention framework.

  5. 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

  6. 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

  7. 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

  8. Trauma systems--state of the art.

    PubMed

    Gwinnutt, C L; Driscoll, P A; Whittaker, J

    2001-01-01

    Trauma is an inevitable consequence of the lives we lead. There are many approaches to dealing with it but an ideal system, universally applicable, probably does not exist because of the national variations in social, economic, cultural and geographical characteristics. Many countries are beginning to recognise that the 'systems' they have in place for dealing with the burden of trauma are seriously deficient and that this situation cannot be allowed to continue into the new millennium. However, it is highly unlikely that in the near future. governments will suddenly find substantial extra finance for trauma care or the implementation of new systems. Throughout many countries, the individual components of trauma care systems are in place but, for whatever reasons, there is a lack of integration, which results in suboptimal care. The system we all should be aiming for is one of closer communication and greater cooperation. By taking into account community and national needs, available resources, and adapting what is currently in place it should then be possible to create 'a set of things working together as parts of a trauma mechanism'.

  9. 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.

  10. Reconstruction after pancreatic trauma by pancreaticogastrostomy

    PubMed Central

    Martín, Gonzalo Martín; Morillas, Patricia Jiménez; Pino, José C. Rodríguez; Canis, José M. Morón; Argenté, Francesc X. González

    2015-01-01

    Introduction Pancreatic lesions are very infrequent after closed abdominal trauma (5% of cases) with a complication rate that affects 30–40% of patients, and a mortality rate that can reach 39%. In our experience, closed abdominal traumatisms occurring at typical popular horse-riding festivals in our region constitute a high risk of pancreatic trauma. The purpose of the present paper is to raise awareness about our experience in the diagnosis and treatment of pancreatic lesions secondary to closed abdominal traumatism. Presentation of case We present the clinical cases of two young patients who, after suffering blunt abdominal trauma secondary to the impact of a horse during the celebration of typical horse-riding festival, were diagnosed with pancreatic trauma type III. The treatment was surgical in both cases and consisted in performing a pancreaticogastric anastomosis with preservation of the distal pancreas and spleen. The postoperative period was uneventful and, at present, both patients are asymptomatic. Discussion Signs and symptoms caused by pancreatic lesion are unspecific and difficult to objectify. With some limitations CT is the imaging test of choice for diagnosis and staging in the acute phase. The Wirsung section is indication for surgical treatment. The most extended surgical procedure in these cases is the resection of pancreatic body, tail, and spleen. Conclusion The identification of a pancreatic injury after closed abdominal trauma requires a high suspicion based on the injury mechanism. A safer option may be the distal pancreatic preservation with pancreaticogastric anastomosis in grade III lesions with healthy pancreatic tissue. PMID:25744560

  11. Trauma networks: present and future challenges

    PubMed Central

    2011-01-01

    In England, trauma is the leading cause of death across all age groups, with over 16,000 deaths per year. Major trauma implies the presence of multiple, serious injuries that could result in death or serious disability. Successive reports have documented the fact that the current ad hoc unstructured management of this patient group is associated with considerable avoidable death and disability. The reform of trauma care in England, especially of the severely injured patient, has already begun. Strong clinical leadership is embraced as the way forward. The present article summarises the steps that have been made over the last decade that led to the recent decision to move towards a long anticipated restructure of the National Health Service (NHS) trauma services with the introduction of Regional Trauma Networks (RTNs). While, for the first time, a genuine political will and support exists, the changes required to maintain the momentum for the implementation of the RTNs needs to be marshalled against arguments, myths and perceptions from the past. Such an approach may reverse the disinterest attitude of many, and will gradually evolve into a cultural shift of the public, clinicians and policymakers in the fullness of time. PMID:22078223

  12. Trauma networks: present and future challenges.

    PubMed

    Kanakaris, Nikolaos K; Giannoudis, Peter V

    2011-11-11

    In England, trauma is the leading cause of death across all age groups, with over 16,000 deaths per year. Major trauma implies the presence of multiple, serious injuries that could result in death or serious disability. Successive reports have documented the fact that the current ad hoc unstructured management of this patient group is associated with considerable avoidable death and disability. The reform of trauma care in England, especially of the severely injured patient, has already begun. Strong clinical leadership is embraced as the way forward. The present article summarises the steps that have been made over the last decade that led to the recent decision to move towards a long anticipated restructure of the National Health Service (NHS) trauma services with the introduction of Regional Trauma Networks (RTNs). While, for the first time, a genuine political will and support exists, the changes required to maintain the momentum for the implementation of the RTNs needs to be marshalled against arguments, myths and perceptions from the past. Such an approach may reverse the disinterest attitude of many, and will gradually evolve into a cultural shift of the public, clinicians and policymakers in the fullness of time.

  13. Combined tracheoesophageal transection after blunt neck trauma.

    PubMed

    Hamid, Umar Imran; Jones, James Mark

    2013-04-01

    Survival following tracheoesophageal transection is uncommon. Establishing a secure airway has the highest priority in trauma management. Understanding the mechanism of the incident can be a useful adjunct in predicting the likelihood and severity of specific anatomical patterns of injuries. We discuss published literature on combined tracheoesophageal injuries after blunt neck trauma and their outcome. A search of MEDLINE for papers published regarding tracheoesophageal injury was made. The literature search identified 14 such articles referring to a total of 27 patients. Age ranged from 3-73 years. The mechanism of injury was secondary to a rope/wire in 33%, metal bar in 4% of cases and unspecified in 63%. All of the patients were managed surgically. A number of tissues were used to protect the anastomosis including pleural and sternocleidomastoid muscle flaps. There were no reported mortalities. Patients with combined tracheoesophageal injury after blunt neck trauma require acute management of airway along with concomitant occult injuries.

  14. Early management of ballistic hand trauma.

    PubMed

    Eardley, W G P; Stewart, M P M

    2010-02-01

    Complex hand wounds are an unfortunate consequence of conflict. Increased battlefield survival rates have resulted in an evolving range of ballistic hand trauma encountered by deployed surgical teams, requiring increased knowledge and understanding of these injuries. In the civilian setting, the combined threats of gun crime and acts of terrorism warrant appreciation for such injury among all surgeons. Surgeons often have to relearn the management of ballistic hand trauma and other aspects of war surgery under difficult circumstances because the experiences of their predecessors may be forgotten. Current evidence regarding these injuries is scarce. Ballistic hand trauma is rarely isolated. The demand on surgical resources from combat injury is significant, and it is imperative that a phased strategy be followed in this setting. Minimal, accurate débridement and decompression with early stability are crucial. Delayed primary closure and an awareness of future reconstructive options are fundamental.

  15. Retroperitoneal hematoma following trauma: its clinical importance.

    PubMed

    Grieco, J G; Perry, J F

    1980-09-01

    Records of 100 consecutive patients treated in 1973 through 1977 with post-traumatic retroperitoneal hematomas (RH) were studied. Eighty RH followed blunt injury and 20 were due to penetrating trauma. Overall mortality was 26%. The worst prognosis was associated with RH from automobile accidents and pedestrian injuries. Pelvic RH were almost uniformly associated with pelvic fracture and were the primary cause of 39% of deaths. Blunt perinephric RH required renal exploration in 47% of patients. Blunt RH in other locations were associated with major visceral or vascular injury in half the patients and were the cause of death in five. Sixty-five per cent of RH due to penetrating trauma had visceral or vascular injury requiring operative correction. Contained rupture of descending choracic aorta presented as retrogastric RH in two patients. RH from penetrating trauma should be explored routinely, since 65% are associated with visceral or vascular injury.

  16. Trauma symptomatology: implications for return to work.

    PubMed

    Strauser, David R

    2008-01-01

    Research has suggested that individuals who experience work related injuries may be at an increased risk for developing trauma symptoms or Posttraumatic Stress Disorder (PTSD). The purpose of this article is to provide a brief overview of PTSD from both a categorical and dimensional perspective and discuss implications for rehabilitation planning with workers with industrial injuries. The negative impact of trauma symptoms and PTSD is profiled according the following four areas that are important for effective career and vocational behavior: (a) making occupational adjustments, (b) adjusting performance to meet specific work demands, (c) utilizing appropriate social and interpersonal skills in the work setting, and (d) meeting the production and time requirements associated with the specific job. Recommendations are then offered to increase the effectiveness of rehabilitation professionals working with industrial injured workers who may be experiencing trauma symptoms or PTSD.

  17. Imaging of sequelae of head trauma.

    PubMed

    Zee, Chi-Shing; Hovanessian, Armen; Go, John L; Kim, Paul E

    2002-05-01

    The imaging of head trauma has been one of the fundamental cornerstones of neuroradiology. As the practice of neuroimaging has matured, great strides have been made in the diagnostic as well as prognostic armamentarium available to physicians. Given the vast diversity of trauma mechanisms and clinical pathways, new advanced imaging technologies have had a lasting impact on the detection, description, and depiction of head trauma. Furthermore, these new tools are allowing the imaging specialist to function not only as an interpreter of what is seen but as a 21st century radiographic oracle. We present a comprehensive review of the imaging findings of sequlae of traumatic brain injury and the growing correlation of new neuroimaging techniques and neurotraumatic outcomes.

  18. Trauma-related papular granuloma annular.

    PubMed

    Hu, Stephanie W; Kaplan, Jennifer; Patel, Rishi R; Kamino, Hideko

    2013-12-16

    Granuloma annulare (GA) is a benign, granulomatous disease with several clinical manifestations, which include localized, generalized, perforating, subcutaneous, patch, papular, and linear forms. We report a case of papular GA of the dorsal aspects of the hands that arose after repeated, direct trauma to the site of subsequent involvement. Although multiple etiologies for GA have been proposed, which include ultraviolet light, arthropod bites, trauma, tuberculin skin tests, viral infections, and PUVA photochemotherapy, the underlying pathogenesis of the disorder remains unclear. However, owing to the key histopathologic findings of focal collagen and elastic fiber degeneration and mucin deosition in GA, it is not surprising that cutaneous trauma may have played a role in connective tissue injury, subsequent degeneration, and the production of a granulomatous response with increased mucin deposition.

  19. 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.

