Firearm Availability and Fatal Police Shootings

Do states with more guns have higher rates of fatal police shootings? This article uses a validated measure of firearm availability (the percentage of suicides committed with a firearm) to examine the relationship between gun proliferation and fatal police shootings. It expands on existing research to include (1) measures of access to Level I and II trauma centers, (2) interpretation of the findings from the lenses of “statistical prediction,” and (3) tests for structural differences between models for black decedents versus nonblack decedents. Findings confirm the correlation between statewide prevalence of gun ownership and fatal police shootings for both all decedents and unarmed decedents. It provides partial support for “statistical prediction” by police and finds that greater access to trauma centers is associated with lower rates of citizen deaths. The analysis suggests a far broader range of policy options for saving lives, such as better enforcement of legal restrictions on firearm possession, than focusing solely on policing systems.

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Does Gender Matter: A Multi-Institutional Analysis of Viscoelastic Profiles for 1565 Trauma Patients With Severe Hemorrhage

The American Surgeon ◽

10.1177/00031348211033542 ◽

2021 ◽

pp. 000313482110335

Author(s):

Alison Smith ◽

Juan Duchesne ◽

Matthew Marturano ◽

Shaun Lawicki ◽

Kevin Sexton ◽

...

Keyword(s):

Alpha Angle ◽

Reaction Times ◽

Maximum Amplitude ◽

Trauma Patients ◽

Trauma Centers ◽

Survival Difference ◽

Severe Hemorrhage ◽

Male Patients ◽

Level I ◽

Clot Formation Time

Background Viscoelastic tests including thromboelastography (TEG) and rotational thromboelastometry (ROTEM) are being used in patients with severe hemorrhage at trauma centers to guide resuscitation. Several recent studies demonstrated hypercoagulability in female trauma patients that was associated with a survival advantage. The objective of our study was to elucidate the effects of gender differences in TEG/ROTEM values on survival in trauma patients with severe hemorrhage. Methods A retrospective review of consecutive adult patients receiving massive transfusion protocol (MTP) at 7 Level I trauma centers was performed from 2013 to 2018. Data were stratified by gender and then further examined by TEG or ROTEM parameters. Results were analyzed using univariate and multi-variate analyses. Results A total of 1565 patients were included with 70.9% male gender (n = 1110/1565). Female trauma patients were older than male patients (43.5 ± .9 vs 41.1 ± .6 years, P = .01). On TEG, females had longer reaction times (6.1 ± .9 min vs 4.8 ± .2 min, P = .03), increased alpha angle (68.6 ± .8 vs 65.7 ± .4, P < .001), and higher maximum amplitude (59.8 ± .8 vs 56.3 ± .4, P < .001). On ROTEM, females had significantly longer clot time (99.2 ± 13.7 vs 75.1 ± 2.6 sec, P = .09) and clot formation time (153.6 ± 10.6 sec vs 106.9 ± 3.8 sec, P < .001). When comparing by gender, no difference for in-hospital mortality was found for patients in the TEG or ROTEM group ( P > .05). Multivariate analysis showed no survival difference for female patients (OR 1.11, 95% CI .83-1.50, P = .48). Conclusions Although a difference between male and females was found on TEG/ROTEM for certain clotting parameters, no difference in mortality was observed. Prospective multi-institutional studies are needed.

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A Descriptive Study of the Perceptions of Workplace Violence and Safety Strategies of Nurses Working in Level I Trauma Centers

Journal of Emergency Nursing ◽

10.1016/j.jen.2005.07.008 ◽

2005 ◽

Vol 31 (6) ◽

pp. 519-525 ◽

Cited By ~ 64

Author(s):

Martha Catlette

Keyword(s):

Workplace Violence ◽

Descriptive Study ◽

Trauma Centers ◽

Safety Strategies ◽

Level I

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Children and Terror Casualties Receive Preference in ICU Admissions

