Bicycle spoke-related injuries in children: emphasise prevention

Three children, a 6-year-old boy and two girls aged 5 and 4 years, were seen at an emergency department due to distal lower-leg injuries sustained from the spokes of bicycle wheels. All three patients had been passengers on rear carrying seats of moving bicycles. Only the third bicyclist had used a special child safety seat. The second girl had drawn her foot up from underneath a strap and suffered a tibial fracture later treated with an osteosynthetic plate. The other two patients recovered after conservative casting treatment. Bicycle spoke-related injuries are sustained when the foot or lower limb makes contact with the spokes of a bicycle wheel and usually by children who are bicycle passengers. In the Netherlands, approximately 4600 children are seen at emergency departments with such injuries each year. Bicycle spoke-related accidents can cause severe damage that can result in lengthy recovery periods. Not only physical complications but also psychological ones can occur. The latter are often overlooked but do deserve proper treatment. The physician treating a spoke-related injury is in a good position to advice parents as to preventive measures, particularly on the use of special child safety seats.     

Cervical cancer prevention in the 21st century: cost is not the only issue

The wide publicity related to human papillomavirus (HPV) vaccines has led to a sense that HPV vaccine programs are inevitable in both developed and developing countries, whereas 2 existing methods of screening-visual inspection with ascetic acid (VIA) and DNA testing-have received much less attention. These screening methods detect cervical lesions better than does the Papanicolaou test and allow immediate treatment, minimizing loss to follow-up. These advantages may outweigh the strengths of HPV vaccines. Priority should be given to improving screening coverage with VIA and DNA tests, focusing on women older than 30 years and underserved populations in all countries. This approach will save the lives of millions of women who have already been exposed to HPV and will develop cervical cancer during the next 20 years.     

The aftermath of road trauma: survivors' perceptions of trauma and growth

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 in relation to posttraumatic growth and posttraumatic stress experiences, as measured by the Posttraumatic Growth Inventory and the Impact of Event Scale. Data were collected from 79 anonymous self-administered postal surveys from participants who had received treatment in an Australian rehabilitation center following serious orthopedic injury. One-third of these survivors continued to experience serious psychological distress in the aftermath of road trauma and a range of other psychosocial consequences four years after their accident. Although 87 percent of the sample continued to experience posttraumatic stress difficulties, 99 percent reported experiences of posttraumatic growth. Implications of these findings for social work practice are discussed.     

HIV prevention and African American youth: examination of individual-level behaviour is not the only answer

African American youth continue to be disproportionately represented in the incidence and prevalence of HIV despite numerous prevention efforts that target adolescent populations and declines in sexual risk behaviour among youth in general during the last decade. Several studies examining individual-level behavioural factors have failed to explain the health disparity in HIV prevalence. African American youth experience higher rates of HIV and other STIs, even when their sexual behaviour is normative. These findings suggest the need to expand beyond the examination of individual-level factors and to consider contextual issues such as economic, geographic and cultural influences. This paper reviews the relationship between contextual factors and HIV risk and prevalence and the implication for prevention for African American youth.     

Health analytics: the road not traveled.

Review of the development of health administration by chronological examination of textbooks reveals that the definition of health administration has changed. In the process of conversion to a business management model, health analytics have been undervalued by health administration programs. Health analytics can be defined as "techniques for the analysis of health services that require in-depth understanding of the workings of the health system and are grounded in a rational-comprehensive public health model of health administration." Health analytics are not simply the application of business techniques to health services. Quality assessment and planning methods are examples of two important aspects of health administration that are addressed by health analytics.     

Wheat germ: not only a by-product

The wheat germ (embryonic axis and scutellum) represents about 2.5-3.8% of total seed weight and is an important by-product of the flour milling industry. The germ contains about 10-15% lipids, 26-35% proteins, 17% sugars, 1.5-4.5% fibre and 4% minerals, as well as significant quantities of bioactive compounds such as tocopherols [300-740 mg/kg dry matter (DM)], phytosterols (24-50 mg/kg), policosanols (10 mg/kg), carotenoids (4-38 mg/kg), thiamin (15-23 mg/kg) and riboflavin (6-10 mg/kg). Oil recovery is achieved by mechanical pressing or solvent extraction, which retrieve about 50% or 90% lipids, respectively; innovative approaches, such as supercritical carbon dioxide extraction, are also proposed. The oil is rich in triglycerides (57% of total lipids), mainly linoleic (18:2), palmitic (16:0) and oleic (18:1) acids, but relevant amounts of sterols, mono- and diglycerides, phospho- and glycolipids are present. The lypophilic antioxidants tocopherols and carotenoids are also abundant. The main by-product of oil extraction is defatted germ meal, which has high protein content (30-32%), is rich in albumin (34.5% of total protein) and globulin (15.6%), and thus presents a well-balanced amino acid profile. Its principal mineral constituents are potassium, magnesium, calcium, zinc and manganese, in decreasing order. Total flavonoid content is about 0.35 g rutin equivalent/100 g DM. The wheat germ is therefore a unique source of concentrated nutrients, highly valued as food supplement. While the oil is widely appreciated for its pharmaceutical and nutritional value, the defatted germ meal is a promising source of high-quality vegetable proteins. Better nutrient separation from the kernel and improved fractioning techniques could also provide high-purity molecules with positive health benefits.     

Effect on road traffic injuries of criminalizing road traffic offences: a time-series study

Objective

To determine the effect of criminalizing some traffic behaviours, after the reform of the Spanish penal code in 2007, on the number of drivers involved in injury collisions and of people injured in traffic collisions in Spain.

Methods

This study followed an interrupted times–series design in which the number of drivers involved in injury collisions and of people injured in traffic collisions in Spain before and after the criminalization of offences were compared. The data on road traffic injuries in 2000–2009 were obtained from the road traffic collision database of the General Traffic Directorate. The dependent variables were stratified by sex, age, injury severity, type of road user, road type and time of collision. Quasi-Poisson regression models were fitted with adjustments for time trend, seasonality, previous interventions and national fuel consumption.

Findings

The overall number of male drivers involved in injury collisions dropped (relative risk, RR: 0.93; 95% confidence interval, CI: 0.89–0.97) after the reform of the penal code, but among women no change was observed (RR: 0.99; 95% CI: 0.95–1.03). In addition, 13 891 men (P < 0.01) were prevented from being injured. Larger reductions were observed among young male drivers and among male motorcycle or moped riders than among the drivers of other vehicles.

Conclusion

The findings suggest that criminalizing certain traffic behaviours can improve road safety by reducing both the number of drivers involved in injury collisions and the number of people injured in such collisions.