  20. Infant survival after cesarean section for trauma.

    PubMed Central

    Morris, J A; Rosenbower, T J; Jurkovich, G J; Hoyt, D B; Harviel, J D; Knudson, M M; Miller, R S; Burch, J M; Meredith, J W; Ross, S E; Jenkins, J M; Bass, J G

    1996-01-01

    HYPOTHESIS: Emergency cesarean sections in trauma patients are not justified and should be abandoned. SETTING AND DESIGN: A multi-institutional, retrospective cohort study was conducted of level 1 trauma centers. METHODS: Trauma admissions from nine level 1 trauma centers from January 1986 through December 1994 were reviewed. Pregnant women who underwent emergency cesarean sections were identified. Demographic and clinical data were obtained on all patients undergoing a cesarean section. Fetal distress was defined by bradycardia, deceleration, or lack of fetal heart tones (FHTs). Maternal distress was defined by shock (systolic blood pressure < 90) or acute decompensation. Statistical analyses were performed. RESULTS: Of the 114,952 consecutive trauma admissions, more than 441 pregnant women required 32 emergency cesarean sections. All were performed for fetal distress, maternal distress, or both. Overall, 15 (45%) of the fetuses and 23 (72%) of the mothers survived. Of 33 fetuses delivered, 13 had no FHTs and none survived. Twenty infants (potential survivors) had FHTs and an estimated gestational age (EGA) of greater than or equal to 26 weeks, and 75% survived. Infant survival was independent of maternal distress or maternal Injury Severity Score. The five infant deaths in the group of potential survivors resulted from delayed recognition of fetal distress, and 60% of these deaths were in mothers with mild to moderate injuries (Injury Severity Score < 16). CONCLUSIONS: In pregnant trauma patients, infant viability is defined by the presence of FHTs, estimated gestational age greater than or equal to 26 weeks. In viable infants, survival after emergency cesarean section is acceptable (75%). Infant survival is independent of maternal distress or Injury Severity Score. Sixty percent of infant deaths resulted from delay in recognition of fetal distress and cesarean section. These were potentially preventable. Given the definition of fetal viability, our initial

  1. Blood transfusion in trauma patients: unresolved questions.

    PubMed

    Cushing, M; Shaz, B H

    2011-03-01

    Massive transfusion is an essential part of resuscitation efforts in acute trauma patients. The goal is to quickly correct trauma-induced coagulopathy and replace red blood cell (RBC) mass with the minimal number as well as the appropriate choice of blood components to minimize the possible adverse effects of transfusions. Early trauma induced coagulopathy (ETIC) is present in about 20% of patients upon hospital admission and predicts for decreased survival. The mechanism of ETIC is still being elucidated; however, most theories of ETIC's pathophysiology justify the early use of plasma. Most massive transfusion protocol (MTP) ratios deliver blood products in a ratio of 1:1:1 for RBCs:plasma:platelets, which is supported by the majority of the literature demonstrating improved patient survival with higher ratios (>1 plasma and platelet for every 2 RBCs transfused). Indeed, formula-driven MTPs allow trauma services to react quickly to ETIC and provide coagulation factors and platelets in these ratios without having to wait for the results of coagulation assays while the patient's coagulopathy worsens. New MTPs are being created which are adjusted according to an individual's coagulation laboratory values based on point-of-care laboratory tests, such as thromboelastography. When creating an MTP, product wastage due to inappropriate activation and improper product storage should be considered and closely monitored. Another area of discussion regarding transfusion in trauma includes the potential association of prolonged storage of RBCs and adverse outcomes, which has yet to be confirmed. Significant progress has been made in the transfusion management of trauma patients, but further studies are required to optimize patient care and outcomes.

  2. [Psychology and psychobiology of childhood trauma].

    PubMed

    van der Kolk, B A

    1998-01-01

    Exposure to overwhelming stress often determines how people subsequently organize their perceptions of themselves and of others. Traumatic experiences at different developmental levels have different effects on cognitive, affective and biological self-organization. Acute or chronic exposure to trauma may be expressed as Post Traumatic Stress Disorder (PTSD), dissociative disorders, somatic disturbances and alterations in perception of self and others. These disorders involve (a) the involuntary repetitive re-living of the trauma in thoughts, images, somatic states or behaviors, (b) attempts to avoid dealing with reminders of the past, (c) problems with the modulation of physiological responses to subsequent stress, and (d) a loss of capacity to engage in love and work with pleasure and satisfaction. The display of extremes of emotional distress, or of bizarre or disorganized behaviors, easily obscures the fact that current problems may have their origins in past trauma. The recognition that many psychiatric patients organize much of their lives around repetitive patterns of re-living and warding off traumatic memories, reminders and affective states, may help clinicians understand their symptoms as misguided attempts to regain a sense of control and safety, rather than as bizarre behaviors that need to be merely controlled. Since safe attachments appear to be the primary way in which children learn to regulate internal state changes, the negotiation of interpersonal safety needs to be the first focus of treatment. Since the labeling and categorization of emotional states is one of the principal areas of functioning that is disrupted by developmental trauma, treatment needs to include learning how to use words to understand and interpret feelings in general and stressful events, in particular. Since distrust and lack of social safety are critical parts of developmental trauma, structure and predictability are essential. Identifying specific trauma-based perceptions

  3. Demystifying damage control in musculoskeletal trauma

    PubMed Central

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

    2016-01-01

    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

  4. 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

  5. [Penetrating ocular trauma with intraocular foreign body].

    PubMed

    Musat, O; Ochinciuc, Uliana; Gutu, Tatiana; Cristescu, T R; Coman, Corina

    2012-01-01

    We present the case of a 65 years old pacient which was admitted for the sudden decrease of visual acuity in the left eye, accompanied by ocular pain and conjunctival hiperemia, simptoms appeared after an ocular trauma. After the clinical and paraclinical examination we determined the diagnosis of OS: Penetrating ocular trauma with retention of a foreign body; posttraumatic cataract. Surgical treatement was warrented and we performed OS : Facoemulsification + PFK implant in sulcus + 23 Ga posterior vitrectomy + peeling of the posterior hyaloid membrane + extraction of the foreign body + LASER endofotocoagulation + transscleral cryotherapy + SF6 gas injection. The post-operatory evolution was favorable.

  6. Evaluation and Reduction of Nasal Trauma

    PubMed Central

    Kelley, Brian P.; Downey, Cara R.; Stal, Samuel

    2010-01-01

    Nasal trauma plays a large and important role in the field of craniofacial trauma. The resulting aesthetic, structural, and functional sequelae associated with these injuries necessitate a thorough understanding of the topic. This includes an appreciation for the unique anatomic features of the region, the important aspects of the initial history and examination, nasal injury classification, and subsequent treatment timing and options. While a large body of literature has accumulated on the topic, the purpose of this article is to focus on both clinically relevant information and pearls of management. Additionally, age-specific concerns, secondary procedures, and nasal fracture grafting, will be addressed as well. PMID:22550458

  7. Evaluation of a low-threshold/high-tolerance methadone maintenance treatment clinic in saint john, new brunswick, Canada: one year retention rate and illicit drug use.

    PubMed

    Christie, Timothy K S; Murugesan, Alli; Manzer, Dana; O'Shaughnessey, Michael V; Webster, Duncan

    2013-01-01

    Objective. To report the one-year retention rate and the prevalence of illicit opioid use and cocaine use in the Low-Threshold/High-Tolerance (LTHT) methadone maintenance treatment (MMT) clinic located in Saint John, New Brunswick, Canada. Methods. A description of the LTHT MMT clinic is provided. The one-year retention rate was determined by collecting data on patients who enrolled in the LTHT MMT clinic between August 04, 2009 and August 04, 2010. The prevalence of illicit drug use was determined using a randomly selected retrospective cohort of 84 participants. For each participant the results of six consecutive urine tests for the most recent three months were compared to the results of the first six consecutive urine tests after program entry. Results. The one-year retention rate was 95%, 67% of the cohort achieved abstinence from illicit opioids and an additional 13% abstained from cocaine use. Conclusion. The novel feature of the LTHT MMT clinic is that patients are not denied methadone because of lack of ancillary services. Traditional comprehensive MMT programs invest the majority of financial resources in ancillary services that support the biopsychosocial model, whereas the LTHT approach utilizes a medical model and directs resources at medical management.

  8. Scaling behavior and the effects of heterogeneity on shallow seismic imaging of mineral deposits: A case study from Brunswick No. 6 mining area, Canada

    NASA Astrophysics Data System (ADS)

    Cheraghi, Saeid; Malehmir, Alireza; Bellefleur, Gilles; Bongajum, Emmanuel; Bastani, Mehrdad

    2013-03-01

    We have studied the scaling behavior of compressional-wave velocity and density logs from an exploration borehole that extends down to about 700 m depth in the Brunswick No. 6 mining area, Bathurst Mining Camp, Canada. Using statistical methods, vertical and horizontal scale lengths of heterogeneity were estimated. Vertical scale length estimates from the velocity, density and calculated acoustic impedance are 14 m, 33 m, and about 20 m, respectively. Although the estimated scale length for the acoustic impedance implies a weak scattering environment, elastic finite difference modeling of seismic wave propagation in 2D heterogeneous media demonstrates that even this weak scattering medium can mask seismic signals from small, but yet economically feasible, massive sulfide deposits. Further analysis of the synthetic seismic data suggests that in the presence of heterogeneity, lenticular-shaped targets may only exhibit incomplete diffraction signals whereby the down-dip tails of these diffractions are mainly visible on the stacked sections. Therefore, identification of orebody generated diffractions is much easier on the unmigrated stacked sections than on migrated stacked sections. The numerical seismic modeling in 2D heterogeneous media indicates that in the presence of large horizontal, but small vertical scale lengths (structural anisotropy), identification of massive sulfide deposits is possible, but their delineation at depth requires detailed velocity modeling and processing algorithms which can handle the anisotropy.

  9. 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.

  10. Torso vascular trauma at an urban level-I trauma center.

    PubMed

    Dente, Christopher J; Feliciano, David V

    2011-03-01

    Injuries to the great vessels of the torso are commonly seen and managed in busy urban trauma centers. This same injury complex is rarely seen in military conflicts, likely because of the high kinetic energy of weapons causing the wounds seen in this setting. Although most of the great advancements in trauma surgery over the past century have generally resulted from our wartime experience, civilian centers have contributed greatly to the understanding and management of torso vascular injuries. This article reviews the presentation and management of injuries to the great vessels of the torso from major penetrating and blunt trauma.

  11. Therapeutic mentoring: reducing the impact of trauma for foster youth.

    PubMed

    Johnson, Sara B; Pryce, Julia M

    2013-01-01

    This study utilized secondary data analysis to examine therapeutic mentoring (TM) as a service intervention in helping to reduce trauma symptoms in foster youth. Outcomes were compared for mentored (n = 106) and non-mentored (n = 156) foster youth related to experience and symptoms of trauma. Results showed that mentored youth improved significantly in the reduction of trauma symptoms relative to non-mentored youth, suggesting that TM shows promise as an important treatment intervention for foster youth with trauma experiences.

