Falls From Height, Facial Injuries and Fatalities: An Institutional Review

2021 ◽  
pp. 194338752110553
Author(s):  
Pasquale G Mollica ◽  
Ellie C McEwen ◽  
Gary R Hoffman

Study Design Retrospective cohort review. Objective To investigate the relationship between falls from height and facial injuries. Methods This is a retrospective cohort study, conducted over a 7-year period, of the medical records of all patients who presented to hospital for a maxillofacial injury following a fall from height. Fall heights were classified as low falls (1–3 m), high falls (3–10 m) and very high falls (≥10 m). Results A total of 111 patients with 218 facial bone fractures were identified (78 men, 33 women and mean age 50.3 years). High falls were the most common (n = 58, 52.3%). Multiple fractures were identified in 51 (46.0%) patients. Orbital and middle third fractures were the most prevalent. Nasal, mandible, bilateral and fractures involving more than one facial third, increased as fall height increased, as did the requirement for operative fixation. The majority of patients had an associated injury (n = 100, 90.1%) and overall mortality was 6.3%. Conclusions Falls from height are prevalent and there is a trend towards increased severity of facial injury, surgical intervention and associated morbidity as fall height increases. Falls from height are a significant public health concern and an important facet of maxillofacial trauma to recognise, as is the requirement for an interdisciplinary approach as they present to hospital.

2021 ◽  
Author(s):  
Melanie Mitsui Wong ◽  
Talha Tahir ◽  
Michael Mitsui Wong ◽  
Annilee Baron ◽  
Rachael Finnerty

Abstract Psychological stress is a significant public health concern as it is associated with various comorbidities and long-term health implications. Music interventions are emerging therapies for alleviating psychological stress and improving one’s physical and mental well-being. We conducted a systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines for reporting to identify all neuroendocrine biomarkers used to evaluate psychological stress in randomized control trials involving music interventions. We identified 18 unique biomarkers of stress from 14 full-text randomized controlled trials studies. Only one of the 14 music studies included a music therapy intervention. The most frequently used biomarkers across the studies were plasma cortisol, salivary cortisol, and salivary α-amylase. Of the 14 studies, 12 included in this review assessed at least one of these three biomarkers. Of these 12 studies, five papers reported p-values for changes in both stress biomarkers and psychological stress outcome measures. Four of the five studies found significant p-values for the reduction of both stress biomarkers and psychological stress in music intervention groups. The variety of stress biomarkers used and the variance in study protocols makes it difficult to assess the magnitude of effect of music interventions on psychological stress. However, our findings suggest that music interventions have the potential for reducing both stress biomarker levels and psychological stress in acute stress situations.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ghose Bishwajit ◽  
Sanni Yaya ◽  
Shangfeng Tang ◽  
Akmal Hossain ◽  
Yang Fan ◽  
...  

In Bangladesh, iron deficiency is the most common cause of anemia and remains a significant public health concern. Being a high anemia prevalent country, numerous efforts have been made to confront the issue especially among women and children by both local and international actors. Though the situation has substantially improved in recent years, a staggering number of adult women are currently living with anemia. The etiology of anemia is a multifactorial problem and has been proposed to be associated with various household, societal, economic, cultural factors apart from dietary habits. However, evidence regarding the household arrangements and socioeconomic determinants of anemia is scarce, especially in the context of Bangladesh. To this end, we utilized the 2011 demographic and health survey data to explore the association between anemia status and selected demographic, socioeconomic, and household characteristics. Our result showed significant correlation of anemia with both sociodemographic and household characteristics. Among the sociodemographic variables the following were found to be significantly associated with anemia status: age (p=0.014; OR = 1.195; 95% CI = 1.036–1.378) and microcredit membership (p=0.014; OR = 1.19; 95% CI = 1.037–1.386). Regarding the household arrangements, women utilizing biomass fuel for cooking (p<0.019; OR = 1.82; 95% CI = 0.981–2.460) were more likely to be anemic.


Author(s):  
John S ◽  
◽  
Woodward J ◽  
Keegan KC ◽  
Tchalukov K ◽  
...  