Disaster Medicine and Public Health Preparedness ◽

10.1001/dmp.2012.6 ◽

2012 ◽

Vol 6 (1) ◽

pp. 14-19 ◽

Cited By ~ 4

Author(s):

Kobi Peleg ◽

Michael Rozenfeld ◽

Eran Dolev ◽

Keyword(s):

Traffic Accidents ◽

Injury Severity ◽

Road Traffic ◽

Age Groups ◽

Trauma Patients ◽

Trauma Centers ◽

Severe Injuries ◽

Level I ◽

Hospital Emergency Departments ◽

Trauma Type

ABSTRACTObjective: Trauma casualties caused by terror-related events and children injured as a result of trauma may be given preference in hospital emergency departments (EDs) due to their perceived importance. We investigated whether there are differences in the treatment and hospitalization of terror-related casualties compared to other types of injury events and between children and adults injured in terror-related events.Methods: Retrospective study of 121 608 trauma patients from the Israel Trauma Registry during the period of October 2000-December 2005. Of the 10 hospitals included in the registry, 6 were level I trauma centers and 4 were regional trauma centers. Patients who were hospitalized or died in the ED or were transferred between hospitals were included in the registry.Results: All analyses were controlled for Injury Severity Score (ISS). All patients with ISS 1-24 terror casualties had the highest frequency of intensive care unit (ICU) admissions when compared with patients after road traffic accidents (RTA) and other trauma. Among patients with terror-related casualties, children were admitted to ICU disproportionally to the severity of their injury. Logistic regression adjusted for injury severity and trauma type showed that both terror casualties and children have a higher probability of being admitted to the ICU.Conclusions: Injured children are admitted to ICU more often than other age groups. Also, terror-related casualties are more frequently admitted to the ICU compared to those from other types of injury events. These differences were not directly related to a higher proportion of severe injuries among the preferred groups.(Disaster Med Public Health Preparedness. 2012;6:14–19)

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Organizational trust: How to include the division of labour?

Economic and Industrial Democracy ◽

10.1177/0143831x15611965 ◽

2015 ◽

Vol 39 (2) ◽

pp. 272-293 ◽

Cited By ~ 1

Author(s):

Sven Svensson

Keyword(s):

Quantitative Analysis ◽

Organizational Trust ◽

Division Of Labour ◽

Social Position ◽

Partial Support ◽

Access To Resources ◽

The Relationship ◽

Shared Norms

The aim of this article is to study the relevance of the division of labour to the formation of organizational trust. Trust is defined as a phenomenon related to the resources available to a person in a given social position, a social position which in turn is related to the division of labour. It is argued that work externalization constitutes a division of labour, and that differing access to resources for internal and external workers explains variations in trust. The theoretical propositions are tested in a quantitative analysis of 711 external workers and internal employees in a Swedish organization. The results lend partial support to the theory. External employees are found to be less likely have strong trust in their co-workers. The relationship is mediated by perceptions of shared norms in the organization.

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ARE PATIENTS BEING TRANSFERRED TO LEVEL-I TRAUMA CENTERS FOR REASONS OTHER THAN MEDICAL NECESSITY?

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-200610000-00002 ◽

2006 ◽

Vol 88 (10) ◽

pp. 2124-2132

Author(s):

KENNETH J. KOVAL ◽

CHAD W. TINGEY ◽

KEVIN F. SPRATT

Keyword(s):

Trauma Centers ◽

Medical Necessity ◽

Level I

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Poster 062. Delays in Air EMS Activation for Trauma Transports from Community Hospitals to Level-I Trauma Centers

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00050937 ◽

1995 ◽

Vol 10 (S3) ◽

pp. S70-S70

Author(s):

Stephen H. Thomas ◽

Timothy Harrison ◽

Suzanne K. Wedel

Keyword(s):

Trauma Centers ◽

Community Hospitals ◽

Level I

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Use of rFVIIa in the Trauma Setting–Practice Patterns in United States Trauma Centers

The American Surgeon ◽

10.1177/000313480807400510 ◽

2008 ◽

Vol 74 (5) ◽

pp. 413-417 ◽

Cited By ~ 2

Author(s):