  12. Early evaluation and resuscitation of the pediatric trauma patient.

    PubMed

    DeRoss, Anthony L; Vane, Dennis W

    2004-05-01

    Trauma is the leading case of death for children in the United States. Effective initial resuscitation of pediatric trauma patients can reduce mortality. Guidelines have been developed to facilitate patient care in a systematic and productive manner. Advances have been made in both diagnostic and therapeutic methods. The evaluation and treatment of trauma patients will continue to engage pediatric surgeons as efforts in trauma prevention become more successful.

  13. Role of Complement in Red Cell Dysfunction in Trauma

    DTIC Science & Technology

    2013-12-01

    surface of membrane of RBCs from trauma. A, Deposition of C4d on the surface of RBCs from trauma patients and healthy donors was measured by flow ...donors was measured by flow cytometry. Representative data are shown. B, Data of C4d deposition on RBCs from all samples were expressed as mean...incubated with trauma sera. Phosphorylation of in healthy RBCs (type O, Rh negative) measured by flow cytometry after incubation with sera from trauma

  14. 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…

  15. 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.

  16. 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…

  17. Damage Control Resuscitation: Directly Addressing the Early Coagulopathy of Trauma

    DTIC Science & Technology

    2007-02-01

    based resuscitation guidelines in prehospital trauma life sup- port ( PHTLS ) and advanced trauma life support (ATLS) may worsen the presenting acidosis and...eds. PHTLS Basic and Advanced Prehospital Trauma Life Support: Military Edition. 6th ed. St. Louis: Mosby; 2006. 56. Martini WZ, Pusateri AE

  18. 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…

  19. 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…

  20. Building a Trauma-Informed Workforce Capacity and Legacy

    ERIC Educational Resources Information Center

    Popescu, Marciana; Strand, Virginia; Way, Ineke; Williams-Hecksel, Cheryl; Abramovitz, Robert

    2017-01-01

    Social workers encounter trauma in a majority of the populations they serve. It is therefore essential to train social work students to understand the impact of trauma, to assess trauma history and symptoms, and to effectively intervene with children and families. This article presents 3 qualitative research narratives that provide an in-depth…

  1. 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…

  2. 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…

  3. Getting Started in Orthopaedic Trauma Research.

    PubMed

    Mir, Hassan R

    2015-11-01

    Incorporating research into practice as an orthopaedic trauma surgeon can be very fulfilling. There are challenges when getting started whether in a university or other practice setting. Understanding the various components of the research process is important before beginning and thereafter. This article reviews some of the issues that may be encountered and strategies to help.

  4. ['Advanced trauma life support' in Netherlands].

    PubMed

    van Vugt, A B

    2000-10-28

    Introduction of the principles of advanced trauma life support (ATLS) in the management of accident victims has been in progress in the Netherlands since 1995. The main ATLS principles are that the aid giver treats the most dangerous disorder first and does no further damage. After assessment and, if necessary, treatment of the airways, the respiration, the circulation and any craniocerebral injury, an exploratory examination is carried out. Physicians receive theoretical and practical instructions in this form of management during an intensive two-day course, counselled by a coordinating organization in the USA. Most of those attending are interns in general surgery, traumatology and orthopaedics, gatekeeper doctors of emergency rooms and army medical officers. The standardized way of thinking improves the communication and understanding between the various disciplines involved in trauma care, in part because there exist comparable programmes for ambulance care and emergency care. Other measures improving the quality of trauma care are regionalization of the trauma care, medical helicopter teams and evaluation of the effects of ATLS as an operating procedure.

  5. 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…

  6. 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…

  7. 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…

  8. Trauma in pregnancy: assessment, management, and prevention.

    PubMed

    Murphy, Neil J; Quinlan, Jeffrey D

    2014-11-15

    Trauma complicates one in 12 pregnancies, and is the leading nonobstetric cause of death among pregnant women. The most common traumatic injuries are motor vehicle crashes, assaults, falls, and intimate partner violence. Nine out of 10 traumatic injuries during pregnancy are classified as minor, yet 60% to 70% of fetal losses after trauma are a result of minor injuries. In minor trauma, four to 24 hours of tocodynamometric monitoring is recommended. Ultrasonography has low sensitivity, but high specificity, for placental abruption. The Kleihauer-Betke test should be performed after major trauma to determine the degree of fetomaternal hemorrhage, regardless of Rh status. To improve the effectiveness of cardiopulmonary resuscitation, clinicians should perform left lateral uterine displacement by tilting the whole maternal body 25 to 30 degrees. Unique aspects of advanced cardiac life support include early intubation, removal of all uterine and fetal monitors, and performance of perimortem cesarean delivery. Proper seat belt use reduces the risk of maternal and fetal injuries in motor vehicle crashes. The lap belt should be placed as low as possible under the protuberant portion of the abdomen and the shoulder belt positioned off to the side of the uterus, between the breasts and over the midportion of the clavicle. All women of childbearing age should be routinely screened for intimate partner violence.

  9. 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…

  10. 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…

  11. 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…

  12. September 11: Children's Responses to Trauma.

    ERIC Educational Resources Information Center

    Berson, Michael J.; Berson, Ilene R.

    2002-01-01

    Teachers can help children deal with confusing emotions during times of crisis by listening to them and creating a comfortable environment. This paper explains what teachers can do in the aftermath of the attacks of September 11th, 2001, focusing on the impact of trauma, how children of different ages react and cope, safety and the future, and…

  13. The onset of rheumatoid arthritis following trauma

    PubMed Central

    Brawer, Arthur E; Goel, Noopur

    2016-01-01

    Background Rheumatoid arthritis (RA) is known to have many predisposing factors. Objective We studied individuals whose RA was initiated by physical injuries. Patients and methods Sixty patients (43 females), previously well, developed RA following trauma. No other known environmental or familial influences were present. Fourteen sustained a fracture; of the 46 who did not, 36 sustained multiple injuries that in part involved the axial skeleton. Subsequent unremitting daily pain, stiffness, limited motion, pain on motion, and/or swelling in the injured areas were mandatory for inclusion. Results Nine months after injuries (span: 2 weeks–36 months), more obvious signs of inflammation (IM) appeared in multiple other joints that were previously not affected by the original trauma. In those with laboratory tests done prior to the spread of IM (30/60), 22 (73%) were normal until an average 8 months after the spread of IM. Of the entire cohort of 60, only 23% had a positive rheumatoid factor, but 43% had a positive antinuclear antibody. Conclusion It seems apparent that any severe trauma to a joint may precipitate an ongoing localized chronic inflammatory disorder for an indefinite period of time, which may then lead to the spread of IM to multiple other joints. The initiation of RA following trauma warrants consideration as a legitimate entity. PMID:27843373

  14. 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.

  15. Blood utilization in orthopedic and trauma practice

    PubMed Central

    Tayara, Bader Kamal; Al-Faraidy, Moaad Hatim; Al-Sayel, Faisal Abdullah; Al-Omran, Abdallah S; Sadat-Ali, Mir

    2015-01-01

    Objectives: Very little is known about blood utilization in orthopedic and trauma surgery and there is no definite policy in this regard. Our objective is to perform an audit on our practice of blood utilization in the orthopedic department. Methods: We have retrospectively analyzed the data of patients who were admitted between January 2011 and December 2012 to the orthopedic male, female and pediatric wards for which blood products were requested. Results: Three hundred and eight patients were admitted for surgery during the study period. The average age was 35.12 ± 20.4 years and postsurgery they stayed in the hospital for 25.60 ± 10.5 days. Blood products were requested for 223 trauma surgeries. In elective orthopedic procedures, only 42.78% of the blood requested was utilized while in trauma patients it was 55.25%. Conclusions: A substantial amount of blood and its product was used in trauma and elective orthopedic surgeries. There was a major discrepancy between the blood requested and utilized and secondly in the majority single unit transfusion was utilized, which is not within the fundamentals of blood transfusion. PMID:26097818

  16. [Videothoracospy in thoracic trauma and penetrating injuries].

    PubMed

    Lang-Lazdunski, L; Chapuis, O; Pons, F; Jancovici, R

    2003-03-01

    Videothoracoscopy represents a valid and useful approach in some patients with blunt chest trauma or penetrating thoracic injury. This technique has been validated for the treatment of clotted hemothorax or posttraumatic empyema, traumatic chylothorax, traumatic pneumothorax, in patients with hemodynamic stability. Moreover, it is probably the most reliable technique for the diagnosis of diaphragmatic injury. It is also useful for the extraction of intrathoracic projectiles and foreign bodies. This technique might be useful in hemodynamically stable patients with continued bleeding or for the exploration of patients with penetrating injury in the cardiac area, although straightforward data are lacking to confirm those indications. Thoracotomy or median sternotomy remain indicated in patients with hemodynamic instability or those that cannot tolerate lateral decubitus position or one-lung ventilation. Performing video-surgery in the trauma setting require expertise in both video-assisted thoracic surgery and chest trauma management. The contra-indications to videothoracoscopy and indications for converting the procedure to an open thoracotomy should be perfectly known by surgeons performing video-assisted thoracic surgery in the trauma setting. Conversion to thoracotomy or median sternotomy should be performed without delay whenever needed to avoid blood loss and achieve an adequate procedure.

  17. Do topical antibiotics help corneal epithelial trauma?

    PubMed Central

    King, J. W.; Brison, R. J.

    1993-01-01

    Topical antibiotics are routinely used in emergency rooms to treat corneal trauma, although no published evidence supports this treatment. In a noncomparative clinical trial, 351 patients with corneal epithelial injuries were treated without antibiotics. The infection rate was 0.7%, suggesting that such injuries can be safely and effectively managed without antibiotics. A comparative clinical trial is neither warranted nor feasible. PMID:8268742

  18. 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

  19. National Trauma Institute: A National Coordinating Center for Trauma Research Funding

    DTIC Science & Technology

    2013-10-01

    Antioxidant Vitamins on Coagulopathy and Nosocomial Pneumonia after Severe Trauma Principal Investigator: Jean-Francois Pittet, MD Lead Site: University of...research: Effect of antioxidant vitamins on coagulopathy and nosocomial pneumonia after severer trauma 20120816 20130913 University of California...protocol deviations, adverse events, study close out upon study completion are managed per the guidelines set forth by the HRPO. An eighteen month No Cost

  20. Establishing a collaborative trauma training program with a community trauma center for military nurses.

    PubMed

    McNamara, K J; Schulman, C; Jepsen, D; Cuffley, J E

    2001-01-01

    A mission of the Navy Nurse Corps is to deploy medical support for military forces on short notice. Navy nurses must possess a working knowledge of trauma management, but meeting this clinical experience is a challenge. Peacetime military hospitals do not routinely care for severely injured patients. This article describes how the Navy established a partnership with a Level 1 Trauma Center, the role and expectations for both Navy and civilian nurses, and an evaluation of the experience.

