骨骺部位及其闭合时间与骨折部位及其发病率对应关系的初步研究

［摘要］〖HTSS〗人体骨骺出现及闭合时间因骨骼部位不同而存在差异。在临床中发现,机体受到间接暴力造成骨折时,骨骺接合部的骨折发生率较高,骨骺闭合较晚的部位较临近部位更易发生骨折,且骨折线走形与骺板融合部走形存在一定相关性。本文对全身重要骨骺部位及其闭合时间与骨折部位及其发生率的对应关系进行了初步研究。     

Outcomes of a consultation service to emergency medicine clinicians for postexposure management of occupational bloodborne pathogen exposures

Potential bloodborne pathogen exposures, many of which occur after hours and are evaluated by emergency medicine physicians, are an important occupational hazard. Emergency medicine physicians might not be as conversant with the latest US Public Health Service guidelines as occupational medicine physicians. This research presents an efficient model in which a single expert occupational medicine physician provides guidance to many emergency medicine clinicians. Outcomes evaluation indicates that the service was widely utilized and highly rated.     

Families Impacted by the Criminal Justice System on the Frontier: A New Model Required

The article examines some of the systemic issues which adversely affect access to justice by Aboriginal people in the East Kimberley. The author contends that little or no adjustment is made in law, policy or service delivery to take account of the circumstances of aboriginal people in the region. The high rate of recidivism and rate of aboriginal imprisonment suggest the current model has failed. The author analysizes why the model has failed and proposes solutions. The paper was originally delivered to the 29th Annual ANZAPPL Congress in November 2009 when the author was the resident magistrate in the East Kimberley.     

Appetitive Violence: A New Phenomenon?

Youth violence has long been regarded as a major social issue. The past decade has, however, seen the scrutiny which encompasses this violence intensify, largely due to a recent media focus on an apparently increasing tendency amongst some young people to engage in acts of ‘appetitive’ or ‘thrill-seeking’ violence. This is reported to be a new form of violence, in which young people act in an excitable state, rather than the more common form of anger-mediated violence. Whilst incidents of appetitive violence are overly represented in the news media and are presented as a major public concern, there is presently no empirical research exploring the validity of this phenomenon and no systematic analysis of the frequency and severity of this form of violent behaviour. Furthermore, the underlying causes of this type of violence are not understood. As such, preventative practices, risk assessment, treatment requirements and targeted management strategies are lacking. The purpose of this review is to examine the current literature on youth violence, particularly youth involvement in ‘thrill-seeking’ acts of violence, as well as describing a range of contemporary factors highlighted as integral to youth violence; specifically, gang involvement, alcohol use and the possession of weapons. This review will also examine an array of international strategies implemented in response to this form of youth violence. Finally, the General Aggression Model (GAM) will be considered to determine whether its framework can assist in advancing our understanding of appetitive violence, by elucidating those characteristics of the individual and their environment that contribute to its expression.     

Risk Assessment: A Reflection on the Principles of Tools to Help Manage Risk of Violence in Mental Health

The proposition that the vast majority of persons experiencing mental illness will never be violent is complicated by the large body of literature demonstrating a heightened risk of violent behaviour in persons suffering from mental disorder. In an era in which resources and individual judgement appear to dictate treatment, the question arises as to why structured clinical judgement is not utilized more in front-line assessment of risk for violence in those with mental and personality disorders? Our review of the literature on mental disorder and violence, risk assessment and risk management led to the contention that front-line mental health professionals can employ structured clinical judgement underpinned by the principles of risk assessment tools, such as the HCR-20. Ongoing resource development, education and availability of expertise should aid the development of more uniform approaches to violence risk management and therapeutic amelioration of the likelihood for violence in persons affected by mental illness.     

Bridging past and present: Embodied intergenerational trauma and the implications for dance/movement therapy

This paper explores the role of the body in intergenerational transmission of trauma using examples of wartime sexual violence (WSV) during World War II in Germany. It is argued that traumatic memory held in the body is transmitted between generations in a similar fashion to how implicit body memory is passed on from body to body. In relationship, the body shapes subjectivity and intersubjectivity and therefore represents a vessel for transmission of trauma on a familial and cultural level. Silence and culture as source of perpetuation of trauma are taken into account. Furthermore, the severe long-term effects of rape, underlying body defences and relational consequences are outlined. Somatic implications for descendents of WSV survivors are unknown and require research. Dance/movement therapy is offered as a body-focused modality to help transform intergenerational trauma caused by WSV. Implications for further research in body-to-body transmission of trauma are highlighted.     

Applications of complementary therapies during rehabilitation for individuals with traumatic Spinal Cord Injury: Findings from the SCIRehab Project

Objective: Evaluate the use of complementary therapies during rehabilitation for patients with traumatic spinal cord injury (SCI).

Design: Secondary analyses were conducted to identify the use and associated outcomes of complementary therapies provided by occupational therapists (OTs) and physical therapists (PTs) during rehabilitation from a public dataset.

Setting: Inpatient rehabilitation.

Participants: A public dataset composed of 1376 patients with SCI that were enrolled in a five-year, multi-center investigation, the SCIRehab Project. Secondary analyses focused on a subset of 93 patients (47 who received complementary therapy during treatment and 46 case-matched controls who received no complementary therapy).

Interventions: OTs and PTs recorded use of complementary therapies during sessions, including yoga, Pilates, tai chi, aromatherapy, relaxation techniques, imagery and other.

Outcome Measures: Pain interference, pain severity, mobility, and social integration.

Results: Three percent of participants received any complementary therapies. Patients who received complementary therapies showed greater reductions in pain severity from 6 months to 12 months relative to matched controls. Furthermore, the amount of time that patients received complementary therapies during physical therapy sessions was associated with reduced pain interference at 6 months and with reduced pain severity at the 6-month and 12-month follow-ups. Complementary therapy use was not associated with mobility or social integration.

Conclusion: The current study provides preliminary evidence documenting the limited use of complementary therapies in rehabilitation settings and highlights the opportunity for further research, particularly regarding pain-related outcomes.