Background: Access to neuroemergent care in the United States represents a significant public health concern, with limited neurosurgery and/ or neurocritical care coverage in both rural and urban settings. Inadequate access to neuroemergent providers, even in urban settings, may result in prolonged patient transfer time, associated neurological decline and translate into increased morbidity and mortality. Methods: A single center retrospective analysis of prospectively collected data of interhospital patient transfers to a neuroscience ICU between 2008-2018 was performed. Results: 9637 patients were included for analysis. A substantial increase in transfer requests were observed, 610 to 1221 from 2008 to 2018 respectively, with concurrent increase in the number and geographic distribution of referral centers. Ultimately, 7726 (80.2%) patients were discharged home or to outpatient or acute rehabilitation while 1820 (18.9%) were discharged to a long-term acute care facility (LTAC), hospice, or expired during the index admission. The leading diagnoses for transfer were: 1. intracerebral hemorrhage, 2. subarachnoid hemorrhage, 3. ischemic stroke, 4. subdural hematoma and 5. brain tumor. Transfer from an ED or ICU constituted 93.3% of requests. Mean total transfer time between 2012-2018 was < 155 minutes annually (range 128-155 minutes). In 2018, 91.5% of patients had health insurance with 68.7% covered by some form of Medicaid or Medicare. Conclusions: The ongoing evolution and overall success of the NTP draws chiefly from the designation of an easily accessible central operator to orchestrate transfer, establishing a network of community referral centers and optimization of regional patient transportation - all with the solitary goal of improving patient outcomes.


2012 ◽  
Vol 1 (2) ◽  
pp. 54 ◽  
Author(s):  
Luigi Brunetti ◽  
Dong-Churl Suh

Background: Medication errors are a significant public health concern.  Although significant advances have been made, errors are still relatively common and represent an opportunity for healthcare improvement.Methodology/Principal Findings: Since the publication of To Err is Human, medication errors have been under tremendous scrutiny.  Organizations have moved towards a non-punitive approach to evaluating errors.  This approach to medication errors has aided in identifying common pathways to medication errors and improving understanding regarding the anatomy of a medication error.  As a result, prevention strategies have been developed to target common themes contributing to errors.  Error prevention strategies may target common contributors of medication errors, broadly grouped as performance lapses, lack of knowledge, and lack or failure of safety systems.  Strategies to thwart medication errors range from process improvement to integration of technology in the health care environment.Conclusions/Significance:  Organizations should devote resources to address medication error prevention strategies in an effort to improve patient outcomes and decrease morbidity and mortality associated with medication errors.


2017 ◽  
Vol 3 (2) ◽  
pp. 100-111 ◽  
Author(s):  
Carol Ann Potter

Purpose The purpose of this paper is to explore the role of fathers in the management of sleeping problems in children with autism and their perspectives of the impact of these difficulties on family life. Design/methodology/approach Semi-structured interviews with 25 UK-based fathers of children with autism were undertaken. Findings Two-thirds of fathers reported that their children experienced severe sleeping problems in the areas of bed-time resistance, sleep onset and night-time waking. Fathers were significantly involved in the management of these difficulties and reported a range of associated deleterious impacts on the family, including significant negative effects on paternal and maternal health, father’s employment, couple relationship and sibling experiences. Research limitations/implications The interview sample cannot be said to be representative of all fathers of children with autism since the backgrounds of those taking part were relatively homogeneous in respect of ethnicity, marital status and level of education. Practical implications Improvements in effective, family-centred provision are urgently needed which employ a co-parenting, gender-differentiated methodology. Social implications Given the severity and frequency of difficulties, sleeping problems in children with autism should be viewed as a significant public health concern. Originality/value This is one of the first studies, qualitative or quantitative, to explore the role and perspectives of fathers of children with autism in the important area of sleep management.