  1. Penetrating Neck Trauma: Review of 192 Cases

    PubMed Central

    Mahmoodie, Mohsen; Sanei, Behnam; Moazeni-Bistgani, Mohammad; Namgar, Mohammad

    2012-01-01

    Background The neck region contains a high density of vital organ structures within a relatively small and unprotected anatomic region, making it one of the most vulnerable areas of the body for all types of injuries. Objectives In this article, we studied penetrating neck trauma cases in Alzahra Hospital over a 10-year period. Patients and Methods In this retrospective, descriptive, analytical study, penetrating neck trauma cases admitted to Alzahra Hospital between April 2000 and April 2010 were analyzed for epidemiology, mechanism of trauma, zone of trauma, therapeutic method, injuries to other organs, complications, and mortality. Results Among 192 penetrating neck injuries, the mean age at the time of injury was 25.08 ± 15.02 years. Of these cases, 96.4% occurred in men. The most common mechanisms of trauma was stab wounds (85.93%). In 56.3% of penetrating neck injuries, zone 2 was involved. Neck exploration was positive in 84.4% of cases, and 52.1% of patients underwent surgery. Vascular exploration was the most common cause of surgery (67.2% of patients). The most common surgical intervention was vein ligation (50.8% of cases). In 11.98% of cases, another organ injury occurred simultaneously, and chest injury was the most common coexisting problem (65.2%). Complications were reported in 9.3% of patients, and the need for intubation was the most common complication (5.2% of patients). Mortality rate was 1.5%. Conclusions According to the findings of this study, the most common cause of penetrating neck injuries was stab wounds, and the majority of patients were young men, therefore, preventive measures should be implemented. Because of fatal complications associated with neck injuries, we recommend early neck exploration in unstable cases or when injuries are deeper than the platysma. PMID:24719835

  2. 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.

  3. Developmental trauma disorder: an attachment-based perspective.

    PubMed

    Rahim, Masuma

    2014-10-01

    Despite the evidence linking chronic early trauma with psychological distress, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) has excluded developmental trauma disorder from its taxonomy. This article considers developmental trauma from an attachment-based perspective and raises some of the difficulties professionals may experience conceptualising the trauma-attachment relationship. It explores the impact of the decision to exclude the diagnosis from DSM-5 on professionals, those who have had traumatic early experiences and their carers. Finally, it presents formulation as an alternative proposition which may better suit those who present to mental health services with attachment- and trauma-linked difficulties.

  4. Integrating nursing education into a trauma outreach program.

    PubMed

    Drury, T; Zacharias, S

    1997-01-01

    A level 1 trauma center is challenged to provide optimal trauma care to patients in the region it serves. One approach is to increase the knowledge and clinical skills of all trauma care providers, especially those who work outside urban areas. This article describes one trauma center's experience of integrating rural nursing education into an existing medical trauma outreach program. The educational strategies, example of course content, and organizational aspects of the program are described, along with marketing strategies used to promote the program.

  5. Role of coordinators in national and international major trauma services.

    PubMed

    Ross, Jessica; Ashby, Nichola

    2016-12-07

    Major trauma services in the UK underwent reform in April 2012, following reports that trauma care in England was 'unacceptable' and in need of desperate change, and urgent recommendations were made to improve coordination, costs, and information about trauma care to avoid unnecessary deaths. Following the reconfiguration of services, NHS England highlighted the need for nurse key-workers, or coordinators, to support patients through the major trauma pathway and into rehabilitation. This article examines the literature on the coordinator role to understand its function in UK and international major trauma networks.

  6. Compliance to advanced trauma life support protocols in adult trauma patients in the acute setting

    PubMed Central

    2013-01-01

    Introduction Advanced Trauma Life Support (ATLS) protocols provide a common approach for trauma resuscitations. This was a quality review assessing compliance with ATLS protocols at a Level I trauma center; specifically whether the presence or absence of a trauma team leader (TTL) influenced adherence. Methods This retrospective study was conducted on adult major trauma patients with acute injuries over a one-year period in a Level I Canadian trauma center. Data were collected from the Alberta Trauma Registry, and adherence to ATLS protocols was determined by chart review. Results The study identified 508 patients with a mean Injury Severity Score of 24.5 (SD 10.7), mean age 39.7 (SD 17.6), 73.8% were male and 91.9% were involved in blunt trauma. The overall compliance rate was 81.8% for primary survey and 75% for secondary survey. The TTL group compared to non-TTL group was more likely to complete the primary survey (90.9% vs. 81.8%, p = 0.003), and the secondary survey (100% vs. 75%, p = 0.004). The TTL group was more likely than the non-TTL group to complete the following tasks: insertion of two large bore IVs (68.2% vs. 57.7%, p = 0.014), digital rectal exam (64.6% vs. 54.7%, p = 0.023), and head to toe exam (77% vs. 67.1%, p = 0.013). Mean times from emergency department arrival to diagnostic imaging were also significantly shorter in the TTL group compared to the non-TTL group, including times to pelvis xray (mean 68min vs. 107min, p = 0.007), CT chest (mean 133min vs. 172min, p = 0.005), and CT abdomen and pelvis (mean 136min vs. 173min, p = 0.013). Readmission rates were not significantly different between the TTL and non-TTL groups (3.5% vs. 4.5%, p = 0.642). Conclusions While many studies have demonstrated the effectiveness of trauma systems on outcomes, few have explored the direct influence of the TTL on ATLS compliance. This study demonstrated that TTL involvement during resuscitations was associated with improved

  7. Suicide by blunt head trauma - Two cases with striking similarities.

    PubMed

    Park, Hyejin; Lee, Bongwoo; Yoon, Connie

    2015-10-01

    There have been several forensic pathological studies on the distinction between falls from height and homicidal blows in blunt head trauma, but few studies have focused on suicidal blows. Self-inflicted blunt head trauma is usually a part of a complex suicide with more than one suicidal method applied. Actually, no reports on suicide indicate blunt head trauma to be the singular cause of death in recent publications. Cases with self-inflicted blunt trauma are often challenging for those involved in the investigation because they are confronted with findings that are also found in homicides. A refined guideline to differentiate suicidal blows from homicidal blows in blunt head trauma allows for a more accurate representation of the events surrounding death. This paper presents two cases of suicide by self-inflicted blunt head trauma in which blunt head trauma from repeatedly hitting the decedent's head with a hammer was considered to be the only cause of death.

  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.

  9. Persistent organochlorine pollutants and toxaphene congener profiles in bottlenose dolphins (Tursiops truncatus) frequenting the Turtle/Brunswick River Estuary (TBRE) in coastal Georgia, USA.

    PubMed

    Pulster, Erin L; Smalling, Kelly L; Zolman, Eric; Schwacke, Lori; Maruya, Keith A

    2009-07-01

    Although the Turtle/Brunswick River Estuary (TBRE) in coastal Georgia (USA) is severely contaminated by persistent organochlorine pollutants (POPs), little information regarding POPs in higher-trophic-level biota in this system is available. In the present study, polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs; including DDTs, chlordanes, and mirex), and chlorinated monoterpenes (toxaphene) were measured using gas chromatography with electron-capture detection and gas chromatography with electron-capture negative ion mass spectrometry (GC-ECNI-MS) in blubber of free-ranging and stranded bottlenose dolphins (Tursiops truncatus). Mean total PCBs (78.6 +/- 32.4 microg/g lipid) and toxaphene (11.7 +/- 9.3 microg/g lipid) were significantly higher in dolphins sampled in the TBRE than in dolphins stranded near Savannah (GA, USA) 80 to 100 km to the north. Levels of OCPs were several-fold lower than levels of PCBs; moreover, PCBs comprised 81 and 67% of the total POP burden in TBRE and non-TBRE dolphins, respectively. Analyses with GC-ECNI-MS revealed that 2,2,5-endo,6-exo,8,8,9,10-octachlorobornane (P-42a), a major component in technical toxaphene and a major residue congener in local estuarine fish species, was the most abundant chlorobornane in both sets of blubber samples. Mean total POP concentrations (sum of PCBs, OCPs, and toxaphene) approached 100 microg/g lipid for the TBRE animals, well above published total PCB thresholds at which immunosuppresion and/or reproductive anomalies are thought to occur. These results indicate extended utilization of the highly contaminated TBRE as habitat for a group of coastal estuarine dolphins, and they further suggest that these animals may be at risk because of elevated POP concentrations.

  10. 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.

  11. Comparing ONRAB® AND RABORAL V-RG® oral rabies vaccine field performance in raccoons and striped skunks, New Brunswick, Canada, and Maine, USA.

    PubMed

    Fehlner-Gardiner, Christine; Rudd, Robert; Donovan, Dennis; Slate, Dennis; Kempf, Libby; Badcock, Jacqueline

    2012-01-01

    Control of rabies in mesocarnivore reservoirs through oral rabies vaccination (ORV) requires an effective vaccine bait. Oral rabies vaccine performance in the field may be affected by a variety of factors, including vaccine bait density and distribution pattern, habitat, target species population density, and the availability of competing foods. A field study in which these covariates were restricted as much as possible was conducted along the international border of the state of Maine (ME), USA, and the province of New Brunswick (NB), Canada, to compare the performance of two oral rabies vaccines in raccoons (Procyon lotor) and striped skunks (Mephitis mephitis). RABORAL V-RG(®) (vaccinia-rabies glycoprotein recombinant oral vaccine in fishmeal-coated sachet) or ONRAB(®) (adenovirus-rabies glycoprotein recombinant oral vaccine in Ultralite bait matrix) were distributed in ME and NB, respectively, by fixed-wing aircraft at a density of 75 baits/km(2) along parallel flight lines spaced 1.0 km apart. Sera were collected from live-trapped raccoons and skunks 5-7 wk post-ORV and assayed to determine antibody prevalence in each area. Duplicate serum samples were provided blind to two different laboratories for analyses by rabies virus serum neutralization assays (at both laboratories) and a competitive enzyme-linked immunosorbent assay (at one laboratory). There was no significant difference in the proportion of antibody-positive animals determined by the three serologic methods, nor was there a significant difference between ONRAB and RABORAL V-RG in the proportion of antibody-positive striped skunks observed post-ORV. In contrast, the proportion of antibody-positive raccoons was significantly higher in the ONRAB- versus the RABORAL V-RG-baited areas (74% vs. 30%; χ(2)=89.977, df=5, P<0.0001). These data support that ONRAB may serve as an effective tool for raccoon rabies control.