John D. Horton ◽

Kent J. Dezee ◽

Michel Wagner

Keyword(s):

United States ◽

Factor Viia ◽

Drug Level ◽

High Volume ◽

Factor Vii ◽

Trauma Centers ◽

Packed Red Blood Cells ◽

Rfviia Administration ◽

Level I ◽

Trauma Surgeons

Much excitement has been generated regarding the off label use of recombinant factor VIIa (rFVIIa) in the severely injured trauma patient. The purpose of our study is 3-fold: 1) describe the type of centers that use rFVIIa, 2) determine which centers use the drug more frequently, and finally 3) investigate how this drug is being administered at trauma centers. A survey was mailed or e-mailed to 435 trauma centers (Level I and II) throughout the nation. One hundred fifty-six surveys were returned. American College of Surgeons (ACS) verification and trauma Level I designation were independent predictors of rFVIIa use (odds ratio [OR] 3.74 and 5.40, P < 0.05). High users of rFVIIa were defined as those centers that had above median usage of the drug. Level I centers accounted for 67 per cent of the high users. Only the number of fellowship-trained trauma surgeons and trauma volume predicted high usage of rFVIIa (OR 1.38 and 14.09, P < 0.05). Trauma volume predicted whether or not Factor VII users implemented a protocol based approach to administration of the drug (OR 6.57, P < 0.05). Most protocols incorporated packed red blood cells (74%) before giving rFVIIa. The dose of 90 mcg/kg was exceeded in 34 per cent of centers, and 3 per cent used the 200 mcg/kg dose. High volume Level I trauma centers use rFVIIa more frequently and are more likely to use a systematic approach to its administration. However, there is no standardized approach to rFVIIa administration in United States trauma centers.

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Assessment of Mortality in Older Trauma Patients Sustaining Injuries from Falls or Motor Vehicle Collisions Treated in Regional Level I Trauma Centers

Annals of Surgery ◽

10.1097/sla.0b013e31819a8b4f ◽

2009 ◽

Vol 249 (3) ◽

pp. 488-495 ◽

Cited By ~ 54

Author(s):

John S. Sampalis ◽

Robin Nathanson ◽

Julie Vaillancourt ◽

Andreas Nikolis ◽

Moishe Liberman ◽

...

Keyword(s):

Motor Vehicle ◽

Regional Level ◽

Trauma Patients ◽

Trauma Centers ◽

Motor Vehicle Collisions ◽

Vehicle Collisions ◽

Level I

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Correlation of Cerebral Cortical Morphology with Behavior

Toxicology and Industrial Health ◽

10.1177/074823378900500209 ◽

1989 ◽

Vol 5 (2) ◽

pp. 247-260 ◽

Cited By ~ 9

Author(s):

Stata Norton

Keyword(s):

Nervous System ◽

Stepwise Multiple Regression ◽

Behavioral Tests ◽

Gestational Exposure ◽

Toxic Agents ◽

Structural Differences ◽

System Variability ◽

The Central Nervous System ◽

Cortical Morphology ◽

The Relationship

Association between functional damage and damage to the central nervous system from toxic agents can be used to determine the value of behavioral tests as predictors of damage to the nervous system. Variability in data from behavioral tests may be caused, in part, by varying levels of structural differences in the nervous system. Stepwise multiple regression is one method for analyzing the relationship between variability in data resulting from linkage between functional and morphological or other parameters of the structure of the nervous system. As an example, the predictive value of four behavioral tests is assessed in detecting thinning of the cerebral cortex following gestational exposure of rats to ionizing radiation. In this analysis, there were seven independent variables for predicting cortical thickness. The sequence of number of times each variable was used in prediction, from most frequent to least frequent, was: angle of stride > negative geotaxis > continuous corridor> body weight > width of stride > length of stride > reflex suspension. The data support the concept that there are varying degrees of predictive associations between these functional and cortical parameters.

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