2008 ◽  
Vol 54 (2) ◽  
pp. 264-272 ◽  
Author(s):  
John W McMurdy ◽  
Gregory D Jay ◽  
Selim Suner ◽  
Gregory Crawford

Abstract Background: Anemia is an underdiagnosed, significant public health concern afflicting &gt;2 billion people worldwide. The detrimental effects of tissue oxygen deficiency on the cardiovascular system and concurrent appearance of anemia with numerous high-risk disorders highlight the importance of clinical screening. Currently there is no universally accepted, clinically applicable, noninvasive hemoglobin/hematocrit screening tool. The need for such a device has prompted an investigation into a breadth of techniques. Methods: A synopsis of the literature and current directions of research in noninvasive total hemoglobin measurement was collected. Contributions highlighted in this review are limited to those studies conducted with a clinical aspect, and most include in vivo patient studies. Results: The review of potential techniques presented here includes optoacoustic spectroscopy, spectrophotometric imaging, diffuse reflectance spectroscopy, transcutaneous illumination, electrical admittance plethysmography, and photoplethysmography. The technological performance, relative benefits of each approach, potential instrumentation design considerations, and future directions are discussed in each subcategory. Conclusions: Many techniques reviewed here have shown excellent accuracy, sensitivity, and specificity in measuring hemoglobin/hematocrit, thus in the near future a new clinically viable tool for noninvasive hemoglobin/hematocrit monitoring will likely be widely used for patient care. Limiting factors in clinical adoption will likely involve technology integration into the current standard of care in each field routinely dealing with anemia.


2021 ◽  
Vol 06 (04) ◽  
pp. 1-1
Author(s):  
Lutvija Hrnjic ◽  
◽  
Nina Fry ◽  
Helané Wahbeh ◽  
◽  
...  

The growing population of older adults with depression is a significant public health concern, and effective treatments are necessary. Mindfulness meditation intervention offers effective treatment for depression, but little research has been conducted on the older population. This study aimed to evaluate if the combination of the Internet Mindfulness Meditation Intervention (IMMI) plus iMINDr application improves well-being in older adults with depressive symptoms. Potential participants were recruited online. IMMI included a one-hour online session once a week, a daily 30-minute home practice of guided meditation using the iMINDr app, and a workbook. Measures were collected online before and after the six-week intervention period. Online session adherence was tracked. Thirty-eight participants completed all study requirements and are included in the analysis. Participants showed clinically and statistically significant improvements in depression symptoms, well-being, positive and negative affect, sleep quality, and pain intensity. Participants took 9.9 ± 3.5 weeks to complete the course. High attrition rates mainly were related to participants' motivation to complete the course and stress levels. There were no significant demographic differences between participants and depression symptoms. Potential applications and limitations are discussed. Internet Mindfulness Meditation Intervention (IMMI) was effective in treating depression symptoms in older adults.


2021 ◽  
Vol 33 (3) ◽  
pp. 49-53
Author(s):  
Tariq Mohammed Muhialdin Alkhalifa ◽  
Ayman Merza Abdulla Mohamed ◽  
Ali Hasan Zainaldeen ◽  
Sharif Omar Ali Ahmed ◽  
Harleen Luther

Transverse sacral fracture is a rare entity in the pediatric age group, primarily resulting from a fall from height. This case report stresses the importance of proper neurological assessment, adequate imaging and highlights different modalities of management of this fracture. We report a case of a 13-year-old child with type III Roy-Camille sacral fracture with associated bladder and bowel dysfunction. The patient underwent spinopelvic fixation and decompression of the sacral canal. The patient partially regained bowel and urinary function and had improved motor function after three months of follow-up. Operative management is generally advocated for such fractures. Keywords: Decompression; Bone fractures; Neural tube; Pediatrics; Sacrum


2021 ◽  
Vol 12 ◽  
Author(s):  
Danwei Zhang ◽  
Zhen Zhang ◽  
Huihua Li ◽  
Kaimo Ding

Excessive daytime sleepiness (EDS) is a significant public health concern, with obstructive sleep apnea (OSA) being a common cause, and a particular relationship exists with the severity of depression. A literature search on OSA, depression, and EDS was performed in PubMed. The chosen evidence was limited to human studies. Available evidence was systematically reviewed to ascertain the association of EDS with depression and OSA according to the general population and some specific population subgroups. In addition, effectiveness of continuous positive airway pressure (CPAP) was analyzed as a standard therapy for improving EDS and depression in patients with OSA. In the general population, patients with OSA, and some other subpopulations, the review contributed to: (1) delineating the prevalence of EDS; (2) substantiating the relationship of EDS and depression; (3) presenting the relationship between EDS and OSA; and (4) revealing that the duration of CPAP is crucial for its therapeutic effects in improving EDS and depressive symptoms in patients with OSA.


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