  12. A dual infection of infectious salmon anaemia (ISA) virus and a togavirus-like virus in ISA of Atlantic salmon Salmo salar in New Brunswick, Canada.

    PubMed

    Kibenge, F S; Whyte, S K; Hammell, K L; Rainnie, D; Kibenge, M T; Martin, C K

    2000-08-10

    Two viruses, infectious salmon anaemia (ISA) virus and a novel togavirus-like virus, were isolated from ISA disease outbreaks that were first reported as a new syndrome, haemorrhagic kidney syndrome (HKS) affecting farmed Atlantic salmon Salmo salar L. on the East coast of Canada. Laboratory confirmation of ISA diagnosis was initially complicated by isolation of only the togavirus-like agent using the CHSE-214 cell line. Here we demonstrate that a clinical sample from a disease outbreak of ISA contained a mixture of ISA virus and togavirus-like virus. Reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed the presence of both viruses during serial passage of cultures in SHK-1 and CHSE-214 cells. Virus harvested at passage level 3 in both cell lines caused high mortalities and severe gross pathology consistent with ISA virus infection in experimentally inoculated Atlantic salmon parr (approximately 35 g) in freshwater, beginning 12 d post inoculation. ISA virus was detected by virus isolation from kidney and liver tissues of all dead or moribund fish tested. A comparison of virus isolation, 1-step procedure RT-PCR and RNA dot-blot hybridization for detection of ISA virus (ISAV) in fish tissues showed virus isolation to have 100% sensitivity, followed by RT-PCR (66 and 28% sensitivity in kidney and liver, respectively), with RNA dot-blot hybridization as the least sensitive method (20 and 10% sensitivity in kidney and liver, respectively). No togavirus-like virus was detected in these samples by virus isolation. Moreover, another togavirus-like virus isolate grown in CHSE-214 cells in the absence of any other detectable pathogen was non-pathogenic in experimentally inoculated fish. This study confirms that the original ISA outbreaks in New Brunswick, Canada, were caused solely by ISAV.

  13. 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.

  14. Attachment Dimensions and Post-traumatic Symptoms Following Interpersonal Traumas versus Impersonal Traumas in Young Adults in Taiwan.

    PubMed

    Huang, Yu-Lien; Chen, Sue-Huei; Su, Yi-Jen; Kung, Yi-Wen

    2016-08-10

    Greater risk of post-traumatic stress disorder (PTSD) is seen in individuals exposed to interpersonal traumatic events. Based on an attachment perspective, interpersonal trauma exposure may activate one's attachment insecurity system and disrupt affect, behaviour and interpersonal function, which may in turn create more difficulties to cope with interpersonal traumas and exacerbate PTSD symptomatology. The present study examined whether attachment anxiety relative to attachment avoidance would be a stronger predictor of greater PTSD symptoms following interpersonal traumas versus impersonal traumas in a Taiwanese sample. One hundred and sixty-two trauma-exposed Taiwanese young adults completed the measures of symptoms of depression, anxiety and PTSD, and attachment anxiety and attachment avoidance. In this Taiwanese study, higher attachment anxiety was observed in individuals who were exposed to interpersonal traumas. The interpersonal trauma group reported greater PTSD symptoms than did the impersonal trauma group. Specifically, after controlling for age, occurrence of trauma and distress of trauma, attachment anxiety, but not attachment avoidance, predicted more PTSD total severity and avoidance symptoms in the interpersonal trauma group. The findings may be pertinent to attachment anxiety-related hyperactivating strategies, as well as specific cultural values and a forbearance strategy applied to regulate traumatic distress in a collectivist society. Copyright © 2016 John Wiley & Sons, Ltd.

  15. Trauma research in Qatar: a literature review and discussion of progress after establishment of a trauma research centre.

    PubMed

    El-Menyar, A; Asim, M; Zarour, A; Abdelrahman, H; Peralta, R; Parchani, A; Al-Thani, H

    2016-02-01

    A structured research programme is one of the main pillars of a trauma care system. Despite the high rate of injury-related mortalities, especially road traffic accidents, in Qatar, little consideration has been given to research in trauma. This review aimed to analyse research publications on the subject of trauma published from Qatar and to discuss the progress of clinical research in Qatar and the Gulf Cooperation Council countries with special emphasis on trauma research. A literature search using PubMed and Google Scholar search engines located 757 English-language articles within the fields of internal medicine, surgery and trauma originating from Qatar between the years 1993 and 2013. A steep increase in the number of trauma publications since 2010 could be linked to the setting up of a trauma research centre in Qatar in 2011. We believe that establishing a research unit has made a major impact on research productivity, which ultimately benefits health care.

  16. The major traumas in youth football.

    PubMed

    Volpi, P; Pozzoni, R; Galli, M

    2003-11-01

    For 4 years we followed a group of football players in the youth division of a professional club, ranging in age from 9 to 19 years, and analyzed the major injuries, i.e., those which required them to be sidelined for at least 4 weeks. We observed 23 sprains, 16 fractures, 16 cases of osteochondrosis, 7 muscle lesions, 6 cases of groin pain (athletic pubalgia), and 4 tendonopathies. The most frequent sites were the knee (n=30) and the ankle (n=11); the trauma factor was predominant (65.2%) with respect to overuse; noncontact traumas were more numerous (63.8%) than those resulting from contrast. Of a total 72 cases 8 regarded goalkeepers, and the remaining 64 cases were distributed among the other positions. As regards the age categories we detected a prevalence of osteochondrosis, traumatic detachments, and some fractures in the younger players, while in the older athletes we observed more sprains, muscle lesions, and tendonopathies.

  17. 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

  18. Missed Gastric Injuries in Blunt Abdominal Trauma

    PubMed Central

    Naiem, Ahmed A.; Taqi, Kadhim M.; Al-Kendi, Badriya H.; Al-Qadhi, Hani

    2016-01-01

    Hollow viscus injuries of the digestive tract are an uncommon occurrence in blunt abdominal trauma. We report a 39-year-old male who was hit by a vehicle as a pedestrian and admitted to the Sultan Qaboos University Hospital, Muscat, Oman, in 2015. He underwent an exploratory laparotomy which revealed injuries to the distal stomach, liver and descending colon. Postoperatively, the patient was febrile, tachycardic and hypotensive. Abdominal examination revealed distention and tenderness. The next day, a repeat laparotomy identified a gastric injury which had not been diagnosed during the initial laparotomy. Although the defect was repaired, the patient subsequently died as a result of multiorgan failure. Missed gastric injuries are rare and are associated with a grave prognosis, particularly for trauma patients. Delays in diagnosis, in addition to associated injuries, contribute to a high mortality rate. PMID:28003902

  19. 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.

  20. Pentadic cartography: mapping birth trauma narratives.

    PubMed

    Beck, Cheryl Tatano

    2006-04-01

    The reported prevalence of posttraumatic stress disorder due to childbirth ranges from 1.5 to 6%. The purpose of this qualitative study is to conduct a narrative analysis of 11 mothers' birth trauma stories. The dramatistic pentad provided the overall structure for this narrative analysis. Using pentadic cartography, the author mapped the verbal terrain of each narrative using the pentad's five terms of scene, act, purpose, agent, and agency. The ratio imbalance between act and agency appeared most prominently on the pentadic map. Viewing the mothers' narratives through the act:agency ratio offered a terministic screen that helped pinpoint where the trauma that women experienced occurred during labor and delivery. Implications for clinical practice focus on the How (agency), the way clinicians provide care to women during childbirth.

  1. Upper extremity trauma: current trends in management.

    PubMed

    Stone, W M; Fowl, R J; Money, S R

    2007-10-01

    Upper extremity trauma can be penetrating or blunt in etiology. The close proximity of vein, artery and nerve makes for a complicated presentation and potentially complicated reconstruction. Orthopedic and neurologic injuries can cause the more long term disability of these patients, but vascular injuries are initially more life threatening. Control of vascular injuries can be particularly difficult due to anatomic issues in the upper extremities. The intervention carried significant morbidity until evolution to endovascular approaches occurred. By reconstructing the injury from a more ''remote'' access site, less concomitant injury to the extremity can be encountered. However, although control of vascular injuries may result in greater survival rates with less morbidity from the procedure, long term outcome remains dependent upon concomitant injuries. This review will encompass both vascular and neurologic injuries secondary to trauma to the upper extremity and outline some of the trends in management.

  2. Returning to contingency: the forward trauma team.

    PubMed

    Dickinson, Andrew; Dalal, S; Beales, L

    2016-12-01

    During Herrick 19, Main Operating Base Price Role 1 treatment facility saw one of the busiest periods of Role 1 trauma care within the British Afghanistan campaign. Within 5 months 73 trauma casualties were treated, 48 of whom were category A. This article shares the experiences of this Role 1 and its unusual context, and discusses the relevance with regard to future medical planning. The focus is on the human element; a fundamental of all military operations yet one that is often overlooked. We consider the team construct and the team members of Role 1 and suggest how this team and its leaders can be optimally prepared, supported and maintained, and then safely disassembled. We also consider how best this team can be placed within the battle group formation in order to provide the highest standard of care.

  3. Biology, childhood trauma, and murder: rethinking justice.

    PubMed

    Heide, Kathleen M; Solomon, Eldra P

    2006-01-01

    This article reviews recent findings in the developmental neurophysiology of children subjected to psychological trauma. Studies link extreme neglect and abuse with long-term changes in the nervous and endocrine systems. A growing body of research literature indicates that individuals with severe trauma histories are at higher risk of behaving violently than those without such histories. This article links these two research areas by discussing how severe and protracted child abuse and/or neglect can lead to biological changes, putting these individuals at greater risk for committing homicide and other forms of violence than those without child maltreatment histories. The implications of these biological findings for forensic evaluations are discussed. Based on new understanding of the effects of child maltreatment, the authors invite law and mental health professionals to rethink their notions of justice and offender accountability, and they challenge policymakers to allocate funds for research into effective treatment and for service delivery.

  4. Management of chest trauma in children.

    PubMed

    Tovar, Juan A; Vazquez, Juan J

    2013-06-01

    Chest trauma in children is caused by high-energy blows, due in general to traffic accidents, that involve several other body regions. They occur mainly in the first decade of life and can be penetrating but are more often non-penetrating. Rib fractures and lung contusions, sometimes associated with pneumothorax or haemothorax, are the more usual injuries, but tracheobronchial rupture, cardiac, oesophageal or diaphragmatic injuries may also occur. These injuries are treated with supportive respiratory and haemodynamic measures, drainage of air or blood from the pleural space and, at times, surgical repair of the injured organ(s). Ruptures of the airway may be difficult to treat and occasionally require suture, anastomosis or resection. Oesophageal injuries can be treated conservatively with antibiotics, drainage and parenteral nutrition. Diaphragmatic tears should be repaired operatively. Overall mortality ranges from 6 to 20%. Mortality is high but this is mainly due to the associated presence of extra-thoracic trauma, and particularly to head injuries.

