Outcomes in pediatric patients with recreational vehicle related forceful head impact

PurposeTo compare outcomes in pediatric patients suffering forceful head impact during recreational vehicle use to patients with forceful head impact from other mechanisms.MethodsRetrospective cohort study of all patients 3–18 years old who suffered forceful head impact (any traumatic mechanism strong enough to result in a face or skull fracture) in our institutional trauma registry between January 2011 and September 2013.ResultsOut of 252 events involving forceful head impact, 64 events were a result of riding a recreational vehicle. Although there is no difference in rates of temporal bone fractures, recreational vehicle accidents have higher rates of otic capsule violation (21% vs. 5%) and higher rates of hearing loss (30% vs 16%) compared to patients with forceful head impact from other mechanisms. All incidents of otic capsule violation and sensorineural hearing loss in recreational vehicle accidents were associated with a temporal bone fracture.ConclusionDespite the increasing use of head protective gear while operating a recreational motor vehicle there is still heightened risk for temporal bone fractures and subsequent hearing loss. The comparative associations in this study suggest that helmets used with recreational vehicles do not protect the temporal bone thus leaving vital structures within the otic capsule at risk for damage and long term consequences. When treating these patients Otolaryngologists should be aware of the elevated risk of otic capsule violation and late hearing loss with temporal bone fractures.     

“There are risks to be taken and some just push it too far”: how farmers perceive quad‐bike incident risk

Objective : To qualitatively explore how farmers perceive personal risk of an occupational quad‐bike incident and develop a model of the factors that modify this perception. Methods : Grounded theory methods were used to inform data collection and analysis. Semi‐structured interviews were undertaken with eight New Zealand livestock farmers. Interviews were inductively analysed to derive categories that helped explain the processes involved in quad‐bike incident risk perception. Results : Farmers perceived personal risk of experiencing a quad‐bike incident could be modelled on a sliding scale from low to high. Four core categories encapsulated risk perception: the impact of previous quad‐bike incidents; personal attributes; getting the job done; and being familiar with the performance of the quad bike, the terrain and task(s) being undertaken. An exploratory model was developed to elucidate the temporal gap between farmers' reflections on their perceived risk and reported real‐time risk management. Conclusions : These findings have implications for planning quad‐bike safety interventions, which may benefit from incorporating both ‘reflective’ contemplation of risks and skills for coping with things suddenly going wrong ‘in the moment’.     

Analyzing preschoolers’ overgeneralizations of object labeling in the process of mother‐tongue acquisition in Turkey

Language, as is known, is acquired under certain conditions: rapid and sequential brain maturation and cognitive development, the need to exchange information and to control others’ actions, and an exposure to appropriate speech input. This research aims at analyzing preschoolers’ overgeneralizations of the object labeling process in different categories in terms of age and gender. In this research, preschoolers’ responses in overgeneralizations of the object labeling process of ‘clothes’, ‘sports’ and ‘ground vehicles’ was found non‐significant in respect of their gender, while preschoolers’ responses in overgeneralizations of the object labeling process of ‘clothes’, ‘sports’ and ‘ground vehicles’ was found significant in respect of their age.     

豫北地区机动车摇柄伤的流行病学调查

目的 对豫北地区机动车发动机摇柄伤的分布情况及其受伤机制进行分析。方法 自1998年1月至2002年5月，对我院就诊的520例机动车发动机摇柄伤患者进行随访。根据性别、年龄和受伤时间、部位等，分析其流行病学特征。结果 本组患者年龄9～53岁，平均31岁；男300例，女220例，男女性别之比为1．36：1。主要以Colles骨折及尺桡骨远端骨折为主，占73．8％(384，／520)。发病时间以5，6月份及9，10月份为主，占85．0％(442／520)。结论 (1)机动车发动机摇柄伤主要致右侧前臂以远损伤，以Colles骨折及尺桡骨远端骨折为主。(2)其受伤原因绝大多数为操作不当所引起，主要发生在农忙季节。(3)寻求减少损伤的对策，应以预防为主，增强安全操作观念及个人防护意识。同时改进机动车发动机结构，避免未成年人不当操作。     

应用循证实践减少机动车伤害

机动车伤害目前已经成为我国重要的公共卫生问题,预防车祸,减少伤亡是全民关注的严重的社会难题之一。随着我国机动车人均拥有数量的不断上升,尤其是私家车的增多,使道路交通伤害的机会不断增加,道路交通伤害的模式在某些地区已类似于发达国家的伤害模式。美国作为发达国家的代表,在预防车祸等机动车伤害方面研究较多,积累了相对成熟的经验,特别是美国疾病预防控制中心下设的预防服务组织运用循证医学的思想和方法总结减少机动车乘员伤害的各种干预措施,从而制订循证社区指南,对于我们在制订减少机动车乘员伤害的策略和措施方面有一定的借鉴意义。本文对此加以介绍。     

药品快检车运行情况分析及建议

目的对进一步提高药品检测车运行效能提出合理化建议。方法分析药品快检车运行中易出现的问题,总结经验。结果只有在实践中不断积极探索,才能确保快检车正常运行。结论药品检测车为基层药品监督管理工作提供了有效的技术支撑。     

The impact of driver distraction on road safety: results from a representative survey in two Australian states.