  5. [Non-operative management of splenic trauma].

    PubMed

    Moog, R; Mefat, L; Kauffmann, I; Becmeur, F

    2005-02-01

    Non-operative management of splenic trauma is one of the most notable advances in paediatric surgery. It should be systematically proposed except for cases of hemodynamic instability. Abdominal CT scan without and with contrast injection is essential with initial optimal management. Stay in paediatric surgical intensive care unit with monitoring can prevent rare but serious complications. The time of hospitalisation stay lies between two and three weeks and will be followed by three months without contact activity. The advantages of this treatment are obvious safeguarding of splenic function and absence of postoperative complications. Consequently only one of the 88 children admitted these ten last past years for splenic trauma in our unity was operated.

  6. 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

  7. Historical and Current Trends in Colon Trauma

    PubMed Central

    Causey, Marlin Wayne; Rivadeneira, David E.; Steele, Scott R.

    2012-01-01

    The authors discuss the evolution of the evaluation and management of colonic trauma, as well as the debate regarding primary repair versus fecal diversion. Their evidence-based review covers diagnosis, management, surgical approaches, and perioperative care of patients with colon-related trauma. The management of traumatic colon injuries has evolved significantly over the past 50 years; here the authors describe a practical approach to the treatment and management of traumatic injuries to the colon based on the most current research. However, management of traumatic colon injuries remains a challenge and continues to be associated with significant morbidity. Familiarity with the different methods to the approach and management of colonic injuries will allow surgeons to minimize unnecessary complications and mortality. PMID:24294119

  8. The glycocalyx and Trauma: A Review

    PubMed Central

    Chignalia, Andreia Z.; Yetimakman, Feliz; Christiaans, Sarah C.; Unal, Sule; Bayrakci, Benan; Wagener, Brant M.; Russell, Robert T.; Kerby, Jeffrey D.; Pittet, Jean-Francois; Dull, Randal O.

    2015-01-01

    In the United States trauma is the leading cause of mortality among those under the age of 45, claiming approximately 192,000 lives each year. Significant personal disability, lost productivity and long term healthcare needs are common and contribute 580 billion dollars in economic impact each year. Improving resuscitation strategies and the early acute care of trauma patients has the potential to reduce the pathological sequelae of combined exuberant inflammation and immune suppression that can co-exist, or occur temporally, and adversely affect outcomes. The endothelial and epithelial glycocalyx has emerged as an important participant in both inflammation and immunomodulation. Constituents of the glycocalyx have been used as biomarkers of injury severity and have the potential to be target(s) for therapeutic interventions aimed at immune modulation. In this review, we provide a contemporary understanding of the physiologic structure and function of the glycocalyx and its role in traumatic injury with a particular emphasis on lung injury. PMID:26513707

  9. Burial at Srebrenica: linking place and trauma.

    PubMed

    Pollack, Craig Evan

    2003-02-01

    Five years after the massacre at Srebrenica in Bosnia-Herzegovina, survivors were faced with the decision: where did they want their loved ones buried? This report explores the reasons for their choice in qualitative interviews with 37 survivors of the massacre and 22 key informants performed over the summer 2000. Survivors wanted the loved ones buried at Potocari, a site just outside of Srebrenica, because it represented the site of ultimate horror, was connected to their sense of home, and underscored the various power relationships. The data points to the importance of place for health. Trauma, as it occurs in particular locations, breaks the sense of attachment to a particular place. Restoring the physical and social environment through burial and memorials mitigates the consequences of the trauma. The burial at Potocari provides a window into the mourning, politics, and recovery after mass violence.

  10. 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

  11. 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.

  12. 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

  13. [Abusive head trauma: report of a case].

    PubMed

    Grana, M; Nazar, M; de Luca, S; Casalini, E; Eyheremendy, E

    2015-01-01

    The abusive head trauma is a form of child abuse. The most frequent injuries are intracranial lesions, such as subdural hematoma, as well as retinal hemorrhages, usually without other external injuries. Due to its complexity, this problem requires a multidisciplinary medical team, where the role of the radiologist is important, since there are multiple diagnostic methods that are complementary in order to arrive at the correct diagnosis.

  14. Trauma 2007: a finger on the pulse.

    PubMed

    Terry, Shawn M

    2007-01-01

    Truma surgery today is facing a number of significant challenges that offer a stimulus for growth and evolution of tl practice. To successfully face these challenges, reexamination of the discipline, the current practice models for its providers, and the definition/scope of the specialty will be necessary. Further development and application of the cute care surgery model may represent the future direction for trauma care practitioners.

  15. Soft tissue trauma and scar revision.

    PubMed

    Mobley, Steven R; Sjogren, Phayvanh P

    2014-11-01

    Numerous techniques and treatments have been described for scar revision, with most studies focusing on the adult population. A comprehensive review of the literature reveals a paucity of references related specifically to scar revision in children. This review describes the available modalities in pediatric facial scar revision. The authors have integrated current practices in soft tissue trauma and scar revision, including closure techniques and materials, topical therapy, steroid injection, cutaneous laser therapy, and tissue expanders.

  16. Contemporary Management of Wartime Vascular Trauma

    DTIC Science & Technology

    2004-06-01

    From the Society for Vascular Surgery Contemporary management of wartime vascular trauma Charles J. Fox, MD,a,b David L. Gillespie, MD,a,b Sean D...injuries. ( J Vasc Surg 2005;41:638-44.)From the time of Hippocrates, the field of vascular surgery has been advanced by the application of lessons...diagnostic and therapeutic approach to the care of the wounded soldier with a vascular injury. From the Department of Surgery , Peripheral Vascular

  17. Incidental findings in trauma patients during focused assessment with sonography for trauma.

    PubMed

    Lanitis, Sophocles; Zacharioudakis, Constantinos; Zafeiriadou, Paraskevi; Armoutides, Vasileios; Karaliotas, Charilaos; Sgourakis, George

    2012-03-01

    During the initial assessment of trauma patients they usually undergo a Focused Assessment with Sonography for Trauma (FAST) in which there are occasionally incidental findings of other surgical conditions. In this audit we discuss the incidence, demographics, and implications of these findings and we propose a management algorithm. Within 2 years we managed 6041 trauma patients in the emergency department based on the Advanced Trauma Life Support protocols, 95 per cent of which underwent a FAST ultrasound. Incidental findings were reported in 468 patients (7.8%), whereas in a further 11.2 per cent of these patients there was a second finding. The mean age of these patients was 57.55 years (15-105), and most of them were men (51.1%). The vast majority of the findings were related to the liver and biliary tree (52.1%) followed by the urinary track (27.1% + 8%). In multivariate analysis only the age was a significant factor associated with incidental findings (P < 0.001) whereas in univariate analysis both the gender [men (54.1%) vs women (45.9), P = 0.013] and the mechanism of trauma (P < 0.001) were as important as the age (P < 0.001). The patients who had incidental findings were 15 years older than the rest. The detection of unknown surgical conditions in FAST may lead to managerial and possible medico-legal issues rendering the development of a proper algorithm mandatory.

  18. Tranexamic Acid (TXA) in Trauma Patients: Barriers to Use among Trauma Surgeons and Emergency Physicians

    PubMed Central

    2017-01-01

    Objective. Tranexamic Acid (TXA) is currently the only drug with prospective clinical evidence supporting its use in bleeding trauma patients. We sought to better understand the barriers preventing its use and elicit suggestions to further its use in trauma patients in the state of Maryland. Methods. This is a cross-sectional study. Results. The overall response rate was 38%. Half of all participants reported being familiar with the CRASH-2 trial and MATTERs study. Half reported being aware of TXA as part of their institution's massive transfusion protocol. The majority of participants felt that TXA would have a significant positive impact on the survival of trauma patients. A majority also felt that the use of TXA would increase if its administration was the responsibility of both trauma surgeons and emergency physicians. Conclusion. Only half of responders reported being aware of TXA as being part of their institution's massive transfusion protocol. Lack of awareness of the clinical data supporting its use is a major barrier. However, most trauma providers and emergency physicians do have a favorable view of TXA and support its incorporation into massive transfusion protocols. We believe that more studies of this kind on both state and national level are needed. PMID:28316839

  19. Implementing a perpetual anesthesia setup standardized for the trauma room in a level I trauma center.

    PubMed

    Faircloth, Amanda C; Ford, Mary B

    2013-02-01

    The trauma room in a level I trauma center is a dynamic environment that provides little room for error. Significant variability can exist if anesthesia providers set up the room differently. Standardization provides a system that is consistent, reliable, and cost-effective. This study examines the process of creating and implementing a standardized anesthesia setup in the trauma room of a level I trauma center. As a result of this study, the medication cart and airway setups have been standardized. Providers are encouraged to only draw up medications that will be immediately used and to ensure that prefilled syringes have been incorporated into the pharmacy formulary. Using the EZ Endo prestyleted endotracheal tube (ETT) vs a regular ETT with stylet has yielded an annual cost savings of $2,673. Ensuring that items such as an esophageal temperature probe, humidifier, and nasogastric tube are available but unopened has provided a savings of $1,989.25 per year. The reservoir bag has been changed to a latex-free bag, and 3 central line kits including an arterial line kit are routinely stocked. An ultrasound machine dedicated for central line access, GlideScope, rapid fluid infuser, and Airtraq laryngoscope have all been incorporated into the permanent setup in the trauma room.

  20. 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

  1. 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

  2. Childhood sexual abuse: sources of trauma.

    PubMed

    Draucker, C B

    1993-01-01

    Many American women who were sexually abused as children seek mental health services to help them heal from their abuse. An appreciation of the varied sources of trauma that may stem from a sexual abuse experience may guide clinicians in facilitating a meaningful discussion with survivors of the ways in which their childhood development and their current lives have been influenced by their sexual abuse. Therefore, the goal of this study was to provide a beginning delineation of possible sources of trauma in the abuse situation, based on the retrospective reflections of women who have survived abuse. One hundred and eighty-six survivors were asked to identify the most traumatic aspects of their abuse experience. A content analysis was performed on their written responses, and the following eight categories, reflecting different sources of trauma, were identified: abandonment, powerlessness, violence, betrayal, guilt and shame, loss of self, loss of childhood, and impact on sexual adjustment. Possible treatment implications and suggestions for future research are discussed.

  3. Evaluation of care of dentoalveolar trauma

    PubMed Central

    FARINIUK, Luiz Fernando; de SOUSA, Maria Helena; WESTPHALEN, Vânia Portela Dietzel; CARNEIRO, Everdan; SILVA NETO, Ulisses X; ROSKAMP, Liliane; CAVALI, Ana Égide

    2010-01-01

    Objectives The aim of this study was to evaluate cases of dental trauma treated at the specialized center of Pontifical Catholic University of Paraná, Curitiba, Brazil, during a period of 2 years. Material and Methods A total of 647 patients were evaluated and treated between 2003 and 2005. Data obtained from each patient were tabulated and analyzed as to gender, age, etiology, time elapsed after the injury, diagnosis (type of trauma), and affected teeth. Results The results revealed that male individuals aged 7 to 13 years presented the highest prevalence of injury, and falling was the main causal factor. In most cases, the time elapsed between the accident and the first care ranged from 4 to 24 h. A total of 1,747 teeth were affected, with higher incidence of concussion/subluxation and coronal fracture, followed by lateral luxation and avulsion. The permanent maxillary central incisors were the most commonly affected teeth. Conclusion The frequency and causes of dentoalveolar trauma should be investigated for identification of risk groups, treatment demands and costs in order to allow for the establishment of effective preventive measures that can reduce the treatment duration and costs for both patients and oral health services. PMID:20835567

  4. Executive Function and PTSD: Disengaging from Trauma

    PubMed Central

    Aupperle, Robin L.; Melrose, Andrew J.; Stein, Murray B.; Paulus, Martin P.

    2016-01-01

    Neuropsychological approaches represent an important avenue for identifying susceptibility and resiliency factors relating to the development and maintenance of posttraumatic stress disorder (PTSD) symptoms post-trauma. This review will summarize results from prospective longitudinal and retrospective cross-sectional studies investigating executive function associated with PTSD. This research points specifically towards subtle impairments in response inhibition and attention regulation that may predate trauma exposure, serve as risk factors for the development of PTSD, and relate to the severity of symptoms. These impairments may be exacerbated within emotional or trauma-related contexts, and may relate to dysfunction within dorsal prefrontal networks. A model is presented concerning how such impairments may contribute to the clinical profile of PTSD and lead to the use of alternative coping styles such as avoidance. Further neuropsychological research is needed to identify the effects of treatment on cognitive function and to potentially characterize mechanisms of current PTSD treatments. Knowledge gained from cognitive and neuroscientific research may prove valuable for informing the future development of novel, more effective, treatments for PTSD. PMID:21349277

  5. Acute renal failure following blunt civilian trauma.

    PubMed Central

    Matas, A J; Payne, W D; Simmons, R L; Buselmeier, T J; Kjellstrand, C M

    1977-01-01

    Renal failure developed in 20 patients following blunt civilian trauma. Ten recovered normal renal function; 8 currently survive. Survivors and nonsurvivors did not differ in age, time from trauma to anuria, mean blood urea nitrogen or creatinine level prior to the first or to subsequent dialyses. However, there was an increased incidence of sepsis and liver failure in those who died. When outcome was related to site of injury, patients with closed head injury and/or intra-abdominal injury had a worse prognosis than those with thoracic or extremity injury only. Only 2 patients with perforated bowel survived; both had peritoneal dialysis combined with peritoneal lavage with antibiotic solutions. Mortality in patients with posttraumatic renal failure remains high; however, death is usually a result of associated complications rather than a result of the renal failure. Aggressive management of other complications of the trauma, especially sepsis or potential sepsis, is necessary. We recommend peritoneal dialysis combined with peritoneal antibiotic lavage where there is a potential for posttraumatic intra-abdominal sepsis associated with renal failure. PMID:843128

  6. Community Disasters, Psychological Trauma, and Crisis Intervention

    PubMed Central

    Boscarino, Joseph A.

    2015-01-01

    The current issue of International Journal of Emergency Mental Health and Human Resilience is focused on community disasters, the impact of trauma exposure, and crisis intervention. The articles incorporated include studies ranging from the World Trade Center disaster to Hurricane Sandy. These studies are related to public attitudes and beliefs about disease outbreaks, the impact of volunteerism following the World Trade Center attacks, alcohol misuse among police officers after Hurricane Katrina, posttraumatic stress disorder after Hurricane Sandy among those exposed to the Trade Center disaster, compassion fatigue and burnout among trauma workers, crisis interventions in Eastern Europe, and police officers' use of stress intervention services. While this scope is broad, it reflects the knowledge that has emerged since the Buffalo Creek and Chernobyl catastrophes, to the more recent Hurricane Katrina and Sandy disasters. Given the current threat environment, psychologists, social workers, and other providers need to be aware of these developments and be prepared to mitigate the impact of psychological trauma following community disasters, whether natural or man-made. PMID:25983663

  7. 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

  8. Community Disasters, Psychological Trauma, and Crisis Intervention.

    PubMed

    Boscarino, Joseph A

    The current issue of International Journal of Emergency Mental Health and Human Resilience is focused on community disasters, the impact of trauma exposure, and crisis intervention. The articles incorporated include studies ranging from the World Trade Center disaster to Hurricane Sandy. These studies are related to public attitudes and beliefs about disease outbreaks, the impact of volunteerism following the World Trade Center attacks, alcohol misuse among police officers after Hurricane Katrina, posttraumatic stress disorder after Hurricane Sandy among those exposed to the Trade Center disaster, compassion fatigue and burnout among trauma workers, crisis interventions in Eastern Europe, and police officers' use of stress intervention services. While this scope is broad, it reflects the knowledge that has emerged since the Buffalo Creek and Chernobyl catastrophes, to the more recent Hurricane Katrina and Sandy disasters. Given the current threat environment, psychologists, social workers, and other providers need to be aware of these developments and be prepared to mitigate the impact of psychological trauma following community disasters, whether natural or man-made.

  9. A case of trauma related Acanthamoeba keratitis.

    PubMed

    Kamel, A G M; Faridah, H; Yusof, S; Norazah, A; Nakisah, M A

    2004-12-01

    Acanthamoeba is an uncommon cause of keratitis but one of the most severe because of the prolonged and painful course of the disease and poor visual outcome. Although contact lens use is the principal risk factor, about 10% of cases occur following trauma and exposure to contaminated soil or water. Two cases of Acanthamoeba keratitis involving women contact lens wearers have previously been reported in Malaysia but this is the first time, a non contact lens related Acanthamoeba keratitis is reported. The case involved a 28 year old Indonesian male construction worker who had a trauma of the right eye during work. His eye was struck by sand and dust particles after which he quickly washed with water from an open tank at the construction site. He experienced pain, redness, glaring and blurring of vision of the right eye three days later. The diagnosis was missed at initial presentation but culture of the corneal scraping had proven Acanthamoeba as the aetiological agent. The history and clinical findings of this trauma related Acanthamoeba keratitis are briefly discussed.

  10. Social support among releasing men prisoners with lifetime trauma experiences.

    PubMed

    Pettus-Davis, Carrie

    2014-01-01

    High rates of lifetime trauma experiences exist among men incarcerated in US state and federal prisons. Because lifetime trauma experiences have been linked to problematic behavioral and psychiatric outcomes for incarcerated populations, trauma-informed interventions could improve post-release well-being of releasing men prisoners with trauma histories. Social support has consistently been found to have a positive impact on trauma-related outcomes in non-incarcerated populations. Therefore, it is reasonable to hypothesize that social support may be an important intervention component for releasing men prisoners with trauma experiences; yet, the relationship between trauma experiences, psychiatric and behavioral factors, and social support has received almost no attention in research with men prisoners. Using a probability sample of 165 soon-to-be-released men, the present study examined differences in certain demographic, criminal justice history, mental health, substance abuse, and social support (type, quality, amount, and source) variables between releasing men prisoners with and without lifetime trauma experiences. Results indicate that men with trauma histories had more negative social support experiences and fewer positive social support resources before prison than their counterparts. Men with trauma histories also had more lifetime experiences with mental health and substance use problems. On further investigation of the subsample of men with trauma histories, those who were older, had substance use disorders, and histories of mental health problems anticipated fewer post-release social support resources. Study findings underscore the nuances of social support for men prisoners with trauma experiences and point to implications for future directions in targeted trauma-informed intervention development for releasing men prisoners.

  11. The significance of addressing trauma in outpatient psychiatry.

    PubMed

    Al-Saffar, S; Borgå, P; Lawoko, S; Edman, G; Hällström, T

    2004-01-01

    Establishing post-traumatic stress disorder as a psychiatric diagnosis has only marginally increased awareness of traumatic experiences. Traumas are inconsistently recorded in initial psychiatric histories and, when observed, rarely reflected in the primary diagnosis and treatment. The present study aimed to investigate if there is an association between sufficiently addressing trauma and long-term outcome and what factors affect whether trauma, according to the patient's view, is sufficiently addressed or not. Socio-demographic data, experiences of trauma and treatment, and outcome, were collected retrospectively from Arabic, Iranian, Turkish and Swedish patients, who had visited a psychiatric clinic 3-4 years earlier. Fifty-one patients whose traumatic experiences had been sufficiently addressed were compared with 39 patients who perceived that their traumas had not been addressed. Logistic regression analyses were performed to examine relationships between clinical variables and whether or not traumas had been addressed. Patients with trauma sufficiently addressed reported high confidence in staff (odds ratio, OR=7.2, p<0.001), high self-rated health (OR=8.0, p<0.01) and low scores on the Self-rating Inventory for PTSD (OR=7.7, p<0.05) and Depression Scale (OR=3.0, p<0.15). Reporting less than five different traumas (OR=4.6, p<0.01) and being an ethnic Swede (OR=2.4, p<0.10) were the background variables independently related to having trauma sufficiently addressed. Addressing trauma may improve patients' confidence in staff, self-rated health and trauma-related symptoms. Multiplicity of traumas and belonging to an ethnic minority implied that trauma was less addressed.