OBJECTIVE: To quantify the prevalence and effects of distracting activities while driving. DESIGN: Cross sectional driver survey. SETTING: New South Wales and Western Australia, Australia. PARTICIPANTS: 1347 licensed drivers aged between 18 and 65 years. Data were weighted to reflect the corresponding driving population. MAIN OUTCOME MEASURES: Prevalence of distracting activities while driving; perceived risks and adverse outcomes due to distractions. RESULTS: The most common distracting activities during the most recent driving trip were lack of concentration (weighted percentage (standard error, SE) 71.8% (1.4%) of drivers); adjusting in-vehicle equipment (68.7% (1.5%)); outside people, objects or events (57.8% (1.6%)); and talking to passengers (39.8% (1.6%)). On average, a driver engaged in a distracting activity once every six minutes. One in five crashes (21%) during the last three years, involving one in 20 drivers (5.0% (0.7%)), was attributed to driver distraction based on self-report. In the population under study, this equated to 242,188 (SE 34,417) drivers. Younger drivers (18-30 years) were significantly more likely to report distracting activities, to perceive distracting activities as less dangerous, and to have crashed as a result. CONCLUSIONS: Distracting activities while driving are common and can result in driving errors. Driver distraction is an important cause of crashes. Further research is needed to estimate the risk conferred by different distracting activities and the circumstances during which activities pose greatest risk. These results suggest that a strategy to minimize distracting activities while driving, with a focus on young drivers, is indicated.     

Influence on pH of vehicle containing glycerin used with calcium hydroxide

Abstract  – The pH values of the external aqueous medium, relative to the roots of 41 human premolar teeth filled with Ca(OH)₂ in to several vehicles, were evaluated in the present study. After root canal biomechanical preparation and smear-layer removal, the teeth were stored individually, immersed in flasks containing 800 ml of ultra-pure deionized water for a period of 118 days. A pH meter was used to analyse the pH values as a function of time. The measurements were divided into phase 1: dissolution, in which all canals remained empty and open in the absence of medicament for 48 days, and phase 2: diffusion, in which the specimens were divided into 10 groups which consisted of three control groups: group 1, water control; group 2, sealing control; and group 3, opened canal dissolution control, and seven experimental groups, with five teeth each, whose canals were filled with Ca(OH)₂ paste associated with the following vehicles: group 4, saline solution; group 5, polyethylene glycol (Calen); group 6, glycerin and parachlorophenol (PMCC); group 7, PMCC; group 8, glycerin; group 9, glycerin and formo cresol (FC); and group 10, anesthetic solution. This phase lasted for 70 days. A total of 1058 measurements of the pH values were made. Regression analysis was used for statistical evaluation. The results show that all groups containing polyol in the composition of the paste had a trend to acidification in the interval between filling and 14 days later (therapeutic period) and, at the end of the experiment (1687 h to 70 days after canal filling), the pH was slightly alkaline. We conclude that polyhydroxy alcohol (glycerin and polyethylene glycol, Calen) diffusion enhances acidification of the aqueous medium.     

寒区野战卫生装备器材使用注意问题研究

目的:针对全军系列卫生装备,对可靠完成跨区进入寒区执行伴随保障准备应注意的问题进行研究。方法:结合在寒区多年执行保障工作经验和全军现配发装备实际,根据寒区实际情况进行分类陈述。结果:对卫生装备器材进入寒区减少损失、发挥保障具有指导作用。结论:对跨区执行医疗卫勤伴随保障的南方部队进入寒区提供借鉴,为相关管理、策划、指挥人员提供参考。     

The Effect of Seatbelt Use on Injury Patterns, Disposition, and Hospital Charges for Elders

OBJECTIVE: To study the relationships between seatbelt use and injury patterns, hospital charges, morbidity, and mortality in elder motor vehicle crash victims. METHODS: A retrospective review of individuals at least 65 years old presenting to an urban emergency department (ED) after a motor vehicle crash. RESULTS: Over a two-year period, 339 patients had documentation of seatbelt use or non-use at the time of the crash. Of these, 241 (71%) patients had been wearing a seatbelt and 98 (29%) had not. Elders not using seatbelts were more likely to require hospitalization (29% unbelted vs. 17% belted) and had a higher mortality rate. Injury patterns were different in the two groups. Emergency department charges were significantly different between belted and unbelted elders ($351 vs. $451, p = 0.01) and head computed tomography (CT) utilization was higher in the unbelted group (25.6% vs 12.7%, p = 0.005). CONCLUSIONS: Improved seatbelt compliance in elders can reduce injuries, hospitalization rates, ED charges, and mortality resulting from motor vehicle crashes.