  12. Trauma injury in adult underweight patients

    PubMed Central

    Hsieh, Ching-Hua; Lai, Wei-Hung; Wu, Shao-Chun; Chen, Yi-Chun; Kuo, Pao-Jen; Hsu, Shiun-Yuan; Hsieh, Hsiao-Yun

    2017-01-01

    Abstract The aim of this study was to investigate and compare the injury characteristics, severity, and outcome between underweight and normal-weight patients hospitalized for the treatment of all kinds of trauma injury. This study was based on a level I trauma center Taiwan. The detailed data of 640 underweight adult trauma patients with a body mass index (BMI) of <18.5 kg/m2 and 6497 normal-weight adult patients (25 > BMI ≥ 18.5 kg/m2) were retrieved from the Trauma Registry System between January 1, 2009, and December 31, 2014. Pearson's chi-square test, Fisher's exact test, and independent Student's t-test were performed to compare the differences. Propensity score matching with logistic regression was used to evaluate the effect of underweight on mortality. Underweight patients presented a different bodily injury pattern and a significantly higher rate of admittance to the intensive care unit (ICU) than did normal-weight patients; however, no significant differences in the Glasgow Coma Scale (GCS) score, injury severity score (ISS), in-hospital mortality, and hospital length of stay were found between the two groups. However, further analysis of the patients stratified by two major injury mechanisms (motorcycle accident and fall injury) revealed that underweight patients had significantly lower GCS scores (13.8 ± 3.0 vs 14.5 ± 2.0, P = 0.020), but higher ISS (10.1 ± 6.9 vs 8.4 ± 5.9, P = 0.005), in-hospital mortality (odds ratio, 4.4; 95% confidence interval, 1.69–11.35; P = 0.006), and ICU admittance rate (24.1% vs 14.3%, P = 0.007) than normal-weight patients in the fall accident group, but not in the motorcycle accident group. However, after propensity score matching, logistic regression analysis of well-matched pairs of patients with either all trauma, motorcycle accident, or fall injury did not show a significant influence of underweight on mortality. Exploratory data analysis revealed that underweight patients

  13. Better trauma care. How Maryland does it.

    PubMed

    Wish, John R; Long, William B; Edlich, Richard F

    2005-01-01

    In March, 1970, the Maryland State Police, in cooperation with the University of Maryland, started the first statewide airborne transportation system. It was modeled after the army's success in Korea and Vietnam, where battlefield injuries were flown to front-line MASH units. The world's premier statewide medical aviation division was made possible through a cooperative effort between the Maryland State Police Aviation Division and Dr. R Adams Cowley at the University of Maryland Hospital as a public service to the citizens of the state. The Maryland Institute for Emergency Medical Services Systems (MIEMSS) has five components: (1) aircraft, (2) state troopers, (3) system communications (SYSCOM) center, (4) ambulance and fire emergency rescue, and (5) Level I adult and pediatric trauma centers and a regional burn center. The Maryland State Police Aviation Division now has 12 Aerospace Dauphin AS365N helicopters that operate out of eight fixed points throughout the state. Each helicopter has a two-person crew that consists of a pilot and a paramedic. Since 1993, the overall coordination of emergency medical services (EMS) has been under the purview of MIEMSS, an independent executive-level state agency that is governed by an appointed board and advisory council. To ensure stable funding for Maryland's world renowned emergency medical services (EMS) system, including med-evac helicopters, ambulances, fire equipment, rescue squads, and trauma units, a "surcharge" of $13.50 per year is collected with the automobile registration fee where applicable. The SYSCOM center in Baltimore coordinates the helicopter transport to the scene of the accident as well as referral to the specialty care facility: Adult Level I Trauma Center, Pediatric Level I Trauma Center, and Regional Burn Center. An on-the-scene evaluation of this exemplary emergency medical system in Maryland provides further convincing evidence of the performance of the Maryland State Police Aviation Division as

  14. Assessing war trauma in refugees: properties of the Comprehensive Trauma Inventory-104.

    PubMed

    Hollifield, Michael; Warner, Teddy D; Jenkins, Janis; Sinclair-Lian, Nityamo; Krakow, Barry; Eckert, Valorie; Karadaghi, Pary; Westermeyer, Joseph

    2006-08-01

    In this article, the authors describe the properties of the Comprehensive Trauma Inventory-104 (CTI-104), developed and designed empirically to improve assessment of traumatic war-related events. The mean number of events reported by 252 community dwelling Kurdish and Vietnamese refugees was 32 (SD=27) out of the 104 items. Internal and test-retest reliability was excellent, and the validity of the CTI-104 as a measure of war trauma was supported by its high correlation with standard measures of known outcomes of trauma. The CTI-104 is reliable and valid, and assesses a broader range of traumatic war-related events in a broader range of refugees than currently available instruments.

  15. Where do I go? A trauma victim's plea in an informal trauma system

    PubMed Central

    Radjou, Angeline N; Mahajan, Preetam; Baliga, Dillip K

    2013-01-01

    Background: The three pillars of a good trauma system are the prehospital care, definitive care, and rehabilitative services. The prehospital care is a critical component of the efforts to lower trauma mortality. Objective: To study the prehospital profile of patients who died due to trauma, compute the time taken to reach our facility, find the cause of delay, and make feasible recommendations. Materials and Methods: A hospital-based study was performed at a trauma center in Puducherry from June 2009 to August 2010. Puducherry is a union territory of India in the geographical terrain of the state of Tamil Nadu. A total of 241deaths due to trauma were included. Apart from the demographic and injury characteristics, a detailed prehospital log was constructed regarding the time of incident, the referral patterns, care given in the prehospital phase, the distance travelled, and the total time taken to reach our center. Results: The majority (59%) of patients were referred, with stopovers at two consecutive referral centers (30%), needing at least two vehicles to transport to definitive care (70%), clocking unnecessary distances (67%), and delayed due to non therapeutic intervention (87%). The majority of deaths (66%) were due to head injury. Only 2.96% of referred cases reached us within the first hour. Few of the patients coming directly to us had vehicle change due to local availability and lack of knowledge of predestined definitive care facility. Overall, 94.6% of direct cases arrived within 4 h whereas 93.3% of referred cases required up to 7 h to arrive at definitive care. Conclusions: Seriously injured patients lose valuable prehospital time because there is no direction regarding destination and interfacility transfer, a lack of seamless transport, and no concept of initial trauma care. The lack of direction is compounded in geographical areas that are situated at the border of political jurisdictions. PMID:23960371

  16. 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

  17. Pediatric Trauma BIG Score: Predicting Mortality in Children After Military and Civilian Trauma

    DTIC Science & Technology

    2011-04-01

    Age-Specific Pediatric Trauma Score ( ASPTS ), and Pediatric Age-Adjusted Trauma and Injury Sever- ity Score (TRISS) (PAAT).6–11 The score was then...yielded the highest area under the curve of 0.89 (95% confidence interval [CI]: 0.83–0.95) compared with the RTS of 0.81 (95% CI: 0.70–0.90), the ASPTS ...revised to the PAAT by the same authors.9 The ASPTS includes GCS, the z scored systolic blood pres- sure, heart rate, and respiratory rate and adds

  18. Effect of basic prehospital trauma life support program on cognitive and trauma management skills.

    PubMed

    Ali, J; Adam, R; Josa, D; Pierre, I; Bedsaysie, H; West, U; Winn, J; Ali, E; Haynes, B

    1998-12-01

    We tested the effectiveness of a basic prehospital trauma life support (PHTLS) program by assessing cognitive performance and trauma management skills among prehospital trauma personnel. Fourteen subjects who completed a standard PHTLS course (group I) were compared to a matched group not completing a PHTLS program (group II). Cognitive performance was assessed on 50-item multiple choice examinations, and trauma skills management was assessed with four simulated trauma patients. Pre-PHTLS multiple choice questionnaire scores were similar (45.8 +/- 9.4% vs. 48.8 +/- 8.9% for groups I and II, respectively), but the post-PHTLS scores were higher in group I (80.4 +/- 5.9%) than in group II (52.6 +/- 4.9%). Pre-PHTLS simulated trauma patient performance scores (standardized to a maximum total of 20 for each station) were similar at all four stations for both groups, ranging from 7.9 to 10.4. The post-PHTLS scores were statistically significantly higher at all four stations for group I (range 16.0-19.0) compared to those for group II (range 8.0-11.1). The overall mean pre-PHTLS score for all four stations was 8.3 +/- 2.1 for group I and 8.8 +/- 2.0 (NS) for group II; the group I post-PHTLS mean score for the four stations was 17.1 +/- 2.7 (p < 0.05) compared to 9.1 +/- 2.3 for group II. Pre-PHTLS Adherence to Priority scores on a scale of 1 to 7 were similar (1.1 +/- 0.9 for group I and 1.2 +/- 1.0 for group II). Post-PHTLS group I Priority scores increased to 5.9 +/- 1.1. Group II (1.1 +/- 1.0) did not improve their post-PHTLS scores. The pre-PHTLS Organized Approach scores in the simulated trauma patients on a scale of 1 to 5 were 2.1 +/- 1.0 for group I and 1.9 +/- 1.2 for group II (NS) compared to 4.2 +/- 0.9 (p < 0.05) in group I and 2.0 +/- 0.8 in group II after PHTLS. This study demonstrates improved cognitive and trauma management skills performance among prehospital paramedical personnel who complete the basic PHTLS program.

  19. Trauma Symptoms, Communication, and Relationship Satisfaction in Military Couples.

    PubMed

    Bakhurst, Melissa; McGuire, Annabel; Halford, W Kim

    2017-03-08

    Trauma symptoms are negatively correlated with couple relationship satisfaction, which is of particular importance in the relationships of military personnel who are often exposed to trauma whilst on overseas deployment. This study tested a model in which communication mediated an association between trauma symptoms and low relationship satisfaction. Thirty-one Australian military couples were observationally assessed during a communication task, and assessed on their relationship satisfaction and individual functioning. As expected, trauma symptoms in the male military spouse were associated with low satisfaction in both spouses. Females' low positive communication fully mediated the relationship between males' trauma symptoms and low female satisfaction, but not male relationship satisfaction. Unexpectedly, males' negative communication behaviors were associated with high male relationship satisfaction, and partially mediated the association between trauma symptoms and male satisfaction. Discussion focused on how some communication usually thought of as negative might be associated with relationship satisfaction in military couples.

  20. The application of mixed methods designs to trauma research.

    PubMed

    Creswell, John W; Zhang, Wanqing

    2009-12-01

    Despite the use of quantitative and qualitative data in trauma research and therapy, mixed methods studies in this field have not been analyzed to help researchers designing investigations. This discussion begins by reviewing four core characteristics of mixed methods research in the social and human sciences. Combining these characteristics, the authors focus on four select mixed methods designs that are applicable in trauma research. These designs are defined and their essential elements noted. Applying these designs to trauma research, a search was conducted to locate mixed methods trauma studies. From this search, one sample study was selected, and its characteristics of mixed methods procedures noted. Finally, drawing on other mixed methods designs available, several follow-up mixed methods studies were described for this sample study, enabling trauma researchers to view design options for applying mixed methods research in trauma investigations.